Table Of Content

Clinical Chemistry Seventh Edition William J Marshall, MA PhD MSc MB BS FRCP FRCPath FRCPEdin FSB FRSC Clinical Director of Pathology, The London Clinic, London, UK Emeritus Reader in Clinical Biochemistry, King’s College London, London, UK Stephen K Bangert, MA MB BChir MSc MBA FRCPath Consultant Chemical Pathologist, East Sussex Healthcare NHS Trust, Eastbourne, UK Marta Lapsley, MB BCh BAO MD FRCPath Consultant Chemical Pathologist, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK Mosby Ltd. Copyright © 2012 Elsevier Ltd All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). First published 1988 by Gower Medical Publishing Second edition 1992 by Gower Medical Publishing Third edition 1995 by Mosby Fourth edition 2000 by Harcourt Publishers Limited Fifth edition 2004 Sixth edition 2008 Seventh edition 2012 ISBN 9780723437031 International ISBN 9780723437048 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Printed in China Preface to the seventh edition Despite the wealth of information now available to students and practitioners of healthcare on the internet, printed books still provide a valuable learning and reference resource, and, judging by sales, the sixth edition of this book proved as popular as its predecessors: we hope that this seventh edition will be as well received. The book was originally written primarily for medical students, but also proved popular with doctors studying for postgraduate examinations and students and practitioners of clinical and biomedical science. Each of these groups has differing requirements, and we have aimed to satisfy all these in our approach to the subject. In doing this, we have been helped by comments received from readers around the world. Please continue to let us know where you think that we could further improve the book. Each chapter includes a summary of the basic biochemistry and physiology upon which understanding clinical biochemistry depends. The nature, choice, use and limitations of laboratory investigations naturally comprises the bulk of each chapter, but clinical biochemistry is only one part of laboratory medicine, and laboratory tests comprise only one group among the many types of investigation available to support diagnosis and management. We have therefore continued to outline the role of other investigations, for example, imaging, and compare the type of information that they provide with that from laboratory tests. And because clinical biochemistry tests are widely used in assessing patients’ responses to treatment, we also provide summaries of treatment options, although we stress that this book is not, and is not intended to be, a textbook of metabolic medicine. The Case histories, all drawn from the authors’ own experience, summarize the key points in each chapter and may provide a useful starting point for examination revision. What we learn from our patients is often better remembered than what we learn from books. We are aware that the book has a considerable overseas readership, greatly increased by the publication of the sixth edition in an international as well as standard edition. The publication of guidelines and recommendations for managing patients with particular conditions has been a feature of clinical practice in recent years. However, these are often country-specific, and we have emphasized where such material has been developed for use in the UK. The two original authors were delighted when Dr Marta Lapsley accepted their invitation to join them in preparing this edition. Now that the senior author is semi-retired, this will provide continuity for the future. We have enjoyed working together and learning from each other’s views and experience. There have been no major changes in this edition, but the whole text has been carefully checked and, where necessary, revised. In addition to reflecting advances in clinical biochemistry, we have eliminated material that we agreed was obsolete. One of the three of us took responsibility for the detailed revision of each chapter and another then reviewed this material, but all us of have checked and agreed the final text. We hope that this approach has not only ensured the authority of the information, but has maintained the uniformity of the overall style. At Elsevier, Timothy Horne, our commissioning editor for several previous editions, has now retired and Jeremy Bowes has taken over from him. We have enjoyed working with Jeremy and with Carole McMurray, the development editor and Anne Collett, the project manager. As always, we are grateful to the designers, whose work results in such an attractive appearance of the book, complementing and not detracting from the text, and to the rest of the in-house team. And at home, Wendy (Marshall), Lorraine (Bangert) and Michael (Lapsley) have been unstinting in their support during our work on this book; we thank them all for their encouragement and for their forbearance throughout. William Marshall Stephen Bangert Marta Lapsley 2012 Further reading Cited references quickly become outdated. Readers seeking the most up-to-date information on a topic are recommended to use one of the bibliographic databases specializing in medical and scientific journals, for example Medline (the database of the National Library of Medicine in the United States of America, which encompasses over nine million references to reviews and papers published in nearly 4000 journals). Journals that publish articles and reviews relating to clinical chemistry include Annals of Clinical Biochemistry and Clinical Chemistry. Each issue of Endocrine and Metabolism Clinics of North America comprises sets of reviews on related topics, most of which are of direct relevance to clinical chemistry. General medical journals such as the British Medical Journal, Lancet and New England Journal of Medicine carry editorials and reviews of topics related to clinical chemistry from time to time. The monthly issues of Medicine together comprise a textbook of medicine, which is updated on a three-year cycle and is highly recommended. Table of Contents Instructions for online access Copyright Preface to the seventh edition Further reading Chapter 1: Biochemical investigations in clinical medicine Chapter 2: Water, sodium and potassium Chapter 3: Hydrogen ion homoeostasis and blood gases Chapter 4: The kidneys Chapter 5: The liver Chapter 6: The gastrointestinal tract Chapter 7: The hypothalamus and the pituitary gland Chapter 8: The adrenal glands Chapter 9: The thyroid gland Chapter 10: The gonads Chapter 11: Disorders of carbohydrate metabolism Chapter 12: Calcium, phosphate and magnesium Chapter 13: Plasma proteins and enzymes Chapter 14: Lipids, lipoproteins and cardiovascular disease Chapter 15: The locomotor and nervous systems Chapter 16: Inherited metabolic diseases Chapter 17: Disorders of haemoproteins, porphyrins and iron Chapter 18: Metabolic aspects of malignant disease Chapter 19: Therapeutic drug monitoring and chemical aspects of toxicology Chapter 20: Clinical nutrition Chapter 21: Clinical chemistry at the extremes of age Appendix Adult reference ranges Index Chapter 1 Biochemical investigations in clinical medicine

Description:

Clinical Chemistry considers what happens to the body's chemistry when affected by disease. Each chapter covers the relevant basic science and effectively applies this to clinical practice. It includes discussion on diagnostic techniques and patient management and makes regular use of case histories