BOOK
Davidson's Principles and Practice of Medicine E-Book
Stuart H. Ralston | Ian D Penman | Mark W J Strachan | Richard Hobson
(2018)
Additional Information
Book Details
Abstract
More than two million medical students, doctors and other health professionals around the globe have owned a copy of Davidson’s Principles and Practice of Medicine since it was first published. Now in its 23rd Edition, this textbook describes the pathophysiology and clinical features of the most frequently encountered conditions in the major specialties of adult medicine and explains how to recognise, investigate, diagnose and manage them. Taking its origins from Sir Stanley Davidson’s much-admired lecture notes, Davidson’s has endured because it keeps pace with how modern medicine is taught and provides a wealth of information in an easy-to-read, concise and beautifully illustrated format. This book will serve readers everywhere as a core text that integrates medical science with clinical medicine, conveying key knowledge and practical advice in a highly accessible and readable format.
- The opening section describes the fundamentals of genetics, immunology, infectious diseases and population health, and discusses the core principles of clinical decision-making and good prescribing.
- A new second section on emergency and critical care medicine encompasses poisoning, envenomation and environmental medicine, and introduces a new chapter on acute medicine and critical illness.
- The third section covers the major medical specialties, each thoroughly revised and brought fully up to date. Two new chapters on maternal and adolescent/transition medicine complement the one on ageing and disease. A new chapter on medical ophthalmology has been included.
- Clinical Examination overviews summarise the main elements for each system and now feature in the biochemistry, nutrition and dermatology chapters.
- Presenting Problems sections provide a clear pathway for the assessment of and approach to the most common complaints in each specialty.
- Practice Point summaries detail the practical skills that medical students and junior doctors must acquire.
- Emergency boxes emphasise the core knowledge needed to manage acutely ill patients.
- In Old Age, In Pregnancy and In Adolescence boxes highlight differences in the practice of medicine in these patient groups, and illustrate the interfaces between medical, obstetric and paediatric services.
- The text is extensively illustrated, with over 1000 diagrams, clinical photographs, and radiology and pathology images.
- The global perspective is enhanced by an International Advisory Board of experts from 17 countries, and by authors from around the world.
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 | iii | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | ix | ||
| Contributors | xi | ||
| International Advisory Board | xv | ||
| Acknowledgements | xvii | ||
| Introduction | xix | ||
| Clinical examination overviews | xix | ||
| Presenting problems | xix | ||
| Boxes | xix | ||
| General Information | xix | ||
| Practice Point | xix | ||
| Emergency | xix | ||
| In Old Age | xix | ||
| In Pregnancy | xx | ||
| In Adolescence | xx | ||
| Terminology | xx | ||
| Units of measurement | xx | ||
| Finding what you are looking for | xx | ||
| 1 Fundamentals of Medicine | 1 | ||
| 1 Clinical decision-making | 1 | ||
| Introduction | 2 | ||
| The problem of diagnostic error | 2 | ||
| Clinical reasoning: definitions | 2 | ||
| Clinical skills and decision-making | 3 | ||
| Use and interpretation of diagnostic tests | 3 | ||
| Normal values | 3 | ||
| Factors other than disease that influence test results | 4 | ||
| Operating characteristics | 4 | ||
| Sensitivity and specificity | 4 | ||
| Prevalence of disease | 5 | ||
| Dealing with uncertainty | 5 | ||
| Cognitive biases | 6 | ||
| Type 1 and type 2 thinking | 7 | ||
