BOOKS FOR DOCTORS
BOOKS FOR DOCTORS
Doctor’s Companion
An extraordinary 350 page guide book to medical diagnosis, investigation and treatment. The “DOCTOR’S COMPANION” has been published in 87 countries, and has been translated into Italian, Spanish, French, German, Flemish, Portuguese, Polish, Turkish, Chinese and Korean. Nine editions have been published in Australia, and it has been acclaimed around the world as a breakthrough in the presentation of medical knowledge.
In other markets the title changes, for example MIMS Companion, GP Companion, Medical Memory Aids, IMS Mediguide, Brevario Clinico, MIMS India Reference System, Le Vademecum de la Consultation, Medex Partner, Medical Vademecum, MD Companion, Diagnostic Companion, Le Vademecum Diagnostique. Circulation exceeds 2.2 million.
The aim of the Doctor’s Companion is to be a quick ready reference for all doctors, from interns to senior specialists, when they are faced with an uncertainty. They will know the outline of the knowledge, but need something other than a detailed text to quickly refresh their memory. What are the exact values for that result? What other conditions can cause these symptoms? What does that eponymous syndrome mean? Just how do you treat this unusual condition? What tests should I order to prove my suspected diagnosis?
By turning traditional medical texts around, and looking up the symptoms, signs or results, rather than the disease, the book becomes a much more practical ready reference tool.
The mail I receive reinforces my belief that the Doctor’s Companion is an invaluable guide to doctors, covering every facet of frontline medical practice, in a single easily referenced volume.
Every day, clinical journals and texts are scoured for the latest information to keep the book as up to date as possible. Although some sections (eg. signs) change minimally over the years, other sections (eg. treatment, pathology interpretation) change so rapidly that daily revisions to the text are necessary. Between any two editions of the book, there are many hundreds of alterations and additions to keep the information as up to date as possible.
SECTION ONE
SYMPTOMS
Symptoms to Diagnosis
SYMPTOM: The consciousness of a disturbance in a bodily function.
Butterworths Medical Dictionary
FORMAT
Presenting Symptom
(Alternate Name)
Explanation of terminology
System or other group of symptoms
Diagnoses that may present with this symptom [alternate name of diagnosis] (other symptoms of each diagnosis, or a discussion of the diagnosis)
See also Symptom of Similar Significance
SAMPLE ENTRIES:-
Ichthyosis
Generalised dryness and scaling of skin
Congenital
Ichthyosis vulgaris (widespread, inherited)
Acquired ichthyosis (precipitated by disease)
Hypothyrodisim (cold intolerance, lethragy)
Lymphomas (eg. Hodgkin's disease)
Sarcoidosis
Leprosy
Vitamin A deficiency
Harlequin syn. (see Syndromes section 6)
Refsum syn. (deaf, ataxia, polyneuritis)
Sjögren-Larsson syn. (spastic diplegia)
Drugs (eg. cimetidine, nicotinic acid, retinoids)
Impotence
Lack of male potency and libido
Psychogenic
Pituitary adenoma
Addison's disease (fatigue, anaemia, irritable)
Testicular disease or tumours
Diabetes mellitus (polyuria, polydipsia, blurred vision)
Thyrotoxicosis (sweating, fatigue, weight loss)
Alcohol and poisons (eg. lead, mercury)
Panhypopituitarism (fatigue, hypothermia)
Hypothyroidism
Hyperprolactinaemia
Multiple sclerosis (weakness, abnormal sensation)
Hypogonadism (tall, shrill voice, hairless)
Atherosclerosis
Hypercholesterolaemia
Pelvic or penile arterial obstruction
Hypertension
Prostatic carcinoma
Prostatectomy
Multiple sclerosis
Peyronie's disease
Paraplegia
Fractured penis (haematoma)
Depression (insomnia, loss of interest)
Fractured pelvis
Drugs (eg. antihypertensives, sedatives, tricyclics, clofibrate, cimetidine, thiazides, spironolactone, beta-blockers, digoxin, nicotine, marijuana)
Syndromes (see Syndromes section 6)
Cushing syn. (obese, hirsute, ecchymoses)
Fröhlich syn. (thin skin, scanty hair, obese)
Klinefelter syn. (delayed puberty, hypoplastic genitalia)
Lariche syn. (claudication, poor pulses)
See also Ejaculation, Premature; Ejaculation, Retarded; Ejaculation, Retrograde; Infertility; Libido, Reduced
FOR DOCTORS
FOR THE PUBLIC
SECTION SIX
SYNDROMES
The Symptoms, Diagnosis, Treatment and Complications
of Medical Syndromes
SYNDROME: A concurrence of several symptoms in a disease.
