By Richard F LeBlond; Richard L DeGowin; Donald D Brown
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Additional resources for DeGowin's diagnostic examination
6. Industrial examinations: Specialized procedures detect the hazards of particular industries. 7. Preoperative screening: See Part III, Chapter 16. CHAPTER 2 History Taking and the Medical Record …[T]here is no more difficult art to acquire than the art of observation, and for some men it is quite as difficult to record an observation in brief and plain language. —Sir William Osler Proper care of a patient for more than a single episode of care requires a medical record documenting the data specific to the patient and their care.
Parts III and IV provide supplemental information. Chapter 16 discusses the preoperative examination. The intent is to give the reader a framework for evaluating the medical risks of surgical procedures and an approach to communicating those risks to the patient and surgeon. Chapter 17 introduces the principles of laboratory testing and imaging. These principles are critical to an efficient use of the laboratory and radiology. Chapter 18 lists many common (not "routine") laboratory tests that provide important information about the patient's condition not accessible from the history or physical examination.
The differential begins with a list of diseases having some or all of the same attributes, adekn. The more problems that are common to the patient and the hypothesized diagnosis, the more likely that particular diagnosis. This method can be a useful adjunct to the branching pathway described above. However, with this process, it is easy to overlook the importance of temporal sequences and it easily degenerates into matching words. This strategy is based upon the abstractions of language ("word space") rather than the physiologic processes observed in the patient and is to be discouraged.