BOOK
Basic Science for the MRCS E-Book
Andrew T Raftery | Michael S. Delbridge | Helen E. Douglas
(2017)
Additional Information
Book Details
Abstract
This is a concise revision guide to the core basic sciences for all surgical trainees preparing for Part A of the Intercollegiate MRCS examination. Covering anatomy, physiology and pathology it has been written in a style to facilitate easy learning of the essential facts, with indications of both their clinical relevance and importance. This book concentrates on those topics which tend to be recurring examination themes for initial surgical training. It will be an invaluable resource for the basic surgical trainee as well as proving useful for those in higher surgical training and for the surgically-inclined, well-motivated student.
- The book covers in one volume all the essentials of the basic sciences – anatomy, physiology and pathology - to aid the candidate for the MRCS examination.
- In covering the applied basic science the books explains the application and clinical relevance of the three sciences.
- The text is written in an appropriate ‘bullet-point’ style to allow easy reading rapid exam preparation.
- The contents concentrate on the recurring common themes of the examination, thus helping direct appropriate learning and focussing on the specific important areas of knowledge.
- The book is illustrated with clear line drawings which are clearly annotated to aid learning.
- Now available on StudentConsult with a downloadable ebook version included.
- 250 new online single-best answer questions in the format of the MRCS Part A examination will give the reader valuable experience in assessing their knowledge. Each answer will refer back to text for further reading as required.
- New and updated OSCE ‘Clinical scenarios’ will be included at the end of every chapter.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Basic Science for the MRCS | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Online contents | vi | ||
| Preface | vii | ||
| Acknowledgements | viii | ||
| I Anatomy | 1 | ||
| 1 The thorax | 3 | ||
| Development | 3 | ||
| Heart and great vessels | 3 | ||
| Heart (Fig. 1.1) | 3 | ||
| Great vessels (Fig. 1.2) | 4 | ||
| Fetal circulation (Fig. 1.3) | 4 | ||
| Congenital anomalies | 5 | ||
| Malposition | 5 | ||
| Left-to-right shunt | 5 | ||
| Atrial septal defect (ASD) | 5 | ||
| Ventricular septal defect | 6 | ||
| Patent ductus arteriosus (PDA) | 6 | ||
| Eisenmenger’s syndrome | 6 | ||
| Right-to-left shunt (cyanotic) | 6 | ||
| Fallot’s tetralogy | 6 | ||
| Other congenital anomalies | 6 | ||
| Coarctation of the aorta | 6 | ||
| Abnormalities of valves | 6 | ||
| The diaphragm (Fig. 1.4) | 6 | ||
| II Physiology | 179 | ||
| 7 General physiology | 181 | ||
| Homeostasis | 181 | ||
| Nervous system | 181 | ||
| Hormonal system | 181 | ||
| Thermoregulation | 181 | ||
| Heat production | 181 | ||
| Heat loss | 181 | ||
| Regulation of body temperature | 181 | ||
| Peripheral thermoreceptors | 182 | ||
| Reflex vasoconstriction | 182 | ||
| Reflex vasodilatation | 182 | ||
| Receptors on internal surfaces | 182 | ||
| Body temperature | 182 | ||
| Core temperature | 182 | ||
| Peripheral temperature | 182 | ||
| Abnormal temperature regulation | 182 | ||
| Fever (pyrexia) | 182 | ||
