BOOK
Davidson's Principles and Practice of Medicine E-Book
Brian R. Walker | Nicki R Colledge | Stuart H. Ralston | Ian Penman
(2013)
Additional Information
Book Details
Abstract
More than two million medical students, doctors and other health professionals from around the globe have owned a copy of Davidson’s Principles and Practice of Medicine since it was first published. Today’s readers rely on this beautifully illustrated text to provide up-to-date detail of contemporary medical practice, presented in a style that is concise and yet easy to read. Davidson’s provides the factual knowledge required to practise medicine, explaining it in the context of underlying principles, basic science and research evidence, and shows how to apply this knowledge to the management of patients who present with problems rather than specific diseases. The book has won numerous prizes including being highly commended in the British Medical Association book awards.
Davidson’s global perspective is enhanced by the input of an international team of authors and a distinguished International Advisory Board from 17 countries. Building on the foundations laid down by its original editor, Davidson’s remains one of the world’s leading and most respected textbooks of medicine.
- The underlying principles of medicine are described concisely in the first part of the book, and the detailed practice of medicine within each sub-specialty is described in later system-based chapters.
- Most chapters begin with a two-page overview of the important elements of the clinical examination, including a manikin to illustrate the key steps in the examination of the relevant system.
- A practical, problem-based clinical approach is described in the ‘Presenting Problems’ sections, to complement the detailed descriptions of each disease.
- The text is extensively illustrated, with over 1000 diagrams, clinical photographs, and radiology and pathology images.
- 1350 text boxes present information in a way suitable for revision, including 150 clinical evidence boxes summarising the results of systematic reviews and randomised controlled trials and 65 ’In Old Age’ boxes highlighting important aspects of medical practice in the older population.
- A combined index and glossary of medical acronyms contains over 10 000 subject entries. The contents can also be searched comprehensively as part of the online access to the whole book on the StudentConsult platform.
- Access over 500 self-testing questions with answers linked to the book’s content for further reading.
- The text uses both SI and non-SI units to make it suitable for readers throughout the globe.
- A new chapter specifically on Stroke Disease recognises the emergence of Stroke Medicine as a distinct clinical and academic discipline.
- A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories.
- New ‘In Adolescence’ boxes recognise the fact that many chronic disorders begin in childhood and become the responsibility of physicians practising adult medicine. These boxes acknowledge the overlap ‘transitional’ phase and highlight the key points of importance when looking after young people.
- The regular introduction of new authors and editors maintains the freshness of each new edition. On this occasion Dr Ian Penman has joined the editorial team and 18 new authors bring new experience and ideas to the content and presentation of the textbook.
- An expanded International Advisory Board of 38 members includes new members from several different countries.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front cover | cover | ||
