Index to George Mathew Medicine

Abdominal pain, 531 Abortus fever, (see Brucellosis) Acid peptic disease, (see Peptic ulcer) Acidosis, 627 metabolic acidosis, 627 respiratory acidosis, 628 Acne vulgaris, 207 Acquired immunodeficiency syndrome (AIDS), 192 Acromegaly, 705 Acute cholecystitis, 532 Acute circulatory failure, (see Shock) Acute coronary syndromes, 434 non-Q-wave MI, 434 non-ST segment elevation myocardial infarction, 434 Q-wave MI, 434 ST elevation MI, 434 unstable angina, 434 Acute inflammatory demyelinating polyradiculoneuropathy (AIDP),282 Miller Fisher syndrome, 283 Acute nephritic syndrome, 632 aetiology, 632 clinical features, 633 Acute pyelonephritis, 638 Acute renal failure, 638 aetiopathogenesis, 645, 646 clinical features, 646 management, 646 diuretic phase, 646 maintenance phase, 646 oliguric phase, 646 non-oliguric renal failure, 646 • Acute respiratory distress syndrome (ARDS), 88 acute lung injury, 88 aetiology, 88, 89 clinical features, 89 investigation, 89 management, 89, 90 non-cardiogenic pulmonary oedema, 88 Acute tubular necrosis, 646 Acute urethral syndrome, 637 Adams-Stokes attacks, 378 Addison's disease, 722 Adrenal crisis, 723 Adrenal gland, 718 hormones, 718 Affective disorders, 591 Agranulocytosis, 28 causes, 29 neutropenia, 29 treatment, 29 • Alcohol withdrawal, 596, 597 alcoholic hallucinosis, 597 delirium tremens, 597 withdrawal seizures, 597 Alimentary glycosuria, 730 Alkalosis, 628 metabolic, 628 respiratory, 628 Allergy, 149 Alpha-fetoprotein, 292, 601 Alphal-antitrypsin, 338 Alphal-antitrypsin deficiency, 143 Alzheimer's disease, 250 Amoebic dysentery, 671, 672 Amoebic.1iver abscess, 687 Anaemia, 4 addisonian pernicious, 10 aetiology, 4 aplastic, 15 autoimmune haemolytic, 25 classification, 4 clinical features, 4 due to blood loss, 4 haemolytic, 25 iron-dextran, 7 iron-sorbitol, 9 management, 5 normocytic, 14 of chronic disease, 15 Anaphylactic reactions, 190 Anaphylactoid purpura, 545, 546 Ancylostomiasis, 694 Angina pectoris, 431 angina decubitus, 431 drug treatment, 432 beta-blockers, 432 calcium antagonists, 433 nitrates, 432 nocturnal, 422, 432 Prinzmetal's,432 variant, 432 Angiotensin converting enzyme inhibitors, 396 Angiotensin receptor blockers, 447 Anion gap, 617, 618 Ankylosing spondylitis, 540 Anorexia, 486 Anthrax, 663 cutaneous, 663 inhalation, 663 Antibiotic associated colitis, 514 Anticholinergic syndrome, 576 • Anticoagulants, 71 coumarin derivative, 71 heparin, 71 heparin-induced thrombocytopenia, 72 hirudin, 73 indandione derivatives, 71 low-molecular weight heparins, 72 unfractionated heparin, 71 warfarin, 72 Antidepressant drugs, 600 Antineutrophil cytoplasmic antibodies, 557 Antinuclear antibodies, 548 Antiphospholipid syndrome, 550 antiphospholipid antibodies, 550 Antipsychotic drugs, 591, 600 Anuria, 630 Anxiety disorders, 593 agoraphobia, 594 classification, 593 generalised anxiety disorder, 594 obsessive compUlsive disorder, 594 panic disorder, 593 phobic disorders, 594 post-traumatic stress disorder, 594 Aortic aneurysms, 474 abdominal, 474, 475 thoracic, 475 Aortic dissection, 476, 532 Aortic regurgitation, 420 aetiology, 420 angina, 422 Austin Flint murmur, 423 clinical features, 424 Corrigan's neck sign, 421 De-Musset's sign, 421 Duroziez's sign, 421 Gerhardt's sign, 421 Hill's sign, 422 Landolfi's sign, 421 lighthouse sign, 421 Muller's sign, 421 nocturnal angina, 422 peripheral signs, 420 pistol-shot femorals, 421 Quincke's sign, 421 Rosenbach's sign, 421 severity, 422 Traube's sign, 421 Aortic stenosis, 418 aetiology, 418 angina, 419 aortic valve, 418 classification, 418 clinical features, 418 severity, 419 Apex beat, 358 abnOlmalities in position, 359 double, 359 • heaving, 359 hyperdynanlic, 359 Hypokinetic, 359 Tapping, 359 Aphasia, 219 motor, 219 Broca's, 219 transcortical, 219 Wernicke's, 219 sensory, 219 Aplastic anaemia, 15 aetiology, 16 classification, 16 clinical features, 16 diagnosis, 17 management, 17 Apoptosis, 606 Apraxia, 218 Arboviruses, 657 major clinical syndromes, 657 Argyll Robertson pupil, 230 Arrhythmias, 364 atrial ectopics, 365 atrial fibrillation, 366 atrial flutter, 366 atrial premature beats, 365 ectopic beats, 365 paroxysmal supraventricular tachycardia, 371 premature beats, 365 sick-sinus syndrome, 371 sinus arrhythmia, 364 sinus tachycardia, 366 supraventricular ectopics, 365 supraventricular tachycardias, 366 torsades de pointes, 456 ventricular ectopics, 365 ventricular extrasystoles, 365 ventricular premature beats, 365 ventricular tachycardia, 372 Wolff-Parkinson-White syndrome, 371 Arterial blood gas, 80 Arterial pulse, 352 character, 354 radiofemoral delay, 355 anacrotic pulse, 354 bisferiens pulse, 354 collapsing, 354 dicrotic pulse, 354 hyperkinetic,354 hypokinetic, 354 pulse, 354 pulsus alternans, 355 pulsus bigeminus, 355 pulsus parvus et tardus, 354 water-hammer, 354 rhythm,353 volume, 353 Asbestos-related diseases, (see Pneumoconioses) Ascariasis, 693 Ascites, 328, 331 ascitic fluid, 332 bacterial, 334 causes, 331 cirrhosis, 328 constrictive pericarditis, 333 mechanism, 331 puddle sign, 331 Athetosis, 254 Atrial septal defect, 470 ostium primum type, 470 ostium secundum type, 470 sinus venosus type 470 Austin Flint murmur, 423 mitral stenosis, 423 Australia antigen, 306 Autoantibodies in connective tissue diseases, 549 antibodies, 549 anti-centromere, 549 anti-double-stranded DNA, 549 anti-histone, 549 anti-jol,549 anti-La, 549 antineutrophil cytoplastic, 549 antiphospholipid, 549 anti-Ro, 549 anti-scl-70, 549 anti-Smith, 549 anti-SS-A, 549 anti-SS-B, 549 anti-topoisomerase I, 549 anti-U1 ribonucleoproteins, 549 Autoimmune haemolytic anaemias, 25 classification, 25 Evan's syndrome, 25 warm antibody, 25 Autoimmunity, 188 Automated external defibrillator (AED), 375 Azotaemia, 630 Babinski's sign, 217 Bacillary dysentery, 671 amoebic, 671 Barbiturate poisoning, 568 Barlow's syndrome, 416 BeG vaccination, 124 complications, 124 contraindications, 124 policy, 124 Bell's palsy, 228 Beriberi,584 dry,585 wet, 584 Beta-blockers, 398 Biliary cirrhosis, 338 primary, 338, 339 secondary, 340 • • Bilirubin, 293 metabolism, 