Professional Documents
Culture Documents
Diagnosis and Treatment in Internal Medicine Oxford University Press 1St Edition Patrick Davey Full Chapter
Diagnosis and Treatment in Internal Medicine Oxford University Press 1St Edition Patrick Davey Full Chapter
mebooksfree.com
mebooksfree.com
DIAGNOSIS AND
TREATMENT
IN INTERNAL
MEDICINE
Edited by
Patrick Davey
Consultant Cardiologist, Northampton General Hospital NHS Trust,
Northampton, UK
David Sprigings
Formerly Consultant Physician, Northampton General Hospital NHS Trust,
Northampton, UK
1
mebooksfree.com
1
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide. Oxford is a registered trade mark of
Oxford University Press in the UK and in certain other countries
© Oxford University Press 2018
The moral rights of the authorshave been asserted
First Edition published in 2018
Impression: 1
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by licence or under terms agreed with the appropriate reprographics
rights organization. Enquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2018941300
ISBN 978–0–19–956874–1
Printed and bound in China by
C&C Offset Printing Co., Ltd.
Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. The authors and
the publishers do not accept responsibility or legal liability for any errors in the
text or for the misuse or misapplication of material in this work. Except where
otherwise stated, drug dosages and recommendations are for the non-pregnant
adult who is not breast-feeding
Links to third party websites are provided by Oxford in good faith and
for information only. Oxford disclaims any responsibility for the materials
contained in any third party website referenced in this work.
mebooksfree.com
Preface
Diagnosis and Treatment in Internal Medicine came about through our experience on
the acute medical take. Here, sick patients present in large numbers with a vast range
of problems. What all patients need, as the bedrock of management, is a differential
diagnosis, and the central aim of our book is to help doctors formulate this. We asked
experts in their field to provide succinct and authoritative guidance across the breadth
of internal medicine. The assessment of symptoms or presenting problems is a major
element of the book, but there is also comprehensive coverage of disorders of the
body systems, including psychological aspects and palliative care. Chapters are struc-
tured so that key information can rapidly be found. Doctors need a broad perspective
on health and its promotion, and there are sections addressing nutrition, lifestyle, and
prevention of disease.
This book approaches medicine from the patient’s perspective, through the stories
that patients tell us about their illness, and provides the knowledge that turns these
narratives into diagnoses, treatment, health, and longevity. Throughout, our focus has
been on meeting the needs of doctors in the clinic, in the emergency department, or
on the ward.
Our eternal thanks go out to our contributors. Some 200 outstanding doctors have
produced admirably compact and lucid chapters. Throughout the lengthy gestation of
the book, we have been ably supported by the staff at Oxford University Press, who
have encouraged us and orchestrated the project. All praise should be directed to the
authors, and any mistakes are ours. Please do let us have your suggestions for improve-
ments (you can contact us at david.sprigings@gmail.com and pftame@gmail.com).
Patrick Davey
David Sprigings
mebooksfree.com
mebooksfree.com
Contents
mebooksfree.com
66 Leg ulcers 191 76 Fever 216
67 Limb ischaemia 193 77 Hyperthermia 218
68 Rashes 195 78 Hypothermia 221
69 Blistering rashes 197 79 Fatigue 224
70 Photosensitive rashes 200 80 Unintentional weight loss 226
71 Itching 203 81 Obesity: differential diagnosis 228
72 Lumps and bumps 205 82 Self-harm 231
73 Falls 209 83 Alcohol intoxication 234
74 Immobility (‘Off legs’) 212 84 Intravenous drug use 239
75 Suspected anaphylaxis 214
viii
mebooksfree.com
138 Sarcoidosis and other granulomatous lung 142 Occupational lung disease 472
disease 458 143 Pleural infection and malignancy 475
139 Interstitial lung disease 460 144 Drug-induced lung disease 477
140 Pulmonary vasculitis 464 145 Psychology in respiratory disease, including
141 Lung cancer (including management of an dysfunctional breathing 480
isolated lung lesion) 467 146 Terminal care in respiratory illness 482
147 Critical illness 486 151 ICU treatment of acute kidney injury 496
148 Role of the intensive care unit 488 152 ICU treatment of sepsis and septic shock 498
149 ICU treatment of respiratory failure 490 153 Terminal care in the intensive care unit 501
150 ICU treatment of cardiovascular failure 493 154 Brain death 503
155 Normal renal function 506 169 Inherited renal diseases 556
156 Diagnosis in suspected renal disease 509 170 The kidney in systemic disease 558
157 Investigation in renal disease 512 171 Renal vascular disease 561
158 Urinary tract infection 518 172 Management of terminal care in renal
