Kumar and Clark's Clinical Medicine

Höfundar: David Randall, John Booth, Kate Wiles (Útgáfa: 11)
Kumar and Clark's Clinical Medicine

Kaup valmöguleikar

The go-to textbook for medical students Designed to be as easy to understand as it is comprehensive, Kumar & Clark's Clinical Medicine is the definitive guide for medical students and doctors in training. Revised and updated to reflect the structure of modern medical care, an all-new Acute Medicine chapter focuses on the initial, problem-based assessment of the unwell patient. Chapters on Medical Specialties explore the diagnosis and management of patients with chronic disease across the spectrum of systems-based disorders.

Sections on The Practice of Medicine, Medicine and the world and Medicine Throughout Life explore medicine in its wider context, addressing the health needs of the population as well as specific patient groups. This book has been the must-have text for medical students and doctors in training for over 35 years. The 11th edition has been fully updated and restructured to suit the needs of a contemporary audience.

A unified chapter format makes the book easy to read and navigateComprehensive content includes clinical skills, basic medical sciences and individual conditionsSuccinct notes on clinical emergencies, differential diagnosis and practical proceduresFully revised and updated throughoutAdditional online videos and self-assessment questions to test knowledge retention and supplement learningNew chapters include: acute medicinediagnostic and interventional radiologyperioperative medicine and anaesthesiastroke medicineliaison psychiatryobesity medicineyoung adult medicinesex and gender in medicineRepresentation of diverse populations including dermatological disease in different skin tonesTwo new editors.

Nánar um bókina

Útgefandi
Elsevier Limited (UK)
ISBN
9780443126758
Print ISBN
9780443125942
Format
ePub
Útgáfa
11
Höfundar
David Randall, John Booth, Kate Wiles
Tungumál
English
Útgefið
2025-07-02
Prent takmörkun á líftíma
10

Kaflar

  • Instructions for online access
  • Title of Book
  • Cover image
  • Title page
  • Table of Contents
  • Copyright
  • Video Contents
  • Foreword to the Eleventh Edition
  • Preface to the Eleventh Edition
  • HOW TO USE THIS BOOK
  • E-Book extras
  • Prescribing
  • Units of measurement
  • List of Contributors
  • International Advisory Board
  • Acknowledgments for the Eleventh Edition
  • Part 1. The Practice of Medicine
  • 1. The art of being a doctor
  • The clinical consultation
  • The initial interaction
  • Forming a rapport
  • Information-gathering
  • The golden minute
  • A meeting of two experts
  • The structure of history-taking
  • The presenting symptom
  • History of the presenting symptom
  • Medical history
  • Drug history
  • Family history
  • Social history
  • Physical examination
  • Investigation
  • Interpretation of test results
  • When not to investigate
  • Diagnostic reasoning
  • Models of diagnosis
  • Clinical intuition
  • Bias and error
  • Levels of diagnostic depth
  • The role of watchful waiting
  • Diagnostic criteria
  • Overdiagnosis: too much medicine
  • Uncertainty
  • Communicating a diagnosis
  • Inequalities in medicine
  • Race and ethnicity
  • Sex and gender
  • People living with disabilities
  • Health inequality and intersectionality
  • Artificial intelligence and medicine
  • 2. Clinical communication
  • Patient-centred care
  • What is clinical communication?
  • Clinical communication is an evidence-based skill
  • Clinical communication affects care outcomes
  • Clinical communication education is effective
  • Key features of effective communication
  • What is effective clinical communication?
  • Responsive
  • Time efficient
  • Patient-centred
  • Language
  • Learning clinical communication
  • Initiating a consultation
  • Ending a consultation
  • Gathering information
  • Sharing information
  • Discussing uncertainty and risk
  • Shared decision-making
  • Breaking bad news
  • Other difficult conversations
  • Remote consulting
  • Communication with colleagues
  • 3. Medical ethics
  • Ethical principles of medicine
  • Duties
  • Consequences
  • Values
  • Frameworks and tools
  • Procedural ethics
  • Regulatory ethics
  • Aspirational ethics
  • Moral injury and the ethics of self-care
  • Professional guidance and codes of practice
  • Ethics of inequality
  • Principles of equality, diversity, and inclusivity
  • Legal and ethical issues in medical practice
  • Respect for autonomy: capacity and consent
  • Capacity
  • Informed consent
  • Consent in educational settings
  • Advance decisions
  • Advance statements
  • Lasting power of attorney
  • Best interests of patients who lack capacity
  • Provision or cessation of life-sustaining treatment
  • Assisted dying
  • Mental health and consent
  • Consent and children
  • Confidentiality
  • Respecting confidentiality in practice
  • When confidentiality must or may be breached
  • Professional competence and mistakes
  • Standards and the law
  • Conscientious objection
  • Clinical negligence
  • 4. Evidence-based practice
  • Background
  • The need for EBP
  • Barriers to EBP
  • Knowledge barriers and the use of clinical guidelines
  • Other factors limiting the implementation of EBP
  • A framework for applying evidence to clinical problems
  • Asking answerable questions
  • Searching for the evidence
  • Primary sources of evidence
  • Secondary sources of evidence
  • How to conduct a search
  • Appraising the evidence
  • The hierarchy of evidence
  • Systematic reviews and meta-analyses
  • Interventional studies
  • Problems with the ‘hierarchy of evidence’
  • Combined approaches
  • Critical appraisal
  • Question 1: Are the results of the study valid?
  • Question 2: What are the results?
  • Question 3: Will the results help?
  • Understanding statistical results
  • Descriptive statistics
  • Inferential statistics
  • Confidence intervals
  • Hypothesis tests and p-values
  • Statistical significance
  • Worked examples
  • Numeric outcomes: differences between means
  • Dichotomous (binary) outcomes
  • Odds and the odds ratio
  • Risk and the risk ratio
  • Absolute risk reduction
  • About odds ratios, risk ratios, and absolute risk reduction
  • Number needed to treat
  • Hypothesis tests for dichotomous outcomes
  • Kaplan-Meier plot
  • Cox regression and the hazard ratio
  • Publication bias
  • Summary and outlook
  • Applying the evidence
  • Challenges of implementing evidence
  • Trial design
  • Barriers and facilitators to change
  • Improving the uptake of evidence
  • Section 1: asking answerable questions and searching for the evidence
  • Section 2: critical appraisal
  • Section 3: interpreting odds ratios, confidence intervals, and p-values
  • Paper 1
  • 5. Human genetics
  • Clinical skills
  • Taking a genetic family history
  • Drawing a pedigree
  • Background
  • Gene editing
  • Clinical genetics
  • Approach to the patient with a suspected genetic disease
  • Ethical considerations
  • Testing for genetic disease
  • Interpreting a genetic test report
  • The cellular basis of genetics
  • DNA and the genetic code
  • Human chromosomes
  • DNA transcription
  • Control of gene expression
  • Protein synthesis and secretion
  • Genetics and the cell
  • Review of cellular genetics
  • Genetic disorders
  • Chromosomal disorders
  • Point mutations, insertions, and deletions
  • Prenatal diagnosis of congenital anomalies
  • Patterns of inheritance of single-gene diseases
  • Complex traits: multifactorial and polygenic inheritance
  • Techniques for studying the genetic code
  • Polymerase chain reaction
  • Sanger sequencing
  • Next-generation sequencing
  • Transcriptomics
  • Epigenetic techniques
  • Genome databases
  • Research techniques
  • Genomic medicine
  • Gene therapy
  • Mitochondrial replacement therapy
  • Stem cell therapy
  • Pre-implantation genetic diagnosis
  • The genetic basis of cancer
  • Inherited cancer syndromes
  • Oncogenes
  • Tumour suppressor genes
  • Genetic diagnostics for cancer
  • Targeted treatments for cancer
  • Precision (or personalized) medicine
  • 6. Immunity
  • Introducing the tissues, cells, and molecules of the immune system
  • Cells involved in immune responses: origin and function
  • The immune system
  • Cytokines
  • Chemokines
  • Innate immune system
  • Complement
  • Neutrophils
  • Eosinophils
  • Mast cells and basophils
  • Monocytes and macrophages
  • Dendritic cells
  • Innate lymphoid cells
  • Adaptive immune system
  • Antigen receptors on T and B lymphocytes
  • T lymphocyte development and activation
  • Natural killer cells
  • Cell migration
  • HLA molecules and antigen presentation
  • The human major histocompatibility complex
  • Antigen presentation
  • The immune system in concert
  • Acute inflammation: events and symptoms
  • Chronic inflammation: events and symptoms
  • Laboratory investigations of the immune system
  • Disorders of immunodeficiency
  • Secondary (acquired) versus primary immunodeficiency
  • Clinical features of immunodeficiency
  • Primary immunodeficiency
  • Disorders of exaggerated immune response
  • Allergic disease (immediate hypersensitivity)
  • Autoimmune disease
  • Mechanisms of tissue damage in autoimmune disease
  • Common autoimmune diseases
  • Organ rejection in clinical transplantation
  • Immune-based therapies
  • Monoclonal antibody therapy (targeted therapy)
  • Chimeric antigen receptor T-cell therapy
  • Immunosuppressive drugs
  • 7. Therapeutics and prescribing
  • Background
  • Why do patients need drugs?
  • Therapeutic choice
  • The dose
  • Pharmacokinetics
  • Pharmacodynamics
  • Therapeutics in special populations
  • Pregnancy
  • Breast-feeding
  • Old age
  • Kidney disease
  • Liver disease
  • Prescribing
  • Act of prescribing
  • Electronic prescribing
  • Calculation skills
  • Ethical issues relating to therapeutics and prescribing
  • Medication review
  • Monitoring drug therapy
  • Adverse drug reactions
  • Classification
  • Diagnosis
  • Management
  • Drug interactions
  • Information sources
  • 8. Radiology
  • Background
  • Plain radiography/X-rays
  • Chest radiography (chest X-ray)
  • Normal CXR
  • Pulmonary oedema
  • Pleural effusion
  • Pneumothorax
  • Nasogastric tube
  • Free gas
  • Pulmonary fibrosis
  • Round opacities
  • Abdominal radiography (abdominal X-ray)
  • Skeletal radiography
  • Mammography
  • Fluoroscopy
  • Barium swallow
  • Voiding micturating cystourethrogram
  • Common indications:
  • Patient preparation:
  • Procedure:
  • Ultrasonography
  • The kidney
  • Thyroid gland
  • Pelvic organs: uterus and ovary
  • Venous ultrasound
  • Hepatobiliary disease
  • Testis
  • Special ultrasound procedures
  • Computed tomography
  • The brain
  • Thorax
  • Abdomen and pelvis
  • CT angiography
  • CT urography
  • Special CT procedures
  • Magnetic resonance imaging
  • The brain
  • The abdomen and pelvis
  • Magnetic resonance cholangiopancreatography
  • Liver MRI
  • Pelvic malignancies
  • Bones, soft tissues, and joints
  • Nuclear medicine and positron emission tomography
  • Brain—DaTScan (dopamine transporter scan)
  • Thorax—ventilation/perfusion (V/Q) scan
  • Bone scan
  • Renal function
  • Endocrine nuclear imaging
  • Positron emission tomography and computed tomography
  • Red and white cell scan
  • Gastric emptying
  • Interventional radiology
  • Surgical drainage and needle biopsies
  • Vascular procedures
  • Abdominal IR procedures
  • Oesophageal stenting
  • Colonic stenting (Fig. 8.72)
  • Radiologically inserted gastrostomy (Fig. 8.73)
  • Transjugular intrahepatic portosystemic shunt
  • Nephrostomy (Fig. 8.74)
  • Biliary drainage
  • Interventional oncology
  • Radiofrequency ablation: liver metastasis
  • Cutting edge and future technology
  • Part 2. Medicine and the World
  • 9. Public health
  • Background
  • Public health and global health
  • Key concepts in public health
  • Epidemiology and causality
  • Health needs assessments
  • Life expectancy and quality of life
  • Health inequalities
  • Deprivation
  • Politics and advocacy
  • Smoking bans
  • Improved nutritional content of food
  • Pillars of public health
  • Health improvement
  • Wider determinants of health
  • Behaviour change
  • Health protection
  • Control
  • Monitoring (surveillance)
  • Prevention
  • Healthcare public health
  • Screening
  • Antimicrobial resistance
  • Health economics
  • Service delivery
  • 10. Global and planetary health
  • BACKGROUND
  • Overview
  • The global scale of the problem
  • Global health challenges
  • The global burden of disease
  • Infectious diseases and pandemics
  • Maternal and child health
  • Maternal health
  • Child health
  • Vaccination
  • Child labour
  • Mental health
  • Surgical challenges
  • Accidents
  • Trauma
  • Surgery
  • Oral disease
  • Social determinants of health
  • Poverty and food security
  • Education
  • Water and sanitation
  • Environmental degradation and pollution
  • Climate change
  • Human migration
  • Conflict and catastrophe
  • Global and planetary health governance
  • Organizations
  • Sustainable Development Goals
  • Economics and politics in global and planetary health
  • Human rights and the value of engagement in global health
  • The healthcare workforce and international recruitment ethics
  • Medical electives
  • Part 3. Acute and Emergency Medicine
  • 11. Acute medicine
  • Background
  • Patient flow through AIM
  • Patient-centred care and admission avoidance
  • Ambulatory care and SDEC
  • Virtual wards and ‘hospital at home’
  • Multidisciplinary care model and approaches to effective patient flow
  • The multidisciplinary care model
  • Approaches to effective patient flow
  • In-reach to ED: enhancing acute patient care
  • The role of the AIM clinician
  • Clinical skills
  • The initial patient assessment: the ‘medical clerking’
