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Mind Maps for Medicine \ 283
282 / Chapter 8 Infectious diseases: Tuberculosis
Tuberculosis
Tuberculosis (TB) is an
infection caused by bacteria
of the Mycobacterium
genus that most commonly
affect the lungs.
•
Close contact of TB patient
•
Ethnic minority groups: predominantly from South Asia and sub-Saharan
Africa
•
Homeless patients, those with alcohol dependency and other drug misusers
•
HIV-positive and other immunocompromised patients; patients on
immunosuppressant drugs are particularly at risk (e.g. infliximab and
etanercept, azathioprine, ciclosporin)
•
Children and elderly patients
•
Other conditions: haematological and some solid cancers, long-term
steroids, diabetes, end-stage renal disease, silicosis and gastrectomy/
jejunoileal bypass
• Worldwide, TB is one of the top 10 causes
of death and the leading cause from a
single infectious agent (above HIV/AIDS)
•
In 2018, an estimated 10million people
fell ill with TB worldwide
Primary TB
• The initial infection with M.tuberculosis
usually occurs in the upper zone of the lung
producing a lesion called the Ghon focus
•
The Ghon focus comprises macrophages
whichhave engulfed the bacilli resulting in
the typical granulomatous lesions with
caseating central necrosis surrounded by
epithelioid cells and Langerhans giant cells
• The Ghon focus is almost always accompanied
by caseous lesions in the hilar lymph nodes
andthe combination of these is known as a
Ghon complex
• In immunocompetent people the initial
lesion usually heals by fibrosis; those who
are immunocompromised may develop
disseminated disease (miliary TB)
•
Reduced quality of life
•
Transmission to others
•
Drug resistance
•
Post-TB bronchiectasis, COPD and
aspergilloma (occur in residual lung
cavities)
• Post-TB cor pulmonale/respiratory
failure may result from lung cavitation,
scarring and fibrosis following
pulmonary TB
• Death
Denition
Risk factors
Complications
Epidemiology
Management
Systemic features
• May be asymptomatic
•
Night sweats
•
Weight loss
•
Malaise
•
Fever
• Anorexia
Local features
• Lung/pleura Cough, sputum, haemoptysis,
breathlessness, lobar collapse, bronchopneumonia,
hoarseness, chest pain, effusion
• Heart/pericardium Pain, arrhythmias, cardiac failure,
pericarditis
• Intestine Malabsorption, diarrhoea, obstruction
• GU tract Haematuria, renal failure, epididymitis,
salpingitis, infertility
• Adrenals Adrenal insufficiency
• Skin Erythema nodosum, erythema induratum, lupus
vulgaris
• Eyes Iritis, choroiditis, phlyctenular keratoconjunctivitis
• Bones/joints Arthritis, osteomyelitis
• Lymphatics Lymphadenopathy, cold abscesses,
sinuses
• Brain Tuberculoma, meningitis
Clinical features
Investigations
Non-pharmacological
• Care should be coordinated through the local multidisciplinary TB team
•
For all TB cases in the UK, the local public health authority should be notified
sothat screening and contact tracing (see Notes) can be arranged
• Patient education, particularly the importance of complying with medical
therapy
Pharmacological
Anti-TB drugs (see Notes, Side effects of anti-TB drugs)
Active TB standard treatment (RIPE):
• Rifampicin For 6months (2months initiation phase+4months continuation
phase)
•
Isoniazid For 6months (2months initiation phase+4months continuation
phase)
• Pyrazinamide For initial 2months (2months initiation phase)
• Ethambutol For initial 2months (2months initiation phase)
Latent TB:
The treatment for latent TB is 3months of isoniazid with pyridoxine and rifampicin
or 6months of isoniazid (with pyridoxine).
Meningeal TB:
Patients with meningeal TB are treated for a prolonged period (at least 12months)
with the addition of steroids.
Secondary (post-primary) TB
• If the host becomes immunocompromised
the initial infection may become
reactivated; reactivation generally occurs
in the apex of the lungs and may spread
locally or to more distant sites
•
The lungs remain the most common site
for secondary TB; extrapulmonary infection
may occur in the following areas:
•
Central nervous system (tuberculous
meningitis, the most serious
complication)
•
Vertebral bodies (Pott’s disease)
•
Cervical lymph nodes (scrofuloderma)
•
Renal
•
GI tract
• CXR Typically shows patchy or nodular
shadows in the upper zone (see Fig. 1);
with miliary TB the CXR may be normal or
show miliary shadows throughout the lung
(see Fig. 2)
•
Sputum (at least 3 samples) Ziehl–Neelsen
or auramine staining of a sputum smear may
demonstrate the presence of acid-fast bacilli;
in vitro culture of the sputum (e.g. Löwenstein–
Jensen medium) may take 4–7weeks to
provide a result and a further 3weeks is
required to identify drug sensitivity
• Whole blood interferon-gamma Aids
diagnosis of TB
• Bronchoscopy with washings of the affected
lobes; useful if there is no sputum available
• Biopsy Diagnosis can sometimes be made
based on the histological demonstration of a
caseating granuloma)
• HIV screening HIV is a big risk factor for TB
(seeCh8: Human immunodeficiency virus)
• Tuberculin test Hypersensitivity to the
tubercle bacillus develops about 3weeks
after initial infection; the Mantoux test is
usually used
Fig. 1 Pulmonary TB
Fig. 2 Miliary TB
Pathophysiology
https://t.me/med1917
Notes
Tuberculosis
Mind Maps for Medicine \ 285
284 / Chapter 8 Infectious diseases: Tuberculosis notes
Side eects of anti-TB drugs (see Table1)
Table 1 Side effects of the main anti-TB drugs
Rifampicin • Discolours body secretions and urine pink
•
Induces liver enzymes
•
Flu-like symptoms
•
Elevation of liver transferases and hepatitis
Isoniazid •
Peripheral neuropathy: prevent with pyridoxine
(vitaminB
6
)
•
Hepatitis
•
Allergic reactions: skin rash and fever
•
Agranulocytosis
•
Inhibits liver enzymes
Pyrazinamide •
Hyperuricaemia
•
Arthralgia and myalgia
•
Gout
•
Hepatitis (rare)
Ethambutol Eyes: optic neuritis (visual acuity and red-green
colour perception should be done before
treatment)
The Bacille Calmette–Guérin (BCG) vaccination
The BCG vaccine contains live attenuated M.bovis. It offers limited protection
against TB and leprosy.