Inside front cover | ifc1 | ||
Half title page | i | ||
Sir Stanley Davidson (1894–1981) | ii | ||
Davidson's Principles and Practice of Medicine, 22/e | iii | ||
Copyright page | iv | ||
Preface | v | ||
Table of Contents | vi | ||
List of presenting problems | viii | ||
Abnormal investigation results | viii | ||
Symptoms and signs | viii | ||
Syndromes | ix | ||
Contributors | x | ||
International Advisory Board | xiv | ||
Introduction | xvi | ||
Clinical examination overviews | xvi | ||
Presenting problems | xvi | ||
Boxes | xvi | ||
General Information | xvi | ||
Evidence-based Medicine | xvi | ||
Practice Point | xvi | ||
Emergency | xvi | ||
In Old Age | xvii | ||
In Pregnancy | xvii | ||
In Adolescence | xvii | ||
Terminology | xvii | ||
Units of measurement | xvii | ||
Finding what you are looking for | xvii | ||
Acknowledgements | xviii | ||
Figure acknowledgements | xix | ||
1 Principles of Medicine | 1 | ||
1 Good medical practice | 1 | ||
Medical practice | 2 | ||
The doctor–patient relationship | 2 | ||
Difficulties in the doctor–patient relationship | 2 | ||
Communication and other clinical skills | 4 | ||
Using investigations | 4 | ||
The ‘normal’ (or reference) range | 5 | ||
Sensitivity and specificity | 5 | ||
Predictive value | 6 | ||
Screening | 6 | ||
Estimating and communicating risk | 7 | ||
Clinical decision-making | 7 | ||
Evidence-based medicine | 8 | ||
Guidelines and protocols | 8 | ||
Guidelines | 8 | ||
Protocols | 9 | ||
Cost-effectiveness | 9 | ||
Quality-adjusted life years | 9 | ||
Practising medicine in low-resource settings | 9 | ||
Medical ethics | 9 | ||
Principles of clinical ethics | 10 | ||
Respect for persons and their autonomy | 10 | ||
Truth-telling | 10 | ||
Informed consent | 10 | ||
Confidentiality | 11 | ||
Beneficence | 11 | ||
Non-maleficence | 11 | ||
Justice | 11 | ||
Types of ethical problem | 11 | ||
A gap or block | 11 | ||
Priority-setting | 11 | ||
A moral dilemma | 11 | ||
Resolving conflict | 12 | ||
Ethical analysis | 12 | ||
A clinical ethics scenario | 13 | ||
On the one hand, considered mainly in teleological terms: | 13 | ||
On the other hand, considered in deontological as well as teleological terms: | 13 | ||
In practice: | 13 | ||
Medical law | 13 | ||
Personal and professional development | 14 | ||
Clinical audit | 15 | ||
Complementary and alternative medicine | 15 | ||
Safety | 16 | ||
Evidence | 16 | ||
Regulation | 16 | ||
Integrated health care | 16 | ||
Further information and acknowledgements | 16 | ||
Websites | 16 | ||
Figure acknowledgements | 16 | ||
2 Therapeutics and good prescribing | 17 | ||
Principles of clinical pharmacology | 18 | ||
Pharmacodynamics | 18 | ||
Drug targets and mechanisms of action | 18 | ||
Dose–response relationships | 19 | ||
Therapeutic index | 20 | ||
Desensitisation and withdrawal effects | 20 | ||
Pharmacokinetics | 21 | ||
Drug absorption and routes of administration | 21 | ||
Enteral administration | 21 | ||
Parenteral administration | 21 | ||
Other routes of administration | 21 | ||
Drug distribution | 22 | ||
Volume of distribution | 22 | ||
Drug elimination | 22 | ||
Drug metabolism | 22 | ||
Drug excretion | 22 | ||
Elimination kinetics | 22 | ||
Repeated dose regimens | 23 | ||
Inter-individual variation in drug responses | 23 | ||
Adverse outcomes of drug therapy | 24 | ||
Adverse drug reactions | 24 | ||
Prevalence of ADRs | 24 | ||
Classification of ADRs | 25 | ||
Detecting ADRs – pharmacovigilance | 27 | ||
Drug interactions | 28 | ||
