Working Patients Up

[DrTennis]

---

Members don't see this ad.

I just recently started my first rotation of 3rd year. Can anyone recommend a good book that explains how to work a patient up starting from the symptoms/signs. I'm currently using The Saint-Frances Guide to Clinical Clerkship in Outpatient Medicine, which does a good job of doing this, but I was wondering if anyone knows some other book titles that teach how to work a patient up that starts from Cheif complaint or symptom/sign. I'm particularly interested in the books that tell you what specific questions to ask, what part of the physical exam and ROS to emphasize.

 

[smq123]

I just recently started my first rotation of 3rd year. Can anyone recommend a good book that explains how to work a patient up starting from the symptoms/signs. I'm currently using The Saint-Frances Guide to Clinical Clerkship in Outpatient Medicine, which does a good job of doing this, but I was wondering if anyone knows some other book titles that teach how to work a patient up that starts from Cheif complaint or symptom/sign. I'm particularly interested in the books that tell you what specific questions to ask, what part of the physical exam and ROS to emphasize.

There probably ARE books that will do this, but I'm afraid that most of it is common sense.

If you need to rely on a textbook each time you see a consult or admit a patient, you're going to be the most painfully slow MS3 ever. MS3s and MS4s are already, as a rule, pretty slow - so imagine how much more time it will take if you have to look it up each time.

 

[DrTennis]

There probably ARE books that will do this, but I'm afraid that most of it is common sense.

If you need to rely on a textbook each time you see a consult or admit a patient, you're going to be the most painfully slow MS3 ever. MS3s and MS4s are already, as a rule, pretty slow - so imagine how much more time it will take if you have to look it up each time.

Lol, my intention was to find a book to read at home after a day on the ward/clinic. There definitely isn't the luxury of time to read while on the wards. If I need to look something up quickly I usually use accessmedicine or up to date.

 

[smq123]

Lol, my intention was to find a book to read at home after a day on the ward/clinic. There definitely isn't the luxury of time to read while on the wards. If I need to look something up quickly I usually use accessmedicine or up to date.

😳 Oops. Sorry!

I can't really think of any books that have an in-depth look at how to work up individual symptoms or chief complaints. Most of the time, it just involves reading about different diseases, how they present, and then wondering if that is affecting your patient. Hopefully someone else will have a better idea....

This is what we did almost every day on IM. We'd sit around a table (which is a big improvement over most students, who have to stand in a crowded, busy hallway), the attending would say, "Patient has a cough. Go!", and then we'd go around the table making a differential. Then we'd go around the table again, naming tests that we'd like to order and how we'd like to work up the patient.

 

[DragonWell]

If you want a pocket book for the wards, check out "History and Physical Examination". It will give you a quick rundown of pertinent positives and negatives and physical exam findings based on chief complaint. I got mine laminated and spiral bound, and it fits nicely in my white coat. This book just covers the H&P, not what tests to order.

For more of a textbook, you might check out a book called "Symptom to Diagnosis" by Lange. I don't know that there's any way to really learn these skills other than experience, but this book is basically an IM textbook which takes more of a case based approach and guides you through the presentation, physical, workup, etc. as it teaches you about the conditions. There's a couple sample chapters online: Hypertension, Diabetes

 

[Law2Doc]

If you read through some of the board review books for the Step 2 CS, you would see lots of examples of differential diagnoses and labs/studies you might want for various presentations. Not sure if that's what you had in mind.

 

[DrTennis]

Thanks for the recommendations. 🙂

 

[USArmyDoc]

If you want a pocket book for the wards, check out "History and Physical Examination". It will give you a quick rundown of pertinent positives and negatives and physical exam findings based on chief complaint. I got mine laminated and spiral bound, and it fits nicely in my white coat. This book just covers the H&P, not what tests to order.

For more of a textbook, you might check out a book called "Symptom to Diagnosis" by Lange. I don't know that there's any way to really learn these skills other than experience, but this book is basically an IM textbook which takes more of a case based approach and guides you through the presentation, physical, workup, etc. as it teaches you about the conditions. There's a couple sample chapters online: Hypertension, Diabetes

Symptom to Dx is awesome....helped me a lot of rotations. Read it before hand and you'll look good

 

[JeffLebowski]

I heard First Aid for the Wards was good.