内科学
2002-2
科学出版社
霍夫 编
436
Medicine is easier than you think！ At the end of the day， there are only a certain number ofthings that can go wrong with any part of us. So， if a patient tells you about a particularsymptom， or you find an abnormal sign on investigation， there are a limited number ofpossibilities that you need to think about. The key is to have a structured approach，remembering that common things are common. In Crash Course internal Medicine， we have tried to write the book we would like to have hadas we faced finals and began house-jobs. The format includes a methodical approach tocommon symptoms， signs， and investigations. This is followed by a comprehensive， theoreticalbackground to specific diseases and how to manage them. We have illustrated the text withdiagrams， and with boxes containing hints and tips that we have found useful ourselves. Armed with the knowledge described in this book， we hope that you will find exams andhouse：jobs less intimidating and more enjoyable.Best wishes.
Medicine is easier than you think！ At the end of the day， there are only a certain number of things that can go wrong with any part of us. So， if a patient tells you about a particularsymptom， or you find an abnormal sign on investigation， there are a limited number ofpossibilities that you need to think about. The key is to have a structured approach，remembering that common things are common.
PrefaceAcknowledgementsDedicationPart I： The Patient Presents With1.Chest PainIntroductionDifferential diagnosis of chest painHistory in the patient with chest painExamining the patient with chest painInvestigating lhe patient with chest pain2. Shortness of BreathIntroductionHistory in the patient with breathlessnessExamining the patient with breathlessnessInvestigating the patient with breathlessness3. PalpitationsIntroductionDifferential diagnosis by description of the rhythmHistoryConsequences of palpitationsExamining the patient with palpitationsinvestigating the patient with palpitations4. Heart MurmursIntroductionDifferential diagnosis of heart murmursHistory in the patient with heart murmursExamining the patient with heart murmurs5.Cough and HaemoptysisIntroductionDifferential diagnosis of cough and haemoptysisHistory in the patient with cough and haemoptysisExamining lhe patient with cough and haemoptysisinvestigating the patient with cough and haemoptysis6. Pyrexia of Unknown OriginIntroductionCausesHistory in the patient with PUOExamining the patient with PUOInvestigating the patient with PUO7. Haematemesis and MelaenaIntroductionDifferential diagnosis of haematemesis and melaenaHistory in the patient with haematemesis and melaenaExamining the patient with haematemesis and melaenaInvestigating the patient with haematemesis and melaena8. Change in Bowel HabitInlroduclionDifferential diagnosis of a change in bowel habitHistory in the patient with a change in bowel habitExamining the patient with a change in bowel habitInvestigating the patient with a change in bowel habit9. Weight LossIntroductionDifferential diagnosis of weight lossHistory in the patient with weight lossExamining the patient with weight lossInvestigating the patient with weight loss10.JaundiceIntroductionDifferential diagnosis of jaundiceHistory in the patient with jaundiceExamining the patient with jaundiceInvestigating the patient with jaundice11.Abdominal PainIntroductionDifferential diagnosis of abdominal painHistory in the patient with abdominal painExamining the patient with abdominal painInvestigating the patient with abdominal pain12.Polyuria and PolydipsiaIntroductionDifferential diagnosis of polyuriaHistory in the patient with polyuria or polydipsiaExamining the patient with polyuria or polydipsiaInvestigating the patient with polyuria and polydipsia13.Haematuria and ProteinuiaIntroductionDifferential diagnosis of haematuria and proteinuriaHistory in the patient with haematuria and proteinuriaExamining the patient with haematuria and proleinuriaInvestigating the patient with haematuria and proteinuria14.HypertensionIntroductionDifferential diagnosis of hypertensionHistory in the patient with hypertensionExamining the patient with hypertensionInvestigating the patient with hypertension15.Headache and Facial PainIntroductionDifferential diagnosis of headache and facial painHistory in the patient with headache or facial painExamining the patient with headache or facial painInvestigating the patient with headache or facial pain16.Joint DiseaseDifferential diagnosis of joint diseaseHistory in the patient with joint diseaseExamining the patient with joint diseaseInvestigating the patient with joint disease17.Skin RashesDifferential diagnosis by appearanceHistory in the patient with skin rashesExamining the patient with skin rashesInvestigating the patient with skin rashes18.Loss of ConsciousnessIntroductionDifferential diagnosis of loss of consciousnessHistory in the patient with loss of consciousnessExamining lhe patient with loss of consciousnessInvestigating the patient with loss of consciousness19.Con~sional StatesIntroductionDifferential diagnosis of confusionHistory in the confused patientExamining the confused patientInvestigating the confused patient20.Acute Neurological DeficitIntroductionDifferential diagnosis of strokeHistory in the stroke patientExamining the stroke patientInvestigating the stroke patient21.Lymphadenopathy and