Textbook of Medicine (MRCP Study Guides) PDF
Preview Textbook of Medicine (MRCP Study Guides)
Edited by R L Souhami MD FRCP FMedSci Emeritus Professor of Medicine, University College London, UK J Moxham MD FRCP Professor of Respiratory Medicine and Vice-Dean, Guy's King's and St Thomas' School of Medicine, King's College Hospital, London, UK CHURCHILL LIVINGSTONE EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 2002 CHURCHILL LIVINGSTONE Commissioning Editor: Laurence Hunter An imprint of Elsevier Limited Project Development Manager: Barbara Simmons Project Manager: Nancy Arnott © Pearson Professional Limited 1996 Designer: Erik Bigland Assigned to Harcourt Brace and Company 1998 © 2002, Elsevier Science Limited. All rights reserved. © 2004, Elsevier Limited. All rights reserved. The right of Robert Souhami and John Moxham to be identified as editors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London WIT 4LP. Permissions may be sought directly from Elsevier's Health Sciences Rights Department in Philadelphia, USA: phone: (+1) 215 238 7869, fax: (+1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com), by selecting 'Customer Support' and then 'Obtaining Permission First edition 1990 Second edition 1994 Third edition 1997 Fourth edition 2002 Reprinted 2004 ISBN 0-443-06464-4 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 Note Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors and the publishers have taken care to ensure that the information given in this text is accurate and up to date. However, readers are strongly advised to confirm that the information, especially with regard to drug usage, complies with the latest legislation and standards of practice. your source for books, ELSEVIER journals and multimedia in the health sciences www.elsevier hea lth.com The publisher's policy is to use paper manufactured from sustainable forest! Printed in China Preface The Fourth Edition of this textbook continues the approach, have been able to incorporate case problems, multiple choice first begun fifteen years ago, to provide a comprehensive questions and clinical images throughout the text. The illustra- account of internal medicine that incorporates the ideas of tive case problems, some of which are in the textbook itself, are modern medical science. The intervening years have strength- designed to allow the reader to test his or her knowledge by ened our belief that an understanding of cellular and physio- practical application in clinical problem solving. Knowledge logical processes makes medicine more exciting and less arbi- and understanding can also be assessed by multiple choice trary. questions, formerly in a companion volume but which are now The emphasis of the book is clinical, giving a full descrip- located on the associated internet site. In addition the website tion of the presentation, investigation and treatment of disease. contains 500 supplementary clinical images. This extra infor- We have attempted to interpret these clinical aspects by refer- mation, all of which is clearly cross-referenced in the text, rep- ence to the underlying mechanisms whenever possible. resents for the reader an important additional compendium of Modern integrated curricula demand this approach. The text- knowledge, which expands the versatility of the book as a book is primarily intended for students of medicine, but we learning aid. hope and anticipate that it will continue to be of value to trainee The range and depth of specialised medical knowledge nec- doctors and health care professionals in many fields. essary for a major textbook has led us to select our authors The Fourth Edition has been completely revised to incorpo- from a wide range of medical schools. They have been chosen rate all major developments and advances, leading to an expan- for their acknowledged reputation in clinical and scientific sion of many sections especially in the areas of infectious dis- medicine. In this Fourth Edition we have again expanded the ease including AIDS, and cardiovascular disease. Many of the team of authors. All of us would be pleased to receive sugges- illustrations have been replaced or extended to include the tions which will help the book change and develop for future most up-to-date epidemiological data. We hope that these will editions. give the reader a sense of the way medicine is developing and where future advances in practice may lead. London RLS The most important innovation, however, affects the entire 2002 JM book. By linking the book to an easily-accessed internet site we V Acknowledgements As in previous editions we are greatly indebted to Laurence The multiple choice questions and answers for the website Hunter for his help in the planning and realisation of the new have been developed by Dr Andrew Freedman, Dr Richard edition. He has a very effective production team that have Watts and Dr Richard Evans. We are very grateful to them for made our task much easier. Our editor Barbara Simmons has, their painstaking work, which has added greatly to the educa- as usual, been helpful, efficient and outstandingly courteous tional value of the book. even in the face of occasionally rather provoking circum- We are also grateful to Dr Donncha O'Gradaigh