159 Glomerulonephritis 521 disease 563
160 Interstitial renal disease 527 173 Disorders of plasma potassium 565
Contents
161 Nephrotic syndrome 529 174 Disorders of plasma sodium 568
162 Acute kidney injury 533 175 Disorders of plasma calcium 570
163 Chronic kidney disease 536 176 Disorders of plasma phosphate 573
164 Diabetic renal disease 540 177 Disorders of plasma magnesium 575
165 Urinary tract obstruction 543 178 Disorders of acid–base balance 577
166 Renal calculi 546 179 Porphyria 580
167 Renal and bladder cancer 549 180 Aminoacidopathies, urea cycle disorders, and
organic acidurias 582
168 Renal replacement therapy 552
181 Amyloidosis 584
182 Normal function of the endocrine system 588 188 Adrenal disease 612
183 Diagnosis and investigation in endocrine 189 Cushing syndrome 617
disorders 593 190 Short stature 619
184 Diabetes mellitus 596 191 Infertility 621
185 Hypoglycaemia 601 192 Pituitary disorders: Prolactinomas, acromegaly,
186 Thyroid disease 603 and pituitary apoplexy 625
187 Primary hyperparathyroidism 610
193 Normal gastrointestinal function 632 195 Investigation in gastrointestinal disease 637
194 Diagnosis in suspected gastrointestinal 196 Immunology and genetics in gastrointestinal and
disease 635 hepatic medicine 641
ix
mebooksfree.com
197 Gastrointestinal infections 644 202 Malabsorption 660
198 Benign oesophageal disease 648 203 Inflammatory bowel disease 663
199 Peptic ulcer disease 651 204 Gastrointestinal tumours 667
200 Gall bladder disease 653 205 Functional gastrointestinal diseases 674
201 Pancreatic disease 656 206 Psychiatry in gastrointestinal medicine 676
219 Normal neurological function 736 232 Motor neuron disease 794
220 Diagnosis in suspected neurological disease 739 233 Spinal cord disease 796
221 Investigation in neurological disease 742 234 Neuropathy 800
222 Demographics of neurological disease 752 235 Myopathy 804
Contents
x
mebooksfree.com
PART 12 DISORDERS OF THE MUSCULOSKELETAL SYSTEM
263 Normal function of the musculoskeletal 269 Systemic lupus erythematosus 918
system 892 270 Crystal arthropathy 921
264 Diagnosis in suspected rheumatological 271 Infection of joints and bones 925
disease 894
272 Vasculitis 927
265 Investigation in rheumatological disease 900
273 Osteomalacia 932
266 Osteoarthritis 906
274 Paget’s disease of bone 933
267 Rheumatoid arthritis 910
275 Osteoporosis and fragility fracture 935
268 Seronegative spondyloarthropathy 914
276 Genetic bone and joint disease 938
Contents
PART 14 DISORDERS OF THE IMMUNE SYSTEM
293 Functions of the immune system 1008 298 Combined T-and B-cell
294 Clinical features and diagnosis of immunological immunodeficiencies 1028
disease 1013 299 Complement deficiencies 1031
295 Neutrophil abnormalities 1017 300 Hypersensitivity diseases 1034
296 Human immunodeficiency virus infection 1020 301 Immunological support 1038
297 Antibody deficiencies 1025 302 Immunosuppressive therapy and therapeutic
monoclonal antibodies 1040
303 Defences against infection 1044 312 Spirochaetal infection (non-syphilis) 1079
304 Nature and demographics: Epidemiology of 313 Syphilis 1082
infective organisms 1048 314 Rickettsial infection 1084
305 Diagnosis in suspected infective disease: 315 Fungal infection 1086
The history and examination 1051
316 Protozoal infection: Gut organisms 1091
306 Investigation in infection 1058
317 Protozoal infection: Malaria 1094
307 Treatment of infection 1061
318 Worm infection (including hydatid
308 Viral infection 1064 disease) 1098
309 Sepsis 1068 319 Prion disease 1101
310 Bacterial infection 1071 320 Sexually transmitted disease
311 Mycobacterial infection other than (gonorrhoea) 1103
tuberculosis 1075
xi
mebooksfree.com
PART 16 CANCERS
331 Normal nutritional function 1134 337 Physical activity and its role in disease
332 Starvation and malnutrition 1136 prevention 1155
333 Vitamin deficiencies 1139 338 Smoking 1158
334 Nutritional support in the critically ill 1144 339 Alcohol 1160
335 Poor diets 1147 340 Environmental radiation 1164
336 Obesity: epidemiology, prevention and 341 Air pollution 1166
management 1150 342 Non-prescription drugs 1168
343 Prevention of cardiovascular disease 1172 347 Prevention of neurological disease 1183
Contents
344 Prevention of respiratory disease 1176 348 Prevention of cerebrovascular disease 1187
345 Prevention of kidney disease 1179 349 Prevention of infection 1189
346 Prevention of gastrointestinal disease 1181 350 Prevention of cancer 1192
351 Screening for cardiovascular disease 1196 354 Screening for gastrointestinal disease 1206
352 Screening for respiratory disease 1202 355 Screening for neurological disease 1209
353 Screening for kidney disease 1205 356 Screening for cancer 1211
Index 1215
xii
mebooksfree.com
Normal values
mebooksfree.com
mebooksfree.com
Abbreviations
mebooksfree.com
AV atrioventricular CCF congestive cardiac failure
aVF augmented voltage unipolar left foot lead CCP cyclic citrullinated peptide
AVIR accelerated idioventricular rhythm CCS Canadian Cardiovascular Society