Administration
• Any person being considered for the BCG vaccine must first be given a
tuberculin skin test; the only exceptions are children <6years who have had
no contact with tuberculosis
•
Given intradermally, normally to the lateral aspect of the left upper arm
•
BCG can be given at the same time as other live vaccines, but if not
administered simultaneously there should be a 4-week interval
Indications
• All infants (aged 0–12months) living in areas of the UK where the annual
incidence of TB is 40/100000 or greater
• All infants (aged 0–12months) with a parent or grandparent who was born
in a country where the annual incidence of TB is 40/100000 or greater; the
same applies to older children but if they are 6years or older they require a
tuberculin skin test first
•
Previously unvaccinated tuberculin-negative contacts of cases of
respiratory TB
• Previously unvaccinated, tuberculin-negative new entrants under 16years
who were born in or who have lived for a prolonged period (at least
3months) in a country with an annual TB incidence of 40/100000 or greater
•
Healthcare workers
•
Prison staff
•
Staff of care homes for the elderly
•
Those who work with homeless people
Contraindications
• Previous BCG vaccination or a past history of TB
•
Positive tuberculin test (Heaf or Mantoux)
•
HIV
•
Pregnancy
Contact tracing
• The Mantoux test should be used to diagnose latent TB in people who are
either household contacts or close work or school contacts (aged ≥5years)
of all patients diagnosed with active TB
•
As the Mantoux test may be positive in patients who have had the bacillus
(BCG vaccine) interferon-gamma testing is the recommended 2nd-line
test for people whose Mantoux testing shows positive results, or instead of
Mantoux test in people for whom Mantoux testing may be less reliable
Observed therapy
• Individualised supportive care may be required for people with clinically or
socially complex needs considered to be at high risk of poor adherence to
treatment
•
Examples of these individuals include the homeless, history of drug misuse;
previous TB treatment; multiple drug resistance TB; prisoners; significant
mental health, memory or cognitive problems
•
This may include ‘directly observed therapy’ (DOT), where drug treatment
is given under the observation of a key worker and the person is observed
to swallow each dose of medication, or ‘video observed therapy’ ( VOT) to
improve adherence, reduce the risk of stopping treatment early and reduce
drug resistance
Tuberculosis notes
https://t.me/med1917
Mind Maps for Medicine \ 287
Chapter 1: Cardiology
Acute coronary syndrome
• Fig. 1 – Adapted from http://medicalnotesonline.blogspot.
com/2011/01/cardiology-myocardial-infarction-and.html
• Fig. 2 – Reproduced from Cardiology in a Heartbeat (Vaswani
et al.) under the Creative Commons Attribution-ShareAlike 4.0
International Licence; reproduced with permission from
Life In The Fast Lane (http://lifeinthefastlane.com).
•
Fig. 3 – Reproduced from Cardiology in a Heartbeat (Vaswani
et al.) under the Creative Commons Attribution-ShareAlike 4.0
International Licence; reproduced with permission from
Life In The Fast Lane (http://lifeinthefastlane.com).
Acute pericarditis
• Fig. 1 – Reproduced from Cardiology in a Heartbeat (Vaswani
et al.) under the Creative Commons Attribution-ShareAlike 4.0
International Licence; reproduced with permission from
Life In The Fast Lane (http://lifeinthefastlane.com).
• Fig. 2 – author’s own
Atrial fibrillation
• Fig. 1 – basic trace
Heart failure
• Fig. 1 – author’s own
• Fig. 2 – Reproduced from Anatomy and Physiology: an
introduction for nursing and healthcare (Minett & Ginesi)
• Fig. 3 – Reproduced from https://meded.ucsd.edu/clinicalmed/
heart.html with permission
• Fig. 4 – Adapted from https://medmnemonics.wordpress.
com/2011/03/04/heart-failure-chest-x-ray-signs-2/
Hypertension
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
• Fig. 2 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Infective endocarditis
• Fig. 1 – Reproduced from www.slideserve.com/derry/
infective-endocarditis
•
Fig. 2 – Reproduced from Cardiology in a Heartbeat
(Vaswani et al.); Licensed under: Public Domain; available
at: http://commons.wikimedia.org/wiki/File:Splinter_
hemorrhage.jpg
•
Fig. 3 – Reproduced from Cardiology in a Heartbeat (Vaswani
et al.); Licensed under: Creative Commons Attribution-
Share Alike 4.0 International; additional attribution: Wikimedia
Commons, Gonzalo M. Garcia; available at: http://commons.
wikimedia.org/wiki/File:Acopaquia.jpg
•
Fig. 4 – Reproduced from http://simple-cardio.blogspot.
com/2012/06/peripheral-signs-of-infective.html with permission
from Professor Sanjay Sharma
Valvular heart disease
• Fig. 1 – Reproduced from https://ecg.utah.edu with permission
•
Fig. 2 – Reproduced from http://learningradiology.com/index.
htm with permission
• Fig. 3 – Reproduced from Cardiology in a Heartbeat (Vaswani
et al.) under the Creative Commons Attribution-ShareAlike 4.0
International Licence; reproduced with permission from
Life In The Fast Lane (http://lifeinthefastlane.com).
