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27 Medical ophthalmology Medical ophthalmology J Olson Functional anatomy and physiology 1164 Investigation of visual disorders 1168 Perimetry 1168 Imaging 1168 Visual electrophysiology 1169 Presenting problems in ophthalmic disease 1169 Watery/dry eye 1170 Pr...

28 Medical psychiatry Medical psychiatry RM Steel SM Lawrie Clinical examination 1180 The psychiatric interview 1181 The mental state examination 1181 Investigations in medical psychiatry 1183 Functional anatomy and physiology 1183 Biological factors 1183 Psyc...

29 Dermatology Dermatology SH Ibbotson Clinical examination in skin disease 1210 Functional anatomy and physiology 1212 Investigation of skin disease 1214 Presenting problems in skin disease 1216 Lumps and lesions 1216 Rash 1216 Blisters 1218 Itch 1219 Photose...

30 Maternal medicine Maternal medicine L Mackillop FEM Neuberger Clinical examination in pregnancy 1270 Clinical evaluation in maternal medicine 1271 Planning pregnancy in patients with medical conditions 1272 Functional anatomy and physiology 1272 Investigati...

31 Adolescent and transition medicine Adolescent and transition medicine R Mann Transition from paediatric to adult health services 1288 Functional anatomy and physiology 1290 Endocrine changes 1290 Physical changes 1290 Cognitive and behavioural changes 1292 ...

32 Ageing and disease Ageing and disease MD Witham Comprehensive Geriatric Assessment 1302 Demography 1304 Functional anatomy and physiology 1304 Biology of ageing 1304 Physiological changes of ageing 1305 Frailty and multimorbidity 1306 Investigations 1306 Co...

33 Oncology Oncology GG Dark Clinical examination of the cancer patient 1314 The 10 hallmarks of cancer 1316 Genome instability and mutation 1316 Resisting cell death 1316 Sustaining proliferative signalling 1317 Evading growth suppressors 1318 Enabling repli...

34 Pain and palliative care Pain and palliative care LA Colvin M Fallon Pain 1338 Functional anatomy and physiology 1338 Investigations 1342 Principles of management 1343 Interventions 1344 Chronic pain syndromes 1348 Palliative care 1349 Presenting problems i...

35 Laboratory reference ranges Laboratory reference ranges SJ Jenks Notes on the international system of units (SI units) 1358 Laboratory reference ranges in adults 1358 Urea and electrolytes in venous blood 1358 Analytes in arterial blood 1358 Hormones in ven...

1.1 On being a patient 3 ESSENTIALS Those who practise medicine should remember that we are all pa- tients at some time, most likely at the beginning and end of our lives. We therefore begin this textbook with an account of encounters with the medical and nurs...

1.2 A young person’s experience of chronic disease 6 ESSENTIALS For as long as I can remember, my life has involved hospital care, both as an inpatient and as an outpatient. I’ve never really thought of myself as having a chronic condition, but I have three of...

1.3 What patients wish you understood 8 ESSENTIALS If I have an acute curable condition, it is likely that your aims as a doctor and mine as a patient are aligned:  we both want the problem to go away. But more people are now like me, living with disease rathe...

1.4 Why do patients attend and what do they want from the consultation? 14 ESSENTIALS It is the job of doctors to know about disease and how to diagnose and treat it, and textbooks such as this are part of that endeavour. However, proportionally little actual ...

1.5 Medical ethics 20 Mike Parker, Mehrunisha Suleman, and Tony Hope ESSENTIALS Medicine is both a scientific and a moral enterprise. It is as important to give reasons for the ethical aspects of clinical decisions as it is for the scientific aspects. The coro...

1.6 Clinical decision- making 26 Timothy E.A. Peto and Philippa Peto ESSENTIALS Clinicians make decisions at every stage of the patient pathway. In routine practice complex decisions are often made rapidly using ‘intuition’ or common sense, but this can lead t...

Contents Contents Volume 1 List of abbreviations  xxxv List of contributors  xlv SECTION 1 Patients and their treatment Section editors: John D. Firth, Christopher P. Conlon, and Timothy M. Cox 1.1 On being a patient  3 Christopher Booth† 1.2 A young person...

Copyright 3 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxfor...

Foreword Foreword Professor Sir John Bell, Regius Professor of Medicine, University of Oxford In 1983, David Weatherall, John Ledingham, and David Warrell launched the first edition of the Oxford Textbook of Medicine. That era of medicine looked entirely diffe...