296 sources, 294 Bioterrorism, 571 Bleeding disorder, 61 coagulation defects, 61 platelet disorder, 61 screening tests, 62 vessel wall abnormalities, 61 Bleomycin, 602 Blood transfusion, 74 complications, 74 Body mass index, 586 Bone marrow transplantation, 31, 35 allogeneic, 35 graft-versus-host disease, 35 indications, 35 Botulism, 666 Breakbone fever, (see Dengue) Briquet syndrome, 595 Bronchial adenoma, 156 Bronchial asthma, 126 aetiopathogenesis, 127 chronic, 128 classification, 127 clinical features, 128 drug therapy, 129 adrenaline, 130 aminophylline, 131 beclomethasone, 131 budesonide, 131 fenoterol 130 fluticasone, 131 formoterol, 130 hydrocortisone, 131 ipratropium, 132 ketotifen, 132 montelukast, 132 nedocromil, 132 prednisolone, 131 salbutamol, 130 salmeterol, 130 sodium cromoglycate, 131 terbutaline, 130 theophylline, 130 tiotropium, 132 zafirlukast, 132 zileuton, 132 episodic asthma 128 exercise-induced asthma, 133 immunotherapy, 129 inhaler, 132 investigations, 129 management, 129, 133 at home, 133 in hospital, 134 non-invasive ventilation, 134 mediators, 127 severe acute asthma, 128, 133 severity, 133 spacer, 132 status asthmaticus, 128 triggering factors, 128 Bronchial carcinoma, 151 aetiology, 151 hypertrophic osteoarthropathy, 155 neurological manifestations, 155 Pancoast's syndrome/tumour, 156 paraneoplastic syndromes, 153 pathology, 152 staging, 154 superior sulcus tumour syndrome, 156 Bronchial obstruction, 136 complete obstruction, 136 management, 137 partial obstruction, 137 Bronchial tumours, 151 classification, 151 Bronchiectasis, 146 aetiology, 147 Brock's syndrome, 149 bronchiectasis sicca, 149 classification, 146 clinical features, 147 complications, 148 definition, 146 investigations, 147 management, 148 middle lobe bronchiectasis, 149 middle lobe syndrome, 149 postobstructive, 149 Bronchopulmonary aspergillosis, 125 ,allergic bronchopulmonary, 126 aspergilloma, 125 classification, 125 invasive pulmonary, 125 Bronchopulmonary segment, 79 Brown-Sequard syndrome, 274 Brucellosis, 673 acute, 673 bacillary dysentery, 673 chronic, 673 Budd-Chiari syndrome, 335, 341 aetiology, 341 clinical features, 342 Calcitonin, 578, 716 • • Calcium channel blockers, 437 • Calcium pyrophosphate dihydrate deposition disease, 559 Calcium, 577 Candidiasis, 680 Carbamate poisoning, 566 atropine, 567 pralidoxime, 567 Carbimazole, 711 Carbon dioxide narcosis, 80 Carcinoid syndrome, 512 Carcinoid tumours, 512 Cardiac cirrhosis, 340 Cardiac murmur and Valsalva manoeuvre, 452 Cardiac tamponade, 465 Cardiogenic shock, (see Shock) Cardiopulmonary resuscitation, 373 advanced life support, 375 basic life support, 373 precordial thump, 375 complete AV block, 378 first degree, 377 Mobitz type I, 377 Mobitz type II second degree, 377 second degree AV block, 377 third degree, 378 Wenckebach,377 Cardioversion, 378 Carey-Coombs murmur, 481, 482 Cardiomyopathy, 459 classification, 460 hypertrophic obstructive cardiomyopathy, 462 idiopathic hypertrophic subaortic stenosis, 462 Cell-mediated immune response, 182 Cerebello-pontine angle, 231 Cerebrospinal fluid, 222 abnOlmalities, 224 nonnal, 257 Cerebrovascular accidents, 243 embolic, 245 haemorrhagic, 245 haemorrhagic strokes, 243 ischaemic strokes, 243 management, 246 risk factors, 243 stroke in evolution, 245 subarachnoid haemorrhage, 248 thrombolytic therapy, 247 thrombotic, 245 transient ischaemic attacks, 244 Chancroid, 698 Charcot joint, 266 Charcot's triad, 300 Chemical terrorism, 571 Chest pain, 348 differential diagnosis, 348 Cheyne-Stokes breathing, 350 Chickenpox, 656 Cholera, 673 cholera sicca, 673 hanging drop, 674 pathogenesis, 673 treatment, 674 Vibrio cholerae, 673 bengalserogroup, 673 classical, 673 E1 Tor, 673 • Chorea minor, (see Sydenham's chorea) Chorea, 254 Christmas disease, 68 Chromosomal disorders, 609 Chromosomes, 607 chromosomal aberrations, 608 chromosomal disorders, 608, 609 Chronic bronchitis, 138 aetiology, 138 clinical features, 139 complications, 139 cor pulmonale 140 definition, 13 8 investigations, 139 management, 141 pathogenesis, 138 pulmonary hypertension, 140 respiratory failure, 140 secondary polycythaemia, 140 severe acute exacerbations, 141 Chronic myeloid leukaemia, 36 accelerated phase, 38 alpha interferon, 44 blast crisis, 38 bone marrow transplantation, 38 cases in all three phases, 46 chronic stable phase, 36 imatinib mesylate, 37 leucocyte alkaline phosphatase, 37 treatment, 37 vs. myelofibrosis, 40 • • Chronic obstructive airway disease, (see Chronic obstructive pulmonary disease) Chronic obstructive pulmonary, 138 chronic bronchitis, 138 disease, 138 definition, 138 emphysema, 138 Chronic pyelonephritis, 639 Chronic renal failure, 641 causes of anaemia, 641 clinical features, 641 investigations, 642 management, 642 reversible factors, 642 Churg-Strauss syndrome, 555 Chvostek sign, 717 Chylous ascites, 335 Ciliary dysfunction, 149 Circle of Willis, 242 aneurysm, 242 Cirrhosis, 313 aetiology, 314 classification, 314 clinical features, 314 pathology, 314 Clubbing, 81 causes, 82 • • grading, 82 mechanisms, 81 Clutton's joints, 546 Coal-worker's pneumoconiosis, (see Pneumoconiosis) Coarctation of aorta, 467 radio-femoral delay, 467 radiological features, 468 Suzman's sign, 467 Coeliac disease, 508 antiendomysial antibodies, 509 anti gliadin antibodies, 509 gliadin, 508 Coma, 285 approach, 287 causes, 286 Edinburgh classification, 286 Glasgow coma scale, 286 Complements, 181, 183 Conduction system, 362 Conn's syndrome, 721 Constipation, 487 Coombs' test, 25 cold haemagglutinin disease, 25 drug-induced, 25 paroxysmal cold haemoglobinuria, 25 Cor pulmonale, 398 acute, 399 chronic, 399 clinical features, 400 management, 400 pathogenesis, 401 Corticosteroids, 121, 724 side effects of, 724 Courvoisier's law, 300 COX enzymes, 537 COX-1,537 COX-2,537 COX-2 inhibitors, 537 Cranial arteritis, 554 Creatinine clearance, 632 Creeping eruption, 695 CREST syndrome, (see Progressive systemic sclerosis) Crigler-Najjar syndrome, 299 Crohn's disease, 523 ANCA,525 ASCA,525 clinical features, 524 complications, 524 pathology, 523 treatment, 525 ulcerative colitis, 