Chapter 2: Respiratory
Acute respiratory distress syndrome
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Asthma
• Fig. 1 – Reproduced from Anatomy and Physiology: an
introduction for nursing and healthcare (Minett & Ginesi).
• Fig. 2 – Reproduced from https://radiopaedia.org/articles/lung-
hyperinflation-1?lang=us (Case courtesy of Assoc Prof Frank
Gaillard, Radiopaedia.org, rID: 10550) with permission.
Bronchiectasis
• Fig. 1 – Licensed under: Creative Commons Attribution-
Share Alike 4.0 International; additional attribution: Wikimedia
Commons, Gonzalo M. Garcia; available at: http://commons.
wikimedia.org/wiki/File:Acopaquia.jpg
• Fig. 2 – Reproduced from imagehttps://radiopaedia.org/cases/
cystic-bronchiectasis-3 (Case courtesy of Dr Bruno Di Muzio,
Radiopaedia.org, rID: 18289) with permission.
Appendix: Figure acknowledgements
https://t.me/med1917
Mind Maps for Medicine \ 289
288 / Appendix: Figure acknowledgements
Chronic obstructive pulmonary disease
• Fig. 1 – Reproduced from Interpreting Chest X-Rays (Ellis).
Interstitial lung disease
• Fig. 1 – Reproduced from Interpreting Chest X-Rays (Ellis).
Lung cancer
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Creative Commons Attribution-Share Alike 3.0
Unported; additional attribution: James Heilman, MD; available at:
https://commons.wikimedia.org/wiki/File:LungCACXR.PNG
Pleural effusion
• Fig. 1 – Reproduced from Interpreting Chest X-Rays (Ellis).
Pneumonia
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Creative Commons Attribution-Share Alike 3.0
Unported; additional attribution: Hellerhoff; available at: https://
commons.wikimedia.org/wiki/File:03-01-Infiltrat_Ausgang.png
Pneumothorax
• Fig. 1 – Reproduced from Medicine in a Minute ( Vaswani & Khaw).
Licensed under Creative Commons Attribution-Share Alike 3.0
Unported; additional attribution: Karthik Easvur; available at:
https://commons.wikimedia.org/wiki/File:Pneumothorax_gif_1.gif
• Fig. 2 – Reproduced from Interpreting Chest X-Rays (Ellis).
•
Notes Fig. (Flowchart of management of spontaneous
pneumothorax) – Reproduced from Thorax (2010) 65: 18 with
permission from BMJ Publishing Group Ltd.
Pulmonary embolism
• Fig. 2 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under the Creative Commons Attribution-ShareAlike 4.0
International Licence; reproduced with permission from
Life In The Fast Lane (http://lifeinthefastlane.com).
• Fig. 3 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Creative Commons Attributions-Share Alike 4.0
International; additional attribution: Rvahudson; available at:
https://commons.wikimedia.org/wiki/File:CTA_Chest_With_
Massive_Pulmonary_Embolism_and_Complete_Occlusion.jpg
Respiratory failure
• Fig. 1 – Reproduced from www.indiamart.com/proddetail/
venturi-mask-3663147912.html.
Sarcoidosis
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under Creative Commons Attribution-Share
Alike 3.0 Unported; additional attribution: James Heilman,
MD; available at: https://commons.wikimedia.org/wiki/index.
php?curid=11520780
• Fig. 2 – Reproduced from Current Clinical Medicine; Sarcoidosis
(DA Culver) (© 2009, 2010 The Cleveland Clinic Foundation, all
rights reserved) with permission.
Chapter 3: Gastroenterology
Acute pancreatitis
• Fig. 1 – reproduced from Chauhan, et al. (2008) Clinical Picture,
372: 54 (DOI: https://doi.org/10.1016/S0140-6736(08)60993-9)
with permission from Elsevier.
Chronic pancreatitis
• Fig. 1 – Reproduced from https://radiopaedia.org/cases/
pancreatic-calcifications-chronic-pancreatitis (Case courtesy of Dr
Domenico Nicoletti, Radiopaedia.org, rID: 67773) with permission.
Cirrhosis
• Fig. 1 – Reproduced from www.luxeclinic.co.uk/
what-is-spider-naevus-and-how-to-treat-it/
• Fig. 2 – Licensed under Creative Commons Attributions-Share
Alike 3.0; available at: https://commons.wikimedia.org/wiki/
File:Gynecomastia_001.jpg
Coeliac disease
• Fig. 1 – Adapted from www.glutenfreetherapeutics.com/
living-gluten-free/medicine-research/chronic-inflammation
• Fig. 2 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Creative Commons Attribution-Share Alike 3.0
Unported; additional attribution: BallenaBlanca; available at:
https://commons.wikimedia.org/wiki/File%3ADiapositiva_1.jpg
• Fig. 3 – Reproduced from www.passmedicine.com/review/
textbook.php?s= with permission.
Gastric cancer
• Fig. 1 – Reproduced from www.nguyenthienhung.com
•
Fig. 2 – Reproduced from Medicine in a Minute (Vaswani
& Khaw). Licensed under Creative Commons Attributions-
Share Alike 3.0 Unported; additional attribution: Thomas
Habif; available at: https://commons.wikimedia.org/wiki/
File:Acanthosis-nigricans4.jpg
Gastro-oesophageal reflux disease
• Fig. 1 – Adapted from https://herniagallbladderwa.com.au/
conditions/hiatal-hernia-treatment-perth
Hereditary haemochromatosis
• Fig. 1 – Reprinted by permission from Springer Nature; Brissot
et al. (2018) Haemochromatosis. Nat Rev Dis Primers 4, 18016
(https://doi.org/10.1038/nrdp.2018.16)
Jaundice
• Fig. 1 – Reproduced from https://imannooor.wordpress.com
• Fig. 2 – Adapted from https://medical-dictionary.
thefreedictionary.com/Bilirubin+metabolism
Oesophageal cancer and other causes of dysphagia
• Fig. 2 – reproduced from The Lancet, 290: 2383, Lagergren, et al.
