Clinician’s Guide to Laboratory Medicine: Pocket (2009) by Samir P. Desai MD is an excellent handbook about the use laboratory studies in clinical medicine.
Almost every laboratory abnormality contains an extensive differential diagnosis, along with an intelligent and efficient approach to further workup and diagnosis. It contains dozens of useful charts, algorithms and tables. The hematology and nephrology sections are especially well-developed. This makes sense as these subspecialties are very heavily reliant upon laboratory investigations. (In contrast, the neurology, endocrinology and pulmonary sections are much smaller, while, unfortunately, an infectious diseases section is absent altogether.)
I particularly like the author’s approach to anemia. While most authors approach anemia by dividing it into microcytic, normocytic, and macrocytic, Dr. Desai begins his approach with determining the reticulocyte production index. This makes a lot sense for several reasons:
- reticulocytosis is an extremely important and rather specific hematological finding.
- reticulocyte count is not included in the complete blood count and so is easy to forget; and finally,
- an increased reticulocyte count can artificially “change” a microcytic anemia to a normocytic anemia, etc.
As such, it is extremely important to think about the reticulocyte count early in the evaluation of anemia. So why not think about it first?!
The book is small and can fit into one’s shirt pocket or lab coat pocket. Unfortunately, the font is tiny so you’ll need good eyes or good glasses to be able to make use of the book.
I recommend this book very highly to anyone who is interested in clinical medicine, from medical students to fully-trained clinicians.
Special thanks to the Philip A. Hoover MD Library at York Hospital for stocking this excellent book. It is one of the best medical books of all time.
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