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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3230_Библиотеки_им_академика_М_И_Перельмана
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About the Oxford American Handbooks in Medicine
The Oxford American Handbooks are flexi-covered pocket clinical
books, providing practical guidance in quick reference, note form. Titles
cover major medical specialties or cross-specialty topics and are aimed at
students, residents, internists, family physicians, and practicing physicians
within specific disciplines.
Their reputation is built on including the best clinical information, com-
plemented by hints, tips, and advice from the authors. Each one is carefully
reviewed by senior subject experts, residents, and students to ensure that
content reflects the reality of day-to-day medical practice.
Key series features
- Written in short chunks, each topic is covered in a two-page spread to
enable readers to find information quickly. They are also perfect for
test preparation and gaining a quick overview of a subject without
scanning through unnecessary pages.
- Content is evidence based and complemented by the expertise and
judgment of experienced authors.
- The Handbooks provide a humanistic approach to medicine—it’s more
than just treatment by numbers.
- A “friend in your pocket,” the Handbooks offer honest, reliable guid-
ance about the difficulties of practicing medicine and provide coverage
of both the practice and art of medicine.
- For quick reference, useful “everyday” information is included on the
inside covers.
- Made with hard-wearing plastic covers, tough paper, and built-in ribbon
bookmarks, the Handbooks stand up to heavy usage.
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Oxford American Handbook of
Clinical Diagnosis
ii
Published and forthcoming Oxford American Handbooks
Oxford American Handbook of Clinical Medicine
Oxford American Handbook of Anesthesiology
Oxford American Handbook of Clinical Dentistry
Oxford American Handbook of Clinical Diagnosis
Oxford American Handbook of Critical Care
Oxford American Handbook of Emergency Medicine
Oxford American Handbook of Nephrology and Hypertension
Oxford American Handbook of Obstetrics and Gynecology
Oxford American Handbook of Oncology
Oxford American Handbook of Otolaryngology
Oxford American Handbook of Pediatrics
Oxford American Handbook of Psychiatry
Oxford American Handbook of Pulmonary Medicine
Oxford American Handbook of Rheumatology
Oxford American Handbook of Surgery
iii
Oxford American
Handbook of
Clinical
Diagnosis
Gregg Y. Lipschik
Joan M. Von Feldt
Lawrence Frame
Scott Akers
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
Salvatore Mangione
Thomas Jefferson School of Medicine
Philadelphia, Pennsylvania
Huw Llewelyn
Kettering General Hospital
Kettering, Northamptonshire
England
iv
Oxford University Press, Inc., publishes works that further
Oxford University’s objective of excellence
in research, scholarship, and education.
Oxford New York
Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto
With offices in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Thailand Turkey Ukraine Vietnam
Copyright © 2009 by Huw Llewelyn
Published by Oxford University Press, Inc.
198 Madison Avenue, New York, New York 10016
www.oup.com
Oxford is a registered trademark of Oxford University Press
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Oxford American handbook of clinical diagnosis/Gregg Lipschik ... [et al.].
p. ; cm.
—(Oxford American handbooks)
Adapted from: Oxford handbook of clinical diagnosis/Huw Llewelyn ... [et al.].
2nd ed. 2008.
Includes bibliographical references and index.
ISBN 978-0-19-536947-2 (flexicover : alk. paper)
1. Diagnosis—Handbooks, manuals, etc. 2. Physical diagnosis—Handbooks,
manuals, etc. 3. Medical history taking—Handbooks, manuals, etc. I. Lipschik,
Gregg, 1954- II. Oxford handbook of clinical diagnosis. III. Title: Handbook of clinical
diagnosis. IV. Series: Oxford American handbooks.
[DNLM: 1. Diagnosis, Differential—Handbooks. 2. Medical History Taking—
Handbooks. 3. Physical Examination—Handbooks. WB 39 O973 2009]
RC71.3.O938 2008
616.07'5—dc22 2008054687
10 9 8 7 6 5 4 3 2 1
Printed in China
on acid-free paper
v
This material is not intended to be, and should not be considered, a
substitute for medical or other professional advice. Treatment for the
conditions described in this material is highly dependent on the individual
circumstances. Although this material is designed to offer accurate infor-
mation with respect to the subject matter covered and to be current as
of the time it was written, research and knowledge about medical and
health issues are constantly evolving and dose schedules for medications
are being revised continually, with new side effects recognized and
accounted for regularly. Readers must, therefore, always check the product
information and clinical procedures with the most up-to-date published
product information and data sheets provided by the manufacturers and
the most recent codes of conduct and safety regulation. Oxford Univer-
sity Press and the authors make no representations or warranties to
readers, express or implied, about the accuracy or completeness of this
material, including, without limitation, that they make no representation
or warranties about the accuracy or efficacy of the drug dosages men-
tioned in the material. The authors and the publishers do not accept, and
expressly disclaim, any responsibility for any liability, loss, or risk that may
be claimed or incurred as a consequence of the use and/or application of
any of the contents of this material.
vi
For Angela
and
for Debra
vii
Preface
This book explains how to use a history, examination, and preliminary
tests to arrive at a diagnosis. This helps us as clinicians to anticipate what
may happen next and how interventions may influence the disease process.
We are also better equipped to share with our patients and colleagues
what we are thinking and doing.
The approach used here enables clinicians to focus on symptoms,
physical signs, and initial test results that are likely to lead to a diagnosis.
This is based on the principle that diagnostic leads with short differential
diagnoses will be more informative than those features with long lists of
causes.
Each sign or symptom on a page is followed by a list of diagnoses with
associated suggestive and confirmatory clinical and laboratory features.
The reader may scan down the page to see which entries are compatible
with the patient’s findings thus far. The compatible findings can then be
used as evidence for the diagnosis.
In the spirit of the Oxford American Handbooks, readers are encour-
aged to be critical about the contents of the book, to make changes, and
to let us know of any significant differences in opinion or errors.
GL & HL
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