| Heatstroke | 182 | ||
| Hypothermia | 182 | ||
| Factors affecting thermoregulation | 183 | ||
| Fluid Balance and Fluid Replacement Therapy | 183 | ||
| Body water | 183 | ||
| Functions of the Kidney | 183 | ||
| Diuresis | 183 | ||
| Water diuresis | 183 | ||
| Osmotic diuresis | 183 | ||
| Water Balance | 184 | ||
| Regulation of total body water | 184 | ||
| Disturbances of Total Body Water Content | 184 | ||
| Water depletion | 184 | ||
| Water intoxication | 184 | ||
| Electrolyte Disorders | 185 | ||
| Sodium | 185 | ||
| Regulation of sodium | 185 | ||
| Renal | 185 | ||
| Extrarenal | 185 | ||
| Sodium excess | 185 | ||
| Sodium depletion | 186 | ||
| Potassium | 186 | ||
| Hyperkalaemia | 187 | ||
| Hypokalaemia | 187 | ||
| Acid–Base Balance | 187 | ||
| Carbonic acid–bicarbonate system | 187 | ||
| Disturbances of acid–base balance | 188 | ||
| Respiratory acidosis | 188 | ||
| Respiratory alkalosis | 188 | ||
| Metabolic acidosis | 189 | ||
| Metabolic alkalosis | 189 | ||
| Mixed acid–base disorders | 189 | ||
| Interpretation of acid–base changes | 190 | ||
| Anion gap | 190 | ||
| Fluid Balance and Fluid Replacement Therapy | 190 | ||
| Fluid balance in the uncomplicated patient | 190 | ||
| Change in fluid and electrolyte requirements in response to surgery and trauma | 190 | ||
| Fluid and electrolyte problems in surgical patients | 191 | ||
| Blood and plasma | 191 | ||
| Gastrointestinal losses | 191 | ||
| Intraperitoneal fluid loss | 192 | ||
| Septicaemia | 192 | ||
| Excessive insensible fluid loss | 192 | ||
| Colloid and Crystalloid Solutions | 192 | ||
| Types | 192 | ||
| Uses | 192 | ||
| Albumin | 192 | ||
| Dextran | 192 | ||
| Gelatins | 192 | ||
| Hydroxyethyl starch | 192 | ||
| Choice of plasma expanders | 193 | ||
| General problems of plasma expanders | 193 | ||
| Crystalloids | 193 | ||
| Common types | 193 | ||
| Uses | 193 | ||
| Oedema and Lymphatic Function | 194 | ||
| Causes of oedema | 194 | ||
| Obstruction to lymphatics | 194 | ||
| Osce Scenarios | 195 | ||
| OSCE Scenario 7.1 | 195 | ||
| OSCE Scenario 7.2 | 195 | ||
| OSCE Scenario 7.3 | 195 | ||
| 8 Respiratory system | 196 | ||
| Introduction | 196 | ||
| Components | 196 | ||
| Function | 196 | ||
| Airway function | 196 | ||
| Mechanics of Ventilation | 196 | ||
| Pulmonary ventilation | 196 | ||
| Lung pressures (Fig. 8.1) | 197 | ||
| Surfactant and surface tension (Fig. 8.2) | 197 | ||
| Compliance (Fig. 8.3) | 198 | ||
| Respiratory muscles | 199 | ||
| Work of breathing (Fig. 8.4) | 199 | ||
| Regional variations in ventilation (Fig. 8.5) | 199 | ||
| Clinical physiology | 200 | ||
| Pneumothorax | 200 | ||
| Spontaneous (primary) pneumothorax | 200 | ||
| Spontaneous (secondary) pneumothorax | 200 | ||
| Traumatic (closed) pneumothorax | 200 | ||
| Tension pneumothorax | 200 | ||
| Open pneumothorax or ‘sucking’ chest wound | 200 | ||
| Pulmonary assessment | 200 | ||
| Lung volumes (Box 8.1) | 200 | ||
| Dead space and alveolar ventilation rate | 201 | ||
| Peak expiratory flow rate (PEFR) | 203 | ||
| Closing capacity | 203 | ||
| Flow–volume and volume–time curves | 204 | ||
| Diffusion capacity | 204 | ||
| Pulmonary Blood Flow | 204 | ||
| Structure of the lung | 204 | ||
| Regulation of pulmonary blood flow | 204 | ||
