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Practical Clinical Pearls

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Essential Medical Facts Every Clinician Should Know
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Abstract

This chapter about how observing some trifles and recognizing what is seen is intended to help us become better diagnosticians.

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References

  1. Meador CK. A little book of doctors’ rules II. Philadelphia: Hanley & Belfus; 1999.

    Google Scholar 

  2. Mainz JG, Koitschev A. Management of chronic rhinosinusitis in CF. J Cyst Fibros. 2009;8(suppl 1):S10–S14.

    Article  PubMed  Google Scholar 

  3. Robertson JM, Friedman EM, Rubin BK. Nasal and sinus disease in cystic fibrosis. Ped Respir Rev. 2008;9(3):213–219.

    Article  Google Scholar 

  4. Yung MW, Gould J, Upton GJ. Nasal polyposis in children with cystic fibrosis: a long-term follow-up study. Ann Otol Rhinol Laryngol. 2002;111(12 Pt 1):1081–1086.

    PubMed  Google Scholar 

  5. Lund VJ. Diagnosis and treatment of nasal polyps. BMJ. 1995;311:1411–1414.

    Article  PubMed  CAS  Google Scholar 

  6. Quinton PM. Cystic fibrosis: lessons from the sweat gland. Physiology (Bethesda). 2007;22:212–225.

    Article  CAS  Google Scholar 

  7. Lorin MI, Palazzi DL, Turner DL, Ward MA. What is a clinical pearl and what is its role in medical education? Med Teach. 2008;30(9–10):870–874.

    Article  PubMed  Google Scholar 

  8. Quoted in Taylor RB. White coat tales: medicine’s heroes, heritage and misadventures. New York: Springer; 2008; pages 127–129.

    Google Scholar 

References

  1. Mangrulkar MD, Saint S, Chu S, Tierney LM. What is the role of the clinical “pearl?” Am J Med. 2002;113(7):1–7.

    Article  Google Scholar 

  2. Reveno WS. Medical Maxims. Springfield IL: Charles C. Thomas; 1951.

    Google Scholar 

References

  1. Brenner P, Krause-Bergmann A. Van VH. Dupuytren contracture in North Germany: epidemiological study of 500 cases. Unfallchirug. 2001;104(4):303–311.

    Article  CAS  Google Scholar 

  2. Spinner RJ, Poliakoff MB, Tiel RL. The origin of “Saturday night palsy.” Neurosurgery. 2002;51(3):737–74.

    PubMed  Google Scholar 

References

  1. Sommer N, Melms A, Weller M, Dichgans J. Ocular myasthenia gravis: a critical review of clinical and pathophysiological aspects. Doc Ophthalmol. 1993;84(4):309–333.

    Article  PubMed  CAS  Google Scholar 

  2. Osher RH, Griggs RC. Orbicularis fatigue: the “peek” sign of myasthenia gravis. Arch Ophthalmol. 1979;97:677–699.

    Article  PubMed  CAS  Google Scholar 

Reference

  1. Marcus DA, Furman JM, Balaban CD. Motion sickness in migraine sufferers. Expert Opin Pharmacother. 2005;6(15):2691–2697.

    Article  PubMed  CAS  Google Scholar 

References

  1. ACROSS Group. Epidemiology of aneurismal subarachnoid hemorrhage in Australia and New Zealand. Incidence and case fatality from the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS). Stroke. 2000;31(9):1843–1850.

    Google Scholar 

  2. Hankey GJ, Nelson MR. Easily missed? Subarachnoid hemorrhage. BMJ. 2009;339:b2874.

    Article  PubMed  Google Scholar 

  3. Edlow JA. Diagnosis of subarachnoid hemorrhage. Neurocrit Care. 2005;2(2):99–109.

    Article  PubMed  Google Scholar 

References

  1. Dang CV. Runner’s anemia. JAMA. 2001;286(6):714–716.

    Article  PubMed  CAS  Google Scholar 

  2. Eichner ER. Runner’s macrocytosis: a clue to footstrike hemolysis. Runner’s anemia as a benefit versus runner’s hemolysis as a detriment. Am J Med. 1985;78(2):321–325.