aVL augmented voltage unipolar left arm lead CD Crohn’s disease
AVN atrioventricular node CDC Centers for Disease Control
AVNRT atrioventricular nodal re-entrant tachycardia CDI cranial diabetes insipidus
AVP arginine vasopressin CF counting fingers
AVPU Alert, Voice, Pain, or Unresponsive CGD chronic granulomatous disease
AVRT atrioventricular re-entrant tachycardia CHD coronary heart disease
AVSD atrioventricular septal defect CHF congestive heart failure
AZA azathioprine CI confidence interval
BAE bronchial artery angiography and embolization CIDP chronic inflammatory demyelinating
BAL bronchoalveolar lavage polyradiculoneuropathy
BC bone conduction CIPO chronic idiopathic pseudo-obstruction
BCC basal cell carcinoma CIS carcinoma in situ
BCLC Barcelona Clinic Liver Cancer CJD Creutzfeldt–Jakob disease
BCNIE blood culture-negative infective endocarditis CK creatine kinase
BCP basic calcium phosphates CKD chronic kidney disease
BCR B-cell receptor CLL chronic lymphoid leukaemia
BCT broad-complex tachycardia CMAP compound muscle action potential
BD brain death CMC carpometacarpal
BDD body dysmorphic disorder CML chronic myeloid leukaemia
BI bacterial index CMRI cardiac magnetic resonance imaging
BIMA bilateral internal mammary artery CMT Charcot–Marie–Tooth disease
BIPAP bi-level positive airway pressure CMV cytomegalovirus
BIPSS bilateral inferior petrosal sinus sampling CNS central nervous system
BMD bone mineral density COCP combined oral contraceptive pill
Abbreviations
xvi
mebooksfree.com
DADS distal acquired demyelinating symmetrical ET essential tremor
DAH diffuse alveolar haemorrhage EUA examination under anaesthesia
DAS Disease Activity Score EUS endoscopic ultrasound
DAT drug action team FAP familial amyloid polyneuropathy
DBS deep brain stimulation FAST Face Arm Speech Test
DCM dilated cardiomyopathy FBC full blood count
DEXA dual-energy X-ray absorptiometry FDA Food and Drug Administration
DF Maddrey discriminant function FDG fluorodeoxyglucose
DHEA dehydroepiandrosterone FDP fibrinogen degradation products
DHEAS dehydroepiandrosterone sulphate FEV1 forced expiratory volume in 1 second
DI diabetes incipidus FFA free fatty acid
DIC disseminated intravascular coagulopathy FFR fractional flow reserve
DILD drug-induced lung disease FFS five-factor score
DILS diffuse infiltrative lymphocytosis syndrome FHH familial hypocalciuric hypercalcaemia
DIP distal interphalangeal FI faecal incontinence
DIS dissemination in space FiO2 inspired fraction of oxygen
DIT dissemination in time; FISH fluorescent in situ hybridization
DLCO diffusing capacity of the lung for carbon monoxide FLAIR fluid attenuated inversion recovery
DLE discoid lupus erythematosus FLI fatty liver index
DM diabetes mellitus FNAC fine-needle aspiration cytology
DMARD disease-modifying anti-rheumatic drug FOB faecal occult blood
DOT directly observed therapy FSGS focal segmental glomerulosclerosis
DPP-4 dipeptidyl peptidase-4 FSH follicle-stimulating hormone
DRE digital rectal examination FTD frontotemporal dementia
dsDNA double-stranded DNA FUO fever of unknown origin
DSE dobutamine stress echocardiography FVC forced vital capacity
DST dexamethasone suppression test FVL factor V Leiden
Abbreviations
DU duodenal ulcer FXTAS fragile X-associated tremor/ataxia syndrome
DVLA Driver and Vehicle Licensing Agency G1 Genotype 1
DVP diastolic blood pressure G2 Genotype 2
DVT deep-vein thrombosis G3 Genotype 3
DWI diffusion-weighted imaging G6PD glucose-6-phosphate dehydrogenase
EBUS-TBNA endobronchial ultrasound-guided transbronchial GA general anaesthesia
needle aspiration GABA gamma-aminobutyric acid
EBV Epstein–Barr virus GAD glutamic acid decarboxylase
ECG electrocardiogram GAD65 glutamic acid decarboxylase autoantibody
Echo echocardiography GALT gut-associated lymphoid tissue
ECOG Eastern Cooperative Oncology Group GAS Group A streptococcus
EDTA ethylenediamine tetra-acetic acid GBM glomerular basement membrane
EEG electroencephalogram GBS Guillain–Barré syndrome
EGDT early goal-directed therapy GCA giant cell arteritis
eGFR estimated glomerular function rate GCS Glasgow Coma Scale
EHEC enterohaemorrhagic Escherichia coli GFR glomerular filtration rate
EIA enzyme immunoassay GGO ground-glass opacity
ELISA enzyme-linked immunosorbent assay GH growth hormone
EMG electromyography GI gastrointestinal
ENA extractable nuclear antigen antibody GIST gastrointestinal stromal tumour
ENT ear, nose, and throat GMC General Medical Council
EOTR end-of-treatment response GN glomerulonephritis
EPAP expiratory positive airway pressure GnRH gonadotropin-releasing hormone
EPO erythropoietin GOLD Global Initiative for Chronic Obstructive Lung
EPP erythropoietic protoporphyria Disease
ePPi extracellular pyrophosphate GORD gastro-oesophageal reflux disease
EPR electronic patient record GOS Glasgow Outcome Score
EPS electrophysiological study GP general practitioner
ERCP endoscopic retrograde cholangiopancreatography GPA granulomatosis with polyangiitis
EROA effective regurgitant orifice area GPI glycosyl-phosphatidylinositol
