THE CLINICAL METHOD

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Talib’s Manual of Internal
Medicine and Clinical Practice
Dr. Hafiz Haseeb Talib, MBBS (AMC), RMP

First Edition — 2025

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CONTENTS

Chapter 1 — The Clinical Method __________________________________________________________________________ 7
INTRODUCTION ________________________________________________________________________________________ 7
⭐ 1. INITIAL APPROACH (THE FIRST 10 SECONDS) ____________________________________________________________ 7
⭐ 2. HISTORY TAKING (70–80% OF DIAGNOSIS) ______________________________________________________________ 8
⭐ SOCRATES — For Any Pain Complaint ____________________________________________________________________ 8
⭐ 3. EXAMINATION — GENERAL + VITALS ___________________________________________________________________ 9
⭐ VITAL SIGNS (Correct Ranges) ___________________________________________________________________________ 9
⭐ 4. SYSTEMIC EXAMINATION (EXAM FORMAT)_____________________________________________________________10
D. NEUROLOGICAL EXAMINATION ________________________________________________________________________11
⭐ 5. DIFFERENTIAL DIAGNOSIS — __________________________________________________________________________13
⭐ 6. INVESTIGATIONS — WHAT TO ORDER FIRST _____________________________________________________________13
⭐ 7. DIAGRAMS _________________________________________________________________________________________13
⭐ 8. CLINICAL SCENARIOS _______________________________________________________________________________14
⭐ 9. SUMMARY TABLE — CLINICAL METHOD _______________________________________________________________21
✅ Chapter 2 — Physical Examination and Bedside Skills ___________________________________________________23
INTRODUCTION _______________________________________________________________________________________23
⭐ 1. PRINCIPLES OF GOOD EXAMINATION _________________________________________________________________23
⭐ 2. GENERAL EXAMINATION _____________________________________________________________________________23
🔶 2.1 PALLOR (Conjunctiva, palms, nail beds) _____________________________________________________________23
🔶 2.2 JAUNDICE (Sclera first) _____________________________________________________________________________24
🔶 2.3 CYANOSIS _________________________________________________________________________________________25
🔶 2.4 CLUBBING _________________________________________________________________________________________26
🔶 2.5 EDEMA ____________________________________________________________________________________________28
⭐ 3. VITAL SIGNS WITH DIFFERENTIALS ______________________________________________________________________28
🔶 3.1 TACHYCARDIA (>100/min) __________________________________________________________________________29
⭐ Mnemonic — “FASTSPADA” ____________________________________________________________________________29
⭐ Memory Phrase_________________________________________________________________________________________29
🔶 3.2 BRADYCARDIA (<60/min) ___________________________________________________________________________30
⭐ Mnemonic — “MEDICH SVE” ___________________________________________________________________________30
⭐ Memory Phrase_________________________________________________________________________________________30
⭐ 4. SYSTEMIC EXAM DIFFERENTIALS _______________________________________________________________________31
🔶 4.1 CVS DIFFERENTIALS _________________________________________________________________________________31