Oxford English Dictionary
FORMAT
Syndrome name [Abbreviation]
(Alternate Name)
Des: Description. Characteristic symptoms and signs of the syndrome. (Symptoms and signs that are not
always present are shown in brackets)
Test: Pathological, radiological, electrophysiological and other appropriate tests used in the diagnosis, with the
expected result of the test in a patient with the syndrome shown in (brackets). See also Section Three Investigations and Section Four Pathology Tests.
Trt: Treatment. The available treatments for the syndrome, if any
Comm: Comment. Further discussion on the epidemiology and complications of the syndrome
See also Other Relevant Syndromes
SAMPLE ENTRIES:-
Frey Syndrome
(Auriculotemporal Syndrome)
Des: Sweating and vasodilatation in the distribution of the auriculotemporal nerve when eating
Trt: Surgery
Comm: Due to disturbance between the sympathetic and parasympathetic nerves. May follow infection or surgery to the parotid gland
Fröhlich Syndrome
(Dystrophia Adiposgenitalis)
Des: Puberty or later onset, loss of libido and sexual function, thin skin that wrinkles prematurely, scanty body hair, fine scalp hair, obesity of buttocks, genitals and thighs, lethargy
Test: Exclude pituitary tumour
Trt: Hormone supplements
Comm: Rare
Fuchs Syndrome
(Fuchs Uveitis, Heterochromic Cyclitis)
Des: Chronic non-granulomatous anterior uveitis, different coloured irises, blurred vision, slow onset, unilateral, young adult or child, (secondary cataract, glaucoma)
Test: Abnormal gonioscopy
Trt: None available
Comm: Regular checks for glaucoma or cataract formation
Gaisböck Syndrome
(Stress Erythrocytosis)
Des: Polycythaemia, hypertension, smoker, plethora (middle aged, overweight, white male, alcohol abuse)
Test: B.erythrocytes (H), plasma volume (L), PCV (H)
Trt: None necessary
Comm: No splenic enlargement. May be familial
SECTION FIVE
TREATMENT
Therapy and Prognosis
FORMAT
Disease [Abbreviation]
(Alternate Name)
Ther: A commonly recognised form of therapy OR other recognised forms of treatment
AND additional therapy that may be required
ADD additional types of therapy if above does not prove effective
1. First step in a therapeutic crescendo or format
2. Second and subsequent steps in a crescendo or format are numbered sequentially
Prec: Precautions that should be observed in the treatment of this disease. For further information on
contraindications, precautions, adverse reactions, interactions, use in pregnancy, use in children, dosage and administration consult a pharmacopaea such as MIMS or MIMS Annual
Prog: Prognosis. The expected result of treatment, statistically treated if appropriate
See also Other Relevant Diseases
SAMPLE ENTRIES:-
Depression
Ther: 1. Emotional and psychological support
2. Antidepressant medication (eg. SSRI, SNRI, tricyclic, RIMA)
ADD benzodiazepine (eg. diazepam) for short-term relief of stress.
3. Buspirone.
4. MAOI.
5. Major or minor tranquillisers.
6. Electroconvulsive therapy.
7. Psychotherapy.
Prec: MAOI - severe reaction with certain foods and drugs, eg. cheese, red wine, beans, liver; other
tyramines, tricyclic antidepressants; amphetamines.
Prog: Generally good. Often recurrent. Very disruptive to family. Beware of potential for suicide.
See also Postnatal Depression
Dermatitis Herpetiformis
Ther: Dapsone OR sulfapyridine
AND gluten-free diet.
Prog: Drugs do not cure, only control and help skin lesions and not those in gut. Gluten-free diet life-long
necessary. May be associated with thyroid disorders, pernicious anaemia, lymphoma and diabetes.
Dermatitis, Most Forms of, Dry
(Xerotic and Asteatotic Dermatitis)
Ther: 1. Avoid irritant clothing, chapping, sweating.
2. Avoid soaps and other allergens.
3. Moisturising creams.
4. 10% urea preparations.
