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• Cover image
• Title page
• Table of Contents
• Copyright
• Preface
• Contributors
• Chapter 1 Uses of biochemical data in clinical medicine
• INTRODUCTION
• SPECIFIC USES OF BIOCHEMICAL TESTS
• CONCLUSION
• Further reading
• Chapter 2 Acquisition and interpretation of biochemical data
• INTRODUCTION
• THE TEST REQUEST
• FACTORS AFFECTING TEST RESULTS
• INTERPRETATION OF RESULTS
• THE PREDICTIVE VALUE OF TESTS
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 3 Quality aspects of laboratory medicine
• INTRODUCTION
• WHAT IS QUALITY?
• QUALITY STANDARDS
• CLINICAL QUALITY INDICATORS
• EVIDENCE-BASED CLINICAL BIOCHEMISTRY
• POINT-OF-CARE TESTING
• CONCLUSION
• FURTHER READING
• Chapter 4 Sodium, water and potassium
• PHYSIOLOGY
• DISORDERS OF SODIUM METABOLISM
• DISORDERS OF WATER METABOLISM
• DISORDERS OF POTASSIUM METABOLISM
• CONCLUSION
• Further reading
• APPENDIX 4.1 FORMULAE
• APPENDIX 4.2 DYNAMIC FUNCTION TESTS
• Chapter 5 Hydrogen ion homoeostasis and tissue oxygenation and their disorders
• INTRODUCTION
• THE PHYSIOLOGICAL ROLE OF HYDROGEN IONS
• HYDROGEN ION HOMOEOSTASIS
• THE ASSESSMENT OF ACID–BASE STATUS
• DISORDERS OF HYDROGEN ION HOMOEOSTASIS
• TISSUE OXYGENATION
• CONCLUSION
• Further reading
• Chapter 6 Calcium, phosphate and magnesium
• CALCIUM METABOLISM
• PHOSPHORUS METABOLISM
• MAGNESIUM METABOLISM
• CONCLUSION
• Further reading
• APPENDIX 6.1 CALCIUM ABSORPTION TEST
• APPENDIX 6.2 ANALYSIS OF TUBULAR HANDLING OF CALCIUM
• APPENDIX 6.3 CLASSIFICATION OF PSEUDOHYPOPARATHYROIDISM
• APPENDIX 6.4 ESTIMATION OF TMP/GFR
• APPENDIX 6.5 MAGNESIUM RETENTION TEST
• APPENDIX 6.6 RENAL TUBULAR REABSORPTION OF MAGNESIUM
• Chapter 7 The kidneys, renal function and kidney disease
• ANATOMY
• RENAL FUNCTION
• RENAL DISEASE AND ITS PRESENTATION
• THE ASSESSMENT OF RENAL FUNCTION
• ACUTE KIDNEY INJURY (ACUTE RENAL FAILURE)
• CHRONIC KIDNEY DISEASE
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 8 Proteinuria
• INTRODUCTION
• PROTEIN CONSERVATION BY THE KIDNEYS
• NORMAL URINARY PROTEIN CONTENT
• PROTEINURIA IN KIDNEY DISEASE
• MICROALBUMINURIA AS A MARKER OF RISK
• CLINICAL INVESTIGATION OF PROTEINURIA
• ACKNOWLEDGEMENT
• Further reading
• Chapter 9 Renal tubular disorders and renal stone disease
• INTRODUCTION
• RENAL TUBULAR DISORDERS
• RENAL CALCULI
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• APPENDIX 9.1 DIAGNOSIS OF RENAL TUBULAR ACIDOSIS
• Chapter 10 Clinical biochemistry of nutrition
• INTRODUCTION
• NUTRITIONAL REQUIREMENTS
• ASSESSMENT OF NUTRITIONAL STATUS
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 11 Nutritional disorders and their management
