Index to Davidson Principles and Practice of Medicine - 2

Hodgkin's lymphoma 1049, 1050, 1051 platinum-based 710 prostate cancer 512 side-effects 265, 266-267 solid tumours 269, 270, 271 tuberculosis 700-70 I HIV / AIDS patients 702 Chemobyl nuclear power explosion 99 Chest examination febrile patient 284, 291,292 liver and biliary disease 936 Chest pain ankylosing spondylitis 1107 cardiac disease 534-539 aortic dissection 607 differential diagnosis 536-537 initial evaluation of suspected pain 537-539 ischaemic 535- 536 differential diagnosis 536-537, 661,662 gastrointestinal causes 536 musculoskeletal 535, 536, 537 neurological causes 536 psychological causes 535, 536-537 respiratory causes 535, 536, 537, 662 systemic lupus erythematosus 1134 Chest radiography/X-ray cardiovascular disorders aortic diseases 606, 607, 625, 627 chronic constrictive pericarditis 646 congenital 637, 638 heart failure 542, 547, 646 mitral valve 620, 622 myocardial infarction 594 cardiovascular system 529- 530 cerebral tumours 1237 respiratory disease 653 aspergillosis 703, 704 asthma 675 bronchial carcinoma 706, 709 bronchial obstruction/lung collapse 707, 708 bronchiectasis 685 chronic ob tructive pulmonary disease 680 haemoptysis 663 HTV-related pulmonary disease 389,390,391 interstitial 714, 715, 716, 717, 718,719 mediastinal tumours 712, 713 pleural 665,732, 734, 735 pleural effusion 664 665 Pllellmocysfis carillii pneumonia 389, 390 pneumonia 690, 691, 692-693, 694 pulmonary embolism 725, 726 solitary pulmonary lesion 663-664 tuberculosis 390, 391, 696-697, 698 Chest wall deformities 736-737 diseases 660 Cheyne-Stokes respiration 540 Chickenpox 305 immunisation 305 immunocompromised patients 1042 incubation period 135 period of infectivity 135 pneumonia 689. 690 prophylaxis 137 rash 305 Chiclero's ulcer 298, 353 Chilblains 102 Child-Pugh classification, cirrhosis prognosis 956, 957 Chi Idbirth, associated psychiatric disorders 251 Chiropractic 15 Chlamydia pllell11l0lliae 341, 689, 690,691 Chlamydia psillaci 341, 690 ChLamydia frac/wmafis 341, 406, 416 Chlamydial infection 341, 406, 407, 409,415 women 415 Chloasma 1281 Chlorambucil chronic lymphocytic leukaemia 1046 Hodgkin's disease 1049 rheumatic disease 1093, 1094 side-effects 1093, 1094 Waldenstrom's macroglobulinaemia 1052 Chloramphenicol 144, 153 adverse reactions 153 contraindication, renal insufficiency 27 effect of hepatic impairment 27 enteric fever 325 melioidosis 325 meningitis 1227 plague 323 rickettsial fevers 340 upper respiratory tract infection 688 Chloride 421 cerebrospinal fluid 1324 reference values, venous blood 1318 urine concentration 434 Chloroquine adverse reactions 30 contraindication, renal insufficiency 27 hyperpigmentation from 1281 hyper-reactive malarial splenomegaly 296 leprosy reactions 338 malaria 347 prevention 347, 348 poisoning 211 porphyria 453 resistance to 343, 346, 347 Chlorphenamine anaphylaxis 87 pruritus 1267 Chlorphenamine maleate 731 Chlorproguanil 347 Chlorproma!ine 243, 244 diarrhoea 295 hepatotoxicity 973 poisoning 212 rabies 1229 Chlorpropamide 832 effect of renal insufficiency 27 ChlVPP regimen, Hodgkin's disease 1049 Cholangiocarci noma 941, 980, 981, 995,996 Cholangiography 941-942, 994, 995 biliary cirrhosis 979 endoscopic retrograde (ERC) 994 percutaneous transbepatic (PTC) 941-942 sclerosing cholangitis 980. 981 Cholangiopancreatography endoscopic retrograde see ERCP magnetic resonance see MRCP Cholangitis 946, 947, 986 acute 994 autoimmune 980 biliary cirrhosis 978 primary sclerosing 943 recurrent pyogenic 995 sclerosing 980-982 stone disease 994 Cholecalciferol 123, 1127, 1128 Cholecystectomy 994, 997 pancreatitis 906 post-cholecystectomy syndrome 996 Cholecystitis 993-995 acute 874, 993-994 chronic 994 gallstones 992 Cholecystography, oral 997 Cholecystokinin (CCK) 854, 855, 857,859,990 Cholecystolithiasis 992 Choledochal cysts 989 Choledochojejunostomy 910 Choledocholithiasis 992, 994-995 Choledochoscopy 995 Cholera 141, 330 fluid loss 294 immunisation 138, 139 incubation period 135 Cholera sicca 330 Cholestasis benign recurrent intrahepatic 946 biliary cirrhosis 979 drug-induced 973 obstetric 1267 pregnancy 947, 987 pruritus 1267 sclerosing cholangitis 980, 981 Cholestatic jaundice 946-947 Cholesterol 854 and cardiovascular disease 446 dietary 110, II I, 449 gallstones 991-992 low-density lipoprotein 40 lowering atherosclerosis prevention 580, 581 coronary heart disease 587 myocardial infarction 599 peripheral vascular disease 602 plasma 443, 444 atherosclerotic vascular disease and 580 diet 44 measurement 446 target levels 449 reFerence values, venous blood 1320 reverse transport 445 see also Hypercholesterolaemia Cholesterol absorption inhibitors 450 Cholesterol atheroembolism 462. 499 Cholesterolosis, gallbladder 997 Choliangoles 939 Cholinergic syndrome, acute, organophosphate poisoning 217-218,219-220 Chondrocalcinosis 776, 1073, 1100, 1115-1116 Chondrocytes 1069, 1070-1071 osteoarthritis 1097 Chondroitin sulphate 1070, 1092 Chondromalacia patellae 1081 CHOP regimen, non-Hodgkin's lymphoma 1051 Chorea 1182 Huntington's disease 1222 Chorion villus sampling (CVS) 1057 Chorionic villus biopsy 57 Choroid plexus I 151 Christmas disease (haemophilia 8) 52, L018, 1060 Chromatography 420 Chromium 127 Chromogranin A 791-792 Chromomycosis (chromoblastomycosis) 373 Chromosomal disorders 46-47, 50-51,53-59 Chromosome X abnormalities 47 inactivation 1057 see also X-linked ... Chromosomes 38 analysis, acute leukaemia 1041 deletions 47, 48 detection of abnormalities 50-5 I sex 38 abnormali ties 47 translocations 47-48 Chronic bronchitis 678, 679 respiratory Function abnormalities 657 Chronic fatigue syndrome 250 toxopla~mosis 358 Chronic interstitial nephritis (ClN) 505-506 drug induced 517 Chronic obstructive pulmonary disease (COPD) 678-684 circulatory measurements 186 clinical features 679-680 exertional dyspnoea 659-660 epidemiology 678 exacerbations 683-684 acute 661 investigations 680-681 management 681-683 older people 684 pathophysiology 678-679 prognosis 683 respiratory failure 668, 669, 670 risk factors 678-679 signs 649 Chronic relapsing syndrome 308 Chronic renal failure (CRF) see Renal failure, chronic CHRPE (congenital hypertrophy of retinal pigment epithelium) 925 Chrysops, loiasis 365 Churg- Strauss syndrome (CSS) 643, 723, 1139, 1141 Chvostek's sign 440, 775 Chylomicrons 444, 445, 854 Chyluria, lymphatic filariasis 364 Chymotrypsin, faecal 863 Chymotrypsinogen 855, 856 Ciclosporin adverse reactions 30 aplastic anaemia 1054 asthma 676 immunosuppression 550 inflammatory bowel disease 917, 918 liver transplant patients 990 myositis I 137 nephrotoxicity 517 plasma concentrations 34 psoriasis 1291 pyoderma gangrenosum 1309 renal transplantation patients 495 Ciclosporin (coll/'d) rheumatic disease 1093, 1094 side-effects 1093 systemic lupus erythematosus 1134 Cidofovir 157, 389, 393 Ciguatera poisoning 225, 226 Ciguatoxin 331 Cilia 651 Ciliary dysfunction syndrome 684, 685 Ciliary dysmotility syndrome 652 Ciliary function, assessment 685 Ci lostazol 602 Cimetidine effect of renal insufficiency 27 peptic ulcer/dyspepsia 889 urticaria 127 I CIN (chronic interstitial nephritis) 505-506 drug induced 517 Ciprotloxacin 151, 152 anthrax 333 bacillary dysentery 331 bronchiectasis 685 cellulitis 1295 cholera 330 enteric fever 325 food poisoning 328 intlammatory bowel disease 919 intestinal bacterial overgrowth 897 meningococcal infection ~ 1227-1228 Mrcobacterium lIl'ium illlracellulare 389, 390 plague 323 prophylactic 137 spontaneous bacterial peritonitis 950 sexually transmitted infection chancroid 416 gonococcal 414 staphylococcal endocarditis, injecting drug user 293 urinary tract infection 469 variceal bleeding 959 Circulation changes at birth 635 coronary 522-523 critically ill patients management 191-192 monitoring 179-182 effects of vasoactive drug infusions In enterohepatic 854 fetal 633---<>34 portal 458 Circulatory failure (shock) 186-187 acute 540-542, 598 management 191-192 for detailed elltry see Shock Circumtlex artery (CX) coronary circulation 522, 523, 524 occlusion 524 Cirrhosis 938, 954-956 alcoholic 954, 969, 970, 971 ascites 948, 949 biliary 954, 977, 978-980 investigations 943 older people 986 cardiac 983 causes 954 cryptogenic 977 drugs to avoid 974 haemochromatosis and 974, 975 hepatic encephalopathy 951 hepatocellular carcinoma 983-984 non-alcoholic fatty liver disease 971, 973 prognosis 956-957 renal failure and 949 viral hepatitis 967 Cisapride 22 Cisplatin 266, 270 bronchial carcinoma 710 ECF, gastric cancer 893 nephrotoxicity 517 testicular tumours 771 toxicity 267 Citalopram 241 Cl D see Creutzfeld-lakob disease CK see Creatine kinase C1adophialopl/Ora carriollii 373 Cladribine 1047 Clarithromycin 150 Helicobacter p)'lori eradication 887,888 leprosy 337 pneumonia 692 HIV/AIDS patients 390 Clatharin-coated pits 40 Claude's syndrome I 192 Claudication arm 603 cauda equina 1243 intermittent 602 Claw foot 1082 CLI (critical limb ischaemia) 602-603 Climacteric 763 Climate change 97 Clindamycin 150 acne vulgaris 1300 babesiosis 348 bacterial vaginosis 409 Clostridium dijJiile infection 931 infective endocarditis 633 Plleumoc),stis carillii pneumonia 390 prophylactic 147 soft tissue infections 315, 316 toxoplasmosis, HIV-related 393 Clinical trials 20- 21 N-of-one (controlled single-patient) 21 CLM (cutaneous larva migrans) 298,367 CLO (columnar lined oesophagus) 879-880, 883 Clobazam I 172, I 174 Clobetasol propionate 1313 Clobetasone butyrate 1313 Clodronate 1143 Clofazimine hyperpigmentation from 1281 leprosy 337 Clomethiazole 26 effect of hepatic impairment 26, 27 CIornifene 769 Clomipramine 240, 241 narcolepsy 1177 Clonazepam 490 epilepsy I 172, I 174 multiple sclerosis 1216 myoclonus 1183 sleep disorders I 177 Clonidine 247, 897 adverse reactions 30 hypertension 613 Clonorchiasis 370 Clonorchis sillellsis 370 Clopidogrel angina 583- 584 unstable 590, 591 coronary heart disease 587 myocardial infarction 596, 600 peripheral vascular disease 602 stroke, secondary prevention 1209,1210 Clostridia, soft tissue infections 316 Clostridium botulinum 316, 333 Clostridium difficile 326, 329, 931-932 HIV infection/AIDS 388 Clostridium Ilov),i, injecting drug user 292 Clostridium perfrillgens food poisoning 326, 327 septicaemia 1035 soft tissue infections 316 Clostridium tetani 316, 1232 Clotri mazole 154, 155 genital candidiasis 409 Clotting see Coagulation Clozapine 22, 243, 244 Clubbing, digital 850, 1283 congenital heart disease 520, 634, 636 Clue cells 409 CMAPs (compound motor action potentials) 1155 CMV (controlled mandatory ventilation) 193, 194 CMV (cytomegalovirus) see Cytomegalovirus infection Coagulation, disseminated intravascular 186, 189, 190, 498, 1018, 1060-1061 Coagulation cascade 185 Coagulation disorders 1057-1061 acquired 1060-] 061 congenital 1057-1060 investigation 10 I 0-1 0 12, 1016, 1018 malaria 345 Coagulation factors 1008 concentrates 1019 older people 10 I 0 see also specific factors Coagulation screen 1322 Coagulation system 1008 inhibitors 1008 investigation 10 I 0-1 0 12 Coagulation tests 10 to, 10 II, 1018 hepatobiliary disease 941 Coal worker's pneumoconiosis 720, 721 Co-amoxiclav hepatotoxicity 973 respiratory tract infection 683 pneumonia 692, 694 upper 688 urinary Iract infection 469 Co-artemether 346 Coarctation, aorta 533, 634, 637, 640 incidence 634 Cobalamin see Vitamin B 12 Cocaine 246 misuse 213 Coccidiodomycosis 375 Cock-up toe deformities 1 t02 Codeine diarrhoea 888, 899, 900, 932 intlammatory bowel disease 917 irritable bowel syndrome 922 effect of hepatic impairment 27 malignant disease ?76 musculo~keletal disorder 1092 overdose 214-215 Codons 39, 40 Coeliac disem,e 891 896 anaemia 1025, 1026 investigation~ 9·B older people 89 small intestine tumours 903 Coeliac plexus neurolysis 908, 910 Coffee, diabetogenic effect 812 Cognitive behaviour therapy (CBT) 238,240,241,244 eating disorder., 249 somatoform disorders 249, 250 Cognitive decline, general (dementia) 1188-1189 Cognitive function, assessment 231 Cognitive therapy (CT) 238, 239 COHb see Carboxyhaemoglobin Coitus, hedache and I 163-1 164 Colchicine I I 14, I 142 gout I I 14 Cold agglutinin disease 1034-1035 Cold haemoglobulinuria, paroxysmal 1034 Cold injury 102 see also Hypothermia Cold sore 304 Cold treatment musculoskeletal disorders 1089 see also Cryotherapy Colectomy, prophylactic 255 Colestipol 450 Colestyramine 450, 898, 900. 