Alagappan's Clinical Medicine for Dental Students

About the Book

As per DCI syllabus with a fresh presentation.
Concise and comprehensive.
Latest definitions and guidelines.
Updated epidemiological data.
Sample assessment charts.
Abbreviations and Glossary.
System-based assessment for developing clinical skills.
Oral manifestations of medical conditions.
Every section starts with a chapter on assessment for better understanding of medicine with in-depth practical knowledge.
Enriched with numerous figures, tables and flowcharts for understanding of complex topics.
Important questions are added at the end of chapters for exam preparation.
Special boxes i.e. candle box and stethoscope box carrying clinically relevant information.

About the Author

R Alagappan MD FICP Priya Verma Gupta MDS FPFA

Table of Contents:
Section 1: General Medicine 1. Aims Objectives and Case History 3 Aims and Objectives 3 Doctor-Patient Interrelationship 3 Case History 3 General Examination 5 Pulse 6 Respiration 6 Blood Pressure 6 Temperature 7 Clinical Examination 9 Examination of Skin 9 Examination of Face 12 Constitution 13 Stature 14 State of Nutrition 14 Oedema 15 Examination of Mouth and Pharynx 16 Examination of Neck 17 Examination of Hands and Fingers 17 Differential Diagnosis 20 Investigations 20 Diagnosis 20 Treatment 21 Prognosis 21 Follow-up 21 Section 2: Abdomen 2. Assessment and Examination 27 General Examination 27 Regions of Abdomen 28 Measurements 28 Surface Marking of Organs 28 Inspection 29 Palpation 29 Percussion 33 Auscultation 35 Investigation 36 3. Diseases of Oral Cavity 40 Introduction 40 Dental Caries 40 Pulpitis 41 Periodontitis 41 Acute Necrotising Ulcerative Gingivitis 42 Sialolithiasis 42 Ranula 42 Aphthous Ulcer 43 4. Diseases of Oesophagus 44 Introduction 44 Dysphagia 44 Plummer-Vinson Syndrome 46 Gastroesophageal Reflux Disease 46 5. Diaseases of Stomach 49 Gastritis 49 Peptic Ulcer 52 6. Diseasess of Intestine 55 Diarrhoea 55 Dysentery 58 Amoebiasis 59 Malabsorption 61 7. Diseases of Liver 63 Jaundice 63 Hepatitis 66 Hepatomegaly 69 Cirrhosis of Liver 69 Ascites 72 8. Glomerulonephritis 76 Introduction 76 Acute Glomerulonephritis 76 Acute Post-Streptococcal Glomerulonephritis 77 Post-infectious Glomerulonephritis 77 9. Nephrotic Syndrome 78 Introduction 78 Pathogenesis 78 Aetiology 78 Clinical Features 79 Investigations 81 Management 81 Complications 81 Difference Between Nephrotic and Nephritic Syndrome 81 Contents Prelims.indd 19 4/11/2015 4:48:53 PM xx Alagappan’s Clinical Medicine for Dental Students 10. Renal Failure 82 Acute Renal Failure 82 Chronic Kidney Disease 83 Chronic Renal Failure 84 Section 3: Cardiovascular System 11. Assessment and Examination 89 General Examination 89 Inspection 89 Palpation 90 Percussion 96 Auscultation 96 Blood Pressure 97 Heart Sounds 99 Heart Murmurs 102 Dynamic Auscultation 102 Investigations 103 Important Symptoms and Signs 104 Palpitation 105 Syncope 105 Cyanosis 106 12. Congenital Heart Diseases 108 Introduction 108 Classification 108 Atrial Septal Defect 110 Ventricular Septal Defect 111 Patent Ductus Arteriosus 113 Eisenmenger Syndrome 114 Tetralogy of Fallot 115 13. Rheumatic Fever 118 Introduction 118 Pathophysiology 118 Diagnosis 118 Management 119 Prevention 119 14. Valvular Heart Disease 120 Mitral Valve Disease 120 Aortic Valve Disease 125 Tricuspid Valve Disease 130 15. Coronary Artery Disease 132 Acute Coronary Syndromes 132 Angina Pectoris 134 Myocardial Infarction 135 Cardiopulmonary Resuscitation (Basic Life Support) 140 Cardioversion (Direct Current Shock) 141 Cardiac Transplantation 141 16. Infective Endocarditis 142 Introduction 142 Types 142 Predisposing Factors 142 Clinical Manifestations 142 Clinical Consequences 143 Investigations 143 Management 144 Prevention 144 