• INTRODUCTION
• MALNUTRITION
• OBESITY
• EATING DISORDERS
• DIET IN THE AETIOLOGY OF DISEASE
• THERAPEUTIC DIETS, DIETARY SUPPLEMENTS AND NUTRACEUTICALS
• PROVISION OF NUTRITION SUPPORT
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 12 Clinical biochemistry of the gastrointestinal tract
• INTRODUCTION
• MOUTH AND OESOPHAGUS
• STOMACH
• PANCREAS
• SMALL BOWEL BACTERIAL OVERGROWTH
• MALDIGESTION AND MALABSORPTION
• INTESTINAL PERMEABILITY
• FAECAL TESTS OF INTESTINAL INFLAMMATION
• THE ACUTE ABDOMEN
• Further reading
• Chapter 13 Assessment of hepatic function and investigation of jaundice
• INTRODUCTION
• ANATOMY OF THE LIVER
• HEPATIC REGENERATION
• PHYSIOLOGICAL FUNCTIONS
• LIVER FUNCTION TESTS
• USES OF LIVER FUNCTION TESTS
• ABNORMAL LIVER FUNCTION TESTS IN ASYMPTOMATIC PATIENTS
• NORMAL LIVER FUNCTION TESTS IN THE PRESENCE OF OVERT LIVER DISEASE
• ROLE OF LIVER FUNCTION TESTS IN ASSESSING PROGNOSIS
• CONCLUSION
• Further reading
• Chapter 14 Acute and chronic liver disease
• CLASSIFICATION OF LIVER DISEASE
• ACUTE HEPATITIS AND ITS SEQUELAE
• ACUTE LIVER FAILURE
• CHRONIC HEPATITIS
• PRIMARY BILIARY CIRRHOSIS (PBC)
• PRIMARY SCLEROSING CHOLANGITIS (PSC)
• ALCOHOLIC LIVER DISEASE
• THE CONCEPT OF CIRRHOSIS
• DRUGS AND THE LIVER
• NEOPLASTIC DISEASE OF THE LIVER AND BILIARY TRACT
• PARENTERAL NUTRITION
• BACTERIAL INFECTIONS
• INHERITED METABOLIC DISORDERS INVOLVING THE LIVER
• LIVER TRANSPLANTATION
• CONCLUSION
• Further reading
• Chapter 15 Glucose metabolism and the pathophysiology of diabetes mellitus
• PHYSIOLOGY AND PATHOPHYSIOLOGY OF GLUCOSE HOMOEOSTASIS
• CLASSIFICATION AND DIAGNOSIS OF DIABETES MELLITUS
• ENDOCRINE ASSOCIATIONS WITH DIABETES
• DIABETES, NUTRITION AND GROWTH
• MECHANISMS OF DIABETIC TISSUE DAMAGE
• CONDITIONS ASSOCIATED WITH INADEQUATELY CONTROLLED DIABETES MELLITUS
• BIOCHEMICAL MEASUREMENTS IN DIABETES MELLITUS
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 16 The clinical management of diabetes mellitus
• INTRODUCTION
• GENERAL ASPECTS OF MANAGEMENT
• GLUCOSE-LOWERING THERAPY IN DIABETES
• OBSTACLES TO ACHIEVING GLYCAEMIC CONTROL
• CHRONIC COMPLICATIONS OF DIABETES
• EMERGENCIES IN DIABETES
• MANAGEMENT OF DIABETES IN THE HOSPITAL SETTING
• PREGNANCY
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 17 Hypoglycaemia
• GLUCOSE HOMOEOSTASIS IN THE FED AND THE POSTABSORPTIVE STATES
• HYPOGLYCAEMIA
• CLASSIFICATION OF HYPOGLYCAEMIC DISORDERS
• PRACTICAL APPROACH TO THE INVESTIGATION OF HYPOGLYCAEMIA
• EMERGENCY TREATMENT OF HYPOGLYCAEMIA
• CAUSES OF HYPOGLYCAEMIA
• CONCLUSION
• Further reading
• Chapter 18 Hypothalamic, pituitary and adrenal disorders
