Clinical Integration: Medicine PDF
Preview Clinical Integration: Medicine
C LINIC A L IN T EGR AT ION: MEDICINE __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 11 1100//0033//22002211 1144::1155 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 11 1100//0033//22002211 1122::5533 Hx Ex Ix Rx C L INIC A L IN T E GR AT ION: Student reviewers Our medical textbooks are assessed and reviewed by the following medical students: MEDICINE University of Aberdeen School of Medicine and Dentistry: Dylan McClurg Barts and The London School of Medicine and Dentistry: Jay Singh University of Birmingham College of Medical and Dental Sciences: Hannah Morgan Cardiff University School of Medicine: Chloe Chia The University of Edinburgh Medical School: Tanith Bain University of Exeter Medical School: Zoe Foster Hull York Medical School: Maalik Imtiaz Edited by King’s College London GKT School of Medical Education: Karan Sagoo University of Liverpool School of Medicine: Sophie Gunter University of Manchester Medical School: Holly Egan Nicholas Law Norwich Medical School: Aneesa Khan (MBBS) University of Nottingham School of Medicine: Tom Charles University of Sheffield Medical School: Rebecca Nutt Manda Raz (MBBS (Hons)) St George’s, University of London: Nawshin Basit Swansea University Medical School: Jack Bartlett University of Central Lancashire School of Medicine: Katie Chi Kei Cheung Sharmayne Brady (MBBS (Hons), BMedSc (Hons), FRACP) University College London Medical School: Camila Nicklewicz We are grateful for their essential feedback. Ar Kar Aung (BMedSci, MBBS, FRACP, MPHTM) Additional student reviewers wanted We are keen to recruit more student reviewers, particularly at UK medical schools where we don’t currently have anyone in post. If you would like to apply for the position, please contact Simon Watkins ([email protected]) and explain why you would be suitable for the role. Errors, omissions (and any other feedback) We’ve worked really hard with the authors to ensure that everything in the book is correct. However, errors and ambiguities can still slip through in books as complex as this. If you spot anything you think might be wrong, please email [email protected] and we will look into it straight away. If an error has occurred, we will correct it for future printings and post a note about it on our website so that other readers of the book are alerted to this. Please also use this email address if you have more general feedback about the book. Thank you for your help. __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 22 1100//0033//22002211 1144::1155 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 22 1100//0033//22002211 1122::5533 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 33 1100//0033//22002211 1122::5533 Hx Ex Ix Rx C L INIC A L IN T E GR AT ION: Student reviewers Our medical textbooks are assessed and reviewed by the following medical students: MEDICINE University of Aberdeen School of Medicine and Dentistry: Dylan McClurg Barts and The London School of Medicine and Dentistry: Jay Singh University of Birmingham College of Medical and Dental Sciences: Hannah Morgan Cardiff University School of Medicine: Chloe Chia The University of Edinburgh Medical School: Tanith Bain University of Exeter Medical School: Zoe Foster Hull York Medical School: Maalik Imtiaz Edited by King’s College London GKT School of Medical Education: Karan Sagoo University of Liverpool School of Medicine: Sophie Gunter University of Manchester Medical School: Holly Egan Nicholas Law Norwich Medical School: Aneesa Khan (MBBS) University of Nottingham School of Medicine: Tom Charles University of Sheffield Medical School: Rebecca Nutt Manda Raz (MBBS (Hons)) St George’s, University of London: Nawshin Basit Swansea University Medical School: Jack Bartlett University of Central Lancashire School of Medicine: Katie Chi Kei Cheung Sharmayne Brady (MBBS (Hons), BMedSc (Hons), FRACP) University College London Medical School: