Oxford Textbook of Medicine

Volume 1......Page 2
Volume 2......Page 8
Volume 3......Page 17
Foreword......Page 24
Preface......Page 25
Color Plate......Page 50
1On being a patient......Page 127
2.1Science in medicine: when, how, and what......Page 129
2.2Scientific method and the art of healing......Page 132
2.3Medical ethics......Page 135
2.4.1Bringing the best evidence to the point of care......Page 138
2.4.2Evidence-based medicine......Page 142
2.4.3Large-scale randomized evidence......Page 146
2.5Complementary and alternative medicine......Page 155
3.1The global burden of disease study......Page 158
3.2Human population size, environment, and health......Page 164
3.3The pattern of care: hospital and community......Page 167
3.4Preventive medicine......Page 170
3.5Health promotion......Page 175
3.6 Screening......Page 179
3.7.1The cost of health care in Western countries......Page 184
3.7.2Health in a fragile future......Page 186
4.1The genomic basis of medicine......Page 188
4.2The human genome sequence......Page 193
4.3Molecular cell biology......Page 194
4.4Cytokines: interleukin-1 and tumour necrosis factor in inflammation......Page 208
4.5Ion channels and disease......Page 212
4.6Apoptosis in health and disease......Page 217
5.1Principles of immunology......Page 225
5.2 Allergy......Page 235
5.3 Autoimmunity......Page 239
5.4 Complement......Page 246
5.5Innate immune system......Page 251
5.6 Immunodeficiency......Page 255
5.7Principles of transplantation immunology......Page 264
6.1Epidemiology of cancer......Page 270
6.2The nature and development of cancer......Page 291
6.3The genetics of inherited cancers......Page 299
6.4Tumour metastasis......Page 305
6.5Tumour immunology......Page 307
6.6Cancer: clinical features and management......Page 311
6.7Cancer chemotherapy and radiation therapy......Page 319
7.1The clinical approach to the patient with suspected infection......Page 323
7.2Fever of unknown origin......Page 325
7.3Biology of pathogenic micro-organisms......Page 328
7.4The host response to infection......Page 332
7.5Physiological changes in infected patients......Page 340
7.6Antimicrobial chemotherapy......Page 343
7.7 Immunization......Page 352
7.8Travel and expedition medicine......Page 356
7.9Nosocomial infections......Page 359
7.10.1Respiratory tract viruses......Page 362
7.10.2Herpesviruses (excluding Epstein–Barr virus)......Page 368
7.10.3The Epstein–Barr virus......Page 383
7.10.4 Poxviruses......Page 388
7.10.5Mumps: epidemic parotitis......Page 391
7.10.6 Measles......Page 394
7.10.6.1Nipah and Hendra viruses......Page 400
7.10.7Enterovirus infections......Page 402
7.10.8Virus infections causing diarrhoea and vomiting......Page 407
7.10.9Rhabdoviruses: rabies and rabies-related viruses......Page 411
7.10.10Colorado tick fever and other arthropod-borne reoviruses......Page 420
7.10.11 Alphaviruses......Page 422
7.10.12 Rubella......Page 425
7.10.13 Flaviviruses......Page 427
7.10.14 Bunyaviridae......Page 434
7.10.15 Arenaviruses......Page 439
7.10.16 Filoviruses......Page 447
7.10.17 Papovaviruses......Page 450
7.10.18Parvovirus b19......Page 455
7.10.19Hepatitis viruses (including ttv)......Page 457
7.10.20Hepatitis C virus......Page 461
7.10.21HIV and AIDS......Page 465
7.10.22HIV in the developing world......Page 481
7.10.23HTLV-I and II and associated diseases......Page 485
7.10.24Viruses and cancer......Page 487
7.10.25 Orf......Page 489
7.10.26Molluscum contagiosum......Page 491
7.11.1 Diphtheria......Page 493
7.11.2Streptococci and enterococci......Page 497
7.11.3Pneumococcal diseases......Page 502
7.11.4 Staphylococci......Page 510
7.11.5Meningococcal infections......Page 517
7.11.6Neisseria gonorrhoeae......Page 525
7.11.7Enterobacteria, campylobacter, and miscellaneous food-poisoning bacteria......Page 528
7.11.8Typhoid and paratyphoid fevers......Page 540
7.11.9Intracellular klebsiella infections......Page 544
7.11.10Anaerobic bacteria......Page 547
7.11.11 Cholera......Page 553
7.11.12Haemophilus influenzae......Page 557