• INTRODUCTION
• CLINICAL ANATOMY OF THE PITUITARY AND HYPOTHALAMUS
• PHYSIOLOGY OF HYPOTHALAMO– PITUITARY–END ORGAN AXES
• CLINICAL ANATOMY AND PHYSIOLOGY OF THE ADRENALS
• ASSESSMENT OF NORMAL PITUITARY FUNCTION
• OTHER DIAGNOSTIC TECHNIQUES IN PITUITARY DISEASE
• PITUITARY HYPERSECRETION STATES
• HYPOTHALAMIC AND PITUITARY DEFICIENCY STATES
• ADRENAL DISEASE
• MONITORING PITUITARY AND ADRENAL REPLACEMENT THERAPY
• CONCLUSION
• Further reading
• APPENDIX 18.1 TEST PROTOCOLS
• Chapter 19 Thyroid dysfunction
• INTRODUCTION
• NORMAL THYROID PHYSIOLOGY
• THE EVALUATION OF THYROID FUNCTION
• HYPERTHYROIDISM
• HYPOTHYROIDISM
• THYROIDITIS
• NEOPLASIA
• SYNDROMES OF RESISTANCE TO THYROID HORMONES
• SCREENING
• ACKNOWLEDGEMENT
• Further reading
• Chapter 20 Metabolic response to stress
• INTRODUCTION
• THE RESPONSE TO STRESS
• STRESS AND THE KIDNEYS
• CYTOKINES
• STRESS AND INFLAMMATION
• SHOCK
• CARE OF THE SHOCKED PATIENT
• CONCLUSION
• Further reading
• Chapter 21 Disorders of puberty and sex development
• INTRODUCTION
• NORMAL SEX DEVELOPMENT
• NORMAL PUBERTAL DEVELOPMENT
• DISORDERS OF SEX DEVELOPMENT
• DISORDERS OF PUBERTY
• Further reading
• Chapter 22 Reproductive function in the female
• INTRODUCTION
• PHYSIOLOGY
• HORMONES REGULATING REPRODUCTIVE FUNCTION
• REPRODUCTIVE STEROID HORMONES
• OLIGO- AND AMENORRHOEA
• INFERTILITY
• HIRSUTISM AND VIRILISM
• PREGNANCY
• ORAL CONTRACEPTION AND HORMONE REPLACEMENT THERAPY
• ACKNOWLEDGEMENT
• Further reading
• APPENDIX 22.1 ACTH STIMULATION TEST FOR THE DIAGNOSIS OF CONGENITAL ADRENAL HYPERPLASIA
• References
• Chapter 23 Reproductive function in the male
• INTRODUCTION
• THE TESTES
• EVALUATION OF TESTICULAR FUNCTION
• MALE HYPOGONADISM
• GYNAECOMASTIA
• IMPOTENCE
• Further reading
• APPENDIX 23.1 PROTOCOLS FOR ENDOCRINE INVESTIGATIONS
• Reference
• Reference
• Reference
• Chapter 24 Inherited metabolic disease
• INTRODUCTION
• CLINICAL PRESENTATION AND PATHOPHYSIOLOGY
• NEWBORN SCREENING
• INHERITANCE
• DIAGNOSTIC STRATEGIES
• PRENATAL DIAGNOSIS
• MANAGEMENT
• CONCLUSION
• Further reading
• Chapter 25 Paediatric clinical biochemistry
• INTRODUCTION
• POSTNATAL INVESTIGATION OF THE SMALL FOR GESTATIONAL AGE NEWBORN
• RESPIRATORY DISORDERS
• RENAL FUNCTION
• CARBOHYDRATE METABOLISM
• CALCIUM AND PHOSPHORUS METABOLISM
• DISORDERS OF LIVER FUNCTION
• Further reading
• Chapter 26 Introduction to haematology and transfusion science
• INTRODUCTION
• GENERAL HAEMATOLOGY
• MORPHOLOGY
• HAEMOSTASIS
• BLOOD TRANSFUSION
• CONCLUSION
• ACKNOWLEDGEMENTS
• Further reading
• Chapter 27 Biochemical aspects of anaemia
• INTRODUCTION
• THE FORMATION, STRUCTURE AND FUNCTION OF THE NORMAL RED CELL