Camila Nicklewicz We are grateful for their essential feedback. Ar Kar Aung (BMedSci, MBBS, FRACP, MPHTM) Additional student reviewers wanted We are keen to recruit more student reviewers, particularly at UK medical schools where we don’t currently have anyone in post. If you would like to apply for the position, please contact Simon Watkins ([email protected]) and explain why you would be suitable for the role. Errors, omissions (and any other feedback) We’ve worked really hard with the authors to ensure that everything in the book is correct. However, errors and ambiguities can still slip through in books as complex as this. If you spot anything you think might be wrong, please email [email protected] and we will look into it straight away. If an error has occurred, we will correct it for future printings and post a note about it on our website so that other readers of the book are alerted to this. Please also use this email address if you have more general feedback about the book. Thank you for your help. __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 33 1100//0033//22002211 1144::1155 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 22 1100//0033//22002211 1122::5533 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 33 1100//0033//22002211 1122::5533 © Scion Publishing Ltd, 2021 First published 2021 All rights reserved. No part of this book may be reproduced or transmitted, in any form or by any means, without permission. A CIP catalogue record for this book is available from the British Library. ISBN 9781911510727 Scion Publishing Limited The Old Hayloft, Vantage Business Park, Bloxham Road, Banbury OX16 9UX, UK www.scionpublishing.com Important Note from the Publisher The information contained within this book was obtained by Scion Publishing Ltd from sources believed by us to be reliable. However, while every effort has been made to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to any person acting or refraining from action as a result of information contained herein can be accepted by the authors or publishers. Readers are reminded that medicine is a constantly evolving science and while the authors and publishers have ensured that all dosages, applications and practices are based on current indications, there may be specific practices which differ between communities. You should always follow the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which you are practising. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be pleased to acknowledge in subsequent reprints or editions any omissions brought to our attention. Registered names, trademarks, etc. used in this book, even when not marked as such, are not to be considered unprotected by law. Typeset by Evolution Design & Digital Ltd, Kent, UK Printed in the UK Last digit is the print number: 10 9 8 7 6 5 4 3 2 1 __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 44 1100//0033//22002211 1144::1155 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 44 1100//0033//22002211 1122::5533 CONTENTS © Scion Publishing Ltd, 2021 First published 2021 All rights reserved. No part of this book may be reproduced or transmitted, in any form or by About the editors viii any means, without permission. List of contributors ix A CIP catalogue record for this book is available from the British Library. Preface x ISBN 9781911510727 Abbreviations xi Chapter 1 Cardiology 1 Scion Publishing Limited Case 1 Aortic dissection 1 Case 2 Aortic stenosis 6 The Old Hayloft, Vantage Business Park, Bloxham Road, Banbury OX16 9UX, UK Case 3 Atrial fibrillation 11 www.scionpublishing.com Case 4 Heart failure with reduced ejection fraction 16 Case 5 Mitral regurgitation 22 Important Note from the Publisher Case 6 Mobitz 2 second-degree heart block 28 The information contained within this book was obtained by Scion Publishing Ltd Case 7 Pericarditis 33 from sources believed by us to be reliable. However, while every effort has been made Case 8 ST elevation myocardial