Edited by Adam Feather, MBBS, FRCP, FAcadMEd; David Randall, MA, MRCP; and Mona Waterhouse, MA, MRCP
Contributors comprise consultants at the top of their fields, paired with younger doctors closer to the exam experience, to ensure authority and relevance.
Enhanced e-book accompanies the print book, for ease of transportation and use on the move.
International Advisory Board, led by Professor Janaka de Silva and Professor Senaka Rajapakse, providing guidance for global coverage from across the world.
Contributions to the e-book by members of the International Advisory Board to amplify areas of clinical importance in their parts of the world.
1. Introduction - p. 98 2. The biology of cancer - p. 98 3. Aetiology and epidemiology - p. 100 4. Screening and investigations - p. 102 5. Principles of cancer treatment - p. 106 6. Acute oncology - p. 116 7. Common solid tumour treatment - p. 118 8. Lung cancer - p. 118 9. Breast cancer - p. 120 10. Upper gastrointestinal cancers - p. 123 11. Lower gastrointestinal cancers - p. 124 12. Hepatobiliary and pancreatic cancers - p. 124 13. Urological cancers - p. 127 14. Gynaecological cancers - p. 130 15. Brain tumours - p. 132 16. Head and neck cancer - p. 133 17. Metastatic cancer of unknown primary - p. 133 18. 7. Palliative care and symptom control - p. 137 19. 8. Sepsis and the treatment of bacterial infection - p. 151 20. 9. Water balance, fluids and electrolytes - p. 169 21. 10. Critical care medicine - p. 203 22. 11. Surgery - p. 239 23. 12. Prescribing, therapeutics and toxicology - p. 251 24. 13. Global health - p. 277 25. 14. Public health - p. 285 26. 15. Geriatric medicine, frailty and multimorbidity - p. 297 27. 16. Haematology - p. 319 28. Core Skills and Knowledge - p. 319 29. Clinical skills for haematology - p. 320 30. Examination - p. 320 31. Investigations - p. 320 32. Introduction - p. 324 33. The red cell - p. 325 34. Anaemia: an introduction - p. 327 35. Microcytic anaemia - p. 328 36. Normocytic anaemia - p. 332 37. Macrocytic anaemias - p. 333 38. Anaemia due to marrow failure (aplastic anaemia) - p. 336 39. Haemolytic anaemias: an introduction - p. 338 40. Inherited haemolytic anaemia - p. 338 41. Acquired haemolytic anaemia - p. 351 42. Polycythaemia - p. 355 43. The spleen - p. 356 44. Blood transfusion - p. 357 45. Blood groups - p. 357 46. Procedure for blood transfusion in hospitals - p. 358 47. Complications of blood transfusion - p. 359 48. Strategies for the avoidance of unnecessary transfusion - p. 362 49. Blood, blood components and blood products - p. 362 50. The white cell - p. 365 51. Haemostasis - p. 367 52. Vascular disorders - p. 372 53. Platelet disorders - p. 372 54. Inherited coagulation disorders - p. 375 55. Acquired coagulation disorders - p. 377 56. 17. Haematological oncology - p. 379 57. 18. Rheumatology - p. 411 58. Core Skills and Knowledge - p. 411 59. Clinical skills for rheumatology - p. 412 60. Approach to the patient - p. 414 61. Anatomy and physiology of the normal joint - p. 414 62. Investigation of rheumatic disease - p. 415 63. Clinical conditions in rheumatology - p. 417 64. Common regional musculoskeletal problems - p. 418 65. Chronic pain syndromes - p. 429 66. Analgesic and anti-inflammatory drugs for musculoskeletal problems - p. 431 67. Disorders of collagen - p. 432 68. Osteoarthritis - p. 433 69. Inflammatory Arthritis - p. 437 70. Rheumatoid arthritis - p. 437 71. Spondyloarthritis - p. 447 72. Infections of joints - p. 454 73. Autoimmune rheumatic diseases - p. 456 74. Systemic inflammatory vasculitis - p. 464 75. Arthritis in children - p. 467 76. Rheumatological problems seen in other diseases - p. 467 77. Miscellaneous arthropathies - p. 468 78. 19. Bone disease - p. 471 79. 