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  Textbook of physical diagnosis : history and examination. 8th ed.

  Mark H. Swartz.

  Summary: Derive the maximum diagnostic information from interviewing and examining patients with Textbook of Physical Diagnosis. Employing a compassionate, humanistic approach, Dr. Swartz explores how cultural differences can influence communication, diet, family relationships, and health practices and beliefs, and demonstrates that your interpersonal awareness is just as essential in physical diagnosis as your level of technical skill. This medical reference book features numerous high-quality color images, an easy-to-use design, and detailed descriptions of exam techniq.
  
  Contents:
  The interviewer's questions
  The patient's responses
  Understanding complementary and alternative medicine
  Putting the history together
  Deconstructing racism and bias in clinical medicine
  The physical examination
  Assessment of nutritional status
  The skin
  The head and neck
  The eye
  The ear and nose
  The oral cavity and pharynx
  The chest
  The heart
  The peripheral vascular system
  The breast
  The abdomen
  Male genitalia and hernias
  Female genitalia
  The musculoskeletal system
  The nervous system
  Putting the examination together
  The pregnant patient
  The pediatric patient
  The geriatric patient
  The acutely ill or injured patient
  Precision, accuracy, and critical thinking in clincal assessment
  The clinical record
  The focused history and physical examination
  Clinical ethics and professionalism.

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• Article

  Immunoglobulin systems of human tonsils. II. Patients with chronic tonsillitis or tonsillar hyperplasia: quantification of Ig-producing cells, tonsillar morphometry and serum Ig concentrations.

  Surjan L, Brandtzaeg P, Berdal P.

  Clin Exp Immunol. 1978 Mar;31(3):382-90.

  Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT) or idiopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal palatine tonsils. Serum concentrations of immunoglobulins, particularly IgG, were increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes was reduced per tonsillar tissue unit. The density of such cells was decreased in the germinal centres of the lymphoid follicles, in the extrafollicular areas and in the reticular parts of the crypt epithelium. However, only small changes in immunocyte class ratios were observed, excepting a significantly raised proportion of IgD-producing cells. The immunohistochemical results indicated a defect in the tonsillar immunological function associated with disease, perhaps as a result of inadequate stimulatory signals for local maturation of B-cell clones. An influence of low age on this result in the HT and ITH groups could not be excluded. In the RT group there was a significant negative correlation between the tonsillar density of IgA-producing cells and the rate of synthesis of serum IgA. This may indicate that compensatory mechanisms are reflected in inversely related levels of local and systemic IgA synthesis.

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  PubMed