Clinical Medicine

Clinical Medicine can be divided into 

• Presentations & history

• Examinations

• Observations

• Investigations 

• Management

This section also contains a section on practical jobs associated with clinical medicine. 

Pathway from presentation to management

Symptom (history) -> signs (examination, obs, investigations) -> diagnosis (disease) -> (severity) management

Definitions

Symptom: feeling described by the patient, e.g. headache

Sign: elicited by the medic by e.g. 

• Examination: enlarged pupils, low GCS

• Observations: hypotension

• Investigation: anaemia, thrombocytopenia, leukocytosis

Disease diagnosis: herpes simplex meningitis 

Management: as per disease diagnosis

Discussion

Outcomes

1. Diagnosis

2. Management

The patient presents with symptoms, the doctor elicits signs and then makes the diagnosis. The diagnosis dictates management. I'm attempting to be precise because the information pages are categorised using this schema. Anaemia isn't a diagnosis and 'feeling anaemic' isn't a precise presenting complaint. 

Investigations

Schema I use is:

• Bedside/everything else

  • • • ECG, peak flow, weight/ height etc

• Body samples

  • • • Urine

      • Blood

      • Faeces

      • Everything else: CSF, pus, transudate fluid, biopsies

• Imaging

  • • • XR

      • US

      • CT

      • MRI

      • Everything else: Pet, barium etc

• Procedural

  • • • Scopes: cystoscopy, ureteroscopy, colonoscopy/ endoscopy

      • Local anesthetic: lumbar puncture, chest drain, abdominal paracentesis

Management

• Lifestyle

  • • • Diet, exercise, stopping smoking/ drinking/ recreation drugs/ caffeine

      • Speaking therapy/ psychology

• Medications

• Procedures/ operations

Written 2024