Acute Medicine. a Symptom-Based Approach

DESCRIPTION

This practical book describes the basic science, clinical presentation and management of the 67 common acute medical presentations stipulated in the Royal College of Physicians syllabus for Core Medical Training and Acute Core Common Stem. • Case scenarios are included for each presentation, and guidance about management is offered in the context of national guidelines and important studies • Experienced clinicians describe their approach to common difficult problems and explain the answers to questions often asked on the ward round by successive generations of trainees • Chapters highlight key decisions that need to be made early, common misunderstandings, and risks • Detailed discussion provides an understanding of the rationale, allowing the reader to apply their knowledge to other situations • Guidance is provided on urgency of referral, safe ambulatory management, and when to seek specialist help. This is an essential resource that provides readers with the knowledge base to practise as a confident medical registrar.

• Each chapter explains the basic science, clinical approach and management in the context of national guidelines, offering a 'one stop shop' for each presentation
• Teaches a logical approach that can be generalised beyond the typical patient, explaining not just what you do but why you do it
• Covers the questions often asked by juniors on the ward round, enabling the reader to develop skills, knowledge and confidence as a registrar

CONTENTS

Introduction - presentations to acute medicine Carla Davies
1. Abdominal mass/hepatosplenomegaly David Tate
2. Abdominal pain Stephen Haydock and G. Walker
3. Abdominal swelling and constipation Charlotte Rutter
4. Abnormal sensation Edward Fathers
5. Acute back pain Luke Gompels
6. Acute kidney injury (AKI) and chronic kidney disease (CKD) Duncan Whitehead
7. Aggressive/disturbed behaviour Stephen Haydock
8. Alcohol and substance dependence Gillian Sims and Stephen Haydock
9. Anaphylaxis Jonathan Hills
10. Anxiety/panic disorder Stephen Haydock
11. Blackout/collapse: cardiac pacemakers Stephen Haydock
12. Breathlessness Robert A. Stone
13. Bruising and spontaneous bleeding Julia Czuprynska
14. Cardio-respiratory arrest Zoe Fritz
15. Chest pain Stuart Walker
16. Confusion/acute delirium Peter M. F. Campbell
17. Cough Robert A. Stone
18. Dialysis Duncan Whitehead and Stephen Haydock
19. Diarrhoea Iftikhar Ahmed and Emma Greig
20. Dyspepsia Paul D. Thomas
21. Dysuria Satish Thomas William
22. Falls Lucy Pollock
23. Fever Daniel E. Greaves and Sani H. Aliyu
24. Fits and seizures Christopher J. S. Price
25. Genital discharge and genital ulceration Satish Thomas William
26. Haematemesis and melaena Gareth Corbett and Ewen Cameron
27. Haematuria Duncan Whitehead
28. Haemoptysis Marko Nikolic and Jonathan Fuld
29. Head injury Cliff Mann
30. Headache Stephen Haydock
31. Hoarseness and stridor Marko Nikolic and Jonathan Fuld
32. Hypothermia Mohamed Yousuf
33. Immobility Matthew R. Hayman, Cally Williamson and Stephen Haydock
34. Incidental findings Stephen Haydock
35. Involuntary movements Mark Fish
36. Jaundice Jane Chalmers and Rudi Matull
37. The swollen joint Catherine Laversuch
38. Unilateral limb pain and swelling Stephen Haydock
39. Loin pain Duncan Whitehead and Stephen Haydock
40. Lymphadenopathy Deepak Mannari
41. Medical complications during acute illness and following surgical procedures Zoe Fritz
42. Medical problems in pregnancy Nic Wenninke
43. Micturition difficulties Duncan Whitehead
44. Memory loss (progressive) Matthew R. Hayman
45. Neck pain Catherine Laversuch
46. End of life care Marianne Tinkler
47. Palpitations Darshan H. Brahmbhatt and Peter J. Pugh
48. Poisoning Stephen Haydock
49. Polydipsia and polyuria: water and sodium homeostasis, hypo- and hypernatraemia John Kalk
50. Polydipsia and polyuria: the patient presenting with polydipsia and/or polyuria Stephen Haydock and John Kalk
51. Pruritus Penny Williams
52. Rash Pawel Bogucki
53. Physical symptoms in absence of organic disease Marguerite Paffard
54. Rectal bleeding Stephen Haydock and G. Walker
55. Sepsis Andrew Thompson
56. The shocked patient Kobus Preller
57. Skin and mouth ulcers Pawel Bogucki and Tony Coll
58. Speech disturbance Rob Whiting and Stephen Haydock
59. Suicidal ideation Marguerite Paffard
60. Swallowing difficulties (dysphagia) Iftikhar Ahmed and Rudi Matull
61. Collapse/blackout Mark Dayer
62. The unconscious patient Christopher Westall and Kobus Preller
63. Unsteadiness and balance disturbance Edward Fathers
64. Visual disturbance Kate R. Petheram and Chris Allen
65. Vomiting and nausea Emma Greig
66. Weakness and paralysis Kate R. Petheram, Chris Allen and Rob Whiting
67. Weight loss Emma Greig
Index.

ABOUT THE AUTHORS

Editors

Stephen Haydock, Taunton and Somerset NHS Foundation Trust, UK
Stephen Haydock is Consultant Physician, Taunton and Somerset NHS Foundation Trust, UK.

Duncan Whitehead, Taunton and Somerset NHS Foundation Trust, UK
Duncan Whitehead is Consultant Nephrologist and Physician, Taunton and Somerset NHS Foundation Trust, UK.

Zoë Fritz, Addenbrooke's Hospital, Cambridge
Zoe Fritz is Wellcome Trust Research Fellow in Bioethics at the Universities of Warwick and Cambridge and Consultant Physician in Acute Medicine at Addenbrooke's Hospital, Cambridge, UK.

Contributors

Carla Davies, David Tate, Stephen Haydock, G. Walker, Charlotte Rutter, Edward Fathers, Luke Gompels, Duncan Whitehead, Gillian Sims, Jonathan Hills, Robert A. Stone, Julia Czuprynska, Zoe Fritz, Stuart Walker, Peter M. F. Campbell, Iftikhar Ahmed, Emma Greig, Paul D. Thomas, Satish Thomas William, Lucy Pollock, Daniel E. Greaves, Sani H. Aliyu, Christopher J. S. Price, Gareth Corbett, Ewen Cameron, Marko Nikolic, Jonathan Fuld, Cliff Mann, Mohamed Yousuf, Matthew R. Hayman, Cally Williamson, Mark Fish, Jane Chalmers, Rudi Matull, Catherine Laversuch, Deepak Mannari, Nic Wenninke, Marianne Tinkler, Darshan H. Brahmbhatt, Peter J. Pugh, John Kalk, Penny Williams, Pawel Bogucki, Marguerite Paffard, Andrew Thompson, Kobus Preller, Tony Coll, Rob Whiting, Mark Dayer, Christopher Westall, Kate R. Petheram, Chris Allen