| Normal values |
|
xiii | |
| Abbreviations |
|
xv | |
| Contributors |
|
xxiii | |
| Part 1: The Approach To The Patient |
|
|
|
|
2 | (6) |
|
2 Dealing with uncertainty |
|
|
8 | (4) |
|
|
|
12 | (3) |
|
4 The physical examination |
|
|
15 | (3) |
|
5 The psychological examination |
|
|
18 | (4) |
|
|
|
22 | (2) |
|
|
|
24 | (4) |
| Part 2: Assessment Of Symptoms And Presenting Problems |
|
|
|
|
28 | (3) |
|
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|
31 | (6) |
|
|
|
37 | (6) |
|
|
|
43 | (4) |
|
|
|
47 | (4) |
|
13 Chronic breathlessness |
|
|
51 | (5) |
|
|
|
56 | (2) |
|
|
|
58 | (3) |
|
|
|
61 | (2) |
|
|
|
63 | (2) |
|
|
|
65 | (2) |
|
|
|
67 | (3) |
|
|
|
70 | (1) |
|
|
|
71 | (2) |
|
|
|
73 | (2) |
|
|
|
75 | (3) |
|
24 Chronic abdominal pain |
|
|
78 | (3) |
|
|
|
81 | (2) |
|
|
|
83 | (2) |
|
|
|
85 | (2) |
|
|
|
87 | (2) |
|
|
|
89 | (2) |
|
|
|
91 | (2) |
|
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|
93 | (2) |
|
|
|
95 | (3) |
|
|
|
98 | (1) |
|
|
|
99 | (2) |
|
35 Splenomegaly and other disorders of the spleen |
|
|
101 | (2) |
|
|
|
103 | (1) |
|
|
|
104 | (2) |
|
|
|
106 | (3) |
|
39 Transient loss of consciousness |
|
|
109 | (3) |
|
|
|
112 | (4) |
|
41 Delirium (acute confusional state) |
|
|
116 | (4) |
|
|
|
120 | (3) |
|
43 Difficulty speaking (including dysphasia and dysarthria) |
|
|
123 | (3) |
|
|
|
126 | (5) |
|
45 Tremor and other abnormal movements |
|
|
131 | (3) |
|
|
|
134 | (3) |
|
|
|
137 | (5) |
|
|
|
142 | (4) |
|
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|
146 | (4) |
|
|
|
150 | (3) |
|
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|
153 | (2) |
|
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|
155 | (2) |
|
|
|
157 | (2) |
|
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|
159 | (2) |
|
|
|
161 | (2) |
|
|
|
163 | (2) |
|
|
|
165 | (2) |
|
|
|
167 | (3) |
|
|
|
170 | (3) |
|
|
|
173 | (2) |
|
|
|
175 | (3) |
|
|
|
178 | (3) |
|
|
|
181 | (2) |
|
|
|
183 | (4) |
|
|
|
187 | (4) |
|
|
|
191 | (2) |
|
|
|
193 | (2) |
|
|
|
195 | (2) |
|
|
|
197 | (3) |
|
|
|
200 | (3) |
|
|
|
203 | (2) |
|
|
|
205 | (4) |
|
|
|
209 | (3) |
|
74 Immobility ('Off legs') |
|
|
212 | (2) |
|
|
|
214 | (2) |
|
|
|
216 | (2) |
|
|
|
218 | (3) |
|
|
|
221 | (3) |
|
|
|
224 | (2) |
|
80 Unintentional weight loss |
|
|
226 | (2) |
|
81 Obesity: differential diagnosis |
|
|
228 | (3) |
|
|
|
231 | (3) |
|
|
|
234 | (5) |
|
|
|
239 | (5) |
| Part 3: Cardiovascular Disorders |
|
|
85 Normal function of the cardiovascular system |
|
|
244 | (4) |
|
86 Risk factors for cardiovascular disease |
|
|
248 | (4) |
|
87 Diagnosis and investigation in suspected heart disease |
|
|
252 | (11) |
|
88 Congenital heart disease in adults |
|
|
263 | (8) |
|
|
|
271 | (4) |
|
90 Acute coronary syndromes |
|
|
275 | (5) |
|
|
|
280 | (3) |
|
|
|
283 | (4) |
|
|
|
287 | (3) |
|
|
|
290 | (2) |
|
|
|
292 | (3) |
|
96 Miscellaneous valvar pathology: Mitral stenosis, pulmonary stenosis, and tricuspid regurgitation |
|
|
295 | (4) |
|
