风暴式医学教程 内科学PDF电子书下载

Part I:The Patient Presents With 1

History in the patient with chest pain 3

Preface 3

1.Chest Pain 3

Introduction 3

Differential diagnosis of chest pain 3

Investigating the patient with chest pain 4

Examining the patient with chest pain 4

Acknowledgements 4

2.Shortness of Breath 9

Introduction 9

History in the patient with breathlessness 9

Dedication 10

Examining the patient with breathlessness 10

Investigating the patient with breathlessness 12

History 15

Differential diagnosis by description of the rhythm 15

Introduction 15

3.Palpitations 15

Consequences of palpitations 16

Examining the patient with palpitations 16

Investigating the patient with palpitations 17

4.Heart Murmurs 19

Introduction 19

Differential diagnosis of heart murmurs 19

History in the patient with heart murmurs 20

Examining the patient with heart murmurs 20

5.Cough and Haemoptysis 25

Introduction 25

Differential diagnosis of cough and haemoptysis 25

History in the patient with cough and haemoptysis 25

Examining the patient with cough and haemoptysis 26

Investigating the patient with cough and haemoptysis 27

Examing the patient with PUO 29

History in the patient with PUO 29

Investigating the patient with PUO 29

Introduction 29

6.Pyrexia of Unknown Origin 29

Causes 29

7.Haematemesis and Melaena 33

Introduction 33

Differential diagnosis of haematemesis and melaena 33

History in the patient with haematemesis and melaena 33

Examining the patient with haematemesis and melaena 34

Investigating the patient with haematemesis and melaena 35

8.Change in Bowel Habit 37

Introduction 37

Differential diagnosis of a change in bowel habit 37

History in the patient with a change in bowel habit 38

Examining the patient with a change in bowel habit 38

Investigating the patient with a change in bowel habit 38

Introduction 41

Differential diagnosis of weight loss 41

9.Weight Loss 41

History in the patient with weight loss 42

Examining the patient with weight loss 42

Investigating the patient with weight loss 43

10.Jaundice 45

Introduction 45

Differential diagnosis of jaundice 45

History in the patient with jaundice 45

Examining the patient with jaundice 47

Investigating the patient with jaundice 48

11.Abdominal Pain 51

Introduction 51

Differential diagnosis of abdominal pain 51

History in the patient with abdominal pain 52

Examining the patient with abdominal pain 52

Investigating the patient with abdominal pain 53

Differential diagnosis of polyuria 55

12.Polyuria and Polydipsia 55

Introduction 55

History in the patient with polyuria or polydipsia 56

Examining the patient with polyuria or polydipsia 57

Investigatig the patient with polyuria and polydipsia 58

13.Haematuria and Proteinuria 61

Introduction 61

Differential diagnosis of haematuria and proteinuria 61

History in the patient with haematuria and proteinuria 62

Investigating the patient with haematuria and proteinuria 63

Examining the patient with haematuria and proteinuria 63

14.Hypertension 67

Introduction 67

Differential diagnosis of hypertension 67

History in the patient with hypertension 67

Examining the patient with hypertension 68

Investigating the patient with hypertension 69

History in the patient with headache or facial pain 71

Differential diagnosis of headache and facial pain 71

15.Headache and Facial Pain 71

Introduction 71

Examining the patient with headache or facial pain 73

Investigating the patient with headache or facial pain 73

16.Joint Disease 77

Differential diagnosis of jointdisease 77

History in the patient with joint disease 77

Examining the patient with joint disease 78

Investigating the patient with joint disease 79

17.Skin Rashes 81

Differential diagnosis by appearance 81

History in the patient with skin rashes 83

Examining the patient with skin rashes 83

Investigating the patient with skin rashes 85

History in the patient with loss of consciousness 87

Differential diagnosis of loss of consciousness 87

Introduction 87

18.Loss of Consciousness 87

Examining the patient with loss of consciousness 88

Investigating the patient with loss of consciousness 89

19.Confusional States 93

Introduction 93

Differential diagnosis of confusion 93

History in the confused patient 93

Examining the confused patient 94

Investigating the confused patient 95

20.Acute Neurological Deficit 97

Introduction 97

Differential diagnosis of stroke 97

History in the stroke patient 98

Examining the stroke patient 98

Investigating the stroke patient 99

History in the patient with lymphadenopathy or splenomegaly 103

Differential diagnosis of lymphadenopathy and splenomegaly 103

