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Book Details
Abstract
Be punctual, hard-working and honest, but most importantly – be excellent.
Written by residents, for interns and residents, the Junior Doctor Survival Guide is a thorough, focused summary of everything you need to know to get through your internship and residency (relatively) intact.
It provides advice on seeking help from your senior clinicians, ensuring ethical practice and decision making, conducting an efficient ward round and carrying out emergency assessments and includes a concise overview of the salient features of specialist medical and surgical care in both in- and outpatient settings.
Covering both clinical and professional contexts, this guide will support you to build your confidence in applying the principles you learned in medical school to the real world.
- Scenario boxes – how difficult conversations should be approached
- Common medications – quick reference tables of common medications and dosages
- Clinical abbreviations and acronyms – a comprehensive list of common abbreviations and acronyms used throughout clinical settings.
- Full eBook on ExpertConsult
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Junior Doctor Survival Guide | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | viii | ||
| Contributors | ix | ||
| Reviewers | x | ||
| Acknowledgements | xi | ||
| Abbreviations, acronyms, mnemonics | xii | ||
| I General information | 1 | ||
| 1 Welcome to medical practice | 3 | ||
| 2 The junior doctor | 5 | ||
| What is a junior doctor anyway? | 5 | ||
| Unit structure | 5 | ||
| Completing a rotation | 7 | ||
| The well junior doctor | 7 | ||
| 3 Careers | 9 | ||
| General career pathways | 9 | ||
| Specialist training colleges | 10 | ||
| 4 Professionalism | 15 | ||
| Professionalism in the workplace | 15 | ||
| The junior doctor and | 17 | ||
| 5 Communication | 19 | ||
| Verbal communication | 19 | ||
| Written communication | 20 | ||
| 6 Teaching and education | 22 | ||
| Teaching as a junior doctor | 22 | ||
| Continuing medical education | 23 | ||
| 7 Representation of junior doctors | 25 | ||
| The Australian Medical Association | 25 | ||
| Your friendly neighbourhood RMO society | 26 | ||
| Your state doctors-in-training agreement | 26 | ||
| 8 Finances | 28 | ||
| Salary and packaging options | 28 | ||
| Salary | 28 | ||
| Salary packaging | 28 | ||
| Income tax and deductions | 29 | ||
| II Initial assessments | 31 | ||
| 9 The emergency department | 33 | ||
| Triage and patient flow | 33 | ||
| Short stay unit (SSU) | 35 | ||
| Junior doctors in the ED | 35 | ||
| 10 Critical care assessments | 37 | ||
| The primary survey and resuscitation | 37 | ||
| Primary survey | 37 | ||
| Airway | 37 | ||
| Breathing | 38 | ||
| Circulation | 38 | ||
| Resuscitation | 38 | ||
| Shock | 41 | ||
| Hypovolaemia shock | 42 | ||
| Cardiogenic shock | 42 | ||
| ‘Distributive’ shock – systemic vasodilatation | 42 | ||
| Trauma | 43 | ||
| Head injury | 44 | ||
| Suspected spinal trauma | 46 | ||
| Limb trauma | 46 | ||
| Severe burns | 46 | ||
| 11 Initial assessment of patients | 49 | ||
| History | 49 | ||
| History of presenting complaint (HOPC) | 50 | ||
| Medical history | 50 | ||
| Medication history | 56 | ||
| Allergies and adverse drug reactions | 56 | ||
| Preventative medicine | 56 | ||
| Past history | 56 | ||
| Social history | 57 | ||
| Family history | 57 | ||
| Examination | 58 | ||
| 12 Investigations | 60 | ||
| Full blood examination | 61 | ||
| Urea, electrolytes and creatinine | 62 | ||
| Calcium, magnesium and phosphate | 62 | ||
| Calcium | 63 | ||
| Magnesium | 64 | ||
| Phosphate | 64 | ||
| Liver function tests | 64 | ||
| C-reactive protein | 67 | ||
| Erythrocyte sedimentation rate | 68 | ||
| Coagulation profile, fibrinogen, D-dimer and anti-Xa | 68 | ||