97 Percutaneous coronary intervention |
|
|
299 | (3) |
|
|
|
302 | (4) |
|
99 Circulatory support therapy |
|
|
306 | (2) |
|
100 Pulmonary hypertension |
|
|
308 | (4) |
|
101 Venous thrombosis and pulmonary embolism |
|
|
312 | (6) |
|
|
|
318 | (2) |
|
|
|
320 | (2) |
|
104 Peripheral arterial disease |
|
|
322 | (3) |
|
|
|
325 | (2) |
|
106 Heart muscle disease (cardiomyopathy) |
|
|
327 | (5) |
|
107 Tumours and the heart |
|
|
332 | (3) |
|
|
|
335 | (5) |
|
|
|
340 | (2) |
|
|
|
342 | (3) |
|
|
|
345 | (3) |
|
112 Focal (ectopic) atrial tachycardia |
|
|
348 | (3) |
|
113 Multifocal atrial tachycardia |
|
|
351 | (3) |
|
114 Atrioventricular nodal re-entrant tachycardia |
|
|
354 | (3) |
|
115 Atrioventricular re-entrant tachycardia |
|
|
357 | (4) |
|
|
|
361 | (5) |
|
|
|
366 | (3) |
|
118 Ventricular tachyarrhythmias: Ventricular tachycardia and ventricular fibrillation |
|
|
369 | (10) |
|
|
|
379 | (5) |
|
|
|
384 | (11) |
|
121 Cardiac device therapy |
|
|
395 | (6) |
|
122 Drug-induced cardiovascular disease |
|
|
401 | (2) |
|
123 Psychological management of coronary heart disease |
|
|
403 | (2) |
|
124 Treatment of terminal cardiovascular disease |
|
|
405 | (5) |
| Part 4: Respiratory Disorders |
|
|
125 Normal respiratory function |
|
|
410 | (2) |
|
126 Diagnosis in suspected respiratory disease |
|
|
412 | (3) |
|
127 Investigation in respiratory disease |
|
|
415 | (10) |
|
128 Upper respiratory tract infections, including influenza |
|
|
425 | (2) |
|
|
|
427 | (4) |
|
|
|
431 | (5) |
|
|
|
436 | (3) |
|
|
|
439 | (2) |
|
|
|
441 | (4) |
|
134 Chronic obstructive pulmonary disease |
|
|
445 | (4) |
|
|
|
449 | (5) |
|
136 Obstructive sleep apnoea |
|
|
454 | (2) |
|
|
|
456 | (2) |
|
138 Sarcoidosis and other granulomatous lung disease |
|
|
458 | (2) |
|
139 Interstitial lung disease |
|
|
460 | (4) |
|
|
|
464 | (3) |
|
141 Lung cancer (including management of an isolated lung lesion) |
|
|
467 | (5) |
|
142 Occupational lung disease |
|
|
472 | (3) |
|
143 Pleural infection and malignancy |
|
|
475 | (2) |
|
144 Drug-induced lung disease |
|
|
477 | (3) |
|
145 Psychology in respiratory disease, including dysfunctional breathing |
|
|
480 | (2) |
|
146 Terminal care in respiratory illness |
|
|
482 | (4) |
| Part 5: Intensive Care Medicine |
|
|
|
|
486 | (2) |
|
148 Role of the intensive care unit |
|
|
488 | (2) |
|
149 ICU treatment of respiratory failure |
|
|
490 | (3) |
|
150 ICU treatment of cardiovascular failure |
|
|
493 | (3) |
|
151 ICU treatment of acute kidney injury |
|
|
496 | (2) |
|
152 ICU treatment of sepsis and septic shock |
|
|
498 | (3) |
|
153 Terminal care in the intensive care unit |
|
|
501 | (2) |
|
|
|
503 | (3) |
| Part 6: Disorders Of The Kidney And Urinary Tract, And Electrolyte And Metabolic Disorders |
|
|
155 Normal renal function |
|
|
506 | (3) |
|
156 Diagnosis in suspected renal disease |
|
|
509 | (3) |
|
157 Investigation in renal disease |
|
|
512 | (6) |
|
158 Urinary tract infection |
|
|
518 | (3) |
|
|
|
521 | (6) |
|