| Regional variations in pulmonary blood flow | 204 | ||
| Cardiac output and pulmonary vascular resistance | 205 | ||
| Ventilation and perfusion | 205 | ||
| Clinical physiology | 205 | ||
| Pulmonary embolus | 205 | ||
| Pleural effusion | 206 | ||
| Pulmonary oedema | 206 | ||
| Adult respiratory distress syndrome | 206 | ||
| Gas Diffusion and Exchange | 207 | ||
| Gas diffusion | 207 | ||
| Gas exchange (Table 8.1) | 207 | ||
| Gas transport (Fig. 8.11) | 207 | ||
| Oxygen transport | 208 | ||
| Carbon dioxide transport | 208 | ||
| Regulation of Respiration | 210 | ||
| Neurological regulation | 210 | ||
| Chemical regulation | 210 | ||
| Hypoxia and respiratory failure | 211 | ||
| Hypoxia and hypoxaemia | 211 | ||
| Respiratory failure | 212 | ||
| Clinical physiology | 212 | ||
| Response to hypoxia | 212 | ||
| Acute | 212 | ||
| Chronic | 212 | ||
| Oxygen therapy and mechanical ventilation | 212 | ||
| Oxygen therapy | 212 | ||
| Mechanical ventilation | 213 | ||
| Indications | 213 | ||
| Intermittent positive pressure ventilation (IPPV) | 213 | ||
| Complications | 213 | ||
| Osce Scenarios | 214 | ||
| OSCE Scenario 8.1 | 214 | ||
| OSCE Scenario 8.2 | 214 | ||
| OSCE Scenario 8.3 | 214 | ||
| 9 Cardiovascular system | 215 | ||
| Cardiac Muscle | 215 | ||
| Cardiac action potential (Fig. 9.1) | 215 | ||
| Phase 0 | 215 | ||
| Phase 1 | 215 | ||
| Phase 2 | 215 | ||
| Phase 3 | 216 | ||
| Phase 4 | 216 | ||
| Excitation/contraction coupling | 216 | ||
| Generation and conduction of cardiac impulse | 216 | ||
| Generation of cardiac output | 216 | ||
| Phases of the Cardiac Cycle (Fig. 9.2) | 216 | ||
| Phase IVc | 217 | ||
| Phase I | 217 | ||
| Phase IIa | 217 | ||
| Phase IIb | 217 | ||
| Phase III | 217 | ||
| Phase IVa | 217 | ||
| Phase IVb | 217 | ||
| Intracardiac Pressures | 217 | ||
| Heart Sounds | 218 | ||
| First heart sound | 218 | ||
| Second heart sound | 218 | ||
| Third heart sound | 218 | ||
| Fourth heart sound | 218 | ||
| Venous Pulse (Fig. 9.4) | 218 | ||
| a-wave | 218 | ||
| c-wave | 218 | ||
| v-wave | 218 | ||
| x-descent | 218 | ||
| y-descent | 218 | ||
| Coronary Circulation | 218 | ||
| Cardiac Output (CO) | 219 | ||
| Regulation of cardiac output | 219 | ||
| Starling’s law of the heart (Fig. 9.5) | 219 | ||
| Factors modifying cardiac output | 219 | ||
| 1 Contractility | 219 | ||
| 2 Preload | 220 | ||
| 3 Afterload | 220 | ||
| Measurement of Cardiac Output | 220 | ||
| Fick method | 220 | ||
| Thermodilution | 220 | ||
| Dye dilution | 220 | ||
| Doppler ultrasound | 220 | ||
| Blood Pressure | 220 | ||
| Control of blood pressure (general systemic blood pressure) | 221 | ||
| Factors determining arterial blood pressure | 221 | ||
| Control of local blood pressure and blood flow | 221 | ||
| Peripheral Resistance (Systemic Vascular Resistance; Svr) | 221 | ||
| Monitoring the Circulation | 221 | ||
| ECG | 221 | ||
| Blood pressure | 221 | ||
| Central venous pressure | 222 | ||
| Pulmonary capillary wedge pressure (pulmonary artery occlusion pressure; PAOP) | 223 | ||
| Pulse oximetry | 223 | ||
| Cardiac output | 223 | ||
| Urine output | 223 | ||
| Echocardiography | 223 | ||
| Echo doppler | 223 | ||
| Cardiovascular Support | 223 | ||
| Ventilate | 223 | ||
| Infusion | 223 | ||
| Pump | 223 | ||