(2017) (DOI: https://doi.org/10.1016/S0140-6736(17)31462-9)
with permission from Elsevier.
Wilson’s disease
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Creative Commons Attribution-Share Alike 3.0
Unported; additional attribution: Herbert L. Fred, MD, Hendrik
A. van Dijk; available at: https://commons.wikimedia.org/wiki/
File:Kayser-Fleischer_ring.jpg
Chapter 4: Renal
Nephritic syndrome
• Fig. 1 – Reproduced under the Open Government Licence v3.0
from www.nhs.uk/conditions/henoch-schonlein-purpura-hsp/
•
Fig. 2 – Reproduced from Journal of Intensive Care (2017) 5: 57
(DOI 10.1186/s40560-017-0251-y) under a CC Attribution 4.0
International License.
Nephrotic syndrome
• Fig. 1 – Reproduced under a CC Attribution License 3.0
Germany; additional attribution: Klaus D. Peter; available at:
https://en.wikipedia.org/wiki/Periorbital_puffiness#/media/
File:Oedema.jpg
• Fig. 2 – Reproduced under the Open Government Licence v3.0
from www.nhs.uk/conditions/nail-problems/
• Fig. 3 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under CC Attribution License 3.0 Germany; additional
attribution: Klaus D. Peter; available at: https://commons.
wikimedia.org/wiki/File:Xanthelasma.jpg
Chapter 5: Endocrinology
Acromegaly
• Fig. 1 – Adapted from www.endotext.org.
•
Fig. 2 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under CC Attribution 2.0 Generic; additional attributions:
Philippe Chanson and Sylvie Salenave; available at: https://
commons.wikimedia.org/wiki/File:Acromegaly_prognathism.
JPEG
• Fig. 3 – Licensed under CC Attribution 3.0 Unported; additional
attributions: Deshpande P1, Guledgud MV1, Patil K1, Hegde U2,
Sahni A1, Huchanahalli Sheshanna S2; available from https://
en.wikipedia.org/wiki/Macroglossia#/media/File:Macroglossia_
with_crenations_along_the_margins_and_loss_of_papillae_
on_dorsum_surface_of_the_tongue.png
• Fig. 4 – Reproduced from Clinical Endocrinology (Whitehead
& Miell).
Adrenal insufficiency
• Fig. 1 – Reproduced from Clinical Endocrinology (Whitehead
& Miell).
Cushing syndrome
• Fig. 2 – Reproduced from https://commons.wikimedia.org/wiki/
File:CushingsFace.jpg under a CC Attribution 2.5 Generic license.
• Fig. 3 – Reproduced from www.reddit.
com/r/Pathognomonic/comments/1sxyig/
purple_abdominal_striae_1cm_cushings_syndrome/
Hyperthyroidism
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under Creative Commons Attribution-Share
Alike 4.0 International; additional attribution: OpenStax; available
at: https://cnx.org/contents/FPtK1zmh@8.108:YhivaL0u@4/
The-Thyroid-Gland
•
Fig. 2 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under Creative Commons Attribution 2.0
Generic; additional attributions: Herbert L. Fred, MD and Hendrik
A. van Dijk; available at: https://commons.wikimedia.org/wiki/
File:Myxedema.jpg
•
Fig. 3 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Creative Commons Attributions-Share Alike
3.0 Unported; additional attributions: Jonathan Trobe, M.D. –
University of Michigan Kellogg Eye Center; available at: https://
commons.wikimedia.org/wiki/File:Proptosis_and_lid_retraction_
from_Graves%27_ Disease.jpg
Hypocalcaemia
• Fig. 2 – Reproduced from https://what-when-how.com/nursing/
endocrine-disorders-adult-care-nursing-part-3/
Hypothyroidism
• Fig. 1 – Reproduced from Anatomy and Physiology: an
introduction for nursing and healthcare (Minett & Ginesi).
Polycystic ovary syndrome
• Fig. 1 – Reproduced from Science Photo Library with permission.
•
Fig. 2 – Reproduced from Clinical Endocrinology (Whitehead &
Miell).
Chapter 6: Neurology
Bell’s palsy
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under CC Attribution-Share Alike 3.0 Unported;
additional attribution: James Heilman, MD; available at: https://
commons.wikimedia.org/wiki/File:Bellspalsy.JPG
•
Fig. 2 – Reproduced from www.pinterest.co.uk/
pin/773985885937936621/
• Fig. 3 – Reproduced from Mortada et al. (2009) Transplant
Infectious Disease, 11: 72 (https://doi.org/10.1111/j.1399-
3062.2008.00353.x) with permission from John Wiley and Sons.
Extradural haematoma
• Fig. 2 – Reproduced from Anatomy and Physiology in Healthcare
(Marshall et al.).
• Fig. 3 – Reproduced from Eureka: Neurology and Neurosurgery
(Collins et al.).
Multiple sclerosis
• Fig. 1 – Adapted from Anatomy and Physiology in Healthcare
(Marshall et al.).
• Fig. 2 – Reproduced from Eureka: Neurology and Neurosurgery
(Collins et al.).
https://t.me/med1917
Mind Maps for Medicine \ 291
290 / Appendix: Figure acknowledgements
Myasthenia gravis
• Fig. 1 – Reproduced from www.epainassist.com/images/Article-
Images/Myasthenia-Gravis.jpg with permission.
