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Arch Dis Child. 2007 June; 92(6): 563.
PMCID: PMC2066154

Tutorials in paediatric differential diagnosis, 2nd edition

Reviewed by Gemma Louise Duffy

Edited by David J Field, David Isaacs, John Stroobant. Published by Elsevier, 2005, pp 288, £29.99 (paperback). ISBN 0-443-07100-4

As medical curricula nationally have moved towards a problem based approach, it is encouraging to find textbooks that mirror this way of learning. When a child presents in a paediatric assessment ward, they will complain of “vomiting” or “noisy breathing” not “problems with the gastrointestinal tract” or “problems with the respiratory system”. This book is divided into chapters with titles that describe the child sitting in front of you, “The floppy baby” and “The crying baby”. This simple labelling allows quick access to the appropriate topic to allow you to work through the problem.

This book does not cover everything you need to know in paediatrics, nor does it propose to. Its remit is described as “designed to provide doctors involved in childcare with a logical approach to interpreting symptoms”.

Divided into 40 short, accessible chapters, it covers almost all presentations you are likely to see during acute medical paediatric receiving. Within each chapter there is a brief introduction before a description of common diagnoses that should be considered in light of the particular presentation. The chapter is concluded in most instances by a clinical case which keeps the reader interested and grounded in the clinical relevance of the chapter. It is well laid out and easy to read. At times it feels a little too list based, but that is that nature of the book. It fulfils its title well by listing differential diagnoses and providing brief descriptions. This makes the book accessible for use as a quick reference during clinical work. Any further information may be sourced from weightier tomes. It never claims to replace your standard paediatric textbooks but instead directs your use of them.

An alternative use suggested by the authors is to use to topic headings to steer departmental teaching in “tutorials”. I have not put this use into practice, but I think used in this way the book would help to ensure some of the most prevalent presenting complaints in paediatric practice are covered. I do not, on the other hand, feel it is a book useful for candidates preparing for MRCPCH; it is not detailed enough with its basic science information for Part 1 A&B. The information contained I would expect most doctors to have obtained through clinical practice by the time they are sitting the clinical examination.

Overall, I feel this is a good quality publication that fulfils its objectives and presents a wide variety of information in a clear and concise format. I feel it would be most useful to those just starting in acute general paediatrics, in particular, the new breed of FY2s who will need to become familiar with common presentations in a short period of time. With specialty placements changing every 4 months, books that allow easy access to core topics will become increasingly popular. I feel this book could be used as a first reference during clinical work and to assist with practice based learning.learning.

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