• ANAEMIA
• ANAEMIAS ASSOCIATED WITH A REDUCTION IN RED CELL PRODUCTION
• ANAEMIAS ASSOCIATED WITH INCREASED RED CELL LOSS
• DIAGNOSIS OF HAEMOLYSIS
• CONCLUSION
• ACKNOWLEDGEMENTS
• Further reading
• Chapter 28 The porphyrias: inherited disorders of haem synthesis
• INTRODUCTION AND OVERVIEW
• PORPHYRIAS PRESENTING WITH ACUTE ATTACKS
• THE CUTANEOUS PORPHYRIAS
• SECONDARY DISORDERS OF PORPHYRIN METABOLISM
• CONCLUSION
• Chapter 29 The haemoglobinopathies
• INTRODUCTION
• THE THALASSAEMIAS
• STRUCTURAL HAEMOGLOBIN VARIANTS
• LABORATORY DIAGNOSIS OF HAEMOGLOBINOPATHIES
• CONCLUSION
• Further reading
• Chapter 30 Immunology for clinical biochemists
• THE IMMUNE SYSTEM
• DISEASES OF THE IMMUNE SYSTEM
• LYMPHOID MALIGNANCIES
• INFECTION AND SEPSIS
• TRANSPLANTATION
• CONCLUSION
• Further reading
• APPENDIX 30.1 IMMUNOLOGICAL INVESTIGATIONS
• Chapter 31 Metabolic bone disease
• BONE BIOLOGY
• OSTEOPOROSIS
• OSTEOMALACIA
• CHRONIC KIDNEY DISEASE – MINERAL AND BONE DISORDER
• BONE DISEASE IN PRIMARY HYPERPARATHYROIDISM
• PAGET DISEASE OF BONE
• BONE TURNOVER AND BONE DISEASE IN CHILDREN
• GENETIC BONE DISEASES
• CONCLUSION
• Further reading
• APPENDIX 31.1 INDICATIONS FOR DIAGNOSTIC TRANSILIAC BONE BIOPSY
• APPENDIX 31.2 PROTOCOL FOR DESFERRIOXAMINE TEST IN DIALYSIS PATIENTS
• Chapter 32 Biochemistry of articular disorders
• INTRODUCTION
• THE ARTICULAR SYSTEM
• DISORDERS OF THE ARTICULAR SYSTEM
• ARTICULAR INVOLVEMENT IN ENDOCRINE AND METABOLIC DISEASES
• LABORATORY TESTING IN ARTICULAR DISEASE
• CONCLUSION
• Further reading
• Chapter 33 Muscle disease
• INTRODUCTION
• FUNCTIONAL ANATOMY AND PHYSIOLOGY OF MUSCLE
• DISEASES OF MUSCLE AND THEIR INVESTIGATION
• BIOCHEMICAL INVESTIGATION OF MUSCLE DISEASE
• INVESTIGATION OF MUSCLE DISEASE
• CONCLUSION
• ACKNOWLEDGEMENTS
• Further reading
• APPENDIX 33.1 THE FOREARM EXERCISE TEST
• Chapter 34 Investigation of cerebrospinal fluid
• INTRODUCTION
• CEREBROSPINAL FLUID PHYSIOLOGY
• INVESTIGATIONS RELEVANT TO PHYSIOLOGY AND PATHOPHYSIOLOGY
• BIOCHEMICAL INVESTIGATIONS IN CNS DISORDERS
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 35 Biochemical aspects of psychiatric disorders
• INTRODUCTION: PSYCHIATRY AS A CLINICAL DISCIPLINE
• THE CLASSIFICATION OF PSYCHIATRIC DISORDERS
• THE AETIOLOGY OF PSYCHIATRIC DISORDERS
• BIOCHEMICAL INVESTIGATIONS IN PSYCHIATRIC DISORDERS
• PSYCHIATRIC MANIFESTATIONS OF ORGANIC DISEASE
• ENDOCRINE AND METABOLIC MANIFESTATIONS OF PSYCHIATRIC DISEASE
• METABOLIC COMPLICATIONS OF PSYCHOTROPIC DRUGS
• FUTURE DEVELOPMENTS
• CONCLUSION
• Further reading
• Chapter 36 Biochemical aspects of neurological disease
• INTRODUCTION