infarction 38 to ensure its accuracy, no responsibility for loss or injury whatsoever occasioned to Case 9 Stable angina 44 any person acting or refraining from action as a result of information contained herein Case 10 Ventricular tachycardia 49 can be accepted by the authors or publishers. Readers are reminded that medicine is a constantly evolving science and while the Chapter 2 Endocrinology 55 authors and publishers have ensured that all dosages, applications and practices Case 11 Addison’s disease 55 are based on current indications, there may be specific practices which differ Case 12 Conn’s disease 60 between communities. You should always follow the guidelines laid down by the Case 13 Cushing’s syndrome 65 manufacturers of specific products and the relevant authorities in the country in which you are practising. Case 14 Hyperthyroidism 71 Case 15 Hypothyroidism 77 Although every effort has been made to ensure that all owners of copyright material Case 16 Osteoporosis 82 have been acknowledged in this publication, we would be pleased to acknowledge in subsequent reprints or editions any omissions brought to our attention. Case 17 Paget’s disease of bone 88 Case 18 Primary hyperparathyroidism 92 Registered names, trademarks, etc. used in this book, even when not marked as such, Case 19 Type 1 diabetes mellitus 97 are not to be considered unprotected by law. Case 20 Type 2 diabetes mellitus 103 Chapter 3 Gastroenterology and hepatology 109 Case 21 Acute pancreatitis 109 Case 22 Cholelithiasis, choledocholithiasis and cholecystitis 114 Case 23 Coeliac disease 119 Case 24 Decompensated liver cirrhosis 124 Case 25 GORD and oesophagitis 130 Case 26 Hepatitis A, B and C 134 Case 27 Inflammatory bowel disease 139 Case 28 Non-alcoholic fatty liver disease 145 Case 29 Oesophageal achalasia 150 Case 30 Peptic ulcer disease 155 Typeset by Evolution Design & Digital Ltd, Kent, UK Printed in the UK Last digit is the print number: 10 9 8 7 6 5 4 3 2 1 __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 55 1100//0033//22002211 1144::1155 CClliinniiccaall IInntteeggrraattiioonn PPrreelliimmss..iinndddd 44 1100//0033//22002211 1122::5533 vi CONTENTS Chapter 4 Haematology 161 Case 31 Acute myeloid leukaemia 161 Case 32 Chronic lymphocytic leukaemia and non-Hodgkin lymphoma 167 Case 33 Chronic myeloid leukaemia 172 Case 34 Haemolytic anaemia 177 Case 35 Haemophilia 182 Case 36 Hodgkin lymphoma 187 Case 37 Idiopathic thrombocytopenic purpura 192 Case 38 Iron-deficiency anaemia 198 Case 39 Multiple myeloma 203 Case 40 Venous thromboembolism 209 Chapter 5 Infectious diseases 215 Case 41 Cellulitis 215 Case 42 Gastroenteritis 220 Case 43 HIV/AIDS 224 Case 44 Infective endocarditis 229 Case 45 Malaria 234 Case 46 Meningoencephalitis 239 Case 47 Osteomyelitis 244 Case 48 Pneumonia 249 Case 49 Septic arthritis 254 Case 50 Urinary tract infections 258 Chapter 6 Neurology 263 Case 51 Acute inflammatory demyelinating polyradiculoneuropathy 263 Case 52 Acute intracerebral haemorrhage 267 Case 53 Dementia 273 Case 54 Motor neurone disease 278 Case 55 Multiple sclerosis 283 Case 56 Muscular dystrophy 289 Case 57 Myasthenia gravis 294 Case 58 Parkinson’s disease 299 Case 59 Spinal cord injury 304 Case 60 Stroke / transient ischaemic attack 308 Chapter 7 Oncology 313 Case 61 Breast carcinoma 313 Case 62 Colorectal carcinoma 319 Case 63 Head and neck carcinoma 324 Case 64 Hepatocellular carcinoma 329 Case 65 Melanoma 335 Case 66 Pancreatic carcinoma 340 Case 67 Prostate carcinoma 345 Case 68 Pulmonary carcinoma 350 Case 69 Renal cell carcinoma 356 Case 70 Testicular carcinoma 361 __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 66 1100//0033//22002211 1144::1155 CONTENTS vii Chapter 8 Renal 365 Case 71 Acute kidney injury 365 Case 72 Chronic kidney disease 370 Case 73 Dialysis-related hypotension 376 Case 74 Hyperkalaemia 380 Case 75 Hypokalaemia 385 Case 76 Hyponatraemia 389 Case 77 Lupus nephritis 394 Case 78 Nephrolithiasis 398 Case 79 