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This textbook assembles the wealth of clinical experiences across multiple medical specialties and offers clinical pearls that will result in better patient care and are highly relevant to daily practice. This book has been compiled by many renowned clinicians, medical educators, and researchers who are experts in their respective disciplines across Australia, New Zealand and the United States. The chapters provide multiple cases in vignette format, illustrating the clinical pearls, and finish with a discussion and practical tips. This format will allow the reader to easily understand how the clinical pearls can be applied in clinical practice.
Evidence-based medicine and clinical guidelines help us choose the best management and treatment options for our patients. However, many questions in medicine have not been researched or are not readily amenable to research. In fact, there is more to the art and mastery of practicing clinical medicine than the evidence-based approach. Information gained over years of reflective clinical practice and cumulative wisdom adds value to evidence-based clinical medicine. With experience and clinical gestalt playing an equal, if not a more prominent role than what evidence can offer in a physician’s approach to solving clinical problems, this book offers unique perspectives on the practice of medicine.
Beyond Evidence-Based Medicine: Clinical Pearls from Experienced Physicians will be valuable for later-year medical students, medical educators, doctors in training, and consultant physicians alike. Aiming to improve the day-to-day medical practices of professionals, the Editors have invited experienced physicians to share their expertise culminating in a unique book with broad applicability and appeal.
Pages i-xviii
Front Matter
Pages 1-1
Consider Adverse Drug Reactions in Undifferentiated Presentations
Pages 3-6
Polypharmacy and Deprescribing
Pages 7-10
Pages 11-14
Pages 15-17
Neuropathic Pain Is a Symptom Not a Diagnosis
Pages 19-22
Pages 23-25
The Skeleton in the Closet: Preventing Hospital-Associated Malnutrition
Pages 27-29
Pages 31-35
Front Matter
Pages 37-37
Pages 39-41
Observation of Gait in the Older Adult
Pages 43-45
Pages 47-49
Do Not Use the Term “Mechanical” Fall
Pages 51-53
Keep an Open Mind: Assessing Unsteadiness in Older People
Pages 55-57
Right Time and Place: Cognitive Testing in Hospital
Pages 59-61
First Do No Harm: Beware the Prescribing Cascade
Pages 63-65
A Delicate Balance: Weighing Risks and Benefits in Frail Patients
Pages 67-69
A Critical Signal: New Atrial Fibrillation in an Inpatient
Pages 71-73
Taboo Clues: Learning from Bodily Functions
Pages 75-77
Front Matter
Pages 79-79
Prolonged Delirium in the Intensive Care Unit (ICU)
Pages 81-83
Looking for Causes of Delirium
Pages 85-88
Agitating for Better Care: Minimise Sedatives in Delirium
Pages 89-91
Antipsychotics and Acute Behavioural Disturbance
Pages 93-96
Urinary Tract Infection May Not Be the Cause of Delirium
Pages 97-99
Is Delirium Better Managed in Hospital or At Home?
Pages 101-103
Front Matter
Pages 105-105
Pages 107-109
Just Because a Treatment Is Available, Does Not Mean That It Must Be Given
Pages 111-114
Shared Decision Making in the End-of-Life Setting
Pages 115-117
Approaching Goals of Care Discussions at the End of Life
Pages 119-121
A Multimodal Approach to Managing Chronic Breathlessness
Pages 123-126
Approach to Respiratory Secretions at the End of Life
Pages 127-129
Medication Management in Parkinson’s Disease
Pages 131-133
Liver Disease and Opioid Prescribing
Pages 135-137
A Good Death: Respecting Goals of Care
Pages 139-141
Front Matter
Pages 143-143
Patient Adjusted Brain Natriuretic Peptide Assessment Improves Diagnostic Performance
Pages 145-147
Heart Failure with Preserved Ejection Fraction: You Don’t Know What You Don’t Look for
Pages 149-152
Sometimes, the Old Ways Are Best: Cost Effective Bedside Diagnostics for Peripheral Arterial Disease
Pages 153-155
Syncope: Keeping the Workup Simple
Pages 157-160
Pages 161-163
Atypical Chest Pain: Fact or Fiction?
Pages 165-168
Digoxin: Too Much of a Good Thing
Pages 169-171
Front Matter
Pages 173-173
Pages 175-179
Beyond the JVP: Overcoming Pitfalls in Fluid Assessment
Pages 181-184
Magnesium: The Most Forgotten Electrolyte
Pages 185-187
Recognising Renal Tubular Acidosis (RTA)
Pages 189-193
Acute Kidney Injury and Cancer
Pages 195-197
It’s Not Always Essential Hypertension
Pages 199-201
Pages 203-205
Haematuria and Acute Kidney Injury
Pages 207-209
Front Matter
Pages 211-211
Beware Intravenous Fluids in the Management of Pulmonary Embolism
Pages 213-217
Pages 219-222
Pages 223-226
Arterial Blood Gas Interpretation
Pages 227-229
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