  • Gathering patient information
  • Formulating an admission plan
  • Additional considerations
  • Discharge planning
  • Risk assessments for common acute medical conditions
  • Ambulatory score
  • Glasgow Admission Prediction score
  • Communicating decisions and referrals
  • SBAR
  • Handover processes
  • Passports for complex patients
  • Discharge planning
  • Commencing early discharge planning
  • Multidisciplinary discharge planning
  • Comprehensive discharge summaries
  • Liaison with acute care MDT
  • Acute frailty in reach
  • Chest physiotherapy for respiratory conditions
  • Drugs and alcohol liaison service
  • Specialist teams for asthma and diabetes
  • Critical care outreach
  • Procedures
  • Point-of-care ultrasound
  • Advanced respiratory support
  • Core clinical presentations in AIM
  • Cardiac arrest
  • Basic life support
  • Advanced cardiac life support
  • Post resuscitation—targeted temperature management
  • Therapeutic procedures used for peri-arrest rhythms
  • Ventricular tachyarrhythmias
  • Anaphylaxis
  • Management
  • Chest pain
  • Clinical assessment
  • Investigations
  • Management
  • Palpitations
  • Differential diagnosis
  • Clinical assessment
  • Investigations
  • Management
  • Atrial fibrillation
  • Atrial flutter
  • Paroxysmal supraventricular tachycardia
  • Breathlessness
  • Clinical assessment
  • Investigations
  • Acute severe asthma
  • Exacerbation of chronic obstructive pulmonary disease (COPD)
  • Acute heart failure
  • Acute viral illness
  • Pneumonia
  • Complications of pneumonia (Box 11.30)
  • Haemoptysis
  • Massive haemoptysis
  • Common causes of haemoptysis
  • Clinical assessment
  • Investigations
  • Management of massive haemoptysis
  • Nausea and vomiting
  • Clinical assessment
  • Investigations
  • Management
  • Diarrhoea
  • Clinical assessment
  • Investigations
  • Management
  • Inflammatory bowel disease flare
  • Haematemesis and melaena
  • Clinical assessment
  • Investigations
  • Risk assessment
  • Management
  • Abdominal swelling
  • Ascites
  • Investigations
  • Management
  • Abnormal blood results
  • Acute kidney injury
  • Definition and staging
  • Causes of AKI
  • Clinical assessment
  • Investigations
  • Management of AKI
  • General measures
  • Sepsis
  • Fluid and electrolyte balance
  • Nutrition
  • Pre-renal AKI
  • Postrenal AKI
  • Intrarenal parenchymal AKI
  • Renal replacement therapy—haemodialysis and haemofiltration
  • Management of the recovery phase of AKI
  • Hyperkalaemia
  • Management
  • Follow-up
  • The unconscious patient
  • Disturbed consciousness: definitions
  • Mechanisms and causes of coma
  • Immediate assessment and management of the unconscious patient
  • General and neurological examination (see Fig. 11.28)
  • Coma ‘look-alikes’
  • Diagnosis and investigations in coma
  • General management
  • Dizziness and blackouts
  • Clinical assessment
  • Investigations
  • Syncope or fainting
  • Other types of syncope
  • Other conditions to consider
  • Vertigo (see also Chapter 21)
  • Headache
  • Clinical assessment
  • Investigations
  • Migraine
  • Tension-type headache
  • Intracranial bleeds
  • Subdural and extradural bleeding
  • Cortical venous thrombosis and dural venous sinus thrombosis
  • Meningitis
  • Viral encephalitis
  • Seizures
  • Seizure types
  • Clinical assessment
  • Management
  • Delirium
  • Clinical assessment
  • Investigations
  • Management
  • Alcohol withdrawal syndrome
  • Functional neurological disorder
  • Polysymptomatology
  • Swollen joint
  • Clinical assessment
  • Investigations
  • Septic arthritis
  • The unwell diabetic patient
  • Diabetic ketoacidosis
  • Sodium-glucose co-transporter-2 (SGLT2) inhibitor-related DKA
  • Hyperosmolar hyperglycaemic state
  • Metformin associated lactic acidosis
  • Hyperglycaemia
  • Hypoglycaemia
  • Deep vein thrombosis and pulmonary embolism
  • Definitions
  • Epidemiology and risk factors
  • Clinical assessment
  • Investigations
  • Diagnosis of DVT and PE
  • Upper limb DVT
  • Management
  • The unwell cancer patient
  • Neutropaenic sepsis
  • Pulmonary embolus
  • Spinal cord compression
  • The cauda equina syndrome
  • Superior vena cava obstruction
  • Raised intracranial pressure
  • Tumour lysis syndrome
  • Acute hypercalcaemia
  • Malignant bile duct obstruction
  • Rash
  • Clinical assessment
  • Investigations
  • Management
  • Acute skin infections
  • Necrotizing fasciitis
  • Gas gangrene
  • Toxin-mediated skin disease
  • Erythroderma and loss of skin function (‘skin failure’)
  • Severe cutaneous adverse drug reactions
  • Drug reaction with eosinophilia and systemic symptoms/drug hypersensitivity syndrome
  • 12. Sepsis and the treatment of bacterial infection
  • Clinical skills
  • History
  • Management of sepsis
  • Examination
  • BACKGROUND
  • Pathophysiology
  • Organ dysfunction
  • Consensus definition (Sepsis-3)
  • Septic shock
  • Recognition of sepsis
  • At-risk groups
  • In-hospital surveillance
  • Origins of sepsis
  • Clinical features
  • Sepsis in special situations
  • Returning travellers
  • People who inject drugs
  • Neutropenic patients
  • Paralysed patients
  • Management of sepsis
  • Surviving Sepsis Campaign guidelines
  • Supporting a failing circulation: fluid resuscitation
  • Treating the underlying infection: antimicrobials and source control
  • Useful diagnostic samples and laboratory processing
  • Source control
  • Antimicrobial stewardship
  • UK-based targets
  • Considerations before starting empirical antibiotics
  • Antimicrobial decision-making at 72 hours
  • Outpatient parenteral antimicrobial treatment
  • Conditions suitable for OPAT services
  • Delivery of OPAT services
  • Monitoring patients in OPAT services
  • Assessment of allergy risk
  • Antibiotic chemoprophylaxis
  • Antibiotic therapies
  • Antibiotics commonly used in the treatment of sepsis
  • Beta-lactams (penicillins, cephalosporins, monobactams) and carbapenems
  • Quinolones
  • Aminoglycosides
  • Glycopeptides
  • Lipopeptides
  • Oxazolidinones
  • Tetracyclines
  • Macrolides
  • Polymyxins (polymyxin B, colistimethate sodium [polymyxin E])
  • Sodium fusidate
  • Sulphonamides and trimethoprim
  • Nitroimidazoles
  • Other antibiotics
  • Treatment of infection caused by multidrug-resistant organisms
  • Meticillin-resistant Staphylococcus aureus
  • Vancomycin-resistant enterococci
  • Carbapenem-resistant Pseudomonas
  • Extended-spectrum β-lactamase-producing Enterobacteriaceae
  • Carbapenem-resistant Enterobacteriaceae
  • 13. Critical care medicine
  • background
  • Clinical approach to the critically ill patient
  • Recognition and diagnosis of critical illness
  • General aspects of managing the critically ill
  • Intensive skilled nursing care
  • Discharge from the ICU/HDU
  • Applied cardiorespiratory physiology
  • Oxygen delivery and consumption
  • Cardiac output
  • Cardiovascular assessment and monitoring of critically ill patients
  • Less invasive techniques for assessing cardiac function and guiding volume replacement
  • Disturbances of acid–base balance
  • Respiratory acidosis
  • Respiratory alkalosis
  • Metabolic acidosis
  • Metabolic alkalosis
  • Shock, sepsis, and acute disturbances of haemodynamic function
  • Aetiology of shock
  • Pathophysiology
  • Clinical features of shock and sepsis
  • Management of shock and sepsis
  • Respiratory failure
  • Classification and aetiology
  • Clinical features
  • Investigations
  • Monitoring
  • Management
  • Acute respiratory distress syndrome
  • Definition and aetiology
  • Pathogenesis and pathophysiology
  • Clinical features
  • Management
  • Prognosis
  • COVID-19
  • Acute kidney injury
  • Neurocritical care
  • Physiology
  • Clinical features and investigations
  • Monitoring
  • Management
  • Outcomes
  • Withholding and withdrawing treatment
  • Death by neurological criteria
  • Preconditions
  • 14. Anaesthesia and perioperative medicine
  • CLINICAL SKILLS
  • Background
  • Pathophysiology
  • Preoperative care
  • Emergency versus elective surgery
  • Consent
  • Shared decision-making
  • Risk assessment
  • Scoring systems and prediction models
  • Functional capacity assessments
  • Serum biomarkers
  • Frailty
  • Anaesthetic assessment and perioperative clinics
  • Airway assessment
  • Specific common diseases in the perioperative patient
  • Diabetes mellitus
  • Hypertension
  • Anaemia
  • Ischaemic heart disease
  • Chronic obstructive pulmonary disease (COPD)
  • Optimization and prehabilitation
  • Fasting and nutrition
  • Intraoperative care
  • Types of anaesthesia
  • General anaesthesia
  • Neuraxial anaesthesia
  • Regional anaesthesia
  • Anaesthetic drugs
  • Volatiles—anaesthetic gases
  • Propofol
  • Opioids
  • Muscle relaxants
  • Local anaesthetics
  • Additional drugs
  • Antiemetics
  • Non-opioid analgesia
  • Emergency drugs
  • Intraoperative fluids
  • Airway management
  • The anaesthetic machine
  • Theatre safety and human factors
  • Postoperative care
  • Location of postoperative care
  • Important and common complications after surgery
  • Bleeding
  • Venous thromboembolism
  • Pneumonia/postoperative pulmonary complications
  • Pain
  • Delirium and perioperative neurocognitive disorders
  • Myocardial infarction and myocardial injury
  • Acute kidney injury
  • Direct complications of surgery
  • Other morbidity and mortality
  • Enhanced recovery after surgery and day-case surgery
  • Orthogeriatrics
  • Perioperative fluid balance
  • Special populations
  • Emergency laparotomy
  • Hip fracture
  • Cancer
  • Obstetrics
  • Trauma
  • 15. Toxicology
  • clinical skills
  • History
  • Examination
  • Risk assessment
  • Resources
  • Background
  • Approach to the poisoned patient
  • Investigations
  • ECG
  • Radiology
  • Principles of management of poisoning
  • Care of the unconscious patient
  • Cardiovascular support
  • Other problems
  • Body ‘packers’ and body ‘stuffers’
  • Management
  • Specific management of the poisoned patient
  • Antidotes
  • Gut decontamination
  • Increasing poison elimination
  • Specific poisons
  • The top ten
  • Paracetamol (acetaminophen)
  • Clinical features
  • Management
  • Non-steroidal anti-inflammatory drugs
  • Clinical features and management
  • Opiates and opioids
  • Management
  • Antidepressants: tricyclics and selective serotonin reuptake inhibitors
  • Clinical features
  • Management
  • Benzodiazepines
  • Clinical features
  • Management
  • Stimulants
  • Clinical features
  • Management
  • Ethanol
  • Clinical features
  • Management
  • Neuroleptics and atypical neuroleptics
  • Clinical features
  • Management
  • Cannabis (marijuana) and synthetic cannabinoids
  • Clinical features
  • Management
  • Anticonvulsants
  • Management
  • Other drugs of importance in poisoning
  • Antidiabetic drugs
  • Clinical features
  • Management
  • Antimalarials
  • Management
  • Beta-adrenoceptor–blocking drugs
  • Management
  • Calcium-channel blockers
  • Clinical features
  • Management
  • Digoxin
  • Clinical features
  • Management
  • Iron salts
  • Clinical features
  • Management
  • Lithium salts
  • Clinical features
  • Management
  • Nitrous oxide
  • Clinical features
  • Management
  • Salicylates
  • Clinical features
  • Management
  • Poisoning with chemicals
  • Arsenic
  • Clinical features
  • Management
  • Carbamate insecticides
  • Clinical features
  • Management
  • Carbon monoxide
  • Clinical features
  • Management
  • Copper sulphate
  • Clinical features
  • Management
  • Corrosive agents
  • Cyanide
  • Clinical features
  • Management
  • Ethylene glycol
  • Clinical features
  • Management
  • Household products
  • Clinical features
  • Hydrofluoric acid and hydrogen fluoride
  • Clinical features
  • Management
  • Lead
  • Clinical features
  • Management
  • Mercury
  • Clinical features
  • Management
  • Methanol
  • Clinical features
  • Management
  • Nerve agents
  • Clinical features
  • Management
  • Organophosphorus insecticides
  • Clinical features
  • Management
  • Phosphides
  • Clinical features
  • Management
  • Poisons in the natural world
  • Venomous snakes
  • Clinical features
  • Management
  • Poisons in the natural world
  • Marine animals
  • Amnesic shellfish (domoic acid) poisoning
  • Clinical features and management
  • Diarrhoeic shellfish (okadaic) poisoning
  • Clinical features and management
  • Neurotoxic shellfish (brevetoxin) poisoning
  • Clinical features and management
  • Paralytic shellfish (saxitoxin) poisoning
  • Clinical features and management
  • Ciguatera fish poisoning
  • Clinical features and management
  • Scombroid fish poisoning
  • Clinical features and management
  • Stings from marine animals
  • Jellyfish stings
  • Clinical features and management
  • Venomous animals
  • Insect stings and bites
  • Scorpions
  • Clinical features and management
  • Spiders
  • Clinical features and management
  • Venomous snakes
  • Clinical features
  • Management
  • Investigations
  • Supportive treatment and treatment of complications
  • Prevention
  • Plants
  • Atropa belladonna
  • Cicuta species
  • Conium maculatum
  • Datura stramonium
  • Digitalis purpurea, Nerium oleander, Thevetia peruviana (yellow oleander)
  • Mushrooms
  • Cytotoxic mushrooms
  • Clinical features and management
  • Gyromitrin poisoning
  • Clinical features and management
  • Hallucinogenic mushroom poisoning
  • Clinical features and management
  • Isoxazole poisoning
  • Clinical features and management
  • Neurotoxic mushroom poisoning
  • Clinical features and management
  • Orellanin poisoning
  • Clinical features and management
  • 16. Environmental medicine
  • CLINICAL SKILLS
  • History
  • Examination
  • Aviation and space
  • Fitness to fly
  • Specific considerations for air travel
  • High altitude
  • Physiology
  • Acclimatization
