Medicine at a Glance

List of Contributors xii Preface xiv Acknowledgements xvi Abbreviations xviii How to use your revision guide xxiv About the companion website xxvi Part 1 Introduction 1 1 How to be a medical student 2 2 Patient confidentiality 4 3 Consent 6 4 Relationship with the patient 8 5 History of presenting complaint 10 6 Past medical history, drugs and allergies 12 7 Family and social history 14 8 Functional enquiry 15 9 Basic clinical skills 16 10 Principles of examination 21 11 Is the patient ill? 22 12 The critically ill patient 24 Part 2 Clinical presentations at a glance 28 Cardiovascular disease 13 Chest pain 30 14 Oedema 34 15 Palpitations 36 16 The painful leg 37 17 Heart murmurs 38 18 Shock 40 Respiratory disease 19 Breathlessness, cough and haemoptysis 42 20 Wheeze (stridor) 46 21 Pleural effusion 47 22 Pneumothorax 48 Gastroenterology 23 Unintentional weight loss 50 24 Constipation and change in bowel habit 52 25 Diarrhoea: acute and chronic 54 26 Vomiting and intestinal obstruction 56 27 Haematemesis and melaena 58 28 Rectal bleeding 62 29 Dysphagia 64 30 Abdominal pain and dyspepsia 66 31 Jaundice 68 32 Abdominal mass 70 33 Ascites 71 Renal medicine 34 Polyuria and oliguria 72 35 Dysuria, frequency and urgency 74 36 Haematuria 75 Endocrinology 37 Sweating, flushing and thyroid swellings 76 38 Obesity 79 39 Hirsutism and infertility 82 40 Erectile dysfunction and gynaecomastia 84 Infectious disease 41 Principles of infection 86 42 Investigation of suspected infection 88 43 An approach to the patient with fever of short duration 90 44 Healthcare-associated infections 94 45 Fever of unknown origin 96 46 Fever and rash 100 47 Fever in HIV-infected patients 102 48 Fever in the returned traveller 104 49 Vaginal discharge and urethritis in men 106 Haematology 50 Anaemia 108 51 Clinical approach to lymphadenopathy and splenomegaly 110 52 The patient with abnormal bleeding or bruising 112 53 Leukopenia 113 Oncology 54 Oncological emergencies 114 Neurology 55 Introduction to neurological diagnosis 1: Neuroepidemiology 117 56 Introduction to neurological diagnosis 2 118 57 Introduction to neurological diagnosis 3 120 58 Common neurological symptoms 122 59 Weakness 125 60 Disturbance of vision: a neurological perspective 128 61 Sudden painless loss of vision 132 62 Tremor and other involuntary movements 134 63 Headache and facial pain 136 64 Episodic alterations in awareness and consciousness 138 Ophthalmology 65 The red eye 142 Rheumatology 66 Introduction to rheumatological disease 144 67 Low back pain and other regional pain syndromes 150 Dermatology 68 Introduction to dermatology 154 69 Pruritus and rashes 156 70 Hair and nail disorders 158 71 Leg ulcers 160 72 Photodermatoses 161 Women’s health 73 Pelvic pain 162 74 Urinary incontinence 166 Other acute medical emergencies 75 Attempted suicide by drug poisoning 168 76 Anaphylaxis 170 77 Allergic reactions 172 78 Cardiac and respiratory arrest 174 79 Delirium 176 80 Coma 179 Part 3 Diseases and treatments at a glance 182 Cardiovascular disease 81 Hypertension 184 82 Hyperlipidaemia 187 83 Acute coronary syndromes 190 84 ST segment elevation myocardial infarction 198 85 Chronic coronary syndromes 202 86 Acute aortic dissection 206 87 Heart failure 208 88 Aortic valve disease 212 89 Mitral valve disease 214 90 Cardiomyopathies 216 91 Pericardial disease 217 92 Pulmonary embolism 218 93 Cardiac infections 220 94 Tachyarrhythmias 222 95 Bradyarrhythmias 228 96 Congenital heart disease 230 Respiratory disease 97 Lung function tests 232 98 Overnight oximetry and sleep apnoea 233 99 Respiratory failure 234 100 Arterial blood gas analysis 236 101 Chest X-ray anatomy 238 102 Basic chest X-ray interpretation 240 103 Chest X-ray cases 1 242 104 Chest X-ray cases 2 244 105 Non-invasive ventilation 246 106 Mechanical ventilation 248 107 Lower respiratory tract infection: pneumonia 250 108 Upper respiratory tract infection 253 109 Asthma 254 110 Chronic obstructive pulmonary disease 257 111 Bronchiectasis 260 112 Cystic fibrosis 262 113 Sarcoidosis and other granulomatous lung diseases 264 114 Hypersensitivity pneumonitis (extrinsic allergic alveolitis) 266 115 Pulmonary fibrosis 268 116 Pulmonary eosinophilia and vasculitis 270 117 Fungi and the lung 272 118 Industrial lung disease 274 119 Lung disease caused by drugs 276 120 BOOP and ARDS 277 121 