Medicine at a Glance

Patrick Davey is Consultant Cardiologist at Northampton General Hospital, and Honorary Senior Lecturer, Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford

Preface to third edition xii

Preface to fourth edition xiii

List of contributors xiv

Acknowledgements xvi

List of abbreviations xviii

How to use your revision guide xxiii

About the companion website xxvii

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 Principles of examination 16

10 Basic clinical skills 17

11 Is the patient ill? 22

12 The critically ill patient 24

Clinical presentations at a glance 27

Cardiovascular disease

13 Chest pain 28

14 Oedema 32

15 Palpitations 34

16 The painful leg 35

17 Heart murmurs 36

18 Shock 38

Respiratory disease

19 Breathlessness, cough and haemoptysis 40

20 Wheeze (stridor) 44

21 Pleural effusion 45

22 Pneumothorax 46

Gastroenterology

23 Unintentional weight loss 48

24 Constipation and change in bowel habit 50

25 Diarrhoea: acute and chronic 52

26 Vomiting and intestinal obstruction 54

27 Haematemesis and melaena 56

28 Rectal bleeding 60

29 Dysphagia 62

30 Abdominal pain and dyspepsia 64

31 Jaundice 66

32 Abdominal mass 68

33 Ascites 69

Renal medicine

34 Polyuria and oliguria 70

35 Dysuria, frequency and urgency 72

36 Haematuria 73

Endocrinology

37 Sweating, flushing and thyroid swellings 74

38 Obesity 77

39 Hirsutism and infertility 80

40 Erectile dysfunction and gynaecomastia 82

Infectious disease

41 Principles of infection 84

42 Diagnosis of infection 86

43 Fever and the assessment of the patient with presumed infection 88

44 Fever and infections in hospital patients 90

45 Fever of unknown origin 93

46 Fever and rash 96

47 Fever in HIV-infected patients 98

48 Fever in the returned traveller 100

49 Vaginal discharge and urethritis 102

Haematology

50 Anaemia 104

51 Clinical approach to lymphadenopathy and splenomegaly 106

52 The patient with abnormal bleeding or bruising 108

53 Leukopenia 109

Oncology

54 Oncological emergencies 110

Neurology

55 Introduction to neurological diagnosis 1 112

56 Introduction to neurological diagnosis 2 114

57 Introduction to neurological diagnosis 3: neuroepidemiology 116

58 Common neurological symptoms 117

59 Weakness 120

60 Disturbance of vision: a neurological perspective 123

61 Sudden painless loss of vision 126

62 Tremor and other involuntary movements 128

63 Headache and facial pain 130

64 Episodic alterations in awareness and consciousness 132

Ophthalmology

65 The red eye 136

Rheumatology

66 Introduction to rheumatological disease 138

67 Low back pain and other regional pain syndromes 142

Dermatology

68 Introduction to dermatology 146

69 Pruritis and rashes 148

70 Hair and nail disorders 150

71 Leg ulcers 152

72 Photodermatoses 153

Women's health

73 Pelvic pain 154

74 Urinary incontinence 156

Other acute medical emergencies

75 Attempted suicide by drug poisoning 158

76 Anaphylaxis 160

77 Allergic reactions 162

78 Cardiac and respiratory arrest 164

79 Delirium 166

80 Coma 169

Diseases and treatments at a glance 172

Cardiovascular disease

81 Hypertension 175

82 Hyperlipidaemia 178

83 Acute coronary syndromes 181

84 ST segment elevation myocardial infarction 186

85 Chronic coronary syndromes 190

86 Aortic dissection 194

87 Heart failure 196

88 Aortic valve disease 200

89 Mitral valve disease 202

90 Cardiomyopathies 204

91 Pericardial disease 205

92 Pulmonary embolism 206

93 Cardiac infections 208

94 Tachyarrhythmias 210

95 Bradyarrhythmias 216

96 Congenital heart disease 218

Respiratory disease

97 Lung function tests 220

98 Sleep apnoea 221

99 Respiratory failure 222

100 Arterial blood gas analysis 224

101 Chest X-ray anatomy 226

102 Basic chest X-ray interpretation 228

103 Chest X-ray cases 1 230

104 Chest X-ray cases 2 232

105 Non-invasive ventilation 234

106 Mechanical ventilation 236

107 Lower respiratory tract infection: pneumonia 238

108 Upper respiratory tract infection 241

109 Asthma 242

110 Chronic obstructive pulmonary disease 245

111 Bronchiectasis 248

112 Cystic fi brosis 250

113 Sarcoidosis and other granulomatous lung diseases 252

114 Extrinsic allergic alveolitis (hypersensitivity pneumonitis) 254

115 Pulmonary fi brosis 256

116 Pulmonary eosinophilia and vasculitis 258

117 Fungi and the lung 260

118 Industrial lung disease 262

119 Lung disease caused by drugs 264

120 BOOP and ARDS 265

121 Primary tumours of the lung 266