ESC European Society of Cardiology GRA glucocorticoid-responsive aldosteronism
ESR erythrocyte sedimentation rate GU gastric ulcer
ESRD end-stage renal disease GUM genito-urinary medicine
xvii
mebooksfree.com
GvHD graft-vs-host disease IBD inflammatory bowel disease
HAART highly active antiretroviral therapy IBS irritable bowel syndrome
HAP hospital-acquired pneumonia IC intermittent claudication
HAS human albumin solution ICA islet cell autoantibody
HAV hepatitis A virus ICa,L L-type calcium current
Hb A adult haemoglobin ICD implantable cardioverter defibrillator
Hb A1c haemoglobin A1c (glycosylated haemoglobin) ICH intracranial haemorrhage
Hb F fetal haemoglobin ICP intracranial pressure
Hb haemoglobin ICU intensive care unit
HBc hepatitis B core protein ID infectious disease
HBeAg hepatitis B e antigen IDL intermediate-density lipoprotein
HBPM home blood-pressure monitoring IDU intravenous drug users
HBsAg hepatitis B surface antigen IE infective endocarditis
HBV hepatitis B virus IFD invasive fungal disease
HCC hepatocellular carcinoma IFN interferon
HCM hypertrophic cardiomyopathy IFN-alpha interferon alpha
HCV hepatitis C virus IgA immunoglobulin A
HD Huntington’s disease IgE immunoglobulin E
HDL high-density lipoprotein IgG immunoglobulin G
HDU high-dependency units IgM immunoglobulin M
HDV hepatitis D virus IGRA interferon gamma release assays
HER2 human epidermal growth factor receptor 2 IHD ischaemic heart disease
HEV hepatitis E virus IK1 inward rectifier potassium current
HF heart failure IKr rapidly activating component of the delayed rectifier
HFmrEF heart failure with mid-range ejection fraction potassium current
HFpEF heart failure with preserved ejection fraction IKs slowly activating component of the delayed rectifier
HFrEF heart failure with reduced ejection fraction potassium channel
Abbreviations
xviii
mebooksfree.com
KCO carbon monoxide transfer coefficient MDS myelodysplasia
KDIGO Kidney Disease: Improving Global Outcomes MDT multidisciplinary team
KEEP Kidney Early Evaluation Program MELAS mitochondrial encephalomyopathy with lactic
KS Kaposi’s sarcoma acidosis and stroke-like episodes
KSHV Kaposi’s sarcoma-associated herpesvirus MELD Model for End-Stage Liver Disease
LACS lacunar stroke MEN multiple endocrine neoplasia
LAD left anterior descending MERRF myoclonic epilepsy with ragged red fibres
LAE left atrial enlargement MG myasthenia gravis
LAVAT local anaesthetic video-assisted thoracoscopy MGUS monoclonal gammopathy of unknown significance
LBBB left bundle branch block MHC major histocompatibility complex
LBC liquid-based cytology MHRA Medicines and Healthcare Products
LBD Lewy body dementia Regulatory Agency
LBP low back pain MI myocardial infarction
LCIS lobular carcinoma in situ MIC minimum inhibitory concentration
LCSD left cervicothoracic sympathetic denervation MM malignant melanoma
LCX left circumflex artery MMA methylmalonic acidaemia
LDCT low-dose computed tomography MMR measles, mumps, rubella
LDH lactate dehydrogenase MMSE Mini-Mental State Examination
LDL low-density lipoprotein MND motor neuron disease
LEMS Lambert–Eaton myasthenia syndrome MOAI monoamine oxidase inhibitor
LET linear-energy transfer MODY maturity-onset diabetes of the young
LFT liver function test MOF multi-organ failure
LH luteinizing hormone MPO myeloperoxidase
LIMA left internal mammary artery MPS myocardial perfusion scan
LMN lower motor neuron MR mitral regurgitation
LMWH low-molecular-weight heparin MRA magnetic resonance angiography
LN lymph node MRA magnetic resonance angiography
Abbreviations
LOS lower oesophageal sphincter MRC Medical Research Council
LP lumbar puncture MRCP magnetic resonance cholangiopancreatography
LPA Lasting Power of Attorney MRI magnetic resonance imaging
LPP lichen planopilaris MRSA meticillin-resistant Staphylococcus aureus
LQTS long-QT syndrome MRV magnetic resonance venography
LR likelihood ratio MS multiple sclerosis
LSMDT local skin cancer multidisciplinary team MSE mental state examination
LT leukotriene MSF Mediterranean spotted fever
LTBI latent infection with Mycobacterium tuberculosis MSM men who have sex with men
LTNP long-term non-progressor MSU monosodium urate
LV left ventricular MSUD maple syrup urine disease
LVAD left ventricular assist device MTP metatarsophalangeal
LVEF left ventricular ejection fraction MTX methotrexate
LVESD left ventricular end-systolic diameter MUP minimum unit price
LVH left ventricular hypertrophy MuSK muscle-specific kinase
LVNC left ventricular non-compaction MUST Malnutrition Universal Screening Tool
LVOT left ventricular outflow tract NAAT nucleic acid amplification test
LVRS lung volume reduction surgery NAC N-acetylcysteine
MAC Mycobacterium avium complex NAD nicotinamide adenine dinucleotide
MALT mucosa-associated lymphoid tissue NADPH nicotinamide adenine dinucleotide phosphate
MAP mean arterial pressure NAFLD non-alcoholic fatty liver disease
MAT multifocal atrial tachycardia NAPQI N-acetyl-p-benzoquinone imine