| Blood cultures and sensitivities | 70 | ||
| Acute phase reactants (APR) | 71 | ||
| Markers of cardiac injury – troponin and creatinine kinase | 72 | ||
| Lipid profile | 72 | ||
| Pancreatic enzymes – lipase and amylase | 73 | ||
| Vitamin D | 74 | ||
| Lactate dehydrogenase | 74 | ||
| Lactate | 74 | ||
| Ammonia | 75 | ||
| Brain natriuretic peptide (BNP) | 75 | ||
| Haematinics: iron studies, folate, vitamin B12 and haemochromatosis genes | 76 | ||
| Thyroid function tests | 77 | ||
| Adrenocorticotrophic hormone (ACTH) and short Synacthen tests | 78 | ||
| Diabetes – oral glucose tolerance test, C-peptide, HbA1c, serum insulin and GAD antibodies | 78 | ||
| Cross-matching and group and hold | 80 | ||
| Human leucocyte antigen (HLA) typing | 81 | ||
| Markers of malignancy | 81 | ||
| Assorted serology panels | 84 | ||
| 13 Investigations | 87 | ||
| Microscopy, culture and sensitivities | 87 | ||
| Urine microscopy, culture and sensitivities | 87 | ||
| Sputum microscopy, culture and sensitivities | 88 | ||
| Wound microscopy, culture and sensitivities | 88 | ||
| Cerebrospinal fluid and lumbar punctures | 89 | ||
| Nasopharyngeal aspirate swab and respiratory multiplex polymerase chain reaction | 89 | ||
| Faecal microscopy, culture and sensitivities plus Clostridium difficile toxin and ova, cysts and parasites | 90 | ||
| 14 Investigations | 92 | ||
| Ordering imaging tests | 92 | ||
| X-rays | 93 | ||
| Chest X-ray (CXR) | 93 | ||
| Abdominal X-ray (AXR) | 93 | ||
| Other X-rays | 97 | ||
| Ultrasound (US) | 97 | ||
| Abdominal ultrasound | 97 | ||
| Kidney and urinary tract ultrasound | 98 | ||
| Pelvic ultrasound | 98 | ||
| Peripheral ultrasound | 98 | ||
| Ultrasound of the head and neck | 99 | ||
| Other uses of ultrasound | 99 | ||
| Computerised tomography (CT) | 100 | ||
| CT contrast | 101 | ||
| CT of the brain | 101 | ||
| CT of the chest | 103 | ||
| CT of the abdomen and pelvis (CTAP) | 105 | ||
| CT of the extremities | 106 | ||
| Magnetic resonance imaging (MRI) | 107 | ||
| MR cholangiopancreatography (MRCP) | 108 | ||
| MRI spine | 108 | ||
| MRI of joints | 108 | ||
| MRI safety | 108 | ||
| 15 Making referrals | 111 | ||
| 16 Admissions | 115 | ||
| History-taking | 115 | ||
| Examination | 117 | ||
| Investigations | 118 | ||
| Impression | 118 | ||
| Plan | 118 | ||
| 17 Clinical procedures | 119 | ||
| Intravenous venous cannulation (IVC) and venepuncture | 119 | ||
| Plastering | 122 | ||
| Complete arm plaster | 124 | ||
| Ankle back + U-slab | 125 | ||
| Suturing and wound management | 126 | ||
| Preparation of the wound | 126 | ||
| Local anaesthetics | 126 | ||
| Suturing | 126 | ||
| Male indwelling catheter (IDC) insertion | 129 | ||
| Nasogastric tubes (NGTs) | 131 | ||
| 18 The patient with mental illness | 133 | ||
| Initial assessment | 133 | ||
| Psychiatric history (mental state examination) | 134 | ||
| Risk assessment | 135 | ||
| Suicide | 135 | ||
| Violence | 135 | ||
| Psychosis | 136 | ||
| Anxiety | 137 | ||
| Management | 137 | ||
| Deliberate self-harm | 138 | ||
| Paracetamol overdose | 139 | ||
| Antidepressant overdose | 140 | ||
| Serotonin syndrome | 140 | ||
| Benzodiazepine overdose | 142 | ||
| Self-injury | 143 | ||
| Inpatient psychiatric referrals | 143 | ||
| Involuntary patient status | 144 | ||
| 19 Forensic medicine | 145 | ||
| Non-accidental injury in a minor | 145 | ||
| Physical assault in an adult | 148 | ||
| Sexual assault in an adult | 150 | ||
| Routine blood alcohol concentration testing | 150 | ||
| 20 Notifiable diseases | 152 | ||
| III The ward | 157 | ||
| 21 The inpatient ward | 159 | ||
| Structure of the ward | 159 | ||
| Life on the inpatient ward | 161 | ||
| Cover shifts | 161 | ||
| 22 Ward rounds | 163 | ||
| Preparing for the ward round | 163 | ||
| The ward list | 164 | ||