20. Infectious disease - p. 488 80. Core Skills and Knowledge - p. 488 81. Core content - p. 488 82. Clinical skills for infectious disease - p. 489 83. Introduction - p. 491 84. Clinical approach to the patient with a suspected infection - p. 492 85. Epidemiology and prevention of infections - p. 502 86. Principles and mechanisms of infection - p. 509 87. Viral Infections - p. 513 88. Virus infections of the skin and mucous membranes - p. 513 89. Virus infections of the respiratory tract - p. 519 90. Systemic viral infections - p. 521 91. Virus infections of the nervous system - p. 526 92. Virus infections of the gastrointestinal tract - p. 529 93. Viral hepatitis - p. 530 94. Viruses and malignant disease - p. 530 95. Viral haemorrhagic fevers - p. 531 96. Antiviral drugs - p. 533 97. Transmissible Spongiform Encephalopathies (Prion Diseases) - p. 535 98. Bacterial Infections - p. 535 99. Bacterial infections of the skin and soft tissues - p. 535 100. Bacterial infections of the respiratory tract - p. 537 101. Bacterial infections of the gastrointestinal tract - p. 539 102. Bacterial infections of the cardiovascular system - p. 544 103. Bacterial infections of the nervous system - p. 545 104. Bacterial bone and joint infections - p. 547 105. Bacterial infections of the urinary tract - p. 547 106. Systemic/multisystem bacterial infections - p. 547 107. Bacterial infections seen in developing and tropical countries - p. 550 108. Antibiotic therapies - p. 559 109. Fungal Infections - p. 559 110. Systemic fungal infections - p. 559 111. Subcutaneous fungal infections - p. 561 112. Superficial fungal infections - p. 562 113. Antifungal drugs - p. 562 114. Protozoal Infections - p. 563 115. Blood and tissue protozoa - p. 563 116. Gastrointestinal protozoa - p. 571 117. Helminthic Infections - p. 573 118. Nematodes - p. 574 119. Trematodes - p. 578 120. Cestodes - p. 580 121. Arthropod Ectoparasites - p. 581 122. 21. Endocrinology - p. 583 123. Core Skills and Knowledge - p. 583 124. Clinical skills for endocrinology - p. 584 125. Introduction - p. 586 126. The pituitary gland and hypothalamus - p. 591 127. Hypothalamo–Pituitary–adrenal axis - p. 598 128. The thyroid axis - p. 609 129. Hypothalamo–pituitary–gonadal axis - p. 622 130. Growth and puberty - p. 632 131. The Thirst Axis - p. 641 132. Disorders of Calcium Metabolism - p. 644 133. Hypoglycaemia in the non-diabetic patient - p. 647 134. Other endocrine disorders - p. 648 135. 22. Dermatology - p. 651 136. Core Skills and Knowledge - p. 651 137. Clinical Skills for Dermatology - p. 652 138. Introduction - p. 654 139. Skin structure and function - p. 654 140. Investigation of Skin Disease - p. 656 141. Principles of Dermatological Therapy - p. 656 142. Erythroderma and Loss of Skin Function (‘Skin Failure’) - p. 657 143. Common rashes - p. 657 144. Skin Infections - p. 669 145. Human Immunodeficiency Virus and the Skin - p. 676 146. Skin Signs of Systemic Disease - p. 677 147. Photosensitivity - p. 685 148. Blistering and Bullous Skin Disease - p. 686 149. Skin Tumours - p. 688 150. Disorders of Pigmentation - p. 693 151. Nail Disorders - p. 694 152. Hair Disorders - p. 694 153. Birth Marks and Neonatal Rashes - p. 695 154. Drug Eruptions - p. 696 155. 23. Diabetes mellitus - p. 699 156. Core Skills and Knowledge - p. 699 157. Clinical skills for diabetes mellitus - p. 699 158. Introduction - p. 701 159. Physiology of insulin structure, secretion and action - p. 701 160. Classification of diabetes - p. 704 161. Clinical Approach to the Patient With Diabetes - p. 710 162. Prevention of Type 2 Diabetes - p. 711 163. Management of diabetes - p. 711 164. Diabetic metabolic emergencies - p. 722 165. Complications of diabetes - p. 725 166. Psychosocial Implications of Diabetes - p. 736 167. Diabetes in special situations - p. 737 168. Organization of diabetes care - p. 741 169. 24. Lipid and metabolic disorders - p. 743 170. 