922 primary biliary cirrhosis 979 pruritus 1267, 1268 sclerosing cholangitis 981 Colic biliary 992 malignant disease 280 renal 471 Co lipase 854, 856 Colitis antibiotic-associated 931-932 cytomegalovirus, HIV/AIDS patients 387 microscopic (lymphocytic) 920 pseudomembranous 915, 931-932 ulcerative 910-920 for detailed entry see Ulcerative colitis Collagen 1068, 1070 osteoarthritis 1097 Collectins 652 Co lies fracture I 123, I 124 Collet- Sicard syndrome 1248 Colloid cyst 1236 Colloids 191, 199 Colomycin 686 Colon acute pseudo-obstruction 931 cancer see Coloreclal cancer common infecting organisms 133 diverticulosis 929-930 function, tests 863 ischaemia 923 motility lests 863 obstruction 874-875 polyps/polyposis 923-925 adenomatous 924-925 see also Familial adenomatous polyposis structure and function 857-858 tumours 923-929 see also Colorectal cancer Colonoscopy 860, 861 abdominal pain 876 colorectal cancer 927, 928 constipation 873 gastrointestinal haemorrhage 868 intlammatory bowel disease 915, 916 older people 862 polyps 923 Colony-forming unit-erythroid (CFU-E) 1003 Colony-forming unit-granulocyte monocyte (CFU-GM) 1002-1003 Colony-forming unitmegakaryocyte (CFU-Meg) 1003, 1004 Colorectal cancer 254, 869, 925-929 advanced, chemotherapy in 266 Colorectal cancer (COllI 'd) aetiology 254-255, 925-927 colonic polyps and 923-924 Dukes staging 928 familial i1denomatous polyposis coli 45, 46, 49 genetics 49 hereditary non-polyposis 44, 50, 926,927 inflammatory bowel disease 914- 915 management 927-929 prevention/screening 928-929 risk r actors 925-927 screening 255 staging 259 Colorimetric chemical reaction 420 Colour bl indness, inheritance 52 Columnar lined (Barrett's) oesophagus (CLO) 879-880, 883 • Coma 189, 1186-1187 diabetics 211 non-ketotic hyperosmolar 814, 823 see also Diabetic ketoacidosis malaria 345 myxoedema 752 poisoning 20-l, 207 respiratory failure 669 systemic causes 189 Comedones acne 1299, 1300 definition 1259 solar 1259 Common cold 687, 688, 689 antibiotics and 147 Comm u n i cati on doctor-patient 5, 9 of risk 9 Comorbidities, older people 165 Compartment syndrome 222, 223 injecting drug user 292-293 Complement 65, 66-68 activation 67-68 measurement 83 deficiencies 71, 72 total haemolytic 72 Complement activation inhibitors, deficiency 498 Complement fixation test (CIT) 143 Complement membrane attack complex 67, 72 Complementary and alternative medicine (CAM) 15-16 pain management 278 Compound motor action potentials (CMAPs) 1155 Compression bandages, leg ulcers 1277 Compression stockings, oedema 481 Computed tomography see CT • • IInagmg COMT (catechol-O-methyltransferase) inhibitors 1221 Concentration, assessment 231 Conduction, heart 524, 526, 527 Condyloma, giant 417 Condylomata lata 411 Confidcntiality 12 Confusion/Confusional states 235 acute 247, 1187-1188 older people 167, 1188 terminal illness 280 Congenital abnormalities diaphragm 736 heart 633-640 adult patients 640 maternal djabetes and 827 pancreas 908-909 rubella and 30 I urinary tract 508 Congenital adrenal hyperplasia 39, 59, 768, 782, 783, 786, 789 inheritance 52 non-classical (late-onset) 789 Congenital hypertrophy of retinal pigment epithelium (CHRPE) 925 Congestive gastropathy 961-962 Coning I 159, 1235 Conj uncti vi tis gonococcal 413,414 psoriatic arthritis II 10 reactive arthritis I 108 Connective tissue, crystal depo,ition IIII Connective tissue diseases 1132-1138 inherited 52, 1138 management, DMARDs 1093 mixed 82, 1075, I 137 prevalence 1068 respiratory involvement 722-723 Conn's syndrome 433, 786, 786-787 Consciousness assessment 1186 episodic loss/alteration 1164-1 167 epi lepsy I 169- 1 176 seizures 1167-1169 see also Coma; Syncope Consent artificial nutritional support 121 informed see Informed consent Consequentialism I I Constipation 873, 930, 1200 assessment 863 clinical 873 causes 873 diabetic neuropathy 845 diverticulosis 929- 930 irritable bowel syndrome 921, 922 older people 930 stroke patients 1207 Consultation, communication in 5 Contact allergic eczema 1285, 1287 Conti nence faecal 858 mechanisms 460 see also Incontinence Continuous ambulatory peritoneal dialysis (CAPO) 492. 494 problems 495 Continuous hyperfractionated accelerated radiotherapy (CHART) 710 Continuous positive airway pressure (CPAP) 193-194 drowning victims 105 sleep apnoea 667 Continuous professional development (CPD) 6 Contraception, oral see Oral con tracept ion/con tracept i ves Contrast media, nephrotoxicity 462, 517 Controlled mandatory ventilation (CMV) 193, 194 Conversion (tIissociative) disorder 236,237,250,251 Coombs test 319,1033- 1034 COP (cryptogenic organising pneumonia) 717 Co-proxamol 215 capo see Chronic obstructive pulmonary disease Coping strategies fibromyalgia 1121 musculoskeletal disease 1089- 1090 Copper 127 deficiency 127 excess, Wilson's disease 975-976 reference values urine 1321 venous blood 1320 Coproporphyria, hereditary 451, 452, 1308 Cor pulmonale 651, 681 Cordocentesis 57 Cordylobia al/lhropophaga 299 Cori disease 443 Corneal arcus, hyperiipidaemja 446, 447 Corneal melting 1104 Corneocytes 1261 Coronary angiography 532, 534, 583.584.599 Coronary angioplasty 533 Coronary arteries 523-524 calcification, imaging 532 CT imaging 532 occlusion 524 stenting 533 Coronary artery bypass grafting (CABG) 587-588 heart failure 550 imaging 532 mitral valve disease and 622-623 Coronary artery spasm 586-587 Coronary blood flow, resistance to 526 Coronary circulation 522- 523 Coronary heart disease (CHO) 581~01, 611 clinical manifestations 581 diabetics 836 hyperlipidaemia and 447 hypertension and 611 hypothyroidism 752 obcsity and III pathology 581 prognosis 588- 589 risk factors 447, 579- 580 Coronary syndromes, acute 589 chest pain 538 management 538-539 post-operative 60 I see also Angina, unstable; Myocardial infarction Coronaviruses 689, 695 Corpus uteri, cancer 270 Corrosives oesophagi tis 881 poisoning 219 Cortical vein thrombosis 1211 Corticosteroids allergy 85, 87 altitude illness 104 blood disorders autoimmune haemolysis 1034 chronic lymphocytic leukaemia 1046 cluster headache I 163 congenital adrenal hyperplasia 789 envenomation 224. 225 genital disorders 410 hepatitis alcohol ic 970-971 autoimmune 978 inflammatory bowel disease 917, 918,919 inhaled 682 asthma 675, 676 injections, rhcumatic disease 1095 insufficiency 782, 783 leprosy reactions 338 musculoskeletal disorders ankylosing spondylitis 1108 myositis 1136-1137 osteoarthritis 1100 systemic lupus erythematosus 1134 vasculitis I 139, I 140, I 141, 1142 neurological disorders meningitis 1227, 1228 multiple sclerosis 1216 myasthenia gravis 1253 polyneuropathy 1250 sciatica 1242 osteoporosis and I 122, I 123, 1125 pain management 278 palliative care 280 pericarditis 644 645 pre-eclampsia 516 pruritus 1267 renal disease 515 glomerulonephritis 500 nephrotic syndrome 480 tubulo-interstitial 505 respiratory disease acute respiratory distress syndrome 196 allergic rhinitis 730 aspcrgillosis 704 asthma 673, 675, 676-677, 678 chronic obstructive pulmonary disease 681, 682. 683 interstitial lung disea~e 717 tuberculosis 699, 701 rheumatic disease 1094-1095 rheumatic fever 618 sepsis 199 septic shock 318 side-effects 785, 1095 long-term use 676 skin disorders atopic eczema 1286-1287 lichen planus 1293 photosensitivity 1273 psoriasis 1291 urticaria 1271 synthesis 778 topical 1312, 1313 side-effects 1286 transplant surgery 90 trichinosis 367 vitiligo 1280 withdrawal 783, 785 see also Cortisol; Glucorticoids; Hydrocortisone; M ineralocorticoids; Prednisolone Corticotrophin-releasing hormone (CRH) 743 Corticotrophin-releasing honnone test 780 Cortisol 778 deficiency 789 hypopituitarism 795 levels adrenal insufficicncy 783 Cushing's syndrome 780,781 reference values urine 1321 venous blood 1319 see also Hydrocortisone CorYllebacleriulIl dip/llheriae 332 Co rYllebact e ri UIIl 111 in III iss i 1/1 LIlli 1263, 1293 Coryza, acute 687, 688, 689 Costs see Economics Co-trimoxazole 153 cyclosporiasis 360 enteric fever 325 Isospora and Cyclospora infections, HIV / AlDS patients 389 listeriosis 324 melioidosis 325 meningitis 1227 mycetoma 373 o Co-trimoxazole (cont'd) Pneumocystis carinii pneumonia 389,390,401 bone marrow transplants 1044 leukaemia patients 1042 side-effects 389 toxoplasmosis, HIV / AIDS patients 40 I vasculitis 1141 Whipple's disease 898 Cotton wool spots, diabetic retinopathy 839 Cough 657-658 asthma 671 at high altitude 104 bovine 707, 730 bronchial carcinoma 706, 707 chronic obstructive pulmonary disease 679-680 headache and I 163 laryngeal paralysis 730 palliative care 279 pneumonia 689 upper respiratory tract infections 688 Cough reflex 650 Councilman bodies 309 Counselling dietary, coeliac disease 896 genetic 57-58 HIV diagnosis 379 post-trauma 239 Counter-current immunoelectrophoresis 143 Coupled enzymatic reaction 420 Courvoisier's sign 909, 910 Cowden's disease 924 Cowpox 306 COX see Cyclo-oxygenase Coxibs 1091-1092 Coxiella, endocarditis 630 Coxiella bumetii 340, 690 Coxsackie viruses 306 myocarditis 641 CPAP (continuous positive airway pressure) 193-194 drowning victims 105 sleep apnoea 667 CPD (continuous professional development) 6 CPPD see Calcium pyrophosphate dihydrate CPR (cardiopulmonary resuscitation) 556, 557 older people 190 CPT (camitine-palmityl transferase) deficiency 1255 Crab lice 