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Education Guides

Browse topical slide sets aimed at instruction of evidence-based medicine (EBM) concepts. Online slideshows are launched in a new HTML window, intended for individual use. PowerPoint downloads are available for group presentations and for printing. Speaker's notes are provided inside each slideshow and download.

How to Use The Rational Clinical Examination Education Guides

Contributors | Usage guidelines

View sample slideshow

A Primer on the Precision and Accuracy of the Clinical Examination

Abdominal Aortic Aneurysm

Abdominal Bruits

Abnormal Central Venous Pressure

Acute Cholecystitis

Airflow Limitation

Appendicitis, Adult

Appendicitis, Child

Cancer, Family History

Cardiac Arrhythmia

Cardiac Tamponade

Carpal Tunnel Syndrome

Compliance and Medication Adherence

Deep Vein Thrombosis

Diabetes, Foot Ulcer

Diabetic Peripheral Neuropathy

Early Pregnancy

Erythema Migrans

Falls, Older Adults

Hearing Impairment

Heart Failure, Congestive

Heart Failure, Left-Sided

Hypovolemia, Adult

Hypovolemia, Child

Irritable Bowel Syndrome

Knee Ligaments and Menisci

Low Back Pain, Disabling

Lumbar Puncture

Malnourishment, Adult

Medical Decision-Making

Meningitis, Adult

Murmur, Diastolic

Murmur, Systolic

Myasthenia Gravis

Myocardial Infarction

Opiates and Abdominal Pain

Otitis Media, Child

Penicillin Allergy

Peripheral Arterial Disease

Pleural Effusion

Pneumonia, Adult, Community-Acquired

Pneumonia, Infant and Child

Pneumonia, Ventilator-Associated

Pulmonary Embolus

Septic Arthritis

Sexual Abuse, Child

Shoulder Instability

Streptococcal Pharyngitis

Stroke, Hemorrhagic

Temporal Arteritis

Thoracic Aortic Dissection

Urinary Incontinence, Women

Urinary Tract Infection, Child

Urinary Tract Infection, Women

Download sample PowerPoint (870 KB)

A Primer on the Precision and Accuracy of the Clinical Examination (905 KB)

Abdominal Aortic Aneurysm (647 KB)

Abdominal Bruits (1.2 MB)

Abnormal Central Venous Pressure (1.7 MB)

Acute Cholecystitis (662 KB)

Airflow Limitation (914 KB)

Alcohol Abuse (777 KB)

Appendicitis, Adult (1.0 MB)

Appendicitis, Child (1.4 MB)

Ascites (1.6 MB)

Breast Cancer (1.8 MB)

Cancer, Family History (732 KB)

Cardiac Arrhythmia (2.3 MB)

Cardiac Tamponade (1.6 MB)

Carotid Bruit (1.4 MB)

Carpal Tunnel Syndrome (1.4 MB)

Clubbing (1.1 MB)

Compliance and Medication Adherence (624 KB)

Death (806 KB)

Deep Vein Thrombosis (991 KB)

Dementia (994 KB)

Depression (830 KB)

Diabetes, Foot Ulcer (1.0 MB)

Diabetic Peripheral Neuropathy (514 KB)

Dyspepsia (1.1 MB)

Early Pregnancy (1.5 MB)

Erythema Migrans (1.7 MB)

Falls, Older Adults (512 KB)

Goiter (1.0 MB)

Hearing Impairment (566 KB)

Heart Failure, Congestive (884 KB)

Heart Failure, Left-Sided (628 KB)

Hepatomegaly (1.2 MB)

Hypertension (908 KB)

Hypovolemia, Adult (969 KB)

Hypovolemia, Child (1.1 MB)

Influenza (1.1 MB)

Irritable Bowel Syndrome (1.1 MB)

Knee Ligaments and Menisci (11 MB)

Low Back Pain (1.2 MB)

Low Back Pain, Disabling (1.5 MB)

Lumbar Puncture (1.4 MB)

Malnourishment, Adult (907 KB)

Medical Decision-Making (866 KB)

Melanoma (1.8 MB)

Meningitis, Adult (944 KB)

Menopause (1.1 MB)

Migraine (1.1 MB)

Murmur, Diastolic (1.3 MB)