| Pharmacological Support | 224 | ||
| Adrenaline | 224 | ||
| Noradrenaline | 224 | ||
| Isoprenaline | 224 | ||
| Dopamine | 224 | ||
| Dobutamine | 224 | ||
| Dopexamine | 224 | ||
| Vasodilators | 224 | ||
| Phosphodiesterase inhibitors | 224 | ||
| OSCE Scenarios | 225 | ||
| OSCE Scenario 9.1 | 225 | ||
| OSCE Scenario 9.2 | 225 | ||
| OSCE Scenario 9.3 | 225 | ||
| 10 Gastrointestinal system | 226 | ||
| Functions | 226 | ||
| Nervous and Hormonal Regulation Within the GI Tract | 226 | ||
| Nervous regulation | 226 | ||
| Hormones and neurotransmitters | 226 | ||
| Oral Cavity, Pharynx and Oesophagus | 226 | ||
| Chewing | 226 | ||
| Saliva | 227 | ||
| Swallowing | 227 | ||
| Oesophageal sphincter | 227 | ||
| Stomach | 227 | ||
| Gastric mucosa | 227 | ||
| Gastric secretion | 228 | ||
| Gastric acid (Fig. 10.1) | 228 | ||
| Pepsinogen secretion | 229 | ||
| Mucus secretion | 229 | ||
| Intrinsic factor secretion | 229 | ||
| Regulation of gastric secretion | 229 | ||
| Gastric motility | 229 | ||
| Storage | 229 | ||
| Mixing and propulsion | 229 | ||
| Clinical physiology | 230 | ||
| Vomiting | 230 | ||
| Treatment of peptic ulceration | 230 | ||
| Medical treatment | 230 | ||
| Surgical treatment | 231 | ||
| Post-gastrectomy syndromes | 231 | ||
| Effects of vagotomy | 231 | ||
| Small Intestine | 231 | ||
| Small intestine mucosa | 231 | ||
| Absorption (Table 10.1) | 233 | ||
| Carbohydrates (Fig. 10.3) | 233 | ||
| Fats (Fig. 10.4) | 233 | ||
| Protein (Fig. 10.5) | 234 | ||
| Fluids and electrolytes | 234 | ||
| Vitamins | 234 | ||
| Iron | 234 | ||
| Calcium | 235 | ||
| Small intestinal motility | 235 | ||
| Clinical physiology | 235 | ||
| Physiological effects of duodenal resection | 235 | ||
| Physiological effects of terminal ileal resection | 235 | ||
| Pancreas | 235 | ||
| Exocrine secretions | 235 | ||
| Fluid component | 235 | ||
| Enzyme component | 236 | ||
| Proteolytic enzymes | 236 | ||
| Amylase | 236 | ||
| Lipolytic enzymes | 236 | ||
| Regulation of exocrine secretions | 236 | ||
| Cephalic | 236 | ||
| Gastric | 236 | ||
| Intestinal | 236 | ||
| Endocrine secretions | 236 | ||
| Clinical physiology | 236 | ||
| Physiological effects of pancreatic resection | 236 | ||
| Liver and Gall Bladder | 236 | ||
| Liver | 236 | ||
| Bile production (Fig. 10.6) | 236 | ||
| Metabolic functions | 238 | ||
| Carbohydrate metabolism | 238 | ||
| Protein metabolism | 238 | ||
| Lipid metabolism | 238 | ||
| Protein synthesis | 238 | ||
| Vitamin D activation | 238 | ||
| Detoxification | 238 | ||
| Vitamin and mineral storage | 238 | ||
| Phagocytosis | 239 | ||
| Haemopoiesis | 239 | ||
| Clinical physiology | 239 | ||
| Jaundice | 239 | ||
| Prehepatic jaundice | 239 | ||
| Hepatocellular jaundice | 239 | ||
| Cholestatic jaundice | 240 | ||
| Gall bladder | 240 | ||
| Clinical physiology | 240 | ||
| Physiological effects of cholecystectomy | 240 | ||
| Water absorption | 240 | ||
| Colonic flora | 240 | ||
| Large intestinal motility | 240 | ||
| Defecation | 241 | ||
| Clinical physiology | 242 | ||
| Diarrhoea | 242 | ||
| Osmotic | 242 | ||
| Secretory | 242 | ||
| Inflammatory | 242 | ||
| Abnormal motility | 242 | ||
| Constipation (Box 10.1) | 242 | ||
| Nutrition | 242 | ||
| Requirements | 242 | ||