7.11.13Haemophilus ducreyi and chancroid......Page 560
7.11.14 Bordetella......Page 562
7.11.15Melioidosis and glanders......Page 565
7.11.16 Plague......Page 569
7.11.17Yersinia, Pasteurella, and Francisella......Page 572
7.11.18 Anthrax......Page 577
7.11.19 Brucellosis......Page 580
7.11.20 Tetanus......Page 584
7.11.21Botulism, gas gangrene, and clostridial gastrointestinal infections......Page 590
7.11.22 Tuberculosis......Page 596
7.11.23Disease caused by environmental mycobacteria......Page 608
7.11.24Leprosy (Hansen's disease)......Page 611
7.11.25Buruli ulcer: Mycobacterium ulcerans infection......Page 619
7.11.26 Actinomycoses......Page 621
7.11.27 Nocardiosis......Page 625
7.11.28Rat-bite fevers......Page 627
7.11.29Lyme borreliosis......Page 629
7.11.30Other borrelia infections......Page 631
7.11.31 Leptospirosis......Page 635
7.11.32Non-venereal endemic treponemoses: yaws, endemic syphilis (bejel), and pinta......Page 639
7.11.33 Syphilis......Page 642
7.11.34 Listeriosis......Page 651
7.11.35Legionellosis and legionnaires' disease......Page 653
7.11.36Rickettsial diseases including ehrlichioses......Page 657
7.11.37Scrub typhus......Page 663
7.11.38Coxiella burnetii infections (Q fever)......Page 665
7.11.39Bartonelloses, excluding Bartonella bacilliformis infections......Page 668
7.11.39.1Bartonella bacilliformis infection......Page 672
7.11.40Chlamydial infections including lymphogranuloma venereum......Page 676
7.11.41 Mycoplasmas......Page 682
7.11.42Newly identified and lesser known bacteria......Page 689
7.12.1Fungal infections......Page 700
7.12.2 Cryptococcosis......Page 715
7.12.3 Coccidioidomycosis......Page 717
7.12.4 Paracoccidioidomycosis......Page 718
7.12.5Pneumocystis carinii......Page 723
7.12.6Infection due to pencillium marneffei......Page 726
7.13.1Amoebic infections......Page 727
7.13.2 Malaria......Page 734
7.13.3 Babesia......Page 755
7.13.4 Toxoplasmosis......Page 757
7.13.5Cryptosporidium and cryptosporidiosis......Page 760
7.13.6 Cyclospora......Page 764
7.13.7 Sarcocystosis......Page 766
7.13.8Giardiasis, balantidiasis, isosporiasis, and microsporidiosis......Page 768
7.13.9Blastocystis hominis infection......Page 773
7.13.10Human african trypanosomiasis......Page 775
7.13.11Chagas' disease......Page 781
7.13.12 Leishmaniasis......Page 786
7.13.13 Trichomoniasis......Page 791
7.14.1Cutaneous filariasis......Page 793
7.14.2Lymphatic filariasis......Page 799
7.14.3Guinea worm disease: dracunculiasis......Page 804
7.14.4Strongyloidiasis, hookworm, and other gut strongyloid nematodes......Page 806
7.14.5Nematode infections of lesser importance......Page 811
7.14.6Other gut nematodes......Page 813
7.14.7Toxocariasis and visceral larva migrans......Page 821
7.14.8 Angiostrongyliasis......Page 823
7.14.9 Gnathostomiasis......Page 826
7.15.1Cystic hydatid disease (echinococcus granulosus)......Page 829
7.15.2Gut cestodes......Page 832
7.15.3 Cysticercosis......Page 836
7.15.4Pseudophyllidean tapeworms: diphyllobothriasis and sparganosis......Page 840
7.16.1 Schistosomiasis......Page 842
7.16.2Liver fluke infections......Page 848
7.16.3Lung flukes (paragonimiasis)......Page 851
7.16.4Intestinal trematode infections......Page 854
7.17Non-venomous arthropods......Page 857
7.18Pentastomiasis (porocephalosis)......Page 863
7.19Chronic fatigue syndrome (postviral fatigue syndrome, neurasthenia, and myalgic encephalomyelitis)......Page 866
7.20Infection in the immunocompromised host......Page 869
8.1Poisoning by drugs and chemicals......Page 874
8.2Injuries, envenoming, poisoning, and allergic reactions caused by animals......Page 922
8.3Poisonous plants and fungi......Page 944
8.4.1Occupational and environmental health and safety......Page 949
8.4. 2 Occupational safety......Page 956
8.5.1Environmental extremes—heat......Page 960
8.5.2Environmental extremes—cold......Page 962
8.5.3 Drowning......Page 964
8.5.4Diseases of high terrestrial altitudes......Page 967
8.5.5Aerospace medicine......Page 972
8.5.6Diving medicine......Page 978