    Article  PubMed  CAS  Google Scholar 

References

  1. Mathews SA, Kurien BT, Scofield RH. Oral manifestations of Sjögren syndrome. J Dent Res. 2008;87(4):308–318.

    Article  PubMed  CAS  Google Scholar 

  2. Lindsay JA. Medical axioms, aphorisms and clinical memoranda. London: H.K. Lewis Co.; 1923; page 7.

    Google Scholar 

References

  1. Oh SH, Han EC, Lee JH, Bang D. Comparison of the clinical features of recurrent aphthous stomatitis and Behçet’s disease. Clin Exp Dermatol. 2009;34(6):e208–e212.

    Article  PubMed  CAS  Google Scholar 

  2. Alli N, Gur G, Yalcin B, Hayran M. Patient characteristics in Behçet disease: a retrospective analysis of 213 Turkish patients during 2001–2004. Am J Clin Dermatol. 2009;10(6):411–418.

    Article  PubMed  Google Scholar 

  3. Yurdakul S, Hamuryudan V, Yazici H. Behçet syndrome. Curr Opin Rheumatol. 2004;16(1):38–42.

    Article  PubMed  Google Scholar 

References

  1. Bielecka-Dabrowa A, Mikhailidis DP, Rysz J, Banach M. The mechanisms of atrial fibrillation in hyperthyroidism. Thyroid Res. 2009;2(1):4–8.

    Article  PubMed  Google Scholar 

  2. Reveno WS. 711 Medical maxims. Springfield IL: Charles C. Thomas; 1951; page 32.

    Google Scholar 

Reference

  1. Goyle KK, Walling AD. Diagnosing pericarditis. Am Fam Physician. 2002;66(9):1695–1702.

    PubMed  Google Scholar 

Reference

  1. Hanak V, Kalra S, Aksamit TR, Hartman TE, Taxelaar HD, Ryu JH. Hot tub lung: presenting features and clinical course of 21 patients. Respir Med. 2006;100(4):610–615.

    Article  PubMed  Google Scholar 

Reference

  1. Gonclaves M, Martins AP, Leal MJ. Acute appendicitis in children. Acta Med Port (Portugal). 1993;6:377–382.

    Google Scholar 

References

  1. Holtry L. Practical Pointers. Consultant, July 2009; p. 437.

    Google Scholar 

  2. Pathology and History, April 17, 1909. Reiling J, series editor. JAMA. 2009;301(16):1721.

    Google Scholar 

References

  1. Parmar MS. “Courvoisier’s law”. CMAJ. 2003;168(7):876–877.

    PubMed  Google Scholar 

  2. Fitzgerald JE, White MJ, Lobo DN. Courvoisier’s gall bladder: law or sign? World J Surg. 2009;33(4):886–891.

    Article  PubMed  Google Scholar 

References

  1. Van der Lely AJ, de Herder WW. Carcinoid syndrome: diagnosis and medical management. Arq Bras Endocrinol Metabol. 2005;49(5):850–860.

    Article  PubMed  Google Scholar 

  2. Jabboour SA, Dividovici BB, Wolf R. Rare syndromes. Clin Dermatol. 2006;24(4):299–316.

    Article  Google Scholar 

Reference

  1. Ukae S, Tsutsumi H, Adachi N, Takahashi H, Kato F, Chiba S. Preschool sarcoidosis manifesting as juvenile rheumatoid arthritis: a case report and a review of the literature of Japanese cases. Acta Paediatr Jpn. 1994;36(5):515–518.

    Article  PubMed  CAS  Google Scholar 

References

  1. Reveno WS. 711 Medical maxims. Springfield IL: Charles C. Thomas; 1951; page 112.

    Google Scholar 

  2. Kraus MD, Fleming MD, Vonderheide RH. The spleen as a diagnostic specimen: a review of 10 years’ experience at two tertiary care institutions. Cancer. 2001;91(11):2001–2009.