  • Accent profiles
  • Altitude illness
  • Clinical features
  • Acute mountain sickness
  • Acute high-altitude cerebral oedema
  • Acute high-altitude pulmonary oedema
  • Cold environments
  • Physiology
  • Hypothermia
  • Urban
  • Austere environments
  • Peripheral cold injury
  • Non-freezing cold injury
  • Freezing cold injury
  • Clinical features
  • Management
  • Surgery
  • Hot environments
  • Physiology
  • Heat acclimatization
  • Heat illness
  • Prickly heat rash (miliaria rubra)
  • Heat cramps
  • Heat syncope
  • Heat exhaustion
  • Management
  • Heat stroke
  • Prevention
  • Water environment
  • Immersion
  • Drowning
  • Diving
  • Decompression illness
  • Treatment
  • Barotrauma
  • Arterial gas embolism
  • Gas problems
  • Recompression therapy
  • The physical world
  • Ionizing radiation
  • Physics and physiology
  • Contamination
  • Internal exposure
  • External exposure
  • Acute radiation sickness
  • Haematopoietic syndrome
  • Late effects of radiation exposure
  • Lightning strike
  • Management
  • Electric shock
  • Part 4. Medical Specialties
  • 17. Cardiology
  • Clinical skills
  • Examination
  • ECG interpretation
  • Anatomy, physiology, and embryology of the heart
  • Conduction system of the heart
  • Starling’s law of the heart
  • Nerve supply of the myocardium
  • Cardiac cycle
  • Coronary circulation
  • Blood vessel control and functions of the vascular endothelium
  • Clinical approach to the patient with heart disease
  • Clinical features of heart disease
  • Central chest pain
  • Dyspnoea
  • Palpitations
  • Syncope
  • Fatigue
  • Peripheral oedema
  • Examination of the cardiovascular system
  • General examination
  • Arterial pulse
  • Blood pressure
  • Jugular venous pressure
  • Precordium
  • Cardiac investigations
  • Blood tests
  • Chest radiograph
  • Electrocardiography
  • Ambulatory monitoring of heart rhythm
  • Implantable loop recording
  • Cardiac data from patient devices
  • Tilt testing
  • Carotid sinus massage
  • Echocardiography
  • Nuclear imaging
  • Cardiac computed tomography
  • Cardiovascular magnetic resonance
  • Positron emission tomography
  • Cardiac catheterization
  • Therapeutic procedures
  • Cardiac arrhythmias
  • Sinus node function
  • Sinus arrhythmia
  • Sinus bradycardia
  • Sinus tachycardia
  • Mechanisms of arrhythmia production
  • Bradycardias and heart block
  • Bradycardia
  • Heart block
  • Tachycardias
  • Supraventricular tachycardias
  • Atrioventricular junctional tachycardias
  • Atrial tachyarrhythmias
  • Ventricular tachyarrhythmias
  • Brugada’s syndrome
  • Management
  • Long QT syndrome
  • Clinical features
  • Management
  • Short QT syndrome
  • Normal heart ventricular tachycardia
  • Non-sustained ventricular tachycardia
  • Ventricular premature beats (ectopics)
  • Long-term management of cardiac tachyarrhythmias
  • Heart failure
  • Pathophysiology
  • Clinical syndromes of heart failure
  • Management of heart failure
  • Coronary artery disease
  • Pathophysiology of coronary atherosclerosis
  • Risk factors for coronary artery disease
  • Diagnosis
  • Cardiovascular risk assessment for primary and secondary prevention of cardiovascular disease
  • Angina
  • Epidemiology
  • Diagnosis
  • Examination
  • Investigations
  • Management of stable angina
  • Acute coronary syndromes
  • Pathophysiology
  • Diagnosis
  • Clinical features
  • Investigations
  • NSTEMI and unstable angina
  • Investigations and management
  • ST-elevation myocardial infarction
  • Pathophysiology
  • Clinical features
  • Investigations
  • Management
  • Valvular heart disease
  • Mitral valve
  • Mitral stenosis
  • Aortic valve
  • Aortic stenosis
  • Pathophysiology
  • Clinical features
  • Investigations
  • Aortic regurgitation
  • Tricuspid valve
  • Tricuspid stenosis
  • Pathophysiology
  • Clinical features
  • Investigations
  • Management
  • Tricuspid regurgitation
  • Pulmonary valve
  • Pulmonary stenosis
  • Clinical features
  • Investigations
  • Management
  • Pulmonary regurgitation
  • Prosthetic valves
  • Mechanical versus tissue valves
  • Complications
  • Interruption of anticoagulant therapy
  • Pregnancy and prosthetic heart valves
  • Infective endocarditis
  • Aetiology
  • Clinical features
  • Diagnosis
  • Investigations
  • Management
  • Prevention
  • Congenital heart disease
  • Fetal circulation
  • Adult congenital heart disease
  • Ventricular septal defect
  • Clinical features
  • Investigations and treatment
  • Atrial septal defect
  • Clinical features
  • Investigations and treatment
  • Patent ductus arteriosus
  • Clinical features
  • Investigations and treatment
  • Coarctation of the aorta
  • Clinical features
  • Investigations and treatment
  • Tetralogy of Fallot
  • Transposition of the great arteries
  • Marfan’s syndrome
  • Diagnosis
  • Management
  • Pulmonary heart disease
  • Pulmonary hypertension
  • Myocardial and endocardial disease
  • Cardiac tumours
  • Myocardial disease
  • Pericardial disease
  • Peripheral vascular disease
  • Peripheral venous disease
  • 18. Hypertension
  • Background
  • Aetiology and pathophysiology
  • Primary hypertension
  • Lifestyle-related issues
  • Diet
  • Lack of exercise
  • Drugs
  • Secondary hypertension
  • Hypertension in pregnancy
  • Clinical approach to the patient with hypertension
  • History
  • Examination and investigations
  • Measurement of blood pressure
  • Office/clinic measurement
  • Home measurement
  • Ambulatory measurement
  • Phenotypes of hypertension
  • Isolated systolic hypertension
  • Orthostatic hypotension
  • Variable blood pressure
  • Hypertensive target organ damage
  • Eyes
  • Heart
  • Kidney
  • Thresholds and targets in hypertension
  • Treatment threshold
  • Treatment target
  • Treatment
  • Population interventions
  • Lifestyle changes
  • Drug treatment
  • Adherence to treatment
  • Choice of therapy
  • Referral to specialist care
  • Renal sympathetic denervation
  • Management of cardiovascular risk
  • Managing blood pressure in hospital
  • Blood pressure on the wards
  • Hypertensive emergencies
  • Blood pressure control in special populations
  • 19. Lipid and metabolic disorders
  • BACKGROUND
  • Approach to the patient
  • History
  • Examination
  • Investigations
  • Physiology
  • Chylomicrons
  • Very-low-density lipoprotein particles
  • Intermediate-density lipoprotein particles
  • Low-density lipoprotein particles
  • High-density lipoprotein particles
  • Measurement of serum lipids
  • Plasma lipids and cardiovascular risk
  • Screening
  • Hyperlipidaemia
  • Secondary hyperlipidaemia
  • Primary hyperlipidaemia
  • Disorders of VLDL and chylomicrons: moderate and severe hypertriglyceridaemia
  • Lipoprotein lipase pathway deficiencies
  • Disorders of LDL: hypercholesterolaemia alone
  • Heterozygous familial hypercholesterolaemia
  • Homozygous familial hypercholesterolaemia
  • Mutations in the apoB and PCSK9 genes
  • Polygenic hypercholesterolaemia
  • Disorders of HDL
  • Tangier disease
  • Combined hyperlipidaemia (hypercholesterolaemia and hypertriglyceridaemia)
  • Familial combined hyperlipidaemia
  • Remnant hyperlipidaemia
  • Other lipid disorders
  • Hypolipidaemia
  • Abetalipoproteinaemia
  • Management of hyperlipidaemia
  • Familial hypercholesterolaemia
  • Hypertriglyceridaemia
  • Management of combined hyperlipidaemia
  • Secondary prevention of cardiovascular disease
  • Primary prevention of cardiovascular disease in people with type 2 diabetes
  • Primary prevention of cardiovascular disease in people without diabetes
  • Risk prediction tables
  • Non-pharmacological approaches
  • Lipid-lowering diet
  • Exercise, weight loss, and smoking
  • Lipid-lowering drugs
  • Lipoprotein(a) inhibitors
  • Apolipoprotein C3 inhibitors
  • Apheresis
  • Novel therapeutics
  • 20. Respiratory medicine
  • CLINICAL SKILLS
  • History
  • Examination
  • Function of the respiratory system
  • Anatomy
  • Physiology
  • Clinical approach to the patient with respiratory disease
  • Clinical features of respiratory disease
  • Nasal symptoms
  • Cough
  • Sputum
  • Haemoptysis
  • Breathlessness
  • Wheezing
  • Chest pain
  • Examination of the respiratory system
  • Inspection
  • Investigation of respiratory disease
  • Diseases of the upper respiratory tract
  • Rhinitis
  • Investigations and diagnosis
  • Management
  • Pharyngitis
  • Acute laryngotracheobronchitis
  • Acute epiglottitis
  • Influenza
  • Clinical features
  • Complications
  • Diagnosis and management
  • Prophylaxis
  • Inhalation of foreign bodies
  • Cough
  • Acute cough
  • Chronic cough
  • Obstructive respiratory disease
  • Asthma
  • Prevalence
  • Classification
  • Aetiology
  • Clinical features
  • Investigations
  • Management
  • Acute bronchitis
  • Chronic obstructive pulmonary disease
  • Epidemiology and aetiology
  • Pathophysiology
  • Chronic bronchitis
  • Pathogenesis
  • Clinical features
  • Diagnosis
  • Investigations
  • Management
  • Prognosis of COPD
  • Obstructive sleep apnoea
  • Pathophysiology
  • Diagnosis
  • Investigations
  • Management
  • Chronic ventilatory failure
  • Smoking
  • Respiratory infection
  • Pneumonia
  • Tuberculosis
  • Pathogenesis
  • Clinical features and diagnosis
  • Pulmonary TB
  • Lymph node TB
  • Miliary TB
  • Microbiological diagnosis
  • Management
  • Non-tuberculous mycobacterial infection
  • Pleural disease
  • Pleural effusion
  • Diagnosis
  • Management
  • Empyema
  • Malignant pleural effusion
  • Chylothorax
  • Tumours of the respiratory tract
  • Malignant tumours
  • Bronchial carcinoma
  • Pathophysiology
  • Clinical features
  • Investigations
  • Mesothelioma
  • Screening for lung cancer
  • Secondary tumours
  • Solitary pulmonary nodules
  • Bronchial carcinoid tumours
  • Benign tumours
  • Pulmonary hamartoma
  • Bronchial adenoma
  • Cylindroma, chondroma, and lipoma
  • Tracheal tumours
  • Bronchiectasis
  • Aetiology
  • Clinical features
  • Investigations
  • Management
  • Prognosis
  • Cystic fibrosis
  • Pathogenesis
  • Clinical features and complications
  • Diagnosis
  • Management
  • Interstitial lung diseases
  • Sarcoidosis
  • Lung and heart–lung transplantation
  • Indications and donor selection
  • Complications and their treatment
  • Prognosis
  • Occupational lung disease
  • Coal-worker’s pneumoconiosis
  • Silicosis
  • Diseases caused by asbestos
  • Byssinosis
  • Berylliosis
  • Miscellaneous respiratory disorders
  • Lung cysts
  • Trauma
  • Kyphoscoliosis
  • Ankylosing spondylitis
  • Pectus excavatum and pectus carinatum
  • Pleurisy
  • Disorders of the diaphragm
  • Diaphragmatic fatigue
  • Unilateral diaphragmatic paralysis
  • Bilateral diaphragmatic weakness or paralysis
  • Complete eventration of the diaphragm
  • Diaphragmatic hernia
  • Hiccups
  • Mediastinal lesions
  • Retrosternal or intrathoracic thyroid
  • Thymic tumours (thymomas)
  • Middle mediastinum pathology
  • Posterior mediastinum pathology
  • 21. Ear, nose, and throat
  • Clinical skills
  • The ear
  • Anatomy
  • Physiology of hearing
  • Clinical approach to the patient with a disorder of the ear
  • Examination
  • Investigations
  • Tuning fork tests and interpretation
  • Dix-Hallpike test
  • Common disorders of the ear
  • The painful ear (otalgia)
  • Otitis externa
  • Acute otitis media
  • Referred otalgia
  • The discharging ear (otorrhoea)
  • Cholesteatoma
  • Hearing loss
  • Conductive hearing loss
  • Otosclerosis
  • Sensorineural hearing loss
  • Presbycusis
  • Noise trauma
  • Vestibular schwannoma
  • Vertigo
  • Peripheral causes of vertigo
  • Benign paroxysmal positional vertigo
  • Ménière’s disease
  • Vestibular neuritis and labyrinthitis
  • Central causes of vertigo
  • Vestibular migraine
  • Tinnitus
  • The nose
  • Anatomy and physiology
  • Clinical approach to THE patient with a disorder of the nose
  • Examination
  • Common disorders of the nose
  • Nasal obstruction
  • Rhinorrhoea (runny nose)
  • Rhinosinusitis
  • Anosmia
  • Epistaxis
  • Trauma
  • Hereditary haemorrhagic telangiectasia
  • Juvenile nasal angiofibroma
  • The throat
  • Anatomy and physiology
  • Clinical approach to the patient with a disorder of the throat
  • Examination
  • Common disorders of the throat
  • Odonophagia (pain on swallowing)
  • Dysphagia
  • Malignancy of upper aerodigestive tract
  • Hoarseness (dysphonia)
  • Stridor
  • Stertor (snoring)
  • 22. Gastroenterology
  • Clinical skills
  • History and examination
  • Visualizing the bowel
  • Background
  • Anatomy and physiology of the gastrointestinal tract
  • Mouth, oropharynx, and oesophagus
  • Stomach and duodenum
  • Physiology
  • Small intestine anatomy
  • Small intestine physiology
  • Colon and rectal anatomy
  • Physiology of the colon
  • Physiology of defecation
  • Clinical features of gastrointestinal disease
  • Dysphagia
  • Dyspepsia
  • Abdominal pain
  • Diarrhoea
  • Pathophysiology
  • Acute diarrhoea
  • Chronic diarrhoea
  • Constipation
  • Diagnosis
  • Management
  • Investigation of gastrointestinal disease
  • Functional gastrointestinal disorders
  • Pathophysiology and brain–gut interactions
  • Mouth
  • Recurrent aphthous ulceration
  • Neoplasia (squamous cell carcinoma)
  • Management
  • Pigmented neoplastic lesions
  • Non-neoplastic lesions
  • Oral white patches
  • Oral pigmented lesions
  • Tongue
  • Glossitis
  • Geographic tongue
  • Gums
  • Teeth
  • Salivary glands
  • Pharynx and oesophagus
  • Gastro-oesophageal reflux disease
  • Epidemiology and pathophysiology
  • Clinical features
  • Diagnosis and investigations
  • Management
  • Complications of gastro-oesophageal reflux disease
  • Peptic stricture
  • Barrett’s oesophagus
  • Diagnosis and classification
  • Motility disorders
  • Achalasia
  • Clinical features
  • Pathogenesis
  • Differential diagnosis
  • Investigations