Mechanisms of drug interactions | 28 | ||
Avoiding drug interactions | 29 | ||
Medication errors | 29 | ||
Responding when an error is discovered | 29 | ||
Drug regulation and management | 30 | ||
Drug development and marketing | 30 | ||
Licensing new medicines | 31 | ||
Drug marketing | 31 | ||
Managing the use of medicines | 31 | ||
Evaluating evidence | 32 | ||
Evaluating cost-effectiveness | 32 | ||
Implementing recommendations | 32 | ||
Prescribing in practice | 33 | ||
Decision-making in prescribing | 33 | ||
Making a diagnosis | 33 | ||
Establishing the therapeutic goal | 33 | ||
Choosing the therapeutic approach | 33 | ||
Choosing a drug | 33 | ||
Absorption. | 33 | ||
Distribution. | 33 | ||
Metabolism. | 33 | ||
Excretion. | 33 | ||
Efficacy. | 33 | ||
Avoiding adverse effects. | 33 | ||
Features of the disease. | 33 | ||
Severity of disease. | 33 | ||
Coexisting diseases | 33 | ||
Avoiding adverse drug interactions. | 33 | ||
Patient adherence to therapy. | 33 | ||
Cost. | 33 | ||
Genetic factors. | 34 | ||
Choosing a dosage regimen | 34 | ||
Dose titration. | 34 | ||
Route. | 34 | ||
Frequency. | 34 | ||
Timing. | 34 | ||
Formulation. | 34 | ||
Duration. | 34 | ||
Involving the patient | 34 | ||
Writing the prescription | 35 | ||
Monitoring treatment effects | 36 | ||
Stopping drug therapy | 36 | ||
Prescribing in special circumstances | 36 | ||
Prescribing for patients with renal disease | 36 | ||
Prescribing for patients with hepatic disease | 36 | ||
Prescribing for elderly patients | 36 | ||
Prescribing for women who are pregnant or breastfeeding | 36 | ||
Writing prescriptions | 37 | ||
Prescribing in hospital | 37 | ||
Hospital discharge (‘to take out’) medicines | 37 | ||
Prescribing in primary care | 37 | ||
Monitoring drug therapy | 39 | ||
Clinical and surrogate endpoints | 39 | ||
Plasma drug concentration | 39 | ||
Timing of samples in relation to doses | 40 | ||
Interpreting the result | 40 | ||
Further information | 40 | ||
Websites | 40 | ||
3 Molecular and genetic factors in disease | 41 | ||
Functional anatomy and physiology | 42 | ||
Cell and molecular biology | 42 | ||
DNA, chromosomes and chromatin | 42 | ||
Genes and transcription | 42 | ||
RNA splicing, editing and degradation | 43 | ||
Translation and protein production | 44 | ||
Mitochondria and energy production | 45 | ||
Protein degradation | 46 | ||
The cell membrane and cytoskeleton | 47 | ||
Receptors, cellular communication and intracellular signalling | 48 | ||
Cell division, differentiation and migration | 49 | ||
Cell death, apoptosis and senescence | 50 | ||
Genetic disease and inheritance | 50 | ||
Meiosis | 50 | ||
Patterns of disease inheritance | 51 | ||
Autosomal dominant inheritance | 51 | ||
Autosomal recessive inheritance | 53 | ||
X-linked inheritance | 53 | ||
Mitochondrial inheritance | 53 | ||
Epigenetic inheritance and imprinting | 53 | ||
Classes of genetic variant | 53 | ||
Nucleotide substitutions | 53 | ||
Insertions and deletions | 55 | ||
Simple tandem repeat mutation | 55 | ||
Copy number variations | 55 | ||
Polymorphic copy number variants | 56 | ||
Consequences of genetic variation | 57 | ||
Loss-of-function mutations | 58 | ||
Gain-of-function and dominant negative mutations | 58 | ||
Polymorphisms | 58 | ||
Neutral variants | 58 | ||
Evolutionary selection | 58 | ||
Constitutional genetic disease | 58 | ||
Allelic heterogeneity | 59 | ||
Locus heterogeneity | 59 | ||
De novo mutations | 59 | ||
Somatic genetic disease | 59 | ||
Investigation of genetic disease | 60 | ||