5. Hydrocortisone 1.0% cream or ointment.
6. Oral antihistamines for pruritus.
7. Oral antibiotics for severe infections.
8. Stronger steroid creams or ointments.
9. Oral prednisone short-term.
Prog: Cure rare, control normally adequate. Often recurrent, or may subside spontaneously.
See also Atopic Eczema; Perioral Dermatitis; Rash; Seborrhoeic Dermatitis
SECTION FOUR
PATHOLOGY
The Interpretation of Pathology Tests
FORMAT
Test Name, Test Substance [Abbreviation]
(Alternate Name) [Abbreviation]
RI: Reference interval (or value), and units. System Internationale (SI) units are used where possible.
(Alternative units are in brackets). 90% of the population have results that lie within this range.
Ind: Indications. The suspected diseases and conditions in which the test is indicated.
Int: Interpretation of the results. The diseases, conditions, syndromes etc. that should be considered with
results that vary from the reference interval (eg: HIGH, LOW, V.LOW). With a history, examination and possibly other tests (in some instances, other tests that should be considered are in brackets after the diagnosis followed by a ?), a definite diagnosis may be made from the differential diagnoses suggested.
Phys: The basic physiology of the test, to enable the significance to be better understood.
See also Other Relevant Tests
SAMPLE ENTRIES:-
Anti-Deoxyribonucleic Acid Titre, Serum [Anti-DNA]
RI: <100 IU/mL
Ind: Connective tissue disease (auto-immune disease)
Int: HIGH – autoimmune disease eg. SLE, rheumatoid arthritis etc.
Phys: Used in association with other tests to diagnose and follow the course of certain autoimmune
disease. Major criteria should be used for diagnosis of individual disease. Does not rise in drug induced SLE
See also ANCA, Serum; Anti-Smith Antibodies, Serum; Cardiolipin Autoantibodies, Blood; Complement C3 and C4; DNA Autoantibodies; ENA, Serum; Histone Autoantibodies, Blood; HLA-DR3, Serum; LE Cells, Blood; Lupus Anticoagulant Antibody, Serum
Sodium, Serum [Na+]
RI: 135-145 mmol/L
Pregnancy : 132-140 mmol/L
Ind: Fluid/electrolyte imbalance
Int: V.LOW (<120 mmol/L) - Critical care required, causes as below.
LOW (hyponatraemia) - Clinical effects not likely unless below 125mmol/L. Over hydration, acute or
chronic diarrhoea, salt losing nephropathy, hypothyroidism, fresh water drowning, hyperglycaemia, Addison's disease, hypopituitarism, acute renal failure, syndrome of inappropriate ADH secretion, infection, carcinoma, cirrhosis, ascites, congestive cardiac failure, cystic fibrosis, severe burns, excess sweating, prolonged storage of sample, recreational drugs (eg. ecstacy), medications (eg. diuretics, tricyclic and SSRI antidepressants, MAOI, clozapine, ACE inhibitors, celecoxib, sulphonylureas, cytotoxics, carbamazepine, phenothiazines, clofibrate, temazepam, desmopressin)
HIGH (hypernatraemia) - Dehydration, salt water drowning, uraemia, diabetes insipidus, hyperaldosteronism, excess salt intake, mechanical ventilation
Phys: The level of serum sodium regulates body water volumes. Dehydration may be due to lack of water
or lack of salt (sodium). Clinical signs of severe hyponatremia include confusion, seizures, reduced cosciousness, and tachycardia.
