Clinical Cases Uncovered Paediatrics PDF

Clinical Cases Uncovered Paediatrics PDF



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Preface

In 2002, a new paediatric course was developed for the graduate entry programme at St George’s Hospital, University of London. We sought to extend the problembased learning approach into clinical medicine. Tutorials started with a case presentation, and then the patient history and examination, the investigative process and the creation of a management plan was dissected. This way students discovered how a paediatrician ‘solves’ a case.
My students were hampered by the lack of books that unpack patient management in this way. Almost all texts are ‘backwards medicine’ – they start with a diagnosis and look at its manifestation and treatment. A more logical approach for a book would be to start with a clinical problem, and see how it could be solved using the simple tools available to doctors – history, examination, investigations. This ‘forwards medicine’ approach would mirror the clinical approach, and such a book needed writing.
In order to do justice to such an idea, and to pitch it at the right level, I wanted to collaborate with medical students towards the end of their course. I was then approached by Alice and Lucy, who had independently had the same idea and had already found a publisher. Having written the first chapter, we realized that this approach could be a valuable addition to the many texts already written in paediatrics. Hayley Salter and Helen Harvey from Blackwell Publishing helped us to develop this idea into a complete book covering the breadth of the speciality.
The book takes 32 common paediatric presentations, ranging from premature infants to teenagers, with problems in all of the body’s systems. Some are emergencies, some acute and some chronic problems. The earlier chapters deal with younger children and later ones with older patients. Each starts with a few details about the presenting problem. Possible questions that might be useful in the history are then discussed, before further patient details are revealed. Children rarely appreciate a lengthy systematic examination, so a focussed approach is developed for each case. The clinical approach for each child is discussed and how this leads to a diagnosis and a management plan. We also include an introduction covering the basics of the speciality and a self assessment section, written to test readers with questions in a format and level similar to MBBS exams.
This book will be most useful to those learning the art of assessing and managing children; doctors in their first paediatric posts or medical students. It would be a useful complement to any clinical course in paediatrics. The introduction has a section on clinical basics, common problems and assessment skills. Going through the cases would give students a head start before starting an attachment or post, helping to develop assessment and management skills. It would serve as a reference book during a post or attachment, explaining why children are looked after in particular ways. Also it will be useful for revision – the presentations covered will form the core of any examination in paediatrics.


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