普通内外科临床问题
2003-3
Elsevier Science Health Science div
Devitt, Peter/ Barker, Juliet/ Mitchell, Jonathan/ Hamilton-Craig, Christian
409
Clinical Problems provides a comprehensive selection of important medical and surgical scenarios. The reader is taken through 62 case histories step by step and is asked to interpret a broad range of medical data. Most of the clinical problems are accompanied by illustrations, which include cardiographs, radiographs, clinical and pathological photographs. In addition to detailed questions and answers, a commentary is provided that highlights the important issues of each case, as well as a guide to further topics of study. The aim of any undergraduate curriculum is to produce graduates who have the knowledge and skills required to enable them to become competent members of the medical fraternity. Understandably, upon qualification these attributes will be raw and untried, but we expect them to be able to show that they possess what it is required of doctors in their first few years after graduation. What is 'required' in a clinical situation is often not obvious to the student and hence the reason for this book. The book represents a departure from the traditional formula of systems and diseases, and an exhaustive review of each subject. Rather the authors have selected what they believe to be a number of important and, for the most part, relatively common medical and surgical scenarios and approached each from the perspective of the practicing clinician presented with a clinical problem. Whilst the book has been written primarily for undergraduates it describes clinical problems as they will be managed by recently qualified doctors. It is not the purpose of this book to challenge or compete with standard reference material, rather it represents an important adjunct to the learning process of clinical reasoning, rather than provide the knowledge that must accompany it, although an considerable amount of factual material is to be found within its pages. Problem solving is a vital component of medical education, and while it can be taught well at the bedside and in small group tutorials, there are few books that help with this style of learning.
THE PROBLEMS: 1 Difficulties with postoperative fluid balance in a 65-year-old man 2 A middle-aged man with postoperative fever 3 Postoperative hypotension 4 Postoperative confusion 5 Swelling in the neck in a 58-year-old man 6 A 26-year-01d man with a swelling below the ear 7 Swelling in the neck 8 A young man with acute scrotal pain 9 A scrotal swelling in a 19-year-old man 10 A 46-year-old woman with a breast lump 11 A skin lesion in a 73-year-old man 12 A 27-year-old man with burns 13 Dysphagia in a middle-aged woman 14 Vomiting and collapse in an elderly woman 15 A 77-year-old man with vomiting 16 Weight loss in a middle-aged woman 17 Abdominal pain in a young woman 18 A man with acute upper abdominal pain 19 A woman with acute upper abdominal pain 20 A 67-year-old woman with acute lower abdominal pair 21 A 49-year-old man with abdominal pain and vomiting 22 Jaundice in an older woman 23 Ayoung man with profuse diarrhoea 24 Rectal bleeding in a 65-year-old woman 25 A 42-year-old man with haematuria 26 A 70-year-old man with a painful hip 27 Acute back pain in a 75-year:old man 28 A 59-year-old man with calf pain 29 Acute leg pain in a 73-year-old worhan 30 A 68-year-old woman with a leg ulcer 31 A 38-year-old man involved in a car crash ……