See also Anion Gap, Serum
SECTION THREE
INVESTIGATIONS
The Pathology Tests and Clinical Signs that will Confirm a Diagnosis and the Differential Diagnoses of Diseases
FORMAT
Suspect Diagnosis [Abbreviation]
(Alternate Name)
Test: The pathology tests (biochemistry, haematology, cytology and bacteriology) that should be considered
when a history and examination indicate that this is a probable diagnosis. The result that may be expected with this diagnosis is shown in (brackets) after each test. Physiological,electrophysiological (eg: ECG) and radiological tests are not always included. See Pathology section four for the explanation and interpretation of these tests
Sign: Signs (not symptoms), methods of examination and clinical findings that may be useful in the diagnosis of, or may be found in association with, this disease or syndrome. See Symptoms section two for the explanation and interpretation of these signs
DD: Differential diagnoses. Other diseases with which this diagnosis may be confused
Phys: The basic physiology of the disease, to enable the reason for abnormal pathology tests or signs to be
better understood
See also Other Entries or Sections of Significance
SAMPLE ENTRIES:-
Goodpasture Syndrome
Test: B.glomerular basement mebrane antibodies (+), lung or renal biopsy (AB), sputum blood (+), sputum
microscopy (haemosiderin laden macrophages), S.urea (H), S.creatinine (H), U.blood (+), U.protein (+)
DD: Bronchitis, pneumonia, TB, renal failure, nephrotic syndrome, glomerulonephritis
Phys: Syndrome of pulmonary haemorrhages and renal failure due to damaged basement membranes in
the kidney and lungs
See also Syndromes section six : Goodpasture Syndrome
Gout
Test: S.urate (H), synovial fluid microscopy (urates present), fluid WCC (H), 24 hour U.urates (L in
underexcretors), ESR (H), WCC (H), S.creatinine (H)
DD: Osteoarthritis, pseudogout, rheumatoid arthritis, trauma, synovitis, cellulitis, osteomyelitis, sarcoid,
multiple myeloma, psoriatic arthritis, Reiter syn., ankylosing spondylitis
Phys: Excess intake of purines and under excretion of urates predisposes to high serum uric acid levels and
crystal deposition in joints. A normal s.urate does not exclude gout as a diagnosis
Granuloma Inguinale
(Donovanosis)
Test: Tissue microscopy (Donovan Bodies +)
Sign: Papule or ulcer on genitals
DD: Neoplasm, chancroid, syphilis, amoebiasis, lymphogranuloma venereum
Phys: Caused by Calymmatobacterium granulomatis
SECTION TWO
SIGNS
Clinical Signs and their Interpretation
SIGN: Objective evidence of disease or deformity
Butterworths Medical Dictionary
FORMAT
Sign (Alternate Name) [Abbreviation]
Exp: An explanation of the sign, with its methodology described in sufficient detail to enable the practitioner
to perform the test.
Int: The interpretation of the sign.
(+) The diseases, syndromes etc. that should be considered if the test is positive
(++) The interpretation of an exaggerated or grossly positive test
(–) Ditto for a negative test result
(AB) Ditto for an abnormal test result
Phys: The pathophysiology of the sign to enable its significance to be better understood
See also Other Signs of Significance
SAMPLE ENTRIES:-
Nail Discolouration
Exp: Nail or subungual tissue colour change
Int: Black – Haematoma, melanoma, naevi, pseudomonas infection, fungal infection, chronic paronychia
Brown – Uraemia, psoriasis, nicotine, Addison's disease, mercury poisoning, silver poisoning, chemical
stains
Yellow – Tinea, jaundice, yellow nail syn., slow growth, lymphoedema, tetracyclines
Blue – Cyanosis, mepacrine, chloroquine, Wilson's disease, argyria, amodiaquine
White (Leuconychia) – Trauma, cardiac disease, renal disease, psoriasis, dermatophyte infection,
hypoalbuminaemia, cytotoxics, arsenic, liver disease
Red – Haemorrhage, congestive cardiac failure (half moons red), cold exposure
Green – Pseudomonas, aspergillus or candida infections
Nail Pitting
Exp: Small isolated or confluent pits on the nail plate
Int: (+) Psoriasis, chronic paronychia, digital eczema, alopecia areata, familial
Phys: Inflammatory damage to nail matrix
Nail Ridging
Exp: Longitudinal or transverse ridging of nail plate
Int: (+) Longitudinal – Elderly, nail matrix tumours, lichen planus, alopecia areata, rheumatoid arthritis,
Darier's disease, mucous cyst of matrix, peripheral vascular disease, nail dystrophy
(+) Multiple transverse – Eczema, chronic paronychia, habit tics, chronic inflammation of digit, chronically wet nails (eg. housework), severe dysmenorrhoea, Raynaud's disease, severe carpal tunnel syn., protein deficiency
(+) Single transverse ‘Beau's line’ – Occurs after severe physical or emotional illness of any cause
Phys: Transverse ridging due to temporary cessation of nail formation. When cause removed, nail growth resumes, and the ridge moves forward with the nail plate growth.
See also Splinter Haemorrhages