Exploring Symptoms - John Frain

. .

Résumé :

Preface xxiii

Abbreviations xxv

1 Exploring Symptoms 1

1.1 This History of the History 1

1.2 What Is a Symptom? 3

1.3 What Do Patients Want from Their Clinicians? 6

1.4 The Structure of a Medical History 8

1.5 Clinical Communication 11

1.6 The Opening Statement and Agreeing the Agenda 12

1.7 How Does the History Work? 15

1.8 Sources of Bias in the History 18

1.9 Ethnicity and Health 19

1.10 Statistical Concepts 23

Acknowledgements 24

References 24

2 The Skin 27

2.1 Symptoms of Skin Disease 27

2.2 About Dermatology 27

2.3 Burden of Skin Disease 28

2.4 Skin Anatomy 29

2.5 Skin Physiology 32

2.6 Assessing Skin of Colour (SOC) 32

2.7 Key Points of the History 32

2.8 The Patient Experience of Skin Disease 34

2.9 Itch (Pruritis) 34

2.10 Colour of Skin When Inflamed 37

2.11 Description of Skin Lesions 38

2.12 Assessing Conditions in Skin of Colour 38

2.13 Eczema 42

2.14 Psoriasis 44

2.15 Skin Appendages 44

2.16 Nails 45

2.17 Wounds 45

References 46

3 Respiratory 51

3.1 Ear, Nose and Throat 51

3.2 Lower Respiratory Tract 57

3.3 Anatomy and Physiology of the Lower Respiratory Tract 58

3.4 Symptoms 58

3.5 Cough 59

3.6 Breathlessness 61

3.7 Wheeze 64

3.8 Sputum 65

3.9 Haemoptysis 66

3.10 Chest Pain 69

3.11 Symptoms Clusters in Respiratory Disease 71

References 71

4 Cardiovascular 75

4.1 Global Burden of Cardiovascular Disease 75

4.2 Key Symptoms of Cardiovascular Disease 77

4.3 Prevalence of Symptoms 77

4.4 Assessment of Cardiovascular Risk 77

4.5 Pain 82

4.6 Breathlessness 90

4.7 Palpitations 93

4.8 Swelling (Oedema) 96

4.9 Syncope 99

References 101

5 Gastrointestinal 105

5.1 Overview 105

5.2 Global Burden of Gastrointestinal Disease 105

5.3 Anatomy and Function 106

5.4 Key Gastrointestinal Symptoms 108

5.5 How Common Are Gastrointestinal Symptoms? 108

5.6 Difficulty Swallowing (Dysphagia) 110

5.7 Dyspepsia 114

5.8 Nausea and Vomiting 119

5.9 Haematemesis 121

5.10 Abdominal Pain 122

5.11 Bloating and Distension 125

5.12 Change in Bowel Habit 129

5.13 Anatomy and Physiology of the Colon 130

5.14 Jaundice 132

Acknowledgements 135

References 135

6 Endocrine and Multisystem Symptoms 139

6.1 Structure and Function of the Endocrine System 139

6.2 Endocrine Symptoms 140

6.3 Burden of Disease 140

6.4 Ethnicity 142

6.5 Lgbtq+ 142

6.6 Fatigue 142

6.7 Fever/Chills/Night Sweats 146

6.8 Sepsis 149

6.9 Key Points in the History 151

6.10 Unintentional Weight Loss 151

6.11 Weight Gain 153

6.12 Dizziness 154

6.13 Thirst and Polyuria 156

6.14 Skin: Rashes/Bruising 156

6.15 Flushing 159

6.16 Long Covid 160

References 163

7 Musculoskeletal 167

7.1 Symptoms of Musculoskeletal (MSK) Disease 167

7.2 Burden of Musculoskeletal Disease 167

7.3 Community Prevalence of Symptoms 168

7.4 Distribution of Symptoms and Signs 169

7.5 Key Points in History-taking 170

7.6 Pain 171

7.7 Stiffness 173

7.8 Swelling 174

7.9 Loss of Function 175

7.10 Activities of Daily Living 176

7.11 Extra-articular Manifestations 177

7.12 Specific Joints 179

7.13 Neck 179

7.14 Thoracolumbar Spine 180

7....