160 Interstitial renal disease |
|
|
527 | (2) |
|
|
|
529 | (4) |
|
|
|
533 | (3) |
|
163 Chronic kidney disease |
|
|
536 | (4) |
|
164 Diabetic renal disease |
|
|
540 | (3) |
|
165 Urinary tract obstruction |
|
|
543 | (3) |
|
|
|
546 | (3) |
|
167 Renal and bladder cancer |
|
|
549 | (3) |
|
168 Renal replacement therapy |
|
|
552 | (4) |
|
169 Inherited renal diseases |
|
|
556 | (2) |
|
170 The kidney in systemic disease |
|
|
558 | (3) |
|
171 Renal vascular disease |
|
|
561 | (2) |
|
172 Management of terminal care in renal disease |
|
|
563 | (2) |
|
173 Disorders of plasma potassium |
|
|
565 | (3) |
|
174 Disorders of plasma sodium |
|
|
568 | (2) |
|
175 Disorders of plasma calcium |
|
|
570 | (3) |
|
176 Disorders of plasma phosphate |
|
|
573 | (2) |
|
177 Disorders of plasma magnesium |
|
|
575 | (2) |
|
178 Disorders of acid-base balance |
|
|
577 | (3) |
|
|
|
580 | (2) |
|
180 Aminoacidopathies, urea cycle disorders, and organic acidurias |
|
|
582 | (2) |
|
|
|
584 | (4) |
| Part 7: Diabetes Mellitus And Endocrine Disorders |
|
|
182 Normal function of the endocrine system |
|
|
588 | (5) |
|
183 Diagnosis and investigation in endocrine disorders |
|
|
593 | (3) |
|
|
|
596 | (5) |
|
|
|
601 | (2) |
|
|
|
603 | (7) |
|
187 Primary hyperparathyroidism |
|
|
610 | (2) |
|
|
|
612 | (5) |
|
|
|
617 | (2) |
|
|
|
619 | (2) |
|
|
|
621 | (4) |
|
192 Pituitary disorders: Prolactinomas, acromegaly, and pituitary apoplexy |
|
|
625 | (7) |
| Part 8: Gastrointestinal Disorders |
|
|
193 Normal gastrointestinal function |
|
|
632 | (3) |
|
194 Diagnosis in suspected gastrointestinal disease |
|
|
635 | (2) |
|
195 Investigation in gastrointestinal disease |
|
|
637 | (4) |
|
196 Immunology and genetics in gastrointestinal and hepatic medicine |
|
|
641 | (3) |
|
197 Gastrointestinal infections |
|
|
644 | (4) |
|
198 Benign oesophageal disease |
|
|
648 | (3) |
|
|
|
651 | (2) |
|
|
|
653 | (3) |
|
|
|
656 | (4) |
|
|
|
660 | (3) |
|
203 Inflammatory bowel disease |
|
|
663 | (4) |
|
204 Gastrointestinal tumours |
|
|
667 | (7) |
|
205 Functional gastrointestinal diseases |
|
|
674 | (2) |
|
206 Psychiatry in gastrointestinal medicine |
|
|
676 | (4) |
| Part 9: Disorders Of The Liver |
|
|
207 Normal hepatic function |
|
|
680 | (6) |
|
208 Investigation in liver disease |
|
|
686 | (4) |
|
|
|
690 | (3) |
|
210 Chronic liver failure |
|
|
693 | (4) |
|
211 Alcoholic liver disease |
|
|
697 | (3) |
|
|
|
700 | (9) |
|
|
|
709 | (4) |
|
214 Genetic liver disease |
|
|
713 | (5) |
|
215 Drug-induced liver disease |
|
|
718 | (3) |
|
216 Miscellaneous liver diseases |
|
|
721 | (5) |
|
217 The liver in systemic disease |
|
|
726 | (5) |
|
|
|
731 | (5) |
| Part 10: Neurological Disorders |
|
|
219 Normal neurological function |
|
|
736 | (3) |
|
220 Diagnosis in suspected neurological disease |
|
|
739 | (3) |
|
221 Investigation in neurological disease |
|
|
742 | (10) |
|
222 Demographics of neurological disease |
|
|
752 | (3) |
|
|
|
755 | (5) |
|
224 Neurocutaneous syndromes |
|
|
760 | (2) |
