CLINICAL MEDICINE
Lecture Notes
LN
John Bradley
Mark Gurnell
Diana Wood
7th Edition
,Clinical Medicine
Lecture Notes
John Bradley
MA, DM, FRCP
Consultant Physician
Addenbrooke’s Hospital
Cambridge
Mark Gurnell
MA(MedEd), PhD, FRCP
Associate Clinical Dean, University Lecturer and Honorary Consultant
Physician
University of Cambridge
School of Clinical Medicine
Addenbrooke’s Hospital
Cambridge
Diana Wood
MA, MD, FRCP
Director of Medical Education, Clinical Dean and Honorary Consultant
Physician
University of Cambridge
School of Clinical Medicine
Addenbrooke’s Hospital
Cambridge
Seventh Edition
,This edition first published 2012, Ó 2012 by John Bradley, Mark Gurnell, Diana Wood, David Rubenstein and David Wayne
Previous editions: 1976, 1980, 1985, 1991, 1997, 2003
Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing programme has been
merged with Wiley’s global Scientific, Technical and Medical business to form Wiley-Blackwell.
Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offices, for customer services and for information about how to apply for permission to
reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance with the Copyright,
Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any
form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the
UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be
available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and
product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective
owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is
designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the
understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert
assistance is required, the services of a competent professional should be sought.
Library of Congress Cataloging-in-Publication Data
Bradley, John, MRCP.
Lecture notes. Clinical medicine / John Bradley, Mark Gurnell, Diana Wood. -
- 7th ed.
p. ; cm.
Clinical medicine
Rev. ed. of: Lecture notes on clinical medicine / David Rubenstein, David
Wayne, John Bradley. 6th ed. 2003.
Includes index.
ISBN 978-1-4051-5714-8 (pbk. : alk. paper)
I. Gurnell, M. II. Wood, Diana. III. Rubenstein, David. Lecture notes on
clinical medicine. IV. Title. V. Title: Clinical medicine.
[DNLM: 1. Clinical Medicine–Handbooks. WB 39]
616–dc23
2011042644
A catalogue record for this book is available from the British Library.
Cover image: Dana Neely/Corbis
Cover design: Grounded Design
Set in 8/10pt Utopia by Thomson Digital, Noida, India
1 2012
, Contents
Preface to the Seventh Edition iv
Preface to the First Edition v Part 2 Clinical Medicine
10 Cardiovascular disease 73
11 Respiratory disease 110
Part 1 Clinical Examination 12 Gastroenterology 128
1 The medical interview 1 13 Liver disease 144
2 General examination 7 14 Renal disease 153
3 Cardiovascular system 10 15 Neurology 171
4 Respiratory system 19 16 Endocrine disorders 208
5 The abdomen 28 17 Metabolic disorders 229
6 Neurological system 39 18 Rheumatology 269
7 Endocrinology and metabolism 57 19 Dermatology 297
8 Musculoskeletal system 62 20 Haematology 321
9 Assessment 66 21 Infectious diseases 336
22 Toxicology 351
SI Units conversion table 361
Index 362
The plate section can be found facing page 314
Lecture Notes
LN
John Bradley
Mark Gurnell
Diana Wood
7th Edition
,Clinical Medicine
Lecture Notes
John Bradley
MA, DM, FRCP
Consultant Physician
Addenbrooke’s Hospital
Cambridge
Mark Gurnell
MA(MedEd), PhD, FRCP
Associate Clinical Dean, University Lecturer and Honorary Consultant
Physician
University of Cambridge
School of Clinical Medicine
Addenbrooke’s Hospital
Cambridge
Diana Wood
MA, MD, FRCP
Director of Medical Education, Clinical Dean and Honorary Consultant
Physician
University of Cambridge
School of Clinical Medicine
Addenbrooke’s Hospital
Cambridge
Seventh Edition
,This edition first published 2012, Ó 2012 by John Bradley, Mark Gurnell, Diana Wood, David Rubenstein and David Wayne
Previous editions: 1976, 1980, 1985, 1991, 1997, 2003
Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing programme has been
merged with Wiley’s global Scientific, Technical and Medical business to form Wiley-Blackwell.
Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offices, for customer services and for information about how to apply for permission to
reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance with the Copyright,
Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any
form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the
UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be
available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and
product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective
owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is
designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the
understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert
assistance is required, the services of a competent professional should be sought.
Library of Congress Cataloging-in-Publication Data
Bradley, John, MRCP.
Lecture notes. Clinical medicine / John Bradley, Mark Gurnell, Diana Wood. -
- 7th ed.
p. ; cm.
Clinical medicine
Rev. ed. of: Lecture notes on clinical medicine / David Rubenstein, David
Wayne, John Bradley. 6th ed. 2003.
Includes index.
ISBN 978-1-4051-5714-8 (pbk. : alk. paper)
I. Gurnell, M. II. Wood, Diana. III. Rubenstein, David. Lecture notes on
clinical medicine. IV. Title. V. Title: Clinical medicine.
[DNLM: 1. Clinical Medicine–Handbooks. WB 39]
616–dc23
2011042644
A catalogue record for this book is available from the British Library.
Cover image: Dana Neely/Corbis
Cover design: Grounded Design
Set in 8/10pt Utopia by Thomson Digital, Noida, India
1 2012
, Contents
Preface to the Seventh Edition iv
Preface to the First Edition v Part 2 Clinical Medicine
10 Cardiovascular disease 73
11 Respiratory disease 110
Part 1 Clinical Examination 12 Gastroenterology 128
1 The medical interview 1 13 Liver disease 144
2 General examination 7 14 Renal disease 153
3 Cardiovascular system 10 15 Neurology 171
4 Respiratory system 19 16 Endocrine disorders 208
5 The abdomen 28 17 Metabolic disorders 229
6 Neurological system 39 18 Rheumatology 269
7 Endocrinology and metabolism 57 19 Dermatology 297
8 Musculoskeletal system 62 20 Haematology 321
9 Assessment 66 21 Infectious diseases 336
22 Toxicology 351
SI Units conversion table 361
Index 362
The plate section can be found facing page 314
