Part I:The Patient Presents With 1
1.Indigestion 3
History of the patient with indigestion 3
Preface 3
Examining the patient with indigestion 5
Investigating indigestion 6
Acknowledgements 7
Differential diagnosis 9
History of the patient with swallowing problems 9
2.Swallowing Problems 9
Dedication 9
Examining the patient with swallowing problems 11
Investigating swallowing problems 11
3.Acute Abdominal Pain 15
History of the patient with acute abdominal pain 15
Examining the patient with acute abdominal pain 16
Investigating acute abdominal pain 17
History of the patient with chronic abdominal pain 21
4.Chronic Abdominal Pain 21
Examining the patient with chronic abdominal pain 22
Investigating chronic abdominal pain 22
5.Abdominal Distension 25
History of the patient with abdominal distension 25
Examining the patient with abdominal distension 25
Investigating abdominal distension 26
6.Weight Loss and Anorexia 29
History of the patient with weight loss 29
Examining the patient with weight loss 29
Investigating weight loss 30
7.Vomiting 33
History and differential diagnosis of vomiting 33
Examining the patient with vomiting problems 34
Investigating vomiting problems 34
8.Haematemesis and Melaena 37
History of the patient with haematemesis 37
Investigating haematemesis 38
Examining the patient with haematemesis 38
9.Diarrhoea 41
History of the patient with diarrhoea 41
Examining the patient with diarrhoea 42
Investigating diarrhoea 42
10.Rectal Bleeding 45
History of the patient with rectal bleeding 45
Examining the patient with rectal bleeding 45
Investigating rectal bleeding 46
History of the patient with anaemia 47
11.Anaemia 47
Examining the patient with anaemia 48
Investigating anaemia 49
12.Jaundice 51
History of the patient with jaundice 51
Examining the patient with jaundice 52
Investigating jaundice 52
Part II:History, Examination, and Common Investigation 52
Examining the patient with abnormal liver biochemistry 55
History of the patient with abnormal liver biochemistry 55
13.Abnormal Liver Biochemistry 55
Investigating abnormal liver biochemistry 56
14.Taking a History 61
The standard structure of a history 61
15.Examination of the Patient 65
Face 65
Hands 66
Neck, thorax, and upper limbs 67
Abdominal examination 68
Lower limb 68
Back 68
Rectal examination 70
Rectal examination technique 70
16.Writing Up A Medical Clerking 73
Purpose 73
Structure 73
Illustration 73
Sample medical clerking 74
Continuity 74
Formulating a differential diagnosis 74
Investigation 74
17.Common Investigations 77
Routine investigations 77
Biochemistry 79
Endocrine and metabolic tests 79
Liver enzymes and liver function tests 81
Liver biopsy 83
Tests of pancreatic function 84
Breath tests 84
Motility physioloqy 85
Serology tests 86
Genetic markers 88
Imaging 89
Anatomy, physiology, and function of the oesophagus 99
Inflammatory conditions 99
18.Oesophagus 99
Neoplasia 103
Anatomical and functional problems 106
Anatomy, physiology, and function of the stomach 109
Acute gastritis 109
19.Stomach 109
Peptic ulcer disease 111
Neoplasia of the stomach 115
Functional and anatomical problems 118
Postgastric surgery complications 119
20.Small Intestine 123
Anatomy, physiology, and function of the small intestine 123
Immune-related problems 124
Neoplastic problems 128
Infections 130
Anatomy, physiology, and function of the colon and rectum 135
Functional disorders 135
21.Colon 135
Inflammatory bowel disease 137
Neoplastic disorders 141
Part III:Diseases and Disorders 141
Anorectal conditions 145
Infections 148
22.Liver 151
Structure and function of the liver 151
Hyperbilirubinaemias 151
Viral hepatitis 153
Other infections involving the liver 159
Metabolic and genetic liver disease 160
Chronic liver disease 163
Cirrhosis 169
Tumours of the liver 175
Drugs and the liver 176
Liver abscesses 179
Parasitic infection of the liver 180
Polycystic liver syndromes 182
Gallstones 183
Anatomy, physiology, and function of the hepatobiliary system 183
23.Biliary Tract 183
Tumours of the biliary tract 187
Benign anatomical bile duct problems 188
Infections of the biliary tract 189
24.Pancreas 191
Anatomy, physiology, and function of the pancreas 191
Acute pancreatitis 191
Chronic pancreatitis 193
Pseudocysts 194
Cystic fibrosis 195
Tumours of the pancreas 195
Part IV:Self-assessment 199
Multiple-choice Questions 201
Short-answer Questions 206
Essay Questions 208
MCQ Answers 209
SAQ Answers 210
Index 213