Biographie:

Preface xxiii

Abbreviations xxv

1 Exploring Symptoms 1

1.1 This History of the History 1

1.2 What Is a Symptom? 3

1.3 What Do Patients Want from Their Clinicians? 6

1.4 The Structure of a Medical History 8

1.5 Clinical Communication 11

1.6 The Opening Statement and Agreeing the Agenda 12

1.7 How Does the History Work? 15

1.8 Sources of Bias in the History 18

1.9 Ethnicity and Health 19

1.10 Statistical Concepts 23

Acknowledgements 24

References 24

2 The Skin 27

2.1 Symptoms of Skin Disease 27

2.2 About Dermatology 27

2.3 Burden of Skin Disease 28

2.4 Skin Anatomy 29

2.5 Skin Physiology 32

2.6 Assessing Skin of Colour (SOC) 32

2.7 Key Points of the History 32

2.8 The Patient Experience of Skin Disease 34

2.9 Itch (Pruritis) 34

2.10 Colour of Skin When Inflamed 37

2.11 Description of Skin Lesions 38

2.12 Assessing Conditions in Skin of Colour 38

2.13 Eczema 42

2.14 Psoriasis 44

2.15 Skin Appendages 44

2.16 Nails 45

2.17 Wounds 45

References 46

3 Respiratory 51

3.1 Ear, Nose and Throat 51

3.2 Lower Respiratory Tract 57

3.3 Anatomy and Physiology of the Lower Respiratory Tract 58

3.4 Symptoms 58

3.5 Cough 59

3.6 Breathlessness 61

3.7 Wheeze 64

3.8 Sputum 65

3.9 Haemoptysis 66

3.10 Chest Pain 69

3.11 Symptoms Clusters in Respiratory Disease 71

References 71

4 Cardiovascular 75

4.1 Global Burden of Cardiovascular Disease 75

4.2 Key Symptoms of Cardiovascular Disease 77

4.3 Prevalence of Symptoms 77

4.4 Assessment of Cardiovascular Risk 77

4.5 Pain 82

4.6 Breathlessness 90

4.7 Palpitations 93

4.8 Swelling (Oedema) 96

4.9 Syncope 99

References 101

5 Gastrointestinal 105

5.1 Overview 105

5.2 Global Burden of Gastrointestinal Disease 105

5.3 Anatomy and Function 106

5.4 Key Gastrointestinal Symptoms 108

5.5 How Common Are Gastrointestinal Symptoms? 108

5.6 Difficulty Swallowing (Dysphagia) 110

5.7 Dyspepsia 114

5.8 Nausea and Vomiting 119

5.9 Haematemesis 121

5.10 Abdominal Pain 122

5.11 Bloating and Distension 125

5.12 Change in Bowel Habit 129

5.13 Anatomy and Physiology of the Colon 130

5.14 Jaundice 132

Acknowledgements 135

References 135

6 Endocrine and Multisystem Symptoms 139

6.1 Structure and Function of the Endocrine System 139

6.2 Endocrine Symptoms 140

6.3 Burden of Disease 140

6.4 Ethnicity 142

6.5 Lgbtq+ 142

6.6 Fatigue 142

6.7 Fever/Chills/Night Sweats 146

6.8 Sepsis 149

6.9 Key Points in the History 151

6.10 Unintentional Weight Loss 151

6.11 Weight Gain 153

6.12 Dizziness 154

6.13 Thirst and Polyuria 156

6.14 Skin: Rashes/Bruising 156

6.15 Flushing 159

6.16 Long Covid 160

References 163

7 Musculoskeletal 167

7.1 Symptoms of Musculoskeletal (MSK) Disease 167

7.2 Burden of Musculoskeletal Disease 167

7.3 Community Prevalence of Symptoms 168

7.4 Distribution of Symptoms and Signs 169

7.5 Key Points in History-taking 170

7.6 Pain 171

7.7 Stiffness 173

7.8 Swelling 174

7.9 Loss of Function 175

7.10 Activities of Daily Living 176

7.11 Extra-articular Manifestations 177

7.12 Specific Joints 179

7.13 Neck 179

7.14 Thoracolumbar Spine 180

7....

Sommaire:

Dr. John Frain is Clinical Associate Professor and GEM Director of Clinical Skills at the University of Nottingham, UK....