Neurofibromatosis
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under CC Attribution-Share Alike 3.0 Unported;
additional attribution: Accrochoc; available at: https://commons.
wikimedia.org/wiki/File:NF-1-Tache_cafe-au-lait.jpg
• Fig. 2 – Reproduced from Medicine in a Minute (Vaswani
& Khaw). Licensed under CC Attribution-Share Alike 4.0
International; available at: https://commons.wikimedia.org/wiki/
File:Cutaneous_neurofibroma_(MedMedicine).jpg
• Fig. 3 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under Public Domain
Stroke
• Fig. 1 – Reproduced from Eureka: Neurology and Neurosurgery
(Collins et al.).
Subarachnoid haemorrhage
• Fig. 2 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under CC Attribution-Share Alike 3.0 Unported;
additional attribution: James Heilman, MD; available at: https://
commons.wikimedia.org/wiki/File:Subarach.png
Subdural haematoma
• Fig. 1 – Reproduced from Eureka: Neurology and Neurosurgery
(Collins et al.).
• Fig. 2 – Reproduced from Eureka: Neurology and Neurosurgery
(Collins et al.).
Chapter 7: Rheumatology
Ankylosing spondylitis
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 3 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Fibromyalgia
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Giant cell arteritis
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Gout
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 2 – Reproduced from Medicine in a Minute (Vaswani & Khaw).
Licensed under CC Attribution 2.0 Generic; additional attribution:
Arthritis Research UK Primary Care Centre, Primary Care Sciences,
Keele University, Keele, UK; available at: https://commons.
wikimedia.org/wiki/File:Tophaceous_gout.jpg
Osteoarthritis
• Fig. 1 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under CC Attribution-Share Alike 3.0 Unported;
additional attribution: Drahreg01; available at: https://commons.
wikimedia.org/wiki/File:Heberden-Arthrose.JPG
• Fig. 2 – Reproduced from Medicine in a Minute (Vaswani &
Khaw). Licensed under CC Attribution-Share Alike 3.0 Unported;
additional attribution: James Heilman, MD; available at: https://
commons.wikimedia.org/wiki/File:Osteoarthritis_left_knee.jpg
Paget’s disease
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Polymyositis and dermatomyositis
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Psoriatic arthritis
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 3 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 4 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 5 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Reactive arthritis
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 3 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Rheumatoid arthritis
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 3 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 4 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Scleroderma
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 3 – Reproduced from Science Photo Library with permission.
Septic arthritis
• Fig. 1 – Reproduced from www.omicsonline.org/mexico/septic-
arthritis-peer-reviewed-pdf-ppt-articles/ under a CC Attribution
4.0 license.
Sjögren syndrome
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Systemic lupus erythematosus
• Fig. 1 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
• Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 3 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 4 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Vitamin D deficiency
• Fig. 1 – Adapted from Clinical Endocrinology (Whitehead & Miell).
•
Fig. 2 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
•
Fig. 3 – Reproduced from Rheumatology: a clinical handbook
(Al-Sukaini et al.).
Chapter 8: Infectious diseases
Tuberculosis
• Fig. 1 – Reproduced from https://radiopaedia.org/cases/
pulmonary-tuberculosis-29 (Case courtesy of Assoc Prof Frank
Gaillard, Radiopaedia.or g, rID: 8632) with permission.
•
Fig. 2 – Licensed under CC Share Alike 4.0; additional attribution:
James Heilman, MD; available at: https://en.wikipedia.org/wiki/
Miliary_tuberculosis#/media/File:PulmonaryTBCXR.png
https://t.me/med1917
Mind Maps for Medicine \ 293
4AT, 188
Abbreviated mental test score (AMTS), 188
ABCD2 score, 217
Acanthosis nigricans, 87, 178
ACE inhibitor, 12–13, 14, 16–17, 22–3,
116–17, 124, 126, 142, 168
Achalasia, 96–9
Acromegaly, 20–1, 50–1, 132–3