| Common cognitive biases in medicine | 7 | ||
| Human factors | 9 | ||
| Reducing errors in clinical decision-making | 9 | ||
| Cognitive debiasing strategies | 9 | ||
| History and physical examination | 9 | ||
| Problem lists and differential diagnosis | 9 | ||
| Mnemonics and checklists | 9 | ||
| Red flags and ROWS (‘rule out worst case scenario’) | 9 | ||
| Using clinical prediction rules and other decision aids | 10 | ||
| Effective team communication | 10 | ||
| Patient-centred evidence-based medicine and shared decision-making | 10 | ||
| Clinical decision-making: putting it all together | 10 | ||
| Evidence-based history and examination | 11 | ||
| Deciding pre-test probability | 11 | ||
| Interpreting test results | 11 | ||
| Treatment threshold | 11 | ||
| Post-test probability | 11 | ||
| Cognitive biases | 11 | ||
| Human factors | 11 | ||
| Reducing cognitive error | 11 | ||
| Person-centred EBM and information given to patient | 12 | ||
| Answers to problems | 12 | ||
| Harvard problem (p. 5) | 12 | ||
| Bat and ball problem (p. 6) | 12 | ||
| Further information | 12 | ||
| Books and journal articles | 12 | ||
| Websites | 12 | ||
| 2 Clinical therapeutics and good prescribing | 13 | ||
| Principles of clinical pharmacology | 14 | ||
| Pharmacodynamics | 14 | ||
| Drug targets and mechanisms of action | 14 | ||
| Dose–response relationships | 14 | ||
| Therapeutic index | 16 | ||
| Desensitisation and withdrawal effects | 16 | ||
| Pharmacokinetics | 17 | ||
| Drug absorption and routes of administration | 17 | ||
| Enteral administration | 17 | ||
| Parenteral administration | 17 | ||
| Other routes of administration | 17 | ||
| Drug distribution | 18 | ||
| Volume of distribution | 18 | ||
| Drug elimination | 18 | ||
| Drug metabolism | 18 | ||
| Drug excretion | 18 | ||
| Elimination kinetics | 19 | ||
| Repeated dose regimens | 19 | ||
| Inter-individual variation in drug responses | 19 | ||
| Adverse outcomes of drug therapy | 21 | ||
| Adverse drug reactions | 21 | ||
| Prevalence of ADRs | 21 | ||
| Classification of ADRs | 22 | ||
| Detecting ADRs – pharmacovigilance | 23 | ||
| Drug interactions | 23 | ||
| Mechanisms of drug interactions | 23 | ||
| Avoiding drug interactions | 24 | ||
| Medication errors | 24 | ||
| Responding when an error is discovered | 26 | ||
| Drug regulation and management | 26 | ||
| Drug development and marketing | 26 | ||
| Licensing new medicines | 26 | ||
| Drug marketing | 27 | ||
| Managing the use of medicines | 27 | ||
| Evaluating evidence | 27 | ||
| Evaluating cost-effectiveness | 28 | ||
| Implementing recommendations | 28 | ||
| Prescribing in practice | 28 | ||
| Decision-making in prescribing | 28 | ||
| Making a diagnosis | 29 | ||
| Establishing the therapeutic goal | 29 | ||
| Choosing the therapeutic approach | 29 | ||
| Choosing a drug | 29 | ||
| Absorption | 29 | ||
| Distribution | 29 | ||
| Metabolism | 29 | ||
| Excretion | 29 | ||
| Efficacy | 29 | ||
| Avoiding adverse effects | 29 | ||
| Features of the disease | 29 | ||
| Severity of disease | 29 | ||
| Coexisting disease | 29 | ||
| Avoiding adverse drug interactions | 29 | ||
| Patient adherence to therapy | 29 | ||
| Cost | 29 | ||
| Genetic factors | 29 | ||
| Choosing a dosage regimen | 29 | ||
| Dose titration | 30 | ||
| Route | 30 | ||
| Frequency | 30 | ||
| Timing | 30 | ||
| Formulation | 30 | ||
| Duration | 30 | ||
| Involving the patient | 30 | ||
| Writing the prescription | 31 | ||
| Monitoring treatment effects | 31 | ||
| Stopping drug therapy | 31 | ||
| Prescribing in special circumstances | 31 | ||
| Prescribing for patients with renal disease | 31 | ||
| Prescribing for patients with hepatic disease | 32 | ||
| Prescribing for elderly patients | 32 | ||
| Prescribing for women who are pregnant or breastfeeding | 32 | ||
| Writing prescriptions | 33 | ||
| Prescribing in hospital | 33 | ||