    Article  PubMed  CAS  Google Scholar 

  3. Taylor RB. Difficult diagnosis. Philadelphia, PA: Saunders; 1985; page 493.

    Google Scholar 

References

  1. Evaluation of nonacute pathology in adult men. Available at: http://www.uptodateonline.com/online/content/topic.do?topicKey=primneth/7784&linkTitle=VARICOCELE&source=preview&selectedTitle=3∼11&anchor=4#4. Accessed March 31, 2009.

  2. Biyani CS, Cartledge J, Janetschek G. Varicocele. Clin Evid (Online). 2009 Jan 6; 2009;pii:1806.

    Google Scholar 

References

  1. Rabinowitz R. The importance of the cremasteric reflex in acute scrotal swelling in children. J Urol. 1984;132(1):89–90.

    PubMed  CAS  Google Scholar 

  2. Schmitz D, Safraned S. How useful is a physical exam in diagnosing testicular torsion? J Fam Pract. 2009;58(8):433–434.

    PubMed  Google Scholar 

Reference

  1. Meijer JWG, Smit AJ, Lefrandt JD, et al. Back to basics in diagnosing diabetic polyneuropathy with the tuning fork! Diabetes Care. 2005;28(9):2201–2205.

    Article  PubMed  Google Scholar 

Reference

  1. Chad DA. Lumbar spinal stenosis. Neurol Clin. 2007;25:407–418.

    Article  PubMed  Google Scholar 

Reference

  1. Neuschwander TB, Cutorne J, Macias BR, et al. The effect of backpacks on the lumbar spine in children: a standing magnetic resonance imaging study. Spine. 2010;35(1):83–88.

    Article  PubMed  Google Scholar 

Reference

  1. Appelboam A, Reuben AD, Benger JR, et al. Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children. BMJ. 2008;337:a2428

    Article  PubMed  CAS  Google Scholar 

References

  1. Cohen MD, Harrington TM, Ginsburg WW. Osteoid osteoma: 95 cases and a review of the literature. Semin Arthritis Rheum. 1983;12(3):265–281.

    Article  PubMed  CAS  Google Scholar 

  2. Azouz EM, Kozlowski D, Marton D, Sprague P, Zerhouni A, Asselah F. Osteoid osteoma and osteoblastoma of the spine in children: report of 22 cases with brief literature review. Pediatr Radiol. 1986;16(1):25–31.

    Article  PubMed  CAS  Google Scholar 

References

  1. Meador CK. A little book of doctors’ rules II. Philadelphia: Hanley & Belfus; 1999, Rule number 51.

    Google Scholar 

  2. Davis PF, Severud E, Baxter DE. Painful heel syndrome: results of non-operative treatment. Foot Ankle Int. 1994;15(10):531–535.

    PubMed  CAS  Google Scholar 

Reference

  1. Robertson GS, Ristic CD, Bullen BR. The incidence of congenitally absent foot pulses. Ann R Coll Surg. 1990;72(2):99–100.

    CAS  Google Scholar 

References

  1. Rice RE. Wisdom of the ageds: clinical pearls. Page 35. Available at: http://www.familymedicine.us.edu/ricer/ClinicalPearls.pdf. Accessed January 16, 2010.

  2. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79(4):368–376.

    Article  PubMed  CAS  Google Scholar 

  3. Gangadhar G, Joseph D, Srinivasan AV, et al. A computational model of Parkinsonian handwriting that highlights the role of the indirect pathway in the basal ganglia. Hum Mov Sci. 2009;28(5):602–618.

    Article  PubMed  CAS  Google Scholar 

References

  1. Suchowersky O, Reich S, Perlmutter J, Zesiewicz T, Gronseth G, Weiner WJ. Practice parameter: diagnosis and prognosis of new onset Parkinson disease: an evidence-based review. Neurology. 2006;66(7):968–975.

    Article  PubMed  CAS  Google Scholar 

  2. Hackney ME, Earhart GM. Short duration, intensive tango dancing for Parkinson disease: an uncontrolled pilot study. Complement Ther Med. 2009;17(4):203–207.