SplenomegalyIntroductionDifferential diagnosis of lymphadenopathy and splenomegalyHistory in the patient with lymphadenopathy or splenomegalyExamining the patient with lymphadenopathy and splenomegalyInvestigating the patient with lymphadenopathy and splenomegaly22.Sensory and Motor Neurological DeficitsIntroductionDifferential diagnosis of sensory and/or motor neurological deficitsHistory in the patient with sensory and/or molor neurological deficitsExamining the patient with sensory and/or motor neurological deficitsInvestigating the patient with sensory and/or motor neurological deficits23.Bruising and BleedingIntroductionDifferential diagnosis of bleeding or bruisingHistory in the patienl with bleeding and bruisingExamining the patient with bleeding and bruisingInvestigating the patient with bleeding and bruising24.Vertigo and DizzinessIntroductionDifferential diagnosis in the patient with vertigo or dizzinessHistory in the patient with vertigoExamining the patient with vertigoInvestigating the patient with vertigo25 .AnaemiaIntroductionDifferential diagnosis of anaemiaHistory in the anaemic patientExamining the anaemic patientInvestigating the anaemic patientPart Ⅱ： History， Examination， and CommonInvestigations26.Taking o HistoryGeneral principles——the bedside manner The historyPresenting complaintHistory of presenting complaintPrevious medical historySystems reviewDrug historyFamily historySocial history27.Examinotion of the PatientIntroductionFirst things firstGeneral inspectionThe face and body habitusThe neckThe handsThe cardiovascular systemThe respiratory systemThe abdomenThe nervous systemThe jointsThe skin28.The ClerkingIntroductionMedical sample clerking29.Common InvestigationsIntroductionThe cardiovascular systemThe respiratory systemThe gastrointestinal systemThe urinary systemThe nervous systemMetabolic and endocrine disordersMusculoskeletal and skin diseaseHaematological disordersPart Ⅲ： Diseases and Disorders30.Cardiovascular SystemIschaemic heart diseaseMyocardial infarctionArrhythmiasHeart failureHypertensionValvular heart diseaseMiscellaneous cardiovascular conditions31.Respiratory DiseaseAsthmaChronic bronchitis and emphysemaTuberculosisLung cancerPneumoniaRespiratory failureMiscellaneous respiratory conditions32.Gastrointestinal and Liver DiseasePeptic ulcer diseaseGastrointestinal haemorrhageInflammatory bowel diseaseCrohns diseaseGastrointestinal tumoursMalabsorptJonDiseases of the gallbladderDiseases of the pancreasAcute viral hepatitisChronic liver diseaseMiscellaneous gastrointestinal disorders33.Genitourinary SystemGlomerular diseaseAcute renal failureChronic renal failureUrinary tract infectionFluid and electrolyte balanceMiscellaneous genitourinary conditions34.Central Nervous SystemCerebrovascular diseaseManagement of conditions causing headacheParkinsonismMultiple sclerosisMeningitisEpilepsyIntracranial tumoursMiscellaneous neurological disorders35.Metabolic and Endocrine DisordersDiabetesLipid disordersMetabolic bone diseaseHyperparathyroidismHypoparathyroidismCrystal arlhropathyHypercaicaemiaPituitary disordersThyroid disordersDisorders of the adrenal glandsMiscellaneous endocrine conditions36.Musculaskeletal and Skin DisordersArthritisOsteoarthritisSystemic lupus erythemaiosusPolymyalgia rheumaticaOther connective tissue disordersPrimary skin diseasesSkin manifestations of systemic diseaseMalignant skin turnouts37.Haematological DisordersAnaemiaLeukaemiasMultiple myelomaMalignant lymphomasBleeding disordersDisseminated intravascular coagulationThrombotic disorders38.Infectious DiseasesIntroductionHIV and AIDSMalaria39.Drug OverdoseEpidemiologyAetiologyPresentationInvestigationsManagementPart IV： Serf-assessmentMultiple-choice questionsShort-answer questionsCase-based questionsMCQ answersSAQ answersIndex
Pustular lesions Acne vulgaris： the most common skin condition，characterized by open and closed comedones. Itvaries from purely cornedonal to pustularinflammatory acne to cysts to nodules. Acne rosacea： erythema and telangiectasia and atendency to flush easily. May have an acneiformcomponent， or hyperplasia of the soft tissue of thenose （rhJnophyma）. Folliculitis： pustules in the hair follicles. Candidiasis： superficial， denuded， beefy-red areaswith or without satellite vesicopustules. Whitish，curd-like concretions on the oral and vaginalmucous membranes. Miliaria. Any vesicular dermatiti& Figurate erythema Figurate erythema lesions look like rings or arcs. Urticaria： eruptions of evanescent wheals or hives. Erythema multiforme： symmetrical erythematouslesions on the extensor surfaces， palms， soles， ormucous membranes， which may be macular， papular，urticarial， bullous， or purpuric. May be target lesionswith clear cenlres and concentric erythematous rings. Erythema migrans： a red expansion around an initialpapule with an advancing border， which is usuallyraised， warm， and red. The centre may clear orbecome indurated， vesicular， or necrotic. Cellulitis： a hot， red， diffuse， spreading infection ofthe skin. Erysipelas： oedematous， spreading， circumscribed，hot， erythematous area， with or without vesic e orbulla formation， frequently involving the face. Erysipeloid： purplish erythema， most often of a fingeror the back of the hand， which gradually extends.Caused by Erysipelothrix insidiosa， it is often seen infishermen and meat handlers.
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