25. Liaison psychiatry - p. 763 171. Core Skills and Knowledge - p. 763 172. Introduction - p. 763 173. Clinical approach to the patient with a psychiatric disorder - p. 764 174. Classification of psychiatric disorders - p. 768 175. Aetiology of psychiatric disorders - p. 768 176. Psychiatric aspects of physical diseases - p. 768 177. Sick role and illness behaviour - p. 769 178. Functional somatic syndromes - p. 769 179. Somatoform disorders - p. 772 180. Dissociative/conversion disorders - p. 773 181. Sleep difficulties - p. 774 182. Mood (affective) disorders - p. 776 183. Suicide and self-harm - p. 784 184. Anxiety disorders - p. 785 185. Alcohol misuse and dependence - p. 790 186. Drug misuse and dependence - p. 792 187. Schizophrenia - p. 793 188. Organic mental disorders - p. 796 189. Eating disorders - p. 797 190. Sexual disorders - p. 798 191. Personality disorders - p. 799 192. Involuntary Detention - p. 800 193. Mental Capacity Act - p. 800 194. 26. Neurology - p. 801 195. Core Skills and Knowledge - p. 801 196. Clinical skills for neurology - p. 886 197. Introduction - p. 803 198. Clinical approach to the patient with neurological disease - p. 803 199. Functional neuroanatomy - p. 806 200. Cranial nerves - p. 809 201. Motor control systems - p. 818 202. Lower motor neurone lesions - p. 821 203. Sensory pathways and pain - p. 822 204. Bladder control and sexual dysfunction - p. 827 205. Investigation of neurological disease - p. 827 206. Unconsciousness and coma - p. 831 207. Stroke - p. 836 208. Intracranial haemorrhage - p. 845 209. Headache, migraine and facial pain - p. 848 210. Epilepsy and loss of consciousness - p. 852 211. Movement disorders - p. 858 212. Neuroinflammatory disorders - p. 864 213. Nervous system infection - p. 868 214. Hydrocephalus - p. 876 215. Traumatic brain injury - p. 877 216. Spinal cord disease - p. 878 217. Neurodegenerative diseases - p. 880 218. Congenital disorders - p. 885 219. Neurogenetic disorders - p. 885 220. Paraneoplastic syndromes - p. 887 221. Peripheral nerve disease - p. 887 222. Muscle diseases - p. 893 223. 27. Ear, nose and throat and eye disease - p. 899 224. 28. Respiratory disease - p. 927 225. Core Skills and Knowledge - p. 927 226. Clinical skills for respiratory medicine - p. 927 227. Function of the respiratory system - p. 930 228. Clinical Approach to the Patient with Respiratory Disease - p. 936 229. Diseases of the Upper Respiratory Tract - p. 945 230. Obstructive Respiratory Disease - p. 949 231. Smoking - p. 962 232. Respiratory Infection - p. 963 233. Pleural Disease - p. 972 234. Tumours of the Respiratory Tract - p. 975 235. Bronchiectasis - p. 982 236. Interstitial Lung Diseases - p. 985 237. Lung and Heart–Lung Transplantation - p. 994 238. Occupational Lung Disease - p. 995 239. Miscellaneous Respiratory Disorders - p. 997 240. Disorders of the Diaphragm - p. 997 241. Mediastinal Lesions - p. 998 242. 29. Venous thromboembolic disease - p. 1001 243. 30. Cardiology - p. 1020 244. Core Skills and Knowledge - p. 1020 245. Clinical skills for cardiology - p. 1020 246. ECG interpretation - p. 1021 247. Anatomy, physiology and embryology of the heart - p. 1023 248. Clinical approach to the patient with heart disease - p. 1028 249. Therapeutic procedures - p. 1045 250. Cardiac arrhythmias - p. 1051 251. Bradycardias and heart block - p. 1052 252. Supraventricular tachycardias - p. 1057 253. Ventricular tachyarrhythmias - p. 1063 254. Heart failure - p. 1069 255. Coronary artery disease - p. 1079 256. Angina - p. 1081 257. Acute coronary syndromes - p. 1084 258. Valvular heart disease - p. 1091 259. Aortic valve - p. 1097 260. tricuspid valve - p. 1100 261. Pulmonary valve - p. 1101 262. Prosthetic valves - p. 1102 263. Infective endocarditis - p. 1103 264. Congenital heart disease - p. 1107 265. Marfan’s syndrome - p. 1113 266. Pulmonary heart disease - p. 1115 267. Myocardial and endocardial disease - p. 1117 268. Myocardial disease - p. 1118 269. Pericardial disease - p. 1125 270. Peripheral vascular disease - p. 1128 271. Peripheral venous disease - p. 1132 272. 31. Hypertension - p. 1133 273. 