    Article  PubMed  Google Scholar 

Reference

  1. Blount BW, Robbins L. Parkinson disease. CME Bull. 2010;9(2):1–6.

    Google Scholar 

References

  1. Meador CK. A little book of doctors’ rules II. Philadelphia: Hanley & Belfus; 1999, Rule number 157.

    Google Scholar 

  2. Hugdahl K. “Hearing voices”: auditory hallucinations as failure of top-down control of bottom-up processes. Scand J Psychol. 2009;50(6):553–560.

    Article  PubMed  Google Scholar 

  3. Alcohol withdrawal syndrome: how to predict, prevent, diagnose and treat it. (No authors listed). Prescribe Int. 2007;16(87):24–31.

    Google Scholar 

Reference

  1. Rice RE. Wisdom of the ageds: clinical pearls. Page 41. Available at: http://www.familymedicine.us.edu/ricer/ClinicalPearls.pdf. Accessed January 16, 2010.

References

  1. Pierce MC, Kaczor K, Aldridge S, O’Flynn J, Lorenz DJ. Bruising characteristics discriminating physical child abuse from accidental trauma. Pediatrics. 2010;125(1):67–74.

    Article  PubMed  Google Scholar 

  2. Meador CK. A little book of doctors’ rules II. Philadelphia: Hanley & Belfus; 1999, Rule number 175.

    Google Scholar 

References

  1. Lambert EC. Modern medical mistakes. Bloomington, IN: Indiana University Press; 1978; page 70.

    Google Scholar 

  2. Chang AL, Khosravi V, Egbert B. A case of argyria after colloidal silver ingestion. J Cutan Pathol. 2006;33(12):808–811.

    Article  Google Scholar 

  3. Kim Y, Suh HS, Cha HJ, Kim SH, Jeong KS, Kim DH. A case of generalized argyria after ingestion of colloidal silver solution. Am J Ind Med. 2009;52(3):246–250.

    Article  PubMed  CAS  Google Scholar 

  4. Blue in the face. (No author listed). Mental_Floss. 2010;9(1):16.

    Google Scholar 

  5. Argyrol SS. Mild Silver Protein Home. Available at: http://argyrol.com/agprotein.phtml. Accessed July 14, 2010.

References

  1. Mori K, Ando I, Kukita A. Generalized hyperpigmentation of the skin due to vitamin B12 deficiency. J Dermatol. 2001;28(5):282–285.

    PubMed  CAS  Google Scholar 

  2. Puri V, Chaudhry N, Goel S, et al. Vitamin B12 deficiency: a clinical and electrophysiological profile. Electromyogr Clin Neurophysiol. 2005;45(5):273–284.

    PubMed  CAS  Google Scholar 

  3. Carmel R. Pernicious anemia. The expected findings of very low serum cobalamin levels, anemia, and macrocytosis are often lacking. Arch Intern Med. 1988;148(8):1712–1714.

    Article  PubMed  CAS  Google Scholar 

References

  1. Fox GN. An aid for spotting basal cell carcinoma. J Fam Pract. 2009;58(2);73–75.

    PubMed  Google Scholar 

  2. Goldberg LH, Friedman RH, Silapunt S. Pigmented speckling as a sign of basal cell carcinoma. Dermatol Surg. 2004;30:1553–1555.

    Article  PubMed  Google Scholar 

Reference

  1. Scope A, Dusza SW, Halpern AC. The “ugly duckling” sign: agreement between observers. Arch Dermatol. 2008;144(1):58–64.

    Article  PubMed  Google Scholar 

References

  1. Campling B. Easy smoking cessation may signal lung cancer. Pulmonary Med. September 1, 2009;9:47.

    Google Scholar 

  2. Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ. 2010;340:b5569.

    Article  PubMed  CAS  Google Scholar 

Reference

  1. Schroeder A, Schroeder MA, D’Amico FD. What’s growing on your stethoscope? And what you can do about it. J Fam Pract. 2009;58(8):404–405.

    PubMed  Google Scholar 

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Taylor, R.B. (2011). Practical Clinical Pearls. In: Essential Medical Facts Every Clinician Should Know. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7874-5_6

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  • DOI: https://doi.org/10.1007/978-1-4419-7874-5_6

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