8.5.7Lightning and electrical injuries......Page 983
8.5.8 Podoconiosis......Page 986
8.5.9 Radiation......Page 988
8.5.10 Noise......Page 991
8.5.11 Vibration......Page 993
8.5.12Disasters: earthquakes, volcanic eruptions, hurricanes, and floods......Page 995
9Principles of clinical pharmacology and drug therapy......Page 997
10.1Diseases of overnourished societies and the need for dietary change......Page 1017
10.2Nutrition: biochemical background......Page 1023
10.3Vitamins and trace elements......Page 1028
10.4Severe malnutrition......Page 1038
10.5 Obesity......Page 1044
10.6Special nutritional problems and the use of enteral and parenteral nutrition......Page 1052
11.1The inborn errors of metabolism: general aspects......Page 1061
11.2Inborn errors of amino acid and organic acid metabolism......Page 1064
11.3.1Glycogen storage diseases......Page 1085
11.3.2Inborn errors of fructose metabolism......Page 1090
11.3.3Disorders of galactose, pentose, and pyruvate metabolism......Page 1094
11.4Disorders of purine and pyrimidine metabolism......Page 1098
11.5The porphyrias......Page 1108
11.6Lipid and lipoprotein disorders......Page 1117
11.7.1Hereditary haemochromatosis......Page 1130
11.7.2Wilson's disease, Menke's disease: inherited disorders of copper metabolism......Page 1140
11.8Lysosomal storage diseases......Page 1147
11.9Peroxisomal diseases......Page 1157
11.10Disorders of oxalate metabolism......Page 1165
11.11Disturbances of acid–base homeostasis......Page 1169
11.12.1The acute phase response and c-reactive protein......Page 1177
11.12.2Metabolic responses to accidental and surgical injury......Page 1183
11.12.3Familial mediterranean fever and other inherited periodic fever syndromes......Page 1185
11.12.4 Amyloidosis......Page 1188
11.13a1-Antitrypsin deficiency and the serpinopathies......Page 1197
12.1Principles of hormone action......Page 1200
12.2Disorders of the anterior pituitary......Page 1206
12.3Disorders of the posterior pituitary......Page 1216
12.4The thyroid gland and disorders of thyroid function......Page 1219
12.5Thyroid cancer......Page 1230
12.6Parathyroid disorders and diseases altering calcium metabolism......Page 1234
12.7.1Disorders of the adrenal cortex......Page 1242
12.7.2Congenital adrenal hyperplasia......Page 1258
12.8.1Ovarian disorders......Page 1262
12.8.2Disorders of male reproduction......Page 1269
12.8.3The breast......Page 1277
12.8.4Sexual dysfunction......Page 1279
12.9.1Normal and abnormal sexual differentiation......Page 1286
12.9.2Normal growth and its disorders......Page 1291
12.9.3 Puberty......Page 1296
12.10Non-diabetic pancreatic endocrine disorders and multiple endocrine neoplasia......Page 1298
12.11.1 Diabetes......Page 1305
12.11.2The genetics of diabetes......Page 1343
12.11.3 Hypoglycaemia......Page 1345
12.12Hormonal manifestations of non-endocrine disease......Page 1352
12.13The pineal gland and melatonin......Page 1359
13.1Physiological changes of normal pregnancy......Page 1361
13.2Nutrition in pregnancy......Page 1364
13.3Medical management of normal pregnancy......Page 1368
13.4Hypertension in pregnancy......Page 1373
13.5Renal disease in pregnancy......Page 1379
13.6Heart disease in pregnancy......Page 1382
13.7Thromboembolism in pregnancy......Page 1387
13.8Chest diseases in pregnancy......Page 1390
13.9Liver and gastrointestinal diseases during pregnancy......Page 1393
13.10Diabetes in pregnancy......Page 1398
13.11Endocrine disease in pregnancy......Page 1402
13.12Neurological disease in pregnancy......Page 1406
13.13The skin in pregnancy......Page 1410
13.14Autoimmune disorders and vasculitis in pregnancy......Page 1413
13.15Infections in pregnancy......Page 1418
13.16Blood disorders in pregnancy......Page 1423
13.17Malignant disease in pregnancy......Page 1430
13.18Prescribing in pregnancy......Page 1433
13.19Benefits and risks of oral contraceptives......Page 1436
13.20Benefits and risks of hormone replacement therapy......Page 1439
14.1Introduction to gastroenterology......Page 1441