General principles of diagnosis | 60 | ||
Constructing a family tree | 60 | ||
Polymerase chain reaction and DNA sequencing | 60 | ||
Assessing DNA copy number | 62 | ||
Non-DNA-based methods of assessment | 62 | ||
Genetic testing in pregnancy and pre-implantation genetic testing | 62 | ||
Genetic testing in children | 63 | ||
Identifying a disease gene in families | 63 | ||
Genetic investigation in populations | 64 | ||
Predictive genetic testing | 64 | ||
Presenting problems in genetic disease | 64 | ||
Major categories of genetic disease | 64 | ||
Inborn errors of metabolism | 64 | ||
Intoxicating IEM | 64 | ||
Mitochondrial disorders | 65 | ||
Storage disorders | 65 | ||
Neurological disorders | 65 | ||
Huntington’s disease | 65 | ||
Other triplet repeat disorders | 65 | ||
Connective tissue disorders | 65 | ||
Learning disability, dysmorphism and malformations | 66 | ||
Chromosome disorders | 66 | ||
Dysmorphic syndromes | 66 | ||
X-linked mental handicap | 66 | ||
De novo mutations | 66 | ||
Familial cancer syndromes | 66 | ||
Retinoblastoma | 66 | ||
Familial adenomatous polyposis coli | 67 | ||
Li–Fraumeni syndrome | 67 | ||
Hereditary non-polyposis colorectal cancer | 67 | ||
Familial breast cancer | 67 | ||
Xeroderma pigmentosum | 67 | ||
Genetic counselling | 67 | ||
Genetics of common diseases | 68 | ||
Measuring the genetic contribution to complex disease | 68 | ||
Genetic testing in complex disease | 69 | ||
Pharmacogenomics | 69 | ||
Research frontiers in molecular medicine | 69 | ||
Gene therapy | 69 | ||
Induced pluripotent stem cells and regenerative medicine | 69 | ||
Pathway medicine | 70 | ||
Further information | 70 | ||
Books and journal articles | 70 | ||
Websites | 70 | ||
4 Immunological factors in disease | 71 | ||
Functional anatomy and physiology of the immune system | 72 | ||
The innate immune system | 72 | ||
Constitutive barriers to infection | 72 | ||
Phagocytes | 72 | ||
Neutrophils | 72 | ||
Monocytes and macrophages | 74 | ||
Dendritic cells | 74 | ||
Cytokines | 74 | ||
Complement | 74 | ||
Mast cells and basophils | 75 | ||
Natural killer cells | 75 | ||
The adaptive immune system | 76 | ||
Lymphoid organs | 76 | ||
The thymus | 76 | ||
The spleen | 76 | ||
Lymph nodes and mucosa-associated lymphoid tissue | 76 | ||
Lymphatics | 77 | ||
Humoral immunity | 77 | ||
B lymphocytes | 77 | ||
Immunoglobulins | 77 | ||
Cellular immunity | 78 | ||
Immune deficiency | 78 | ||
Presenting problems in immune deficiency | 79 | ||
Recurrent infections | 79 | ||
Primary phagocyte deficiencies | 79 | ||
Leucocyte adhesion deficiencies | 79 | ||
Chronic granulomatous disease | 79 | ||
Defects in cytokines and cytokine receptors | 79 | ||
Complement pathway deficiencies | 79 | ||
Investigations and management | 79 | ||
Primary deficiencies of the adaptive immune system | 80 | ||
Primary T-lymphocyte deficiencies | 80 | ||
DiGeorge syndrome | 80 | ||
Bare lymphocyte syndromes | 80 | ||
Autoimmune lymphoproliferative syndrome | 80 | ||
Investigations and management | 80 | ||
Combined B- and T-lymphocyte immune deficiencies | 80 | ||
Primary antibody deficiencies | 80 | ||
Investigations | 81 | ||
Management | 81 | ||
Secondary immune deficiencies | 82 | ||
The inflammatory response | 82 | ||
Physiology and pathology of inflammation | 82 | ||
Acute inflammation | 82 | ||
Acute phase proteins | 82 | ||
Resolution of inflammation | 82 | ||
Sepsis and septic shock | 83 | ||
Chronic inflammation | 83 | ||
Investigations in inflammation | 83 | ||
C-reactive protein | 84 | ||