526 CT scan, 222 contrast agents, 222 Cushing's syndrome, 718 Cutaneous larva migrans, 695 Cyanosis, 351 central, 352 differential, 352 peripheral,352 Cyclic neutropenia, 29 Cyclophosphamide, 602 Cysticercosis, (see Taenia solium) Cytokines, 181, 186 Datura poisoning, 570 Dawn phenomenon, 743 De-Carvallo's sign, 424 De Quervain's thyroiditis, 711 Deep venous thrombosis, 452 common sites, 453 D-dimer, 454 Doppler ultrasonography, 454 phlebpgraphy, 454 prophylaxis, 454 risk factors, 454 treatment, 454 Defibrillation, 462 Dehydration, 620 Delirium, 220 Dementia, 221 Dendritic cells, 181 Dengue, 658 breakbone fever, 658 clinical classification, 659 dengue haemorrhagic fever, 659 criteria for diagnosis, 659 pathogenesis, 659 dengue shock syndrome, 659 Depression, 592 Dermatomyositis, 552 classification, 553 Gottron's sign, 553 polymyositis, 553 Dermatophytosis, 214 tinea barbae, 214 tinea capitis, 214 tinea corporis, 214 tinea cruris, 214 tinea pedis, 214 tinea unguium, 214 Diabetes insipidus, 707 desmopressin, 707 nephrogenic, 707 primary, 707 secondary, 707 • water deprivation test, 707 Diabetes mellitus, 726 Benedict's test, 730 classification, 726 clinical features, 728 complications, 737, 738 dawn phenomenon, 743 diabetic ketoacidosis, 738 • • diabetic nephropathy, 744 diabetic neuropathy, 745 diabetic retinopathy, 745 diagnosis, 746 dietary management, 731 gestational diabetes mellitus, 747 glycosylated haemoglobin, 738 glycosylated proteins, 737 hyperglycaemic hyperosmolar state, 740 hyperosmolar non-ketotic diabetic coma, 740 hypoglycaemia, 741 impaired fasting glucose, 729 impaired glucose tolerance, 729 insulin, 734 analogues, 734 aspart, 736 human, 735 lispro, 735 preparations, 736 purification, 734 latent diabetics, 728 lactic acidosis, 743 necrobiosis lipoidica diabeticorurn, 747 oral glucose tolerance test, 730 oral hypoglycaemic drugs, 731 alpha-glucosidase inhibitors, 733 biguanides, 732 meglitinide, 732 sulphonylureas, 731 thiazolidinediones, 733 pathogenesis, 738 potential diabetics, 728 regimens, 736 Somagyiphenomenon, 742 type lItype 2, 728 Diarrhoea, 488 chronic, 489 traveller's, 512 Differential cyanosis, 351 Digoxin, 393 loop diuretics, 394 potassium sparing diuretics, 394 amiloride, 394 spironolactone, 394 triamterene, 394 thiazides, 395 acetazolamide, 395 toxicity, 393 Dilated cardiomyopathy, 460 Diphtheria, 662 Directly observed treatment short course, (see Pulmonary tuberculosis) Disseminated intravascular coagulation, 68 causes, 69 clinical features, 69 investigations, 69 management, 69 pathogenesis, 69 Diuretics, 394 angiotensin converting enzyme inhibitors, 396 carbonic anhydrase inhibitors, 394 heart failure, 394 precautions, 397 vasodilator therapy, 395 DNA cloning, 652 DNA probes, 652 Down's syndrome, 613 Dressler's syndrome, 435 Dubin-Johnson syndrome, 299 Dumping syndrome, 502 Dwarfism, 704 Dyspepsia, 503 flatulent, 503 functional, 503 non-ulcer, 503-505 ulcer, 519, 528 Dysphagia, 494 Dyspnoea, 177 acute onset, 177 differential diagnosis, 178 hysterical hyperventilation syndrome, 179 laryngeal obstruction, 178 Dystonia, 255 Echinococcus granulosus, 692 Echoencephalography, 223 Eczema, 204 endogenous, 204 asteatotic, 204 atopic, 204 discoid, 204 gravitational, 204 pompholyx, 204 seborrhoeic, 204 exogenous, 204 allergic, 204 irritant, 204 Eisenmenger's syndrome, 472 Electrocardiogram, 362 Electroconvulsive therapy, 600 Electrolytes, 617 Emphysema, 143 aetiology, 143 clinical features, 144 compensatory, 143 complications, 143 definition, 143 investigations, 143 mediastinal, 143 pathology, 143 pink puffers, 146 pulmonary, 146 subcutaneous, 143 treatment, 145 vs. chronic bronchitis, 146 • Empyema thoracis, 171 complications, 172 Encephalitis, 261 herpes simplex, 262 post-infectious, 262 Endemic goitre, 714 Endoscopic retrograde cholangiopancreatography, 293 Endoscopic variceal band ligation, 324 Enteric fever, 668 carrier state, 668 complications of, 669 nalidixic acid resistant Salmonella typhi, 669 prevention, 670 Widal test, 669 Enterobiasis, 693 Eosinophilia, 2 Epilepsy, 235 absence seizures, 236 aetiology, 236 antiepileptic drugs, 239 causes, 239 classification, 236 complex absence seizures, 237 complex partial seizures, 237 EEG,238 jacksonian seizures, 237 petit mal, 237 reflex, 237 secondary generalised seizures, 237 simple partial seizures, 237 tonic-clonic seizures, 237 Erythema multifonne, 208 Erythropoietin, 1 ectopic sources, 1 indications, 1 recombinant human erythropoietin, 1 side effect, 1 Extrinsic allergic alveolitis, (see Hypersensitivity pneumonitis) Facial nerve, 230 lesions, 230 topographical anatomy, 230 Fallot's tetralogy, 473 Fanner's lung, (see Hypersensitivity pneumonitis) Fatty liver, 342 alcoholic, 342 steatohepatitis, 342 steatosis, 342 non-alcoholic, 342 steatohepatitis, 420 steatosis, 342 Felty's syndrome, 538 Fever of unknown origin, (see Pyrexia of unknown origin) Fibrinolytic agents, 73 acyl-SK-plasrninogen, 73 indications, 73 pro-urokinase, 73 recombinant tissue plasminogen activator, 73 streptokinase, 73 urokinase, 73 Filariasis, 696 bancroftian, 696 lymphatic, 696 Fluorosis, 586 Folic acid, 13 deficiency, 13 Fomepizole, 563 Food poisoning, 670 • causes, 670 Fosphenytoin, 242 Friedlander's pneumonia, 100 Froin's syndrome, 225 Giardiasis, 511 Gardner's syndrome, 515 Gastro-oesophageal reflux disease, 495 Gaucher's disease, 46 Gel electrophoresis, 652 Gene therapy, 615 Geniculate herpes, 229 German measles, (see Rubella) Giant cell arteritis, 554 Gilbert's syndrome, 299 Glandular fever, (see Infectious mononucleosis) Globus hystericus, 515 Glomerulonephritis, 632 acute, 632 Glossitis, 494 Glucose-6-phosphate dehydrogenase, 19 Gluten-induced enteropathy, 508 Gonococcal urethritis, 697 Gout, 557 Graham Steell murmur, 411, 449 Graves' disease, (see Hyperthyroidism) Guillain-Barre syndrome, 282 Gynaecomastia, 313 complications, 317 prognosis, 317 Haematopoietic growth factors, 1 granulocyte colony-stimulating factor, 1 thrombopoietin, 1 Haematuria, 631 painless, 631 Haemochromatosis, 335 Haemodialysis, 643 dialysis dementia, 643 dialysis disequilibrium syndrome, 643 