Diagnosis and Treatment in Internal Medicine

Diagnosis and Treatment in Internal Medicine equips trainee doctors with the essential skills and core knowledge to establish a diagnosis reliably and quickly, before outlining the management of the clinical condition diagnosed.

Organised into three sections, the first provides a vital overview, whilst the second focuses on common presentations and diagnoses. Uniquely, this new book shows readers how to turn symptoms into a list of diagnoses ordered by probability - a differential diagnosis. Experienced consultants who teach trainees every day demonstrate how to derive an ordered differential diagnosis, how to narrow this down to a single diagnosis and if not, how to live with diagnostic uncertainty. The final section provides a comprehensive account of the management of system-based syndromes and diseases.

Highly-structured chapters emphasize how common conditions present, how to approach a diagnosis, and how to estimate prognosis, treatment and its effectiveness. An onus is placed on the development of crucial diagnostic skills and the ability to devise evidence-based management plans quickly and accurately, making this an ideal text for core medical trainees.

Patrick Davey, Consultant Cardiologist, Northampton General Hospital, Cliftonville, Northampton, UK,David Sprigings, Formerly Consultant Physician, Department of Medicine, Northampton General Hospital NHS Trust, Northampton, UK

Part 1 The approach to the patient
1. Diagnostic reasoning
2. Dealing with uncertainty
3. Taking the history
4. The physical examination
5. The psychological examination
6. Confidentiality
7. Consent
Part 2 Assessment of symptoms and presenting problems
8. Palpitation
9. Acute chest pain
10. Chronic chest pain
11. Hypotension
12. Acute breathlessness
13. Chronic breathlessness
14. Peripheral oedema
15. Murmur
16. Cough
17. Wheeze
18. Haemoptysis
19. Pleural effusion
20. Chylothorax
21. Difficulty swallowing
22. Haematemesis
23. Acute abdominal pain
24. Chronic abdominal pain
25. Dyspepsia
26. Abdominal mass
27. Constipation
28. Acute diarrhoea
29. Chronic diarrhoea
30. Rectal bleeding
31. Jaundice
32. Ascites
33. Chylous ascites
34. Swelling in the neck
35. Splenomegaly and other disorders of the spleen
36. Lymphadenopathy
37. Anaemia
38. Bruising and bleeding
39. Transient loss of consciousness
40. Coma
41. Delirium (Acute confusional state)
42. Seizures
43. Difficulty speaking (including dysphasia and dysarthria)
44. Weakness
45. Tremor and other abnormal movements
46. Gait disorders
47. Sensory loss
48. Headache
49. Loss of vision
50. The red eye
51. Hearing loss
52. Facial pain
53. Dizziness
54. Disorders of sleep
55. Haematuria
56. Oliguria and anuria
57. Polyuria
58. Dysuria
59. Urinary incontinence
60. Faecal incontinence
61. Vaginal discharge
62. Joint pain
63. Muscle pain
64. Low back pain
65. Painful leg
66. Leg ulcer
67. Limb ischaemia
68. Rashes
69. Blistering rashes
70. Photosensitive rashes
71. Itching
72. Lumps and bumps
73. Falls
74. Immobility ( Off legs )
75. Suspected anaphylaxis
76. Fever
77. Hyperthermia
78. Hypothermia
79. Fatigue
80. Unintentional weight loss
81. Obesity
82. Self-harm
83. Alcohol intoxication
84. Intravenous drug use
Part 3 Cardiovascular disorders
85. Normal function of the cardiovascular system
86. Risk factors for cardiovascular disease
87. Diagnosis and investigation in suspected heart disease
88. Congenital heart disease in adults
89. Chronic stable angina
90. Acute coronary syndromes
91. Acute heart failure
92. Chronic heart failure
93. Aortic stenosis
94. Aortic regurgitation
95. Mitral regurgitation
96. Miscellaneous valvar pathology: mitral stenosis, pulmonary stenosis, and tricuspid regurgitation
97. Percutaneous coronary interventions
98. Heart surgery
99. Circulatory support therapy
100. Pulmonary hypertension
101. Venous thrombosis and pulmonary embolism
102. Aortic aneurysm
103. Aortic dissection
104. Peripheral arterial disease
105. Raynaud's phenomenon
106. Heart muscle disease (cardiomyopathy)
107. Tumours and the heart
108. Cardiac infection
109. Pericardial disease
110. Extrasystoles
111. Sinus tachycardia
112. Focal (ectopic) atrial tachycardia (FAT/EAT)
113. Multifocal atrial tachycardia (MAT)