for writing stances. We owe her a lot and are very grateful. the rheumatology case studies. vi Contributors Geoffrey J Bellingan PhD MRCP Jeremy Holmes MD MRCP FRCPsych Senior Lecturer, Department of Medicine, University College Consultant Psychotherapist, Devon Partnership Trust; Senior London Medical School; Consultant, Department of Intensive Lecturer, University of Exeter, Exeter, UK Care Medicine, University College London Hospitals, London, UK Cameron T C Kennedy MA MB BChir FRCP Consultant Dermatologist and Clinical Senior Lecturer, Brian T Cooper BSC MD FRCP Bristol Dermatology Centre, Bristol, UK Consultant Gastroenterologist, City Hospital, Birmingham; Senior Clinical Lecturer in Medicine, University of Michael E J Lean MA MD FRCP Birmingham, UK Professor of Human Nutrition, University of Glasgow; Consultant Physician, Glasgow Royal Infirmary; Non-execu- John Costello MD FRCP FRCPI tive Director, Health Education Board for Scotland, Glasgow, Consultant Physician and Clinical Director of Medicine, UK King's College Hospital, London, UK David C Linch BA MB BChir FRCP FRCPath FMedSci John Cunningham MD FRCP Professor of Haematology, Royal Free and University College Professor of Renal and Metabolic Medicine, Barts and the London Medical School, London, UK London, Queen Mary's School of Medicine and Dentistry, University of London, UK Richard G Long MD(Lond) FRCP (Lond) Consultant Gastroenterologist, City Hospital and Queen's J David M Edgar BSc(Hons) FRCP MRCPath Medical Centre, Nottingham; Clinical Teacher, Nottingham Consultant Immunologist, Regional Immunology Service, University Medical School, Nottingham, UK The Royal Hospitals Belfast, N Ireland John P Monson MD FRCP Jeremy M Gibbs MD FRCP Professor of Endocrinology, Department of Endocrinology, Consultant Neurologist and Honorary Senior Lecturer, Royal Barts and the London, Queen Mary's School of Medicine and Free Hospital, London, UK Dentistry, London, UK John Goldstone MD FRCA John Moxham MD FRCP Consultant in Intensive Care Medicine and Consultant Professor of Respiratory Medicine and Vice-Dean, Guy's Anaesthetist, University College London Hospitals, London, King's and St Thomas' School of Medicine, King's College UK Hospital, London, UK Robin A C Graham-Brown BSc MB FRCP John O'Grady MD FRCPI Consultant and Honorary Senior Lecturer in Dermatology, Consultant Hepatologist, King's College Hospital, London, University Hospital of Leicester NHS Trust and Leicester UK Royal Infirmary, Leicester, UK Peter W Overstall FRCP Brian Hazleman MA FRCP Consultant in Geriatric Medicine, Hereford Hospital, Consultant Rheumatologist, Addenbrooke's Hospital, Hereford, UK Cambridge; Director Rheumatology Research Unit; Fellow, Corpus Christi College, Cambridge, UK VII Philip A Routledge MD FRCP FRCPE John Wilding DM FRCP Professor of Clinical Pharmacology, University of Wales Reader in Medicine and Honorary Consultant Physician, College of Medicine, Cardiff; Honorary Consultant Physician, University of Liverpool and University Hospital Aintree, Cardiff and Vale NHS Trust, Cardiff, UK Liverpool, UK John W Scadding MD FRCP Gareth Williams MA MD FRCP Consultant Neurologist, The National Hospital for Neurology Professor of Medicine and Honorary Consultant Physician, and Neurosurgery and Whittington Hospital, London, UK Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK Herb F Sewell MB ChB MSC PHD FRCP FRCPath FMedSci Professor and Consultant Immunologist, University of Ian G Williams BSC MRCP Nottingham, Queen's Medical Centre, Nottingham, UK Senior Lecturer, Department of Sexually Transmitted Diseases, University College London Medical School, Martin Smith MBBS FRCA London, UK Consultant Neuroanaesthetist, Department of Neuroanaesthesia and Intensive Care, The National Hospital Robin M Winter FRCP FMedSci for Neurology and Neurosurgery, London, UK Professor of Dysmorphology and Clinical Genetics, Institute of Child Health, London, UK Robert L Souhami MD FRCP FMedSci Emeritus Professor of Medicine, University College London, Stephen G Wright MB FRCP UK Consultant Physician, Hospital for Tropical Diseases, London; Honorary Senior Lecturer, London School of L B Tan DPM FRCP FESC Hygiene and Tropical Medicine, London, UK Consultant Cardiologist, Leeds General Infirmary, Leeds, UK J Malcolm Walker MD FRCP MULTIPLE CHOICE QUESTIONS Consultant Cardiologist and Clinical Director of the Hatter Institute of Cardiovascular Studies, University College Richard H Evans MRCP Hospitals, London, UK Specialist Registrar in Infectious Diseases and General (Internal) Medicine, University Hospital of Wales, Cardiff, Mark H Wansbrough-Jones MSC FRCP UK Consultant Physician and Senior Lecturer in Infectious Diseases, St George's Hospital and Medical School, London, Andrew Freedman MA MD FRCP UK Senior Lecturer in Infectious Diseases, University of Wales College of Medicine; Consultant Physician, University Antony P Weetman MD DSC FRCP Hospital of Wales, Cardiff, UK Professor of Medicine, University of Sheffield; Honorary Consultant Physician, Sheffield Teaching Hospitals Trust, Richard A Watts MA DM FRCP Sheffield, UK Consultant Rheumatologist Ipswich Hospital NHS Trust, Ipswich, UK viii
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