32. Gastroenterology - p. 1147 274. Core Skills and Knowledge - p. 1147 275. Clinical Skills for Gastroenterology - p. 1148 276. INTRODUCTION - p. 1149 277. Anatomy and physiology of the gastrointestinal tract - p. 1149 278. Investigation of Gastrointestinal Disease - p. 1158 279. Functional Gastrointestinal Disorders - p. 1159 280. Mouth - p. 1161 281. Salivary Glands - p. 1162 282. Pharynx and Oesophagus - p. 1162 283. Stomach and Duodenum - p. 1173 284. Acute and Chronic Gastrointestinal Bleeding - p. 1181 285. Small Intestine - p. 1185 286. Inflammatory Bowel Disease - p. 1198 287. Colon and Rectum - p. 1209 288. The Acute Abdomen - p. 1220 289. Peritoneum - p. 1223 290. 33. Nutrition - p. 1225 291. 34. Liver disease - p. 1261 292. Core Skills and Knowledge - p. 1261 293. Clinical skills for liver disease - p. 1261 294. Introduction - p. 1263 295. Anatomy of the liver and biliary system - p. 1263 296. Functions of the liver - p. 1265 297. Investigations in the patient with liver disease - p. 1268 298. Jaundice - p. 1271 299. Hepatitis - p. 1275 300. Acute hepatic failure - p. 1285 301. Autoimmune hepatitis - p. 1286 302. Drug-induced chronic hepatitis - p. 1287 303. Chronic hepatitis of unknown cause - p. 1287 304. Non-alcoholic fatty liver disease - p. 1287 305. Cirrhosis - p. 1288 306. Alcoholic liver disease - p. 1303 307. Budd–chiari syndrome - p. 1304 308. Hepatic sinusoidal obstruction syndrome - p. 1305 309. Fibropolycystic diseases - p. 1305 310. Liver abscess - p. 1305 311. Other infections of the liver - p. 1306 312. Liver disease in pregnancy - p. 1308 313. Liver tumours - p. 1308 314. Miscellaneous conditions of the liver - p. 1310 315. Drugs and the liver - p. 1310 316. 35. Biliary tract and pancreatic disease - p. 1313 317. 36. Kidney and urinary tract disease - p. 1339 318. Core Skills and Knowledge - p. 1339 319. Clinical Skills for Nephrology - p. 1339 320. Examination - p. 1341 321. Introduction - p. 1342 322. Anatomy and Physiology of the Kidney and Urinary Tract - p. 1342 323. Investigation of Renal and Urinary Tract Disease - p. 1348 324. The Glomerulus and Glomerular Disease - p. 1351 325. Kidney Involvement in Other Diseases - p. 1368 326. Hypertension and the Kidney - p. 1370 327. Other Vascular Disorders of the Kidney - p. 1372 328. Renal Calculi and Nephrocalcinosis - p. 1373 329. Urinary Tract Obstruction - p. 1376 330. Drugs and the Kidney - p. 1380 331. Urinary Tract Infection - p. 1381 332. Tubulointerstitial Nephritis - p. 1385 333. Acute Kidney Injury - p. 1387 334. Chronic Kidney Disease - p. 1392 335. Cystic Renal Disease - p. 1405 336. Tumours of the Kidney and Genitourinary Tract - p. 1406 337. Diseases of the Prostate Gland - p. 1407 338. The Urinary Tract in the Elderly - p. 1407 339. 37. Sexually transmitted infections and human immunodeficiency virus - p. 1409 340. Core Skills and Knowledge - p. 1409 341. Clinical skills for STI and HIV care - p. 1410 342. Sexually transmitted infections - p. 1413 343. Asymptomatic STI screening - p. 1413 344. Investigation of STIs - p. 1413 345. Management, prevention and control - p. 1415 346. Specific infections - p. 1416 347. Human immunodeficiency virus and acquired immunodeficiency syndrome - p. 1425 348. Clinical features of untreated hiv infection - p. 1429 349. Clinical approach to the patient with HIV - p. 1432 350. Management of HIV-positive patients - p. 1434 351. Specific conditions associated with HIV infection - p. 1441 352. Prevention and control of HIV infection - p. 1449 353. 38. Obstetric medicine - p. 1451 354. 39. Women’s health - p. 1463 355. 40. Men’s health - p. 1477 356. 41. Environmental medicine - p. 1487 357. Index - p. 1497 358. Normal Values - p. 1545
Edited by Adam Feather, MBBS, FRCP, FAcadMEd; David Randall, MA, MRCP; and Mona Waterhouse, MA, MRCP
Contributors comprise consultants at the top of their fields, paired with younger doctors closer to the exam experience, to ensure authority and relevance.