| The round | 164 | ||
| Ward round notes | 166 | ||
| Issue-based documentation | 167 | ||
| ‘SOAP’ notes | 168 | ||
| After the ward round | 169 | ||
| 23 Inpatient prescribing | 171 | ||
| The inpatient medication chart | 171 | ||
| Admission and discharge medications | 175 | ||
| High risk medications | 176 | ||
| Anti-infectives | 177 | ||
| Gentamicin dosing | 177 | ||
| Vancomycin dosing | 178 | ||
| Insulin and blood glucose levels | 178 | ||
| Hypoglycaemia | 179 | ||
| Hyperglycaemia | 180 | ||
| ‘Narcotics’ and other analgesia | 180 | ||
| Chemotherapy | 181 | ||
| Venous thromboprophylaxis | 181 | ||
| Finding information | 182 | ||
| 24 Managing fluids and infusions | 184 | ||
| Physiology | 184 | ||
| Categories of fluid | 185 | ||
| Crystalloids | 185 | ||
| Colloids | 186 | ||
| Prescribing fluids | 186 | ||
| Maintenance fluid therapy (for fasting or poor oral intake) | 186 | ||
| Fluid resuscitation and replacement fluid therapy | 187 | ||
| Massive transfusion protocol (MTP) | 188 | ||
| The fluid review | 189 | ||
| Electrolyte abnormalities | 191 | ||
| Sodium | 191 | ||
| Potassium | 192 | ||
| Calcium | 193 | ||
| Magnesium | 194 | ||
| Phosphate | 194 | ||
| Iron | 194 | ||
| Other infusions | 195 | ||
| Proton pump inhibitors | 195 | ||
| Infliximab | 195 | ||
| Blood products | 196 | ||
| Packed red blood cells | 196 | ||
| Platelets | 196 | ||
| Buffy coat transfusions | 197 | ||
| Fresh frozen plasma | 197 | ||
| Cryoprecipitate | 197 | ||
| Albumin | 197 | ||
| Intravenous immunoglobulins | 198 | ||
| Supplemental feeding | 198 | ||
| Enteral feeding – nasogastric tubes, percutaneous endoscopic gastrostomies and percutaneous endoscopic jejunostomies | 198 | ||
| Total parental nutrition | 198 | ||
| 25 The deteriorating patient | 200 | ||
| The medical emergency team and emergency calls | 200 | ||
| Hypertension | 202 | ||
| Hypotension | 203 | ||
| Tachycardia | 204 | ||
| Bradycardia | 205 | ||
| Hypoxia, increased work of breathing and increasing oxygen requirements | 205 | ||
| Oliguria or anuria | 206 | ||
| Altered conscious state | 207 | ||
| Medical staff concern | 208 | ||
| Code black and code grey | 208 | ||
| 26 The dying patient | 209 | ||
| Identifying a dying patient | 209 | ||
| Advanced care plans | 209 | ||
| Role of the palliative care team in an inpatient setting | 211 | ||
| Arranging outpatient palliative care | 211 | ||
| Rationalising medications | 211 | ||
| Managing cancer pain | 216 | ||
| 27 The deceased patient | 217 | ||
| The process of certifying death | 217 | ||
| Notifying the next of kin | 218 | ||
| Completing a death certificate | 219 | ||
| Reportable deaths | 219 | ||
| Organ and tissue donation | 220 | ||
| 28 The preoperative patient | 222 | ||
| Preoperative work-up | 222 | ||
| Fasting and management of regular medications | 223 | ||
| Anaesthetics | 223 | ||
| Preparing the patient for urgent surgery | 225 | ||
| 29 The operating theatre | 228 | ||
| Introduction to theatre | 228 | ||
| The theatre | 229 | ||
| Positioning the patient and the sterile field | 230 | ||
| Positioning | 230 | ||
| Gloving and gowning | 230 | ||
| ‘Prepping’ and draping | 231 | ||
| Theatre equipment | 233 | ||
| The theatre set-up | 233 | ||
| Suction | 233 | ||
| Diathermy | 233 | ||
| Assisting in surgery | 235 | ||
| Postoperative orders | 235 | ||
| Minimal access surgery | 237 | ||
| 30 The postoperative patient | 239 | ||
| Routine review of the postoperative patient | 239 | ||
| Pain | 240 | ||
| Acute pain service | 241 | ||
| Fever | 244 | ||
| Atelectasis | 244 | ||
| Wound infections | 245 | ||
| Respiratory tract infections | 245 | ||
| Deep abdominal infections | 245 | ||
| Deep vein thrombosis and pulmonary embolus | 245 | ||
| Nausea and vomiting | 246 | ||
| Hypotension | 246 | ||
| Intravascular losses | 246 | ||