Non-infective Endocarditis 145 17. Arrhythmias 146 Introduction 146 Atria Origin Arrhythmias 146 Ventricle Origin Arrhythmias 147 18. Cardiac Failure 150 Introduction 150 Classification 150 Aetiology 151 Investigations 152 Management 152 19. Hypertension 158 Introduction 158 Aetiology 158 Clinical Features 159 Diagnosis 159 Factors Influencing Prognosis 160 Management 160 Section 4: Respiratory System 20. Assessment and Examination 169 General Examination 169 Surface Markings 169 Inspection 171 Palpation 174 Percussion 176 Auscultation 179 Investigations 181 Important Signs and Symptoms 185 21. Bronchial Asthma 187 Introduction 187 Aetiology and Types 187 Pathophysiology 188 Prelims.indd 20 4/11/2015 4:48:54 PM Contents xxi Clinical Features 188 Investigations 189 Management 190 Status Asthmaticus 191 22. Chronic Obstructive Pulmonary Disease 192 Introduction 192 Predisposing Factors for Chronic Obstructive Pulmonary Disease 193 Pathogenesis 193 Clinical Features 193 Diagnosis 194 Investigations 194 Management 195 23. Pneumonia 196 Introduction 196 Classification 196 Predisposing Factors 197 Pathological Stages 197 Clinical Features 197 Primary Pneumonia 198 Physical Findings 198 Investigations 199 Secondary Pneumonia 199 Management 200 Complications 201 24. Pulmonary Tuberculosis 203 Introduction 203 Causative Organism 203 Mode of Infection 203 Primary Tuberculosis 204 Clinical Features 204 Miliary Tuberculosis 205 Post Primary Pulmonary Tuberculosis 205 Extrapulmonary Tuberculosis 205 Investigations 205 Management 206 25. Pleural Effusion 209 Introduction 209 Pathogenesis 209 Clinical Features 210 Physical Examination 210 Investigations 210 Parapneumonic Effusion 212 Empyema Thoracis 212 Malignant Effusions 213 Chylothorax 213 Haemothorax 213 Bilateral Pleural Effusion 213 26. Pneumothorax 215 Introduction 215 Spontaneous Pneumothorax 215 Traumatic Pneumothorax 215 Catamenial Pneumothorax 216 Investigations 216 Management 216 Complications 217 27. Pulmonary Suppuration 218 Lung Abscess 218 Bronchiectasis 219 28. Lung Cancers 222 Introduction 222 Aetiology and Risk Factors 222 Classification 222 Clinical Features 223 Investigations 223 Management 223 Section 5: Haematology 29. Disorders of Red Blood Cells 227 Anaemia 227 Iron Deficiency Anaemia 228 Megaloblastic Anaemia 230 Addisonian Pernicious Anaemia 232 Haemolytic Anaemia 233 Haemolytic Disease of Newborn 234 Red Cell Enzymopathy 236 Sickle Cell Anaemia 236 Thalassaemias 238 Aplastic Anaemia 239 Polycythaemia Rubra Vera (Osler’s Disease) 240 30. Disorders of White Blood Cells 242 Introduction 242 Acute Myeloid Leukaemia 242 Acute Lymphoblastic Leukaemia 246 Chronic Myeloid Leukaemia 247 Chronic Lymphocytic Leukaemia 249 31. Heamostatis Disorders 251 Introduction 251 Platelet Disorders 251 Qualitative Platelet Disorders 251 Quantitative Platelet Disorders 251 Disorders Due to Deficiency of Clotting Factors 254 Prelims.indd 21 4/11/2015 4:48:54 PM xxii Alagappan’s Clinical Medicine for Dental Students Haemophilia A 254 Haemophilia B (Christmas Disease) 254 von Willebrand’s Disease 255 Vitamin K Deficiency 255 Disseminated Intravascular Coagulation 255 32. Disorders of Lymph Nodes and Spleen 257 Introduction 257 Lymph Nodes 257 Lymphadenopathy 258 Splenomegaly 259 Hypersplenism 260 Hyposplenism/Asplenia 260 Section 6: Nervous System 33. Assessment and Examination 265 General Examination 265 Inspection 265 Examination 265 34. Disorders of Cranial Nerve 289 Facial Nerve Palsy 289 Trigeminal Neuralgia (Facialpain) 291 35. Epilepsy 293 Introduction 293 Classification 293 Pathophysiology 294 Aetiology 294 Clinical Features 295 Oral Manifestations 295 Investigations 295 Management 296 Status Epilepticus 296 Epilepsy in Pregnant Women 297 36. Stroke 299 Introduction 299 Clinical Classification 