Acute coronary syndrome (ACS), 4–7, 187
Acute glaucoma, see Glaucoma, acute
Acute kidney injury, see Kidney injury, acute
Acute liver failure, see Liver failure, acute
Acute pancreatitis, see Pancreatitis, acute
Acute pericarditis, see Pericarditis, acute
Acute respiratory distress syndrome (ARDS),
28–9, 54–5, 62–3, 68–9, 70–1
Addison’s disease, 134–5
Adrenal insufficiency, 134–5, 156–7, 168–9,
282–3
AIDS, 55, 276–8
Alpha-1 antitrypsin deficiency, 34–5, 36–9,
72–3, 76–7, 94–5
Alpha blockers, 23, 176–7, 254
Amantadine, 204, 210–12
Aminophylline, 32, 36–7
Aminosalicylates, 82–4, 106
Amyotrophic lateral sclerosis, 202
Angina, 2–3, 4–7, 12–13, 18–19
Angiotensin receptor blocker, 14–17, 22–3
Ankylosing spondylitis, 12–13, 42–3, 56–7,
82–3, 106–7, 228–9
Anticoagulation, 10–11, 18–19, 126–7, 150,
201, 220
Antimuscarinics, 210–12
Antiphospholipid syndrome, 217, 262
Anti-TB drugs, 282–4
Aortic regurgitation, 12
Aortic stenosis, 12, 14–15
Apomorphine, 210–12
Arrhythmogenic right ventricular
cardiomyopathy, 18–19
Arthritis
psoriatic, 246–7
reactive, 248–9
Index
rheumatoid, 13, 102–3, 182–3, 214–15,
242–3, 250–3
septic, 256–7
Asbestosis, 42–5
Ascites, 9, 14–15, 52, 68–9, 76–8, 87, 104,
109, 126–7, 273, 274
Aspirin, 2–3, 4–6, 68–9, 100–1, 198–200,
216–17, 218–20, 262
Asthma, 30–3, 34–5, 36–9, 56–7, 62–3
Atrial fibrillation, 10–11, 18–19, 162–3,
164–7, 216–17, 220–1
Autoimmune hepatitis, 68–9, 77, 94
Bariatric surgery, 145, 168–9
Barthel index, 221
Bell’s palsy, 182–5
Beta blockers, 2–3, 7, 10–11, 12–13, 14–17,
18–19, 22–3, 30–1, 52–3, 140–1, 150,
166, 176, 206–7, 212
Bisphosphonates, 40, 48, 100, 155, 156–7,
228, 238–9, 240, 242
Blatchford score, 110
Bouchard’s nodes, 237
Bronchiectasis, 34–5, 40–1, 42–3, 54–5,
62–3, 282–3
Bronchitis, chronic, 36–7
Bronchodilators, 34–5, 36–7, 40–1, 45, 72–3
B-type natriuretic peptide, 14–16
Calcitonin, 46, 155–7, 238
Calcium channel blocker, 2–3, 7, 10–11, 13,
22–3, 150, 206, 254–5
Cancer
gastric, 86–7, 98
lung, 36–7, 45, 46–8, 56–7, 72–3, 98,
134–5, 136–7, 244–5
oesophageal, 80–1, 96–8
Carbamazepine, 192
Cardiac tamponade, 8–9, 14–15
Carpal tunnel syndrome, 118, 133, 161, 234
Central venous thrombosis, 201
Child–Pugh score, 78
Chronic bronchitis, see Bronchitis, chronic
Chronic pancreatitis, see Pancreatitis, chronic
Chvostek’s sign, 155
Circinate balanitis, 249
Circle of Willis, 222–3
Cirrhosis, 16–17, 40–1, 52–3, 72–3, 76–8,
90–1, 94–5, 102–3, 104–5, 112–13,
170–3, 270–1, 272–3, 274–5
Clopidogrel, 6–7, 216–17, 220
Cluster headache, 200
Coal worker’s pneumoconiosis, 42–4
Coeliac disease, 80–1, 92–3, 96–7, 102–3,
264–5
COMT inhibitors, 210–12
Confusion assessment method (CAM), 188
Constrictive pericarditis, see Pericarditis,
constrictive
Corticobasal degeneration, 211
Cortisol, 134–5, 136–7, 148–9, 168–9,
170–1, 174–5
CREST syndrome, 254–5
Cryoglobulinaemia, 122–3, 272
Cystic fibrosis, 34–5, 40–1, 56–7, 74–5,
76–7, 173, 264–5
Cullen’s sign, 71
Cushing disease, 136–7
Cushing syndrome, 20–1, 134–5, 136–7
DAS28, 253
DDP4 inhibitors, 74–5, 146–7
De Quervain’s thyroiditis, 160–1, 164–5
Delirium, 166, 186–8
Dementia, 186–8
Lewy body, 210–11
Denosumab, 156–7, 238–9
Dermatitis herpetiformis, 81
Dermatomyositis, 86–7, 242–3, 244–5
Diabetes insipidus, 138–9, 156–7
Diabetes mellitus, 2–3, 4–5, 40–1, 74–5,
80–1, 90–1, 116–17, 126–7,
140–50
overview, 140–1
type 1 management, 142–3
type 2 management, 144–7
Diabetic ketoacidosis, 148–9, 166
Dialysis, 52, 68, 116, 118–21, 122, 156, 254
Discoid lupus, 261–2
Dopamine receptor agonists, 212
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Mind Maps for Medicine \ 295
294 / Index
Dressler syndrome, 4–5, 8
Dysphagia, 96–9, 100–1, 202, 206–7,
218–19, 244–5, 254–5, 258–9
Emphysema, 36–7, 72–3
Encephalitis, 139, 173, 174, 186–7, 191,
201, 210
Endocarditis, infective, 7, 13, 24–5, 122–3,
216–17
Entresto, 16–17
Epilepsy, 186–7, 190–3, 204–5, 208–9,
216–17
Ethosuximide, 192
Exophthalmos, 165
Extradural haematoma, 194–5, 201
Faecal calprotectin, 83, 93, 106
Fibromyalgia, 230–1, 242–3
Focal segmental glomerulosclerosis, 126–7
Gastric cancer, see Cancer, gastric
Gastro-oesophageal reflux disease (GORD),
88–9, 254–5
Giant cell arteritis, 200, 232–3
Glaucoma, acute, 201
Gliptins, see DDP4 inhibitors
Goodpasture syndrome, 116–17, 118–19,
122–3
Gout, 234–5, 236–7, 250–1, 256–7
Glasgow Imrie criteria, 70
GLP-1 analogues, 145, 146–7
Glucocorticoids, 82–3, 156, 174–5, 242,