Haemoglobin, 20 structure, 20 Haemoglobinopathies, 20 classification, 20 Haemolytic anaemias, 25 causes, 27 classification, 27 • clinical features, 27 diagnosis, 27 treatment, 27 Haemophilia A, 66 antenatal diagnosis, 67 classification, 67 clinical features, 67 cryoprecipitate, 67 desmopressin, 67 epsilon amino-caproic acid, 67 factor VIII concentrate, 67 genetics, 66 investigations, 67 management, 67 tranexamic acid, 67 Haemophilia B, 68 Christmas disease, 68 Haemoptysis, 109 causes, 109 investigations, 109 massive, 109 vs. haematemesis, 176 Haemostasis, 58 coagulation cascade, 59 common pathway, 60 extrinsic pathway, 60 inhibitors of coagulation, 60 intrinsic pathway, 60 fibrinolytic system, 61 mechanism, 58 primary, 59 secondary, 59, 60 Hand muscles, wasting, 285 Hansen's disease, (see Leprosy) Hashimoto's thyroiditis, 714 Heart failure, 386-388 acute, 387 afterload, 395 amrinone,391 ascites, 392 pathogenesis, 392 backward, 387 biventricular, 387 brain natriuretic peptide (BNP), 390 cardiac cachexia, 390 cardiac oedema, 389 causes, 388 chronic, 387 forward,387 high output, 387 left sided, 387 low output, 387 management, 390 milrinone, 391 myocardial contractility, 386 myocardial remodelling, 386 orthopnoea, 386 paroxysmal nocturnal dyspnoea, 388 precipitating, 388 preload,386 refractory heart failure, 392 right sided, 387 Heart sounds, 389 rhythm,362 gallop, 389 quadruple, 389 triple, 389 Heat-related illnesses, 572 exertional heat injury, 574 heat cramps, 572 heat exhaustion, 573 heat oedema, 573 heat stroke, 574 predisposing factors, 573 Heerfordt-Waldenstrom syndrome, (see Sarcoidosis) Heinz's bodies, 3 Helicobacter pylori, 496 tests, 499 treatment, 500 Hemiballismus, 255 Hemiplegia, 217 Henoch-Schonlein purpura, 545 Hepatic encephalopathy, 325 chronic, 325 portosystemic encephalopathy, 325 Hepatic failure, 306 complications, 307 fulminant, 306 subacute, 308 Hepatic venous outflow tract, 341 Hepatitis, acute, 362, 363 anicteric hepatitis, 368 clinical features, 367 complications, 369 delta hepatitis, 366 hepatitis A, 364 hepatitis B, 365 hepatitis e, 367 hepatitis E, 367 serological tests, 369 toxin-induced,362 viral,363 Hepatitis B surface antigen, 306 chronic carrier, 306 Hepatitis, chronic, 306 autoimmune, 311 causes, 310 hepatitis B, 311 • hepatitis e, 313 hepatitis D, 313 lobular, 309 chronic persistent, 309 classification, 309 grade, 309 stage, 309 , Hepatocellular carcinoma, 344 Hepatoma, 344 Hepatorenal syndrome, 327 Hereditary spherocytosis, 19 Herpes viruses, 655 diseases, 655 Herpes zoster, 263 Hiatus hernia, 497 sliding, 497 Hiccough, 486 HLA system, 191 genes, 192 immune functions, 192 significance, 192 HookwOlm disease, 694 Homer's syndrome, 228 Howell-Jolly bodies, 3 • • • HTreceptor antagonists, (see Peptic ulcer) Human immunodeficiency virus, 242 acute sero~conversion, 244 aetiology, 243 AIDS dementia complex, 196 AIDS-related complex, 194 antiretroviral drugs, 198 indications, 199 non-nucleoside reverse transcriptase inhibitors, 198 nucleoside reverse transcriptase inhibitors, 198 protease inhibitors, 199 antiretroviral regimens, 199 antitubercular drugs, 200 cancers, 194 classification, 193 clinical categories, 193 constitutional disease, 194 cryptococcal meningitis, 197 diagnosis, 195 candida, 196 cryptococcus, 197 cytomegalovirus, 195 herpes zoster, 195 H. simplex, 195 toxoplasma, 195 diarrhoea, 196 healthcare workers, 202 infections, 197 neurological diseases, 196 , , persistent generalised lymphadenopathy, 194 Pneumocystis carin ii, 195 post-exposure prophylaxis, 202 pregnancy, 201 primary eNS lymphoma, 197 progressive multifocal leucoencephalopathy, 196 replication cycle, 193 retinitis, 197 spectrum, 194 toxoplasma encephalitis, 197 transmission, 193 Humoral immune response, 181 Hydatid disease, 692 Hydropneumothorax, 175 physical signs, 175 Hyperaldosteronism, 721 primary, 721 secondary, 721 Hypercalcaemia, 716 Hypercalcaemic crisis, 716 Hypercapnic encephalopathy, 80 Hyperkalaemia, 625 Hyperlipidaemia, 748 bile acid sequestrants, 750 causes, 748 fibrates, 751 HMG-CoA reductase inhibitors, 750 management, 750 niacin, 751 risk factors, 749 statins, 751 Hypematraemia, 620 Hyperparathyroidism, 715 classification, 715 clinical features, 715 Hyperprolactinaemia, 706 Hypersensitivity pneumonitis, 135 clinical features, 136 definition, 135 investigations, 136 treatment, 136 Hypersplenism, 48 Hypertension, 442 aetiology, 442 classification, 442 complications, 443 drug therapy, 445 primary, 442 secondary, 442 malignant hypertension, 444 Hypertensive encephalopathy, 448 Hyperthermia, 575 Hyperthyroidism, 709 antithyroid drugs, 711 ophthalmopathy, 710 pathogenesis, 709 pretibial myxoedema, 710 radioactive iodine, 711 surgical treatment, 711 Hypertrophic cardiomyopathy, 479 Hyperuricaemia, 567 Hypervitaminosis D, 579 Hypokalaemia, 624 Hyponatraemia, 618 Hypoparathyroidism, 717 Hypopituitarism, 703 Hypothalamic hormones, 703 Hypothyroidism, 712 • myxoedema facies, 713 neuropsychiatric manifestations, 714 primary, 712 secondary, 712 Hypoxaemia, 81 Hysteria, 595 Briquet's syndrome, 595 conversion disorder, 595 dissociation disorder, 595 Idiopathic thrombocytopenic purpura, 64 acute, 64 chronic, 64 diagnosis, 64 treatment, 64 androgens, 65 anti-RbD globulin, 65 corticosteroids, 64 immunosuppressive therapy, 65 intravenous immunoglobulin, 65 splenectomy, 64 Idiopathic tropical malabsorption syndrome, (see Tropical sprue) Immune reactions, 189 anaphylactic, 189 antibody, 189 cell-mediated, 189 cytotoxic, 189 immune complex mediated, 189 stimulatory, 189 Immune thrombocytopenic purpura, 64 Immunity, 180 innate, 180 cellular components, 180 Immunoglobulins, 185, 186 functions, 186 Immunosuppressive drugs, 203 Impotence, 725 Infectious mononucleosis, 655 Epstein-Barr virus, 655 Paul Bunnell test, 655 Infective endocarditis, 425 acute, 425 common organisms, 426 Janeway lesions, 430 Osler's nodes, 427 postoperative, 425 predisposing factors, 426 prophylaxis, 429 Roth's spots, 427 splinter haemorrhages, 427 subacute, 425 Inflammatory bowel disease, 519, 524 complications, 524 Crohn's disease, 523 ulcerative colitis, 520 