1298 Crack cocaine 213 Cramps drug-induced I 142 heat 102 occupational 1183 Cranial nerves examination I 147 lesions/diseases 1248-1249 nerves 3, 4 and 6 1195-1196 nerves 9 to 12 1192, 1248 nuclei 1152, 1153 see also specific nerves by name Craniopharyngioma 793, 798, 802, 803, 1236 Creams 1312, 1313 Creatine kinase (CK) musculoskeletal disease 1075-1076 myocardial infarction 593-594 myopathy 1088 myositis I 136 reference values, venous blood 1320 Creatinine blood levels 461 chronic renal failure 488 clearance 461, 462 older people 28 reference values urine 1321 venous blood 1318 Creola bodies 672 CREST syndrome 82, 1135 Cretinism 126 Creutzfeld-lakob disease (Cl D) 1189, 1234 variant (vC1D) 1234 transmission in blood products 1019,1023,1059 CRF (chronic renal failure) see Renal failure, chronk CRH see Corticotrophin-releasing hormone Cri du chat syndrome 47 Crico-arytenoid arthritis, connective tissue disorders 722 Crigler- Najjar syndrome 945 Cri mean-Congo haemorrhagic fever 310 Critical care/Critically ill patient 176-201 admission guidelines 178-179 circulatory support 191-192 clinical examination/assessment 176-178 costs 201 discharge 200 gastrointestinal support 197-198 hepatic support 197- 198 management, principles 190-191 monitoring 176, 177, 179-182 circulation 179-182 respiratory function 182 neurological support 198- 199 nutrition 197 older people 190 organisation 178 outcome 190,201 outreach 178 oxygen delivery 182-185 physiology 182-186 recognition 176, 178 renal support 197 respiratory support 193-196 scoring systems 200-201 transport of patient 179 withdrawal of care 200 Critical illness, presenting problems 186-190 Critical limb ischaemia (CLI) 602-603 Crohn's disease 910--920, 1028 arthritis I I 10 childhood 919 clinical features 913-914 comparison with ulcerative colitis 920 complications 914-915 investigations 914-915 management 918-919 pathogellesis 91 1-912 pathology 912-913 perianal 918-919 pregnancy 919 prognosis 920 sclerosing cholangitis and 980 small bowel 915 Cronkhite-Canada syndrome 924 Cross-infection 190 see also Health care-acquired infections Croup 687, 688, 689 Crouzon syndrome 42, 53 CRP see C-reactive protein CRT (cardiac resynchronisation therapy) 577-578 Crust, skin, definition 1259 Cruveilhier- Baumgarten syndrome 957 Cryoglobulinaernic vasculitis 1141 Cryoglobulins/Cryoglobulinaemia 83,1141,1142 Cryoprecipitate 1021, 1061 Cryosurgery, chromomycosis 373 Cryotherapy 1314 cutaneous leishmaniasis 354 molluscum contagiosum 417, 1297 skin cancer 1304 warts 1296 anogenital 417 Cryptitis 912 Cryptococcus neoformans, HIV/ AIDS patients 390 Cryptococcus/Cryptococcosis 375, 1228 HI V-related 393, 394, 40 I Cryptogenic eosinophi lic pneumonia 724 Cryptogenic fibrosing alveolitis see Pulmonary fibrosis, idiopathic Cryptogenic organising pneumonia (COP) 717 Cryptorchidism 765, 767 CryptosporidialCryptosporidiosis 343,360,903 HIV / AIDS patients 387, 389 Crystal-associated disease 1111-1117 Crystal formation 1I11 Crystal shedding 1111 Crystalloids 191, 199 CSF see Cerebrospinal fluid CSS (Churg-Strauss syndrome) 643, 723, 1I39, 1141 CT (cognitive therapy) 238, 239 CT (computed tomography) angiography 653, 654, 1206 brain, older people 167 cardiovascular system 522, 523, 532, 608 pulmonary embolism 541 ga trointestinal tract 859, 861 abdominal pain 874, 876 colorectal cancer 927 helical 532 hepatobiliary disease 941, 993, 995 hepatocellular carcinoma 984 high-resolution 653, 675, 704, 714,715,716,718,719 musculoskeletal disease fractures 1086 low back pain 1084 neurological disease 1156-1157, 1159 cerebral abscess 1231, 1232 cerebral tumours 1236 cerebrovascular disease 1204, 1205, 1206 epilepsy 1170, 1171 meningitis 1226 viral encephalitis 1229 pancreatic cancer 910 pancreatitis 905 phaeochromocytoma 788 pulmonary angiography 653, 654, 727 renal disease 464, 468, 497 respiratory disease 653, 654, 663, 664,665,675,704 bronchiectasis 685 chronic obstructive pulmonary disease 681 interstitial lung disease 714, 715,716,718,719 pleural 733, 734 rheumatic disease 1074 spine 1242, 1243, 1244 stone disease 472 urinary tract tumours 514 Cullen's sign 904 Cupulolithiasis I 166 CURB-65 score 692 Curettage, skin disease 1314 cancer 1304, 1305 Curschmann's spirals 672 Cushing's disease 779-780, 782, 793, 798 management 782 Cushing's syndrome 766, 768, 779-782 aetiology 779 c1as ification 779 clinical features 779-780 cyclical 782 iatrogenic 779 investigations 780-782 management 782 non-iatrogenic 779 obesity 113 Cutaneous larva rnigrans (CLM) 298, 367 CVP see Central venous pressure CVS (chorion villus sampling) 1057 CX (circumflex artery) coronary circulation 522, 523, 524 occlusion 524 Cyanide 208 Cyanosis, congenital heart disease 520,634,636,640 Cyclic citrullinated peptide, anti bodies to 81 Cyclin-dependent kinases (CDKs) 43 Cyclizine 280 Cyclo-oxygenase (COX) 1007, 1090 Cyclo-oxygenase (COX) inhibitors 928, 1090,1091- 1092 Cyclopenthiazide 613 Cyclophosphamide 266, 269 blood disorders autoimmune haemolysis 1035 non-Hodgkin's Iymphom<'- 1051 bronchial carcinoma 710 idiopathic thrombocytopenic purpura 1057 multiple sclerosis 1216 myositis 1137 polyneuropathy 1250 prostate cancer 512 renal disease 515 rheumatic disease 1093, 1094 side-effects 267, 1093, 1094 systemic lupu erythematosus 1134 vasculitis 1140, 1141 Cyclops spp. 366 Cyclospora infections, HJV/AIDS patients 388, 389 Cyclosporiasis 343, 360 Cyproterone acetate 512, 769 acne 1300 alopecia 1279 Cystadenocarcinoma, mucinous 910 Cystathionine p-synthase deficiency 442 Cystathionine synthetase deficiency 1138 Cystectomy 5 14 Cysteine 110 Cystic fibrosis (CF) 685-687 biliary fi brosis and 989 bronchiectasis 686 complications 686 gastrointestinal manifestations 908 geneticslinheritance 40, 45, 46, 52 screening 56 Cystic fibrosis transmembrane conductance regulator (CFTR) 45, 685 Cystic kidney diseases 506-507 Cysticercosis 297, 371 Cysticercus bovis 370 Cystine stones 471,472 Cystinosis 508 Cystinuria 508 Cystitis 468, 470 Cystourethrography, micturating, Cysts urinary tract infection 468, 509,510 Baker's (popliteal) 1018, 1081, 1099, 1103 ruptured 1074, 1103 choledochal 989 hepatic 987, 988-989 hydatid, liver 987 Cytarabine (Ara-C) 266 acute leukaemia 1042 chronic myeloid leukaemia 1045, 1046 Cytokines 66, 67, 68, 70, 135 alcoholic liver disease 970 asthma 67 1,672 deficiencies 71, 72, 73 pro-inflammatory 76, 80 pyrogenic 136 Cytomegalovirus (CMV) infection 303 acquired 308 bone marrow transplants 1044 gastrointestinal, Hrv / AIDS patients 386-387, 389 hepatitis 969 HIV/AIDS patients 378, 393 gastrointestinal infection 386-387,389 retinitis 395 liver transplant patients 990 pregnancy 308 Cytoplasm 42 Cytosine 38 Cytoskeleton 42-43 Cytotoxic drugs 265-267 myeloproliferative disorders 1055 side-effects 265, 266-267 see aLso Chemotherapy; names of specific drugs Cytotoxin-associated gene (cagA) 885 D D-dimers 1009, 1322 pulmonary embolism 726-727 d4T (stavudine) 394, 397, 398 Dacarbazine 266 Dactylitis 1036, 1077, 1109, 1110 Dandruff 1285 Dane particles 963 Dantrolene 244 Dapsone with chlorproguanil (Lapdap) 347 dermatitis herpetiformis 896 haemolysis from 1035 leprosy 337 mycetoma 373 Pneumocystis carinii pneumonia 389 pyoderma gangrenosum 1309 spider bite 224 Daunorubicin 266 acute leukaemia 1042 Kaposi's sarcoma 386, 389, 390, 396 DCCT (Diabetes Control and Complications Trial) 837- 838 DDAvP (desmopressin) bleeding disorders 1059-1060, 1061 diabetes insipidUS 797 ddC (zalcitabine) 394, 397, 398 ddl (didanosine) 394, 397, 398, 399 De Quervain's tenosynovitis 1080 De Quervain's thyroiditis 744, 757-758 'Dead-in-bed syndrome' 824 Deafness, Paget's disease 1129 Death diagnosis, cold patient 101 see also Brain death; Dying; Sudden death Debrisoquine 60 DEC (diethylcarbamazine) 364, 365,366 Deci ion making conflict of opinion 13,281 end of life 281 ethical analysis 13 ethical issues lO-14 informed consent 11 - 12 involvement of patients/families 9,11-12,13-14 lack of capacity for 11- 12,281 use of tests 8 Decompression, musculoskeletal disease 1096 Decompression illness aviators 103 divers 106-107 Deep venous thrombosis (DVT) 724,1018, 1061 air travellers 105 anticoagulant therapy 1063 heart failure 546 prevention 1064 stroke patients 1207 Defecation 858, 863 disorders of 930 obstructed 863, 873 Defensins 65, 652 Defibrillation 555, 556, 575-576 implantable cardiac defibrillator 576,600 heart failure 550 hypertrophic cardiomyopathy 643 ventricular arrhythmias 568 myocardial infarction 594 public access 555-556 Dehydration cholera 330 diabetics 822, 823 gastric outlet obstruction 890 gastroenteritis/diarrhoea 294 heat illness 102 intestinal ,esection 899 see also Water, body, depletion Dejerine- Sottas disease 1251 Dejeune-Klumke paralysis 1251 Delavirdine 397 Delhi boil 298 Delirium 232, 233, 243, 247, 1187 cognitive impairment 231 fever 285 older people 235 prevalence 228 terminal illness 280 Delirium tremens (DTs) 245, 1188 Delta virus see Hepatitis D Delusional disorders 243 Delusional parasitosis 249 Delusional perception 243 Delusions 230, 232-233 schizophrenia 242, 243 Demeclocycline 43 1 Dementia 233, 247, 1188-1189 alcoholic 245 degenerative causes 1217-1218 HI V-associated 393-394 management 247 vascu lar 247 Demography 162 Demyelinating polyneuropathy, acute inflammatory see Guillain-Barre syndrome Demyelination 1247 acute disseminated encephalomyelitis 1216 Guillain-Barre syndrome 1249-1250 mUltiple sclerosis 1213, 1214 transverse myelitis 1216 vitamin BI2 deficiency 125, 1027 Dendritic cells 69 antigen-presenting 1007 Dendritic ulcers 303, 304 Dengue 308-309, 310 Dental caries, fluoride and 127 Dentato-ru bro-pa II ido-I uysi an atrophy (DRPLA) 46, 1222 Deoxycoformycin 1047 1 I-Deoxycorticosterone 789 ll-Deoxycorticosterone-secreting adrenal tumour 786 L-Deoxythymidine 966 Depolarisation, cardiac muscle 526, 527- 528 Depression 240-242 aetiology 241 alcohol and 245 assessment, self-poisoning and 205-206 delusions and hallucinations 232 drug treatment 238 management 241-242 manic (bipolar disorder) 232, 240, 242 and medical illness 236, 237 memory disturbance 1188 negative cognitive triad 238 older people 235 in palliative care patients 280 post-partum 251 prevalence 228 stroke patients 1207 symptoms 230, 231, 241 Depressive adjustment disorder 231 Dermatitis chronic actinic 1272, 1273 exfoliative 1311 herpetiformis 896, 1273, 1275, 1276 seborrhoeic, HJv/AIDS 384, 386 otherwise see Eczema Dermatobia hominis 299 Dermatofi broma 1265 Dermatographism 87 Dermatomyositis 82, 1136-1137, 1239, 1282 respiratory complications 722 DermatophyteslDermatophyte infection 1283, 1297 HTV/AIDS 384 Dermatoscopy l263 Dermatosis, genital 407, 410 Dermis l261, 1262 Dermoscopy 1263 Des-aspargate-arginine vasopressin see Desmopressin Desensitisation 240 Desferrioxamine 208, 212 Desmoid tumours 925 Desmopressin (DDAvP) bleeding disorders 