| Fluid balance and electrolyte disturbances | 247 | ||
| Urinary retention and constipation | 247 | ||
| Delirium | 248 | ||
| 31 Inpatient discharges | 249 | ||
| Discharge summaries | 249 | ||
| Introduction | 249 | ||
| Presentation | 249 | ||
| Medical, past and social histories | 251 | ||
| Investigations | 251 | ||
| Summary | 252 | ||
| Plan | 252 | ||
| Discharge scripts | 252 | ||
| Outpatient follow-up | 254 | ||
| 32 Allied health and clinical support staff | 255 | ||
| Allied health | 255 | ||
| Physiotherapists | 255 | ||
| Occupational therapists | 256 | ||
| Social workers | 257 | ||
| Speech pathologists | 257 | ||
| Dietitians | 257 | ||
| Diabetes educators | 258 | ||
| Clinical support staff | 258 | ||
| Bed manager (or admitting officer [AO]) | 258 | ||
| Post-discharge acute/subacute care | 258 | ||
| 33 Unit meetings | 260 | ||
| Meetings and audits | 260 | ||
| Multidisciplinary meetings (MDMs) | 262 | ||
| Radiology meetings | 262 | ||
| IV Medical and surgical specialties | 265 | ||
| 34 General medicine | 267 | ||
| Congestive cardiac failure (CCF) | 267 | ||
| Diagnosis | 268 | ||
| Natural history | 268 | ||
| Investigations | 268 | ||
| Management | 269 | ||
| Chronic obstructive pulmonary disease (COPD) | 271 | ||
| Diagnosis | 271 | ||
| Investigations | 272 | ||
| Management | 272 | ||
| Delirium | 273 | ||
| Diagnosis | 273 | ||
| Natural history | 274 | ||
| Investigations | 274 | ||
| Management | 274 | ||
| Cognitive impairment and dementia | 275 | ||
| Diagnosis | 275 | ||
| Natural history | 278 | ||
| Investigations | 278 | ||
| Management | 278 | ||
| Falls | 279 | ||
| Investigations | 280 | ||
| Management | 280 | ||
| Polypharmacy | 281 | ||
| Constipation | 282 | ||
| Diagnosis | 282 | ||
| Natural history | 283 | ||
| Investigations | 283 | ||
| Management | 283 | ||
| 35 Cardiology | 285 | ||
| Ischaemic heart disease | 285 | ||
| Diagnosis | 286 | ||
| Natural history | 286 | ||
| Investigations | 287 | ||
| Management | 288 | ||
| Infective endocarditis | 290 | ||
| Diagnosis | 291 | ||
| Natural history | 291 | ||
| Investigations | 291 | ||
| Management | 292 | ||
| Atrial fibrillation | 295 | ||
| Diagnosis | 295 | ||
| Natural history | 296 | ||
| Investigations | 296 | ||
| Management | 296 | ||
| Venous thromboembolic events: deep vein thrombosis and pulmonary embolus | 298 | ||
| Diagnosis | 298 | ||
| Natural history | 299 | ||
| Investigations | 300 | ||
| Management | 300 | ||
| Ventricular tachycardia and ventricular fibrillation | 301 | ||
| Diagnosis | 302 | ||
| Natural history | 302 | ||
| Investigations | 302 | ||
| Management | 303 | ||
| 36 Respiratory medicine | 305 | ||
| Community- and hospital-acquired pneumonia | 305 | ||
| Diagnosis | 306 | ||
| Natural history | 307 | ||
| Investigations | 307 | ||
| Management | 309 | ||
| Asthma | 310 | ||
| Diagnosis | 310 | ||
| Natural history | 311 | ||
| Investigations | 311 | ||
| Management | 311 | ||
| Pulmonary hypertension | 312 | ||
| Diagnosis | 313 | ||
| Natural history | 314 | ||
| Investigations | 314 | ||
| Management | 314 | ||
| Pleural effusion | 315 | ||
| Diagnosis | 316 | ||
| Investigations | 316 | ||
| Management | 317 | ||
| 37 Gastroenterology | 318 | ||
| Inflammatory bowel disease (IBD) – Crohn’s disease and ulcerative colitis | 319 | ||
| Diagnosis | 319 | ||
| Natural history | 320 | ||
| Investigations | 320 | ||
| Management | 321 | ||
| Coeliac disease | 324 | ||
| Diagnosis | 324 | ||
| Natural history | 325 | ||
| Investigations | 326 | ||
| Management | 326 | ||
| Irritable bowel syndrome | 326 | ||
| Diagnosis | 327 | ||
| Natural history | 327 | ||
| Investigations | 327 | ||
| Management | 327 | ||
| Gastroenteritis | 328 | ||
| Diagnosis | 328 | ||
| Natural history | 329 | ||
| Investigations | 329 | ||
| Management | 329 | ||