Enhanced e-book accompanies the print book, for ease of transportation and use on the move.
International Advisory Board, led by Professor Janaka de Silva and Professor Senaka Rajapakse, providing guidance for global coverage from across the world.
Contributions to the e-book by members of the International Advisory Board to amplify areas of clinical importance in their parts of the world.
1. Introduction - p. 98 2. The biology of cancer - p. 98 3. Aetiology and epidemiology - p. 100 4. Screening and investigations - p. 102 5. Principles of cancer treatment - p. 106 6. Acute oncology - p. 116 7. Common solid tumour treatment - p. 118 8. Lung cancer - p. 118 9. Breast cancer - p. 120 10. Upper gastrointestinal cancers - p. 123 11. Lower gastrointestinal cancers - p. 124 12. Hepatobiliary and pancreatic cancers - p. 124 13. Urological cancers - p. 127 14. Gynaecological cancers - p. 130 15. Brain tumours - p. 132 16. Head and neck cancer - p. 133 17. Metastatic cancer of unknown primary - p. 133 18. 7. Palliative care and symptom control - p. 137 19. 8. Sepsis and the treatment of bacterial infection - p. 151 20. 9. Water balance, fluids and electrolytes - p. 169 21. 10. Critical care medicine - p. 203 22. 11. Surgery - p. 239 23. 12. Prescribing, therapeutics and toxicology - p. 251 24. 13. Global health - p. 277 25. 14. Public health - p. 285 26. 15. Geriatric medicine, frailty and multimorbidity - p. 297 27. 16. Haematology - p. 319 28. Core Skills and Knowledge - p. 319 29. Clinical skills for haematology - p. 320 30. Examination - p. 320 31. Investigations - p. 320 32. Introduction - p. 324 33. The red cell - p. 325 34. Anaemia: an introduction - p. 327 35. Microcytic anaemia - p. 328 36. Normocytic anaemia - p. 332 37. Macrocytic anaemias - p. 333 38. Anaemia due to marrow failure (aplastic anaemia) - p. 336 39. Haemolytic anaemias: an introduction - p. 338 40. Inherited haemolytic anaemia - p. 338 41. Acquired haemolytic anaemia - p. 351 42. Polycythaemia - p. 355 43. The spleen - p. 356 44. Blood transfusion - p. 357 45. Blood groups - p. 357 46. Procedure for blood transfusion in hospitals - p. 358 47. Complications of blood transfusion - p. 359 48. Strategies for the avoidance of unnecessary transfusion - p. 362 49. Blood, blood components and blood products - p. 362 50. The white cell - p. 365 51. Haemostasis - p. 367 52. Vascular disorders - p. 372 53. Platelet disorders - p. 372 54. Inherited coagulation disorders - p. 375 55. Acquired coagulation disorders - p. 377 56. 17. Haematological oncology - p. 379 57. 18. Rheumatology - p. 411 58. Core Skills and Knowledge - p. 411 59. Clinical skills for rheumatology - p. 412 60. Approach to the patient - p. 414 61. Anatomy and physiology of the normal joint - p. 414 62. Investigation of rheumatic disease - p. 415 63. Clinical conditions in rheumatology - p. 417 64. Common regional musculoskeletal problems - p. 418 65. Chronic pain syndromes - p. 429 66. Analgesic and anti-inflammatory drugs for musculoskeletal problems - p. 431 67. Disorders of collagen - p. 432 68. Osteoarthritis - p. 433 69. Inflammatory Arthritis - p. 437 70. Rheumatoid arthritis - p. 437 71. Spondyloarthritis - p. 447 72. Infections of joints - p. 454 73. Autoimmune rheumatic diseases - p. 456 74. Systemic inflammatory vasculitis - p. 464 75. Arthritis in children - p. 467 76. Rheumatological problems seen in other diseases - p. 467 77. Miscellaneous arthropathies - p. 468 78. 19. Bone disease - p. 471 79. 