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24 of 26 people found the following review helpful
5.0 out of 5 stars Essential for med school revision
I bought this book a week ago and my confidence in diagnosis has increased ten fold. Not only can you pick the symptom you think is most relavent and look up what could be causing it, you also get a list of conditions with associated features, and how the condition is confirmed.

In real terms when on for example A&E, you get a patient with difuse hair loss (I...
Published on 10 Feb. 2007 by Clair Melville

versus
2.0 out of 5 stars Rated highly by others. They must not be referring to the psychiatry chapter. I hope.
As you can see from the preview section, the information is divided up into 10 topics. One topic is "Psychiatric and Neurological Symptoms and Signs". This chapter is about 80 pages long. There were alomost 70 topics covered in the section. As a psychiatrist, I felt competent to reflect on the quality of 16 of the differentials. The most note-worthy were as...
Published on 17 May 2010 by Pen Name and That A


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24 of 26 people found the following review helpful
5.0 out of 5 stars Essential for med school revision, 10 Feb. 2007
By 
I bought this book a week ago and my confidence in diagnosis has increased ten fold. Not only can you pick the symptom you think is most relavent and look up what could be causing it, you also get a list of conditions with associated features, and how the condition is confirmed.

In real terms when on for example A&E, you get a patient with difuse hair loss (I had no idea where to start on this one) and you get given options of cytotoxic drugs , iron deficiency, sever illness, hypogonadism and recent pregnancy. You would then see what the symptoms of each are, and how you would confirm each.

It made the situation of coming away from a patient totally confused much easier. I am also better at coming up with differentials now.
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8 of 9 people found the following review helpful
4.0 out of 5 stars Very useful with an excellent layout, 20 Sept. 2009
A Kid's Review
This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
As a medical student, this book has been of great use to me, both for learning and revising. It provides an invaluable starting point for anyone trying to work out what's wrong with a patient. This is something that students don't find easy. Additionally, it contains the differential diagnoses for uncommon signs or symptoms - something medical school doesn't give a lot of guidance on.

The layout is the real reason that this book's so useful. Each page is headed by a clinical sign or symptom, with possible causes listed below. Additionally, there is advice about how to investigate each sign/ symptom and how other signs/symptoms and the results of investigations can be used to rule out possible causes and form a logical, reasoned diagnosis. Furthermore, the introductory chapters titled 'The diagnostic process' and 'Interpreting the history and examination' provide useful hints and tips about forming a diagnosis.
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2.0 out of 5 stars Rated highly by others. They must not be referring to the psychiatry chapter. I hope., 17 May 2010
This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
As you can see from the preview section, the information is divided up into 10 topics. One topic is "Psychiatric and Neurological Symptoms and Signs". This chapter is about 80 pages long. There were alomost 70 topics covered in the section. As a psychiatrist, I felt competent to reflect on the quality of 16 of the differentials. The most note-worthy were as follows.

General Anxiety
===============
Page 570,1. The listed "Main differential diagnoses" were as follows: GAD, Panic disorder, alcohol withdrawal, thyrotoxicosis, hypoglycaemia, phaeochromocytoma. This is a DDx list of 6, of which the sixth is phaeochromocytoma! Have you ever seen a phaeochromocytoma? Me, either. That's a dumb differential for a beginner's book. Panic disorder is "confirmed" by the basic DSM IV criteria for panic disorder (as if, if someoene had only had 3 (and not 4) episodes of panic in the last month they wouldn't have the disorder) and the following organic exclusions: thyrotoxicosis, hypoglycaemia, Cushing's disease, phaeo', and no other physical cause of symptoms. Well: the "no other" is the bit of this book that I wanted to know about. And it was dumb to put phaeo' ahead of cardiac ischaemia, cardiac arrhythmia, hypoxia, cardiac ischaemia, major depressive disorder, agitated depression, psychosis and etc.

The section on alcohol withdrawal says that there is decrease in MCV, which is wrong. It also says that the initial management is "sedation and alcohol detoxification (e.g. chlordiazepoxide) with tailing off over days." May I suggest, 20 mg oral diazepam, IV thiamin and call the registrar as a better plan?

The section on thyrotoxicosis gives the basic management of thyrotoxicosis. Would anyone striking this rare diagnosis not have time to look up Oxford Clinical Medicine?

Anxiety Response to Specific Issues
===================================
This section has numerous problems. For example, one of the DDx's is somatization disorder. The Initial Management includes: "explanation of mechanisms of symptoms. May I suggest that what no body needs is the resident taking it upon themselves to explain to the patient that their symptoms are all in their head.

Simple phobia. They recommend "flooding, implosion therapy, and benzos", amongst a few other things. If someone routinely treated simple phobia with benzos, I would recommend reviw by the medical board. As for flooding, are there many fully qualified psychiatrist/psychologist who would not confer with other seniours before they did this? Remember, this is a book for juniours.

In the PTSD section, they give some manaement ideas, but do not mention the all-important first aid following traumatic events.

Depression
==========
Major depression has "Antidepressant, especially if somatic syptoms" as the initial management. I suggest that decisions about what therapy to use should be made according to severity (and patient preference) rather than the presence of somatic spymtoms). The differential "Depression Secondary or Partly Due to Other Conditions" suggests that this diagnosis is "Suggested by any other illness that undermines self-confidence , e.g. physical illness but especially anxiety disorders, alcohol abuse, substance abuse." This suggests that the mechanism of alcohol induced depression is the undermining of one's self-confidence! Unbelieveably dumb.