Infiuenza,92 Innocent murmurs, 484 Insulin resistance syndrome, 747 Interferon alfa-2b, 312 Interferons, 187 Interleukins, 186 Interstitial lung diseases, 160 aetiology, 160 clinical features, 160 definition, 160 idiopathic pulmonary fibrosis, 162 investigations, 161 treatment, 161 Intervertebral disc prolapse, 272 Intestinal ulcers, 519 Intracerebral haemorrhage, 249 Intracranial pressure, 231 Iron deficiency anaemia, (see Anaemia) Irritable bowel syndrome, 515 pain-predominant, 516 Ischaemic colitis, 513 Ischaemic heart disease, 430 aetiology, 430 risk factors, 431 Janeway lesions, 430 Japanese encephalitis, 661 Jaundice, 290, 296 cholestatic, 297 clinical features, 297 conjugated hyperbilirubinaemia, 297 haemolytic, 297, 298 hepatocellular, 297, 298 obstructive, 298 unconjugated hyperbilirubinaemia, 290 Jud-Basedow phenomenon, 714 Jugular venous pressure, 356 abdominojugular reflux test, 356 abnormalities in wave form, 357 hepatojugular reflux, 356 raised jugular venous pressure, 357 Juvenile rheumatoid arthritis, 538 Juxtaglomerular apparatus, 629 Kala-azar, 689 amphotericin B, 690 investigations, 689 miltefosine, 690 pentamidine, 690 pentavalent antimonials, 690 visceral leishmaniasis, 689 Kartagener's syndrome, 149 Kayser-Fleischer ring, 337 Keratoconjunctivitis sicca, 539 Kernicterus, 26 Kidney, 629 functions, 629 nephron, 629 • , Klinefelter's syndrome, 613 Korsakoff's psychosis, 585 Kussmaul's sign, 358, 466 Lactose intolerance, 510 Langerhans cells, 181 Large granular lymphocytes, 181 Lateral medullary syndrome, 245 Left atrial myxoma, 481 Leishmaniasis, 690 Lenegre's disease, 378 Leprosy, 674 bacterial index, 675 determinate, 675 erythema nodosum leprosum, 677 indeterminate, 675 lepromatous, 676 lepromin test, 677 morphological index, 675 multibacillary, 678 paucibacillary, 675 reversal reaction, 677 SFG index, 675 treatment, 677 tuberculoid, 677 type l/type 2 lepra reaction, 677 Leptospirosis, 678 investigations, 679 treatment, 680 Leukaemias, 29 acute, 29 acute lymphoblastic, 30 acute myelogenous, 30 bone marrow transplantation, 31 clinical features, 30 definition, 30 investigations, 31 leukaemic meningitis, 31 management, 31 aetiology, 30 aleukaemic,33 chronic lymphocytic, 42 Binet staging, 43 clinical features, 42 clinical staging, 43 investigations, 42 treatment, 42 chronic myeloid, 45 accelerated phase, 48 alpha interferon, 47 blast crisis, 38 bone marrow transplantation, 38 imatinib mesylate, 37 treatment, 37 vs. myelofibrosis, 38 classification, 29 hairy cell leukaemia, 44 cladribine, 44 Leukaemoid reaction, 33 Lev's disease, 378 Libman-Sachs endocarditis, 546 Lipoproteins, 748 transport, 748 Liver, 290 albumin 291 alkaline phosphatase,.291 aminotransferases, 292 biopsy, 292 coagulation factors, 291 function tests, 290 functions, 290 gamma-glutamyl transpeptidase, 291 globulins, 291 Liver abscess, 345 pyogenic, 345 Lobes of brain, 268 features of lesions, 268 functions, 268 • Loeffier's syndrome, (see Sarcoidosis), 135,695 Lower gastrointestinal bleeding, 514 Lower motor neuron lesion, 217 Lumbago,272 Lumbar puncture, 223 formation, 223 functions, 224 .Lung abscess, 150 complications, 150 Lutembacher's syndrome, 470 Lymphadenopathy, 76 differential diagnosis, 76--78 Lymphocytes, 181 Lymphogranuloma venereum, 698 Lymphomas, 48 adult T celllymphomaJleukaemia, 51 Hodgkin's disease, 48 Ann Arbor classification, 49 classification, 48 clinical manifestations, 48 clinical staging, 49 investigation, 49 management, 50 Pel-Ebstein fever, 49 Reed-Sternberg (RS) cell, 48 vs. Hodgkin's disease, 52 vs. non-Hodgkin's lymphoma, 52 non-Hodgkin's lymphoma, 50 anaplastic large cell, 51 Burkitt's, 51 classification, 50 clinical features, 51 management, 52 mantle cell, 51 • mucosa-associated lymphoid tissue (MALT), 51 mycosis fungoides, 51 Magnetic resonance imaging, 222 Major histocompatibility complex, 182 Malabsorption syndrome, 506 aetiology, 506 clinical features, 507 investigations, 507 Maladie de Roger, 471 Malaria, 680 algid,684 anaemia, 684 black water fever, 685 cerebral malaria, 683 chemoprophylaxis, 687 chemotherapy, 686 circulatory collapse, 684 diagnosis, 687 disseminated intravascular coagulation, 684 disturbances, 684 epidemiology, 681 falciparum malaria, 682 fluid,684 haemoglobinuria, 685 hyperparasitaemia, 685 hyperpyrexia,685 hypoglycaemia, 684 malaria, 680 malignant tertian, 682 plasmodium, 681 life cycle, 681 prevention, 687 pulmonary oedema, 684 radical cure, 686 renal failure, 684 stable, 680 unstable, 680 • Malignant ascites, 334 Malignant hyperthermia, 575 Malignant pustule, (see Anthrax) Malta fever, (see Brucellosis) Mammary souffie, 484, 485 Mania, 600 Mantoux test, (see Tuberculin test) Marie-Strumpell disease, (see Ankylosing spondylitis) Measles, 653 Koplik's spots, 653 MMR vaccine, 654 Mediastinal masses, 158 Mediastinum, 156 anterior, 157 middle, 157 posterior, 157 superior, 157 Mediterranean, (see Brucellosis) Megaloblastic macrocytic anaemias, (see Anaemia) Meigs'syndrome,335 Men 1, 715 Men 2A, 715 Men 2B, 715 Meniere's disease, 227 Meningitis, 257 • aetiology, 257 antibiotics, 259 Brudzinski's leg sign, 259 Brudzinski's neck sign, 259 classification, 257 complications, 260 CSF findings, 259 H irif/uenzae, 258' Kemig's sign, 259 Listeria monocytogenes, 258 neck rigidity, 259 N meningitidis, 258 pneumococcal, 258 prophylaxis, 260 pyogenic, 257 steroids, 260 viral,259 Mental retardation, 614 Mesenteric artery occlusion, 532 Metabolic acidosis, 627 Metabolic alkalosis, 628 Methaemoglobinaemia, 22 Methanol poisoning, 568 ethanol, 569 Methotrexate, 535 Microalbuminuria, 630 Microscopic polyangiitis, 555 Migraine, 234 classification, 234 precipitating factors, 234 treatment, 235 Miliary tuberculosis, 121 types, 121 classical, 122 cryptic, 122 diagnosis, 122 non-reactive, 122 Mitral regurgitation, 413 aetiology, 413 clinical features, 414 complications, 416 pathophysiology, 414 severity,415 Mitral stenosis, 407 aetiology, 407 clinical features, 408 complications, 411 juvenile, 407 mitral facies, 409 mitral valve, 407 opening snap, 410 opening snap vs. split S2' 413 opening snap vs. S3' 413 Ortner's