253, 264
Granulomatosis with polyangiitis, 125,
52–3, 122–3
Graves’ disease, 164–5
Grey Turner’s sign, 71
Gynaecomastia, 17, 23, 77, 109, 165
Haemochromatosis, hereditary, 90–1
Haemodialysis, 68–9, 118–19, 121, 156–7
Haemolytic uraemic syndrome, 123
Headaches, 20–1, 46–7, 174–5, 190–1,
198–201, 224–5, 230–1, 276–7
Heart failure, 4–7, 10–11, 12–13, 14–17,
18–19, 20–1, 52–3, 60–1, 64–5, 68–9,
90–1, 116–17, 118–19, 132–3, 147,
160–1, 164–6, 170–3, 186–7, 216–17,
218–19, 254–5
Heberden’s nodes, 237
Heerfordt syndrome, 65
Henoch–Schönlein purpura (HSP), 122–3
Hepatic encephalopathy, 68–9, 76, 78
Hepatitis A, 68–9, 90–1, 94–5, 268–9
Hepatitis B, 116–17, 122–3, 126–7, 270,
272–3, 276–7
Hepatitis C, 68–9, 274–5
Hepatitis D, 270
Hepatitis E, 270
Hereditary haemochromatosis, 90–1
Hiatus hernia, 88–9
Highly active antiretroviral therapy (HAART),
264–5, 276–8
Human immunodeficiency virus (HIV),
276–8, 282–3
Hyperaldosteronism, 20–1, 152–3
Hypercalcaemia, 46–7, 64–5, 70–1, 74–5,
100–1, 138–9, 156–7, 186–7, 190–1,
240–1
Hyperosmolar hyperglycaemic state, 150
Hyperparathyroidism, 20–1, 46–7, 118–19,
156–7, 238–9
Hyperprolactinaemia, 132–3, 158–9, 178–9
Hypersensitivity pneumonitis, 43
Hypertension, 2–3, 4–7, 10–11, 14–15,
20–3, 36–7, 50–1, 118–21, 122–5,
126–7, 132–3, 136–7, 142–3, 152–3,
176–7, 182–3, 194–5, 218–21, 222–3,
234–5, 260–1
Hyperthyroidism, 14–15, 150, 156–7, 160–1,
164–6, 186–7, 238–9
subclinical, 166
Hypertrophic obstructive cardiomyopathy
(HOCM), 12–13, 18
Hypocalcaemia, 70–1, 116–17, 154–5,
190–1, 264–5
Hypoglycaemia, 168–9, 174–5, 186–7,
190–3, 214–15, 216–17, 280–1
Hypogonadism, 158–9, 174–5
Hyponatraemia, 23, 46–7, 116–17, 170–3,
190–2
Hypopituitarism, 90–1, 132–3, 134–5,
158–9, 160–1, 174–5
Hypothyroidism, 8–9, 50–1, 52–3, 102–3,
158–9, 160–2
subclinical, 162
Idiopathic pulmonary fibrosis, 42–4, 56–7
IgA nephropathy, 122–3
Infective endocarditis, see Endocarditis,
infective
Inflammatory bowel disease, 82–4, 106–7
Insulinoma, 168–9
Interstitial lung disease, 42–5, 56–7, 64–5,
244–5
Irritable bowel syndrome, 80–1, 92–3
Ivabradine, 17
Jaccoud’s arthropathy, 261
Jaundice, 68–9, 70–1, 76–7, 86–7, 94–5,
102–3, 104–5, 108–9, 166, 268–9,
272–3, 274–5, 280–1
Kartagener’s syndrome, 34–5
Keratoderma blennorrhagica, 249
Kidney injury, acute, 54–5, 76–7,
116–17, 122–3, 128–9, 148–9
Lamotrigine, 192
Lateral medullary syndrome, 218–19
Leuconychia, 77, 127
Levetiracetam, 192
Levodopa, 210–12
Lewy body dementia, 210–11
Light’s criteria, 53
Lisch nodules, 209
Livedo reticularis, 212, 261–2
Liver failure, acute, 68–9
Löfgren syndrome, 65
Lung cancer, see Cancer, lung
Malaria, 126–7, 280–1
Mallory–Weiss tear, 108–10
Membranoproliferative glomerulonephritis,
122–3, 126–7
Membranous glomerular disease, 126–7
Meningitis, 139, 174, 183, 186–7, 190–1,
201, 224, 276, 283
Mesothelioma, 45, 48, 52–3, 173
Metformin, 142, 145–7, 178–9
Migraine, 198–201, 216–17
Mikulicz syndrome, 65
Miller Fisher syndrome, 197
Minimal change glomerular disease, 126–7
Mitral stenosis, 13, 18–19
Monoamine oxidase B inhibitors, 212
Motor neurone disease (MND), 202–3
MRC dyspnoea scale, 38
Multiple sclerosis (MS), 98, 173, 182–3,
204–5
Multiple system atrophy, 211
Myasthenia gravis, 62–3, 98, 164–5, 206–7
Myasthenic crisis, 207
Myxoedema coma, 162
Nephritic syndrome, 122–5
Nephrotic syndrome, 14–15, 52–3, 78, 112,
126–7, 152–3, 172, 280–1
Neurofibromatosis, 176–7, 208–9, 222–3
New York Heart Association (NYHA)
Classification, 15
Nitrates, 2–3, 4–7, 13, 14–17
Obstructive sleep apnoea (OSA), 14–15,
50–1, 62–3, 132–3, 216–17
Oesophageal cancer, see Cancer,
oesophageal
Oesophagitis, 88–9, 98–9, 108–9
Osteoarthritis, 112, 230, 236–7
Osteomalacia, 80–1, 82–3, 118–19, 240–1,
242–3, 264–5
Osteoporosis, 102–3, 106–7, 136–7, 156–7,
158–9, 164–6, 228–9, 232–3, 238–9,
240–1, 250–1, 264–5
Paget’s disease, 236–7, 240–1
Pancreatitis
acute, 28–9, 70–1, 154–5
chronic, 70–1, 74–5
Parkinsonism, 112–13, 210–12
Parkinson’s disease, 210–12
Peak flow, 30–1
Peptic ulcer disease, 7, 100–1, 156–7
Pericardial effusion, 8–9, 14–15, 262
Pericarditis
acute, 8–9
constrictive, 8–9, 14–15, 18–19, 52–3,
76–8
Peritoneal dialysis, 52–3, 118–21
Phaeochromocytoma, 20–1, 156–7, 176–7
Phenobarbital, 192–3
Phenytoin, 68–9, 155, 192–3, 214–15
Pleural effusion, 14–15, 46–8, 52–3,
54–5, 70–1, 78, 126–7, 160–1,
250–1, 260–2
Pneumonia, 28–9, 30–1, 34–5, 42–3,
46–7, 52–3, 54–5, 56–7, 62–3,