14.1.1.1Structure and function of the gut......Page 1442
14.1.1.2Symptomatology of gastrointestinal disease......Page 1445
14.2.1Colonoscopy and flexible sigmoidoscopy......Page 1448
14.2.2Upper gastrointestinal endoscopy......Page 1451
14.2.3Radiology of the gastrointestinal tract......Page 1455
14.2.4Investigation of gastrointestinal function......Page 1460
14.3.1The acute abdomen......Page 1465
14.3.2Gastrointestinal bleeding......Page 1468
14.4Immune disorders of the gastrointestinal tract......Page 1471
14.5The mouth and salivary glands......Page 1480
14.6Diseases of the oesophagus......Page 1498
14.7Peptic ulcer diseases......Page 1510
14.8Hormones and the gastrointestinal tract......Page 1520
14.9.1Differential diagnosis and investigation of malabsorption......Page 1528
14.9.2Small bowel bacterial overgrowth......Page 1531
14.9.3Coeliac disease......Page 1535
14.9.4Gastrointestinal lymphoma......Page 1539
14.9.5Disaccharidase deficiency......Page 1543
14.9.6Whipple's disease......Page 1546
14.9.7Effects of massive small bowel resection......Page 1548
14.9.8Malabsorption syndromes in the tropics......Page 1551
14.10Crohn's disease......Page 1554
14.11Ulcerative colitis......Page 1560
14.12Functional bowel disorders and irritable bowel syndrome......Page 1568
14.13Colonic diverticular disease......Page 1572
14.14Congenital abnormalities of the gastrointestinal tract......Page 1576
14.15Tumours of the gastrointestinal tract......Page 1584
14.16Vascular and collagen disorders......Page 1596
14.17Gastrointestinal infections......Page 1602
14.18.1The structure and function of the liver, biliary tract, and pancreas......Page 1609
14.18.2Ct and mri of the liver and pancreas......Page 1615
14.18.3.1Acute pancreatitis......Page 1619
14.18.3.2Chronic pancreatitis......Page 1626
14.18.3.3Tumours of the pancreas......Page 1631
14.19.1Congenital disorders of the liver, biliary tract, and pancreas......Page 1634
14.19.2Diseases of the gallbladder and biliary tree......Page 1638
14.19.3 Jaundice......Page 1646
14.20.1Viral hepatitis—clinical aspects......Page 1651
14.20.2.1Autoimmune hepatitis......Page 1657
14.20.2.2Primary biliary cirrhosis......Page 1660
14.20.2.3Primary sclerosing cholangitis......Page 1663
14.21.1Alcoholic liver disease and non-alcoholic steatosis hepatitis......Page 1667
14.21.2Cirrhosis, portal hypertension, and ascites......Page 1669
14.21.3Hepatocellular failure......Page 1677
14.21.4Liver transplantation......Page 1686
14.21.5Primary and secondary liver tumours......Page 1691
14.21.6Hepatic granulomas......Page 1696
14.21.7Drugs and liver damage......Page 1699
14.21.8The liver in systemic disease......Page 1702
14.22Miscellaneous disorders of the gastrointestinal tract and liver......Page 1708
15.1.1.1 Introduction......Page 1713
15.1.1.2Vascular endothelium: its physiology and pathophysiology......Page 1715
15.1.1.3Vascular smooth muscle cells......Page 1721
15.1.2.1The pathogenesis of atherosclerosis......Page 1724
15.1.2.2The haemostatic system in arterial disease......Page 1729
15.1.3.1Physiological considerations: biochemistry and cellular physiology of heart muscle......Page 1735
15.1.3.2Clinical physiology of the normal heart......Page 1744
15.2.1Chest pain......Page 1751
15.2.2The syndrome of heart failure......Page 1755
15.2.3Syncope and palpitation......Page 1767
15.2.4Physical examination of the cardiovascular system......Page 1771
15.3.1Chest radiography in heart disease......Page 1775
15.3.2 Electrocardiography......Page 1780
15.3.3 Echocardiography......Page 1797
15.3.4Nuclear techniques......Page 1803
15.3.5Cardiovascular magnetic resonance and computed X-ray tomography......Page 1808
15.3.6Cardiac catheterization and angiography......Page 1814
15.4.1.1Influences acting in utero and early childhood......Page 1821
15.4.1.2The epidemiology of ischaemic heart disease......Page 1824
15.4.2.1The pathophysiology of acute coronary syndromes......Page 1833
15.4.2.2Management of stable angina......Page 1836
15.4.2.3Management of acute coronary syndromes: unstable angina and myocardial infarction......Page 1839