Erythrocyte sedimentation rate | 84 | ||
Plasma viscosity | 85 | ||
Presenting problems in inflammation | 85 | ||
Unexplained raised ESR | 85 | ||
Clinical assessment | 85 | ||
Investigations | 85 | ||
Imaging | 85 | ||
Periodic fever syndromes | 85 | ||
Familial Mediterranean fever | 85 | ||
Mevalonate kinase deficiency | 85 | ||
TNF receptor-associated periodic syndrome | 85 | ||
Amyloidosis | 86 | ||
Diagnosis | 86 | ||
Management | 86 | ||
Autoimmune disease | 86 | ||
Pathophysiology of autoimmunity | 86 | ||
Immunological tolerance | 86 | ||
Factors predisposing to autoimmune disease | 87 | ||
Classification of autoimmune diseases | 87 | ||
Investigations in autoimmunity | 88 | ||
Autoantibodies | 88 | ||
Measures of complement activation | 88 | ||
Cryoglobulins | 88 | ||
Allergy | 89 | ||
Pathology of allergy | 89 | ||
Susceptibility to allergic diseases | 89 | ||
Presenting problems in allergy | 90 | ||
A general approach to the allergic patient | 90 | ||
Clinical assessment | 90 | ||
Investigations | 90 | ||
Skin prick tests | 90 | ||
Specific IgE tests | 90 | ||
Supervised exposure to allergen (challenge test) | 90 | ||
Mast cell tryptase | 90 | ||
Non-specific markers of atopic disease: total serum IgE and eosinophilia | 90 | ||
Management | 90 | ||
Anaphylaxis | 91 | ||
Clinical assessment | 91 | ||
Investigations | 92 | ||
Management | 92 | ||
Angioedema | 93 | ||
Specific allergies | 94 | ||
Insect venom allergy | 94 | ||
Peanut allergy | 94 | ||
Birch oral allergy syndrome | 94 | ||
C1 inhibitor deficiency | 94 | ||
Hereditary angioedema | 94 | ||
Acquired C1 inhibitor deficiency | 94 | ||
Transplantation Immunology | 94 | ||
Transplant rejection | 94 | ||
Investigations | 95 | ||
Pre-transplantation testing | 95 | ||
C4d staining | 95 | ||
Complications of transplant immunosuppression | 95 | ||
Organ donation | 96 | ||
Further information and acknowledgements | 96 | ||
Websites | 96 | ||
Figure acknowledgements | 96 | ||
5 Environmental and nutritional factors in disease | 97 | ||
Principles and investigation of environmental factors in disease | 98 | ||
Environmental effects on health | 98 | ||
The hierarchy of systems – from molecules to ecologies | 98 | ||
Interactions between people and their environment | 98 | ||
The life course | 98 | ||
Investigations in environmental health | 99 | ||
Incidence and prevalence | 99 | ||
Variability by time, person and place | 99 | ||
Measuring risk | 99 | ||
Establishing cause and effect | 99 | ||
Preventive medicine | 100 | ||
Environmental diseases | 100 | ||
Alcohol | 100 | ||
Smoking | 100 | ||
Obesity | 101 | ||
Poverty and affluence | 101 | ||
Atmospheric pollution | 102 | ||
Carbon dioxide and global warming | 102 | ||
Radiation exposure | 102 | ||
Types of ionising radiation | 102 | ||
Dosage and exposure | 103 | ||
Effects of radiation exposure | 103 | ||
Deterministic effects | 103 | ||
Stochastic effects | 103 | ||
Management of radiation exposure | 103 | ||
Extremes of temperature | 103 | ||
Thermoregulation | 103 | ||
Hypothermia | 104 | ||
Clinical features | 104 | ||
Investigations | 104 | ||
Management | 105 | ||
Mild hypothermia | 105 | ||
Severe hypothermia | 105 | ||
Cold injury | 105 | ||
Freezing cold injury (frostbite) | 105 | ||
Non-freezing cold injury (trench or immersion foot) | 105 | ||
Chilblains | 105 | ||
Heat-related illness | 105 | ||
Heat cramps | 106 | ||
Heat syncope | 106 | ||
Heat exhaustion | 106 | ||
Heat stroke | 106 | ||
High altitude | 106 | ||
Physiological effects of high altitude | 107 | ||
Illnesses at high altitude | 107 | ||