114. Atrioventricular nodal re-entrant tachycardia (AVNRT)
115. Atrioventricular re-entrant tachycardia (AVRT)
116. Atrial fibrillation
117. Atrial flutter
118. Ventricular tachyarrhythmias: ventricular tachycardia and ventricular fibrillation
119. Bradyarrhythmias
120. Sudden cardiac death
121. Cardiac device therapy
122. Drug-induced cardiovascular disease
123. Psychological management of coronary heart disease
124. Treatment of terminal cardiovascular disease
Part 4 Respiratory disorders
125. Normal respiratory function
126. Diagnosis in suspected respiratory disease
127. Investigation in respiratory disease
128. Upper respiratory tract infection, including influenza
129. Pneumonia
130. Tuberculosis
131. Pneumothorax
132. Cystic fibrosis
133. Asthma
134. Chronic obstructive pulmonary disease
135. Respiratory failure
136. Obstructive sleep apnoea
137. Bronchiectasis
138. Sarcoidosis and other granulomatous lung disease
139. Interstitial lung disease
140. Pulmonary vasculitis
141. Lung cancer (including management of an isolated lung lesion)
142. Occupational lung disease
143. Pleural infection and malignancy
144. Drug-induced lung disease
145. Psychology in respiratory disease including dysfunctional breathing
146. Terminal care in respiratory illness
Part 5 Intensive care medicine
147. Critical illness
148. Role of the intensive care unit
149. ICU treatment of respiratory failure
150. ICU treatment of cardiovascular failure
151. ICU treatment of renal failure
152. ICU treatment of sepsis and septic shock
153. Terminal care in the intensive care unit
154. Brain death
Part 6 Disorders of the kidney and urinary tract
155. Normal renal function
156. Diagnosis in suspected renal disease
157. Investigation in renal disease
158. Urinary tract infection
159. Glomerulonephritis
160. Interstitial renal disease
161. Nephrotic syndrome
162. Acute renal failure
163. Chronic kidney disease
164. Diabetic renal disease
165. Urinary tract obstruction and tumours
166. Renal calculi
167. Renal and bladder cancer
168. Renal support therapy
169. Inherited renal diseases
170. The kidney in systemic disease
171. Renal vascular disease
172. Management of terminal care in renal disease
173. Disorders of plasma potassium
174. Disorders of plasma sodium
175. Disorders of plasma calcium
176. Disorders of plasma phosphate
177. Disorders of plasma magnesium and other elements
178. Disorders of acid-base balance
179. Porphyria
180. Aminoacidopathies, urea cycle disorders and organic acidurias
181. Amyloidosis
Part 7 Diabetes mellitus and endocrine disorders
182. Normal function of the endocrine system
183. Diagnosis and investigation in endocrine disorders
184. Diabetes mellitus
185. Hypoglycaemia
186. Thyroid disease
187. Primary hyperparathyroidism
188. Adrenal disease
189. Cushing syndrome
190. Short stature
191. Infertility
192. Pituitary disorders: prolactinomas, acromegaly and pituitary apoplexy
Part 8 Gastro-intestinal disorders
193. Normal gastrointestinal function
194. Diagnosis in suspected gastrointestinal disease
195. Investigation in gastrointestinal disease
196. Immunology and genetics in gastrointestinal and hepatic medicine
197. Gastrointestinal infections
198. Benign oesophageal disease
199. Peptic ulcer disease
200. Gall bladder disease
201. Pancreatic disease
202. Malabsorption
203. Inflammatory bowel disease
204. Gastrointestinal tumours
205. Functional gastrointestinal diseases
206. Psychiatry in gastrointestinal medicine
Part 9 Disorders of the liver
207. Normal hepatic function
208. Investigation in liver disease
209. Acute liver failure
210. Chronic liver failure
211. Alcoholic liver disease
212. Viral hepatitis
213. Auto-immune hepatitis
214. Genetic liver disease
215. Drug-induced liver disease
216. Miscellaneous liver diseases
217. The liver in systemic disease
218. Liver cancer
Part 10 Neurological disorders
219. Normal neurological function
220. Diagnosis in suspected neurological disease
221. Investigation in neurological disease
222. Demographics of neurological disease
223. Neurogenetic disease
224. Neuro-cutaneous syndromes
225. Congenital neurological disorders
226. Epilepsy
227. Stroke
228. Dementia
229. Neurological infection
230. Disorders of movement
231. Multiple sclerosis
232. Motor neurone disease
233. Spinal cord disease