| Upper gastrointestinal bleeding | 330 | ||
| Diagnosis | 330 | ||
| Natural history | 332 | ||
| Investigations | 332 | ||
| Management | 333 | ||
| Oesophageal motility disorders | 334 | ||
| Diagnosis | 335 | ||
| Investigations | 335 | ||
| Management | 337 | ||
| Gastro-oesophageal reflux disease | 337 | ||
| Diagnosis | 337 | ||
| Natural history | 338 | ||
| Investigations | 338 | ||
| Management | 339 | ||
| Acute liver failure | 339 | ||
| Diagnosis | 339 | ||
| Natural history | 340 | ||
| Investigations | 340 | ||
| Management | 341 | ||
| Decompensation of chronic liver disease | 341 | ||
| Diagnosis | 342 | ||
| Natural history | 342 | ||
| Investigations | 343 | ||
| Management | 344 | ||
| 38 Renal medicine | 346 | ||
| Urinary tract infections and urosepsis | 347 | ||
| Diagnosis | 347 | ||
| Natural history | 348 | ||
| Investigations | 348 | ||
| Management | 348 | ||
| Acute kidney injury | 349 | ||
| Management | 350 | ||
| Chronic renal impairment and dialysis-dependent patients | 352 | ||
| Principles of renal replacement therapy | 352 | ||
| Drug-related nephrotoxicity | 355 | ||
| 39 Endocrinology | 356 | ||
| Hyperglycaemic crises: diabetic ketoacidosis and hyperosmolar hyperglycaemic state | 356 | ||
| Diagnosis | 357 | ||
| Natural history | 357 | ||
| Investigations | 358 | ||
| Management | 358 | ||
| Hyperthyroidism | 360 | ||
| Diagnosis | 360 | ||
| Natural history | 361 | ||
| Investigations | 361 | ||
| Management | 361 | ||
| Hypothyroidism | 362 | ||
| Diagnosis | 362 | ||
| Natural history | 363 | ||
| Investigations | 363 | ||
| Management | 363 | ||
| Adrenal insufficiency | 364 | ||
| Diagnosis | 364 | ||
| Natural history | 365 | ||
| Investigations | 365 | ||
| Management | 365 | ||
| Cushing’s syndrome | 366 | ||
| Diagnosis | 367 | ||
| Natural history | 367 | ||
| Investigations | 368 | ||
| Management | 368 | ||
| Syndrome of inappropriate anti-diuretic hormone secretion | 369 | ||
| Diagnosis | 369 | ||
| Investigations | 370 | ||
| Management | 370 | ||
| 40 Neurology | 373 | ||
| Stroke | 373 | ||
| Diagnosis | 374 | ||
| Natural history | 375 | ||
| Investigations | 377 | ||
| Management | 377 | ||
| Meningitis and encephalitis | 379 | ||
| Diagnosis | 380 | ||
| Natural history | 381 | ||
| Investigations | 381 | ||
| Management | 382 | ||
| Epilepsy | 383 | ||
| Diagnosis | 384 | ||
| Investigations | 384 | ||
| Management | 384 | ||
| Migraines | 385 | ||
| Management | 386 | ||
| Bell’s palsy | 386 | ||
| Diagnosis | 386 | ||
| Natural history | 387 | ||
| Investigations | 387 | ||
| Management | 387 | ||
| Myasthenia gravis | 388 | ||
| Diagnosis | 388 | ||
| Natural history | 389 | ||
| Investigations | 389 | ||
| Management | 390 | ||
| Guillain–Barré Syndrome | 390 | ||
| Diagnosis | 391 | ||
| Natural history | 391 | ||
| Investigations | 392 | ||
| Management | 392 | ||
| 41 Infectious diseases | 394 | ||
| Travel medicine and fever in the returned traveller | 394 | ||
| Immunisations | 397 | ||
| infection control | 398 | ||
| Common sexually transmitted infections | 400 | ||
| Fever of unknown origin | 403 | ||
| Diagnosis | 403 | ||
| Investigations | 404 | ||
| Management | 405 | ||
| Cellulitis | 405 | ||
| Diagnosis | 406 | ||
| Investigations | 406 | ||
| Management | 406 | ||
| Human immunodeficiency virus | 407 | ||
| Diagnosis | 410 | ||
| Natural history | 411 | ||
| Investigations | 411 | ||
| Management | 412 | ||
| Tuberculosis | 413 | ||
| Diagnosis | 413 | ||
| Natural history | 414 | ||
| Investigations | 414 | ||
| Management | 415 | ||
| 42 Medical oncology | 417 | ||
| Febrile neutropenia | 417 | ||
| Diagnosis | 418 | ||
| Natural history | 419 | ||
| Investigations | 419 | ||
| Management | 420 | ||
| Malignant epidural spinal cord compression | 421 | ||
| Diagnosis | 422 | ||