Primary tumours of the lung 278 Gastroenterology 122 Gastrointestinal infections 281 123 Reflux 282 124 Peptic ulcer disease 283 125 Iron deficiency 284 126 Abnormal liver chemistry 286 127 Diverticular disease 289 128 Inflammatory bowel disease 290 129 Gallstone disease 293 130 Malabsorption 294 131 Pancreatitis and pancreatic cancer 296 132 Inflammatory liver disease: viral and immune 298 133 Metabolic liver disease (including alcohol) 302 134 Acute and chronic liver disease 304 135 Functional gastrointestinal disorders 307 136 Upper gastrointestinal cancer 308 137 Colorectal cancer 310 138 Nutrition 312 Renal medicine 139 Renal physiology and function tests 314 140 Hypokalaemia and hyperkalaemia 316 141 Hyponatraemia and hypernatraemia 318 142 Disorders of acid–base balance 320 143 Urinary calculi 322 144 Nephrotic and nephritic syndromes 324 145 Glomerulonephritis 326 146 Renal involvement in systemic disease 328 147 Hereditary renal disorders 332 148 Tubulointerstitial disease 334 149 Acute renal failure 336 150 Chronic renal failure and the dialysis patient 338 151 The renal transplant recipient 340 152 Drugs and renal failure 342 153 Benign prostatic hypertrophy 343 154 Urinary tract infection 344 Endocrinology 155 Diabetes and its complications 346 156 Diabetic emergencies 352 157 Hyperprolactinaemia and acromegaly 354 158 Hypothyroidism 356 159 Hyperthyroidism 358 160 Calcium metabolism 360 161 Adrenal disease 362 162 Miscellaneous endocrine disorders 364 163 Hypogonadism 366 Infectious disease 164 Bacteraemia and septic shock 368 165 Herpes virus infections in adults 370 166 HIV infection and advanced HIV disease 374 167 Common fungal infections 376 168 Specific bacterial infections 378 169 Malaria 380 170 Tuberculosis 382 171 Tropical infectious diseases 384 172 Diseases predisposing to infection 386 173 Immunological deficiency syndromes 388 Haematology 174 Haematinic deficiency anaemias 392 175 Haemolytic anaemia 394 176 Thalassaemia and sickle cell disease 398 177 Bone marrow failure 400 178 Acute leukaemia 402 179 Lymphoma 404 180 Non-Hodgkin lymphoma 406 181 Myeloproliferative neoplasms 408 182 Myeloma 410 183 Myelodysplasia 411 184 The blood in systemic disease 412 185 Platelet disorders 416 186 Disorders of coagulation 418 187 Anticoagulation and antiplatelet drugs 420 188 Thrombophilia 422 Oncology 189 Aetiology of cancer 424 190 Diagnostic strategies and basic principles of cancer management 426 191 Cancer screening and early detection 430 192 Breast cancer 432 193 Prostate cancer 435 194 Cancer with an unknown primary 438 195 Paraneoplastic cancer syndromes and hormone-producing cancers 440 196 Palliative care 442 Neurology 197 Head computed tomography cases 444 198 Head magnetic resonance imaging cases 446 199 Stroke 448 200 Management of stroke 450 201 Other vascular disorders of the brain 452 202 Dementias 454 203 Epilepsy 456 204 Multiple sclerosis 458 205 Infections of the central nervous system 460 206 Tumours and the nervous system 462 207 Spinal cord disease 464 208 Neuromuscular disease 466 209 Peripheral neuropathy 468 210 Movement disorders 470 Rheumatology 211 Osteoarthritis 472 212 Gout and pseudogout (calcium pyrophosphate dihydrate arthropathy) 474 213 Arthritis associated with infectious agents 476 214 Vasculitis 478 215 Metabolic bone disease 481 216 Other bone disease 484 217 Rheumatoid arthritis 486 218 Inflammatory spondyloarthropathies 491 219 Systemic lupus erythematosus 496 220 Myositis syndromes, polymyalgia rheumatica and systemic sclerosis 500 Dermatology 221 Eczema and urticaria 503 222 Psoriasis 506 223 Blistering diseases 508 224 Skin infections and infestations 510 225 Acne, rosacea and hidradenitis 513 226 The skin and systemic disease 514 227 Disorders of skin pigmentation 517 228 Skin tumours 518 229 Orogenital disease 520 Women’s health 230 Endometriosis and adenomyosis 522 231 Polycystic ovary syndrome 526 232 Hypertensive disorders of pregnancy 530 233 Cardiovascular disease in pregnancy 532 234 Other medical and surgical conditions in pregnancy 534 Miscellaneous 235 Fluid replacement therapy 536 236 Illness in elderly people 538 237 Chronic tiredness and other medically unexplained symptoms 540 238 Psychiatric disorders 542 239 Substance misuse 544 240 Alcohol misuse 546 241 Drug toxicity (adverse drug reactions) 548 242 Covid-19 554 Index 558