syndrome, 412 paediatric, 407 pathophysiology, 408, 413 radiological features, 411 severity of stenosis, 407, 410 • Mitral valve prolapse, 416 Molecular methods, 652 gel electrophoresis, 652 restriction enzymes, 652 Mood disorders, 591 Motor neuron disease, 276 amyotrophic lateral sclerosis, 276 Kugelberg-Welander disease, 276 primary lateral sclerosis, 276 progressive bulbar palsy, 276 progressive muscular atrophy, 276 Werdnig-Hoffinann disease, 276 Movement disorders, 254 intentional, 256 postural, 252 static, 256 tremors, 256 M-protein,54 paraprotein, 54 pathogenesis, 54 pathology, 54 prognostic factors, 55 radiography, 55 renal failure, 56 treatment, 56 Multifactorial disorders, 609 Multiple myeloma, 67 Bence-Jones, protein, 67, 69 ~2-microglobulin, 69 clinical features, 68 diagnosis, 68 immunopathology, 67 investigations, 69 light-chain, 67 M-band,54 M -component, 54 M-protein,54 paraprotein, 54 pathogenesis, 54 pathology, 54 prognostic factors, 55 radiography, 55 renal failure, 56 treatment, 56 Mumps, 654 Munchausen's syndrome, 595 Murmurs, 480, 481 continuous, 484 differential diagnosis, 480 ejection systolic, 483 differential diagnosis, 480 straight back syndrome, 480, 478 innocent, 484 mid-diastolic, 482 Carey-Coombs, 481 differential diagnosis, 480 pansystolic, 480 differential diagnosis, 480 venous hum, 484 • Mushroom poisoning, 569 Myasthenia gravis, 283 edrophonium test, 283 tensilon test, 283 Mycobacteria, 104 diseases, 104 mycobacteria other than tuberculosis, 104 non-tuberculous, 104. Myelodysplastic syndrome, 40 aetiology, 40 chronic myelomonocytic leukaemia, 41 classification, 40 diagnosis, 41 refractory anaemia, 41 with excess blasts, 40 with sideroblasts, 40 treatment, 42 Myelofibrosis, 38 agnogenic myeloid metaplasia, 38 causes, 39 clinical features, 39 investigations, 39 myelofibrosis with myeloid metaplasia, 38 treatment, 39 vs. chronic myeloid leukaemia, 40 Myelopathy, 270 extradural, 270 intradural,270 intramedullary, 270 Myeloproliferative diseases, 26 Myocardial infarction, 434 antithrombin therapy, 438 aspartate aminotransferase, 436 clinical features, 434 complications, 435 creatine kinase, 436 electrocardiogram, 435 lactate dehydrogenase, 436 management, 436 myoglobin, 436 percutaneous coronary intervention, 439 right ventricular infarction, 439 thrombolytic therapy, 437 contraindications, 438 indications, 438 thrombolytic agents, 441 troponins, 435 Myocarditis, 458 viral,459 Myoclonus, 255 Myxoedema, (see Hypothyroidism) Myxoedema coma, 713 Myxoedema madness, 713 Natural killer cell, 181 acquired, 181 adaptive, 181 cell-mediated immune response, 182 • • humoral immune response, 181 mechanism, 182 primary, 182 secondary response, 182 Neck stiffness, causes, 261 . viral,261 Nelson's syndrome, 721 Nephrotic syndrome, 636 causes, 638 investigations, 637 management, 639 membranous glomerulonephritis, 636 minimal change disease, 636 pathogenesis, 637 Neurocysticercosis, (see Taenia solium) Neurogenic bladder, 267 Neurogenic shock, (see Shock) Neuroleptic drugs, 591 Neuroleptic malignant syndrome, 576 Neuropathy, 280 autonomic, 280 distal,281 mononeuritis multiplex, 280 mononeuropathy, 280 peripheral, 208 polyneuropathy, 281 proximal, 281 Neurosyphilis, 265 asymptomatic, 265 symptomatic, 265 general paralysis of insane, 266 meningeal, 266 meningovascular, 266 tabes dorsalis, 266 Neutropenia, 29 causes, 29 . treatment, 29 Non-cirrhotic portal fibrosis, 340 Non-pulmonary tuberculosis, 121 Non-ST elevation myocardial infarction, 548 Non-tropical sprue, (see Coeliac disease) Northern blotting, 783 Obesity,586 leptin, 587 orlistat, 588 sibutramine, 588 Obstruction, 341 Occupational lung diseases, 163 Oedema, 621 cardiac, 621 hepatic, 621 renal,621 Oleander poisoning, 569 Oliguria, 630 Oncogenes, 605 Organic brain syndrome, 220 dementia, 220 Organophosphorus poisoning, 566 Osler's nodes, 430 Osteomalacia, 580 Osteoporosis, 583 Oxygen therapy, 88 hazards, 88 indications, 88 technique, 88 Pancreatic ascites, 334 Pancreatitis, 532 Pancreatitis, acute, 597 Pancytopenia, 15 causes, 15 clinical features, 16 diagnosis, 16 management, 17 Papilloedema, 225 Paralysis agitans, (see Parkinson's disease) Paraplegia, 267 in extension, 267 in flexion, 267 Parathyroid honllone, 578 Paratyphoid fever, (see Enteric fever) Parkinson's disease, 251 Parkinsonism, 251 classification, 252 idiopathic, 251 Patent ductus arteriosus, 468 Patterson-Kelly syndrome, 6, 7, 495 Pellagra, 716 Pemphigus vulgaris, 262 Peptic ulcer, 497 aetiopathogensis, 497 antacids, 500 carbenoxolone sodium, 50 I clinical features, 497 colloidal bismuth compounds, 501 bismuth subsalicylate, 501 colloidal bismuth subcitrate, 50 I duodenal ulcer, 502 gastric ulcer, 502 H2-receptor antagonists, 500 cimetidine, 500 esomeprazole, 501 famotidin~, 502 lansoprazole, 501 misoprostol, 501 nizatidine, 500 omeprazole, 501 pantoprazole, 501 rabeprazole, 501 ranitidine, 502 prostaglandin analogues, 501 stress ulcers, 498 surgery, 502 treatment, 500 • • Percutaneous transhepatic cholangiography, 293 bilirubin-UDP-glucuronosyl-transferase, 294 excretion, 294 transport, 294 Pericardial effusion, 463 Pericarditis, 463, 465 constrictive, 466 tuberculous, 465 Peripheral blood stem cell transplantation, 34 Peritoneal dialysis, 644 continuous ambulatory, 644 continuous cycling, 644 Peutz-Jeghers syndrome, 515 Phaeochromocytoma, 725 Philadelphia chromosome, 36, 609 Pinworm infection, 693 Pituitary gland, 702 anatomy, 702 hormones, 702 Pituitary tumours, 704 macroadenomas, 704 microadenomas, 704 Plague, 665 bubonic, 665 pneumonic, 666 septicaemic, 665 Plantar reflex, 217 Plasma cell disorder, 57 Platelets, 58 Pleural effusion, 167 causes, 167 chylothorax, 171 chylous, 171 classification, 167 eosinophilic, 171 exudate 169 exudate vs. transudate, 169 Grocco's sign/triangle, 167 haemorrhagic, 170 Light's criteria, 169 malignant, 170 parapneumonic, 171 post-pneumonic, 171 pseudochylous, 171 sub-pulmonic, 170 synpneumonic, 171 transudate, 169 Plummer-Vinson (sideropenic dysphagia; Patterson-Kelly) syndrome, 6, 7 Pneumoconioses, 163 asbestos-related diseases, 163 asbestosis, 164 mesothelioma, 