20. Infectious disease - p. 488 80. Core Skills and Knowledge - p. 488 81. Core content - p. 488 82. Clinical skills for infectious disease - p. 489 83. Introduction - p. 491 84. Clinical approach to the patient with a suspected infection - p. 492 85. Epidemiology and prevention of infections - p. 502 86. Principles and mechanisms of infection - p. 509 87. Viral Infections - p. 513 88. Virus infections of the skin and mucous membranes - p. 513 89. Virus infections of the respiratory tract - p. 519 90. Systemic viral infections - p. 521 91. Virus infections of the nervous system - p. 526 92. Virus infections of the gastrointestinal tract - p. 529 93. Viral hepatitis - p. 530 94. Viruses and malignant disease - p. 530 95. Viral haemorrhagic fevers - p. 531 96. Antiviral drugs - p. 533 97. Transmissible Spongiform Encephalopathies (Prion Diseases) - p. 535 98. Bacterial Infections - p. 535 99. Bacterial infections of the skin and soft tissues - p. 535 100. Bacterial infections of the respiratory tract - p. 537 101. Bacterial infections of the gastrointestinal tract - p. 539 102. Bacterial infections of the cardiovascular system - p. 544 103. Bacterial infections of the nervous system - p. 545 104. Bacterial bone and joint infections - p. 547 105. Bacterial infections of the urinary tract - p. 547 106. Systemic/multisystem bacterial infections - p. 547 107. Bacterial infections seen in developing and tropical countries - p. 550 108. Antibiotic therapies - p. 559 109. Fungal Infections - p. 559 110. Systemic fungal infections - p. 559 111. Subcutaneous fungal infections - p. 561 112. Superficial fungal infections - p. 562 113. Antifungal drugs - p. 562 114. Protozoal Infections - p. 563 115. Blood and tissue protozoa - p. 563 116. Gastrointestinal protozoa - p. 571 117. Helminthic Infections - p. 573 118. Nematodes - p. 574 119. Trematodes - p. 578 120. Cestodes - p. 580 121. Arthropod Ectoparasites - p. 581 122. 21. Endocrinology - p. 583 123. Core Skills and Knowledge - p. 583 124. Clinical skills for endocrinology - p. 584 125. Introduction - p. 586 126. The pituitary gland and hypothalamus - p. 591 127. Hypothalamo–Pituitary–adrenal axis - p. 598 128. The thyroid axis - p. 609 129. Hypothalamo–pituitary–gonadal axis - p. 622 130. Growth and puberty - p. 632 131. The Thirst Axis - p. 641 132. Disorders of Calcium Metabolism - p. 644 133. Hypoglycaemia in the non-diabetic patient - p. 647 134. Other endocrine disorders - p. 648 135. 22. Dermatology - p. 651 136. Core Skills and Knowledge - p. 651 137. Clinical Skills for Dermatology - p. 652 138. Introduction - p. 654 139. Skin structure and function - p. 654 140. Investigation of Skin Disease - p. 656 141. Principles of Dermatological Therapy - p. 656 142. Erythroderma and Loss of Skin Function (‘Skin Failure’) - p. 657 143. Common rashes - p. 657 144. Skin Infections - p. 669 145. Human Immunodeficiency Virus and the Skin - p. 676 146. Skin Signs of Systemic Disease - p. 677 147. Photosensitivity - p. 685 148. Blistering and Bullous Skin Disease - p. 686 149. Skin Tumours - p. 688 150. Disorders of Pigmentation - p. 693 151. Nail Disorders - p. 694 152. Hair Disorders - p. 694 153. Birth Marks and Neonatal Rashes - p. 695 154. Drug Eruptions - p. 696 155. 23. Diabetes mellitus - p. 699 156. Core Skills and Knowledge - p. 699 157. Clinical skills for diabetes mellitus - p. 699 158. Introduction - p. 701 159. Physiology of insulin structure, secretion and action - p. 701 160. Classification of diabetes - p. 704 161. Clinical Approach to the Patient With Diabetes - p. 710 162. Prevention of Type 2 Diabetes - p. 711 163. Management of diabetes - p. 711 164. Diabetic metabolic emergencies - p. 722 165. Complications of diabetes - p. 725 166. Psychosocial Implications of Diabetes - p. 736 167. Diabetes in special situations - p. 737 168. Organization of diabetes care - p. 741 169. 24. Lipid and metabolic disorders - p. 743 170. 