This is a book for medical students and first-year doctors who wish to learn how to approach a patient's symptoms, and sharpen their skills of clinical reasoning and diagnosis. Fifty-four presenting symptoms are discussed, covering approaches and conditions across various medical and surgical disciplines. Each chapter sets out the thought process behind history, examination, and investigations for a symptom, providing a systematic and practical algorithm to distinguish one differential from another. The reader will gain not only a functional approach to patients' presenting complaints, but also learn how to better organize and apply medical knowledge in diagnostic reasoning.
Readership: Medical students and first-year doctors.
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Medicine has become ever more sophisticated in the last twenty years. But the complaints that our patients present with, and the art of clinical diagnosis, remain essentially the same. The physician's first task is to diagnose, separating key signs and symptoms from supplementary details, distinguishing between many competing diagnoses, and identifying not only what is likely but also what is critical to exclude. This task which daunts many who are new to clinical medicine, who have often learnt about individual diseases, but find it challenging to work forward from symptoms to diagnosis. This book arms medical students and first-year doctors with a handy approach to the different problems that patients present with. Going beyond lists of differential diagnoses, or pointers on key signs and symptoms to look for, this book provides diagnostic algorithms and discusses the thought process behind making a clinically sound judgment, emphasising bedside diagnosis and simple tests over advanced investigations. It is both a concise on-the-go reference, as well as a primer in diagnostic clinical reasoning. Differential diagnosis is an essential skill for every physician and medical student. Yet it is a gap that is poorly covered in most major medical texts. Most student texts cover diseases individually, with only cursory sections on how to approach symptoms, offering neither a reasoning process nor algorithm. Some reference works do offer more comprehensive coverage on approach to symptoms; however, these are too bulky for student use. This book will help students and junior clinicians learn how to approach patients.
Dr Nigel Fong is a Resident in Internal Medicine at Singapore General Hospital, Singapore's largest tertiary academic medical centre. He was a recipient of the prestigious President's scholarship, and graduated with honours from the Yong Loo Lin School of Medicine, National University of Singapore. Apart from clinical medicine, his interests include medical education and healthcare policy.
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