• ENCEPHALOPATHY
• SPINAL CORD DISORDERS
• PERIPHERAL NEUROPATHY
• MOVEMENT DISORDERS
• ATAXIA
• INFLAMMATORY DISORDERS OF THE CENTRAL NERVOUS SYSTEM
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 37 Lipids and disorders of lipoprotein metabolism
• INTRODUCTION
• LIPIDS
• LIPOPROTEINS
• APOLIPOPROTEINS
• CHOLESTEROL ABSORPTION
• TRIGLYCERIDE DIGESTION
• BILE ACID METABOLISM
• LIPOPROTEIN METABOLISM
• ENZYMES INVOLVED IN LIPOPROTEIN METABOLISM
• TRANSFER PROTEINS INVOLVED IN LIPOPROTEIN METABOLISM
• RECEPTORS INVOLVED IN LIPOPROTEIN METABOLISM
• OTHER PROTEINS INVOLVED IN LIPOPROTEIN SYNTHESIS, TRANSPORT AND METABOLISM
• CLASSIFICATION OF LIPOPROTEIN DISORDERS
• THE PRIMARY DYSLIPOPROTEINAEMIAS
• ACQUIRED HYPERLIPIDAEMIAS
• ACQUIRED HYPOLIPIDAEMIA
• INVESTIGATION OF LIPID DISORDERS
• TREATMENT OF HYPERLIPIDAEMIA
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• Chapter 38 Clinical biochemistry of the cardiovascular system
• INTRODUCTION
• CARDIAC MUSCLE STRUCTURE AND BIOCHEMISTRY
• ARTERIAL STRUCTURE AND FUNCTION
• ATHEROSCLEROSIS
• ACUTE MYOCARDIAL DAMAGE
• HEART FAILURE
• CARDIOVASCULAR RISK FACTORS
• HYPERTENSION
• CONCLUSION
• Further reading
• APPENDIX 1 PROTOCOL FOR INVESTIGATION OF ALDOSTERONISM: SCREENING AND CONFIRMATORY TESTS
• Chapter 39 Therapeutic drug monitoring
• INTRODUCTION
• USE OF THERAPEUTIC DRUG MONITORING
• PROVISION OF A THERAPEUTIC DRUG MONITORING SERVICE
• PHARMACODYNAMIC MONITORING, BIOMARKERS AND PHARMACOGENETICS
• INDIVIDUAL DRUGS
• ACKNOWLEDGEMENT
• Further reading
• APPENDIX 39.1 CALCULATIONS FOR THE DETERMINATION OF DOSE REQUIREMENTS TO ACHIEVE STEADY-STATE CONCENTRATIONS
• Chapter 40 Poisoning
• INTRODUCTION
• AETIOLOGY OF POISONING
• TYPES OF LESION IN POISONING
• DIAGNOSIS AND MANAGEMENT OF POISONING: GENERAL PRINCIPLES
• SPECIFIC POISONS
• CONCLUSION
• ACKNOWLEDGEMENT
• Further reading
• APPENDIX 40.1 POISONS CENTRES
• Chapter 41 Metabolic effects of tumours
• INTRODUCTION
• NEUROENDOCRINE TUMOURS
• MULTIPLE ENDOCRINE NEOPLASIA
• METABOLIC CHANGES IN MALIGNANCY
• ENDOCRINE SEQUELAE OF TUMOURS AND THEIR TREATMENT
• CONCLUSION
• Further reading
• Chapter 42 Tumour markers
• INTRODUCTION
• TUMOUR MARKERS IN THE MANAGEMENT OF SPECIFIC CANCERS
• SUMMARY
• Further reading
• Chapter 43 Molecular clinical biochemistry
• INTRODUCTION
• GENES AND GENE EXPRESSION
• THE TECHNIQUES OF GENETIC ANALYSIS
• THE APPLICATIONS OF DNA ANALYSIS
• GENE THERAPY
• CONCLUSION
• ACKNOWLEDGEMENTS
• Further reading
• Chapter 44 Forensic biochemistry
• INTRODUCTION
• SAMPLES AND SAMPLING
• POISONING WITH ENDOGENOUS AGENTS
• POST-MORTEM BIOCHEMISTRY
• SPECIFIC DIAGNOSTIC PROBLEMS
• Further reading
• Index