Acute mountain sickness | 107 | ||
High-altitude cerebral oedema | 107 | ||
High-altitude pulmonary oedema | 107 | ||
Chronic mountain sickness (Monge’s disease) | 107 | ||
High-altitude retinal haemorrhage | 107 | ||
Venous thrombosis | 107 | ||
Refractory cough | 107 | ||
Air travel | 107 | ||
Advice for patients with respiratory disease | 108 | ||
Advice for other patients | 108 | ||
Deep venous thrombosis | 108 | ||
Under water | 108 | ||
Drowning and near-drowning | 108 | ||
Clinical features | 108 | ||
Management | 108 | ||
Diving-related illness | 109 | ||
Clinical features | 109 | ||
Decompression illness | 109 | ||
Barotrauma | 109 | ||
Management | 110 | ||
Nutritional factors and disease | 110 | ||
Physiology of nutrition | 110 | ||
Energy balance | 110 | ||
Regulation of energy balance | 110 | ||
Responses to under- and over-nutrition | 111 | ||
Macronutrients (energy-yielding nutrients) | 112 | ||
Carbohydrates | 112 | ||
Dietary fibre | 113 | ||
Fats | 113 | ||
Proteins | 114 | ||
Dietary recommendations for macronutrients | 114 | ||
Clinical assessment and investigation of nutritional status | 114 | ||
Anthropometric measurements | 114 | ||
Disorders of altered energy balance | 115 | ||
Obesity | 115 | ||
Complications of obesity | 115 | ||
Body fat distribution | 115 | ||
Aetiology | 116 | ||
Susceptibility to obesity | 116 | ||
Reversible causes of obesity and weight gain | 117 | ||
Clinical assessment and investigations | 117 | ||
Management | 117 | ||
Lifestyle advice | 118 | ||
Weight loss diets | 118 | ||
Drugs | 119 | ||
Surgery | 119 | ||
Treatment of additional risk factors | 120 | ||
Under-nutrition | 120 | ||
Starvation and famine | 120 | ||
Clinical assessment | 121 | ||
Investigations | 121 | ||
Management | 121 | ||
Under-nutrition in hospital | 122 | ||
Nutritional support of the hospital patient | 122 | ||
Normal diet | 122 | ||
Dietary supplements | 123 | ||
Enteral tube feeding | 123 | ||
Parenteral nutrition | 123 | ||
Refeeding syndrome | 124 | ||
Legal and ethical aspects of artificial nutritional support | 124 | ||
Cachexia | 124 | ||
Micronutrients, minerals and their diseases | 124 | ||
Vitamins | 124 | ||
Fat-soluble vitamins | 126 | ||
Vitamin A (retinol) | 126 | ||
Vitamin D | 127 | ||
Vitamin E | 127 | ||
Vitamin K | 127 | ||
Water-soluble vitamins | 127 | ||
Thiamin (vitamin B1) | 127 | ||
Deficiency – beri-beri | 128 | ||
Riboflavin (vitamin B2) | 128 | ||
Niacin (vitamin B3) | 128 | ||
Deficiency – pellagra | 128 | ||
Toxicity | 129 | ||
Pyridoxine (vitamin B6) | 129 | ||
Biotin | 129 | ||
Folate (folic acid) | 129 | ||
Hydroxycobalamin (vitamin B12) | 129 | ||
Neurological consequences of vitamin B12 deficiency | 129 | ||
Vitamin C (ascorbic acid) | 129 | ||
Deficiency – scurvy | 129 | ||
Other dietary organic compounds | 129 | ||
Inorganic micronutrients | 130 | ||
Calcium and phosphorus | 130 | ||
Iron | 130 | ||
Iodine | 131 | ||
Zinc | 131 | ||
Selenium | 132 | ||
Fluoride | 132 | ||
Sodium, potassium and magnesium | 132 | ||
Other essential inorganic nutrients | 132 | ||
Further information and acknowledgements | 132 | ||
Websites | 132 | ||
Telephone numbers | 132 | ||
Figure acknowledgements | 132 | ||
6 Principles of infectious disease | 133 | ||
Infectious agents | 134 | ||
Prions | 134 | ||
Viruses | 134 | ||
Prokaryotes: bacteria (including mycobacteria and actinomycetes) | 135 | ||
Eukaryotes: fungi, protozoa and helminths | 135 | ||
Normal flora | 136 | ||
Host–pathogen interactions | 137 | ||
Characteristics of successful pathogens | 137 | ||