|
225 Congenital neurological disorders |
|
|
762 | (2) |
|
|
|
764 | (3) |
|
|
|
767 | (10) |
|
|
|
777 | (4) |
|
229 Neurological infection |
|
|
781 | (6) |
|
230 Disorders of movement |
|
|
787 | (4) |
|
|
|
791 | (3) |
|
|
|
794 | (2) |
|
|
|
796 | (4) |
|
|
|
800 | (4) |
|
|
|
804 | (3) |
|
236 Vasculitis in neurology |
|
|
807 | (5) |
|
|
|
812 | (3) |
|
238 Non-metastatic neurological manifestations of malignancy |
|
|
815 | (2) |
|
|
|
817 | (4) |
|
240 Drug-induced neurological disease |
|
|
821 | (4) |
|
241 Functional and dissociative disorders in neurology |
|
|
825 | (3) |
|
242 Palliative care in neurological disease |
|
|
828 | (4) |
| Part 11: Disorders Of The Skin |
|
|
|
|
832 | (4) |
|
244 Approach to diagnosing skin disease |
|
|
836 | (3) |
|
245 Investigation in skin disease |
|
|
839 | (3) |
|
246 Skin infection and infestation |
|
|
842 | (3) |
|
|
|
845 | (2) |
|
|
|
847 | (3) |
|
|
|
850 | (3) |
|
|
|
853 | (2) |
|
|
|
855 | (2) |
|
|
|
857 | (3) |
|
|
|
860 | (3) |
|
|
|
863 | (2) |
|
|
|
865 | (3) |
|
|
|
868 | (2) |
|
257 Polymorphic light eruption and actinic prurigo |
|
|
870 | (2) |
|
258 Disorders of pigmentation |
|
|
872 | (2) |
|
|
|
874 | (8) |
|
260 Skin markers of internal medicine |
|
|
882 | (4) |
|
261 Drug-induced skin disease |
|
|
886 | (3) |
|
262 Psychocutaneous medicine |
|
|
889 | (3) |
| Part 12: Disorders Of The Musculoskeletal System |
|
|
263 Normal function of the musculoskeletal system |
|
|
892 | (2) |
|
264 Diagnosis in suspected rheumatological disease |
|
|
894 | (6) |
|
265 Investigation in rheumatological disease |
|
|
900 | (6) |
|
|
|
906 | (4) |
|
|
|
910 | (4) |
|
268 Seronegative spondyloarthropathy |
|
|
914 | (4) |
|
269 Systemic lupus erythematosus |
|
|
918 | (3) |
|
|
|
921 | (4) |
|
271 Infection of joints and bones |
|
|
925 | (2) |
|
|
|
927 | (5) |
|
|
|
932 | (1) |
|
274 Paget's disease of bone |
|
|
933 | (2) |
|
275 Osteoporosis and fragility fracture |
|
|
935 | (3) |
|
276 Genetic bone and joint disease |
|
|
938 | (6) |
| Part 13: Haematological Disorders |
|
|
277 Normal blood function |
|
|
944 | (7) |
|
278 Diagnosis and investigation in haematology |
|
|
951 | (4) |
|
|
|
955 | (3) |
|
|
|
958 | (9) |
|
281 Normal platelet function |
|
|
967 | (3) |
|
|
|
970 | (5) |
|
283 Normal haemostatic function |
|
|
975 | (4) |
|
|
|
979 | (5) |
|
285 Prothrombotic conditions |
|
|
984 | (5) |
|
|
|
989 | (3) |
|
|
|
992 | (3) |
|
|
|
995 | (1) |
|
|
|
996 | (3) |
|
290 Multiple myeloma and related conditions |
|
|
999 | (3) |
|
291 Myeloproliferative disorders |
|
|
1002 | (3) |
|
292 Terminal care in haematological disease |
|
|
1005 | (3) |
| Part 14: Disorders Of The Immune System |
|
|
293 Functions of the immune system |
|
|
1008 | (5) |
|
294 Clinical features and diagnosis of immunological disease |
|
|
1013 | (4) |
|
295 Neutrophil abnormalities |
|
|
1017 | (3) |
|
296 Human immunodeficiency virus infection |
|
|
1020 | (5) |
|
297 Antibody deficiencies |
|
|
1025 | (3) |
|
298 Combined T-and B-cell immunodeficiencies |