Gastroenterology

122 Food poisoning and gastrointestinal infections 268

123 Refl ux 269

124 Peptic ulcer disease 270

125 Diverticular disease 271

126 Iron defi ciency 272

127 Abnormal liver function tests 274

128 Infl ammatory bowel disease 276

129 Malabsorption 278

130 Pancreatitis and pancreatic cancer 280

131 Gallstone disease 282

132 Infl ammatory liver disease: viral and immune 283

133 Acute and chronic liver disease 287

134 Metabolic liver disease (including alcohol) 290

135 Upper gastrointestinal cancer 292

136 Colorectal cancer 294

137 Imaging in gastrointestinal disease 296

138 Functional gastrointestinal disorders 297

139 Nutrition 298

Renal medicine

140 Renal physiology and function tests 300

141 Hypokalaemia and hyperkalaemia 302

142 Hyponatraemia and hypernatraemia 304

143 Disorders of acid-base balance 306

144 Urinary calculi 308

145 Nephrotic and nephritic syndromes 310

146 Glomerulonephritis 312

147 Renal involvement in systemic disease 314

148 Hereditary renal disorders 318

149 Tubulointerstitial disease 320

150 Acute renal failure 322

151 Chronic renal failure and the dialysis patient 324

152 The renal transplant recipient 326

153 Drugs and renal failure 328

154 Benign prostatic hypertrophy 329

155 Urinary tract infection 330

Endocrinology

156 Diabetes mellitus 332

157 Complications of diabetes 334

158 Diabetic emergencies 336

159 Hyperprolactinaemia and acromegaly 337

160 Hypothyroidism 338

161 Hyperthyroidism 340

162 Calcium metabolism 342

163 Adrenal disease 344

164 Miscellaneous endocrine disorders 346

165 Hypogonadism 348

Infectious disease

166 Bacteraemia and septic shock 350

167 Common viral infections in adults 352

168 HIV infection and AIDS 354

169 Common fungal infections 356

170 Specifi c bacterial infections 358

171 Malaria 360

172 Tuberculosis 362

173 Tropical infectious diseases 364

174 Diseases predisposing to infection 366

175 Immunological defi ciency syndromes 368

Haematology

176 Haematinic defi ciency anaemias 372

177 Haemolytic anaemia 374

178 Thalassaemia and sickle cell disease 378

179 Bone marrow failure 380

180 Acute leukaemia 382

181 Chronic leukaemia 384

182 Lymphoma 386

183 Myeloproliferative disorders 388

184 Myeloma 390

185 Myelodysplasia 391

186 The blood in systemic disease 392

187 Platelet disorders 396

188 Disorders of coagulation 398

189 Anticoagulation and antiplatelet drugs 400

190 Thrombophilia 402

Oncology

191 Aetiology of cancer 404

192 Diagnostic strategies and basic principles of cancer management 406

193 Cancer screening and early detection 408

194 Breast cancer 410

195 Prostate cancer 412

196 Cancer with an unknown primary 414

197 Paraneoplastic syndromes and hormone-producing cancers 416

198 Palliative care 418

Neurology

199 Head computed tomography cases 420

200 Head magnetic resonance imaging cases 422

201 Stroke 424

202 Management of stroke 426

203 Other vascular disorders of the brain 428

204 Dementias 430

205 Epilepsy 432

206 Multiple sclerosis 434

207 Infections of the central nervous system 436

208 Tumours and the nervous system 438

209 Spinal cord disease 440

210 Neuromuscular disease 442

211 Peripheral neuropathy 444

212 Movement disorders 446

Rheumatology

213 Osteoarthritis 448

214 Gout and pseudogout 450

215 Arthritis associated with infectious agents 452

216 Metabolic bone disease 454

217 Other bone disease 456

218 Rheumatoid arthritis 458

219 Seronegative spondyloarthropathies 462

220 Vasculitis 466

221 Systemic lupus erythematosus 469

222 Infl ammatory muscle disease and selected forms of vasculitis 472

Dermatology

223 Eczema and urticaria 474

224 Psoriasis 477

225 Acne, rosacea and hidradenitis 478

226 Disorders of skin pigmentation 479

227 Blistering diseases 480

228 Skin infections and infestations 482

229 The skin and systemic disease 485

230 Skin tumours 488

231 Orogenital disease 490

Women's health

232 Endometriosis and adenomyosis 492

233 Polycystic ovarian syndrome 494

234 Hypertensive disorders of pregnancy 496

235 Cardiovascular disease in pregnancy 498

236 Other medical and surgical conditions in pregnancy 500

Miscellaneous

237 Fluid replacement therapy 502

238 Illness in elderly people 504

239 Chronic tiredness and other medically unexplained symptoms 506

240 Psychiatric disorders 508

241 Substance misuse 510

242 Alcohol misuse 512

243 Drug toxicity (adverse drug reactions) 514

Index 519