299 Aetiology 299 Pathophysiology 300 Investigations 301 Management 302 37. Headaches 304 Headache 304 Migraine 305 Neuralgic Headache 307 Tension Headaches 307 38. Meningitis 308 Introduction 308 Aetiology 308 Clinical Features 309 Investigations 309 Management 310 39. Approach to Coma 312 Introduction 312 Aetiology 312 Assessment and Examination 313 Differentiating Features between Structural and Metabolic Coma 316 Section 7: Endocrine System 40. Thyroid Gland Disorders 319 Hyperthyroidism 319 Neonatal Hyperthyroidism 322 Hypothyroidism 322 Myxoedema Coma (Hypothermic Coma) 324 41. Parathyroid Gland Disorders 325 Primary Hyperparathyroidism 325 Familial Benign Hypercalcaemia 327 Hypercalcaemia in Malignancy 327 Secondary Hyperparathyroidism 327 Tertiary Hyperparathyroidism 327 Hypocalcaemic Disorder 328 Pseudohypoparathyroidis (Target Organ Resistance) 330 42. Adrenal Gland Disorders 331 Introduction 331 Primary Hyperaldosteronism 331 Secondary Hyperaldosteronism 332 Cushing’s Syndrome 332 Adrenal Insufficiency (Addison’s Disease) 334 Phaeochromocytoma 336 43. Pituitary Gland Disorders 339 Hypopituitarism 339 Hyperpituitarism—Acromegaly and Gigantism 341 Hyperprolactinaemia 343 Pituitary Tumours 344 Diabetes Insipidus 344 Syndrome of Inappropriate Antidiuretic Hormone Secretion 346 Prelims.indd 22 4/11/2015 4:48:54 PM Contents xxiii 44. Diabetes Mellitus 348 Introduction 348 Diabetes Mellitus Type1 349 Diabetes Mellitus Type2 352 Acute Complications of Diabetes 356 Long-term Complications of Diabetes 359 GestationalDiabetesMellitus 364 Section 8: Nutrition 45. Nutrition and Health 369 Introduction 369 Definitions 369 The Importance of Food in Health and Disease 369 Classification of Food 370 Carbohydrate 370 Fat 372 Protein 373 Daily Energy Requirement 373 Basal Metabolic Rate 374 46. Vitamins and Minerals 375 Vitamins Minerals 384 47. Balanced Diet and Nutritional Disorders 391 Balanced Diet 391 Nutritional Disorders 392 Aetiology 392 Malnutrition 392 Assessment of Nutritional Status 393 Protein-Energy Malnutrition 394 Obesity 397 Anorexia Nervosa and Bulimia 401 Section 9: Infectious Diseases 48. Typhoid and Paratyphoid Fever 405 Introduction 405 Epidemiology 405 Clinical Features 406 Investigations 407 Management 408 Complications 408 49. Diphtheria 410 Introduction 410 Pathology 410 Clinical Features 410 Classification 410 Differential Diagnosis 411 Diagnosis 411 Management 411 Complications 412 Prevention 412 50. Viral Exanthema 413 Measles (Rubeola) 413 Rubella 415 Mumps 416 Herpes Zoster (Shingles) 417 Herpes Simplex 418 51. Sexually Transmitted Diseases 421 Syphilis 421 Gonorrhoea 425 Chancroid 426 52. HIV and AIDS 427 Introduction 427 Pathogenesis 427 Modes of Transmission 428 Clinical Staging 428 Immunopathogenesis 429 Clinical Features 430 Investigations 432 Prevention 435 53. Malaria 437 Introduction 437 Epidemiology 437 Transmission of Malaria 438 Life Cycle 438 Human Cycle (Schizogony) 439 Mosquito Cycle (Sporogony) 439 Clinical Features 440 Immunity 442 Recrudescence and Relapse 442 Laboratory Diagnosis 442 Treatment 444 Prophylaxis 445 54. Infectious Mononucleosis 446 Introduction 446 Pathogenesis 446 Clinical Features 446 Prelims.indd 23 4/11/2015 4:48:54 PM xxiv Alagappan’s Clinical Medicine for Dental Students Laboratory Findings 447 Management 448 55. Oral Manifestations of Mucocutaneous Lesions 449 Introduction 449 Oral Manifestations of Dermatological Disorders 449 Management 450 Behcet’s Syndrome 450 Ludwig’s Angina 451 Oral Manifestations of Infectious Diseases 451 Pigment Disorders 453 Oral Manifestations of Haematological Disorders 455 Appendices Appendix I: Common Drugs Used in Dentistry 457 Appendix II: Drugs of Choice 463 Appendix III: Adverse Effects of Drugs 465 Index 469 Prelims.indd 24 4/11/2015 4:48:54 PM