| Natural history | 422 | ||
| Investigations | 422 | ||
| Management | 422 | ||
| Tumour lysis syndrome | 423 | ||
| Diagnosis | 424 | ||
| Natural history | 424 | ||
| Investigations | 424 | ||
| Management | 424 | ||
| Extravasation of chemotherapy | 425 | ||
| Mucositis | 426 | ||
| Diagnosis | 426 | ||
| Natural history | 426 | ||
| Management | 427 | ||
| Neutropenic enterocolitis | 427 | ||
| Diagnosis and natural history | 427 | ||
| Investigations | 428 | ||
| Management | 428 | ||
| Side effects of chemotherapy | 428 | ||
| 43 Haematology | 431 | ||
| Haemolysis | 431 | ||
| Diagnosis | 432 | ||
| Natural history | 432 | ||
| Investigations | 432 | ||
| Management | 433 | ||
| Haemophilia | 434 | ||
| Diagnosis | 434 | ||
| Natural history | 435 | ||
| Investigations | 435 | ||
| Management | 436 | ||
| Pancytopenia | 437 | ||
| Diagnosis | 437 | ||
| Investigations | 438 | ||
| Management | 438 | ||
| Disseminated intravascular coagulopathy | 439 | ||
| Diagnosis | 439 | ||
| Natural history | 440 | ||
| Investigations | 440 | ||
| Management | 441 | ||
| Haematological malignancies | 441 | ||
| Risk factors | 442 | ||
| Pretreatment management | 442 | ||
| Trial patients | 443 | ||
| Management | 443 | ||
| 44 Rheumatology | 444 | ||
| Seronegative spondyloarthropathies | 444 | ||
| Diagnosis | 445 | ||
| Natural history | 447 | ||
| Investigations | 447 | ||
| Management | 447 | ||
| Dermatomyositis and polymyositis | 449 | ||
| Diagnosis | 449 | ||
| Natural history | 450 | ||
| Investigations | 450 | ||
| Management | 450 | ||
| Fibromyalgia | 451 | ||
| Diagnosis | 452 | ||
| Natural history | 452 | ||
| Investigations | 452 | ||
| Management | 452 | ||
| 45 General surgery | 454 | ||
| Acute abdomen | 454 | ||
| History and examination | 454 | ||
| Investigations | 456 | ||
| Appendicitis | 457 | ||
| Examination | 457 | ||
| Investigations | 457 | ||
| Management | 457 | ||
| Appendicectomy | 458 | ||
| The acute biliary tract | 459 | ||
| Acute cholecystitis | 459 | ||
| History and examination | 459 | ||
| Investigations | 459 | ||
| Management | 459 | ||
| Choledocolithiasis | 460 | ||
| Investigations | 460 | ||
| Management | 461 | ||
| Cholangitis (ascending cholangitis, biliary sepsis) | 461 | ||
| Investigations | 462 | ||
| Management | 462 | ||
| Pancreatitis | 462 | ||
| Investigations | 463 | ||
| Classification of pancreatitis | 463 | ||
| General management | 463 | ||
| Management of causes | 463 | ||
| Management of complications | 464 | ||
| Chronic pancreatitis | 464 | ||
| Investigations | 464 | ||
| Management | 465 | ||
| Peptic ulcers | 465 | ||
| Perforated ulcer | 466 | ||
| Investigations | 466 | ||
| Management | 466 | ||
| Diverticular disease | 466 | ||
| Diverticulitis | 467 | ||
| Investigations | 467 | ||
| Management | 468 | ||
| Perforated diverticulum | 469 | ||
| Trauma | 469 | ||
| Abdominal trauma | 469 | ||
| Investigations | 469 | ||
| Management | 471 | ||
| Bowel obstruction | 472 | ||
| Small bowel obstruction (SBO) | 472 | ||
| Investigations | 472 | ||
| Management | 473 | ||
| Large bowel obstruction (LBO) | 473 | ||
| Volvulus | 474 | ||
| Sigmoid volvulus | 474 | ||
| Caecal volvulus | 474 | ||
| Investigations | 474 | ||
| Management | 476 | ||
| Ischaemic bowel | 476 | ||
| Investigations | 477 | ||
| Management | 477 | ||
| Endoscopy | 478 | ||
| Gastroscopy | 478 | ||
| Endoscopic retrograde cholangiopancreatography (ERCP) | 478 | ||
| Endoscopic ultrasound (EUS) | 479 | ||
| Colonoscopy | 480 | ||
| Breast surgery | 481 | ||
| Breast conservation surgery | 481 | ||
| Sentinel lymph node biopsy (SLNB) | 482 | ||
| Mastectomy | 483 | ||
| Axillary lymph node dissection | 484 | ||
| Hepatopancreatobiliary (HPB) surgery | 485 | ||
| Cholecystectomy | 485 | ||
| Bile duct injuries | 486 | ||
| Liver resection | 486 | ||