| Regulation | 243 | ||
| Osce Scenarios | 244 | ||
| OSCE Scenario 10.1 | 244 | ||
| OSCE Scenario 10.2 | 244 | ||
| OSCE Scenario 10.3 | 244 | ||
| 11 Urinary system | 245 | ||
| Components | 245 | ||
| Functions | 245 | ||
| Structure | 245 | ||
| Renal Blood Supply | 245 | ||
| Renal circulation | 245 | ||
| Regulation of renal blood flow | 245 | ||
| Glomerulus (Fig. 11.1) | 246 | ||
| Microscopic structure | 246 | ||
| Glomerular filtration | 246 | ||
| Proximal convoluted tubule | 246 | ||
| Loop of Henle | 247 | ||
| Countercurrent multiplier mechanism (Fig. 11.2) | 247 | ||
| Distal convoluted tubule and collecting ducts | 248 | ||
| Regulation of Na+ and Water Reabsorption | 248 | ||
| Antidiuretic hormone | 248 | ||
| Renin–angiotensin–aldosterone system (RAS) | 248 | ||
| Atrial natriuretic peptide (ANP) | 248 | ||
| Ion and nutrient reabsorption | 249 | ||
| Potassium | 249 | ||
| Calcium and phosphate | 249 | ||
| Hydrogen and bicarbonate (Fig. 11.3) | 249 | ||
| Glucose and amino acids | 250 | ||
| Urea | 250 | ||
| Glomerular Filtration Rate (GFR) and Renal Plasma Flow | 250 | ||
| Measuring GFR | 250 | ||
| Measuring renal plasma flow | 250 | ||
| Micturition | 250 | ||
| Clinical Physiology | 251 | ||
| Bladder function and spinal injury | 251 | ||
| Hormone Production | 251 | ||
| Renin | 251 | ||
| Erythropoietin | 252 | ||
| 1α-hydroxylase | 252 | ||
| OSCE Scenarios | 252 | ||
| OSCE Scenario 11.1 | 252 | ||
| OSCE Scenario 11.2 | 252 | ||
| OSCE Scenario 11.3 | 252 | ||
| 12 Endocrine system | 253 | ||
| Introduction | 253 | ||
| Pituitary and Hypothalamic Function | 253 | ||
| Control of pituitary function | 253 | ||
| Anterior pituitary | 253 | ||
| Posterior pituitary | 253 | ||
| Anterior pituitary hormones | 253 | ||
| Adrenocorticotrophic hormone (ACTH) | 253 | ||
| Thyroid-stimulating hormone (TSH) | 254 | ||
| Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) | 254 | ||
| Prolactin | 254 | ||
| Growth hormone (GH) | 254 | ||
| Posterior pituitary hormones | 254 | ||
| Oxytocin | 254 | ||
| Antidiuretic hormone | 254 | ||
| Clinical physiology | 254 | ||
| Pituitary disorders | 254 | ||
| Increased hormone secretion | 254 | ||
| Decreased hormone secretion | 254 | ||
| Thyroid Function | 254 | ||
| Anatomy | 254 | ||
| Synthesis of thyroid hormone (Fig. 12.1) | 255 | ||
| Clinical physiology | 255 | ||
| Antithyroid drugs | 255 | ||
| Secretion and transport of thyroid hormone | 255 | ||
| Effects of thyroid hormone | 255 | ||
| Clinical physiology | 256 | ||
| Thyroid disorders | 256 | ||
| Hyperthyroidism | 256 | ||
| Hypothyroidism | 256 | ||
| Sick euthyroid syndrome | 256 | ||
| Calcium and Phosphate Regulation | 257 | ||
| Calcium | 257 | ||
| Regulation of calcium balance | 258 | ||
| Parathormone | 258 | ||
| Vitamin D | 259 | ||
| Calcitonin | 259 | ||
| Regulation of phosphate balance | 259 | ||
| Clinical physiology | 259 | ||
| Disorders of calcium and phosphate balance | 259 | ||
| Hypoparathyroidism | 259 | ||
| Hyperparathyroidism | 259 | ||
| Vitamin D deficiency | 259 | ||
| Hypocalcaemia | 260 | ||
| Hypercalcaemia | 260 | ||
| Hypophosphataemia | 260 | ||
| Hyperphosphataemia | 260 | ||
| Adrenal Function | 260 | ||
| Cortex | 261 | ||
| Synthesis and excretion | 261 | ||