MBL mannan-binding-lectin NASH non-alcoholic steatohepatitis
MCA middle cerebral artery NCRN National Cancer Research Network
MCandS microscopy, culture, and sensitivities NCS nerve conduction study
MCBT mindfulness-based cognitive therapy NEWS National Early Warning Score
MCH mean cell haemoglobin NFD nephrogenic fibrosing dermopathy
MCHC mean cell haemoglobin concentration NGT nasogastric tube
MCI mild cognitive impairment NHL non-Hodgkin’s lymphoma
MCP metacarpophalangeal NICE National Institute for Health and Care Excellence
MCV mean corpuscular volume NIHL noise-induced hearing loss
MDM multidisciplinary meeting NIHSS National Institutes of Health Stroke Scale
MDR multidrug-resistant NIPPV nasal intermittent positive pressure ventilation
xix
mebooksfree.com
NIV non-invasive ventilation PET positron emission tomography
NK natural killer PEX plasma exchange
NMO neuromyelitis optica PFT pulmonary function testing
NMS neuroleptic malignant syndrome PG prostaglandin
NP nosocomial pneumonia PH pulmonary hypertension
NPL no perception of light PHT pressure half-time
NRH nodular regenerative hyperplasia PI pancreatic insufficiency
NRT nicotine replacement therapy PIP proximal interphalangeal
NS nephrotic syndrome PISA proximal isovelocity surface area
NSAID non-steroidal anti-inflammatory drug PJP Pneumocystis jiroveci pneumonia
NSCLC non-small cell lung carcinoma PJRT persistent junctional reciprocating tachycardia
NSLBP non-specific low back pain PK pyruvate kinase
NSTEMI non-ST-elevation myocardial infarction PKU phenylketonuria
NSVT non-sustained ventricular tachycardia PL perception of light
NTA National Treatment Authority PLAX parasternal long-axis view
NTG glyceryl trinitrate (nitroglycerin) PLE polymorphic light eruption
NTM non-tuberculous mycobacteria PLMS periodic leg movements during sleep
NT-pro-BNP N-terminal brain natriuretic peptide PLS primary lateral sclerosis
NYHA New York Heart Association PML progressive multifocal leucoencephalopathy
OA osteoarthritis PML progressive multifocal leukoencephalopathy
OAC oral anticoagulation PMN polymorphonuclear
OCP oral contraceptive pill PMT pacemaker-mediated tachycardia
OCSP Oxfordshire Community Stroke Project PNH paroxysmal nocturnal haemoglobinuria
ODI oxygen desaturation index PNS peripheral nervous system
OGD oesophagogastroduodenoscopy POF premature ovarian failure
OHS obesity hypoventilation syndrome POI premature ovarian insufficiency
OLM ocular larva migrans POTS postural tachycardia syndrome
Abbreviations
xx
mebooksfree.com
RBV ribavirin SPECT single-photon emission computed tomography
RCC red-cell count SQTS short-QT syndrome
RCM restrictive cardiomyopathy SRH stigmata of recent haemorrhage
RCT randomized control trial SSP secondary spontaneous pneumothorax
RDT rapid diagnostic test SSRI selective serotonin reuptake inhibitor
REM rapid-eye-movement ssRNA single-stranded RNA
RF rheumatoid factor SSSS staphylococcal scalded skin syndrome
RFA radiofrequency ablation STD sexually transmitted disease
RIP Riyadh Intensive Care Programme STEMI ST-elevation myocardial infarction
RIPA ristocetin-induced platelet aggregation STI sexually transmitted infection
RNP ribonucleoprotein STIR short T1 inversion recovery
RNS repetitive nerve stimulation SUA serum uric acid
ROSIER Recognition of Stroke In the Emergency Room SUDEP sudden unexpected death in epilepsy
RPGN rapidly progressive glomerulonephritis SUNCT short-lasting neuralgiform headache with
RR relative risk conjunctival injection and tearing
RRT renal replacement therapy SV40 simian virus 40
RS reactive site SVC superior vena cava
RSV respiratory syncytial virus SVR sustained virologic response
RTA road traffic accident SVT supraventricular tachycardia
RUQ right upper quadrant SWEDD subjects without evidence of dopaminergic deficits
RV right ventricular T3 triiodothyronine
RVAD right ventricular assist device T4 thyroxine
RVOT right ventricular outflow tract TAA thoracic aortic aneurysm
RVOTO right ventricular outflow tract obstruction TACE trans-arterial chemo-embolization
SAA serum amyloid A protein TB tuberculosis
SAAG serum–ascites albumin gradient TBG thyroxine-binding globulin
SAB Staphylococcus aureus bacteraemia TBNA transbronchial needle aspiration
Abbreviations
SAECG signal-averaged electrocardiogram TCA tricyclic antidepressant
SAH subarachnoid haemorrhage TCR T-cell receptor
SAI secondary adrenal insufficiency TdP torsades de pointes
SALT speech and language therapists TE thromboembolism
SaO2 arterial oxygen saturation TFPI tissue factor pathway inhibitor
SAPS Simplified Acute Physiology Score TFT thyroid function test
SARS severe acute respiratory syndrome TGA transposition of the great arteries
SBP systolic blood pressure Th T helper
SCA sudden cardiac arrest Th2 T-helper type 2
SCC squamous cell carcinoma TIA transient ischaemic attack
SCD sudden cardiac death TIN tubulointerstitial nephritis
SCID severe combined immune deficiency TINU tubulointerstitial disease with uveitis
SCLC small cell lung carcinoma TIPS transjugular intra-hepatic portosystemic shunt