164 coal-worker's pneumoconiosis, 164 Caplan's syndrome, 164 progressive massive fibrosis, 164 simple, 164 silicosis, 165 accelerated, 165 acute, 165 chronic, 165 Pneumonia, 95 actinomycosis, 101 aspiration, 103 • bacterial, 103 . chemical, 103 bronchopneumonia, 102 classification, 95 aspiration, 95 atypical, 95 bronchopneumonia, 95 interstitial, 95 lobar, 95 necrotizing, 95 primary, 95 secondary, 95 suppurative, 95 clinical features, 96 complications, 97 Friedlander's, 100 indications for hospitalization, 95 investigations, 96 Klebsiella, 97 Legionella, 97 Legionnaire's disease, 97 lobar, 95 nosocomial, 96 . pneumococcal, 96 staphylococcal, 100 treatment, 100 viral, 102 Pneumothorax, 172 aetiology, 173 catamenial, 174 clicking, 172 radiological findings, 173 spontaneous, 173 closed, 174 open, 174 recurrent, 174 tension (valvular), 174 Poisoning, 566 activated charcoal, 567 alkaline diuresis, 562 antidotes, 563 cathartics, 561 diagnosis, 566 dialysis, 562 gastric lavage, 561 • gut decontamination, 561 multiple-dose activated charcoal, 562 osmolol gap, 569 resuscitation, 560 stabilisation, 560 syrup of ipecac, 561 • toxidromes, 560 whole bowel irrigation, 562 Poliomyelitis, 263 post-polio syndrome, 263 Polyarteritis nodosa, 554 Polyarthritis, 533 Polycystic kidney disease, 648 adult,648 . infantile, 648 Polycythaemia, 26 absolute, 27 causes, 27 classification, 27 clinical features, 27 erythraemia, 27 primary, 27 relative, 27 secondary, 27 Polycythaemia vera, 27 clinical features, 27 complications, 28 diagnosis, 27 primary, 28 secondary, 28 treatment, 28 Polymerase chain reaction, 653 • Polymyalgia rheumatica, 554 Polymyositis, (see Delmatomyositis) Polyuria, 630 Portal hypertension, 319 aetiology, 319 classification, 319 complications, 319 pathogenesis, 319 Portal venous system, anatomy, 319 Posterior column, 275 diseases, 275 Romberg's sign, 275 sensations, 275 Primary pulmonary hypertension, 452 Progressive systemic sclerosis, 539 CREST syndrome, 551 diffuse, 551 localised, 551 morphoea, 551 sclerodelma, 551 Prolactinoma, 706 Proteinuria, 630 Proton pump inhibitors, (see Peptic ulcer) Proto-oncogenes, 605 Pseudobronchiectasis, 149 Pseudo-gout, 559 Pseudomembranous colitis, 514 Psoriasis, 205 Psoriatic arthritis, 543 Psychogenic vomiting, 515 Ptosis, 225 Pulmonary embolism, 455 • • • D-dimer, 457 Doppler, 457 electrocardiogram, 456 perfusion scanning, 457 pulmonary angiography, 457 radiological features, 457 spiral CT chest, 457 thrombolytic therapy, 458 Pulmonary eosinophilia, 126 Pulmonary fibrosis, 159 focal, 159 interstitial, 159 replacement, 159 Pulmonary function tests, 83 arterial blood gas analysis, 99 diffusing capacity, 100 exercise tests, 100 flow-volume curves, 99 gas transfer factor, 100 lung volumes, 99 reversibility of airflow limitation, 98 ventilatory capacity, 98 Pulmonary hypertension, 449 aetiology, 449 clinical features, 449 pathophysiology, 449 Pulmonary oedema, 384 cardiogenic,384 non-cardiogenic,384 Pulmonary stenosis, 424 Pulmonary tuberculosis, 105 acid-fast bacilli, 110 false-negative results, 111 false-positive results, 111 fluorescent microscopy, 111 antituberculous drugs, 114 bactericidal, 114 rifabutin, 115 rifapentine, 115 sterilising, 114 short-course, 116 side effects, 115 assessment of activity, 113 chemoprophylaxis, 124 indications, 121 primary, 117 secondary, 117 fall and rise phenomenon, 117 haemoptysis, 109 post-primary, 106 clinical features, 107 complications, 108 investigations, 108 pathogenesis, 106 pathology, 106 prevention, 125 primary, 105 • bronchial complications, 106 clinical manifestations, 106 diagnosis, 106 erythema nodosum, 105 fate, 106 Ghon's complex, 105 pathogenesis, 106 pathology, 107 primary complex of Ranke, 105 radiography, 107 relapse, 118 categories of tuberculosis, 119 treatment, 119 sputum smear examination, 110 fluorochrome staining, 111 Ziehl-Neelsen method, 111 Pulsus paradoxus, 355 Punctate basophilia, 3 Pyrexia of unknown origin, 650 aetiology, 650 approach, 650 classic PUQ, 650 HIV-associated, 650 laboratory tests, 651 neutropenic, 650 nosocomial, 650 Pyrophosphate arthropathy, 559 Ramsay Hunt syndrome, 229 Raynaud's phenomenon, 474 Reactive arth, ritis, 542 Reflux nephropathy, 639 Reflux oesophagitis, 495 Reiter's syndrome, 542 Renal bone disease, 580 Renal clearance, 632 Renal glycosuria, 730 Renal transplantation, 644 Renal tuberculosis, 649 Renin, 630 • Renin-angiotensin-aldosterone replacement, 159 Respiratory acidosis, 628 Respiratory alkalosis, 628 Restriction enzymes, 652 Restrictive cardiomyopathy, 461 Reversed differential cyanosis, 469 Reye's syndrome, 309 Rheumatic fever, 401 aetiology, 401 clinical manifestations, 402 carditis, 402 Carey-Coombs murmur, 402 Jaccoud's arthritis, 402 diagnosis, 403 Jones criteria, 405 management, 405 pathogenesis, 401 • • pathology, 402 Aschoff giant cells, 402 prevention, 406 rheumatic chorea, 403 Sydenbam's chorea, 404 Rheumatoid arthritis, 533 articular manifestations, 533 corticosteroids, 536 . diagnosis, 533 disease modifying antirheumatic drugs, 535 D-penicillamine, 535 etanercept, 536 gold,535 hydroxychloroquine, 535 methotrexate, 535 sulphasalazine, 535 extra-articular manifestations, 541 Felty's syndrome, 557 haematological, 534 neurological, 534 nodules, 534 ophthalmological, 534 osteoporosis, 534 pleuropulmonary, 534 vasculitis, 534 immunosuppressants, 536 investigations, 541 juvenile rheumatoid arthritis, 542 pleuropulmonary, 539 Rheumatoid factor, 536 Rickets, 578 Roth's spots, 430 Rotor syndrome, 300 Roundworm infection, 693 Rubella, 654 congenital, 654 expanded syndrome, 654 Rubeola, (see Measles) Saint Vitus' dance, 404 Salicylate poisoning, 569 Sarcoidosis, 165 extrapulmonary manifestations, 166 Kveim test, 165 pulmonary manifestations, 166 radiological features, 166 Schilling test, 15 Schizophrenia, 590 aetiology, 590 first-rank symptoms, 590 negative symptoms, 590 types, 591 Sciatica,272 • Scleroderma, (see Progressive systemic sclerosis) Sclerotherapy, 324 Scorpion stings, 565 Scurvy, 583 • Septic shock, (see Shock) Serum sickness, 191 Sheehan's syndrome, 704 Shock,379 anaphylactic, 379 