  • Management
  • Complications
  • Systemic sclerosis
  • Diffuse oesophageal spasm
  • Management
  • Miscellaneous motility disorders
  • Other oesophageal disorders
  • Oesophageal diverticulum
  • Rings and webs
  • Benign oesophageal stricture
  • Oesophageal infections
  • Management
  • Mallory–Weiss syndrome
  • Eosinophilic oesophagitis
  • Management
  • Oesophageal perforation
  • Management
  • Oesophageal rupture
  • Oesophageal tumours
  • Cancer of the oesophagus
  • Epidemiology and aetiology
  • Clinical features
  • Investigations
  • Other oesophageal tumours
  • Functional oesophageal disorders
  • Globus
  • Functional chest pain of presumed oesophageal origin
  • Stomach and duodenum
  • Gastritis and gastropathy
  • Gastritis
  • Gastropathy
  • Helicobacter pylori infection
  • Epidemiology
  • Pathogenesis
  • Peptic ulcer disease
  • Epidemiology of peptic ulcer disease
  • Clinical features of peptic ulcer disease
  • Diagnosis of Helicobacter pylori infection
  • Investigation of suspected peptic ulcer disease
  • Management
  • Complications of peptic ulcer disease
  • Other H. pylori-associated diseases
  • NSAIDs, Helicobacter and ulcers
  • Management
  • Gastroparesis
  • Functional dyspepsia
  • Cyclical vomiting syndrome
  • Management
  • Gastric tumours
  • Adenocarcinoma
  • Epidemiology and pathogenesis
  • Screening
  • Pathology
  • Clinical features
  • Diagnosis
  • Gastrointestinal stromal tumours
  • Management
  • Primary gastric lymphoma
  • Aetiology
  • Clinical features
  • Management
  • Gastric polyps
  • Acute and chronic gastrointestinal bleeding
  • Acute upper gastrointestinal bleeding
  • Endoscopic management of acute gastrointestinal bleeds
  • Prognosis
  • Acute lower gastrointestinal bleeding
  • Management
  • Chronic gastrointestinal bleeding
  • Diagnosis
  • Management
  • Small intestine
  • Irritable bowel syndrome
  • Diagnosis
  • Management
  • Pain/gas/bloat syndrome/midgut dysmotility
  • Functional diarrhoea
  • Malabsorption
  • Coeliac disease (gluten-sensitive enteropathy)
  • Aetiology
  • Clinical features
  • Diagnosis
  • Other investigations
  • Management
  • Complications
  • Dermatitis herpetiformis
  • Non-coeliac gluten intolerance
  • Tropical sprue
  • Aetiology
  • Clinical features
  • Diagnosis
  • Management
  • Prognosis
  • Bacterial overgrowth
  • Clinical features
  • Management
  • Bile acid malabsorption
  • Lactose intolerance
  • Short bowel syndrome
  • Whipple’s disease
  • Diagnosis
  • Management
  • Radiation enteritis
  • Parasite infestation
  • Other causes of malabsorption
  • Miscellaneous intestinal diseases
  • Protein-losing enteropathy
  • Meckel’s diverticulum
  • Tuberculosis
  • Clinical features
  • Diagnosis
  • Management
  • Amyloidosis
  • Autoimmune rheumatic diseases
  • Intestinal ischaemia
  • Eosinophilic gastroenteritis
  • Intestinal lymphangiectasia
  • Abetalipoproteinaemia
  • Tumours of the small intestine
  • Adenocarcinoma and lymphoma
  • Management of small intestinal tumours
  • Carcinoid tumours
  • Diagnosis of carcinoid syndrome
  • Management of carcinoid syndrome
  • Peutz–Jeghers syndrome
  • Management
  • Other tumours
  • Inflammatory bowel disease
  • Epidemiology
  • Aetiology and pathogenesis
  • Pathology
  • Differential diagnosis
  • Crohn’s disease
  • Clinical features
  • Examination
  • Investigations
  • Medical management of Crohn’s disease
  • Surgical management of Crohn’s disease
  • Prognosis
  • Ulcerative colitis
  • Clinical features
  • Examination
  • Investigations
  • Medical management of ulcerative colitis
  • Refractory/severe colitis of any extent
  • Surgical management of ulcerative colitis
  • Course and prognosis
  • Microscopic colitis
  • Colon and rectum
  • Miscellaneous colonic conditions
  • Clostridium difficile-associated diarrhoea and pseudomembranous colitis
  • Treatment
  • Megacolon
  • Faecal incontinence
  • Ischaemic disease of the colon (ischaemic colitis)
  • Examination
  • Differential diagnosis and investigations
  • Management
  • Diverticular disease
  • Clinical features and investigations
  • Management
  • Acute diverticulitis
  • Investigations
  • Management
  • Complications of diverticular disease
  • Anorectal disorders
  • Pruritus ani
  • Haemorrhoids
  • Management
  • Anal fissures
  • Fistula in ano and anorectal abscesses
  • Rectal prolapse, intussusception, and solitary rectal ulcer syndrome
  • Colonic tumours
  • Colon polyps and polyposis syndromes
  • Classification of colorectal polyps
  • Sporadic adenomas
  • Sessile serrated adenomas
  • Inherited polyposis syndromes
  • Colorectal carcinoma
  • Genetics
  • Pathology
  • Clinical features
  • Screening for CRC
  • Investigations
  • Management
  • The acute abdomen
  • Diagnosis
  • Investigations
  • Acute appendicitis
  • Clinical features
  • Differential diagnosis
  • Management
  • Gynaecological causes of an acute abdomen
  • Acute peritonitis
  • Clinical features
  • Investigations
  • Management
  • Complications
  • Intestinal obstruction
  • Clinical features
  • Management
  • Acute colonic pseudo-obstruction
  • Peritoneum
  • Anatomy and physiology
  • Disorders affecting the peritoneum
  • Peritoneal adhesions
  • Retroperitoneal fibrosis (peri-aortitis)
  • Tuberculous peritonitis
  • Management
  • 23. Hepatology
  • CLINICAL SKILLS
  • Background
  • Anatomy of the liver and biliary system
  • Liver
  • Biliary system
  • Functions of the liver
  • Protein metabolism
  • Carbohydrate metabolism
  • Lipid metabolism
  • Formation of bile
  • Hormone and drug inactivation
  • Immunological function
  • Investigations in the patient with liver disease
  • Jaundice
  • Hepatitis
  • Viral hepatitis
  • Acute hepatitis due to other infectious agents
  • Acute hepatic failure
  • Autoimmune hepatitis
  • Drug-induced chronic hepatitis
  • Chronic hepatitis of unknown cause
  • Metabolic dysfunction–associated steatotic liver disease
  • Cirrhosis
  • Liver transplantation
  • Complications and effects of cirrhosis
  • Types of cirrhosis
  • Alcohol related liver cirrhosis
  • Alcohol and alcoholic liver disease
  • Budd–Chiari syndrome
  • Hepatic sinusoidal obstruction syndrome
  • Fibropolycystic diseases
  • Liver abscess
  • Other infections of the liver
  • Liver disease in pregnancy
  • Liver tumours
  • Secondary liver tumours
  • Primary malignant tumours
  • Benign tumours
  • Miscellaneous conditions of the liver
  • Drugs and the liver
  • Drug metabolism
  • Drug hepatotoxicity
  • Drug prescribing for patients with liver disease
  • 24. Biliary tract and pancreatic disease
  • Background
  • Gall bladder and biliary system
  • Biliary system (FIG. 24.1)
  • Gallstones
  • Miscellaneous conditions of the biliary tract
  • Gall bladder
  • Extrahepatic biliary tract
  • Tumours of the biliary tract
  • Pancreas
  • Pancreatitis
  • Pancreatic cancer
  • Pancreatic adenocarcinoma
  • Aetiology
  • Pathogenesis
  • Clinical features
  • Diagnosis and investigations
  • Differential diagnosis
  • Management
  • Pancreatic cystic neoplasms
  • Pancreatic neuroendocrine tumours
  • Clinical syndromes
  • Investigations
  • Management
  • 25. Nutrition
  • Clinical skills
  • Assessment and diagnosis of malnutrition
  • Screening
  • Nutritional assessment
  • Clinical examination
  • Global assessment tools
  • Management
  • Malnutrition: introduction and background
  • Mechanisms in under-nutrition
  • Dietary requirements
  • Water and electrolyte balance
  • Energy
  • Protein
  • Fat
  • Carbohydrate
  • Dietary fibre
  • The healthy diet
  • Starvation-related under-nutrition
  • Pathophysiology of starvation
  • Regulation of metabolism
  • Proportion of lean-to-fat tissue
  • Clinical features
  • Investigations
  • Management
  • Re-feeding
  • Rehabilitation
  • Care setting
  • Prognosis
  • Prevention
  • Re-feeding syndrome
  • Nutrition and ageing
  • Micronutrients and deficiencies
  • Fat-soluble vitamins
  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Vitamin K
  • Water-soluble vitamins
  • Vitamin C (ascorbic acid)
  • B vitamins
  • Minerals
  • Calcium
  • Chloride
  • Chromium
  • Copper
  • Fluoride
  • Iodine
  • Iron
  • Magnesium
  • Manganese
  • Molybdenum
  • Phosphate
  • Potassium
  • Sodium
  • Selenium
  • Zinc
  • Food fortification
  • Nutritional support
  • Principles of nutritional support
  • Nutritional requirements for adults
  • Enteral nutrition
  • Post-pyloric feeding
  • Feeding regimen
  • Parenteral nutrition
  • Vascular access for parenteral nutrition
  • Complications of parenteral nutrition
  • Intestinal failure
  • Functional classification of intestinal failure
  • Type 1 intestinal failure
  • Type 2 intestinal failure
  • Type 3 intestinal failure
  • Short bowel syndrome
  • Chronic intestinal failure: alternatives to home parenteral nutrition
  • Intestinal transplant
  • Bowel lengthening procedures
  • GLP2 analogues
  • Food intolerances
  • Lactose intolerance
  • FODMAPs
  • Non-coeliac gluten sensitivity
  • 26. Kidney and urinary tract disease
  • Clinical skills
  • A diagnostic approach to new kidney disease
  • Background
  • Anatomy and physiology
  • Functional anatomy
  • Physiology
  • Glomerular filtration rate
  • Drugs, toxins, proteins, and the kidney
  • Endocrine function
  • Autocrine function
  • Investigation of kidney and urinary tract disease
  • Examination of the urine
  • Blood tests
  • Imaging techniques
  • Transcutaneous kidney biopsy
  • The glomerulus and glomerular disease
  • Nephrotic syndrome
  • Non-nephrotic range proteinuria
  • Causes of proteinuria and nephrotic syndrome
  • Glomerulonephritis
  • Mixed nephritic and nephrotic syndrome
  • Other glomerular disorders
  • Kidney involvement in other diseases
  • Hypertension and the kidney
  • Essential hypertension
  • Renal hypertension
  • Renovascular disease
  • Screening
  • Renal artery occlusion
  • Cholesterol embolization (atheroembolic kidney disease)
  • Renal vein thrombosis
  • Kidney calculi and nephrocalcinosis
  • Urinary tract obstruction
  • Calculi
  • Pelviureteric junction obstruction
  • Obstructive megaureter
  • Retroperitoneal fibrosis (chronic peri-aortitis)
  • Aetiology
  • Clinical features and investigation
  • Management
  • Benign prostatic hypertrophy
  • Prognosis of urinary tract obstruction
  • Drugs and the kidney
  • Using drugs in patients with impaired kidney function
  • Urinary tract infection
  • Tubolointerstitial nephritis
  • Acute kidney injury
  • Renal replacement therapy in AKI
  • Chronic kidney disease
  • Complications of CKD
  • Management of CKD
  • Kidney replacement therapy
  • Kidney transplantation
  • Cystic kidney disease
  • Tumours of the kidney and genitourinary tract
  • Diseases of the prostate gland
  • The urinary tract in the elderly
  • 27. Water balance, fluids, and electrolytes
  • Clinical skills
  • Assessing a patient’s fluid status
  • Assessing acid–base disturbance
  • Background
  • Disorders of extracellular volume
  • Increased extracellular volume
  • Aetiology
  • Clinical features
  • Management
  • Decreased extracellular volume
  • Clinical features
  • Aetiology
  • Investigations
  • Management
  • Disorders of sodium concentration
  • Hyponatraemia
  • Hyponatraemia with hypovolaemia
  • Clinical features
  • Management
  • Hyponatraemia with euvolaemia
  • Syndrome of inappropriate AVP secretion
  • Clinical features
  • Hyponatraemic encephalopathy
  • Investigations
  • Management
  • Osmotic demyelination syndrome
  • Hyponatraemia with hypervolaemia
  • Hypernatraemia
  • Clinical features
  • Investigations
  • Management
  • Disorders of potassium concentration
  • Hypokalaemia
  • Aetiology
  • Bartter’s syndrome
  • Gitelman’s syndrome
  • Liddle’s syndrome
  • Clinical features
  • Management
  • Hyperkalaemia
  • Aetiology
  • Hyporeninaemic hypoaldosteronism
  • Hyperkalaemic periodic paralysis
  • Gordon’s syndrome (familial hyperkalaemic hypertension, pseudohypoaldosteronism type 2)
  • Suxamethonium and other depolarizing muscle relaxants
  • Clinical features
  • Management
  • Disorders of magnesium concentration
  • Hypomagnesaemia
  • Clinical features
  • Management
  • Hypermagnesaemia
  • Clinical features
  • Management
  • Disorders of phosphate concentration
  • Hypophosphataemia
  • Aetiology
  • Vitamin D–dependent rickets type I
  • Vitamin D–dependent rickets type II
  • Dent’s disease
  • Hypophosphataemia related to re-feeding syndrome
  • Diagnosis
  • Management
  • Hyperphosphataemia
  • Acid–base disorders
  • Normal acid–base physiology
  • Renal reabsorption of bicarbonate
  • Renal excretion of [H+]
  • Buffer systems in acid excretion
  • Aetiology of acid–base disturbance
  • Diagnosis
  • Respiratory acidosis and alkalosis
  • Respiratory acidosis
  • Respiratory alkalosis
  • Metabolic acidosis and alkalosis
  • Metabolic acidosis
  • Metabolic acidosis with a normal anion gap
  • Metabolic acidosis with a high anion gap
  • Mixed metabolic acidosis
  • Clinical features of acidosis
  • General treatment of acidosis
  • Metabolic alkalosis
  • Classification and definitions
  • Clinical features
  • Management
  • 28. Neurology
  • Clinical Skills
  • Background
  • Functional neuroanatomy
  • Neuron and synapse
  • Neurotransmitters
  • Patterns of Neurological Disease
  • Cortical disease
  • Cortical disorders of communication
  • Cortical disorders of movement
  • Cortical disorders of sensation and perception
  • Cortical disorders of memory
  • Cortical disorders of executive function
  • Cranial nerve lesions
  • I: Olfactory nerve
  • II: Optic nerve and visual system
  • III, IV, VI: Oculomotor, trochlear, and abducens nerves
  • V: Trigeminal nerve
  • VII: Facial nerve
  • VIII: Vestibulocochlear nerve
  • Lower cranial nerves IX, X, XI, XII
  • Disorders of motor control systems
  • Corticospinal (pyramidal) system
