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