cardiogenic, 379 clinical manifestations, 381 hypovolaemic, 382 neurogenic, 379 pathophysiology, 380 septic, 379 sympathomimetic amines, 379 Short stature, 704 SIADH secretion, 625 Sickle cell anaemia, 21 clinical features, 21, 22 investigations, 22 management, 22 pathogenesis, 21 Sideroblastic anaemias, (see Anaemia) Sideropenic dysphagia, 495 Silicosis, (see Pneumoconiosis) Sjogren's syndrome, 539 Sleep apnoea, 86 central sleep, 87 clinical features, 87 pathophysiology, 87 sleep study, 87 treatment, 87 obstructive sleep, 86 pickwickian syndrome, 87 Smallpox, 663 Snake, 563 antivenom treatment, 564 cholinergics, 565 clinical manifestations, 566 cobras, kraits, 563 first aid, 564 investigations, 564 poisonous, 565 sea snakes, 564 vipers, 564 Sodium valproate, 240 Southern blotting, 782 Space occupying lesions, 232 Splenomegaly, 39 massive,44 46 Spondylitis, 273 Spondylosis, 273 Spontaneous bacterial peritonitis, 330 Status epilepticus, 241 treatment, 241 Stevens-Johnson syndrome, 208 iris lesions, 208 Still's disease, 538, 659 adult-onset, 539 Stokes-Adams-Morgagni attacks, 378 • Stomatitis, 586 Stool,491 occult blood, 492 Stool examination, 491 Straight back syndrome, 478 Stress ulcers, 498 Stroke in evolution, 245 Strongyloidiasis, 695 Subacute combined degeneration, 275 Subacute thyroiditis, 711 Subarachnoid haemorrhage, 248 Substance abuse, 595 Substance dependence, 595 Sumatriptan, 231 prophylaxis, 235 Summation gallop, 362 Superior vena cava syndrome, 157 Sydenham's chorea, 254, 404, 406 diagnosis, 405 Jones criteria, 405 management, 405 prevention, 406 Sympathomimetic amines, 382, 383 adrenaline, 383 dobutamine, 383 dopamine, 383 isoproterenol, 383 noradrenaline, 383 phenylephrine, 383 Syncope,350 cardiac, 350 drug-induced,351 orthostatic, 351 postural, 351 vasovagal,351 Syndrome X, 747 Syndrome of inappropriate antidiuretic hormone (SIADH), 625 Syphilis, 477, 546 cardiovascular, 477 congenital, 494 early, 485 late, 485 stigmata 699 diagnosis, 478 latent, 633 late, 640 , asymptomatic, 546 quaternary, 699 tertiary, 699 management, 701 primary, 595 secondary, 620 Syringomyelia, 273 • dissociated suspended anaesthesia, 273 Systemic inflammation, 380 acute lung injury, 88, 380 acute respiratory distress syndrome, 380 • • bacteraemia, 380 infection, 380 management, 381 multiple organ dysfunction syndrome, 380 sepsis, 380 septic shock, 380 severe sepsis, 380 systemic inflammatory response syndrome, 380 Systemic lupus erythematosus, 546 anti-dsDNA,547 antinuclear antibodies, 547 autoantibodies, 547 clinical manifestations, 551 T 2 resin uptake, 711 Taenia solium, 691 Tamm-Horsfall mucoprotein, 630 Target cells, 3 Tegaserod, 516 constipations-predominant, 516 diarrhoea-predominant, 516 Temporal arteritis, 554 Tetany, 717 Thalassaemias, 23 beta thalassaemia major, 23 clinical features, 23 cOnlmon forms, 23 genetics, 23 investigations, 24 management, 24 thalassaemia intennedia, 24 thalassaemia minor, 24 Threadworm infection, 693 Thrombocytopenia, 62 causes, 62 clinical manifestations, 63 Hess test, 62 investigations, 63 management, 63 tourniquet test, 63 Thyroid crisis, 712 Thyroid function tests, 711 free T3, 711 free T4, 711 radionuclide scan, 711 serum TSH, 711 thyroglobulin, 709 thyroid peroxidase, 709 thyroid-stimulating immunoglobulins, 709 TRH test, 711 uptake of radioactive iodine, 711 Thyrotoxic crisis, 712 Tic douloureux, 227 Tinea versicolor, 214 Tolerance, 188 Toxic megacolon, 648 Toxoplasmosis, 690 congenital, 691 infection in immunocompetent host, 691 infection in immunocompromised host, 691 ocular infection, 691 Transjugular intrahepatic porto systemic shunt, 324 Traube's space, 179 Traveller's diarrhoea, 512 Tremors, 255 Trichuriasis, 694 . Tricuspid regurgitation, 424 Tricuspid stenosis, 424 De-Carvallo's sign, 424 Trigeminal neuralgia, 227 Tropical pulmonary eosinophilia, 134, 697 Meyers-Kouwenaar syndrome, 697 Weingarten syndrome, 697 Tropical splenomegaly syndrome, 46, 687 Tropical sprue, 509 Trousseau's sign, 717 Tuberculin testing, 112 corticosteroids, 121 drug resistances, 117 multi-drug resistant, 117 natural, 117 primary, 117 secondary, 117 transient, 117 Heaftest, 112 interpretation, 113 tuberculins, 112 Tuberculosis, 649 renal,649 urinary tract, 649 TuMrculous meningitis (TBM), 264 CSF findings, 265 Tuberculous peritonitis, 333 Tuberculous pleural effusion, 123 adenosine deaminase, 123 clinical features, 123 investigations, 123 management, 123 pathogenesis, 123 Tumour, 231 Tumour markers, 601 Tumour necrosis factor-a, 203 Tumour suppressor genes, 606 Typhoid fever, (see Enteric fever) Ulcerative colitis, 519 aetiology, 519 ASCA,522 clinical features, 519 Crobn's disease, 519 investigations, 519 pANCA,522 pathology, 520 crypt abscesses, 520 treatment, 522 corticosteroids, 522 immunosuppressive agents, 523 • • infliximab, 535 mycophenolate mofetil, 525 sulphasalazine, 522 surgery, 523 Undifferentiated spondyloarthropathy, 664 Undulant fever, (see Brucellosis) Unifactorial disorders, 609 Universal precautions, 202 Unstable angina, 440 Upper gastrointestinal bleeding, 513 Upper motor neuron lesion, 217 Urinary tract infection, 636 pathogenesis, 636 Urobilinogen, 290 Urticaria, 198 Van den Bergh reaction, 296 Variceal bleeding, 323 Vasculitis, 556 classification, 556 small vessel vasculitis, 556 Vasodilators, 395 arteriolar, 396 venous, 396 Vasopressor agents, (see Sympathomimetic amines) Venous hum, 484 Ventricular septal defect, 471 Vesicoureteric reflux, 636 Visual pathway, 226 field defects, 226 Vitamin B12, 11, 12 deficiency, 11 Vitamin D, 577 cholecalciferol, 577 ergocalciferol, 577 Vitamin K, 69 Vitamins, 280 Volume depletion, 618 Vomiting, 486 von Willebrand's disease/factor, 68 Wallenberg's syndrome, 245 Waterhouse-Friderichsen syndrome, 725 Wegener's granulomatosis, 556 Weight loss, 494 Weil's syndrome, (see Leptospirosis) Werner's syndrome, 715 Wernicke's encephalopathy, 585 Western blotting, 652 Whipple's disease, 511 Whipworm infection, 694 Whooping cough, 667 Wilson's disease, 337 Wool sorter's disease, (see Anthrax) Xanthochromia, 223 Young's syndrome, 149 Zollinger-Ellison syndrome, 502 • •