15.4.2.4Percutaneous interventional cardiac procedures......Page 1855
15.4.2.5Coronary artery bypass grafting......Page 1861
15.4.2.6The impact of coronary heart disease on life and work......Page 1864
15.5.1Pharmacological management of heart failure......Page 1868
15.5.2Therapeutic anticoagulation in atrial fibrillation and heart failure......Page 1875
15.5.3Cardiac rehabilitation......Page 1876
15.5.4Cardiac transplantation and mechanical circulatory support......Page 1878
15.6Cardiac arrhythmias......Page 1883
15.7Valve disease......Page 1903
15.8.1 Myocarditis......Page 1921
15.8.2The cardiomyopathies: hypertrophic, dilated, restrictive, and right ventricular......Page 1924
15.8.3Specific heart muscle disorders......Page 1936
15.9Pericardial disease......Page 1940
15.10.1Acute rheumatic fever......Page 1948
15.10.2Infective endocarditis......Page 1954
15.10.3Cardiovascular syphilis......Page 1962
15.10.4Cardiac disease in hiv infection......Page 1964
15.11.1Cardiac myxoma......Page 1967
15.11.2Other tumours of the heart......Page 1969
15.12Cardiac involvement in genetic disease......Page 1970
15.13Congenital heart disease in adolescents and adults......Page 1973
15.14.1Thoracic aortic dissection......Page 1994
15.14.2Peripheral arterial disease......Page 1998
15.14.3Cholesterol embolism......Page 2004
15.14.4Takayasu arteritis......Page 2007
15.15.1The pulmonary circulation and its influence on gas exchange......Page 2011
15.15.2.1Primary pulmonary hypertension......Page 2014
15.15.2.2Pulmonary oedema......Page 2021
15.15.3.1Deep venous thrombosis and pulmonary embolism......Page 2028
15.15.3.2Therapeutic anticoagulation in deep vein thrombosis and pulmonary embolism......Page 2036
15.16.1.1Prevalence, epidemiology, and pathophysiology of hypertension......Page 2038
15.16.1.2Genetics of hypertension......Page 2045
15.16.1.3Essential hypertension......Page 2049
15.16.2.1Hypertension—indications for investigation......Page 2060
15.16.2.2Renal and renovascular hypertension......Page 2063
15.16.2.3Primary hyperaldosteronism (Conn's syndrome)......Page 2066
15.16.2.4 Phaeochromocytoma......Page 2069
15.16.2.5Aortic coarctation......Page 2073
15.16.2.6Other rare causes of hypertension......Page 2074
15.16.3Hypertensive emergencies and urgencies......Page 2075
15.17 Lymphoedema......Page 2080
15.18Idiopathic oedema of women......Page 2085
16.1The clinical approach to the patient who is very ill......Page 2087
16.2The circulation and circulatory support of the critically ill......Page 2090
16.3Cardiac arrest......Page 2096
16.4 Anaphylaxis......Page 2101
16.5.1Pathophysiology and pathogenesis of acute respiratory distress syndrome......Page 2106
16.5.2The management of respiratory failure......Page 2110
16.6.1Sedation and analgesia in the critically ill......Page 2117
16.6.2Management of raised intracranial pressure......Page 2120
16.6.3Brainstem death and organ donation......Page 2124
16.6.4The patient without hope......Page 2127
17.1.1The upper respiratory tract......Page 2129
17.1.2Structure and function of the airways and alveoli......Page 2132
17.1.3'First-line' defence mechanisms of the lung......Page 2139
17.2The clinical presentation of chest diseases......Page 2143
17.3.1Thoracic imaging......Page 2151
17.3.2Respiratory function tests......Page 2162
17.3.3Microbiological methods......Page 2168
17.3.4Diagnostic bronchoscopy, thoracoscopy, and tissue biopsy......Page 2171
17.4.1Asthma: genetic effects......Page 2178
17.4.2Allergic rhinitis ('hay fever')......Page 2180
17.4.3Basic mechanisms and pathophysiology of asthma......Page 2184
17.4.4 Asthma......Page 2188
17.4.5Occupational asthma......Page 2202
17.5.1Upper respiratory tract infections......Page 2206
17.5.2.1Pneumonia—normal host......Page 2209
17.5.2.2Nosocomial pneumonia......Page 2216
17.5.2.3Pulmonary complications of HIV infection......Page 2219
17.6Chronic obstructive pulmonary disease......Page 2223
17.7Chronic respiratory failure......Page 2241