  • Extrapyramidal system
  • Cerebellum
  • Tremor
  • Dysarthria
  • Lower motor neuron lesions
  • Spinal reflex arc
  • Disorders of sensory pathways and pain
  • Peripheral nerves and spinal roots
  • Lesions of the sensory pathways
  • Pain
  • Bladder control and sexual dysfunction
  • Essential functions and anatomy
  • Neurological disorders of micturition
  • Male erectile dysfunction
  • Investigation of neurological disease
  • Neurophysiological investigations
  • Psychometric assessment
  • Neurological Conditions
  • Headache, migraine, and facial pain
  • Mechanisms
  • Primary headache disorders
  • Secondary headache disorders
  • Facial pain
  • Epilepsy and loss of consciousness
  • Epilepsy
  • Other causes of blackouts
  • Sleep disorders
  • Movement disorders
  • Parkinsonian disorders
  • Other akinetic–rigid syndromes
  • Hyperkinetic movement disorders
  • Neuroinflammatory disorders
  • Multiple sclerosis
  • Nervous system infection
  • Meningitis
  • Encephalitis
  • HIV and neurology
  • Other infections and post-infectious inflammatory conditions
  • Brain and spinal abscesses
  • Brain tumours
  • Hydrocephalus
  • Brain injury
  • Traumatic brain injury
  • Hypoxic–ischaemic brain injury
  • Disorders of consciousness
  • Spinal cord disease
  • Spinal cord compression
  • Other spinal cord disorders
  • Syringomyelia and syringobulbia
  • Pathophysiology
  • Clinical features
  • Investigations and management
  • Dementia
  • Epidemiology
  • Clinical assessment
  • Investigations
  • Mild cognitive impairment
  • Causes and risk factors
  • Dementia syndromes
  • Dementia with Lewy bodies and Parkinson’s disease dementia
  • Vascular dementia
  • Frontotemporal dementia
  • Prion diseases, including Creutzfeldt–Jakob disease
  • Other dementias
  • Management of dementia
  • Motor neuron disease
  • Pathogenesis
  • Congenital disorders
  • Clinical features
  • Neurogenetic disorders
  • Neurocutaneous syndromes
  • Hereditary ataxias
  • Paraneoplastic syndromes
  • Peripheral nerve disease
  • Mechanisms of damage to peripheral nerves
  • Nerve regeneration
  • Types of peripheral nerve disease
  • Clinical approach to neuropathy
  • Mononeuropathies
  • Polyneuropathies (peripheral neuropathy)
  • Plexus and nerve root lesions
  • Muscle diseases
  • Definitions
  • Clinical approach to muscle disease
  • Inflammatory myopathies
  • Metabolic and endocrine myopathies
  • Neuromuscular junction disorders
  • Muscular dystrophies
  • Myotonic syndromes
  • Skeletal muscle channelopathies
  • Stiff person syndrome
  • Mitochondrial diseases
  • 29. Stroke medicine
  • Background
  • Definitions
  • Pathogenesis and aetiology
  • TOAST classification
  • Large artery atherosclerosis
  • Cardioembolism
  • Small vessel disease
  • Stroke of other determined aetiology
  • Carotid and vertebral artery dissection
  • Venous stroke
  • Hypoperfusion
  • Stroke of undetermined aetiology
  • Stroke classification by vascular territory
  • Vascular anatomy
  • Anterior circulation clinical stroke syndromes
  • Posterior circulation clinical stroke syndromes
  • Transient ischaemic attack
  • Clinical features
  • TIA diagnosis
  • Differential diagnosis and stroke mimics
  • Prognosis
  • Acute ischaemic stroke
  • Imaging
  • Intravenous thrombolysis
  • IV thrombolysis windows
  • Mechanical thrombectomy
  • Stroke unit care, rehabilitation, and recovery
  • Acute stroke unit care
  • Post-stroke complications
  • Goals of therapy
  • Primary and secondary ischaemic stroke prevention
  • Secondary prevention of stroke
  • Primary prevention of stroke and cardiovascular disease
  • Personalized and goal-directed management of risk factors
  • Lifestyle modifications
  • Smoking cessation
  • Pharmacological approaches
  • Blood pressure management
  • Antiplatelet therapy
  • Anticoagulation: atrial fibrillation and other conditions
  • Lipid management
  • Diabetes
  • Contraception and hormone replacement
  • Specific interventions
  • Carotid intervention
  • Dissection of vessels
  • Embolic stroke of undetermined source
  • Patent foramen ovale
  • Left atrial appendage occlusion
  • Infective endocarditis
  • Cerebral venous sinus thrombosis
  • Other aetiologies
  • Recurrent ischaemic stroke
  • Intracerebral haemorrhage
  • Introduction
  • Aetiology (Fig. 29.16)
  • Clinical features
  • Investigations
  • Medical management
  • Surgical management
  • Secondary prevention
  • 30. General hospital psychiatry
  • Clinical skills
  • Approach to the patient
  • Additional diagnostic information
  • Formulation
  • Risk assessment
  • Treatment approaches in psychiatry
  • Prescribing in psychiatry
  • Background
  • Liaison psychiatry
  • The liaison psychiatry team
  • Ethical and legal issues in psychiatry
  • Consent and confidentiality
  • Patients wanting to leave hospital
  • The legal framework for mental health treatment
  • Aetiology of mental disorders
  • Biological mechanisms
  • The wider context of mental illness
  • Epidemiology of mental illness
  • Physical health in patients with mental illness
  • Common psychiatric emergencies
  • Self-harm and suicide
  • Managing suicidal patients in healthcare settings
  • Acute disturbance
  • Pharmacological management
  • Alcohol withdrawal
  • Delirium tremens
  • Wernicke-Korsakoff syndrome
  • Neuroleptic malignant syndrome and serotonin syndrome
  • Serotonin syndrome
  • Catatonia
  • Common psychiatric disorders
  • Depression
  • Aetiology
  • Genetic factors
  • Bipolar affective disorder
  • Diagnosing elevated mood
  • Anxiety disorders
  • Epidemiology
  • Aetiology of anxiety syndromes
  • Panic disorders
  • Anxiety syndromes
  • Generalized anxiety disorder
  • Agoraphobia
  • Phobic disorders
  • Social anxiety disorder
  • Disorders specifically associated with stress
  • Acute stress reaction
  • Adjustment disorder
  • Post-traumatic stress disorder (PTSD)
  • Complex post-traumatic stress disorder (CPTSD)
  • Normal and abnormal grief reactions
  • Obsessive–compulsive disorder
  • Assessment of anxiety disorders
  • Treatment of anxiety disorders in medical settings
  • Psychosis
  • Clinical features
  • Psychotic disorders
  • Psychotic disorders due to other medical conditions
  • Management
  • Medication
  • Medically unexplained symptoms and functional neurological disorders
  • Classification and terminology
  • Addictions
  • Alcohol dependence
  • Assessment
  • Management
  • Opioid addiction
  • Novel psychoactive substances
  • Personality disorder
  • Theoretical approaches
  • Diagnosis
  • Management
  • Eating and feeding disorders
  • Epidemiology
  • Anorexia nervosa
  • History
  • Physical examination
  • Investigations
  • Management
  • Bulimia nervosa
  • Avoidant/restrictive food intake disorder
  • Additional considerations in selected patient groups
  • Neurodiversity and learning disability
  • Attention deficit hyperactivity disorder
  • Mental health problems in older people
  • Patients in the criminal justice system
  • Diagnoses of exclusion: factitious disorder and factitious disorder induced by another
  • Management of factitious disorder
  • Factitious disorder imposed on another
  • Prevention of mental illness: public mental health
  • 31. Ophthalmology
  • Background
  • Applied anatomy and physiology
  • Clinical approach to the patient with a disorder of the eye
  • History
  • Examination
  • Clinical examination
  • Ophthalmic emergencies
  • Eye trauma
  • Acute red eye
  • Sudden onset sight loss
  • Common disorders of the eye
  • Refractive errors
  • Management
  • Disorders of the lids
  • Entropion
  • Ectropion
  • Dacryocystitis
  • Blepharitis
  • Management
  • Conjunctivitis
  • Bacterial conjunctivitis
  • Gonococcal conjunctivitis
  • Management
  • Chlamydial conjunctivitis
  • Management
  • Trachoma
  • Viral conjunctivitis
  • Phthiriasis palpebrarum
  • Management
  • Allergic conjunctivitis
  • Corneal disorders
  • Keratitis
  • Keratoconus
  • Management
  • Corneal dystrophy
  • Corneal transplantation
  • Cataracts
  • Aetiology
  • Clinical features
  • Investigations
  • Management
  • Glaucoma
  • Primary open-angle glaucoma
  • Clinical features
  • Management
  • Acute angle-closure glaucoma
  • Clinical features
  • Management
  • Uveitis
  • Anterior uveitis (iritis)
  • Management
  • Intermediate uveitis
  • Management
  • Posterior uveitis
  • Management
  • Disorders of the retina
  • Central retinal vein occlusion
  • Management
  • Central retinal artery occlusion
  • Management
  • Retinal detachment
  • Retinitis pigmentosa
  • Age-related macular degeneration
  • Management
  • Visual loss
  • 32. Rheumatology
  • Clinical skills
  • Taking a musculoskeletal history
  • Examination
  • Anatomy and physiology of the normal joint
  • Investigation of rheumatic disease
  • Clinical conditions in rheumatology
  • Common regional musculoskeletal problems
  • Pain in the neck and shoulder
  • Pain in the shoulder
  • Pain in the elbow
  • Pain in the hand and wrist
  • Pain in the lower back
  • Pain in the hip
  • Pain in the knee
  • Pain in the shin, calf, and ankle
  • Pain in the foot
  • Pain under the heel
  • Pain in the chest
  • Pain associated with sport and the performing arts
  • Chronic pain syndromes
  • Chronic widespread pain
  • Chronic regional pain
  • Analgesic and anti-inflammatory drugs for musculoskeletal problems
  • Simple and compound analgesic agents
  • Non-steroidal anti-inflammatory drugs
  • Disorders of collagen
  • Osteoarthritis
  • Inflammatory arthritis
  • Rheumatoid arthritis
  • Spondyloarthritis
  • Crystal arthritis
  • Infection of joints
  • Specific types of bacterial arthritis
  • Arthritis in viral disease
  • Fungal infections
  • Autoimmune rheumatic diseases
  • Systemic lupus erythematosus
  • Epidemiology
  • Aetiology
  • Pathogenesis
  • Pathology
  • Clinical features
  • Investigations
  • Management
  • Prognosis
  • Antiphospholipid syndrome
  • Pathogenesis
  • Clinical features
  • Management
  • Systemic sclerosis (scleroderma)
  • Pathology and pathogenesis
  • Clinical features
  • Investigations
  • Management
  • Prognosis
  • Polymyositis and dermatomyositis
  • Clinical features
  • Investigations
  • Management
  • Inclusion body myositis
  • Sjögren’s syndrome
  • Pathology and investigations
  • Management
  • ‘Overlap’ syndromes and undifferentiated autoimmune rheumatic disease
  • Systemic inflammatory vasculitis
  • Large-vessel vasculitis
  • Medium-sized vessel vasculitis
  • Small-vessel vasculitis
  • Behçet’s disease
  • Arthritis in children
  • Juvenile idiopathic arthritis
  • Rheumatological problems seen in other diseases
  • Gastrointestinal and liver disease
  • Respiratory disease
  • Malignant disease
  • Skin disease
  • Neurological disease
  • Blood disease (see also Chapter 38)
  • Endocrine and metabolic disorders
  • Miscellaneous arthropathies
  • 33. Bone disease
  • Clinical skills
  • History
  • Clinical features
  • Risk factors for osteoporosis
  • Examination
  • Biochemical tests
  • Anatomy and physiology of bone
  • Bone structure
  • Matrix components
  • Bone cells
  • Bone growth and remodelling
  • Calcium homeostasis and its regulation
  • Calcium absorption and distribution
  • Vitamin D metabolism
  • Parathyroid hormone
  • Calcitonin
  • Investigation of bone and calcium disorders
  • Total plasma calcium
  • Plasma phosphate
  • Plasma PTH
  • Serum 25-hydroxyvitamin D
  • 24-hour urinary calcium
  • Biochemical markers of bone formation and resorption
  • Diagnostic imaging
  • Osteoporosis
  • Pathogenesis
  • Risk factors
  • Clinical features
  • Investigations
  • Prevention and management
  • Pharmacological intervention
  • Bisphosphonates
  • Denosumab
  • Selective oestrogen-receptor modulators
  • Recombinant human parathyroid hormone
  • Romosozumab
  • Hormone replacement therapy
  • Calcitriol (1,25-dihydroxyvitamin D3) and calcitonin
  • Combination therapies
  • Surgery
  • Treatment of specific conditions
  • Osteonecrosis
  • Paget’s disease of bone
  • Aetiology and pathogenesis
  • Clinical features
  • Investigations
  • Management
  • Rickets and osteomalacia
  • Aetiology
  • Clinical features
  • Investigations
  • Management
  • Bone infections
  • Acute and chronic osteomyelitis
  • Diagnosis
  • Management
  • Tuberculous osteomyelitis
  • Neoplastic disease of bone
  • Investigations
  • Management
  • Scheuermann’s disease
  • 34. Endocrinology
  • Clinical skills
  • Background
  • Hormonal activity
  • Aetiology and pathology
  • Endocrine investigations
  • The pituitary gland and hypothalamus
  • Presentation of pituitary and hypothalamic disease
  • Hypothalamo–pituitary–adrenal axis
  • The adrenal cortex
  • The adrenal medulla
  • The thyroid axis
  • Anatomy and physiology
  • Hypothyroidism
  • Hyperthyroidism
  • Graves’ orbitopathy (ophthalmopathy)
  • Goitre (thyroid enlargement)
  • Thyroid cancer
  • Hypothalamo–pituitary–gonadal axis
  • Anatomy and physiology
  • Disorders in the male
  • Disorders in the female
  • Disorders of sex development
  • The thirst axis
  • Disorders of calcium metabolism
  • Hypoglycaemia in the non-diabetic patient
  • Other endocrine disorders
  • Diseases of many glands
  • Ectopic hormone secretion
  • 35. Diabetes mellitus
  • Clinical skills
  • Language matters
  • Background
  • Physiology of insulin secretion and action
  • Glucose metabolism
  • Hormonal regulation
  • Classification of diabetes
  • Clinical approach to the person with diabetes
  • Presentation
  • Physical examination at diagnosis
  • Diagnosis and investigations
  • Prevention of type 2 diabetes
  • Management of diabetes
  • Aims of diabetes care
  • Risks of tight glycaemic management
  • Role of self-management education
  • Physical activity
  • Tobacco smoking
  • Medication for diabetes
  • Insulin
  • Non-insulin antidiabetes treatments
  • Which drug and when?