| Actions of the adrenal cortex hormones | 261 | ||
| Aldosterone | 261 | ||
| Cortisol | 261 | ||
| Androgens | 262 | ||
| Medulla | 262 | ||
| Clinical physiology | 262 | ||
| Disorders of adrenal function | 262 | ||
| Addison’s disease | 262 | ||
| Hyperaldosteronism | 263 | ||
| Cushing’s disease/syndrome | 263 | ||
| Adrenogenital syndrome | 263 | ||
| Phaeochromocytoma | 264 | ||
| Growth hormone | 264 | ||
| Clinical physiology | 265 | ||
| Disorders of growth hormone secretion | 265 | ||
| Gigantism | 265 | ||
| Acromegaly | 266 | ||
| Endocrine Function of the Pancreas | 266 | ||
| Insulin | 267 | ||
| III Pathology | 291 | ||
| 14 Cellular injury | 293 | ||
| Mechanisms of Cellular Injury | 293 | ||
| Cell Death | 293 | ||
| Necrosis | 293 | ||
| Coagulative necrosis | 293 | ||
| Colliquative necrosis | 293 | ||
| Caseous necrosis | 293 | ||
| Gangrenous necrosis | 293 | ||
| Fibrinoid necrosis | 294 | ||
| Fat necrosis | 294 | ||
| Apoptosis | 294 | ||
| Function of apoptosis | 294 | ||
| Mediators of apoptosis | 294 | ||
| p53 | 294 | ||
| bcl-2 | 294 | ||
| fas (CD 95) | 294 | ||
| Caspases | 294 | ||
| Morphological features of apoptosis | 294 | ||
| Diseases of increased apoptosis | 295 | ||
| Diseases of decreased apoptosis | 295 | ||
| The Process of Healing | 295 | ||
| Regeneration and repair | 295 | ||
| Cell renewal | 295 | ||
| Repair | 295 | ||
| Granulation tissue | 295 | ||
| Clinical problems with organization and wound contraction | 295 | ||
| Organization | 295 | ||
| Wound contraction | 295 | ||
| Injuries to Specific Tissues | 295 | ||
| Skin | 295 | ||
| Skin anatomy (Fig. 14.1) | 295 | ||
| Incised wound (surgical incision) – healing by first intention | 295 | ||
| Tissue loss – healing by second intention | 296 | ||
| Abnormalities of skin healing | 296 | ||
| Keloid | 296 | ||
| Hypertrophied scar | 296 | ||
| Anatomy of repair of defects | 296 | ||
| Reconstructive ladder (Fig. 14.3) | 296 | ||
| Grafts | 297 | ||
| Skin grafts | 297 | ||
| Mechanism of skin graft take | 297 | ||
| Split-thickness skin grafts (Fig. 14.4) | 297 | ||
| Full-thickness skin grafts (Fig. 14.5) | 298 | ||
| Flaps | 298 | ||
| Classification | 299 | ||
| Local flaps | 299 | ||
| Transposition flap (Fig. 14.9A) | 299 | ||
| Rotation flap (Fig. 14.9B) | 299 | ||
| Advancement flap (Fig. 14.9C) | 300 | ||
| Z-plasty (Fig. 14.9D) | 300 | ||
| Free flaps (Fig. 14.10) | 300 | ||
| Radial forearm flap | 301 | ||
| Anterolateral thigh flap | 301 | ||
| Deep inferior epigastric perforator (DIEP)/transverse rectus abdominis myocutaneous (TRAM) flap | 301 | ||
| Bone | 301 | ||
| Factors affecting bone healing | 302 | ||
| Liver | 302 | ||
| Kidney | 302 | ||
| Cardiac muscle | 302 | ||
| Neural tissue | 302 | ||
| Peritoneum | 302 | ||
| Gastrointestinal tract | 303 | ||
| Mucosal erosions | 303 | ||
| Mucosal ulcers | 303 | ||
| Gastrointestinal anastomoses | 303 | ||
| Factors affecting wound healing | 303 | ||
| Local | 303 | ||
| Systemic | 304 | ||
| Injury Due to Ionizing Radiation | 304 | ||
| Mode of action | 304 | ||
| Effects on tissues | 304 | ||
| Effect on individual tissues | 304 | ||
| Bone marrow | 304 | ||
| Skin | 304 | ||
| Intestines | 305 | ||
| Gonads | 305 | ||
| Lung | 305 | ||
| Kidney | 305 | ||
| Whole-body irradiation | 305 | ||