121, 150, 173, 186–7, 196–7,
218–19, 244, 276–7
Pneumothorax, 56–8, 62–3
Polycystic ovary syndrome (PCOS), 140–1,
178–9
Polymyalgia rheumatica (PMR), 232–3,
242–3
Polymyositis, 242–3, 244–5
Polyneuropathy, 118–19, 214–15, 250–1
Portal hypertension, 76–8, 104–5
Post-streptococcal glomerulonephritis,
116–17, 122–4
Pretibial myxoedema, 165
Primary lateral sclerosis, 202
Primary polydipsia, 138–9
Primary sclerosing cholangitis, 76–7,
82–4, 94–5, 102–3, 104–5, 106–7
Progressive bulbar palsy, 202
Progressive muscular atrophy, 202
Progressive supranuclear palsy, 211
Pseudobulbar palsy, 202
Pseudogout, 234–5, 256–7
Psoriatic arthritis, see Arthritis, psoriatic
Pulmonary embolism, 14–15, 52–3,
60–1, 62–3, 121, 166, 218–19
Pulmonary hypertension, 13, 36–7, 50–1,
62–3, 254–5
Ramsay Hunt syndrome, 182–4
Raynaud’s, 244–5, 254–5, 258–9
Reactive arthritis, see Arthritis, reactive
Renal transplant, 116, 118–19, 121
Respiratory failure, 28–9, 30–1, 34–5,
36–7, 40–1, 42–3, 50–1, 54–5, 56–7,
60–1, 62–3, 186–7, 196–7, 202,
206–7, 282–3
Restrictive cardiomyopathy, 8–9, 14–15,
18–19
Rheumatic fever, 8–9, 12
Rheumatoid arthritis, see Arthritis,
rheumatoid
Rickets, 264–5
Rockall score, 110
Sarcoidosis, 18–19, 42–3, 52–3, 56–7,
64–5, 96–7
Scleroderma, 96–7, 242–3, 254–5, 258–9
Septic arthritis, see Arthritis, septic
SGLT-2 inhibitors, 146–7, 148–9
Silicosis,
42–5, 282–3
Sjögren syndrome, 34–5, 74–5, 102–3,
182–3, 242–3, 250–1, 258–9
Sodium valproate, 70–1, 192
Spider naevi, 76–7, 109, 273
Spirometry, 30–1, 36–8, 40–1, 42–3,
62–3, 72–3, 196–7
Spironolactone, 13, 14–17, 22–3, 78,
152, 178
Statin, 2–3, 4–7, 118–19, 140–2, 144,
216–17, 220
Status epilepticus, 190–3
Stroke, 216–17, 218–21
Subarachnoid haemorrhage, 174–5, 201,
218–20, 222–3
Subdural haematoma, 201, 224–5
Sulfonylureas, 145, 146–7, 168–9
Syndrome of inappropriate ADH secretion
(SIADH), 172–3
Systemic lupus erythematosus (SLE), 260–2
Tension headache, 200
Thiazide diuretics, 14–15, 17, 22–3, 74–5,
138–9, 156–7, 173
Thiazolidinediones, 146–7
Thrombectomy, 218
Thrombolysis, 60–1, 218–20
Thyroid eye disease, 166
Thyroid storm, 164–6
Thyrotoxicosis, see Hyperthyroidism
Toxic multinodular goitre, 164–6
Transient ischaemic attack (TIA), 216–17,
218–19
Transjugular intrahepatic portosystemic
shunt (TIPS), 78, 108
Trigeminal neuralgia, 200
Troisier’s sign, 87
Trousseau’s sign, 155
Tuberculosis (TB), 54–5, 134–5, 242–3,
282–4
Type 1 diabetes mellitus, 140–3, 148–9
Type 2 diabetes mellitus, 140–1, 144–7, 150
Ulcerative colitis, 82–4, 106–7
Upper gastrointestinal bleed, 76–7, 108–10
Urethral syndrome, 128–9
Urinary tract infection, 116–17, 128–9,
256–7
Ursodeoxycholic acid, 102–3, 104–5
Vascular parkinsonism, 211
Vitamin D deficiency, 118–19, 154–5,
156–7, 238–9, 264–5
Wegener’s granulomatosis, see
Granulomatosis with polyangiitis
Wilson’s disease, 76–7, 94, 112, 210–11
Xanthelasma, 3, 77, 127
Yellow nail syndrome, 35
Zollinger–Ellison syndrome, 100
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MIND MAPS
FOR
MEDICINE
9 781911 510369
ISBN 978-1-911510-36-9
www.scionpublishing.com
The book features over 100 easy to follow,
full colour mind maps
of clinically relevant
medical conditions using a systems-based
structure:
• Cardiology
•
Respiratory
•
Gastroenterology
•
Renal
•
Endocrinology
• Neurology
• Rheumatology
• Infectious diseases
The mind maps give you quick access to
key information in a visually appealing
way. Where appropriate the mind map
is followed by additional reference
information to remind you about, for
example, risk assessment tools, staging
criteria, and treatment algorithms.
All mind maps are
presented consistently
and cover:
•
Definition
•
Pathophysiology
•
Causes and risk factors
•
Clinical features: signs and symptoms
•
Epidemiology
•
Investigations: blood tests and imaging
•
Management: lifestyle, pharmacological
and surgical
•
Complications
Other key features:
• Images are provided throughout the
book to help illustrate key signs.
•
Mnemonics are used throughout to
aid learning.
•
Information is up-to-date and based
around the latest guidelines.
• All topics are clinically relevant or likely to
appear in
medical school examinations.
Mind Maps for Medicine
is crucial reading for all medical students
but particularly those who consider themselves visual learners.
An innovative, visual textbook to help medical students learn
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