Handbook on Clinical Approach to Respiratory Medicine
Handbook on Clinical Approach to Respiratory Medicine
SECOND EDITION
K Surendra Menon MD
Former Professor and Head Department of Pulmonary Medicine Medical Education Service Government of Kerala
Kerala, India
R Pajanivel MD FRCP
Professor and Head Department of Pulmonary Medicine Mahatma Gandhi Medical College and Research Institute
Sri Balaji Vidyapeeth Puducherry, India
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Handbook on Clinical Approach to Respiratory Medicine / K Surendra Menon, R Pajanivel
First Edition: 2017
Second Edition: 2021
9789390595730
Printed at
Our second edition is dedicated to
The Health Professionals
who are fighting coronavirus disease 2019 (COVID-19)
day in and day out.
Handbook On Clinical Approach to Respiratory Medicine is published with the intention of reaching out to the undergraduates, interns, and postgraduates to understand the importance of proper case taking. The authors are happy that this book is well-received and appreciated. This gives us the extra drive to publish the second edition with the addition of chapters like “Interpreting Chest X-rays in a Systematic Way” which is well-illustrated for better understanding and a list of frequently asked questions in clinical examination and viva.
Medicine is all about knowledge and observation. The essential element is the decisional process by probing history, recognition of signs, and clinical reasoning. Hands, ears, and the brain play a major part in diagnosing in spite of the laboratory tools available. As scientists, we are on a mission to alleviate the patients' suffering and have to go deeper into every aspect of the patient's disease process.
The art of history taking and proper examination of the patient is almost becoming extinct. This book confines basically to case taking in respiratory medicine and will give the reader a deeper insight into history taking and examination of the patient. This methodology will help in examining the other systems such as cardiovascular system (CVS), central nervous system (CNS), etc. Without a correct diagnosis, all efforts will be futile to treat the patient.
K Surendra Menon
R Pajanivel
Preface to the First Edition
Handbook on Clinical Approach to Respiratory Medicine is published with the intention of reaching out to the undergraduates, interns and postgraduates to understand the importance of proper case taking. Medicine is all about knowledge and observation. The essential element is the decisional process by probing history, recognition of signs and clinical reasoning. Hands, ears and the brain play a major role in diagnosing in spite of the laboratory tools available. As scientists, we are on a mission to alleviate the patients' sufferings and have to go deeper into every aspect of the patient's disease process.
The art of history taking and proper examination of the patient has become almost extinct. This book confines basically to case taking in respiratory medicine and will give the reader a deeper insight into history taking and examination of the patient. This methodology will help the reader in examining the other systems like CVS, CNS, etc. Without a correct diagnosis, all our efforts will be futile to treat the patient.
K Surendra Menon
R Pajanivel
Acknowledgments
We express our gratitude to our family members, all the faculty, and postgraduate students of the department. It is imperative to thank all the health professionals including our old students who are actively involved in this fight against the coronavirus all over the world.
Introduction
The content of the book emphasizes on the correct way of history taking, examination of the patient, relevant investigations, and arriving at a final diagnosis.
History taking is the time the doctor and the patient get to know each other and the patients' fears and concerns can be understood. The skills in taking history develop with experience, so students are encouraged to take history independently. Difficult diagnostic problems are more often solved by carefully taken history than by a battery of laboratory tests. At the end of history taking, we may be able to come to a few differential diagnoses before touching the patient. Our studies have shown that the correct history taking will make us zero in, onto a possible diagnosis in most of the cases, i.e., about 80%.
All systems are also required to be examined. As an examinee, quick history taking without missing any relevant points is essential and the last minute panic can be avoided, especially while appearing for the examination. It is advisable to finish the history taking in 10–12 minutes. But remember, this pattern has to be followed after graduation also to become a successful clinician.
Symptoms narrated by the patient should be carefully listened to and as a “medical detective” pertinent questions should be asked as some patients may go off the track. Patient's complaints should be documented and analyzed. Like a perfect diplomat, we should show tactfulness and patience when the subject mentions the complaint.
In the second edition, we are adding two chapters: X-ray of Chest and Commonly Asked Clinical Examination and Viva Voce Questions. The questions cover all the aspects of pulmonary medicine.
All the diagrams and photos are schematic (not to scale).