  • Pancreatic islet and whole-pancreas transplantation
  • Monitoring glucose levels in people with diabetes
  • Diabetes-related metabolic emergencies
  • Complications of diabetes
  • Microvascular complications
  • Diabetic retinopathy
  • Other ways in which diabetes can affect the eye
  • Diabetic nephropathy
  • Diabetic neuropathy
  • Diabetes-related foot problems
  • Macrovascular complications
  • Other complications of diabetes
  • Psychosocial implications of diabetes
  • Diabetes in special situations
  • Organization of diabetes care
  • 36. Metabolic disease
  • Background
  • Approach to the patient
  • History
  • Examination
  • Investigations
  • Acute presentations of inherited metabolic diseases
  • Known inherited metabolic disease
  • Situations when an inherited metabolic disease should be suspected
  • Encephalopathy and urea cycle disorders
  • Rhabdomyolysis
  • Stroke
  • Hypoglycaemia
  • Acidosis
  • General principles of management of inherited metabolic diseases
  • Dietary manipulation to bypass ‘metabolic block’
  • Maintenance of regular and adequate calorie intake
  • Supplementation with vitamins, minerals, and co-factors
  • Enzyme replacement therapy
  • Newer therapies
  • Supportive management and surveillance
  • Specific inherited metabolic diseases
  • Mitochondrial diseases
  • Diagnosis
  • Management
  • Disorders of protein metabolism
  • Phenylketonuria
  • Lysosomal storage disorders
  • Disorders of carbohydrate metabolism
  • Glycogen storage disorders
  • Disorders of fatty acid oxidation defects
  • Porphyrias
  • Peroxisomal diseases
  • X-Adrenoleukodystrophy
  • Adult Refsum’s disease
  • 37. Obesity
  • Background
  • Prevalence
  • Aetiology
  • Obesogenic environment
  • Biology: genetics and obesity
  • Epigenetics in obesity
  • Physiological mediators of obesity
  • Control of appetite
  • The gut–brain axis
  • Hedonic hunger
  • Clinical approach to obesity
  • Motivational interviewing
  • History
  • Examination
  • Anthropometric measurements
  • Waist-to-height ratio
  • Skinfold measurements
  • Neck circumference
  • Bioelectrical impedance analysis
  • Body mass index and obesity diagnosis
  • Staging of obesity
  • Investigations
  • Genetic investigations
  • Cardiovascular disease
  • Respiratory disease
  • Liver disease
  • Gastrointestinal disease
  • Endocrine disease
  • Reproductive system disease
  • Neurological disease
  • Renal disease
  • Musculoskeletal disease
  • Surgical
  • Psychological
  • Obstetric and perinatal
  • Skin
  • Pathophysiology of obesity complications
  • Inflammation
  • The Krebs cycle and obesity
  • Management
  • General principles of management
  • Other considerations
  • Weight management goals
  • Potential therapeutic strategies
  • The multidisciplinary team in obesity care
  • Obesity through the life course
  • Lifestyle interventions
  • Dietary strategies
  • Specific dietary strategies
  • Physical activity in obesity care
  • Medical therapy
  • Vitamin D
  • Orlistat
  • Glucagon-like peptide 1 receptor agonists
  • Clinical delivery of a glucagon-like peptide 1 agonist programme
  • Bupropion and naltrexone combination therapy
  • Phentermine and topiramate combination therapy
  • Setmelanotide
  • Diabetes medications
  • Future therapies for obesity and areas of interest
  • Bariatric surgery
  • 38. Haematology
  • Clinical skills
  • Background
  • The formation of blood cells (haemopoiesis)
  • Haemopoietic growth factors
  • Peripheral blood
  • Red blood cells
  • Erythropoiesis
  • Haemoglobin synthesis
  • Haemoglobin function
  • Anaemia
  • Microcytic anaemia
  • Normocytic anaemia
  • Macrocytic anaemias
  • Megaloblastic anaemia
  • Macrocytosis without megaloblastic changes
  • Anaemia caused by marrow failure (aplastic anaemia)
  • Haemolytic anaemias
  • Inherited haemolytic anaemia
  • Red blood cell membrane defects
  • Haemoglobin abnormalities
  • The thalassaemias
  • Sickle syndromes
  • Metabolic disorders of the red blood cell
  • Acquired haemolytic anaemia
  • Autoimmune haemolytic anaemias
  • Drug-induced immune haemolytic anaemia
  • Alloimmune haemolytic anaemia
  • Non-immune haemolytic anaemia
  • Mechanical haemolytic anaemia
  • Polycythaemia
  • The spleen
  • Blood transfusion
  • Blood groups
  • Procedure for blood transfusion in hospitals
  • Pre-transfusion compatibility testing
  • Blood ordering
  • Complications of blood transfusion
  • Prevention of wrong blood transfusions
  • Immunological complications
  • Non-immunological complications
  • Strategies for the avoidance of unnecessary transfusion
  • Blood, blood components, and blood products
  • White blood cells
  • Neutrophils
  • Eosinophils
  • Basophils
  • Monocytes
  • Lymphocytes
  • Haemostasis
  • Vessel wall
  • Platelets
  • Coagulation and fibrinolysis
  • Investigation of bleeding disorders
  • Vascular disorders
  • Platelet disorders
  • Thrombocytopenia
  • Platelet function disorders
  • Thrombocytosis
  • Inherited coagulation disorders
  • Acquired coagulation disorders
  • 39. Haematological oncology
  • Clinical skills
  • History
  • Assessing suitability for treatment
  • Examination
  • Aims of treatment
  • Background
  • Aetiology
  • Pathogenesis
  • Investigations
  • Aetiology
  • Acute leukaemias
  • Clinical features
  • Investigations
  • Management
  • Acute myeloid leukaemia
  • Management
  • Acute promyelocytic leukaemia
  • Acute lymphoblastic leukaemia
  • Prognosis
  • Management
  • Chronic myeloid leukaemia and the myeloproliferative neoplasms
  • Chronic myeloid leukaemia
  • Clinical features
  • Investigations
  • Management
  • Other myeloproliferative disorders
  • Polycythaemia vera
  • Clinical features
  • Diagnosis
  • Management
  • Prognosis
  • Essential thrombocythaemia (ET)
  • Clinical features
  • Investigations
  • Management
  • Secondary thrombocytosis
  • Myelofibrosis
  • Clinical features
  • Investigations
  • Management
  • Prognosis
  • Other myeloproliferative neoplasms
  • Myelodysplasia
  • Clinical features
  • Investigations
  • Management
  • Myelodysplastic syndrome–myeloproliferative neoplasm overlap syndromes
  • Lymphomas
  • Overall management strategy common to all lymphomas
  • Investigations
  • Hodgkin lymphoma
  • Aetiology
  • Diagnosis
  • Clinical features
  • Investigations
  • Management
  • Non-Hodgkin lymphoma (NHL)
  • Aetiology
  • Pathogenesis
  • Clinical features
  • B-cell lymphoma
  • Diffuse large B-cell lymphoma
  • Clinical features
  • Management
  • Follicular lymphoma
  • Management
  • Prognosis
  • Burkitt lymphoma
  • Management
  • Prognosis
  • Mantle cell lymphoma
  • Management
  • Prognosis
  • Lymphoplasmacytic lymphoma
  • Management
  • Prognosis
  • Primary central nervous system lymphoma
  • Management
  • Marginal zone lymphoma
  • Management
  • T-cell lymphoma
  • Management
  • Mycosis fungoides and Sézary’s syndrome
  • Chronic lymphocytic leukaemia
  • Clinical features
  • Investigations
  • Prognosis
  • Management
  • Hairy cell leukaemia
  • Clinical features
  • Management
  • Myeloma and other plasma cell disorders
  • Myeloma
  • Clinical features
  • Diagnosis
  • Investigations
  • Staging and prognosis
  • Management
  • Asymptomatic (smouldering) myeloma
  • Monoclonal gammopathy of undetermined significance
  • Solitary plasmacytoma
  • Heavy-chain diseases
  • Monoclonal gammopathies of clinical significance
  • 40. Venous thromboembolic disease
  • Clinical Skills
  • Diagnosis
  • Examination
  • Investigation
  • Background
  • Pathogenesis of thrombosis
  • Arterial and venous thrombosis
  • Factors influencing thrombosis
  • Acute venous thromboembolism
  • Long-term management of venous thromboembolism
  • Prediction of recurrent venous thromboembolism
  • Complications
  • Death
  • Cancer
  • Post-thrombotic syndrome
  • Pulmonary hypertension
  • Investigation after venous thrombosis
  • General investigations
  • Thrombophilia testing
  • Heritable thrombophilias
  • Acquired thrombophilias
  • Prevention
  • Mechanical prophylaxis
  • Pharmacological prophylaxis
  • Anticoagulant agents
  • Parenteral anticoagulants
  • Heparin
  • Oral anticoagulants
  • Oral factor Xa and thrombin inhibitors
  • Vitamin K antagonists
  • 41. Malignant disease
  • Clinical skills
  • History
  • Investigations
  • Formulating a management plan
  • Examination
  • Background
  • Principles of oncology
  • The biology of cancer
  • Evading growth suppression
  • Inducing angiogenesis
  • Invasion and metastasis
  • Aetiology and epidemiology
  • Aetiology
  • Genetic factors
  • Environmental factors
  • Epidemiology
  • Screening and investigations
  • Asymptomatic detection through screening
  • Symptomatic patients with cancer
  • Principles of cancer treatment
  • Aims of treatment
  • A curative approach
  • Assessment before treatment
  • Staging
  • Performance status
  • Assessment of the benefits of treatment
  • Principles of chemotherapy
  • Classification of cytotoxic drugs
  • Side-effects of chemotherapy
  • Principles of endocrine therapy
  • Principles of biological and targeted therapy
  • Immunotherapy
  • Targeted therapies
  • Gene therapy
  • Principles of radiation therapy
  • Theoretical background
  • Clinical application of radiation therapy
  • Types of radiation therapy
  • Side-effects of radiotherapy
  • Common solid tumour treatment
  • Lung cancer
  • Prognosis
  • Staging
  • General approach to management
  • Non–small-cell lung cancer
  • Management
  • Surgery
  • Radiation therapy for cure
  • Genetic profiling and tyrosine kinase inhibitors
  • Immunotherapy
  • Conventional chemotherapy
  • Small-cell lung cancer
  • Prognosis
  • Management
  • Symptomatic care for patients with lung cancer
  • Metastases in the lung
  • Breast cancer
  • Management of early disease
  • Surgery
  • Radiotherapy
  • Systemic therapy
  • Targeted therapy
  • Bisphosphonates
  • Follow-up
  • Management of advanced disease
  • Widespread visceral disease
  • Limited metastatic disease
  • Indolent metastatic disease that is not immediately life-threatening
  • Metastatic disease confined to regional lymph nodes
  • Relapsed disease after previous systemic therapy
  • Upper gastrointestinal cancers
  • Oesophageal cancer
  • Prognosis and management
  • Treatment of early-stage disease
  • Treatment of advanced or metastatic disease
  • Palliative approaches
  • Gastric cancer
  • Prognosis and management
  • Treatment of early-stage disease
  • Treatment of advanced disease
  • Palliative approaches
  • Gastrointestinal stromal tumours
  • Lower gastrointestinal cancers
  • Small intestinal cancer
  • Colorectal cancer
  • Prognosis
  • Management
  • Surgery
  • Neoadjuvant chemotherapy and radiotherapy
  • Adjuvant chemotherapy and radiotherapy
  • Follow-up
  • Metastatic colorectal cancer
  • Anal cancer
  • Hepatobiliary and pancreatic cancers
  • Liver
  • Hepatocellular carcinoma
  • Prognosis and management
  • Biliary tract
  • Cholangiocarcinoma
  • Pancreas
  • Pancreatic adenocarcinoma
  • Prognosis
  • Surgery
  • Advanced disease
  • Palliative interventions
  • Urological cancers
  • Renal cancer
  • Clinical features and diagnosis
  • Investigations and management
  • Disease confined to the kidney
  • Metastatic disease
  • Systemic therapy
  • Urothelial (bladder and ureteric) cancer
  • Superficial cancers
  • Invasive bladder cancer
  • Metastatic urothelial cancer
  • Upper tract tumours
  • Prostate cancer
  • Clinical features and diagnosis
  • Prognosis
  • Management
  • Disease localized to the prostate
  • Locally advanced disease
  • Endocrine therapy
  • Non-hormonal therapy
  • Penile cancer
  • Testicular and ovarian germ cell tumours
  • Management
  • Seminomas
  • Non-seminomas
  • Gynaecological cancers
  • Cervical cancer
  • Management and prognosis
  • Localized disease
  • Metastatic disease
  • Endometrial cancer
  • Early disease
  • Advanced and metastatic disease
  • Ovarian cancer
  • Prognosis
  • Management
  • Brain tumours
  • Brain metastases
  • Primary brain tumours
  • Glioma
  • Management
  • Meningioma
  • Neurofibroma and schwannoma
  • Head and neck cancer
  • Staging
  • Management
  • Early disease
  • Locally advanced disease
  • Metastatic disease
  • Malignant melanoma
  • Management
  • Staging
  • Metastatic cancer of unknown primary origin
  • Diagnosis and investigation
  • Investigations
  • Management
  • 42. Infectious disease
  • Clinical skills
  • History
  • Background
  • Infectious agents
  • Clinical approach to the patient with a suspected infection
  • Diagnostic assessment
  • Clinical examination
  • Investigations
  • Epidemiology and prevention of infections
  • Increased population mobility
  • Changing patterns of disease
  • Factors limiting control of infectious diseases in low- and middle-income countries