| Hospital discharge (‘to take out’) medicines | 33 | ||
| Prescribing in primary care | 33 | ||
| Monitoring drug therapy | 34 | ||
| Clinical and surrogate endpoints | 35 | ||
| Plasma drug concentration | 36 | ||
| Timing of samples in relation to doses | 36 | ||
| Interpreting the result | 36 | ||
| Further information | 36 | ||
| Websites | 36 | ||
| 3 Clinical genetics | 37 | ||
| The fundamental principles of genomics | 38 | ||
| The packaging of genes: DNA, chromatin and chromosomes | 38 | ||
| From DNA to protein | 38 | ||
| Transcription: DNA to messenger RNA | 38 | ||
| RNA splicing, editing and degradation | 40 | ||
| Translation and protein production | 40 | ||
| Non-coding RNA | 40 | ||
| Cell division, differentiation and migration | 40 | ||
| Cell death, apoptosis and senescence | 41 | ||
| Genomics, health and disease | 42 | ||
| Classes of genetic variant | 42 | ||
| Nucleotide substitutions | 42 | ||
| Insertions and deletions | 42 | ||
| Simple tandem repeat mutations | 43 | ||
| Copy number variations | 44 | ||
| Consequences of genomic variation | 44 | ||
| Normal genomic variation | 45 | ||
| Polymorphisms and common disease | 45 | ||
| Evolutionary selection | 45 | ||
| Constitutional genetic disease | 46 | ||
| Constructing a family tree | 46 | ||
| Patterns of disease inheritance | 46 | ||
| Autosomal dominant inheritance | 46 | ||
| Autosomal recessive inheritance | 48 | ||
| X-linked inheritance | 48 | ||
| Mitochondrial inheritance | 49 | ||
| Imprinting | 49 | ||
| Somatic genetic disease | 50 | ||
| Interrogating the genome: the changing landscape of genomic technologies | 51 | ||
| Looking at chromosomes | 51 | ||
| Looking at genes | 52 | ||
| Gene amplification: polymerase chain reaction | 52 | ||
| Gene sequencing | 52 | ||
| NGS capture | 53 | ||
| Challenges of NGS technologies | 53 | ||
| Uses of NGS | 54 | ||
| Third-generation sequencing | 56 | ||
| Genomics and clinical practice | 56 | ||
| Genomics and health care | 56 | ||
| Genomics in rare neurodevelopmental disorders | 56 | ||
| Genomics and common disease | 56 | ||
| Genomics and obstetrics | 56 | ||
| Genomics and oncology | 56 | ||
| Genomics in infectious disease | 58 | ||
| Treatment of genetic disease | 58 | ||
| Pharmacogenomics | 58 | ||
| Gene therapy and genome editing | 58 | ||
| Induced pluripotent stem cells and regenerative medicine | 58 | ||
| Pathway medicine | 58 | ||
| Ethics in a genomic age | 59 | ||
| Further information | 59 | ||
| Books and journal articles | 59 | ||
| Websites | 59 | ||
| 4 Clinical immunology | 61 | ||
| Functional anatomy and physiology | 62 | ||
| The innate immune system | 62 | ||
| Physical barriers | 62 | ||
| Phagocytes | 63 | ||
| Neutrophils | 64 | ||
| Monocytes and macrophages | 64 | ||
| Dendritic cells | 64 | ||
| Cytokines | 64 | ||
| Integrins | 66 | ||
| Complement | 66 | ||
| Mast cells and basophils | 66 | ||
| Natural killer cells | 67 | ||
| The adaptive immune system | 67 | ||
| Lymphoid organs | 67 | ||
| The thymus | 67 | ||
| The spleen | 67 | ||
| Lymph nodes | 67 | ||
| Mucosa-associated lymphoid tissue | 67 | ||
| Lymphatics | 67 | ||
| Humoral immunity | 68 | ||
| Immunoglobulins | 68 | ||
| Cellular immunity | 69 | ||
| CD8+ T lymphocytes | 70 | ||
| CD4+ T lymphocytes | 70 | ||
| The inflammatory response | 70 | ||
| Acute inflammation | 70 | ||
| The acute phase response | 70 | ||
| Septic shock | 70 | ||
| Resolution of inflammation | 71 | ||
| Chronic inflammation | 71 | ||
| Laboratory features of inflammation | 71 | ||
| C-reactive protein | 72 | ||
| Erythrocyte sedimentation rate | 72 | ||
| Plasma viscosity | 72 | ||
| Presenting problems in immune disorders | 73 | ||
| Recurrent infections | 73 | ||
| Aetiology | 73 | ||
| Clinical assessment | 73 | ||
| Investigations | 73 | ||
| Management | 73 | ||
| Intermittent fever | 74 | ||
| Aetiology | 74 | ||
| Clinical assessment | 74 | ||