25. Liaison psychiatry - p. 763 171. Core Skills and Knowledge - p. 763 172. Introduction - p. 763 173. Clinical approach to the patient with a psychiatric disorder - p. 764 174. Classification of psychiatric disorders - p. 768 175. Aetiology of psychiatric disorders - p. 768 176. Psychiatric aspects of physical diseases - p. 768 177. Sick role and illness behaviour - p. 769 178. Functional somatic syndromes - p. 769 179. Somatoform disorders - p. 772 180. Dissociative/conversion disorders - p. 773 181. Sleep difficulties - p. 774 182. Mood (affective) disorders - p. 776 183. Suicide and self-harm - p. 784 184. Anxiety disorders - p. 785 185. Alcohol misuse and dependence - p. 790 186. Drug misuse and dependence - p. 792 187. Schizophrenia - p. 793 188. Organic mental disorders - p. 796 189. Eating disorders - p. 797 190. Sexual disorders - p. 798 191. Personality disorders - p. 799 192. Involuntary Detention - p. 800 193. Mental Capacity Act - p. 800 194. 26. Neurology - p. 801 195. Core Skills and Knowledge - p. 801 196. Clinical skills for neurology - p. 886 197. Introduction - p. 803 198. Clinical approach to the patient with neurological disease - p. 803 199. Functional neuroanatomy - p. 806 200. Cranial nerves - p. 809 201. Motor control systems - p. 818 202. Lower motor neurone lesions - p. 821 203. Sensory pathways and pain - p. 822 204. Bladder control and sexual dysfunction - p. 827 205. Investigation of neurological disease - p. 827 206. Unconsciousness and coma - p. 831 207. Stroke - p. 836 208. Intracranial haemorrhage - p. 845 209. Headache, migraine and facial pain - p. 848 210. Epilepsy and loss of consciousness - p. 852 211. Movement disorders - p. 858 212. Neuroinflammatory disorders - p. 864 213. Nervous system infection - p. 868 214. Hydrocephalus - p. 876 215. Traumatic brain injury - p. 877 216. Spinal cord disease - p. 878 217. Neurodegenerative diseases - p. 880 218. Congenital disorders - p. 885 219. Neurogenetic disorders - p. 885 220. Paraneoplastic syndromes - p. 887 221. Peripheral nerve disease - p. 887 222. Muscle diseases - p. 893 223. 27. Ear, nose and throat and eye disease - p. 899 224. 28. Respiratory disease - p. 927 225. Core Skills and Knowledge - p. 927 226. Clinical skills for respiratory medicine - p. 927 227. Function of the respiratory system - p. 930 228. Clinical Approach to the Patient with Respiratory Disease - p. 936 229. Diseases of the Upper Respiratory Tract - p. 945 230. Obstructive Respiratory Disease - p. 949 231. Smoking - p. 962 232. Respiratory Infection - p. 963 233. Pleural Disease - p. 972 234. Tumours of the Respiratory Tract - p. 975 235. Bronchiectasis - p. 982 236. Interstitial Lung Diseases - p. 985 237. Lung and Heart–Lung Transplantation - p. 994 238. Occupational Lung Disease - p. 995 239. Miscellaneous Respiratory Disorders - p. 997 240. Disorders of the Diaphragm - p. 997 241. Mediastinal Lesions - p. 998 242. 29. Venous thromboembolic disease - p. 1001 243. 30. Cardiology - p. 1020 244. Core Skills and Knowledge - p. 1020 245. Clinical skills for cardiology - p. 1020 246. ECG interpretation - p. 1021 247. Anatomy, physiology and embryology of the heart - p. 1023 248. Clinical approach to the patient with heart disease - p. 1028 249. Therapeutic procedures - p. 1045 250. Cardiac arrhythmias - p. 1051 251. Bradycardias and heart block - p. 1052 252. Supraventricular tachycardias - p. 1057 253. Ventricular tachyarrhythmias - p. 1063 254. Heart failure - p. 1069 255. Coronary artery disease - p. 1079 256. Angina - p. 1081 257. Acute coronary syndromes - p. 1084 258. Valvular heart disease - p. 1091 259. Aortic valve - p. 1097 260. tricuspid valve - p. 1100 261. Pulmonary valve - p. 1101 262. Prosthetic valves - p. 1102 263. Infective endocarditis - p. 1103 264. Congenital heart disease - p. 1107 265. Marfan’s syndrome - p. 1113 266. Pulmonary heart disease - p. 1115 267. Myocardial and endocardial disease - p. 1117 268. Myocardial disease - p. 1118 269. Pericardial disease - p. 1125 270. Peripheral vascular disease - p. 1128 271. Peripheral venous disease - p. 1132 272. 