Nephrotic syndrome 401 Case 80 Renal transplant rejection 404 Chapter 9 Respiratory 411 Case 81 Acute respiratory distress syndrome 411 Case 82 Asbestosis 414 Case 83 Asthma 417 Case 84 Chronic obstructive pulmonary disease 422 Case 85 Cystic fibrosis 428 Case 86 Idiopathic pulmonary hypertension 434 Case 87 Interstitial lung disease 437 Case 88 Lung transplantation 442 Case 89 Pleural effusion 445 Case 90 Pneumothorax 448 Chapter 10 Rheumatology 453 Case 91 ANCA-associated vasculitis 453 Case 92 Ankylosing spondylitis 459 Case 93 Giant cell arteritis 465 Case 94 Gout 470 Case 95 Non-specific low back pain 476 Case 96 Osteoarthritis 481 Case 97 Polymyositis 487 Case 98 Rheumatoid arthritis 493 Case 99 Scleroderma 499 Case 100 Systemic lupus erythematosus 504 Index of conditions 511 __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 77 1100//0033//22002211 1144::1155 ABOUT THE EDITORS Dr Nicholas Law MBBS Nicholas Law is a junior doctor with a keen interest in medical oncology and general medicine. He studied undergraduate medicine at Monash University, Australia. Nicholas is also involved in improving medical education and junior doctor welfare at his local institution. Dr Manda Raz MBBS (Hons) Manda Raz is an Australian doctor affiliated with Peninsula Health in Melbourne, with a broad interest in academia, research and acute care medicine. He completed his MBBS from Monash University, Australia. Dr Raz is the recipient of several scholarships, awards and medals for his academic achievements and contribution to empirical research and clinical governance. He is also the author and editor of multiple books and reference works spanning a number of clinical, legal and administrative specialties, and is currently studying for his MBioethics. Dr Sharmayne Brady MBBS (Hons), BMedSc (Hons), FRACP Sharmayne Brady is a senior staff specialist in Rheumatology at Alfred Health and also works in private practice. She is also an NHMRC-supported PhD scholar. She studied undergraduate medicine and completed a Bachelor of Medical Science at Monash University, Australia. Dr Brady completed physician training at the Alfred Hospital in Melbourne and completed her rheumatology specialist training at both the Alfred and Western Hospitals in Melbourne. Sharmayne has published fifteen papers in leading peer-reviewed journals and has presented her research at several leading international and national conferences over the past ten years. She has also worked as a specialist at Box Hill and Cabrini Hospitals in Melbourne and worked as a sub-investigator for several randomised controlled clinical trials with the Musculoskeletal Research Unit at Monash University. Dr Ar Kar Aung BMedSci, MBBS, FRACP, MPHTM Ar Kar Aung is currently a consultant physician in General Medicine and Infectious Diseases at Alfred Hospital, Melbourne, Australia, and is also an adjunct senior research fellow at Monash University. He was the previous Director of Physician Education at Alfred Health. He has served in key leadership positions as the Chair of Advance Training Committee in General and Acute Care Medicine at the Royal Australasian College of Physicians and as a Director on the Board of Internal Medicine Society of Australia and New Zealand. viii __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 88 1100//0033//22002211 1144::1155 LIST OF CONTRIBUTORS Cindy Bach Cases 81, 82, 86, 88 and 89 Kathryn Connelly Cases 91–100 Jessica Deitch Cases 13, 17 and 18 Mauli Govinna Cases 11, 12, 16 and 19 Thushan Hettige Cases 71–80 Qinyuan Hu Cases 51–60 Rohan Khanal Cases 83–85, 87 and 90 Nathan Kuk Cases 21–30 John Lee Cases 2, 5, 6, 8 and 10 Elisabeth Ng Cases 14, 15 and 20 Briony Shaw Cases 31–40 Udit Thakur Cases 1, 3, 4, 7 and 9 Naomi Whyler Cases 41–50 Kate Williams Cases 61–70 ix __CClliinniiccaall IInntteeggrraattiioonn 226655xx221100 44tthhPPrrooooff__CCSS22002211..iinnddbb 99 1100//0033//22002211 1144::1155
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