| Ultraviolet light | 305 | ||
| Therapeutic Irradiation | 305 | ||
| Radical applications | 305 | ||
| Adjuvant radiotherapy | 305 | ||
| Palliative radiotherapy | 305 | ||
| Fractionation of dose | 305 | ||
| Response modifiers | 305 | ||
| Injury Due to Burns | 305 | ||
| Types of burn | 306 | ||
| Thermal | 306 | ||
| Electrical | 306 | ||
| Chemical | 306 | ||
| Causes of burns | 306 | ||
| Predisposing medical conditions | 306 | ||
| Burn injury response | 306 | ||
| Local response (Fig. 14.11) | 306 | ||
| Systemic response | 307 | ||
| Carbon monoxide effects | 307 | ||
| Assessing a burn | 307 | ||
| The extent of body surface area burnt (Fig. 14.12) | 308 | ||
| The depth of the burn (Fig. 14.13) | 308 | ||
| OSCE Scenarios | 310 | ||
| OSCE Scenario 14.1 | 310 | ||
| OSCE Scenario 14.2 | 310 | ||
| OSCE Scenario 14.3 | 310 | ||
| 15 Disorders of growth, morphogenesis and differentiation | 311 | ||
| Growth | 311 | ||
| Cell turnover | 311 | ||
| Cell cycle | 311 | ||
| Phases of the cell cycle (Fig. 15.1) | 311 | ||
| Other factors involved in the cell cycle | 311 | ||
| Control of cell division | 311 | ||
| Therapeutic interruptions of cell cycle (Fig. 15.2) | 311 | ||
| Factors affecting growth | 313 | ||
| Genetic factors | 313 | ||
| Hormones | 313 | ||
| Nutrition | 313 | ||
| Blood supply | 313 | ||
| Oxygen supply | 313 | ||
| Nerve supply | 313 | ||
| Growth factors | 313 | ||
| Increased growth | 313 | ||
| Physiological hypertrophy and hyperplasia | 313 | ||
| Pathological hypertrophy | 314 | ||
| Pathological hyperplasia | 314 | ||
| Atrophy | 314 | ||
| Physiological (Box 15.1) | 314 | ||
| Pathological | 314 | ||
| Decreased growth (hypoplasia) | 314 | ||
| Differentiation | 314 | ||
| Control of differentiation | 314 | ||
| Morphogenesis | 315 | ||
| Congenital disorders of differentiation and morphogenesis | 315 | ||
| Chromosomal abnormalities affecting whole chromosomes | 315 | ||
| Chromosomal abnormalities affecting parts of chromosomes | 315 | ||
| Single gene alterations | 315 | ||
| Functional aspects of developmental disorders | 315 | ||
| Anomalies of organogenesis | 315 | ||
| Agenesis (aplasia) | 315 | ||
| Atresia | 315 | ||
| Hypoplasia | 315 | ||
| Dysgenesis (dysplasia) | 316 | ||
| Ectopia (heterotopia) | 316 | ||
| Acquired disorders of differentiation and growth | 316 | ||
| Metaplasia | 316 | ||
| Dysplasia | 317 | ||
| Polyps | 317 | ||
| Pathological processes causing polyps | 317 | ||
| Symptoms of polyps | 317 | ||
| Examples of polyps | 317 | ||
| Neoplasia | 318 | ||
| OSCE Scenarios | 319 | ||
| IV Appendix | 447 | ||
| Appendix OSCE scenario answers | 449 | ||
| OSCE Scenario Answer 1.1 | 449 | ||
| OSCE Scenario Answer 1.2 | 449 | ||
| OSCE Scenario Answer 1.3 | 450 | ||
| OSCE Scenario Answer 2.1 | 450 | ||
| Initial pain | 450 | ||
| Localized pain | 451 | ||
| OSCE Scenario Answer 2.2 | 451 | ||
| OSCE Scenario Answer 2.3 | 452 | ||
| OSCE Scenario Answer 3.1 | 452 | ||
| OSCE Scenario Answer 3.2 | 453 | ||
| OSCE Scenario Answer 3.3 | 453 | ||
| OSCE Scenario Answer 4.1 | 453 | ||
| OSCE Scenario Answer 4.2 | 454 | ||
| OSCE Scenario Answer 4.3 | 454 | ||
| OSCE Scenario Answer 5.1 | 455 | ||
| OSCE Scenario Answer 5.2 | 455 | ||
| OSCE Scenario Answer 5.3 | 456 | ||
| OSCE Scenario Answer 6.1 | 456 | ||