17.8.1Upper airways obstruction......Page 2247
17.8.2Sleep-related disorders of breathing......Page 2252
17.9 Bronchiectasis......Page 2261
17.10Cystic fibrosis......Page 2266
17.11.1Diffuse parenchymal lung disease: an introduction......Page 2275
17.11.2Cryptogenic fibrosing alveolitis......Page 2281
17.11.3Bronchiolitis obliterans and organizing pneumonia......Page 2287
17.11..4The lungs and rheumatological diseases......Page 2290
17.11.5The lung in vasculitis......Page 2295
17.11.6 Sarcoidosis......Page 2299
17.11.7 Pneumoconioses......Page 2306
17.11.8Pulmonary haemorrhagic disorders......Page 2314
17.11.9Eosinophilic pneumonia......Page 2316
17.11.10Lymphocytic infiltrations of the lung......Page 2319
17.11.11Extrinsic allergic alveolitis......Page 2321
17.11.12Eosinophilic granuloma of the lung and pulmonary lymphangiomyomatosis......Page 2328
17.11.13Pulmonary alveolar proteinosis......Page 2330
17.11.14Pulmonary amyloidosis......Page 2332
17.11.15Lipoid (lipid) pneumonia......Page 2334
17.11.16Pulmonary alveolar microlithiasis......Page 2336
17.11.17Toxic gases and fumes......Page 2337
17.11.18Radiation pneumonitis......Page 2339
17.11.19Drug-induced lung disease......Page 2341
17.12Pleural disease......Page 2345
17.13Disorders of the thoracic cage and diaphragm......Page 2353
17.14.1Lung cancer......Page 2359
17.14.2Pulmonary metastases......Page 2370
17.14.3Pleural tumours......Page 2371
17.14.4Mediastinal tumours and cysts......Page 2373
17.15The genetics of lung diseases......Page 2376
17.16Lung and heart–lung transplantation......Page 2379
18.1Joints and connective tissues: introduction......Page 2385
18.2Clinical presentation and diagnosis of rheumatic disease......Page 2389
18.3Clinical investigation......Page 2392
18.4Back pain and regional disorders......Page 2400
18.5Rheumatoid arthritis......Page 2404
18.6Spondyloarthropathies and related arthritides......Page 2418
18.7.1Pyogenic arthritis......Page 2428
18.7.2Reactive arthritis......Page 2431
18.8 Osteoarthritis......Page 2435
18.9Crystal-related arthropathies......Page 2441
18.10.1Autoimmune rheumatic disorders and vasculitis......Page 2450
18.10.2Systemic lupus erythematosus and related disorders......Page 2452
18.10.3Systemic sclerosis......Page 2461
18.10.4Polymyalgia rheumatica and giant-cell arteritis......Page 2467
18.10.5Behçet's disease......Page 2470
18.10.6Sjögren's syndrome......Page 2474
18.10.7Polymyositis and dermatomyositis......Page 2477
18.10.8Kawasaki syndrome......Page 2480
18.11Miscellaneous conditions presenting to the rheumatologist......Page 2484
19.1Disorders of the skeleton......Page 2491
19.2Inherited defects of connective tissue: Ehlers-Danlos syndrome, Marfan's syndrome, and pseudoxanthoma elasticum......Page 2520
19.3 Osteomyelitis......Page 2529
19.4 Osteoporosis......Page 2533
19.5Avascular necrosis and related topics......Page 2538
20.1Structure and function of the kidney......Page 2540
20.2.1Water and sodium homeostasis and their disorders......Page 2545
20.2.2Disorders of potassium homeostasis......Page 2555
20.3.1The clinical presentation of renal disease......Page 2563
20.3.2Clinical investigation of renal disease......Page 2573
20.4Acute renal failure......Page 2585
20.5.1Chronic renal failure......Page 2597
20.5.2Bone disease in chronic renal failure......Page 2610
20.6.1 Haemodialysis......Page 2615
20.6.2The treatment of endstage renal disease by peritoneal dialysis......Page 2623
20.6.3Renal transplantation......Page 2626
20.7.1The glomerulus and glomerular injury......Page 2638
20.7.2Iga nephropathy and Henoch–Schönlein purpura......Page 2642
20.7.3Thin membrane nephropathy......Page 2646
20.7.4Minimal-change nephropathy, focal segmental glomerulosclerosis, and membranous nephropathy......Page 2647
20.7.5Proliferative glomerulonephritis......Page 2654
20.7.6Mesangiocapillary glomerulonephritis......Page 2656
20.7.7Antiglomerular basement membrane disease......Page 2659
20.7.8Infection-associated nephropathies......Page 2662
20.7.9Malignancy-associated renal disease......Page 2666