Introduction 103

21.Lymphadenopathy and Splenomegaly 103

Examining the patient with lymphadenopathy and splenomegaly 104

Investigating the patient with lymphadenopathy and splenomegaly 106

22.Sensory and Motor Neurological Deficits 109

Introduction 109

Differential diagnosis of sensory and/or motor neurological deficits 109

History in the patient with sensory and/or motor neurological deficits 110

Examining the patient with sensory and/or motor neurological deficits 111

Investigating the patient with sensory and/or motor neurological deficits 113

23.Bruising and Bleeding 115

Introduction 115

Differential diagnosis of bleeding or bruising 115

History in the patient with bleeding and bruising 115

Examining the patient with bleeding and bruising 116

Investigating the patient with bleeding and bruising 117

History in the patient with vertigo 121

Differential diagnosis in the patient with vertigo or dizziness 121

24.Vertigo and Dizziness 121

Introduction 121

Examining the patient with vertigo 123

Investigating the patient with vertigo 123

25.Anaemia 125

Introduction 125

Differential diagnosis of anaemia 125

History in the anaemic patient 125

Examining the anaemic patient 127

Investigating the anaemic patient 127

Part II:History, Examination, and Common Investigations 131

26.Taking a History 133

General principles--the bedside manner 133

The history 133

Presenting complaint 133

History of presenting complaint 133

Systems review 134

Previous medical history 134

Drug history 138

Family history 139

Social history 140

27.Examination of the Patient 143

Introduction 143

First things first 143

General inspection 143

The face and body habitus 144

The neck 145

The hands 146

The cardiovascular system 148

The respiratory system 151

The abdomen 154

The nervous system 157

The joints 167

The skin 167

Medical sample clerking 169

28.The Clerking 169

Introduction 169

29.Common Investigations 173

Introduction 173

The cardiovascular system 173

The respiratory system 177

The gastrointestinal system 181

The urinary system 183

The nervous system 184

Metabolic and endocrine disorders 184

Musculoskeletal and skin disease 189

Haematological disorders 189

Part III:Diseases and Disorders 193

30.Cardiovascular System 195

Ischaemic heart disease 195

Myocardial infarction 200

Arrhythmias 206

Heart failure 211

Hypertension 215

Valvular heart disease 220

Miscellaneous cardiovascular conditions 222

31.Respiratory Disease 231

Asthma 231

Chronic bronchitis and emphysema 235

Tuberculosis 237

Lung cancer 240

Pneumonia 244

Respiratory failure 246

Miscellaneous respiratory conditions 248

32.Gastrointestinal and Liver Disease 253

Peptic ulcer disease 253

Gastrointestinal haemorrhage 254

Inflammatory bowel disease 256

Crohn s disease 259

Gastrointestinal tumours 260

Malabsorption 262

Diseases of the gallbladder 264

Diseases of the pancreas 265

Acute viral hepatitis 267

Chronic liver disease 269

Miscellaneous gastrointestinal disorders 273

33.Genitourinary System 275

Glomerular disease 275

Acute renal failure 278

Chronic renal failure 280

Urinary tract infection 283

Fluid and electrolyte balance 284

Miscellaneous genitourinary conditions 287

34.Central Nervous System 289

Cerebrovascular disease 289

Management of conditions causing headache 293

Parkinsonism 296

Multiple sclerosis 299

Meningitis 301

Epilepsy 303

Infracranial tumours 306

Miscellaneous neurological disorders 307

35.Metabolic and Endocrine Disorders 311

Diabetes 311

Lipid disorders 317

Metabolic bone disease 319

Hyperparathyroidism 324

Hypoparathyroidism 325

Crystal arthropathy 325

Hypercalcaemia 327

Pituitary disorders 327

Thyroid disorders 331

Disorders of the adrenal glands 336

Miscellaneous endocrine conditions 339

36.Musculoskeletal and Skin Disorders 341

Arthritis 341

Osteoarthritis 343

Systemic lupus erythematosus 346

Polymyalgia rheumatica 348

Other connective tissue disorders 349

Primary skin diseases 353

Skin manifestations of systemic disease 355

Malignant skin tumours 357

37.Haematological Disorders 359

Anaemia 359

Leukaemias 367

Multiple myeloma 370

Malignant lymphomas 371

Bleeding disorders 374

Disseminated intravascular coagulation 375

Thrombotic disorders 376

Introduction 379

HIV and AIDS 379

38.Infectious Diseases 379

Malaria 382

39.Drug Overdose 387

Epidemiology 387

Aetiology 387

Presentation 387

Management 388

Investigations 388

Part IV:Self-assessment 391

Multiple-choice questions 393

Short-answer questions 399

Case-based questions 400

MCQ answers 401

SAQ answers 402

Index 405