The section "Depression Secondary or Partly Due to Medication" mentions beta blockers first. It is possible that they cause depression. But they do not mention medications for dyslipidaemias!

Delusions
=========
The physical differentials listed are only: infection, hypothyroidism, etc. This is dumb. They also say that schizophrenia is "confirmed" if you have two schniederian first rank symptoms for a month or more and clear sensorium (if you are not manic or depressed). This is so dumb.

Acute Confusion
===============
Reasonable DDx, I think. But I am not an expert in Dx-ing acute confusion.

Fatigued, "Tired all the time"
==============================
Diabetes is 7 out of a DDx of 10. I think is should have been listed ahead of Post-Viral Fatigue, don't you?

Disturbed Consciousness
=======================
Page 604. Recons "probably moderate brain injury" if CGS is 9-12. I'll keep it in mind next time someone overdoses. Details the scoring and categories, but does not tell you how to do the test - i.e. how hard to try and wake the person up.

Speech Disturbance
==================
Recons "Innatention dut to dementia, depression, etc" is "confirmend by low MMSE with or without CT/MRI showing cerebral atrophy". Way to ignore delerium and any number of psychiatric illnesses, Einsteins.

Course Tremor
=============
Lists hepatic failure (a flap is not a tremor, guys). Much worse: their entire DDx list for Parkinsonian tremor is: Park Dis, Lewy body Dem, drug-induced, post-encephalitis and morm press hydro. Dear Reader, please refer to page 499 of the OHoCM for a decent DDx.

Brisk Reflexes
==============
Three differentials: thyrotoxicosis, pyramidal tract x2. Well: brisk reflexes is probably the first sign of serotonin syndrome that is not caused by anxiety, so, how bouts mentioning it?

Diminished Reflexes
===================
The DDx does not include "normal for them" which I recon is the most important cause.

---------

After all that, the authors have the cheek to have a complicated, mathematical chapter at the back of the book about pre and post test probability and what not. I suggest that the authors concentrate on getting the basic differentials right, not being so reckless about saying when a diagnosis is confirmed, forget about listing rare treatment (e.g. flooding) and list urgent management (e.g. IV thiamine).

Also, I understand English is commonly spoken and written in England, so, can some joker stop these bozos using 'danger quotes' wrongly. Which gets me started on their excuse of a MSE. The say " 'affect' " and don't bother defining or using the word. (It means "facial expression" at your level).

The bits of this book that I have read are no good for students, residents, registrars or consultants of any speciality. If you want a book about DDx, start with Differential Diagnosis Pocket (Pocket (Borm Bruckmeier Publishing)).

P.S. For dementia, there are only 5 differentials. The 5th is CJD. I can see it now, consultants sitting around the tea room, laughing at how the resident missed a case of CJD, all because the resident didn't read this book... not. Here's hint from me, next time you wonder if someone has dementia, don't bother ruling out CJD, ok?

P.P.S. For Abnormal tongue movement, they have four DDx's all and the way to tell the difference is with MRI for each of the four. Way to waste a page! Except that they forgot to list tardive dyskinesia, which can not to be Dxed by MRI. Way to waste my money, Huw.
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14 of 17 people found the following review helpful
5.0 out of 5 stars Excellent book, 22 Mar. 2006
By 
Dr. E. C. Pooley "edpooley" (Leicester, UK) - See all my reviews
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This book is one of the most comprehensive I have read on clinical diagnosis and provides a checklist of discriminating criteria for many of the symptoms and signs encountered in clinical practice. My only criticism of this book, from the point of view of a finals student, is that it doesn't specifically list investigations that would be required when a patient has a list of 2 or 3 possible differentials after the history/examination, which are often asked in examinations. In this regard, "Differential Diagnosis" is a useful book to read alongside this one.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Awesome, 20 Aug. 2013
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This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
Fab book - really useful especially to test yourself on common conditions and their presentations. Good size and easy to use.
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1 of 1 people found the following review helpful
4.0 out of 5 stars Really excellent for med school clinical years, 6 April 2013
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This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
Simple layout:
Sign or symptom
Initial investigations
Main differentials and typical outline evidence, further investigations and inital management.
Simple, comprehensive and trustworthy.

This is a very worthy addition to any med student's or clinician's library.
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1 of 1 people found the following review helpful
5.0 out of 5 stars Very good, 24 Feb. 2013
This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
Very good. Worked out perfectly. No problems. Book in good shape. Trustable. Very good. Worked out perfectly. No problems. Book in good shape. Trustable.
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5.0 out of 5 stars Good little reference book, 9 Dec. 2014
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This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
Absolutely love it. As a medical student I use it when writing up cases to present to seniors to help think of my differential diagnosis. It's small as well making it easy to carry too and from hospital. Would definitely recommend. I use it in conjunction with the Oxford Handbook of clinical Medicine.
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4.0 out of 5 stars Good Stuff., 2 Feb. 2013
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Exactly as it says on the tin, great reference tool and a handy size for carrying around. Service & delivery good and condition (important with used books) was as stated. Very pleased, these books are expensive new.
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5.0 out of 5 stars Clinical hand book, 11 May 2014
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This review is from: Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks) (Paperback)
Good condition and got delivered on time. Very nicely packed. Very satisfied and in time for my GP block. And of course very handy book I carry it all the time.
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Oxford Handbook of Clinical Diagnosis (Oxford Medical Handbooks)
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