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Doody's Review ServiceReviewer: David O. Staats, MD (University of Oklahoma Health Sciences Center)
Description: The work of a single author, this book reviews the physical diagnosis of older persons and is illustrated with superb line drawings instead of photographs.
Purpose: The purpose it to help motivated clinicians become more astute observers of older persons and to enhance bedside clinical examination. The author accomplishes these are worthy objectives handsomely.
Audience: Motivated clinicians of all stripes and all degrees of training can gain much from using this book. The author is an authority in this area and takes a scholarly approach, which is nowhere more in evidence than in his annotations of a carefully selected reading list.
Features: The book opens with three excellent chapters of general principles, the approach to the older patient, and the initial impression, followed by 23 chapters on physical examination by organ system and region that include evaluation of urinary incontinence and skin disease.
Assessment: This excellent scholarly book has much to savor. Included are useful tips on how to diagnose conditions from patterns of shoe wear. Older persons are heterogeneous, and so is the physical diagnosis of them. In some cases, the presence of rales can be ascribed to a variety of etiologies and other means must be used to differentiate among them. In frail older persons whose abdomens are normally quite scaphoid, the impacted abdomen is flat, which to the uninitiated, mimics the appearance of a normal abdomen in a younger adult. Thus, one must experience the subtleties of physical diagnosis in older persons, and this book is a most useful guide in doing so.