Life is short, the art long, opportunity fleeting,
experiment treacherous, judgement difficult.
Hippocrates (c. 460–370 BC). Aphorisms, Aph. 1.
BSc (Hons), MBBS, MRCPsych, MA (Phil), AKC
Tu t o r i n P s y c h i a t r y
G reen Tem p l et o n C o l l e g e
Fifth edition © Neel Burton, 2015
Fifth edition published in 2015 by Scion Publishing Ltd
First edition published in 2003 by BIOS Scientific Publishers
Second edition published in 2006 by Informa Healthcare
Third edition published in 2009 by Scion Publishing Ltd
Fourth edition published in 2011 by Scion Publishing Ltd
All rights reserved. No part of this book may be reproduced or transmitted, in any form or by
any means, without permission.
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4. Cannulation and setting up a drip 7
7. Intramuscular, subcutaneous, and intradermal drug injection 14
8. Intravenous drug injection 16
9. Examination of a superficial mass and of lymph nodes 18
II. CARDIOVASCULAR AND RESPIRATORY MEDICINE
11. Cardiovascular risk assessment 24
12. Blood pressure measurement 26
13. Cardiovascular examination 28
14. Peripheral vascular system examination 33
15. Ankle-brachial pressure index (ABPI) 36
17. Respiratory system examination 41
20. Drug administration via a nebuliser 50
27. Male genitalia examination 69
31. History of ‘funny turns’ 78
32. Cranial nerve examination 81
33. Motor system of the upper limbs examination 86
34. Sensory system of the upper limbs examination 89
35. Motor system of the lower limbs examination 91
36. Sensory system of the lower limbs examination 95
37. Gait, co-ordination, and cerebellar function examination 97
39. General psychiatric history 103
40. Mental state examination 106
44. Suicide risk assessment 118
46. Eating disorders history 123
48. Assessing capacity (the Mental Capacity Act) 127
49. Common law and the Mental Health Act 130
VI. OPHTHALMOLOGY, ENT AND DERMATOLOGY
51. Vision and the eye examination (including fundoscopy) 136
52. Hearing and the ear examination 140
53. Smell and the nose examination 145
54. Lump in the neck and thyroid examination 147
55. Dermatological history 151
56. Dermatological examination 153
57. Advice on sun protection 156
VII. PAEDIATRICS AND GERIATRICS
59. Developmental assessment 159
61. The six-week surveillance review 166
62. Paediatric examination: cardiovascular system 169
63. Paediatric examination: respiratory system 173
64. Paediatric examination: abdomen 176
65. Paediatric examination: gait and neurological function 179
66. Infant and child Basic Life Support 181
67. Child immunisation programme 184
69. Geriatric physical examination 188
VIII. OBSTETRICS, GYNAECOLOGY, AND SEXUAL HEALTH
72. Gynaecological history 195
73. Gynaecological (bimanual) examination 198
74. Speculum examination and liquid based cytology test 200
80. Combined oral contraceptive pill (COCP) explanation 217
81. Pessaries and suppositories explanation 220
IX. ORTHOPAEDICS AND RHEUMATOLOGY
82. Rheumatological history 222
83. The GALS screening examination 226
84. Hand and wrist examination 229
90. Ankle and foot examination 245
X. EMERGENCY MEDICINE AND ANAESTHESIOLOGY
91. Adult Basic Life Support 247
93. In-hospital resuscitation 252
95. The primary and secondary surveys 258
96. Management of medical emergencies 260
– acute myocardial infarction 261
– massive pulmonary embolism 262
97. Bag-valve mask (BVM/’Ambu bag’) ventilation 266
98. Laryngeal mask airway (LMA) insertion 267
99. Pre-operative assessment 269
100. Syringe driver operation 273
101. Patient-Controlled Analgesia (PCA) explanation 275
102. Epidural analgesia explanation 276
104. Blood glucose measurement 280
105. Urine sample testing/urinalysis 282
106. Blood test interpretation 284
107. Arterial blood gas (ABG) sampling 290
108. ECG recording and interpretation 294
109. Chest X-ray interpretation 306
110. Abdominal X-ray interpretation 311
XII. PRESCRIBING AND ADMINISTRATIVE SKILLS
111. Requesting investigations 315
112. Drug and controlled drug prescription 318
115. Death certificate completion 326
117. Imaging tests explanation 333
118. Endoscopies explanation 337
121. The angry patient or relative 341
122. The anxious or upset patient or relative 342
123. Cross-cultural communication 343
124. Discharge planning and negotiation 344
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