1059-1060, 1061 diabetes insipidUS 797 Desmosomes 1261, 1262 Desquamative interstitial pneumonia (DIP) 717 Detrusor muscle 460 overactivity 475 Detrusor- sphincter dyssynergia 1199, 1200 Developing countries, allocation of resources 10 Devic's disease 1216 DEXA (dual energy X-ray absorptiometry) coeliac disease 896 musculoskeletal disease 1074 osteoporosis 1123 Dexamethasone adjunctive, bacterial meningitis 1227 brain tumours 262 cerebral tumours 1237 myeloma 1053 spinal cord compression 260 thyrotoxicosis 750 toxoplasmosis, HIV-related 392 viral encephalitis 1229 Dexamethasone suppression test (DST) Cushing's syndrome/disease 780, 781-782,793 hirsutism 768 Dexamfetamine I 177 Dexfenfluramine 115 Dextran 1056 Dextropropoxyphene musculoskeletal disease 1092 poisoning 214-215 Dextrose hypoglycaemia 211, 791,825 hypovolaemia 425 DFMO see Eflomithine DHA (docosahexaenoic acid) 450 Di George syndrome 774 Diabetes Control and complications Trial (DCCT) 837-838 Diabetes insipidus 796-797 cranial (central) 431,793, 796-797 nephrogenic 431, 432, 507, 508, 793, 797 Diabetes mellitus 805-847 acromegaly 80 I acute myocardial infarction 827 aetiology and pathogenesis 810-815 air travel and 104-105 atherosclerotic vascular disease and 580 'brittle diabetes' 829 bronzed 975 cardiovascular disease, risk prediction chart 1323 children 808, 826-827 classification 810 clinical examination 806-807 complications 808, 829, 846 long-term 836-845 pathophysiology 836-837 prevention 837-838 see aLso specific complicatiolls cystic fibrosis and 687 diarrhoea 897 driving and 819 epidemiology 808 functional anatomy/physiology 808- 817 gestational 814, 815, 826 hypertension and 612 Diabetes mellitu~ (COllI 'd) investigations/diagnosis 815-818 latent autoimmune diabetes in adults 81 I, 818 I long-term supervision 819-820 management 818-820, 829-836, 846 combined oral anti-diabetic therapy and insulin 833-834 dietary 818, 829-831 goals 820 insulin 818, 834-836 older people 838 oral hypoglycacmic drugs 831-834 maturity onsct diabctes of thc young 815, 818, 826, 828 metabolic disturbances type I diabetes 812-813 type 2 diabetes 814 morbidity 829 mortality 829, 836 older people 838 nephropathy 506, 514 older people 814 pancreatitis 907, 908 patient education 818-819, 825-826 pregnancy and 814, 815, 818, 826--827 presenting problems 817-829 prevention 846 risk, obesity and III, 112, 113 signs 807 surgery and 827-828 type I 810, 811-813 aetiology and pathogenesis 811-813 clinical features 818 glycaemic control 827, 837-838 HLA associations 80 management 818-819 pregnancy and 826-827 prevalence 808 prevention 846 sibl ing risk 58 type 2 810-81 I, 813-815 actiology and pathogenesis 813-815 blood pressure control 838 clinical features 818 glycaemic control 838 management 818-819 prevalence 808 prevention 846 vascular disease 603 Diabetic amyotrophy 1251 Diabetic foot 603, 844-846 Diabetic ketoacidosis 813, 816, 820-823,827 complications 823 management 821-823 pregnancy 827 Diabetic microangiopathy 836 Diabetic nephropathy 841-843, 846 pregnancy and 827 Diabetic ncuropathy 837, 843-844 Diabetic retinopathy 807, 808, 838-841, 846 pregnancy and 827 Diagnosis interview 5 investigations 6-8 Diagnostic and Statistical Manual, American Psychiatric Association (DSM-IV) (4th ed) 228 Dialysis amyloidosis associated with 79 hyperkalaemia 436 peritoneal 492,493 acute renal failure 491 automated 492. 494 continuous ambulatory (CAPD) 492. 494, 495 problcms 495 poisoning 209, 212 renal 491, 492 acutc renal failure 491 chronic renal failure 485. 491, 493-494 older people 495 systemic lupus erythematosus 515 see also Haemodialysis 3,4-Diaminopyridi ne, Lambert-Eaton myasthenic syndrome 1254 Diamorphine 277 myocardial infarction 595 Diaphragm, diseases acquired disorders 736, 90 I congenital 736 Diarrhoea 869-870 acute 293-295, 869 assessment of patient 294 causes 293 food poisoning and 294 managcmcnt 294-295 after peptic ulcer surgcry 888 amoebic dysentery 358 antibiotic-associated 329, 931-932 bloody 293-294 cholera 330 chronic 295-296 chronic/relapsing 869-870 diabetic 845, 897 faceal incontinence 930 haemolytic uraemic syndrome 498 H I V / A I DS patients 387, 388 infcctive 869 older people 326 inflammatory bowel disease 913, 914,915 irritable bowel syndrome 869. 920-921 malabsorption 870-871 small bowel disease 896, 897. 898,899,900 sugar intolerances 902 traveller's 328. viral 311-312 Zollinger-Ellison syndrome 890 Diascopy 1263 Diastematomyelia 1245 Diathermy 862 bladder canccr 514 Diazepam acutc poisoning 210. 211. 212 alcohol withdrawal 246 delirium trcmcns 1188 disturbed behaviour 233 effect of hepatic impairmcnt 27 terminal agitation 280 Dibenzodiazepine 238, 243 DIC (disseminated intravascular coagulation) 186. 189, 190. 498, 1018,1060-1061 Diclofenac 1J73, 1091 cholecystitis 993 renal colic 472 Dicobalt edetate 208 Didanosine (ddl) 394, 397, 398, 399 Diethylcarbamazine (DEC) 364. 365, 366 Diethylenepenta-acetic acid (DTPA), technetium-labelled 464 Diet(s) and asthma 671 atherosclerotic vascular disease and 580 cholesterol levels and 444 colorectal cancer and 925, 926 cystic fibrosis 909 diabctes aetiology of type I diabetes 812 management 829-831 type 2 814, 818, 830 diverticulosis and 929 dyslipidaemia management 449 elimination 90 I, 902 gallstones and 991 gastric cancer risk 892 gluten-free 896 high-fibre 929 hospital patients 119 inflammatory bowel disease management 918 irritable bowel syndrome management 921, 922 low-fat 90 I low-protein, chronic renal failure 485,488 multiple sclerosis management 1215 starvation 114-115 starvation management 118 stone disease 472 vegan 1028 very low calorie 115 diabetics 831 weight reduction 114-115 Diffuse idiopathic skeletal hyperostosis (DISH) 1085, 1086 Diffuse parenchymal lung disease (DPLD) 713-718 classification 714 diagnosis 713-714 DiGeorge syndrome 47,53,73 Digcstion 854-856 malabsorption 870-871 Digital subtraction angiography (DSA) 654 Digitalis, adverse reactions 30 Digoxin 24, 573, 575 arrhythmias 574, 575 atrial fibrillation 563 tachyarrhythmias 562. 565, 566 effect of renal insufficiency 27 heart failure 550 ventricular septal defect 639 mitral val ve disease 620, 623 prescription 26 toxicity/poisoning 28, 210, 567, 575 cardioversion and 575 Digoxin-specific antibody fragments (F(ab» 208, 210 Dihydrocodeine 246 malignant disease 276 musculoskeletal disease 1092 poisoning 214-215 Dihydropyridines angina 585 unstable 590 hypertension 613, 614 1,25-Dihydroxycholecalciferol 123 hypoparathyroidism 775 osteoporosis 1126 rderence values, venous blood 1320 1,25 Dihydroxyvitamin D 1127.1128.1129 Diidotyrosine (DIT) 745 Diloxanide furoate 358-359, 359 Diltiazem 573 angina 585 unstable 590 atrial fibri lIation 563 hypertension 613 Diltiazem cream, anal fissure 933 Dilute Russell viper venom time (DRVVT) 1062 2,3-Dimercapto-l-propane sulphonate (DMPS) 208, 219 2,3-Dimercaptosuccinic acid (DMSA) 208. 219 technetium-labelled (99"'Tc_ DMSA) 464, 509 Dinitrochlorobenzene 1296 DIP (desquamative interstitial pneumonia) 717 Diphencyprone 1296 Diphenoxylate 295,897,900.932 Diphenylbutylpiperidines 238, 243 2,3 Diphosphoglycerate (DPG) 1005 Diphtheria 141,331-332 chemoprophylaxis 137 immunisation 138. 139. 332 incubation period 135 laryngeal obstruction 731 period of infectivity 135 Diphyllobolhrium lalulll 370 Dipivoxil 157 DIPJs (distal interphalangcal joints), psoriatic arthritis I 109 Diplopia 1193, 1195-1196 diabetics 843 Graves' disease 756, 757 Wegener's granulomatosis 1141 Dipyridamole, stroke, secondary prevention 1209, 1210 Directly observed therapy (DOTS), tuberculosis 391. 70 I, 702 Dirofi laria immitis 366 Disability I 148 International Classification of Functioning and Disability 169 older pcople 162, 164, 169 Discoid eczema 1268. 1285 Discriminative score, Maddrey's 970 Discs, intervertebral degeneration 1241, 1242 herniation 1242 prolapsed 1085, 1086 Discs, intra-articular 1071 Disease modifying antirheumatic drugs (DMARDs) 1092-]094 ankylosing spondylitis I 108 rheumatoid arthritis 1105 DISH (diffuse idiopathic skelctal hyperostosis) 1085, 1086 Disodium calcium edetate 208 Disopyramide, arrhythmias 572, 573,574 tachyarrhythmias 565, 574 Disseminated intravascular coagulation (DIC) 186. 189. 190.498,1018,1060-1061 Dissociative (conversion) disorder 236,237,250,251 Distal interphalangeal joints (DIPJs), psoriatic arthritis 1109 Disulfiram 246 DIT (diidoryrosine) 745 Dithranol 1290 Diuretics 427-428 ascites 949 clinical use 4?7-428 drug interactions 32 heart fai lure 548 site of action 549 ventricular septal defect 639 hypertension 613. 614, 615 hyponatraemia 431 loop 427. 428. 436. 441. 949 heart failure 548, 549 oedema 480 mechanisms of action 427 Diuretics (COll I 'd) mitral regurgitation 623 obliterative cardiomyopathy 643 oedema 480, 481 osmotic 427 potassium-sparing 427, 428, 431, 432,434,435 renal insufficiency and 26 resistance 428 side-effects 427-428 see also Thiazides Diverticulitis, acute 874 Diverticulosis 929-930 bleeding 868 jejunal 897 Diving effects/illness 106-107 Dizziness 1164-1165 older people 168, I 165 DLI (donor leucocyte infusion) 1043 DMARD (disease-modifying antirheumatic drug) 1092-1094 ankylosing spondylitis 1108 rheumatoid arthritis 1105 DMPS (2,3-dimercapto-l-propane sulphonate) 208, 219 DMSA (2,3-dimcrcaptosuccinic acid) 208, 219 technetium-labelled 464-465, 509 DNA 38-39 analysis, neurological disease 1158 chips 51, 52 mitochondrial 42 probes 51 proviral 381 repair/repair enzymes 44 sequence analysis 52 transcription 38- 39 DNAase, recombinant human, cystic fibrosis 687 Dobutamine 184 circulatory effects 192 Docetaxel 266, 267 Docosahexaenoic acid (DHA) 450 Doctor- patient relationship 4-5 ethical issues 11- 12 Domperidone 891, 900, I 162 Donath-Landsteiner antibody 1035 Donepezil, Alzheimer's disease 247, 1189,1217 Donor leucocyte infusion (DLI) 1043 Donovanosis 416 Dopamine 1150 circulatory effects 192 low-dose, acute renal failure 482 Dopamine agonists acromegaly 802 chronic renal failure 490 Parkinson's disease 1220, 1221 pregnancy 800--80 I prolactinomas 799, 800 sleep disorders I 177 Dopamine antagonists, adverse reactions 30 Dopexamine 198 circulatory effects 192 Doppler ultrasound echocardiography 531 - 532 colour flow Doppler 531 valvular heart disease 615. 