| OSCE Scenario Answer 6.2 | 456 | ||
| OSCE Scenario Answer 6.3 | 457 | ||
| OSCE Scenario Answer 7.1 | 457 | ||
| OSCE Scenario Answer 7.2 | 458 | ||
| OSCE Scenario Answer 7.3 | 458 | ||
| OSCE Scenario Answer 8.1 | 459 | ||
| OSCE Scenario Answer 8.2 | 459 | ||
| OSCE Scenario Answer 8.3 | 460 | ||
| OSCE Scenario Answer 9.1 | 460 | ||
| OSCE Scenario Answer 9.2 | 461 | ||
| OSCE Scenario Answer 9.3 | 462 | ||
| OSCE Scenario Answer 10.1 | 462 | ||
| OSCE Scenario Answer 10.2 | 463 | ||
| OSCE Scenario Answer 10.3 | 463 | ||
| OSCE Scenario Answer 11.1 | 464 | ||
| OSCE Scenario Answer 11.2 | 464 | ||
| OSCE Scenario Answer 11.3 | 465 | ||
| OSCE Scenario Answer 12.1 | 465 | ||
| OSCE Scenario Answer 12.2 | 466 | ||
| OSCE Scenario Answer 12.3 | 466 | ||
| OSCE Scenario Answer 13.1 | 467 | ||
| OSCE Scenario Answer 13.2 | 467 | ||
| OSCE Scenario Answer 13.3 | 468 | ||
| OSCE Scenario Answer 14.1 | 468 | ||
| History | 468 | ||
| Examination | 468 | ||
| Investigations | 469 | ||
| Management | 469 | ||
| OSCE Scenario Answer 14.2 | 469 | ||
| OSCE Scenario Answer 14.3 | 470 | ||
| OSCE Scenario Answer 15.1 | 471 | ||
| OSCE Scenario Answer 15.2 | 471 | ||
| History | 471 | ||
| Examination | 471 | ||
| Investigations | 472 | ||
| Management | 472 | ||
| OSCE Scenario Answer 15.3 | 472 | ||
| OSCE Scenario Answer 16.1 | 472 | ||
| History | 472 | ||
| Examination | 473 | ||
| Investigations | 473 | ||
| OSCE Scenario Answer 16.2 | 473 | ||
| OSCE Scenario Answer 16.3 | 474 | ||
| OSCE Scenario Answer 17.1 | 475 | ||
| Examination | 475 | ||
| Investigations | 475 | ||
| OSCE Scenario Answer 17.2 | 475 | ||
| OSCE Scenario Answer 17.3 | 476 | ||
| OSCE Scenario Answer 18.1 | 477 | ||
| OSCE Scenario Answer 18.2 | 478 | ||
| OSCE Scenario Answer 18.3 | 479 | ||
| OSCE Scenario Answer 19.1 | 480 | ||
| Symptoms | 480 | ||
| Signs | 480 | ||
| OSCE Scenario Answer 19.2 | 480 | ||
| OSCE Scenario Answer 19.3 | 481 | ||
| OSCE Scenario Answer 20.1 | 482 | ||
| Questions | 482 | ||
| Investigations | 482 | ||
| Possible further investigations | 482 | ||
| OSCE Scenario Answer 20.2 | 482 | ||
| OSCE Scenario Answer 20.3 | 483 | ||
| OSCE Scenario Answer 21.1 | 483 | ||
| Investigations | 483 | ||
| Management | 484 | ||
| OSCE Scenario Answer 21.2 | 484 | ||
| OSCE Scenario Answer 21.3 | 484 | ||
| OSCE Scenario Answer 22.1 | 485 | ||
| Histopathologically | 485 | ||
| Clinically | 485 | ||
| OSCE Scenario Answer 22.2 | 486 | ||
| Medical | 486 | ||
| Surgical | 486 | ||
| OSCE Scenario Answer 22.3 | 486 | ||
| Types of pneumothorax | 487 | ||
| Causes | 487 | ||
| Treatment | 487 | ||
| OSCE Scenario Answer 22.4 | 487 | ||
| OSCE Scenario Answer 22.5 | 488 | ||
| OSCE Scenario Answer 22.6 | 489 | ||
| OSCE Scenario Answer 22.7 | 489 | ||
| Pre-hepatic jaundice | 489 | ||
| Hepatic jaundice | 490 | ||
| Post-hepatic/cholestatic jaundice | 490 | ||
| Index | 491 | ||
| A | 491 | ||
| B | 494 | ||
| C | 496 | ||
| D | 499 | ||
| E | 500 | ||
| F | 501 | ||
| G | 503 | ||
| H | 504 | ||
| I | 506 | ||
| J | 508 | ||
| K | 508 | ||
| L | 508 | ||
| M | 510 | ||
| N | 512 | ||
| O | 513 | ||
| P | 514 | ||
| Q | 517 | ||
| R | 518 | ||
| S | 519 | ||
| T | 523 | ||
| U | 525 | ||
| V | 526 | ||
| W | 527 | ||
| X | 527 | ||
| Y | 527 | ||
| Z | 527 |