31. Hypertension - p. 1133 273. 32. Gastroenterology - p. 1147 274. Core Skills and Knowledge - p. 1147 275. Clinical Skills for Gastroenterology - p. 1148 276. INTRODUCTION - p. 1149 277. Anatomy and physiology of the gastrointestinal tract - p. 1149 278. Investigation of Gastrointestinal Disease - p. 1158 279. Functional Gastrointestinal Disorders - p. 1159 280. Mouth - p. 1161 281. Salivary Glands - p. 1162 282. Pharynx and Oesophagus - p. 1162 283. Stomach and Duodenum - p. 1173 284. Acute and Chronic Gastrointestinal Bleeding - p. 1181 285. Small Intestine - p. 1185 286. Inflammatory Bowel Disease - p. 1198 287. Colon and Rectum - p. 1209 288. The Acute Abdomen - p. 1220 289. Peritoneum - p. 1223 290. 33. Nutrition - p. 1225 291. 34. Liver disease - p. 1261 292. Core Skills and Knowledge - p. 1261 293. Clinical skills for liver disease - p. 1261 294. Introduction - p. 1263 295. Anatomy of the liver and biliary system - p. 1263 296. Functions of the liver - p. 1265 297. Investigations in the patient with liver disease - p. 1268 298. Jaundice - p. 1271 299. Hepatitis - p. 1275 300. Acute hepatic failure - p. 1285 301. Autoimmune hepatitis - p. 1286 302. Drug-induced chronic hepatitis - p. 1287 303. Chronic hepatitis of unknown cause - p. 1287 304. Non-alcoholic fatty liver disease - p. 1287 305. Cirrhosis - p. 1288 306. Alcoholic liver disease - p. 1303 307. Budd–chiari syndrome - p. 1304 308. Hepatic sinusoidal obstruction syndrome - p. 1305 309. Fibropolycystic diseases - p. 1305 310. Liver abscess - p. 1305 311. Other infections of the liver - p. 1306 312. Liver disease in pregnancy - p. 1308 313. Liver tumours - p. 1308 314. Miscellaneous conditions of the liver - p. 1310 315. Drugs and the liver - p. 1310 316. 35. Biliary tract and pancreatic disease - p. 1313 317. 36. Kidney and urinary tract disease - p. 1339 318. Core Skills and Knowledge - p. 1339 319. Clinical Skills for Nephrology - p. 1339 320. Examination - p. 1341 321. Introduction - p. 1342 322. Anatomy and Physiology of the Kidney and Urinary Tract - p. 1342 323. Investigation of Renal and Urinary Tract Disease - p. 1348 324. The Glomerulus and Glomerular Disease - p. 1351 325. Kidney Involvement in Other Diseases - p. 1368 326. Hypertension and the Kidney - p. 1370 327. Other Vascular Disorders of the Kidney - p. 1372 328. Renal Calculi and Nephrocalcinosis - p. 1373 329. Urinary Tract Obstruction - p. 1376 330. Drugs and the Kidney - p. 1380 331. Urinary Tract Infection - p. 1381 332. Tubulointerstitial Nephritis - p. 1385 333. Acute Kidney Injury - p. 1387 334. Chronic Kidney Disease - p. 1392 335. Cystic Renal Disease - p. 1405 336. Tumours of the Kidney and Genitourinary Tract - p. 1406 337. Diseases of the Prostate Gland - p. 1407 338. The Urinary Tract in the Elderly - p. 1407 339. 37. Sexually transmitted infections and human immunodeficiency virus - p. 1409 340. Core Skills and Knowledge - p. 1409 341. Clinical skills for STI and HIV care - p. 1410 342. Sexually transmitted infections - p. 1413 343. Asymptomatic STI screening - p. 1413 344. Investigation of STIs - p. 1413 345. Management, prevention and control - p. 1415 346. Specific infections - p. 1416 347. Human immunodeficiency virus and acquired immunodeficiency syndrome - p. 1425 348. Clinical features of untreated hiv infection - p. 1429 349. Clinical approach to the patient with HIV - p. 1432 350. Management of HIV-positive patients - p. 1434 351. Specific conditions associated with HIV infection - p. 1441 352. Prevention and control of HIV infection - p. 1449 353. 38. Obstetric medicine - p. 1451 354. 39. Women’s health - p. 1463 355. 40. Men’s health - p. 1477 356. 41. Environmental medicine - p. 1487 357. Index - p. 1497 358. Normal Values - p. 1545