SCLE subacute cutaneous lupus erythematosus TK tyrosine kinase
ScvO2 central venous oxygen saturation TKI tyrosine kinase inhibitor
SD standard deviation TLC total lung capacity
SF synovial fluid TLCO transfer factor for carbon monoxide
SHBG sex hormone-binding globulin TLoC transient loss of consciousness
SIADH syndrome of inappropriate antidiuretic hormone TLR Toll-like receptor
excretion TLS tumour lysis syndrome
SIRS systemic inflammatory response syndrome TM tympanic membrane
SIV simian immunodeficiency virus TNFα tumour necrosis factor alpha
SLE systemic lupus erythematosus TNM tumour, node, and metastases
SLNB sentinel lymph node biopsy TOE transoesophageal echocardiography
SMA smooth muscle antibody TPMT thiopurine methyltransferase
SMART Specific, Measurable, Achievable, Realistic, TPO thyroid peroxidase
and Timed TPR total peripheral resistance
SMR standard mortality ratio TRH thyrotropin-releasing hormone
SNHL sensorineural hearing loss TRUS trans-rectal ultrasound
SNRT sinus node re-entrant tachycardia TSE transmissible spongiform encephalopathy
SOD sphincter of Oddi dysfunction TSH thyroid-stimulating hormone
SOFA Sequential Organ Failure Assessment TT thrombin time
SOV single-organ vasculitis TTE transthoracic echocardiography
xxi
mebooksfree.com
TTP thrombotic thrombocytopenic purpura VC vital capacity
TURBT trans-urethral resection of bladder tumour VCD vocal cord dysfunction
TURP trans-urethral resection of the prostate VCLAD very long-chain acyl-coenzyme A dehydrogenase
TWI T-wave inversion deficiency
UA undifferentiated arthritis VDRL Venereal Disease Research Laboratory
U&E urea and electrolytes VEGF vascular endothelial growth factor
UC ulcerative colitis VF ventricular fibrillation
UCD urea cycle disorder VGCC voltage-gated calcium channel
UDCA ursodeoxycholic acid VGKC voltage-gated potassium channel complex
UGIH upper gastrointestinal haemorrhage VKA vitamin K antagonist
UKPDS UK Prospective Diabetes Study VLDL very-low-density lipoprotein
UKRR UK Research Reserve VLM visceral larva migrans
ULN upper limit of normal VOC volatile organic compound
ULT urate-lowering therapy VPC premature ventricular complex
UMN upper motor neuron VQ ventilation–perfusion
UNSCEAR United Nations Scientific Committee on the Effects VSD ventricular septal defect
of Atomic Radiation VT ventricular tachycardia
URTI upper respiratory tract infection VTE venous thromboembolism
USRDS United States Renal Data System VUJ vesicoureteric junction
USS ultrasound scan VZV varicella zoster virus
UTI urinary tract infection WBC white blood cell
UUN urinary urea nitrogen WCC white-cell count
UV ultraviolet WG Wegener’s granulomatosis (granulomatosis with
UVA ultraviolet light A polyangiitis)
UVB ultraviolet light B WG–MPA Wegener’s granulomatosis–microscopic polyangiitis
VA effective alveolar volume WHO World Health Organization
VaD vascular dementia WPW Wolff–Parkinson–White syndrome
Abbreviations
xxii
mebooksfree.com
Contributors
mebooksfree.com
Elaine Buchanan Lucy Cottle
Consultant Physiotherapist, Oxford University Hospitals NHS Consultant Physician in Infectious Diseases, Leeds Teaching
Foundation Trust, Oxford, UK Hospitals NHS Trust, Leeds, UK
Professor of Clinical Cardiology and Consultant Cardiologist, Guy’s Consultant Rheumatologist, Kettering General Hospital NHS
and St Thomas’ NHS Foundation Trust, London UK Foundation Trust, Kettering, UK
Patrick Deegan
Metabolic Physician, Addenbrooke’s Hospital, Cambridge, UK
xxiv
mebooksfree.com
Alastair Denniston Sherif Gonem
Consultant Ophthalmologist, University Hospitals Birmingham National Institute for Health Research Clinical Lecturer in
NHSFT & Hon Professor, University of Birmingham, Respiratory Medicine, University of Leicester, Leicester, UK
Birmingham, UK
Lynsey Goodwin
Dhananjay Desai Specialist Trainee in Infectious Diseases and General Medicine,
Consultant Respiratory Physician, University Hospital Coventry, Royal Liverpool University Hospital, Liverpool and North
Coventry, UK Manchester General Hospital, Manchester, UK
Contributors
Birmingham, Birmingham, UK Yvonne Hart
Consultant Neurologist, Newcastle Upon Tyne NHS Foundation
Tom Fletcher Trust, Newcastle, UK
Wellcome Trust/Ministry of Defence Research Training
Fellow and Speciality Registrar in Infectious Diseases, Liverpool Catherine Harwood
School of Tropical Medicine, and Royal Liverpool University Professor in Dermatology and Honorary Consultant Dermatologist,
Hospital, Liverpool, UK Queen Mary University of London, London, UK
xxv
mebooksfree.com
Sarosh Irani Chris Lavy
Honorary Consultant Neurologist and Senior Clinical Fellow, John Professor of Orthopaedic and Tropical Surgery, and Consultant
Radcliffe Hospital, Oxford, UK Orthopaedic and Spine Surgeon, University of Oxford, Oxford, UK
xxvi
mebooksfree.com
Susan Mollan Joanna Pepke-Zaba
Consultant Ophthalmologist, University Hospitals Birmingham Consultant Respiratory Physician, Papworth Hospital, Papworth
NHSFT & Clinical Fellow, University of Birmingham, Everard, UK