234. Neuropathy
235. Myopathy
236. Vasculitis in neurology
237. Neurological tumours
238. Non-metastatic neurological manifestations of malignancy
239. Neurosurgery
240. Drug-induced neurological disease
241. Functional and dissociative neurological symptoms
242. Palliative care in neurological disease
Part 11 Disorders of the skin
243. Normal skin function
244. Approach to diagnosing skin disease
245. Investigation in skin disease
246. Skin infection and infestation
247. Cutaneous vasculitis
248. Acne
249. Psoriasis
250. Eczema
251. Urticaria
252. Bullous disorders
253. Hair disorders
254. Nail disorders
255. Mucosal disease
256. Genital disease
257. Polymorphic light eruption and actinic prurigo
258. Disorders of pigmentation
259. Skin cancer
260. Skin markers of internal disease
261. Drug-induced skin disease
262. Psychocutaneous medicine
Part 12 Disorders of the musculoskeletal system
263. Normal function of the musculoskeletal system
264. Diagnosis in suspected rheumatological disease
265. Investigation in rheumatological disease
266. Osteoarthritis
267. Rheumatoid arthritis
268. Sero-negative spondylarthropathy
269. Systemic lupus erythematosus
270. Crystal arthropathy
271. Infection of joints and bones
272. Vasculitis
273. Osteomalacia
274. Paget's disease of bone
275. Osteoporosis and fragility fracture
276. Genetic bone and joint disease
Part 13 Haematological disorders
277. Normal blood function
278. Diagnosis and investigation in haematology
279. Haematinic-deficiency anaemia
280. Haemolytic anaemia
281. Normal platelet function
282. Platelet disorders
283. Normal haemostatic function
284. Bleeding disorders
285. Prothrombotic conditions
286. Acute leukaemia
287. Chronic leukaemia
288. Myelodysplasia
289. Lymphoma
290. Multiple myeloma and related conditions
291. Myeloproliferative disorders
292. Terminal care in haematological disease
Part 14 Disorders of the immune system
293. Functions of the immune system
294. Clinical features and diagnosis of immunological disease
295. Neutrophil abnormalities
296. Human immunodeficiency virus (HIV) infection
297. Antibody deficiencies
298. Combined T and B cell immunodeficiencies
299. Complement deficiencies
300. Hypersensitivity diseases
301. Immunological support
302. Immunosuppressive therapy and therapeutic monoclonal antibodies
Part 15 Infectious diseases
303. Defences against infection
304. Nature and demographics: Epidemiology of infective organisms
305. Diagnosis in suspected infective disease: The history and examination
306. Investigation in infection
307. Treatment of infection
308. Viral infection
309. Sepsis
310. Bacterial infection
311. Mycobacterial infection other than tuberculosis
312. Spirochaetal infection (non-syphilis)
313. Syphilis
314. Rickettsial infection
315. Fungal infection
316. Protozoal infection: Gut organisms
317. Protozoal infection: Malaria
318. Worm infection (including hydatid disease)
319. Prion disease
320. Sexually-transmitted disease (gonorrhoea)
Part 16 Cancers
321. Cancers related to infection
322. Principles of oncogenesis
323. Presentations in suspected cancer
324. Diagnosis and staging of cancer
325. Treatment of cancer
326. Prostate cancer
327. Breast cancer
328. Ovarian and testicular cancer
329. Symptom-control in cancer
330. Dying from cancer
Part 17 Dietary, lifestyle and environmental factors affecting health
331. Normal nutritional function
332. Starvation and malnutrition
333. Vitamin deficiencies
334. Nutritional support in the critically ill
335. Poor diets
336. Obesity
337. Physical activity and its role in disease prevention
338. Smoking
339. Alcohol
340. Environmental radiation
341. Air pollution
342. Non-prescription drugs
Part 18 Prevention of disease
343. Prevention of cardiovascular disease
344. Prevention of respiratory disease
345. Prevention of kidney disease
346. Prevention of gastrointestinal disease
347. Prevention of neurological disease
348. Prevention of cerebrovascular disease
349. Prevention of infection
350. Prevention of cancer
Part 19 Screening for disease
351. Screening for cardiovascular disease
352. Screening for respiratory disease
353. Screening for kidney disease
354. Screening for gastrointestinal disease
355. Screening for neurological disease
356. Screening for cancer