Murmur, Systolic (1.9 MB)

Myasthenia Gravis (8.9 MB)

Myocardial Infarction (1.0 MB)

Opiates and Abdominal Pain (1.4 MB)

Osteoporosis (1.6 MB)

Otitis Media, Child (968 KB)

Paracentesis (1.1 MB)

Parkinsonism (1.5 MB)

Penicillin Allergy (876 KB)

Peripheral Arterial Disease (2.1 MB)

Pleural Effusion (1.4 MB)

Pneumonia, Adult, Community-Acquired (1.1 MB)

Pneumonia, Infant and Child (1.4 MB)

Pneumonia, Ventilator-Associated (1.2 MB)

Pulmonary Embolus (975 KB)

Septic Arthritis (1 MB)

Sexual Abuse, Child (1.1 MB)

Shoulder Instability (2.7 MB)

Sinusitis (2.2 MB)

Splenomegaly (2.1 MB)

Streptococcal Pharyngitis (927 KB)

Stroke (971 KB)

Stroke, Hemorrhagic (1.2 MB)

Temporal Arteritis (938 KB)

Thoracic Aortic Dissection (900 KB)

Urinary Incontinence, Women (3.6 MB)

Urinary Tract Infection, Child (1.1 MB)

Urinary Tract Infection, Women (1.5 MB)

Vaginitis (1.4 MB)

Vertigo (3.3 MB)

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis

The Rational Clinical Examination:

Evidence-Based Clinical Diagnosis®

David L. Simel and Drummond Rennie

Contributors | Foreword | Preface | Acknowledgments | Copyright

- A Primer on the Precision and Accuracy of the Clinical Examination

- TABLE: Levels of Evidence

- TABLE: Pretest Probabilities and Likelihood Ratios for Clinical Findings

Show all sections | Hide all sections

Abdominal Aortic Aneurysm

· Make the Diagnosis: Abdominal Aortic Aneurysm

· Original Article: Does This Patient Have Abdominal Aortic Aneurysm?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Abdominal Bruits

· Make the Diagnosis: Abdominal Bruits

· Original Article: Is Listening for Abdominal Bruits Useful in the Evaluation of Hypertension?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Abnormal Central Venous Pressure

· Make the Diagnosis: Abnormal Central Venous Pressure

· Original Article: Does This Patient Have Abnormal Central Venous Pressure?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Acute Cholecystitis

· Make the Diagnosis: Acute Cholecystitis

· Original Article: Does This Patient Have Acute Cholecystitis?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Airflow Limitation

· Make the Diagnosis: Airflow Limitation

· Original Article: Does the Clinical Examination Predict Airflow Limitation?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Alcohol Abuse

· Make the Diagnosis: Alcohol Abuse

· Original Article: Does This Patient Have an Alcohol Problem?

Online Only :

· Evidence To Support the Update

· Compiled Clinical Scenarios

Appendicitis, Adult

· Make the Diagnosis: Appendicitis, Adult

· Original Article: Does This Adult Patient Have Appendicitis?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Appendicitis, Child

Online Only :

· Make the Diagnosis: Appendicitis, Child

· Original Article: Does This Child Have Appendicitis?

Ascites

· Make the Diagnosis: Ascites

· Original Article: Does This Patient Have Ascites? How to Divine Fluid in the Abdomen

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Breast Cancer

· Make the Diagnosis: Breast Cancer

· Original Article: Does This Patient Have Breast Cancer? The Screening Clinical Breast Examination: Should It Be Done? How?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Cancer, Family History

· Make the Diagnosis: Cancer, Family History

· Original Article: Does This Patient Have a Family History of Cancer?

Online Only :

· Compiled Clinical Scenarios

Cardiac Arrhythmia

Online Only :

· Make the Diagnosis: Does This Patient With Palpitations Have a Cardiac Arrhythmia?

· Original Article: Does This Patient With Palpitations Have a Cardiac Arrhythmia?

Cardiac Tamponade

Online Only :

· Make the Diagnosis: Cardiac Tamponade

· Original Article: Does This Patient With a Pericardial Effusion Have Cardiac Tamponade?