620, 622,625-626,627,628 ventricular septal defect 639 hepatobiliary disease 941 leg ulcers 1276, 1278 nervous system 1157, 1159 oesophageal, cardiac output monitoring 181 renal 462 renal artery stenosis 497 venous thromboembolism 727 Dosulepin 241 DOTS (directly observed therapy), tuberculosis 391, 701, 702 Double effect, principle of 281 Down's syndrome (trisomy 21) genetics 47, 48, 53 screening 47,57 Doxapram 669, 684 Doxazosin 613 Doxorubicin 266, 893 bronchial carcinoma 710 hepatocellular carcinoma 985 liposomal, Kaposi's sarcoma 386, 389,390,396 non-Hodgkin's lymphoma 1051 Doxycycline 153 bacterial angiomatosis 3&6 brucellosis 319 cholera 330 leptospirosis 322 Lyme disease 320 malaria 346, 347, 348 melioidosis 325 non-specific urethritis/chlamydial infection 415 plague 323 Q fever 340 relapsing fever 320 rickettsial fevers 340 sexually transmitted infections chancroid 416 granuloma inguinale 416 lymphogranuloma venereum 416 syphilis 386, 413 DPG (2,3 diphosphoglycerate) 1005 DPLD see Diffuse parenchymal lung disease DPT vaccine 139 Dracunculiasis (guinea worm) 298, 366 DracuIJculus medinensis 366 Drainage intercostal tube 734-735 postural, bronchiectasis 685 Dressings 1312, 1313 Dressler's syndrome 598 Dribble, post-micturition 475 Drinking, problem 259 Driving diabetes and 819 epileptics 1172 Drotrecogin alfa, septic shock 318 Drowning/near-drowning 105 DRPLA (dentato-rubro-pallidoluysian atrophy) 46, 1222 Drug eruptions 1310-1311, 1312 blisters 1273 photosensitive 1272, 1273 rash 1268, 1269 Drug misuse 235-236, 246-247 candidiasis 374 hepatitis transmission 967 intravenous fever in injecting drug user 291 -293 injectioll site infection 313-3 14 leishmaniasis transmission 349 management 247 polydrug misuse 247 Drug-related disorders anaemia 1012 aplastic 1054 platelet functional disorders 1056--1057 ana ph y lax is/ana ph y I actoi d reactions 87 asthma 671 autoi mmune disease 80 bleeding 1016 Cushing's syndrome 779 hacmolysis 1035 he pari n-induced thrombocytopenia 1063 hyperpigmentation 1281 hypoglycaemia 791 leukaemia 1039 liver 943, 973-974 lungs 724 musculoskeleial system I 142 osteoporosis I 122. J 123 neutropenia 1014 obesity I 13 oesophagi tis 881 peripheral neuropathy 1247 renal 482, 483, 504-506, 516-517 see also Drug eruptions Drug therapy 18-35 adverse effects, number needed to treat for harm to occur 19 assessment from NNT Band N TH 19-20 balance of benefit to harm 18, 19-20 benefit/number needed to treat 19,20 choice of 22-24 clinical trials 20-21 duration 28-29 evidence-based medicine in 18-21 frequency of administration 25, 26 monitoring 34 older people 26-28 risk ratio and odds ratio 20 time of administration 25- 26 topical 1311 - 1313 Druo" s adverse effects 29, 30 genetic influences 23, 24 older people 26 post-marketing surveillance 22 controllcd, prescription 32-33 development 21 marketing 22 surveillance of ncw drug 22 discovery 21 dosages 24-25 alteration in special ci rcumstances 26--28 dose-related adverse reactions 29, 30 older people 26, 27, 28 writing 32 formulations 24 oldcr peoplc 27 prescription/nomenclature and 33 interactions 23, 29, 31-32 avoidance 32 older people 27 pharmaceutical 29, 31 pharmacodynamic 32 pharmacokinetic 31-32 metabolism drug interactions and 31-32 genetic influences 23, 24 older people 28 of misuse 212-215 bodypackers 215 nomenclature 33-34 overdose/poisoning 204-215, 234 drugs of misuse 212-215 plasma concentrations 34 prescription 18-21, 22-29 controlled drugs 32-33 developing countries 29 junior doctors 29 nomenclature in 33-34 older people 28. 167-168 topical drugs 131 1- 13 J 2 writing prescriptions 32-33 route of administration 24 topical 1312 toxicity 29, 30 DRVVT (dilute Russell viper venom time) 1062 DSA (digital subtraction angiography) 654 DSM-IV 228 DST see Dexamethasone suppression test DTPA, technetium-labelled 464 DTs (delirium tremens) 245, 1188 Dual energy X-ray absorptiometry see DEXA Dubin-Johnson syndrome 945 Duchenne muscular dystrophy 1254, 1255 gene test 52 inheritance 52, 56 Ductopenia 973 Ductus arteriosus persistent 633, 634, 636-637 closure device 533 incidence 634 Dukes classification of tumours 259 Duloxetine 241 Dumping syndrome 888 late 790 Duodenal ulcers 885-891 complications 889-890 management 887-889 surgery 868 Duodenogastro-oesophageal renux 879 Duodenum, functional anatomy 852-853 Dupuytren's contracture/disease 1080 diabetes 807 Dusts, lung disease and 718-722 Dutaseride 51 I Duties of doctor 5 DVT see Deep venous thrombosis Dwarfism 127 Laron 793 DXA see DEXA Dying care in 280-281 ethical issues 280-281 sUppOl1 for 200 Dynorphins 1150 Dysaesthesia 274 multiple sclerosis 1216 Dysarthria I 190, 1192, I 193 Dysbetalipoproleinaemia 447. 448. 451 Dysdiadochokinesis 1179, 1193 Dysentery amoebic 141, 358 bacillary 141, 330-331 incubation period 135 management 295 Shigella, reactive arthritis and 1108 Dysexecutive syndrome I 190 Dysgraphia I 192 Dyshormonogenesis, congenital thyroid disease 762 Dyskinesia, drug-induced 1220, 1221 Dyslexia 1192 Dyslipidaemia 446-451 diabetes role of statins 837 type 2 813, 814, 820 management 448-451 Dysmetria 1179 ocular 1196 Dysmorphic syndrome 53 Dyspepsia 864 865 causes 864 gallstone 992 non-ulcer 89] Dysphagia 864, 877, I 192- 1193 gastro-oesophageal reflux 879, 880 investigation 865 oesophageal cancer 883 oesophageal dysmotility 881, 882 stroke patients 1207 Dysphasia I 190-1191 Dysphonia 1190 Dyspnoea (breathlessness) 658-663 acute dyspnoea at rest 659 acute severe 661-662 causes 539, 659 and chest pain 536 chronic exertional 659-663 chronic obstructive pulmonary disease 680 heart disease 539-540, 659, 660, 661 valvular 619,621,624,626 modified MRC scale 680 palliative care 279 paroxysmal nocturnal 539- 540 pathophysiology 658, 659 perception 279 psychogenic 660-66 I rcspiratory disease 539 Dysthymia 240 Dystonia 1182-1183, 1190 Dystrophia myotonica 1189 E E-cadherin gene, mutations 892 EAEC (entero-aggregative Escherichia coli) 329 Ears common infecting organisms 133 examination, febrile patient 284 Eastern Cooperative Oncology Group (ECOG) performance scale 257, 258 Eating disorders 248-249 Ebola virus disease 310, 311 Ebstein's anomaly 628, 640 Eburnation 1097 EB V see Epstein- Barr virus Ecchymosis, definition 1259 Eccrine glands 1262- 1263 ECF (epirubicin, cisplatin and 5-fluorouracil) 893 ECF (extracellular fluid) see Extracellular fluid ECG (electrocardiography) 179, 526-529 acute coronary syndromes 538-539 ambulatory (Holter monitoring) 529 angina 582 unstable 590 aortic dissection 607 aortic regurgitation 627 aortic stenosis 625 artificial pacemaker 577 atrial fibrillation 562 atrioventricularlbundle branch block 571-572 exercise (stress) 528- 529, 582, 583 hypothermia 101 mitral regurgitation 622 mitral stenosis 619-620 myocardial infarction 528, 592-594 myocardial ischaemia 528 pericardial tamponade 542 pericarditis 644 potassium balance disorders 432-433,434 pulmonary embolism 725, 726 standard 12-lead 527-528, 529 syncope 552- 553 tachyarrhythmias 561-562, 564, 565-566,567,568-569 ventricular fibrillation 555 Echinocandins 155 Echinococcus grallulosus 371-372, 987 Echinococcus 11lulrilocularis 371 Echocardiography (ECHO) 522, 530-532 acute circulatory failure 541, 542 aortic dissection 607 atrial fibrillation 563 atrial septal defect 638, 639 Doppler 531-532 valvular heart disease 615, 620, 622,625-626,627, 628 ventricular septal defect 639 endocarditis 631 heart failure 547 myocardial infarction 594 pericardial effusion 645 pulmonary embolism 727 stress 583 three-dimensional 530-531 tissue imaging 532 transoesophageal 532 two-dimensional 530 valvular disease 615 aortic 625-626, 627, 628 mitral 620, 622 ECOG (Eastern Cooperative Oncology Group) performance scale 257, 258 Econazole 154, 409 Economic factors, effect on health 97 Economics health care resources 10 medicine in low-resource settings 10 screening programmes 9 Ecstasy (drug) 214, 246 ECT (electroconvulsive therapy) 237-238 Ecthyma 1293--1294 Ectopic beats 554 atrial 561 ventricular 566-567 Ectothrix 1278 Eczema 1283--1287 allergic contact 1285- 1286, 1287 asteatotic 1286 atopic 1284 1285 management 1286-1287 pruritus 1267, 1269 rash 1267, 1269 discoid 1268, 1285 dressings 1312 gravitational (stasis) 1286, 1287 irritant 1285, 1287 nails in t283 napkin 1285 older people 1287 pruritus 1266, 1267 seborrhoeic 1285, 1287 HlV/AlDS 384, 386 superinfection 1269, 1285 Eczema herpeticum 304, 1269, 1285 Eczema vaccinatum 306 Edrophonium bromide, myasthenia gravis diagnosis 1253 EDTA (ethylenediaminetetraacetic acid) clearance 461, 462 51CrEDTA test 863 Education, patient asthma 675 diabetes 818-819, 825-826 fibromyalgia 1120-1121 heart failure 548 insulin therapy 819, 826 leprosy 338 musculoskeletal disease 1084 low back pain 1089 public health issues 14 Edwards' syndrome (trisomy 18) 47 EEG (electroencephalography) 1153--1154 epilepsy 1153-1154, 1170-1171 hepatic encephalopathy 951 seizures I 167 sleep disorders I 177 viral encephalitis 1229 Efaluzimab 1292 EFAs (essential fatty acids), deficiency I 10 Efavirenz 391, 395, 399 Eflornithine (DFMO) 355 Eflornithine creams 770 EHEC (entcro-haemorrhagic Escherichia coli) 294, 329 Ehlers- Danlos syndrome 52, 1056, 1138 Eicosapentaenoic acid (EPA) 450 ElEC (entero-invasive Escherichia coli) 328 Eisenmenger's syndrome 550, 629, 634,636,639 Ejaculation 460, 1200 Ekbom's (restless leg) syndrome 490, 1177 Elafin 652 Elastase, faecal 863 Elation 232 Elbow pain 1080 Elderly see Older people Elderly Mobility Scale 169 Electrocardiography see ECG Electroconvulsive therapy (ECT) 237- 238 Electrodes, ion selective 420 Electrodessication, warts 1296 Electroencephalography see EEG Electrolyte balance in renal failure acute 485 chronic 489 Electrol ytes absorption/secretion 855- 856 daily requirements 425 depletion, diabetic ketoacidosis 821 investigations 421-422 normal distribution 421-422 reabsorption 422 reference values, venous blood l318 transport 855 see also Bicarbonate; Chloride; Potassium; Sodium Electromagnetic spectrum 1271, 1272 Electromyography (EMG) 1076, 1136,1137, 1155 motor ncuron disease 1223 Electron microscopy, skin samples 1264 Electrophoresis 420 Elephantiasis 364 non-filarial 365 ELISA 142 brucellosis 319 leptospirosis 322 Lyme disease 320 toxoplasmosis 358 Elliptocytes 1004 Elliptocytosis, hereditary 1032 Embolism acute limb ischaemia 604 detection of cardiac sources 1206-1207 myocardial infarction 598 pulmonary see Pulmonary embolism/thromboembolism EMDR (eye movement desensitisation and reprocessing) 239 Emery-Dreyfuss muscular dystrophy 1254 EMG (electromyography) 1076, 1136, 1137, 1155, 1223 Emollients eczema 1287 psoriasis 1290 Emphysema 653, 678, 679, 680, 681 CT imaging 681 respiratory function abnormalities 657 Employment, sheltered 244 Empyema 732-733 subdural 1164,1231-]232 tuberculous 733 Emtricitabine (FTC) 389, 397, 398, 399 Enalapril heart failure 550 hypertension 613 myocardial infarction 600 Encephalitis acute 141 brain-stem 1229 herpes simplex virus 304 Japanese (B) 138, 139, 312, 1228-1229 limbic 1189, 1239 mumps 303 tick-borne, immunisation 139 viral 312, 1228-1229 West Nile 1229 Encephalitozoon cuniculi 388 Encephalitozoon hel/em 388 Encephalitozoon il1lestinalis 388 Encephalomyelitis, acute disseminated 1216 Encephalopathy 247 hepatic (portasystemic) 950-952 acute hepatic failure 952 clinical grading 950 hypertensive 610, 614 mitochondrial 1189 transmissible spongiform 341, 1234 Wernicke's 120, 124, 1218 Endocannabinoids 