| Investigations | 74 | ||
| Management | 74 | ||
| Anaphylaxis | 75 | ||
| Aetiology | 75 | ||
| Clinical assessment | 75 | ||
| Investigations | 76 | ||
| Management | 76 | ||
| Immune deficiency | 77 | ||
| Primary phagocyte deficiencies | 77 | ||
| Chronic granulomatous disease | 77 | ||
| Leucocyte adhesion deficiencies | 77 | ||
| Defects in cytokines and cytokine receptors | 78 | ||
| Complement pathway deficiencies | 78 | ||
| Clinical features | 78 | ||
| Investigations | 78 | ||
| Management | 78 | ||
| Primary antibody deficiencies | 78 | ||
| X-linked agammaglobulinaemia | 78 | ||
| Selective IgA deficiency | 78 | ||
| Common variable immune deficiency | 79 | ||
| Functional IgG antibody deficiency | 79 | ||
| Investigations | 79 | ||
| Management | 79 | ||
| Primary T-lymphocyte deficiencies | 79 | ||
| DiGeorge syndrome | 79 | ||
| Bare lymphocyte syndromes | 79 | ||
| Severe combined immune deficiency | 79 | ||
| Investigations | 80 | ||
| Management | 80 | ||
| Autoimmune lymphoproliferative syndrome | 80 | ||
| Secondary immune deficiencies | 80 | ||
| Periodic fever syndromes | 81 | ||
| Familial Mediterranean fever | 81 | ||
| Mevalonic aciduria (mevalonate kinase deficiency) | 81 | ||
| TNF receptor-associated periodic syndrome | 81 | ||
| Amyloidosis | 81 | ||
| Pathophysiology | 81 | ||
| Clinical features | 81 | ||
| Investigations | 81 | ||
| Management | 81 | ||
| Autoimmune disease | 81 | ||
| Pathophysiology | 82 | ||
| Clinical features | 83 | ||
| Investigations | 83 | ||
| Autoantibodies | 83 | ||
| Complement | 84 | ||
| Cryoglobulins | 84 | ||
| Management | 84 | ||
| Allergy | 84 | ||
| Pathophysiology | 84 | ||
| Clinical features | 85 | ||
| Insect venom allergy | 85 | ||
| Peanut allergy | 85 | ||
| Birch oral allergy syndrome | 85 | ||
| Diagnosis | 85 | ||
| Investigations | 86 | ||
| Skin-prick tests | 86 | ||
| Specific IgE tests | 86 | ||
| Supervised exposure to allergen | 86 | ||
| Mast cell tryptase | 86 | ||
| Serum total IgE | 86 | ||
| Eosinophilia | 86 | ||
| Management | 86 | ||
| Avoidance of the allergen | 86 | ||
| Antihistamines | 86 | ||
| Glucocorticoids | 86 | ||
| Sodium cromoglicate | 86 | ||
| Antigen-specific immunotherapy | 86 | ||
| Omalizumab | 86 | ||
| Adrenaline (epinephrine) | 86 | ||
| Angioedema | 87 | ||
| Pathophysiology | 87 | ||
| Clinical features | 87 | ||
| Investigations | 87 | ||
| Management | 87 | ||
| Hereditary angioedema | 88 | ||
| Clinical features | 88 | ||
| Investigations | 88 | ||
| Management | 88 | ||
| Acquired C1 inhibitor deficiency | 88 | ||
| Transplantation and graft rejection | 88 | ||
| Transplant rejection | 88 | ||
| Investigations | 89 | ||
| Pre-transplantation testing | 89 | ||
| Post-transplant biopsy: C4d staining | 89 | ||
| Complications of transplant immunosuppression | 89 | ||
| Organ donation | 90 | ||
| Tumour immunology | 90 | ||
| Further information | 90 | ||
| 5 Population health and epidemiology | 91 | ||
| Global burden of disease and underlying risk factors | 92 | ||
| Life expectancy | 92 | ||
| Global causes of death and disability | 92 | ||
| Risk factors underlying disease | 93 | ||
| Social determinants of health | 93 | ||
| The hierarchy of systems – from molecules to ecologies | 93 | ||
| The life course | 93 | ||
| Preventive medicine | 93 | ||
| Alcohol | 94 | ||
| Smoking | 94 | ||
| Obesity | 94 | ||
| Poverty and affluence | 94 | ||
| Atmospheric pollution | 94 | ||
| Climate change and global warming | 94 | ||
| Principles of screening | 94 | ||
| Epidemiology | 95 | ||
| Understanding causes and effect | 95 | ||
| Health data/informatics | 97 | ||
| Further information | 98 | ||
| Books and journal articles | 98 | ||
| Websites | 98 | ||
| 6 Principles of infectious disease | 99 | ||
| Infectious agents | 100 | ||
| Viruses | 100 | ||
| Prokaryotes: bacteria (including mycobacteria and actinomycetes) | 100 | ||