20.7.10Glomerular disease in the tropics......Page 2668
20.8.1Renal tubular disorders......Page 2673
20.9.1Acute interstitial nephritis......Page 2679
20.9.2Chronic tubulointerstitial nephritis......Page 2682
20.10.1Diabetes mellitus and the kidney......Page 2693
20.10.2Hypertension and the kidney......Page 2699
20.10.3Vasculitis and the kidney......Page 2702
20.10.4The kidney in rheumatological disorders......Page 2710
20.10.5Renal involvement in plasma cell dyscrasias, immunoglobulin-based amyloidoses, and fibrillary glomerulopathies, lymphomas, and leukaemias......Page 2717
20.10.6Haemolytic uraemic syndrome......Page 2723
20.10.7Sickle-cell disease and the kidney......Page 2727
20.11Renal involvement in genetic disease......Page 2729
20.12Urinary tract infection......Page 2735
20.13Urinary stones, nephrocalcinosis, and renal tubular acidosis......Page 2746
20.14Urinary tract obstruction......Page 2756
20.15Tumours of the urinary tract......Page 2769
20.16Drugs and the kidney......Page 2775
21.1 Epidemiology......Page 2782
21.2Sexual behaviour......Page 2786
21.3Vaginal discharge......Page 2788
21.4Pelvic inflammatory disease......Page 2791
21.5Infections and other medical problems in homosexual men......Page 2793
21.6Cervical cancer and other cancers caused by sexually transmitted infections......Page 2797
22.1 Introduction......Page 2799
22.2.1Stem cells and haemopoiesis......Page 2803
22.2.2Stem-cell disorders......Page 2809
22.3.1Cell and molecular biology of human leukaemias......Page 2812
22.3.2The classification of leukaemia......Page 2816
22.3.3Acute lymphoblastic leukaemia......Page 2820
22.3.4Acute myeloblastic leukaemia......Page 2824
22.3.5Chronic lymphocytic leukaemia and other leukaemias of mature B and T cells......Page 2829
22.3.6Chronic myeloid leukaemia......Page 2836
22.3.7 Myelodysplasia......Page 2841
22.3.8The polycythaemias......Page 2845
22.3.9Idiopathic myelofibrosis......Page 2851
22.3.10 Thrombocytosis......Page 2855
22.3.11Aplastic anaemia and other causes of bone marrow failure......Page 2859
22.3.12Paroxysmal nocturnal haemoglobinuria......Page 2865
22.4.1Leucocytes in health and disease......Page 2868
22.4.2Introduction to the lymphoproliferative disorders......Page 2874
22.4.3 Lymphoma......Page 2878
22.4.4The spleen and its disorders......Page 2889
22.4.5Myeloma and paraproteinaemias......Page 2895
22.4.6 Eosinophilia......Page 2903
22.4.7 Histiocytoses......Page 2907
22.5.1Erythropoiesis and the normal red cell......Page 2911
22.5.2Anaemia: pathophysiology, classification, and clinical features......Page 2916
22.5.3Anaemia as a world health problem......Page 2920
22.5.4Iron metabolism and its disorders......Page 2924
22.5.5Normochromic, normocytic anaemia......Page 2933
22.5.6Megaloblastic anaemia and miscellaneous deficiency anaemias......Page 2935
22.5.7Disorders of the synthesis or function of haemoglobin......Page 2950
22.5.8Anaemias resulting from defective red cell maturation......Page 2968
22.5.9Haemolytic anaemia - congenital and acquired......Page 2971
22.5.10Disorders of the red cell membrane......Page 2981
22.5.11Erythrocyte enzymopathies......Page 2986
22.5.12Glucose-6-phosphate dehydrogenase (G6PD) deficiency......Page 2990
22.6.1The biology of haemostasis and thrombosis......Page 2994
22.6.2Evaluation of the patient with a bleeding diathesis......Page 3007
22.6.3Disorders of platelet number and function......Page 3013
22.6.4Genetic disorders of coagulation......Page 3020
22.6.5Acquired coagulation disorders......Page 3029
22.7The blood in systemic disease......Page 3037
22.8.1Blood transfusion......Page 3047
22.8.2Haemopoietic stem cell transplantation......Page 3054
23.1Diseases of the skin......Page 3058
23.2Molecular basis of inherited skin diseases......Page 3132
24.1Introduction and approach to the patient with neurological disease......Page 3139
24.2Electrophysiology of the central and peripheral nervous systems......Page 3141
24.3Brain and mind: functional neuroimaging......Page 3153