The host response | 138 | ||
Pathogenesis of infectious disease | 138 | ||
The febrile response | 138 | ||
Investigation of infection | 138 | ||
Direct detection | 139 | ||
Detection of whole organisms | 139 | ||
Detection of components of organisms | 139 | ||
Nucleic acid amplification tests (NAAT) | 139 | ||
Culture | 140 | ||
Blood culture | 141 | ||
Specific immunological tests | 141 | ||
Antibody detection | 141 | ||
Enzyme-linked immunosorbent assay | 141 | ||
Immunoblot (Western blot) | 141 | ||
Immunofluorescence assays | 142 | ||
Complement fixation test | 142 | ||
Agglutination tests | 142 | ||
Other tests | 142 | ||
Antibody-independent specific immunological tests | 142 | ||
Antimicrobial susceptibility testing | 143 | ||
Epidemiology of infection | 143 | ||
Geographic and temporal patterns of infection | 143 | ||
Endemic disease | 143 | ||
Emerging and re-emerging disease | 143 | ||
Reservoirs of infection | 143 | ||
Human reservoirs | 143 | ||
Animal reservoirs | 144 | ||
Environmental reservoirs | 144 | ||
Transmission of infection | 144 | ||
Deliberate release | 145 | ||
Infection prevention and control | 145 | ||
Health care-acquired infection | 145 | ||
Outbreaks of infection | 147 | ||
Principles of food hygiene | 147 | ||
Immunisation | 148 | ||
Vaccination | 148 | ||
Types of vaccine | 148 | ||
Use of vaccines | 149 | ||
Treatment of infectious diseases | 149 | ||
Principles of antimicrobial therapy | 149 | ||
Antimicrobial action and spectrum | 150 | ||
Empiric versus targeted therapy | 150 | ||
Combination therapy | 150 | ||
Antimicrobial resistance | 151 | ||
Duration of therapy | 152 | ||
Antimicrobial prophylaxis | 152 | ||
Pharmacokinetics and pharmacodynamics | 152 | ||
Therapeutic drug monitoring | 154 | ||
Beta-lactam antibiotics | 154 | ||
Pharmacokinetics | 154 | ||
Adverse effects | 154 | ||
Drug interactions | 155 | ||
Penicillins | 155 | ||
Cephalosporins and cephamycins | 155 | ||
Monobactams | 156 | ||
Carbapenems | 156 | ||
Macrolide and lincosamide antibiotics | 156 | ||
2 Practice of Medicine | 179 | ||
8 Critical illness | 179 | ||
Clinical examination of the critically ill patient | 180 | ||
Physiology of critical illness | 182 | ||
Oxygen transport | 182 | ||
Cardiovascular component of oxygen delivery: flow | 182 | ||
Preload | 182 | ||
Afterload | 183 | ||
Myocardial contractility | 183 | ||
Oxygenation component of oxygen delivery: content | 183 | ||
Oxygen consumption | 184 | ||
Relationship between oxygen consumption and delivery | 184 | ||
Pathophysiology of the inflammatory response | 184 | ||
Local inflammation | 184 | ||
Systemic inflammation | 185 | ||
Monitoring | 185 | ||
Monitoring the circulation | 185 | ||
Electrocardiogram | 185 | ||
Blood pressure | 185 | ||
Central venous pressure | 185 | ||
Pulmonary artery catheterisation and pulmonary artery ‘wedge’ pressure | 185 | ||
Cardiac output | 186 | ||
Echocardiography | 187 | ||
Urine output | 187 | ||
Peripheral skin temperature | 187 | ||
Blood lactate, hydrogen ion and base excess/deficit | 187 | ||
Monitoring respiratory function | 187 | ||
Oxygen saturation | 187 | ||
Arterial blood gases | 187 | ||
Lung function | 188 | ||
Capnography | 188 | ||
Transcutaneous PCO2 | 188 | ||
Recognition of critical illness | 188 | ||
Assessment and initial resuscitation of the critically ill patient | 188 | ||
Airway and breathing | 188 | ||
Circulation | 189 | ||
Disability | 189 | ||
Exposure, evidence and examination | 189 | ||
Clinical decision-making and referral to critical care | 189 | ||