| Hepatectomy | 488 | ||
| Pancreatectomy | 489 | ||
| Upper gastrointestinal (UGI) surgery | 490 | ||
| Gastrectomy | 490 | ||
| Fundoplication | 492 | ||
| Oesophagectomy | 493 | ||
| Bowel surgery | 495 | ||
| Small bowel surgery | 495 | ||
| Small bowel resections | 495 | ||
| Ileostomy | 496 | ||
| Large bowel surgery | 498 | ||
| Colectomy | 498 | ||
| Colostomy | 499 | ||
| Rectal surgery | 500 | ||
| Examination under anaesthesia (EUA) | 500 | ||
| Haemorrhoidectomy | 501 | ||
| Pilonidal sinus | 502 | ||
| Hernia surgery | 503 | ||
| Inguinal hernia repair | 503 | ||
| Umbilical and paraumbilical hernia repair | 504 | ||
| Epigastric and incisional hernias | 505 | ||
| 46 Orthopaedic surgery | 507 | ||
| Open fractures | 507 | ||
| Management | 507 | ||
| External fixation | 508 | ||
| Neck of femur (NOF) fractures | 510 | ||
| Management | 510 | ||
| Femoral fractures | 511 | ||
| Examination | 514 | ||
| Investigations | 514 | ||
| Management | 514 | ||
| Tibial fractures | 517 | ||
| Pelvic fractures | 518 | ||
| Examination | 520 | ||
| Investigations | 521 | ||
| Management | 521 | ||
| Compartment syndrome | 522 | ||
| Examination | 522 | ||
| Investigations | 523 | ||
| Management | 523 | ||
| Dislocations | 524 | ||
| Examination | 524 | ||
| Investigations | 524 | ||
| Management | 524 | ||
| The acute joint | 527 | ||
| Investigations | 528 | ||
| Management | 528 | ||
| Osteomyelitis (OM) | 529 | ||
| Investigations | 529 | ||
| V Outpatients | 667 | ||
| 53 Pre-admission clinic | 669 | ||
| The Pre-admission Clinic | 669 | ||
| Completing the preoperative assessment | 670 | ||
| Preoperative investigations | 672 | ||
| Anaemia | 672 | ||
| Blood transfusion | 674 | ||
| Anticoagulant therapy in surgery | 674 | ||
| Preoperative review referrals | 676 | ||
| 54 Informed consent | 677 | ||
| What is informed consent? | 677 | ||
| Consent forms | 677 | ||
| 55 Medical outpatient clinics | 680 | ||
| Principles of medical clinics | 680 | ||
| 56 Cardiology outpatients | 683 | ||
| Hypertension | 683 | ||
| Hyperlipidaemia | 685 | ||
| Arrhythmias and pacemaker clinic | 686 | ||
| Valvulopathies | 686 | ||
| Chest pain clinic | 687 | ||
| Cardiac transplant monitoring | 688 | ||
| 57 Respiratory outpatients | 690 | ||
| Asthma | 690 | ||
| Chronic obstructive pulmonary disease (COPD) | 692 | ||
| Cystic fibrosis | 694 | ||
| Bronchiectasis | 697 | ||
| Interstitial lung disease (ILD) | 698 | ||
| Obstructive sleep apnoea | 701 | ||
| Lung transplant monitoring | 703 | ||
| 58 Gastroenterology outpatients | 704 | ||
| Preparation for endoscopy | 704 | ||
| Periendoscopy medication management | 707 | ||
| Anticoagulants and endoscopy | 707 | ||
| Insulin therapy and endoscopy | 708 | ||
| Inflammatory bowel diseases | 708 | ||
| Liver disease | 709 | ||
| Liver transplant monitoring | 711 | ||
| 59 Renal outpatients | 712 | ||
| Acute kidney injury | 712 | ||
| Chronic renal impairment and dialysis clinics | 715 | ||
| Renal transplant patients | 718 | ||
| Glomerular disease | 719 | ||
| Nephrotic syndrome | 719 | ||
| Nephritic syndrome | 720 | ||
| 60 Endocrinology outpatients | 721 | ||
| Diabetes mellitus | 721 | ||
| Hyperthyroidism | 724 | ||
| Hypothyroidism | 726 | ||
| Hypopituitarism | 727 | ||
| Paget’s disease of the bone | 728 | ||
| 61 Neurology outpatients | 730 | ||
| Epilepsy and first seizure clinic | 730 | ||
| Headache | 732 | ||
| Multiple sclerosis | 735 | ||
| Parkinson’s disease and parkinsonism | 737 | ||
| Dizziness and vertigo | 738 | ||
| 62 Medical Oncology outpatients | 741 | ||
| Melanoma | 743 | ||
| Breast cancer | 744 | ||
| Colon cancer | 745 | ||
| Prostate cancer | 747 | ||
| Lung cancer | 749 | ||
| Cancer of unknown primary | 751 | ||
| Reviewing Chemotherapy Day Unit patients | 752 | ||
| 63 Haematology outpatients | 754 | ||