|
|
1028 | (3) |
|
299 Complement deficiencies |
|
|
1031 | (3) |
|
300 Hypersensitivity diseases |
|
|
1034 | (4) |
|
301 Immunological support |
|
|
1038 | (2) |
|
302 Immunosuppressive therapy and therapeutic monoclonal antibodies |
|
|
1040 | (4) |
| Part 15: Infectious Diseases |
|
|
303 Defences against infection |
|
|
1044 | (4) |
|
304 Nature and demographics: Epidemiology of infective organisms |
|
|
1048 | (3) |
|
305 Diagnosis in suspected infective disease: The history and examination |
|
|
1051 | (7) |
|
306 Investigation in infection |
|
|
1058 | (3) |
|
307 Treatment of infection |
|
|
1061 | (3) |
|
|
|
1064 | (4) |
|
|
|
1068 | (3) |
|
|
|
1071 | (4) |
|
311 Mycobacterial infection other than tuberculosis |
|
|
1075 | (4) |
|
312 Spirochaetal infection (non-syphilis) |
|
|
1079 | (3) |
|
|
|
1082 | (2) |
|
314 Rickettsia! infection |
|
|
1084 | (2) |
|
|
|
1086 | (5) |
|
316 Protozoal infection: Gut organisms |
|
|
1091 | (3) |
|
317 Protozoal infection: Malaria |
|
|
1094 | (4) |
|
318 Worm infection (including hydatid disease) |
|
|
1098 | (3) |
|
|
|
1101 | (2) |
|
320 Sexually transmitted disease (gonorrhoea) |
|
|
1103 | (3) |
| Part 16: Cancers |
|
|
321 Cancers related to infection |
|
|
1106 | (3) |
|
322 Principles of oncogenesis |
|
|
1109 | (2) |
|
323 Presentations in suspected cancer |
|
|
1111 | (2) |
|
324 Diagnosis and staging of cancer |
|
|
1113 | (2) |
|
|
|
1115 | (3) |
|
|
|
1118 | (4) |
|
|
|
1122 | (4) |
|
328 Ovarian and testicular cancer |
|
|
1126 | (2) |
|
329 Symptom control in cancer |
|
|
1128 | (3) |
|
|
|
1131 | (3) |
| Part 17: Dietary, Lifestyle, And Environmental Factors Affecting Health |
|
|
331 Normal nutritional function |
|
|
1134 | (2) |
|
332 Starvation and malnutrition |
|
|
1136 | (3) |
|
|
|
1139 | (5) |
|
334 Nutritional support in the critically ill |
|
|
1144 | (3) |
|
|
|
1147 | (3) |
|
336 Obesity: epidemiology, prevention and management |
|
|
1150 | (5) |
|
337 Physical activity and its role in disease prevention |
|
|
1155 | (3) |
|
|
|
1158 | (2) |
|
|
|
1160 | (4) |
|
340 Environmental radiation |
|
|
1164 | (2) |
|
|
|
1166 | (2) |
|
342 Non-prescription drugs |
|
|
1168 | (4) |
| Part 18: Prevention Of Disease |
|
|
343 Prevention of cardiovascular disease |
|
|
1172 | (4) |
|
344 Prevention of respiratory disease |
|
|
1176 | (3) |
|
345 Prevention of kidney disease |
|
|
1179 | (2) |
|
346 Prevention of gastrointestinal disease |
|
|
1181 | (2) |
|
347 Prevention of neurological disease |
|
|
1183 | (4) |
|
348 Prevention of cerebrovascular disease |
|
|
1187 | (2) |
|
349 Prevention of infection |
|
|
1189 | (3) |
|
|
|
1192 | (4) |
| Part 19: Screening For Disease |
|
|
351 Screening for cardiovascular disease |
|
|
1196 | (6) |
|
352 Screening for respiratory disease |
|
|
1202 | (3) |
|
353 Screening for kidney disease |
|
|
1205 | (1) |
|
354 Screening for gastrointestinal disease |
|
|
1206 | (3) |
|
355 Screening for neurological disease |
|
|
1209 | (2) |
|
|
|
1211 | (4) |
| Index |
|
1215 | |