Carotid Bruit

· Make the Diagnosis: Carotid Bruit

· Original Article: Does This Patient Have a Clinically Important Carotid Bruit?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Carpal Tunnel Syndrome

· Make the Diagnosis: Carpal Tunnel Syndrome

· Original Article: Does This Patient Have Carpal Tunnel Syndrome?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Chronic Wound Infection

Online Only :

· Make the Diagnosis: Infection of Chronic Wounds

· Original Article: Does This Patient Have an Infection of a Chronic Wound?

Clubbing

· Make the Diagnosis: Clubbing

· Original Article: Does This Patient Have Clubbing?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Compliance and Medication Adherence

· Make the Diagnosis: Compliance and Medication Adherence

· Original Article: Is This Patient Taking the Treatment as Prescribed?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Death

· Make The Diagnosis: Death

· Original Article: Is This Patient Dead, Vegetative, or Severely Neurologically Impaired? Assessing Outcome for Comatose Survivors of Cardiac Arrest

Online Only :

· Compiled Clinical Scenarios

Deep Vein Thrombosis

· Make the Diagnosis: Deep Vein Thrombosis

· Original Article: Does This Patient Have Deep Vein Thrombosis? Part 1

· Original Article: Does This Patient Have Deep Vein Thrombosis? Part 2

Online Only :

· Compiled Clinical Scenarios

Delirium

Online Only :

· Make the Diagnosis: Delirium

· Original Article: Does This Patient Have Delirium? Value of Bedside Instruments

Dementia

Online Only :

· Make the Diagnosis: Dementia

· Original Article: Does This Patient Have Dementia?

Depression

· Make the Diagnosis: Depression

· Original Article: Is This Patient Clinically Depressed?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Diabetes, Foot Ulcer

Online Only :

· Make the Diagnosis: Diabetes, Foot Ulcer

· Original Article: Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?

Diabetic Peripheral Neuropathy

Online Only :

· Make the Diagnosis: Diabetic Peripheral Neuropathy

· Original Article: Does This Patient With Diabetes Have Large-Fiber Peripheral Neuropathy?

Dyspepsia

Online Only :

· Make the Diagnosis: Does This Patient With Epigastric Discomfort Have Organic or Functional Dyspepsia?

· Original Article: Can the Clinical History Distinguish Between Organic and Functional Dyspepsia?

Early Pregnancy

· Make the Diagnosis: Early Pregnancy

· Original Article: Is This Patient Pregnant?

Online Only :

· Evidence To Support The Update

· Compiled Clinical Scenarios

Erythema Migrans

Online Only :

· Make the Diagnosis: Erythema Migrans

· Original Article: Does This Patient Have Erythema Migrans?

Falls, Older Adults

Online Only :

· Make the Diagnosis: Will this Patient Fall?

· Original Article: Will this Patient Fall?

Floaters and Flashes

Online Only :

· Make the Diagnosis: Does This Patient With Floaters and/or Flashes Have a Retinal Tear?

· Original Article: Acute-Onset Floaters and Flashes: Is This Patient at Risk for Retinal Detachment?

Goiter

· Make the Diagnosis: Goiter

· Original Article: Does This Patient Have a Goiter?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Health Literacy

Online Only :

· Make the Diagnosis: Health Literacy

· Original Article: Can This Patient Read and Understand Written Health Information? Health Literacy

Hearing Impairment

Online Only :

· Make the Diagnosis: Hearing Impairment

· Original Article: Does This Patient Have Hearing Impairment?

Heart Failure

· Make the Diagnosis: Heart Failure

· Original Article: Can the Clinical Examination Diagnose Left-Sided Heart Failure in Adults?

· Original Article: Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Hepatomegaly

· Make the Diagnosis: Hepatomegaly

· Original Article: Does This Patient Have Hepatomegaly?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Hypertension

· Make the Diagnosis: Hypertension

· Original Article: Does This Patient Have Hypertension?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Hypovolemia, Adult

· Make the Diagnosis: Hypovolemia, Adult

· Original Article: Is This Adult Patient Hypovolemic?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Hypovolemia, Child

· Make the Diagnosis: Hypovolemia, Child

· Original Article: Is This Child Dehydrated?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Influenza

· Make the Diagnosis: Influenza

· Original Article: Does This Patient Have Influenza?