Birmingham, UK
Erlick A. C. Pereira
Rhiain Morris Senior Lecturer in Neurosurgery, St George’s, University of London,
Clinical Psychologist, Oxfordshire Counselling and Psychology London, UK, and Consultant Neurosurgeon, St George’s Hospital,
Practice, Oxford, UK London, UK
Contributors
Trust, Northampton, UK
Norman Qureshi
Abdul Nasimudeen
Consultant Cardiologist and Electrophysiologist, Imperial College
Consultant Chest Physician, Northampton General Hospital NHS
Healthcare NHS Trust, London, UK
Trust, Northampton, UK
Kazem Rahimi
Pavithra Natarajan
Professor of Medicine, University of Oxford, Oxford, UK
Consultant in Infectious Diseases, North Manchester General
Hospital, Manchester, UK Kim Rajappan
Consultant Cardiologist, John Radcliffe Hospital, Oxford, UK
John Newell-Price
Professor of Endocrinology and Consultant Endocrinologist, Tommy Rampling
University of Sheffield, Sheffield, UK Academic Clinical Fellow, University College London, London, UK
Jim Newton James Ramsden
Consultant Cardiologist, Oxford University Hospitals NHS Consultant ENT Surgeon, John Radcliffe Hospital, Oxford, UK
Foundation Trust, Oxford, UK
Anna Rathmell
Pippa Newton Medical Manager, Takeda UK Ltd, Wooburn Green, UK, and Lay
Consultant in Infectious Diseases, Manchester University NHS Member, South Central–Oxford C Research Ethics Committee,
Foundation Trust, Manchester, UK Bristol, UK
Kannan Nithi David Ratliff
Consultant Neurologist and Neurophysiologist, Northampton Consultant Vascular Surgeon, Northampton General Hospital NHS
General Hospital NHS Trust, Northampton, UK Trust, Northampton, UK
Christopher A. O’Callaghan Karim Raza
Professor of Medicine and Honorary Consultant Physician and Professor of Clinical Rheumatology, University of Birmingham,
Nephrologist, University of Oxford, Oxford, UK Birmingham, UK
Liz Orchard Dave Riley
Consultant Cardiologist, John Radcliffe Hospital, Oxford, UK Palliative Medicine Consultant and Clinical Director,
Northamptonshire Healthcare NHS Foundation Trust,
Rakesh Panchal
Northampton, UK
Consultant Respiratory Physician, Glenfield Hospital, Leicester, UK
Simon Rinaldi
Manish Pareek
MRC Clinician Scientist and Honorary Consultant Neurologist,
Senior Clinical Lecturer in Infectious Diseases, University of
University of Oxford, Oxford, UK
Leicester, Leicester, UK, and Honorary Consultant in Infectious
Diseases, Leicester Royal Infirmary, Leicester, UK
xxvii
mebooksfree.com
Joanna Robson Christine Soon
Consultant Senior Lecturer in Rheumatology, University of Consultant Dermatologist, Northampton General Hospital NHS
the West of England, Bristol, UK Trust, Northampton, UK
xxviii
mebooksfree.com
Jaime Vera, Pippa Watson
Clinical Senior Lecturer, Brighton and Sussex Medical School, Consultant Rheumatologist, University Hospital of South
Brighton, UK Manchester, Manchester, UK
Contributors
xxix
mebooksfree.com
mebooksfree.com
Figure 87.8 Myocardial perfusion imaging with single-photon emission computed tomography (SPECT): An example of inducible hypoperfusion in
the anterior wall and apex. Panels, from left to right, show representative vertical long-axis (VLA), horizontal long-axis (HLA), and mid short-axis (SAX)
slices, with stress above rest. The white arrows show a perfusion defect which is present on the stress slices but which resolves at rest.
Reproduced with permission from Warrell, Cox and Firth, Oxford Textbook of Medicine, fifth edition, Oxford University Press, Oxford, UK, Copyright © 2010
Figure 87.9 CT coronary angiography showing a critical soft plaque stenosis in the left main stem.
Reproduced with permission from Warrell, Cox and Firth, Oxford Textbook of Medicine, fifth edition, Oxford University Press, Oxford, UK, Copyright © 2010
mebooksfree.com
Figure 87.11 To assess the fractional flow reserve, which is the ratio of the pressures distal to and proximal to a stenosis, a small flexible wire with
two separate pressure sensors is placed across a candidate coronary artery stenosis. Under resting conditions (A), there is only a 10 mm Hg gradient
(ΔP) across the lesion but, under maximal hyperaemia (‘adenosine i.v.’; B), the gradient increases markedly to 33 mm Hg, with a mean distal-to-
proximal pressure ratio of 0.56. Thus, in this case, the fractional flow reserve indicates the presence of a functionally significant stenosis, and coronary
angioplasty is indicated; FFR, fractional flow reserve; i.v., intravenous.
mebooksfree.com
Figure 155.3 Normal glomerulus and glomerular filtration barrier under light and electron microscopy; note the glomerular basement membrane
(G), with endothelial cells (E) at its upper edge, and the foot processes of the podocytes (P) abutting its lower edge.
image courtesy of Ian Roberts
(A) (B)
Figure 157.1 Microscopic haematuria. (A) Isomorphic red cells. Isomorphic red cells are seen in non-glomerular haematuria. (B) Dysmorphic red
cells. Dysmorphic red cells are seen in glomerular haematuria, but may also be found in non-glomerular and tubulointerstitial disease.