| Anaemia | 754 | ||
| Neutropenia | 757 | ||
| Thrombosis and haemostasis | 758 | ||
| Thrombocytopenia | 759 | ||
| Monitoring of haematological malignancies | 761 | ||
| 64 Rheumatology outpatients | 762 | ||
| Rheumatoid arthritis and ankylosing spondylitis | 762 | ||
| Osteoarthritis | 765 | ||
| Gout and pseudogout | 766 | ||
| Connective tissue disorders | 767 | ||
| Osteoporosis and osteopenia | 769 | ||
| 65 Surgical clinics | 771 | ||
| The surgical clinic | 771 | ||
| Booking post-discharge appointments | 772 | ||
| Elective theatre bookings | 772 | ||
| Documentation | 773 | ||
| 66 General surgery outpatients | 775 | ||
| Breast lumps | 775 | ||
| History and examination | 775 | ||
| Investigations | 776 | ||
| Breast cancer | 777 | ||
| Investigations | 777 | ||
| Classification and staging of breast cancer | 777 | ||
| Management | 778 | ||
| Prognosis | 779 | ||
| Upper GI cancer | 779 | ||
| Oesophageal cancer | 779 | ||
| Investigations | 779 | ||
| Staging of oesophageal cancer | 780 | ||
| Management | 780 | ||
| Prognosis | 780 | ||
| Gastric cancer | 780 | ||
| Investigations | 781 | ||
| Gastric cancer staging | 781 | ||
| Management | 782 | ||
| Prognosis | 782 | ||
| Liver masses | 782 | ||
| Primary liver cancer | 782 | ||
| Investigations | 782 | ||
| Management of HCC | 783 | ||
| VI Appendices | 921 | ||
| Appendix I Common medications | 923 | ||
| Appendix II Normal laboratory values | 940 | ||
| Appendix III Microbiology | 943 | ||
| Introduction | 943 | ||
| Bacteria ‘family tree’ | 943 | ||
| Virus ‘family tree’ | 945 | ||
| fungi ‘family tree’ | 945 | ||
| Parasites ‘family tree’ | 945 | ||
| Normal flora | 945 | ||
| Infectious diseases | 945 | ||
| Appendix IV Antibiotics | 955 | ||
| References and further reading | e1 | ||
| Chapter 4 | e1 | ||
| Chapter 5 | e1 | ||
| Chapter 6 | e1 | ||
| Chapter 8 | e1 | ||
| Chapter 9 | e2 | ||
| Chapter 10 | e2 | ||
| Chapter 11 | e3 | ||
| Chapter 12 | e3 | ||
| Chapter 13 | e6 | ||
| Chapter 14 | e6 | ||
| Chapter 15 | e8 | ||
| Chapter 16 | e8 | ||
| Chapter 17 | e8 | ||
| Chapter 18 | e8 | ||
| Chapter 19 | e9 | ||
| Chapter 20 | e10 | ||
| Chapter 21 | e10 | ||
| Chapter 22 | e11 | ||
| Chapter 23 | e11 | ||
| Chapter 24 | e12 | ||
| Chapter 25 | e14 | ||
| Chapter 26 | e15 | ||
| Chapter 27 | e15 | ||
| Chapter 28 | e15 | ||
| Chapter 29 | e16 | ||
| Chapter 30 | e16 | ||
| Chapter 31 | e17 | ||
| Chapter 32 | e17 | ||
| Chapter 33 | e18 | ||
| Chapter 34 | e18 | ||
| Chapter 35 | e19 | ||
| Chapter 36 | e21 | ||
| Chapter 37 | e22 | ||
| Chapter 38 | e24 | ||
| Chapter 39 | e24 | ||
| Chapter 40 | e25 | ||
| Chapter 41 | e27 | ||
| Chapter 42 | e28 | ||
| Chapter 43 | e29 | ||
| Chapter 44 | e30 | ||
| Chapter 45 | e30 | ||
| Chapter 46 | e33 | ||
| Chapter 47 | e35 | ||
| Chapter 48 | e37 | ||
| Chapter 49 | e38 | ||
| Chapter 50 | e40 | ||
| Chapter 51 | e40 | ||
| Chapter 52 | e42 | ||
| Chapter 53 | e44 | ||
| Chapter 54 | e44 | ||
| Chapter 55 | e44 | ||
| Chapter 56 | e45 | ||
| Chapter 57 | e45 | ||
| Chapter 58 | e46 | ||
| Chapter 59 | e47 | ||
| Chapter 60 | e48 | ||
| Chapter 61 | e48 | ||
| Chapter 62 | e49 | ||
| Chapter 63 | e50 | ||
| Chapter 64 | e51 | ||
| Chapter 65 | e51 | ||
| Chapter 66 | e51 | ||
| Chapter 67 | e53 | ||
| Chapter 68 | e56 | ||
| Chapter 69 | e57 | ||
| Chapter 70 | e57 | ||
| Chapter 71 | e59 | ||
| Chapter 72 | e59 | ||
| Chapter 73 | e62 | ||
| Index | 967 | ||
| A | 967 | ||
| B | 970 | ||
| C | 972 | ||
| D | 977 | ||
| E | 979 | ||
| F | 982 | ||
| G | 984 | ||
| H | 986 | ||
| I | 989 | ||
| J | 991 | ||
| K | 991 | ||
| L | 992 | ||
| M | 993 | ||
| N | 996 | ||
| O | 997 | ||
| P | 1000 | ||
| Q | 1004 | ||
| R | 1004 | ||
| S | 1006 | ||
| T | 1010 | ||
| U | 1012 | ||
| V | 1013 | ||
| W | 1014 | ||
| X | 1015 | ||
| Y | 1015 | ||
| Z | 1015 |