| Eukaryotes: fungi, protozoa and helminths | 101 | ||
| Prions | 102 | ||
| Normal microbial flora | 102 | ||
| Host–pathogen interactions | 104 | ||
| Characteristics of successful pathogens | 104 | ||
| The host response | 104 | ||
| Pathogenesis of infectious disease | 104 | ||
| The febrile response | 104 | ||
| Investigation of infection | 105 | ||
| Direct detection of pathogens | 105 | ||
| Detection of whole organisms | 105 | ||
| Detection of components of organisms | 106 | ||
| Nucleic acid amplification tests | 106 | ||
| Culture | 106 | ||
| Blood culture | 106 | ||
| Indirect detection of pathogens | 106 | ||
| Antibody detection | 106 | ||
| Enzyme-linked immunosorbent assay | 106 | ||
| Immunoblot (Western blot) | 107 | ||
| Immunofluorescence assays | 107 | ||
| Complement fixation test | 107 | ||
| Agglutination tests | 108 | ||
| Other tests | 108 | ||
| Antibody-independent specific immunological tests | 109 | ||
| Antimicrobial susceptibility testing | 109 | ||
| Epidemiology of infection | 110 | ||
| Geographical and temporal patterns of infection | 110 | ||
| Endemic disease | 110 | ||
| Emerging and re-emerging disease | 110 | ||
| Reservoirs of infection | 110 | ||
| Human reservoirs | 110 | ||
| Animal reservoirs | 110 | ||
| Environmental reservoirs | 110 | ||
| Transmission of infection | 111 | ||
| Deliberate release | 111 | ||
| Infection prevention and control | 111 | ||
| Health care-associated infection | 111 | ||
| Outbreaks of infection | 114 | ||
| Immunisation | 114 | ||
| Vaccination | 114 | ||
| Types of vaccine | 114 | ||
| Use of vaccines | 115 | ||
| Antimicrobial stewardship | 115 | ||
| Treatment of infectious diseases | 116 | ||
| Principles of antimicrobial therapy | 116 | ||
| Antimicrobial action and spectrum | 116 | ||
| Empiric versus targeted therapy | 116 | ||
| Combination therapy | 116 | ||
| Antimicrobial resistance | 116 | ||
| Duration of therapy | 118 | ||
| Pharmacokinetics and pharmacodynamics | 118 | ||
| Therapeutic drug monitoring | 119 | ||
| Antimicrobial prophylaxis | 119 | ||
| Antibacterial agents | 120 | ||
| Beta-lactam antibiotics | 120 | ||
| Pharmacokinetics | 120 | ||
| Adverse effects | 120 | ||
| Drug interactions | 121 | ||
| Penicillins | 121 | ||
| Cephalosporins and cephamycins | 121 | ||
| Monobactams | 121 | ||
| Carbapenems | 121 | ||
| Macrolide and lincosamide antibiotics | 121 | ||
| Pharmacokinetics | 121 | ||
| Macrolides | 121 | ||
| Lincosamides (e.g. clindamycin) | 122 | ||
| 2 Emergency and Critical Care Medicine | 131 | ||
| 7 Poisoning | 131 | ||
| Comprehensive evaluation of the poisoned patient | 132 | ||
| General approach to the poisoned patient | 134 | ||
| Triage and resuscitation | 134 | ||
| Clinical assessment and investigations | 134 | ||
| Psychiatric assessment | 135 | ||
| General management | 135 | ||
| Gastrointestinal decontamination | 135 | ||
| Activated charcoal | 136 | ||
| Gastric aspiration and lavage | 136 | ||
| Whole bowel irrigation | 136 | ||
| Urinary alkalinisation | 136 | ||
| Haemodialysis and haemoperfusion | 136 | ||
| Lipid emulsion therapy | 136 | ||
| Supportive care | 137 | ||
| Antidotes | 137 | ||
| Poisoning by specific pharmaceutical agents | 137 | ||
| Analgesics | 137 | ||
| Paracetamol | 137 | ||
| 3 Clinical Medicine | 215 | ||
| 11 Infectious disease | 215 | ||
| Clinical examination of patients with infectious disease | 216 | ||
| Presenting problems in infectious diseases | 218 | ||
| Fever | 218 | ||
| Index | 1365 | ||
| A | 1365 | ||
| B | 1370 | ||
| C | 1372 | ||
| D | 1378 | ||
| E | 1380 | ||
| F | 1382 | ||
| G | 1384 | ||
| H | 1385 | ||
| I | 1389 | ||
| J | 1391 | ||
| K | 1392 | ||
| L | 1392 | ||
| M | 1394 | ||
| N | 1397 | ||
| O | 1399 | ||
| P | 1400 | ||
| Q | 1405 | ||
| R | 1405 | ||
| S | 1408 | ||
| T | 1412 | ||
| U | 1414 | ||
| V | 1415 | ||
| W | 1417 | ||
| X | 1417 | ||
| Y | 1417 | ||
| Z | 1417 |