1150 Endocarditis gonococcal 414 infective 629~33 for detailed entry see Infective endocarditis Libman-Sacks 1134 Q fever 340 Endocrine axes 742, 743 Endocrine diseases 740-804 classification 742-743 clinical examination/presentation 740-741 genetic 52 HlV-related 395 hypertension and 785 investigation 743- 744 musculoskeletal manifestations 1143- 1144 presentation 740-741, 744 Endocrine function, chronic renal failure 490 Endocrine glands 743 functional anatomy and physiology 742-743 Endocri ne therapy, prostate cancer 512 Endocrine tumours, pancreatic 910 Endocytosis 40 Endometrial adhesions 765 Endometrial cancer, treatment 270 hormonal 270 Endometriosis 932 Endomysium antibodies 895 Endoperoxides 1007 Endoplasmic reticulum (ER) 42 Endorphins 1150 Endoscopic retrograde cholangiography (ERC) 994 Endoscopic retrograde cholangiopancreatography see ERCP Endoscopy 859-860 abdominal pain 876 achalasia 882 capsule 860 corrosive oesophagitis 881 gastric cancer 893 gastric outlet obstruction 890 gastro-oesophageal reflux 880 inflammatory bowel disease 915- 916 obscure major bleeding 869 oesophageal cancer 883, 884 older people 862 peptic ulcer 887 respiratory tract 654-655 small bowel disease 897 therapeutic gastrointestinal haemorrhage 867-868 oesophageal disease 882 pancreatitis 908 uses 862 upper gastrointestinal 859, 861 Endothelial cells, liver 938 Endothelins 526 endothelin I 186 Endothrix 1278 Endotoxin 136 Endotracheal intubation 194-195 critically ill patients 179 withdrawal 196 Energy intake 107, 108, 112 acute renal failure 485 requirements I I I Energy balance 108-109 effects of alteration 111- 121 older people 118 Energy-yielding nutrients 108-110 Enfuvirtide (1'20) 397, 399 Engerix 967 Enkephalins 1150 Entacapone 1220, 1221 Entamoeba histoLytica 358 HlY/AIDS patients 388 life cycle 359 liver abscess 987 Enteric fevers 342-345 Enteritis, radiation 899-900 Enterobius vermicuLaris (threadworm) 362-363 Enterococci, endocarditis 629, 630, 632 Enterococcus faecalis 315, 629 Enterococcus faecium 629 Enterocytes 854 Enterocytozoon bieneusi 388 Enteroglucagon 859 Enterohepatic circulation 854 Enterokinase 855 Enteropathy, protein-losing 900--901 Enteroscopy 860, 869 Enteroviruses, respiratory infection 689 Enthesis 1071 Enthesopathy foot 1082 gluteal 1081 knee 1081 Enthesophytes 1072, 1073 Entrapment neuropathies 1104, 1246,1247, 1248 Entropion 341 Environmental disorders 96-107 infections 133, 134 poisoning 226 Environmental factors in disease 94-107 allergy 84 asthma 670-671 atopic eczema 1284 autoimmune disease 80 cancer 255 colorectal 925 diabetes mellitus 810 type I 812 type 2 814 inflammatory bowel disease 911-912 investigations 95- 96 older people 96 osteoporosis 1122 psychiatric disorders 229 Enzyme-linked immunosorbent assay see ELISA Enzymes pancreatic 854, 855, 856-857 cystic fibrosis management 909 plasma, myocardial infarction 593- 594 Eosinophil chemotactic factor 84 Eosinophilia 296-298 atopy 85 causes 296, 297, 1006 parasite infections 297 heart disease 643 helminthic infections 360, 361, 362, 365 investigation 297- 298 pulmonary 723-724 drug-induced 724 tropical 363, 364 Eosinophilic gastroenteritis 901 Eosinophils 1003,1005-1006 asthma 671, 672 EPA (eicosapentaenoic acid) 450 EPEC (enteropathogenic Escherichia coli) 328-329 Ependymal cell I 148 Ependymoma 1236, 1237 spine 1245 Ephelides 1281 Epicondylitis 1080 Epidemiology, descriptive 95-96 Epidermal necrolysis, toxic 1273-1276,1311 Epidermis 1260-1262 Epidermolysis bullosa 52, 1273, 1274 acquisita 1259, 1275, 1276 dystrophic 1305 Epidermolysis bullosa simplex 43 Epidermophytort jloccosum 1297 Epididymo-orchitis 415 Epiglottitis, acute 687, 688 Epilepsy 1169-1176 cysticercosis 371 investigations 1170-1171 EEG 1153-1154,1170-1171 Jacksonian 1169 management I 171-1173 anticonvulsant drugs 1172- 1176 myoclonic 11 70, 1173 myoclonic epilepsy with ragged red fibres 1255 older people I 176 pregnancy/oral contraception 1173, 1176 prognosis 1173 progressive myotonic 46 restrictions on epileptics 1171-1172 temporal lobe 232, 243 types 1169-1170 Epimysium 1071 Epinephrine see Adrenaline Epiphysis 1068, 1069 Epirubicin 266, 893 Episcleritis, rheumatoid arthritis 1103 Eplerenone 600 heart failure 548 mineralocorticoid excess 786 Epo see Erythropoietin Epoprostenol see Prostacyclin EPs see Evoked potentials Epstein-Barr virus (EBY) 303 cancer and 48 hepatitis 969 infectious mononucleosis 307 primary CNS lymphoma 392, 393 Epworth sleepiness scale 666 ER (endoplasmic reticulum) 42 Erb-Duchenne paralysis 1251 ERC (endoscopic retrograde cholangiography) 994 ERCP (endoscopic retrograde cholangiopancreatography) 860,862,941 - 942 cholangiocarcinoma 996 cholecystitis 994 pancreatic cancer 910 pancreatitis, acute 906 sclerosing cholangitis 980, 981 Erectile dysfunction 476-477 diabetics 844, 845 Erectile function 460 Ergocalciferol 123, 1123 Erosion, skin, definition 1259 Erysipelas 1295 Erythema drug-induced 1311 toxic 1311 vulval 410 Erythema ah igne 1407 Erythema infectosum 302 Erythema marginatum 616, 617 Erythema migrans 319, 320, 1118 Erythema multi forme 1308--1309, 1311 Erythema nodosum 284, 716, 1309 Erythema nodosum leprosum 336 Erythrasma 1293 Erytbroblasts 1003 Erythrocyte sedimentation rate (ESR) 77, 78, 1322 older people 10\0 rheumatic disease 1074 unexplained raised 78 Erythrocytes see Red cells Erythrocytosis, hepatobiliary disease 940 Erythroderma 1269 Erythroid cells 1003 Erythromycin 150 acne 1300 diphtheria 332 Lyme disease 320 non-specific urethritis/chlamydial infection 415 prophylactic 137, 147 relapsing fever 321 respiratory tract infection 688, 692 rheumatic fever 618 sexually transmitted infections lymphogranuloma venereum 416 syphilis 413 skin infections 1293, 1295 tetanus 1233 Erythropoiesis, ineffective 1027 Erythropoietic porphyria, congenital 451, 452 Erythropoictic protoporphyria 451, 452, 1308 Erythropoietin (Epo) 458, 460, 1003 anaemia of chronic disease \030 chronic renal failure 488-489 recombinant human, chronic renal failure 489 Erythrovirus 1031 arthropathy I I 18 transmission in blood products 1059 Erythrovirus 19299,301-302 sickle-cell disease \036 Eschar 289, 333 rickettsial 298, 339 Escherichia, hospital-acquired pneumonia 693 Escherichia coLi entero-aggregative (EAEC) 329 entero-haemorrhagic (EHEC) 294,329 entero-invasive (EIEC) 328 enteropathogenic (EPEC) 328-329 enterotoxigenic (ETEC) 328 food poisoning 328--329 spontaneous bacterial peritonitis 950 thrombotic microangiography 498 type 0157 329, 498 urinary tract infection 467 verocytotoxigenic (VTEC) 329 Escitalopram 241 Esomeprazole 889 Espundia 353 ESR see Erythrocyte sedimentation rate Essential fatty acids (EFAs), deficiency I 10 Essential oils, poisoning 219 ESWL (extra-corporeal shock wave lithotripsy) 472, 473, 993, 994 Etanercept 1094, 1292 ETEC (enterotoxigenic Escherichia coLt) 328 Ethambutol 903 adverse effects 702 Mycobacterium avium intraceLLulare 389, 390 opportunistic mycobacterial infection 703 tuberculosis 70 I HIV / AIDS patients 390 Ethanol reference values 1320 see also Alcohol Ethical analysis 13, 14 Ethical issues artificial nutritional support 120-121 genetic testing 56-57 Ethics 10--15 clinical 11-14 types of problem 12-13 dentological II end of life decisions 281-282 public health 14 research 14-15 situation 11 teleological II virtue 10-11 Ethosuximide 1170, 1172, 1174 Ethylene glycol poisoning 208, 219 Ethylenediaminetetraacetic acid (EOTA) clearance 461,462 Etidronate osteoporosis I 125 Paget'~ disease I 130 Etodolac 1091 Etoposide 266 acute leukaemia 1042 bronchial carcinoma 710 testicular tumours 771 ETT (exercise tolerance testing) 528- 529,538,582 myocardial infarction 599 Eukaryotes 130 Eumycetoma 373 Eunuchoid habitus 765 Euphoria 232 Euthanasia 281-282 Evidence-based medicine 18- 19 drug therapy 18-21 Evoked potentials 1154 mUltiple sclerosis 1214 visual 1154 Examination, clinical 6 Exanthem subitum 303 Exanthems, childhood 299- 303 Exchange transfusion malaria 347 megaloblastic anaemia 1029 sickle-cell discasc 1037 Excoriation, definition 1259 Exenatide 834 Exercise(s) atherosclerotic vascular disease and 580 chest pain and 535, 537 chronic obstructive pulmonary disease 682 headache and I 163- 1 164 heart disease and 534 hypoglycaemia and 824--825 and insulin sensitivity 813 musculoskeletal disease management 1089 ankylosing spondylitis 1108 fibromyalgia 1121 osteoarthritis I 100 peripheral vascular disease management 602 weight reduction 114 Exercise ECG 528-529, 582, 583 Exercise testing 538, 539, 582 chronic obstructive pulmonary disease 680, 681 myocardial infarction 599 respiratory disease 657, 673 Exons 39, 40 Exophthalmos 1197 Graves' disease 756 Extracellular fluid (ECF) 421, 422, 424 volume overload 427 Extracorporeal shock wave lithotripsy (ESWL) 472, 473,993,994 Extractable nuclear antigens, antibodies to 82 Extrapyramidal lesions 1179 Extrasystoles 554, 561, 566-567 Extrinsic allergic alveolitis (EAA) see Hypersensitivity pneumonitis Eye disorders genetic 52 Graves' disease 746, 747, 756 HIV/AIDS 378 movement disorders 1195-1197 Wegener's granulomatosis 1141 Eye movement desensitisation and reprocessing (EMOR) 239 Eyelid disorders I 197 Eyes diabetes mellitus 806, 807, 838-841 examination blood disorders 1000 cardiovascular disease 520 diabetes mellitus 806, 807 febrile patient 284, 285, 291 respiratory disease 648 skin disease 1258 pain 1164 rheumatoid arthritis 1103- 1104 Ezctimibe 449, 450, 451 F Fabry's disease 444 Face examination cardiovascular disease 520 liver and biliary disease 936 respiratory disease 648 skin discase 1258 hemifacial spasm 1249 Facial (7th cranial) nerve, tests 1147 Facial nerve palsy 1249 Facial pain I 160, 1164 Facio-scapulo-humeral dystrophy 1254, 1255 Factitious disorders 251 'brittle diabetes' 829 Factitious fever 288 Factor II 1008, 1009 deficiency 10 II, 1061 Factor V 1008 acute liver failure 953 deficicncy 10 II, 1018, 1060 Leiden variant 1061, 1062 Factor VII 1008, 1009 deficiency 10 II, 10 18, 1061 stroke 1209 Factor Vlll 1008, 1057 antibodies 1059 concentrates 1019, 1058, 1059- 1060, 1060 virus transmission 1059 deficiency 10 II, 1018, 1060 haemophi I ia A 1057 inhibitor bypassing activity (FEIBA) 1059 Factor IX 1008, 1009 concentrates 1019, 1060 deficiency 10 II, 1018, 1061 haemophilia B 1060 Factor X 1008, 1009 deficiency 1011, 1018, 1061 Factor XI 1008, 1009 deficiency 10 II, 1018 Factor XII, deficiency 1011 Factor XIII 1008 Faecal antigen test, Helicobacter pylori infection 886 Faecal continence 858 Faecal impaction 930 Faecal incontinence 932-933, 1200 Faecal occult blood (FOB) testing 255, 869 colorect'41 cancer screening 928 Fai nts see Syncope Fallat's spells 640 Falls, older people 166-167 prevention 166-167 FAM, gastric cancer 893 Famciclovir 156 herpes virus infection 304, 305 genital 416, 417 Familial adenomatous polyposis (FAP) 45, 46, 49, 52, 903, 