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Authors: Nicholas J. Talley,Simon O’connor

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Examination Medicine: A Guide to Physician Training

BOOK: Examination Medicine: A Guide to Physician Training
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examination MEDICINE

A guide to physician training


Nicholas J. Talley, MB BS (Hons), MMedSc (Clin Epi) (Newc), MD (NSW), PhD (Syd), FRACP, FAFPHM, FRCP (Lond), FRCP (Edin), FACP

Deputy Vice-Chancellor Research (Acting); Pro Vice-Chancellor and Dean (Health and Medicine), and Professor, University of Newcastle, Callaghan, NSW, Australia

Senior Staff Specialist, John Hunter Hospital, Newcastle, Australia

Simon O’Connor, FRACP, DDU, FCSANZ

Cardiologist, The Canberra Hospital; Clinical Senior Lecturer, Australian National, University Medical School, Canberra, ACT, Australia

Table of Contents

Cover image

Title page



Preface to the 7th edition

Authors’ statement




Chapter 1: Basic physician training

Basic Training Units
Trainees’ Committee
Medical Education Officers
Examinations Unit

Chapter 2: The written examination

The examination format
Approaching multiple-choice questions
Preparation for the written examination

Chapter 3: The clinical examination

The examination format
The mini-CEX
Preparation for the clinical examination

Chapter 4: The long case

The history-taking and physical examination
The presentation
The long case rationale
Types of long case

Chapter 5: The cardiovascular long case

Ischaemic heart disease
Infective endocarditis
Congestive cardiac failure
Diastolic heart failure (heart failure with preserved ejection fraction)
Heart transplantation
Cardiac arrhythmias

Chapter 6: The respiratory long case

Lung carcinoma
Chronic obstructive pulmonary disease
Sleep apnoea
Interstitial lung disease, including idiopathic pulmonary fibrosis
Pulmonary hypertension
Cystic fibrosis
Lung transplantation

Chapter 7: The gastrointestinal long case

Peptic ulceration
Malabsorption and chronic diarrhoea
Inflammatory bowel disease
Colon cancer
Chronic liver disease
Liver transplantation

Chapter 8: The haematological long case

Haemolytic anaemia
Idiopathic myelofibrosis
Essential thrombocythaemia
Chronic myeloid leukaemia (CML)
Multiple myeloma (myeloma)
Bone marrow (haematopoietic cell) transplantation

Chapter 9: The rheumatological long case

Rheumatoid arthritis
Systemic lupus erythematosus
Systemic vasculitis
Antiphospholipid antibody syndrome
Systemic sclerosis (scleroderma)

Chapter 10: The endocrine long case

Osteoporosis (and osteomalacia)
Paget’s disease of the bone (osteitis deformans)
Types 1 and 2 diabetes mellitus

Chapter 11: The renal long case

Chronic kidney disease (chronic renal failure)
Renal transplantation

Chapter 12: The neurological long case

Multiple sclerosis
Myasthenia gravis
Guillain-Barré syndrome
Transient ischaemic attacks and ‘funny turns’

Chapter 13: The infectious disease long case

Pyrexia of unknown origin

Chapter 14: Think like a physician, think like an examiner – an approach with long case examples

Chapter 15: The short case

Chapter 16: Common short cases

The cardiovascular system
The cardiovascular examination
Notes on valve diseases
The hypertensive examination
Marfan’s syndrome
The respiratory system
The respiratory examination
Chest X-ray films
The gastrointestinal system
The abdominal examination
The haematological system
The haemopoietic examination
The endocrine system
The thyroid gland
Cushing’s syndrome
Addison’s disease
Diabetes mellitus
The rheumatological system
The hands
The knees
The feet
The back
The nervous system
Cranial nerves
One-and-a-half syndrome
Horner’s syndrome
Notes on the cranial nerves
Higher centres
Upper limbs
Shoulder girdle examination
Lower limbs
Notes on the neurological examination of the limbs
Notes on spinal cord lesions
Dystrophia myotonica
Parkinson’s disease



Churchill Livingstone is an imprint of Elsevier

Elsevier Australia. ACN 001 002 357 (a division of Reed International Books Australia Pty Ltd)

Tower 1, 475 Victoria Avenue, Chatswood, NSW 2067

This edition © 2014 Elsevier Australia.

6th edn 2010; 5th edn 2006; 4th edn 2001; 3rd edn 1996; 2nd edn 1991; 1st edn 1986

eISBN: 9780729581684

This publication is copyright. Except as expressly provided in the Copyright Act 1968 and the Copyright Amendment (Digital Agenda) Act 2000, no part of this publication may be reproduced, stored in any retrieval system or transmitted by any means (including electronic, mechanical, microcopying, photocopying, recording or otherwise) without prior written permission from the publisher.

Every attempt has been made to trace and acknowledge copyright, but in some cases this may not have been possible. The publisher apologises for any accidental infringement and would welcome any information to redress the situation.

This publication has been carefully reviewed and checked to ensure that the content is as accurate and current as possible at time of publication. We would recommend, however, that the reader verify any procedures, treatments, drug dosages or legal content described in this book. Neither the author, the contributors, nor the publisher assume any liability for injury and/or damage to persons or property arising from any error in or omission from this publication.

National Library of Australia Cataloguing-in-Publication Data


Talley, Nicholas Joseph, author.
Examination medicine : a guide to physician training / Nicholas J. Talley, Simon O’Connor.
7th edition.
9780729541688 (paperback)
Includes index.
Physical diagnosis.
Medical history taking.
O’Connor, Simon, author.

Content Strategist: Larissa Norrie

Senior Content Development Specialist: Neli Bryant

Senior Project Manager: Natalie Hamad

Edited by Margaret Trudgeon

Proofread by Forsyth Publishing Services

Picture research and permissions by Jonas Creative

Cover and internal design by Stan Lamond

Index by Robert Swanson

Typeset by Midland Typesetters

Printed by China Translation & Printing Services Ltd


The business of becoming a specialist physician requires many years of intensive training, but beyond that there is, in Australia and New Zealand, a major hurdle – the examination set by the Royal Australasian College of Physicians. This hurdle is encountered at the end of basic training, and must be passed before the trainee can begin advanced training.

The College of Physicians exam was undoubtedly the most stressful event that many of us practising physicians had experienced to that point in our lives. Those of us who sat the exam in the years before 1986 (in my case, 1964), when the first edition of
Examination Medicine
appeared, had no authoritative guidance about how best to approach this ordeal. And an ordeal it certainly was. We can still vividly remember details of the written exam and of our long and short cases. We remember well which examiners were terrifying and which were of a gentler disposition.

Examination Medicine
immediately found its niche. It was unapologetically written to help those about to sit the College exam. It was not a textbook of internal medicine, systematically trawling through every known disease of every system. Rather, the knowledge it imparted was particularly directed towards helping the examinee give their best possible performance in the clinical exam, where clinical skills were to be tested, in addition to medical knowledge. One chapter was devoted to requirements for basic training and one to a discussion of the written exam, but the remainder of the book was focused on the approach to the clinical examination, with many examples of the long and short cases likely to be encountered.

BOOK: Examination Medicine: A Guide to Physician Training
12.72Mb size Format: txt, pdf, ePub

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