24.4Investigation of central motor pathways: magnetic brain stimulation......Page 3155
24.5Imaging in neurological diseases......Page 3158
24.6.1Inherited disorders......Page 3168
24.6.2 Neurogenetics......Page 3174
24.7Lumbar puncture......Page 3178
24.8Disturbances of higher cerebral function......Page 3180
24.9Brainstem syndromes......Page 3186
24.10Subcortical structures—the cerebellum, thalamus, and basal ganglia......Page 3189
24.11Visual pathways......Page 3193
24.12.1Eye movements and balance......Page 3199
24.12.2Disorders of hearing......Page 3203
24.13.1The unconscious patient......Page 3207
24.13.2 Headache......Page 3212
24.13.3Epilepsy in later childhood and adults......Page 3219
24.13.4 Narcolepsy......Page 3231
24.13.5 Syncope......Page 3233
24.13.5.1Head-up tilt-table testing in the diagnosis of vasovagal syncope and related disorders......Page 3236
24.13.6Brain death and the vegetative state......Page 3237
24.13.7Stroke: cerebrovascular disease......Page 3239
24.13.8Alzheimer's disease and other dementias......Page 3249
24.13.9Human prion diseases......Page 3258
24.13.10Parkinsonism and other extrapyramidal diseases......Page 3264
24.13.11Disorders of movement (excluding Parkinson's disease)......Page 3270
24.13.12Ataxic disorders......Page 3279
24.13.13The motor neurone diseases......Page 3284
24.13.14Diseases of the autonomic nervous system......Page 3288
24.13.15Disorders of cranial nerves......Page 3294
24.13.16Diseases of the spinal cord......Page 3298
24.13.17Spinal cord injury and its management......Page 3302
24.13.18.1Intracranial tumours......Page 3308
24.13.18.2Traumatic injuries of the head......Page 3312
24.13.19Benign intracranial hypertension......Page 3316
24.14.1Bacterial meningitis......Page 3319
24.14.2Viral infections of the central nervous system......Page 3330
24.14.3Intracranial abscess......Page 3339
24.14.4Neurosyphilis and neuroAIDS......Page 3341
24.15Metabolic disorders and the nervous system......Page 3346
24.16Demyelinating disorders of the central nervous system......Page 3352
24.17Disorders of the neuromuscular junction......Page 3362
24.18Paraneoplastic syndromes......Page 3368
24.19Diseases of the peripheral nerves......Page 3372
24.20Neurological complications of systemic autoimmune and inflammatory diseases......Page 3385
24.21Developmental abnormalities of the central nervous system......Page 3392
24.22.1Introduction: structure and function......Page 3407
24.22.2Muscular dystrophy......Page 3411
24.22.3 Myotonia......Page 3421
24.22.4Metabolic and endocrine disorders......Page 3425
24.22.5Mitochondrial encephalomyopathies......Page 3432
24.22.6Tropical pyomyositis (tropical myositis)......Page 3436
25The eye in general medicine......Page 3437
26.1General introduction......Page 3448
26.2Taking a psychiatric history from a medical patient......Page 3449
26.3Neuropsychiatric disorders......Page 3452
26.4Acute behavioural emergencies......Page 3460
26.5.1Grief, stress, and post-traumatic stress disorder......Page 3463
26.5.2The patient who has attempted suicide......Page 3469
26.5.3Medically unexplained symptoms in patients attending medical clinics......Page 3472
26.5.4Anxiety and depression......Page 3479
26.5.5Eating disorders......Page 3485
26.5.6Schizophrenia, bipolar disorder, obsessive–compulsive disorder, and personality disorder......Page 3490
26.6.1Psychopharmacology in medical practice......Page 3493
26.6.2Psychological treatment in medical practice......Page 3500
26.7.1Alcohol and drug dependence......Page 3502
26.7.2Brief interventions against excessive alcohol consumption......Page 3508
26.7.3Problems of alcohol and drug users in the hospital......Page 3511
27Forensic medicine and the practising doctor......Page 3515
28Sports and exercise medicine......Page 3524
29Adolescent medicine......Page 3532
30.1Medicine in old age......Page 3535
30.2Mental disorders of old age......Page 3548
31Palliative care......Page 3550
32Reference intervals for biochemical data......Page 3562
33Emergency medicine......Page 3564