924--925,926 Familial hypercholesterolaemia 40, 52,446 Familial Mediterranean fever (FMF) 78 Fami Iy history atherosclerotic vascular disease 579 blistering 1273 genetic disease 51-52 melanoma 1265 psychiatric disorders and 230 Family therapy, schizophrenia 244 Faminc 117-118 Famotidine 889 Fanconi's syndrome 438,508 Fansidar 153 malaria 346, 347 FAP (familial adenomatous polyposis) 45, 46, 49, 52, 903,924--925,926 Farmer's lung 719 Fasciculations 1178, I 179 Fasciculi 1069,1071 Fascioliasis/Fasciola hepatica 370 Fast, prolonged, hypoglycaemia diagnosis 790 Fat, body, distribution 112 Fat, dietary 110, 449 composition 854 diabetics 830, 831 digestion/absorption 854 tests 863 malabsorption, small bowel disease 898 recommended intake II I Fatigue chronic fatigue syndrome 250 fibromyalgia 1120 multiple sclerosis 1216 rheumatoid arthritis 1103 Fatty acids I 10, 854 dietary 444 n-3 45~51 non-esterified ('free') see Free fatty acids polyunsaturated 110 Fatty liver alcoholic 970, 971 microvesicular 988 non-alcoholic 938, 943, 971-973 pregnancy 988 Favism 331 FBC (full blood count) 1009, 10 10 rheumatic disease 1074, 1075 FOPs (fibrin degradation products) 1009 Feeding enteral (tube) 119,121,197,199 cystic fibrosis 687 multiple organ failure 197 pancreatitis 906 sepsis 199 short bowel syndrome 899 intravenous I 19- 120 malnutrition managcmcnt 118 parenteral 119-120 Feet see Foot FEIBA 1059 Feline spongiform encephalopathy (FSE) 1234 Felty's syndrome 1104, 1105 Femoral neck fractures 1086 Femoral stretch test 290, 291, 1242 Fenfluramine liS Fentanyl, transdermal 277 Ferritin, serum/plasma anaemia of chronic disease 1030 haemochromatosis 975 iron deficiency anaemia 1026 older people 1030 Ferrous gluconate 1027 Ferrous sulphate 1027 Festination 1181, 1219 Fetal circulation 633---{j34 • Fetor hepaticus 950, 953, 957 FEV I (forced expiratory volume in one second) 656, 657 chronic obstructive pulmonary disease 680, 682 oldcr people 652 FEV IIVC ratio 652, 656, 657 asthma 673, 674 chronic obstructive pulmonary disease 680 Fever(s) clinical examination 284--286 injecting drug users 291-292 patients in/from tropics 289 definition 136 factitious 288 febrile response 136 as defence mechanism 136 haemorrhagic see Haemorrhagic fevers history-taking 285, 286 injecting drug users 291- 292 returning travellers 288-289 in/from tropics 288- 290 injecting drug user 291-293 neutropenic patient 293 cancer patients 260 older people 289 presentation 285 rashes and 289 recurrent 285 of unknown origin 286-288 investigations 286-287 older people 289 Fexofenadine 1271 FFAs (free fatty acids), diabetes 809,810,813,814 FFP (fresh frozen plasma) 1021 FGF23 (fibroblast growth factor 23) 1128 Fibrates effect of renal insufficiency 27 hyperlipidaemia management 450,451 Fibre, dietary 109- 1 10, 873 recommended intake III Fibrin 1007 Fibrin degradation products (FOPs) 1009 Fibrinogen 76, 1007, 1008 concentration 1010, 101 I, 1018 deficiency 1060, 1061 reference values 1322 Fibrinoid necrosis 611 Fibrinolysis 1008-1009 Fibroblast growth factor 23 (FGF23) I 128 Fibromuscular dysplasia, renal artery stenosis 496, 497 Fibromyalgia 1119-1121 prevalence 1068 systemic lupus erythematosus 1134 Fibropolycystic diseases, liver and biliary system 988-989 Fibrosing alveolitis 722 cryptogenic see Pulmonary fibrosis, idiopathic systemic sclerosis 1135, 1136 Fi fth disease 302 Fight and fright responses 1263 FIGO staging 270 Filaments, intermediate 1261 Filariases 297, 363-366 incubation period 135 Filoviruses 299 Finasteride 511, 769 alopecia 1279 Fingers osteoarthritis 1096, 1098 rheumatoid arthritis 1102, 1103 triggering I 102 Finkelstein 's sign 1080 Finnish nephropathy 52 Fish, food poisoning 331 FISH (fluorescent in situ hybridisation) 50-51 Fish eye disease 448 Fish oi Is I I 0, 45~51 Fissure, skin, definition 1259 Fistulae anorectal 933-934 aorto--duodenal 867 inflammatory bowel disease 913, 914,918-919 Fitz-Hugh- Curtis syndrome 934 Fitzpatrick sign 1265 Flapping tremor (asterixis) 937, 950, 952, I 182 Flat feet 1082, I 103 Flaviviruses 299, 308, 309, 312, 342 Fleas, typhus 339, 340 Flecainide 573, 574 arrhythmias 562, 563, 565, 566 Flucloxaciilin 147,148 cerebral abscess 123 I hepatotoxicity 973 impetigo 1293 infective endocarditis 632 pneumonia 692, 694 septic arthritis I I 18 staphylococcal infections injccting drug user 293 skin/soft tissue 313, 314 systemic sclerosis 1136 Fluconazole 154, 155 acute leukaemia patients 1042 candidiasis 877 genital 409, 410 HIV/AIDS patients 386, 389 cryptococcal infections. HTV-related 390, 393 cutaneous leishmaniasis 354 systemic fungal infections 374, 375 Flucytosine 154, 155 aspergi Ilosis 704-705 cryptococcal infections 375, 393 Fludarabine chronic lymphocytic leukaemia 1046 Waldenstrom's macroglobulinaemia 1052 Fludrocoltisone, adrenal insufficiency 784 Fluid balance 855 assessment, critically ill patients 182 renal failure acute 485 chronic 489 Fluid intake renal failure acute 485 chronic 489 stone disease 472 Fluid loss diabetic ketoacidosis 821 see a/so Dehydration Fluid reabsorption 422 Fluid replacement acute diarrhoea 294-295 bacillary dysentery 331 cholera 330 circulatory collapse 191 diabetic ketoacidosis 822 dying patient 281 food poisoning 326 heat illness 102, 103 intensive care unit 1019 mtravenous acute severe asthma 678 decompression illness 106-107 hypovolaemia 425 metabolic acidosis 439 non-ketotic hyperosmolar diabetic coma 823 pneumonia 691 renal failure acute 485 chronic 489 sepsis 199 short bowel syndrome 899 Flukes (trematodes) 360, 367- 370 liver 297, 370 Flumazenil 213, 233 Fluorescent in situ hybridisation (FISH) 50-51 Fluoride 127 osteomalacia I 129 poisoning 127 Fluorimetry 420 Fluoroquinolones 151 enteric fever 325 plague 323 Fluorosis 226 5-Fluorouracil (5-FU), cancer therapy 265, 266 colorectal cancer 928 gastric cancer 893 pancreatic cancer 910 prostate cancer 5 12 skin cancer 1303 Fluoxetine 241,1177 bulimia 249 fibromyalgia 1121 Flupentixol 243 Fluphenazine 243 Flutamide 769 Fluticasone676,1313 Fluvoxamine 241 FMF (familial Mediterranean fever) 78 FOB (faecal occult blood) testing 255,869 colorectal cancer screening 928 Focal nodular hyperplasia (FNH), liver 986 Focal segmental glomerulosclerosis (FSGS) 500, 50 I, 502, 503 Folate (folic acid) 121, 125 absorption 1028-1029 deficiency 121, 1012, 1027, 1028-1029 coeliac disease 895 management 1029 dietary sources 121 , 125 haemolytic anaemia 1031 myelofi brosis 1055 prevention of neural tube defects 125 reference values 1322 sickle-cell disease 1037 supplements 1029 hereditary spherocytosis 1032 tropical sprue 896 Folate antagonists 152-153 Folinic acid colorectal cancer 928 toxoplasmosis 358 Foilicle-stimtWating hormone (FSH) 743, 762, 763 deficiency 793, 795 reference values in venous blood 1319 Folliculitis 1294 pruritic 1267 Fondaparinux 1064 Fonsecaea compacta 373 Fonsecaea pedrosoi 373 Food allergy 87, 88, 902 Food hygiene 140 Food intolerance 902 irritable bowel syndrome 921 Food poisoning 141, 325-331 and gastroenteritis 294 listeriosis 323, 324 non-infectious causes 331 Foods diabetic 831 glycaemic index 830-831 Foot/Feet arthritis rheumatoid 1102- 1 103 target sites 1072 claw 1082 cold injury 102 diabetic 603, 843, 844 855 examination blood disorders 1000 diabetes 806, 807, 820 fiat 1082, 1103 mossy 1277 pain 1082 Foot drop 490, 844, I 181 Forced expiratory volume in one second (FEV I) 656, 657 chronic obstructive pulmonary disease 680, 682 older people 652 Forced expiratory volume in one second/vital capacity (FEV / VC) ratio 652, 656, 657 asthma 673, 674 chronic obstructive pulmonary disease 680 Forced vital capacity (FYC) 656 Forchheimer spots 30 I Foreign bodies inhalation 658, 661 larynx 731 Formication 246 Fonnoterol 676 Forrestier's disease 1085 Fortification spectra I 195 Fosamprenavir 397, 398, 399 Foscarnet 156 • CMV infection 389, 393 Fosphenytoin 1173 Fractures 1086-1087 fragility 1086, 1087 high-energy 1086, 1087 hip 1123, 1124 preventive measures 167 osteoporotic 1068, 1086, 1121, I 123, I 124 prevention I 125, 1126 pain 1086 pathological 1086 stress (fatigue) 1086, 1087 vertebral 1086, 1087, I 123, I 124, 1125, 1126 Fragile site mental retardation (FRAXE) 46 Fragile X syndrome 46, 52 Frailty 162, 164 Francisella tu/arellsis 325 FRAXE (fragile site mental retardation) 46 FRC (functional residual capacity) 188,656 Freckles 1281 Free fatty acids (FFAs), diabetes 809,810,813,814 Frequency of micturition 473-474 Fresh frozen plasma (FFP) 1021 Ftiedreich's ataxia 643, 1222, 1223 genetics/inheritance 46, 52 Froin's syndrome 1244 Frontal lobes 1151 functions 1149, 1152 effects of damage I 152, I 190 Frostbite 102 Frozen shoulder 1079- 1080 Fructosamine 817 Fructose 855 Fructose intolerance, ~nherited 508 Fruit allergy 88 FSE (feline spongiform encephalopathy) 123 FSH see Follicle-stimulating hormone FTC (emtricitabine) 389, 397, 398, 399 5-FU see 5-Fluorouracil Full blood count (FBC) 1009, 1010 rheumatic disease 1074, 1075 Fumagillin 388, 389 Fumes, lung disease and 720, 721 Functional residual capacity (FRC) 188,656 Functional somatic syndromes 236 Fungal infections 1228 acute leukaemia patients 1042 antifungal agents 154-156 bone marrow transplants 1044 diabetes 807 endocarditis 630, 632 immune deficiency and 71 meningitis 1228 nervous system 1224 respiratory 703-705 irnmunocompromised patients 695 • skin 132, 372- 375, 1297 deep infections 372- 375 HIY/AIDS patients 384 identi fication 1263-1264 scalp 1278 systemic 373- 375 Fungal toxins 505, 517 Funnel chest 737 Funny turns see Blackouts Furosemide 25, 427, 428, 436 ascites 949 heart failure 548 hypertension 613 oedema 481 prescription 26 Furuncies 1294 Fusidic acid 154 impetigo 1293 Fusobacterium u/cerans 298 FYC (forced vital capacity) 656 G G-CSF (granulocyte colony stimulating factor) 266-267, 1003, 1004 melioidosis 325 G-protein-linked receptors 41 , 42 G6PD (glucose-6-phosphate dehydrogenase) 1032 deficiency 52, 1032-1033 GABA (gamma-aminobutyric acid) 1150, 1167 hepatic encephalopathy 950 Gabapentin chronic renal failure 490 epilepsy 1172, 1174 multiple sclerosis 1216 neuropathic pain 278 post-herpetic neuralgia 306 trigeminal neuralgia 1164 GAD (glutamic acid decarboxylase) antibodies, type I diabetes 811 Gait diabetic neuropathy 843 examination, neurological disease 1146, 1147 stamping I 181 waddling 1181 Gait disorders 1180-1181 Parkinson's disease 1181, 1219 Galactorrhoea 799, 800 8 Galactosaemia 442 inheritance 52 Galactose 855 Galactose-I-phosphate uridylyltransferase gene (GALT) 442 Galantamine 1189, 1217 Gallbladder 990, 991 adenomyomatosis 997 cholecystitis 992, 993-995 cholesterolosis 997 disease in older people 997 porcelain 992, 995 strawberry 997 tumours 995-996 gallstones and 993 Gallstones 898, 991-993 hereditary spherocytosis 1031, 1032 pancreatitis 906 pigment 992 ultrasound 941 GALT 442 Gambiense trypanosomiasis 354, 355 