  • Goals in international development
  • Acquisition of infection
  • Routes of transmission
  • Classification of outbreaks
  • Infection prevention and control
  • Principles and mechanisms of infection
  • Host–organism interactions, including the human microbiome
  • Development of infection by commensal organisms
  • Symptoms of infection and the host response
  • Specificity of microorganisms
  • Pathogenesis
  • Metabolic and immunological consequences of infection
  • Viral infections
  • Outcomes of virus infection of a cell
  • Virus infections of the skin and mucous membranes
  • Vesicular viral rashes
  • Maculopapular viral rashes
  • Virus infections of the respiratory tract
  • Upper respiratory tract infections
  • Lower respiratory tract infections
  • Systemic viral infections
  • Virus infections of the nervous system
  • Virus infections of the gastrointestinal tract
  • Viral hepatitis
  • Viruses and malignant disease
  • Viral haemorrhagic fevers
  • Antiviral drugs
  • Anti-herpesvirus drugs
  • Anti-SARS-CoV-2 drugs
  • Anti-influenza drugs
  • Anti–hepatitis B and anti–hepatitis C drugs
  • Other antiviral drugs
  • Interferons
  • Transmissible spongiform encephalopathies (prion diseases)
  • Bacterial infections
  • Bacterial infections of the skin and soft tissues
  • Invasive staphylococcal infection
  • Toxin-mediated skin disease
  • Bacterial infections of the respiratory tract
  • Upper respiratory tract infections
  • Lower respiratory tract infections
  • Bacterial infections of the gastrointestinal tract
  • Bacterial infections of the cardiovascular system
  • Bacterial infections of the nervous system
  • Bacterial meningitis
  • Toxin-mediated infections
  • Bacterial bone and joint infections
  • Bacterial infections of the urinary tract
  • Systemic and multisystem bacterial infections
  • Bacterial infections seen in low- and middle-income countries
  • Skin, soft tissue, and eye diseases
  • Gastrointestinal infections
  • Systemic infections
  • Other bacterial infections
  • Antibiotic therapies
  • Fungal infections
  • Systemic fungal infections
  • Subcutaneous fungal infections
  • Superficial fungal infections
  • Antifungal drugs
  • Polyenes
  • Azoles
  • Echinocandins
  • Flucytosine
  • Allylamines
  • Protozoal infections
  • Blood and tissue protozoa
  • Malaria
  • Trypanosomiasis
  • Leishmaniasis
  • Other protozoal diseases of the blood and tissues
  • Gastrointestinal protozoa
  • Helminth infections
  • Nematodes
  • Tissue-dwelling worms
  • Human intestinal nematodes
  • Zoonotic nematodes
  • Trematodes
  • Water-borne flukes
  • Food-borne flukes
  • Cestodes
  • Arthropod ectoparasites
  • Local hypersensitivity reactions
  • Resident ectoparasite infections
  • Systemic envenoming
  • Vectors of infection
  • 43. Sexually transmitted infections
  • Clinical skills
  • History
  • Examination in the sexual health clinic
  • Investigations
  • Sexually transmitted infections
  • Asymptomatic Screening
  • Hepatitis A screening and vaccination
  • Hepatitis B screening and vaccination
  • Hepatitis C screening
  • Investigations for symptomatic patients
  • management, prevention, and control of STIs
  • Biomedical prevention
  • Specific infections
  • Human immunodeficiency virus and acquired immunodeficiency virus
  • Hepatitis B
  • Chlamydia trachomatis
  • Clinical features
  • Diagnosis
  • Management
  • Gonorrhoea
  • Clinical features
  • Diagnosis
  • Management
  • Non-gonococcal urethritis and Mycoplasma genitalium
  • Clinical features
  • Diagnosis
  • Management
  • Pelvic inflammatory disease
  • Clinical features
  • Diagnosis
  • Management
  • Epididymo-orchitis
  • Clinical features
  • Diagnosis
  • Investigations
  • Management
  • Bacterial vaginosis
  • Clinical features
  • Diagnosis
  • Management
  • Candidiasis
  • Clinical features
  • Diagnosis
  • Management
  • Trichomoniasis
  • Clinical features
  • Diagnosis
  • Management
  • Human papillomavirus (anogenital warts)
  • Clinical features
  • Diagnosis
  • Management
  • Prevention and vaccination
  • Molluscum contagiosum
  • Diagnosis
  • Management
  • Herpes simplex
  • Clinical features
  • Diagnosis
  • Management
  • Syphilis
  • Clinical features
  • Diagnosis
  • Management
  • Lymphogranuloma venereum
  • Clinical features
  • Diagnosis
  • Management
  • Mpox
  • Clinical features
  • Diagnosis
  • Management
  • Chancroid
  • Clinical features
  • Diagnosis and management
  • Donovanosis
  • Clinical features
  • Diagnosis and management
  • Pediculosis pubis
  • Diagnosis and management
  • 44. Human immunodeficiency virus
  • Clinical skills
  • History
  • Examination
  • Acute HIV infection
  • Advanced HIV with immunosuppression
  • Investigation
  • Background
  • History of HIV
  • Epidemiology
  • HIV in sub-Saharan Africa
  • HIV in high-income countries
  • The changing face of the epidemic
  • Acquisition
  • Routes of acquisition
  • Sexual transmission (vaginal and anal)
  • Vertical transmission (transplacental, perinatal, breast-feeding)
  • Contaminated blood, blood products, and organ donation
  • Contaminated needles
  • Viral structure
  • Pathogenesis
  • Early disease: incubation and acute seroconversion illness
  • Viral testing
  • Clinical latency
  • Persistent generalized lymphadenopathy
  • Symptomatic HIV infection
  • HIV-related end-organ disease
  • Neurological disease
  • Eye disease
  • Mucocutaneous manifestations
  • Haematological complications
  • Gastrointestinal effects
  • Kidney complications
  • Respiratory complications
  • Endocrine complications
  • Cardiac complications
  • Conditions associated with immunosuppression
  • HIV testing
  • HIV antibodies
  • Viral p24 antigen
  • Genome detection assays
  • Clinical approach to the person living with HIV
  • Initial assessment
  • HIV resistance testing (genotyping)
  • Monitoring
  • Immunological monitoring
  • Virological monitoring
  • Monitoring other aspects of health
  • Management of HIV
  • Anti-retroviral therapy
  • Starting anti-retroviral therapy
  • Which anti-retroviral therapy to start
  • Nucleoside/nucleotide reverse transcriptase inhibitors
  • Integrase strand transfer inhibitors
  • Non-nucleoside analogues
  • Protease inhibitors
  • Entry inhibitors, co-receptor blockers, and capsid inhibitors
  • Monitoring anti-retroviral therapy
  • Drug resistance
  • Drug interactions with anti-retroviral therapy
  • Adherence
  • Anti-retroviral therapy failure
  • Switching anti-retroviral therapy
  • Stopping anti-retroviral therapy
  • Complications and long-term safety of anti-retroviral therapy
  • Allergic reactions
  • Lipodystrophy and metabolic syndrome
  • Mitochondrial toxicity and lactic acidosis
  • Bone metabolism
  • Immune reconstitution inflammatory syndrome
  • Pregnancy
  • Post-exposure prophylaxis
  • Toward a cure
  • HIV-associated disease
  • Avoidance of infection
  • Immunization strategies
  • Chemoprophylaxis
  • Fungal infections
  • Pneumocystis jirovecii infection
  • Cryptococcosis
  • Candidiasis
  • Aspergillosis
  • Histoplasmosis, blastomycosis, coccidioidomycosis, and Talaromycosis spp.
  • Protozoal infections
  • Toxoplasmosis
  • Cryptosporidiosis
  • Microsporidiosis
  • Leishmaniasis
  • Viral infections
  • Hepatitis B
  • Hepatitis C
  • Hepatitis B and C virus co-infection
  • Cytomegalovirus (CMV)
  • Herpes infections
  • Human papillomavirus infection
  • Polyomavirus infection
  • SARS-CoV-2 (COVID-19) infection
  • Mpox infection
  • Influenza infection
  • Bacterial infections
  • Mycobacterium tuberculosis
  • Mycobacterium avium-intracellulare infection
  • Salmonella spp.
  • Other bacterial infections
  • Infections caused by other organisms
  • HIV-associated cancers
  • Kaposi’s sarcoma
  • Lymphoma
  • Cervical cancer
  • Anal cancer
  • Prevention and control of HIV
  • Expanding HIV testing
  • Strategies for reducing HIV transmission
  • Pre-exposure prophylaxis
  • Global strategies
  • 45. Dermatology
  • Clinical skills
  • Background
  • Skin’s structure and function
  • Epidermis
  • Barrier functions of the epidermis
  • Immune functions of the epidermis
  • Dermis
  • Hair and nails
  • Subcutis
  • Investigation of skin disease
  • Principles of dermatological therapy
  • Topical therapy
  • Phototherapy
  • Systemic therapy
  • Dermatological emergencies
  • Common rashes
  • Acne and related disorders
  • Acne
  • Clinical features
  • Management
  • Hidradenitis suppurativa (‘acne inversa’)
  • Rosacea
  • Clinical features
  • Management
  • Perioral dermatitis
  • Other rarer causes of facial rashes
  • Eczema and dermatitis
  • Atopic eczema
  • Aetiology
  • Investigations
  • Management
  • Seborrhoeic eczema
  • Aetiology
  • Management
  • Venous eczema (varicose eczema, stasis, gravitational eczema)
  • Management
  • Discoid eczema (nummular eczema)
  • Asteatotic eczema (winter eczema, eczema craquelé)
  • Hand eczema
  • Allergic and irritant contact eczema
  • Lichen simplex
  • Nodular prurigo
  • Chronic actinic dermatitis
  • Psoriasis
  • Aetiology
  • Exacerbating factors
  • Clinical features
  • Associated features
  • Management
  • Other common papulosquamous rashes
  • Pityriasis rosea
  • Polymorphic light eruption
  • Lichen planus
  • Clinical features
  • Diagnosis and treatment
  • Granuloma annulare
  • Lichen sclerosus
  • Urticaria and angio-oedema
  • Aetiology and clinical features
  • Management
  • Urticarial vasculitis
  • Skin infections
  • Bacterial infections
  • Impetigo
  • Management
  • Ecthyma and ecthyma gangrenosum
  • Cellulitis
  • Folliculitis
  • Management
  • Boils (furuncles) and carbuncles
  • Management
  • Erythrasma and pitted keratolysis
  • Management
  • Borrelia infection: Lyme disease
  • Mycobacterial infections
  • Leprosy (Hansen disease)
  • Skin manifestations of tuberculosis
  • Atypical mycobacterial infections
  • Viral infections
  • Viral exanthems
  • Herpes simplex virus
  • Management
  • Varicella zoster virus
  • Herpes zoster (shingles)
  • Management
  • Human papillomavirus
  • Management
  • Molluscum contagiosum
  • Orf
  • Mpox (formerly monkeypox)
  • SARS-CoV-2 infection and COVID-19
  • Fungal infections
  • Superficial mucocutaneous fungal infections
  • Parasites and infestations
  • Scabies
  • Diagnosis and management
  • Lice
  • Papular urticaria (persistent insect bite reactions)
  • Bed bug infestation
  • Tropical dermatoses
  • Human immunodeficiency virus and the skin
  • Seroconversion rash
  • Cutaneous infections
  • Inflammatory dermatoses
  • Drug rashes
  • Cutaneous malignancy
  • HIV-specific dermatoses
  • Immune reconstitution inflammatory syndrome
  • Skin signs of systemic disease
  • Multisystem inflammatory disorders
  • Erythema nodosum
  • Pruritus
  • Endocrine disease
  • Thyroid disease
  • Diabetes mellitus
  • Cushing syndrome
  • Addison disease
  • Acanthosis nigricans
  • Flushing
  • Metabolic disease
  • Hyperlipidaemias
  • Porphyria cutanea tarda
  • Haematological disease
  • Amyloidosis
  • Chronic liver disease
  • Chronic kidney disease
  • Autoimmune rheumatic disease
  • Dermatomyositis
  • Scleroderma
  • Lupus erythematosus
  • Disorders of blood vessels and lymphatics
  • Vasculitis
  • Livedo reticularis
  • Leg ulcers
  • Management
  • Prevention
  • Lymphatic disease
  • Systemic malignant disease
  • Genetic disease
  • Neurofibromatosis type 1
  • Tuberous sclerosis
  • Ehlers–Danlos syndrome
  • Pseudoxanthoma elasticum
  • Photosensitivity disorders
  • Blistering and bullous skin disease
  • Immunobullous diseases
  • Pemphigus
  • Investigations
  • Management
  • Bullous pemphigoid
  • Investigations
  • Management
  • Linear IgA disease
  • Dermatitis herpetiformis
  • Management
  • Mechanobullous diseases (epidermolysis bullosa)
  • Investigations and management
  • Skin tumours
  • Benign skin tumours
  • Melanocytic naevi
  • Epidermal naevi
  • Basal cell papillomas (‘seborrhoeic keratoses’ or ‘seborrheic warts’)
  • Dermatofibroma (benign fibrous histiocytoma)
  • Lipoma
  • Epidermoid cyst (‘sebaceous cyst’) and pilar cyst
  • Pyogenic granuloma
  • Cherry angioma (Campbell de Morgan spots)
  • Keloid and hypertrophic scars
  • Dysplastic and premalignant skin lesions
  • Actinic (solar) keratoses
  • Bowen disease (squamous cell carcinoma in situ, intraepidermal carcinoma)
  • Keratoacanthoma
  • Lentigo maligna (Hutchinson melanotic freckle)
  • Malignant skin tumours
  • Keratinocyte cancers
  • Basal cell carcinoma
  • Clinical features
  • Management
  • Cutaneous squamous cell carcinoma
  • Clinical features
  • Management
  • Melanoma
  • Classification and clinical features
  • Diagnosis
  • Management
  • Photoprotection and vitamin D deficiency
  • Cutaneous lymphomas: primary cutaneous T-cell lymphoma (mycosis fungoides)
  • Treatment
  • Kaposi sarcoma