Online Only :

· Compiled Clinical Scenarios

Irritable Bowel Syndrome

Online Only :

· Make the Diagnosis: Irritable Bowel Syndrome

· Original Article: Will the History and Physical Examination Help Establish That Irritable Bowel Syndrome Is Causing This Patient’s Lower Gastrointestinal Tract Symptoms?

Knee Ligaments and Menisci

· Make the Diagnosis: Knee Ligaments and Menisci

· Original Article: Does This Patient Have a Torn Meniscus or Ligament of the Knee?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Liver Disease and Cirrhosis NEW

Online Only :

· Make the Diagnosis: Cirrhosis

· Original Article: Does This Patient With Liver Disease Have Cirrhosis?

Low Back Pain

· Make the Diagnosis: Low Back Pain

· Original Article: What Can the Medical History and Physical Examination Tell Us About Low Back Pain?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Low Back Pain, Disabling

Online Only :

· Make the Diagnosis: Will This Patient Develop Disabling Back Pain?

· Original Article: Will This Patient Develop Persistent Disabling Low Back Pain?

Low Back Pain, Lumbar Spinal Stenosis

Online Only :

· Make the Diagnosis: Low Back Pain, Lumbar Spinal Stenosis

· Original Article: Does This Older Adult With Lower Extremity Pain Have the Clinical Syndrome of Lumbar Spinal Stenosis?

Lumbar Puncture

Online Only :

· Make the Diagnosis: Lumbar Puncture to Diagnose Bacterial Meningitis

· Original Article: How Do I Perform a Lumbar Puncture and Analyze the Results to Diagnose Bacterial Meningitis?

Malaria

Online Only :

· Make the Diagnosis: Malaria

· Original Article: Does This Patient Have Malaria?

Malnourishment, Adult

· Make the Diagnosis: Malnourishment, Adult

· Original Article: Is This Adult Patient Malnourished?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Medical Decision-Making Capacity

Online Only :

· Make the Diagnosis: Medical Decision-Making Capacity

· Original Article: Does This Patient Have Medical Decision Making Capacity?

Melanoma

· Make the Diagnosis: Melanoma

· Original Article: Does This Patient Have a Mole or a Melanoma?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Meningitis, Adult

· Make the Diagnosis: Meningitis, Adult

· Original Article: Does This Adult Patient Have Acute Meningitis?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Menopause

· Make the Diagnosis: Menopause

· Original Article: Is This Woman Perimenopausal?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Migraine

Online Only :

· Make the Diagnosis: Does This Patient With Headaches Have a Migraine or Need Neuroimaging?

· Original Article: Does This Patient With Headache Have a Migraine or Need Neuroimaging?

Murmur, Diastolic

· Make the Diagnosis: Murmur, Diastolic

· Original Article: Does This Patient Have Aortic Regurgitation?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Murmur, Systolic

· Make the Diagnosis: Murmur, Systolic

· Original Article: Does This Patient Have an Abnormal Systolic Murmur?

Online Only :

· Evidence To Support The Update

· Compiled Clinical Scenarios

Myasthenia Gravis

· Make the Diagnosis: Myasthenia Gravis

· Original Article: Does This Patient Have Myasthenia Gravis?

Online Only :

· Compiled Clinical Scenarios

Myocardial Infarction

· Make the Diagnosis: Myocardial Infarction

· Original Article: Is This Patient Having a Myocardial Infarction?

Online Only :

· Evidence To Support The Update

· Compiled Clinical Scenarios

Opiates and Abdominal Pain

Online Only :

· Make the Diagnosis: Opiates and Abdominal Pain

· Original Article: Do Opiates Affect the Clinical Evaluation of Patients With Acute Abdominal Pain?

Osteoporosis

· Make the Diagnosis: Osteoporosis

· Original Article: Does This Patient Have Osteoporosis?

Online Only :

· Evidence To Support The Update

· Compiled Clinical Scenarios

Otitis Media, Child

· Make the Diagnosis: Otitis Media, Child

· Original Article: Does This Child Have Acute Otitis Media?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Paracentesis

Online Only :

· Make the Diagnosis: Paracentesis

· Original Article: Does This Patient Have Bacterial Peritonitis or Portal Hypertension? How Do I Perform a Paracentesis and Analyze the Results?

Parkinsonism

· Make the Diagnosis: Parkinsonism

· Original Article: Does This Patient Have Parkinson Disease?