Presenting problems/Management of major organ failure | 190 | ||
Circulatory failure: ‘shock’ | 190 | ||
Low stroke volume | 190 | ||
Vasodilatation | 190 | ||
Clinical assessment and complications | 190 | ||
Circulatory support | 190 | ||
Therapeutic options to optimise cardiac function | 191 | ||
Prognosis | 191 | ||
Respiratory failure and acute respiratory distress syndrome | 191 | ||
Acute lung injury and the acute respiratory distress syndrome | 192 | ||
Respiratory support | 193 | ||
Oxygen therapy | 193 | ||
Non-invasive respiratory support | 193 | ||
CPAP therapy | 193 | ||
Non-invasive ventilation | 194 | ||
Emergency endotracheal intubation and mechanical ventilation | 194 | ||
General considerations in the management of the ventilated/intubated patient | 194 | ||
Initial settings | 195 | ||
Mandatory modes of ventilation | 195 | ||
Volume-controlled modes. | 195 | ||
Pressure-controlled modes. | 195 | ||
Weaning or spontaneously breathing modes. | 196 | ||
Mixed modes. | 196 | ||
Advanced ventilation strategies | 196 | ||
Prone ventilation. | 196 | ||
High-frequency oscillatory ventilation (HFOV). | 196 | ||
Nitric oxide. | 196 | ||
Extracorporeal membrane oxygenation therapy (ECMO). | 196 | ||
Corticosteroids. | 196 | ||
Weaning from respiratory support | 196 | ||
Spontaneous breathing trials (SBTs). | 197 | ||
Progressive reduction in pressure support ventilation. | 197 | ||
Weaning protocols. | 197 | ||
Acute kidney injury | 197 | ||
Renal support | 197 | ||
Gastrointestinal and hepatic disturbance | 198 | ||
Gastrointestinal and hepatic support | 198 | ||
Neurological failure (coma) | 198 | ||
Neurological support | 199 | ||
Neurological complications in intensive care | 199 | ||
Sepsis | 200 | ||
Management | 201 | ||
Corticosteroids | 201 | ||
Disseminated intravascular coagulation | 201 | ||
General principles of critical care management | 201 | ||
Daily clinical management in the ICU | 202 | ||
Sedation and analgesia | 202 | ||
Muscle relaxants | 202 | ||
Delirium | 203 | ||
Discharge from intensive care | 203 | ||
Withdrawal of intensive support | 203 | ||
Brainstem death | 203 | ||
Outcome of intensive care | 204 | ||
Scoring systems | 204 | ||
Further information | 204 | ||
Websites | 204 | ||
9 Poisoning | 205 | ||
Comprehensive evaluation of the poisoned patient | 206 | ||
Taking a history in poisoning | 206 | ||
Evaluation of the envenomed patient | 207 | ||
Taking a history in envenoming | 207 | ||
General approach to the poisoned patient | 208 | ||
Triage and resuscitation | 208 | ||
Clinical assessment and investigations | 209 | ||
Psychiatric assessment | 210 | ||
General management | 210 | ||
Gastrointestinal decontamination | 210 | ||
Activated charcoal | 210 | ||
Gastric aspiration and lavage | 210 | ||
Whole bowel irrigation | 210 | ||
Urinary alkalinisation | 210 | ||
Haemodialysis and haemoperfusion | 211 | ||
Lipid emulsion therapy | 211 | ||
Supportive care | 212 | ||
Antidotes | 212 | ||
Poisoning by specific pharmaceutical agents | 212 | ||
Analgesics | 212 | ||
Paracetamol | 212 | ||
Management | 212 | ||
Salicylates (aspirin) | 212 | ||
Clinical features | 212 | ||
Index | 1313 | ||
A | 1313 | ||
B | 1318 | ||
C | 1321 | ||
D | 1328 | ||
E | 1331 | ||
F | 1334 | ||
G | 1335 | ||
H | 1338 | ||
I | 1342 | ||
J | 1344 | ||
K | 1344 | ||
L | 1345 | ||
M | 1347 | ||
N | 1350 | ||
O | 1352 | ||
P | 1354 | ||
Q | 1360 | ||
R | 1360 | ||
S | 1362 | ||
T | 1366 | ||
U | 1369 | ||
V | 1370 | ||
W | 1372 | ||
X | 1372 | ||
Y | 1372 | ||
Z | 1372 |