Reproduced with permission from Davidson et al, Oxford Textbook of Clinical Nephrology, Third Edition, Oxford University Press, Oxford, UK, Copyright © 2005
mebooksfree.com
(A)
(B)
mebooksfree.com
(A) (B)
(C)
Figure 157.3 (A) Red cell cast; inset: haemoglobin cast. Red cell casts are typically seen in glomerulonephritis. (B) Epithelial cell cast. Epithelial cell
casts may be seen in glomerular and tubular disease. (C) White cell cast; individual white cells (arrows) are clearly seen. White cell casts may be seen
in pyelonephritis and tubulointerstitial disease.
Reproduced with permission from Davidson et al, Oxford Textbook of Clinical Nephrology, Third Edition, Oxford University Press, Oxford, UK, Copyright © 2005.
mebooksfree.com
Figure 158.1 Urinary bacteria (rods).
Reproduced with permission from Davidson et al, Oxford Textbook of Clinical Nephrology,
Third Edition, Oxford University Press, Oxford, UK, Copyright © 2005
mebooksfree.com
Figure 159.1 Histology of renal biopsy. (A) IgA nephropathy showing mesangial hypercellularity in which there are at least four mesangial cells
in a peripheral mesangial area (periodic acid-Schiff stain). (B) Postinfectious glomerulonephritis showing endocapillary hypercellularity, in which the
capillary lumina are filled with infiltrating leucocytes (hematoxylin and eosin stain (H&E)). (C) Antiglomerular basement membrane disease, showing
extracapillary proliferation (a cellular crescent), in which there is partial tuft collapse and proliferation of cells within Bowman’s space (H&E and silver).
(D) ANCA-associated vasculitis, showing necrosis with capillary wall rupture and fibrin exudation (H&E and silver). (E, F) Membranoproliferative
pattern, showing a lobular appearance of the glomerular tuft, with mesangial hypercellularity and thickened capillary walls, with glomerular basement
membrane duplication evident on the silver stain (H&E and silver).
Reproduced with permission from Turner, Oxford Textbook of Clinical Nephrology, Fourth Edition Oxford University Press, Oxford, UK, Copyright © 2015
mebooksfree.com
Figure 159.2 Immunofluorescence of renal biopsy. (A) Linear glomerular basement membrane (GBM) positivity for IgG in anti-GBM disease.
(B) Granular capillary wall positivity for IgG in membranous nephropathy. (C) Mesangial positivity for IgA in IgA nephropathy. (D) Mesangial and
capillary wall positivity for C3 in C3 glomerulonephritis. (E) Mesangial and tubular basement membrane positivity for kappa light chains in light chain
deposition disease. (F) Positivity for lambda light chains in tubular casts in light chain cast nephropathy.
Reproduced with permission from Turner, Oxford Textbook of Clinical Nephrology, Fourth Edition Oxford University Press, Oxford, UK, Copyright © 2015
mebooksfree.com
Figure 160.1 Cast nephropathy.
Reproduced with permission from Turner et al, Oxford Textbook of Clinical Nephrology,
Fourth Edition, Oxford University Press, Oxford, UK, Copyright © 2015
mebooksfree.com
(A)
(B)
(C) (D)
(E)
Figure 161.2 Renal biopsy images from nephrotic patients. (A) Sub-epithelial spikes (arrow) on silver stain in membranous nephropathy. (B) Granular
IgG on immunofluorescence in membranous nephropathy. (C) Focal segmental glomerulosclerosis (indicated by SGS). (D) Normal podocytes.
(E) Podocyte effacement on electron microscopy.
images courtesy of Ian Roberts
Reproduced with permission from Turner et al, Oxford Textbook of Clinical Nephrology, Forth Edition, Oxford University Press, Oxford, UK, Copyright © 2015
mebooksfree.com
Figure 164.2 Renal biopsy demonstrating nodular (indicated by ‘N’)
glomerulosclerosis..
Reproduced with permission from Turner et al, Oxford Textbook of Clinical Nephrology,
Fourth Edition, Oxford University Press, Oxford, UK, Copyright © 2015
(A) (B)
(C) (D)
Figure 168.1 (A) A tunnelled, dual-lumen dialysis catheter. (B) A left brachiocephalic arteriovenous fistula, showing arterial and venous needles in
situ. (C) A Tenckhoff catheter. (D) An automated peritoneal dialysis machine and a dialysate bag; A, area of arteriovenous anastomosis; ES, exit site; T,
subcutaneous tunnel from point of insertion in internal jugular vein.
mebooksfree.com
Figure 168.2 An anastomosed transplanted kidney.
Figure 181.1 Amyloid deposition (amorphous material; boxed area) in a lymph node in amyloid light-chain amyloidosis.
mebooksfree.com
Figure 192.1 Hands of a patient with acromegaly.
mebooksfree.com
Figure 260.1 Erythema nodosum, with painful bruise-like lesions on
the shins.
From: Ethnic Dermatology: Clinical Problems and Skin Pigmentation, Archer CB, Copyright
2008, Informa Healthcare, reproduced by permission of Taylor & Francis Books UK
mebooksfree.com
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of Modern cookery
for private families
This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.
Language: English
F O R P R I VAT E FA M I L I E S
BY ELIZA ACTON
NEW EDITION
LONDON
LONGMANS, GREEN, READER, AND DYER
1882.
PREFACE.
Farce—forcemeat.
Fondu—a cheese soufflé.
Nouilles—a paste made of yolks of egg and flour, then cut small like
vermicelli.
Sparghetti—Naples vermicelli.
Stock—the unthickened broth or gravy which forms the basis of
soups and sauces.
Zita—Naples maccaroni.
TABLE OF CONTENTS.
CHAPTER I.
SOUPS.
Page