incubation period 135 Gamma-aminobutyric acid (GABA) 1150, 1167 hepatic encephalopathy 950 Gamma-glutamyl transferase (GGT) plasma drugs causing increase 940 liver function test 940 reference levels, venous blood 1320 Gamma rays 99 Gammahydroxybutyrate (GHB) 214 Gammopathy 1051 monoclonal 1051 of uncertain significance (MGUS; monoclonal gammopathy unclassified; MGu; benign monoclonal gammopathy) 1051 Ganciclovir 156 CMV infection bone marrow transplant patients 1044 HIV-related 389, 393 Gangliosidosis, GM2- 444 Gangosa 317 Gangrene 10 17 streptococcal 3 16 Gas-bloat syndrome 880 Gas exchange, lungs 651 Gas gangrene 316 chemoprophylaxis 147 Gas transfer factor, measurements 656,657 Gas transfer factor for carbon monoxide (TLco) 656, 657 Gases blood see Arterial blood gases lung disease and 720, 721 Gastrectomy gastric cancer 893 partial gastric cancer 893 peptic ulcer 888-889, 890 vitamin B J2 deficiency 1028 Gastric acid secretion 853 peptic ulcer 887 Zollinger-Ellison syndrome 890 Gastric inhibitory polypeptide (GW) 859 Gastric intrinsic factor 1027-1028 Gastric lavage 211, 212, 219 Gastric surgery, anaemia and 1025, 1028 Gastric tonometry 197 Gastric volvulus 880 Gastric ... see also Stomach Gastrin 853, 859 reference values in venous blood 1319 Zollinger-Ellison syndrome 890 Gastrin-releasing polypeptide 858 Gastrinomas 791, 792, 890 Gastritis 884 885 bile reflux 888 Helicobacter pylori infection 884-885, 886 Gastroenteritis acute management 294-295 severity markers 295 anthrax 333 bacterial 325-331 eosinophilic 901 food poisoning 294 viral 31 1-312 Gastroenteropathy, allergic 902 Gastroenterostomy 890 Gastrointestinal bleeding acute upper gastrointestinal haemorrhage 866-868 endoscopic therapy 867-868 risk factors for death 868 liver disease 947 lower gastrointestinal tract 868-869 NSAIDs and 1090-1091 obscure major bleeding 869 occult 869 Gastrointestinal stromal tumour (GIST) 269, 271, 883, 894, 903 Gastrointestinal tract biopsy 862 clinical examination 850-851 critically ill patients 197-198 diseases/disorders 852 chest pain 536 chronic renal failure 491 endocrine 789 HIV-related 386-388 inheritance 52 investigation 858-864 presenting problems 864-876 protozoal 358-360 systemic sclerosis 1135 tuberculosis 697-698, 699 see also Gastroenteritis function control of 857-858 tests 862-863 functional anatomy 852-857 infections see Infections, gastrointestinal tract obstruction, malignant disease 280 see also individual parts Gastro-oesopbageal reflux disease 877-881, 882-883 with aspiration 658 older people 880 Gastroparesis 845, 863, 891 Gastropathy, congestive 961-962 Gastrostomy, percutaneous endoscopic 119, 120 Gaucher's ~isease 42, 444 Gaze palsy 1196 GBM see Glomerular basement membrane GCA (giant cell arteritis) 1139-1140, 1161 GCK (glucokinase), maturity onset diabetes in the young 815 GCS (Glasgow Coma Scale) 204, 1186 Gefitinib 269 Gegenhal ten 1190 Gels 13 I 2, 1313 Gene linkage 51-52, 59 Gene promoter 38 Gene testing 52 Gene therapy 38, 60-61 cystic fibrosis 687 respiratory disease 650 General Medical Council (UK), duties of registered doctor 4 Generalised anxiety 240 Genes 38 mutations see Mutations oncogenes 48-49 Genetic counselling 57-58 older people 58 Genetic disease(s) 38, 39, 44 48 chromosomal 46-47, 50-51, 53- 59 inheritance patterns 52-54 investigations 50-52, 54-55 monogenic 53-59 older people 58 polygenic 58-59 presenting problems 52-59 risk calculation 58 spectrum of 55 Genetic factors alcoholic liver disease 969 allergy 84 Alzheimer's disease 1217 aortic aneurysm 605 asthma 671 atherosclerotic vascular disease 579 atopic eczema 1284 autoimmune disease 80 cancer 255 colorectal 925-927 cardiomyopathy 642 diabetes mellitus type 1 811-812 type 2814 hyperlipidaemia 446 infection response 135 inflammatory bowel disease 902 leukaemia 1039 obesity 113 osteoarthritis 1098-1099 osteoporosis 1122, 1123 Paget's disease 1129 polygenic disease 58-59 psychiatric disorders 229 rheumatoid arthritis 110 I seronegative spondarthritis 1106 Genetic screening 56-57 Genetic testing 52, 54-57 colorectal cancer 927 ethical issues 56-57 familial adenomatous polyposis 925 predictive 54, 56 Huntington's disease 56 prenatal 56, 57 Genetics, molecular 38 44 Genital cancer, HIV-related 397 Genital itch/rash 407-408 Genital lumps men 408 women 410 Genital ulcers men 408 women 410 Genitalia, examination endocrine disease 740 febrile patient 284 Genitourinary tuberculosis 699 Genome 38-39 Genomic imprinting 54, 56 Gentamicin 151 cerebral abscess 1231 drug interactions 23 infective endocarditis 632, 633 liver abscess 987 meningitis 1227 plague 323 prophylactic 147 tularaemia 325 urinary tract infection 469, 470 Geriatric medicine 160-171 presenting problems 165-168 see also Older people German measles see Rubella Gerstmann-Striiussler-Scheinker syndrome 1189, 1234 GFR see Glomerular filtration rate GGT see Gamma-glutamyl transferase GH see Growth bormone GHB (gammahydroxybutyrate) 214 GHb (glycated haemoglobin) 816-817, 1320 Ghon focus/complex 696 Ghrelin 108, 109,859 GHRH (growth hormone-releasing hormone) 743 Giant cell arteritis (GCA) 1139-1140, 1161 Giardia infections, HIV/AIDS patients 388 Giardia lamblia (intestinalis) infection 296, 359-360 Giardiasis 343, 359-360, 897, 898 Gibbus 1119 Gigantism 801 Gilbert's syndrome/disease 52, 945- 946 Gilles de la Tourette syndrome 1183 GIP (gastric inhibitory polypeptide) 859 GISA (glycopeptide intermediate Staphylococcus au reus) 313 GIST (gastrointestinal stromal tumour) 269, 271, 883, 894, 903 Gitelman's syndrome 434, 440, 508 Gla (y-carboxyglutamic acid) 123 Glabellar tap sign 1219 Glandular fever (infectious mononucleosis) 307-308 Glasgow Coma Scale (GCS) 204, 1186 Glatiramer acetate, multiple sclerosis 1215, 1216 Gliadin, antibodies 895 Glibenclamide 825, 832 Gliclazide 832 Glimepiride 832 Glioblastoma multiforme 1237 Glioma 1206, 1236, 1237 spine 1245 Gliosis 838 Glipizide 831 Glitazones see Thiazolidinediones Global warming 97 Globe disorders I 197 Glomerular basement membrane (GBM) 458, 459 Alport's syndrome 504 anti-GBM (Goodpasture's disease) 499, 501,502,503 thin GBM disease 504 Glomerular diseases 465, 467, 499-504 inherited 503-504 Glomerular filtration rate (GFR) 422,424,434,458,461,462 assessment 462 renal failure acute 482 chronic 487, 488 Glomerulonephritis 499-503 crescentic 502 drug-induced 517 focal segmental (necrotising) 501,502 drug-induced 517 G lomerulonephri tis (cont' d) infection and 501. 503 mesangiocapillary (membranoproliferative) (MCGN; MPGN) 501 • nephrotic syndrome 480 nodular diabetic 842 rapidly progressive 483, 503 systemic lupus erythematosus 515,1134 Glomerulosclerosis, focal segmental (FSGS) 500, 50 I, 502,503 Glomerulus 422, 432, 458, 459 Glossitis, atrophic 850 Glossopharyngeal (9th cranial) nerve, tests 1147 Gloves and socks syndrome 302 GLP-I (glucagon-like peptide) 834 Glucagon 810 cardiotoxic drug poisoning 208, 210 hypoglycaemia 791, 824 management 825 type 2 diabetes 813 Glucagon-like peptide (GLP-I) 834 Glucagonomas 791, 910 Glucocorticoid therapy 24, 25, 784-785 adrenal insufficiency 784 advice to patients 784 congenital adrenal hyperplasia 789 Graves' disease 757 older people 785 prescription 26 side-effects 785 withdrawal 783, 785 see aLso Corticosteroids; Hydrocortisone; Prednisolone Glucocorticoids 778 excess 779-782 see aLso Cushing's syndrome insufficiency 782, 783- 784, 789 Glucokinase (GCK) 815 Gluconeogenesis 808, 809 Glucosamine, musculoskeletal disease 1092 Glucose 855 blood diabetes 816, 817, 819, 820 fasting 817 impaired fasting glucose 817 impaired tolerance 808 normal metabolism 808-810 reference values 1320 stroke patients 1208 see aLso Hyperglycaemia; Hypoglycaemia cerebrospinal fluid 1324 hypoglycaemia management 825 intravenous hyperkalaemia 436 porphyria 453 urinary 815. 819 Glucose tolerance, impaired 808, 817,819 Glucose tolerance test 816, 817 acromegaly 793, 80 I, 802 prolonged 791 Glucose-6-phosphate dehydrogenase (G6PD) 1032 deficiency 52, 1032-1033 Glucuronic acid 1005 Glue sniffing 246 GLUT 4 809 Glutamate 1150, 1167 Glutamic acid decarboxylase (GAD) antibodies, type 1 diabetes 811 Glutaminase 437 Glutamine supplementation, multiple organ failure 197 Glutathione 652 Gluteal enthesopathy 1081 Gluten, coeliac disease 894, 895 Gluten-free diet 896 Glycaemic control, diabetes older people 838 retinopathy prevention 838, 840 self-assessment 819 type I 827, 837- 838 pregnancy 827 type 2 838 Glycaemic index 109 foods 830-83 I Glycaemic load 831 Glycated haemoglobin (GHb) 816--817, 1320 Glycation 816 protein modification 163 Glyceryl trinitrate (GTN) angina 585, 586 unstable 590 circulatory effects 192 effect of hepatic impairment 27 intravenous, malignant hypertension 614 myocardial infarction 597 ointment, anal fissure 933 prescription 26 sublingual 585, 586,597 Glycine 110, 1150 Glycogen 809 Glycogen storage diseases (GSD) 442 443 inheritance 52 Glycols, poisoning 219 Glycopeptide intermediate StaphyLococcus aureus (GfSA) 313 Glycopeptides 144,152 Glycoprotein IIblIlla inhibitors 590-591,598 Glycoprotein intrinsic factor 853 Glycosidases 1071 Glycosides, cardiac plasma concentrations 34 poisoning 208 Glycosuria 812, 814, 815 alimentary (lag storage) '815,816 older people 814 pregnancy 815 renal 508, 815 Glycylcycline 153 GM-CSF (granulocyte macrophage colony stimulating factor) 1003, 1004, 1007 Gnathostomiasis 297 GnRH see Gonadotrophin-releasing hormone Goitre endemic 126,758 Hashimoto'S thyroiditis 757 multinodular 744,747,753, 759-760 retrosternal 662 toxic 760 simple diffuse 759 thyrotoxico~is 746 Gold adverse effects on kidney 517 intramuscular rheumatic disease 1093 side-effects 1093 oral, asthma 676 Golfer's elbow 1080 Golgi apparatus 42 Gonadectomy, prophylactic 771 Gonadotrophin deficiency 764-765 Gonadotrophin-releasing hormone (GnRH) 743 deficiency 764 Gonadotrophin-releasing hormone (GnRH) analogues 512 Gonadotrophin-releasing hormone (GnRH) therapy, infertility 766, 767 Gonococcal infection, disseminated (DGI) 414 Gonorrhoea 406, 409, 413-414 arthritis I 118 incubation period 135 pharyngeal 414 urethritis 406, 407 Goodpasture's disease 499,501, 502,503 Goserelin 512 Gottron's papules 1136, 1282 Gout 1075, 1077, 1078,1111-1115 drug-induced 1142 older people 1114 pressure erosions 1073 prevalence 1068 Graft-versus-host disease (GYHD) 1043, 1044 transfusion-associated 1023 Graham SteeU munnur 629 Granulocyte colony stimulating factor (G-CSF) 266-267, 1003, 1004 melioidosis 325 Granulocyte macrophage colony stimulating factor (GM-CSF) 1003, 1004, 1007 Granulocytes, formation 1003, 1004 Granuloma annulare 1310 Granuloma inguinale 416 Granulomas 77 sarcoidosis 716 tuberculous 696, 699 Granulomatosis, Wegener's 83, 515, 720, 1139, 1141 Granulomatous disease, chronic 71 Granzymes 68 Graves' disease 744,746-747, 754-757,756 HLA associations 80 ophthalmology 746, 747, 756 Grays (Gy)