  • Clinical features
  • Treatment
  • Other rare skin tumours
  • Disorders of pigmentation
  • Hypopigmentation
  • Vitiligo
  • Management
  • Post-inflammatory hypopigmentation
  • Leprosy
  • Oculocutaneous albinism
  • Hyperpigmentation
  • Freckles (ephelides)
  • Lentigines
  • Café-au-lait macules
  • Melasma (chloasma if it occurs in pregnancy)
  • Post-inflammatory hyperpigmentation
  • Metabolic and endocrine effects
  • Urticaria pigmentosa (cutaneous mastocytosis)
  • Nail disorders
  • Hair disorders
  • Hair loss (alopecia)
  • Male pattern and female pattern alopecia
  • Alopecia areata
  • Clinical features
  • Management
  • Traction alopecia
  • Telogen effluvium
  • Metabolic causes of hair loss
  • Dissecting cellulitis
  • Increased hair growth
  • Hirsutism
  • Hypertrichosis
  • Birth marks and neonatal rashes
  • Port-wine stain (naevus flammeus)
  • Drug eruptions
  • Maculopapular (morbilliform) exanthems
  • Fixed drug eruptions
  • Drug-induced and drug-exacerbated dermatoses
  • Severe cutaneous adverse reactions
  • Psychodermatology
  • Primary psychiatric disease presenting to dermatology healthcare professionals
  • Primary dermatological disease in which there are psychosocial co-morbidities
  • Part 5. Medicine Throughout Life
  • 46. Young adult medicine
  • Background
  • Mortality and morbidity
  • Mental health issues in young people
  • Eating disorders
  • Bullying
  • Screen time and social media
  • Lifestyle choices in young people
  • Nutrition and obesity
  • Physical activity
  • Smoking and vaping
  • Alcohol
  • Recreational drugs
  • Gambling
  • Vaccination
  • Sleep
  • Long-term health conditions
  • Shared decision-making
  • Health literacy
  • Other considerations when addressing the needs of young people
  • Neurodiversity
  • Sexual and reproductive health
  • Menstruation
  • Gender identity
  • 47. Sex and gender in medicine
  • Breast disease
  • History
  • Examination
  • Investigation
  • Breast cancer
  • Congenital abnormalities of the breast
  • Aberrations of development and involution
  • Fibroadenoma
  • Tubular and lactating adenoma
  • Juvenile hypertrophy
  • Pain and nodularity
  • Palpable breast cysts
  • Duct ectasia
  • Sclerosing lesions
  • Benign neoplasms and proliferations
  • Epithelial hyperplasia
  • Duct papilloma
  • Phyllodes tumours
  • Lipomas
  • Granular cell tumours
  • Other benign conditions of the breast
  • Nipple conditions
  • Haematomas
  • Fat necrosis
  • Diabetic mastopathy
  • Mondor’s disease
  • Hamartomas
  • Mastalgia
  • Nipple discharge
  • Breast infection
  • Peripheral non-lactating breast abscesses
  • Granulomatous lobular mastitis
  • Mammary duct fistula
  • Skin-associated infection
  • Hidradenitis suppurativa
  • Post-surgical infection
  • Female health
  • Examination
  • The life course approach
  • Female adolescence
  • Heavy menstrual bleeding
  • Medical treatments
  • Surgical treatments
  • Pre-pregnancy counselling
  • Miscarriage and stillbirth
  • Recurrent miscarriage
  • Stillbirth
  • Pregnancy
  • The postnatal visit
  • Contraception
  • Hormonal contraception
  • Long-acting reversible contraception
  • Barrier methods
  • Emergency contraception
  • Sterilization
  • Termination of pregnancy
  • Menopause
  • Hormone replacement therapy
  • Female urinary incontinence
  • Uterine fibroids (leiomyomata)
  • Gynaecological malignancy
  • Domestic abuse and violence
  • Female genital mutilation
  • Male health
  • Examination
  • Bladder scanning
  • Benign conditions of the prostate
  • Prostatitis
  • Benign enlargement of the prostate gland
  • Prostate cancer
  • Diseases of the penis
  • Phimosis
  • Paraphimosis
  • Priapism
  • Penile cancer
  • Testicular and spermatic cord disease
  • Testicular torsion
  • Epididymitis and orchitis
  • Hydrocele and epididymal cyst
  • Varicocele
  • Cryptorchidism (undescended testes)
  • Testicular germ cell tumours
  • Loss of libido and erectile dysfunction
  • The ageing male
  • Transgender health
  • The science of gender
  • Sex, gender, and terminology
  • Epidemiology of gender incongruence
  • Aetiology of gender incongruence
  • Neuroanatomical
  • Genetic
  • Hormonal
  • Neurodevelopmental
  • Environmental
  • Assessment of gender incongruence
  • History
  • Examination
  • Investigation
  • Diagnosis of gender incongruence
  • Management of gender incongruence
  • Social gender role change
  • Physical interventions
  • Hormone therapy
  • Speech and language therapy
  • Surgical Intervention
  • Treatment of non-binary people
  • 48. Obstetric medicine
  • Clinical skills
  • History
  • Examination
  • Investigations
  • Screening
  • Background
  • Hypertensive disorders
  • Chronic or pre-existing hypertension
  • Management
  • Gestational hypertension
  • Pre-eclampsia
  • Clinical features
  • Investigations
  • Management
  • HELLP
  • Liver disease
  • Hyperemesis gravidarum
  • Intrahepatic cholestasis of pregnancy
  • Acute fatty liver of pregnancy
  • Investigations
  • Cardiac disease
  • Pregnancy and prosthetic heart valves
  • Thromboembolic disease
  • Diagnosis
  • Management
  • Respiratory disease
  • Asthma
  • Pneumonia
  • Tuberculosis
  • Sarcoidosis
  • Cystic fibrosis
  • Severe restrictive lung disease
  • Neurological disease
  • Epilepsy
  • Birth defects
  • Management
  • Contraception and epilepsy
  • Migraine
  • Multiple sclerosis
  • Myasthenia gravis
  • Stroke
  • Endocrine disease
  • Type 1 and 2 diabetes
  • Adverse effects of diabetes in pregnancy
  • Management of diabetes during pregnancy
  • Gestational diabetes
  • Diagnosis of gestational diabetes
  • Management of gestational diabetes
  • Thyroid and parathyroid disease
  • Thyrotoxicosis
  • Hypothyroidism
  • Hyperparathyroidism
  • Pituitary disease
  • Prolactinomas
  • Diabetes insipidus
  • Hypopituitarism
  • Adrenal disease
  • Conn’s syndrome and hyperaldosteronism
  • Phaeochromocytoma and paraganglioma
  • Kidney disease
  • Urinary tract infection
  • Chronic kidney disease
  • Kidney transplantation
  • Acute kidney injury
  • Skin disorders
  • Rheumatic disease
  • Prescribing in pregnancy
  • 49. Medicine of the older adult
  • Background
  • Ageing
  • Why do we age?
  • Theories related to limited cell replication
  • Telomere shortening
  • Damage accumulation theory
  • Free radical theory
  • Theories related to evolution
  • Disposable soma theory
  • Mutation accumulation theory
  • Antagonistic pleiotropy theory
  • Calorie restriction
  • Cell senescence
  • Applied anatomy and physiology of ageing
  • Clinical approach to the older adult
  • Frailty, multimorbidity, and disability
  • Frailty
  • Identifying frailty
  • Frailty phenotype
  • Frailty index
  • The Clinical Frailty Scale
  • Multimorbidity
  • Sarcopenia
  • Investigations in older adults
  • Comprehensive geriatric assessment
  • Multidisciplinary team working
  • Advance care planning
  • Common issues facing older people
  • Polypharmacy
  • Prescribing in older people
  • Drug interactions
  • Patient choice
  • Evidence base
  • Benefits of therapy
  • Clinical decision-making
  • Falls and instability
  • Consequences of falls
  • Postural hypotension
  • Aetiology
  • Management
  • Delirium
  • Managing challenging behaviours
  • Urinary tract infections
  • Investigations
  • Management
  • Urinary incontinence
  • Stress incontinence
  • Urge incontinence (overactive bladder)
  • Overflow incontinence
  • Functional incontinence
  • Complex discharge planning
  • Important considerations
  • Rehabilitation goals
  • Managing risk
  • Cognitive impairment
  • Social and functional support
  • Carer strain
  • Older adult abuse and safeguarding
  • Loneliness
  • Ageing well and advantages of ageing
  • Societal and economic advantages of an active older population
  • Health and wellbeing
  • 50. Palliative care and symptom control
  • Background and general aspects
  • Who provides palliative care?
  • When should palliative care needs be assessed: problems rather than prognosis?
  • What are the patient’s needs, and what is the patient’s understanding?
  • Advance care planning: planning for the future
  • Difficult conversations
  • Do not attempt cardiopulmonary resuscitation orders and treatment escalation plans
  • Symptom control
  • Pain
  • Pain and the use of opioids
  • Cancer pain and the World Health Organization analgesic ladder
  • Strong opioid drugs
  • Adjuvants and alternatives
  • Gastrointestinal symptoms
  • Nausea and vomiting
  • Constipation
  • Bowel obstruction
  • Anorexia, weight loss, and malaise
  • Respiratory symptoms
  • Breathlessness
  • Cough
  • Secretions
  • Other physical symptoms
  • Fatigue
  • Mouth symptoms
  • Loss of function, disability, and rehabilitation
  • Poor sleep
  • Psychosocial issues
  • Palliative care in non-malignant disease
  • Heart failure
  • Chronic respiratory disease
  • Opioid titration in non-malignant respiratory disease
  • COVID-19
  • Renal disease
  • Withdrawal of dialysis
  • Liver disease
  • Neurological disease
  • Motor neurone disease
  • Palliative care for young adults
  • Recognizing dying
  • Care of the dying
  • A. Chapter questions
  • Chapter 2: Clinical communication
  • Chapter 3: Medical ethics
  • Chapter 4: Evidence-based practice
  • Chapter 5: Human genetics
  • Chapter 6: Immunity
  • Chapter 7: Therapeutics and prescribing
  • Chapter 8: Radiology
  • Chapter 9: Public health
  • Chapter 10: Global and planetary health
  • Chapter 11: Acute medicine
  • Chapter 12: Sepsis and the treatment of bacterial infection
  • Chapter 13: Critical care medicine
  • Chapter 14: Anaesthesia and perioperative medicine
  • Chapter 15: Toxicology
  • Chapter 16: Environmental medicine
  • Chapter 17: Cardiology
  • Chapter 18: Hypertension
  • Chapter 19: Lipid and metabolic disorders
  • Chapter 20: Respiratory medicine
  • Chapter 21: Ear, nose, and throat
  • Chapter 22: Gastroenterology
  • Chapter 23: Hepatology
  • Chapter 24: Biliary tract and pancreatic disease
  • Chapter 25: Nutrition
  • Chapter 26: Kidney and urinary tract disease
  • Chapter 27: Water balance, fluids, and electrolytes
  • Chapter 28: Neurology
  • Chapter 29: Stroke medicine
  • Chapter 30: General hospital psychiatry
  • Chapter 31: Ophthalmology
  • Chapter 32: Rheumatology
  • Chapter 33: Bone disease
  • Chapter 34: Endocrinology
  • Chapter 35: Diabetes mellitus
  • Chapter 36: Metabolic disease
  • Chapter 37: Obesity
  • Chapter 38: Haematology
  • Chapter 39: Haematological oncology
  • Chapter 40: Venous thromboembolic disease
  • Chapter 41: Malignant disease
  • Chapter 42: Infectious disease
  • Chapter 43: Sexually transmitted infections
  • Chapter 44: Human immunodeficiency virus
  • Chapter 45: Dermatology
  • Chapter 46: Young adult medicine
  • Chapter 47: Sex and gender in medicine
  • Chapter 48: Obstetric medicine
  • Chapter 49: Medicine of the older adult
  • Chapter 50: Palliative care and symptom control
  • B. Answers to chapter questions
  • Chapter 2: Clinical communication
  • Chapter 3: Medical ethics
  • Chapter 4: Evidence-based practice
  • Chapter 5: Human genetics
  • Chapter 6: Immunity
  • Chapter 7: Therapeutics and prescribing
  • Chapter 8: Radiology
  • Chapter 9: Public health
  • Chapter 10: Global and planetary health
  • Chapter 11: Acute medicine
  • Chapter 12: Sepsis and the treatment of bacterial infection
  • Chapter 13: Critical care medicine
  • Chapter 14: Anaesthesia and perioperative medicine
  • Chapter 15: Toxicology
  • Chapter 16: Environmental medicine
  • Chapter 17: Cardiology
  • Chapter 18: Hypertension
  • Chapter 19: Lipid and metabolic disorders
  • Chapter 20: Respiratory medicine
  • Chapter 21: Ear, nose, and throat
  • Chapter 22: Gastroenterology
  • Chapter 23: Hepatology
  • Chapter 24: Biliary tract and pancreatic disease
  • Chapter 25: Nutrition
  • Chapter 26: Kidney and urinary tract disease
  • Chapter 27: Water balance, fluids, and electrolytes
  • Chapter 28: Neurology
  • Chapter 29: Stroke medicine
  • Chapter 30: General hospital psychiatry
  • Chapter 31: Ophthalmology
  • Chapter 32: Rheumatology
  • Chapter 33: Bone disease
  • Chapter 34: Endocrinology
  • Chapter 35: Diabetes mellitus
  • Chapter 36: Metabolic disease
  • Chapter 37: Obesity
  • Chapter 38: Haematology
  • Chapter 39: Haematological oncology
  • Chapter 40: Venous thromboembolic disease
  • Chapter 41: Malignant disease
  • Chapter 42: Infectious disease
  • Chapter 43: Sexually transmitted infections
  • Chapter 44: Human immunodeficiency virus
  • Chapter 45: Dermatology
  • Chapter 46: Young adult medicine
  • Chapter 47: Sex and gender in medicine
  • Chapter 48: Obstetric medicine
  • Chapter 49: Medicine of the older adult
  • Chapter 50: Palliative care and symptom control
  • Index
  • Reference Intervals
  • Haematology
  • Biochemistry