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Richard LeBlond - DeGowins Diagnostic Examination, Ninth Edition

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The classic point-of-care guide to the undifferentiated patient -- completely revised and easier to navigate than ever! A Doodys Core Title for 2011! 5 STAR DOODYS REVIEW! DeGowins is considered one of the first books on diagnosis, and the one most physicians trained in the last 40 years grew up with. With this edition, the authors continue the unparalleled tradition of providing a comprehensive, understandable way to approach a patient....DeGowins is considered one of the first books on diagnosis, and the one most physicians trained in the last 40 years grew up with. With this edition, the authors continue the unparalleled tradition of providing a comprehensive, understandable way to approach a patient.--Doodys Review Service Part physical examination primer, part differential diagnosis tool, DeGowins Diagnostic Examination takes you a step beyond elementary physical diagnosis. DeGowins covers all physical examination techniques and procedures, but this highly practical point-of-care guide goes further, focusing on the meaning of signs and symptoms. It also shows you how to catalog clinical findings resulting from the physical examination--and order them into a differential diagnosis. FEATURES All the essentials of the diagnosis exam procedure and patient record preparation - in one ultra-handy reference Top-to-bottom coverage of differential diagnosis, organized by systems, signs, and syndromes High-yield overviews of each organ/region/system, followed by the definition of key presenting signs and their possible origins NEW! Updated content includes the latest developments in evidence-based physical examination, along with references to the popular JAMA series The Rational Clinical Examination NEW! 24 full-color illustrations NEW! Full-text download for your mobile device

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DeGowin's DIAGNOSTIC EXAMINATION

NOTICE

Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error and changes in medical sciences, neither the editors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.

DeGowin's DIAGNOSTIC EXAMINATION

Ninth Edition

Richard F. LeBlond, MD, MACP

Professor of Internal Medicine (Clinical)
The University of Iowa College of
Medicine Iowa City, Iowa

Richard L. DeGowin, MD, FACP

Professor Emeritus of Internal Medicine
The University of Iowa College of
Medicine Iowa City, Iowa

Donald D. Brown, MD, FACP

Professor of Internal Medicine
The University of Iowa College of Medicine
Iowa City, Iowa

Illustrated by

Elmer DeGowin, MD,
Jim Abel,
and Shawn Roach

Copyright 2009 2004 by The McGraw-Hill Companies Inc All rights reserved - photo 1

Copyright 2009 2004 by The McGraw-Hill Companies Inc All rights reserved - photo 2

Copyright 2009, 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior written permission of the publisher.

ISBN: 978-0-07-164118-0
MHID: 0-07-164118-1

The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-147898-4, MHID: 0-07-147898-1.

All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps.

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TERMS OF USE

This is a copyrighted work and The McGraw-Hill Companies, Inc. ("McGraw-Hill") and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill's prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms.

THE WORK IS PROVIDED "AS IS." McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.

To our patients,
who allow us to practice our art,
encourage us with their confidence,
and humble us with their courage.
Richard F. LeBlond

It is not easy to give exact and complete details of an operation in writing; but the reader should form an outline of it from the description.

Hippocrates
"On Joints"

[Studies] perfect Nature, and are perfected by Experience: For Natural Abilities, are like Natural Plants, that need proyning by study: And Studies themselves, due give forth Directions too much at Large, except they be bounded in by experience. Crafty Men Contemne Studies; Simple Men Admire them; And Wise Men Use them; For they teach not their owne Use; But that is a Wisdome without them, and above them, won by Observation. Reade not to Contradict, and Confute; Nor to Beleeve and Take for granted; Nor to Finde Talke and Disourse; But to weigh and Consider.

Francis Bacon
"Of Studies"

It is only by persistent intelligent study of disease upon a methodical plan of examination that a man gradually learns to correlate his daily lessons with the facts of his previous experience and that of his fellows, and so acquires clinical wisdom.

Sir William Osler

Sources for Quotations:

Brecht quotation from: Bertolt Brecht. Poems 19131956. London, Methuen London Ltd., 1979.

Eliot quotation from: T.S. Eliot. The Complete Poems and Plays, 19091950. New York, Harcourt, Brace & World, Inc., 1971.

Frazer quotation from: Sir James George Frazer. The Golden Bough, A Study in Magic and Religion, abridged edition. New York, MacMillan Publishing Company, 1922.

Hippocrates quotation from: Jacques Jouanna (M.B. DeBevoise translator). Hippocrates. Baltimore, The Johns Hopkins University Press, 1999.

Osler quotation from: Sir William Osler. Aequanimitas, with other Addresses to Medical Students, Nurses and Practictioners of Medicine. Philadelphia, P. Blakistons Son and Co., 1928.

Roethke quotations from: Theodore Roethke. On Poetry and Craft. Port Townsend, Washington Copper Canyon Press, 2001.

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