Online Only :

· Compiled Clinical Scenarios

Penicillin Allergy

· Make The Diagnosis: Penicillin Allergy

· Original Article: Is This Patient Allergic to Penicillin?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Peripheral Arterial Disease

Online Only :

· Make the Diagnosis: Peripheral Arterial Disease

· Original Article: Does the Clinical Examination Predict Lower Extremity Peripheral Arterial Disease?

Pertussis, Adult or Adolescent

Online Only :

· Make the Diagnosis: Pertussis, Adult or Adolescent

· Original Article: Does This Coughing Adolescent or Adult Patient Have Pertussis?

Pleural Effusion

Online Only :

· Make the Diagnosis: Pleural Effusion

· Original Article: Does This Patient Have a Pleural Effusion?

Pneumonia, Adult, Community-Acquired

· Make the Diagnosis: Pneumonia, Adult, Community-Acquired

· Original Article: Does This Adult Patient Have Community-Acquired Pneumonia?

Online Only :

· Evidence To Support The Update

· Compiled Clinical Scenarios

Pneumonia, Infant and Child

· Make the Diagnosis: Pneumonia, Infant and Child

· Original Article: Does This Infant Have Pneumonia?

Online Only :

· Evidence To Support The Update

· Compiled Clinical Scenarios

Pneumonia, Ventilator-Associated

Online Only :

· Make the Diagnosis: Pneumonia, Ventilator-Associated

· Original Article: Does This Patient Have Ventilator-Associated Pneumonia

Pulmonary Embolus

· Make the Diagnosis: Pulmonary Embolus

· Original Article: Does This Patient Have Pulmonary Embolism?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Septic Arthritis

Online Only :

· Make the Diagnosis: Septic Arthritis

· Original Article: Does This Patient Have Septic Arthritis?

Sexual Abuse, Child

Online Only :

· Make the Diagnosis: Sexual Abuse, Child

· Original Article: Has This Prepubertal Girl Been Sexually Abused?

Shoulder Instability

· Make the Diagnosis: Shoulder Instability

· Original Article: Does This Patient Have an Instability of the Shoulder or a Labrum Lesion?

Online Only :

· Compiled Clinical Scenarios

Sinusitis

· Make the Diagnosis: Sinusitis

· Original Article: Does This Patient Have Sinusitis?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Splenomegaly

· Make the Diagnosis: Splenomegaly

· Original Article: Does This Patient Have Splenomegaly?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Streptococcal Pharyngitis

· Make the Diagnosis: Streptococcal Pharyngitis

· Original Article: Does This Patient Have Strep Throat?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Stroke

· Make the Diagnosis: Stroke

· Original Article: Is This Patient Having a Stroke?

Stroke, Hemorrhagic

Online Only :

· Make the Diagnosis: Does This Patient Have a Hemorrhagic Stroke?

· Original Article: Does This Patient Have a Hemorrhagic Stroke?

Temporal Arteritis

· Make the Diagnosis: Temporal Arteritis

· Original Article: Does This Patient Have Temporal Arteritis?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Thoracic Aortic Dissection

· Make the Diagnosis: Thoracic Aortic Dissection

· Original Article: Does This Patient Have an Acute Thoracic Aortic Dissection?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Urinary Incontinence, Women

Online Only :

· Make the Diagnosis: Urinary Incontinence, Women

· Original Article: What Type of Urinary Incontinence Does This Woman Have?

Urinary Tract Infection, Child

Online Only :

· Make the Diagnosis: Urinary Tract Infection, Child

· Original Article: Does This Child Have a Urinary Tract Infection?

Urinary Tract Infection, Women

· Make the Diagnosis: Urinary Tract Infection, Women

· Original Article: Does This Woman Have an Acute Uncomplicated Urinary Tract Infection?

Online Only :

· Compiled Clinical Scenarios

Vaginitis

· Make the Diagnosis: Vaginitis

· Original Article: What Is Causing This Patient's Vaginal Symptoms?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

Vertigo

· Make the Diagnosis: Vertigo

· Original Article: Does This Dizzy Patient Have a Serious Form of Vertigo?

Online Only :

· Evidence to Support the Update

· Compiled Clinical Scenarios

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