An Introduction to Human Disease, 7e
Leonard Crowley, MD
ISBN: 0-7637-4231-7~ Hardcover ~ 825 Pages ~ © 2007
Jones and Bartlett Publishers
Preface
Many advances and new developments in medicine have occurred since the last edition of this
book. I have attempted to distill the essential features from this wealth of new information and
have added some additional topics of current interest. I have updated the annotated list of
references at the end of each chapter. The organization of the book, as well as the study aids and
other features that have been received favorably in previous editions, has not been changed.
These features are described in the Preface to the First Edition.
In the first five chapters additional material on lysosomes and their relationship to
lysosomal storage disease are described. The section on movement of materials in and out of
cells has been expanded and new diagrams added. Some of the problems related to gene therapy
are considered. The section on immunity, hypersensitivity, and autoimmunity has been updated,
but I have resisted adding more detail than is necessary to understand the important concepts. The
concept of suppressor T cells has given way to the concept that it is the helper T cells that
perform all of the regulator functions that modulate the immune response. In Chapters 6, 7, and
8 Ehrlichia has been added to the section on rickettsial diseases, and the malaria-like illness
caused by a protozoal parasite transmitted by ticks called Babesiosis has been added to the
section on parasitic diseases.
The sections on the two most common worms, Ascaris and pinworms, have been
expanded, and updated material on cryptosporidiosis was added. Non–culture-based tests to
identify gonococcal and chlamydial infections are described, and the material on HIV/AIDS has
been undated. In Chapter 9, the material on the fragile X syndrome has been expanded to include
the concepts of premutations and full mutations and how the triplet nucleotide repeats disrupt
brain functions. Material on prenatal diagnosis of congenital abnormalities has been undated,
including the role of prenatal screening tests performed on maternal blood. In Chapter 10
dealing with tumors, the section on lymphomas has been rewritten to reflect changing views on
classification, diagnosis, prognosis, and treatment. Chapters 11 and 12 include new material on
hereditary gene mutations that increase blood coagulability and predispose to venous thrombosis,
and a section on amnionic fluid embolism has been added. Several new items have been added to
Chapter 13, including the cardiac cycle, the role of atrial contractions on cardiac function,
ventricular volumes and the ejection fraction as a measure of ventricular function, cardiac output,
isolated systolic hypertension, coronary disease manifestations with apparently normal coronary
arteries, and diastolic heart failure compared with systolic heart failure. The section on aortic
aneurysm has been rewritten to include the role of heredity, screening tests to detect
asymptomatic aneurysms, and new methods of treatment. Chapter 14 has updated material on
hereditary spherocytosis and sickle cell disease. Chapter 15 has new material and a new table
dealing with the respiratory distress syndrome. Chapter 16 includes new material on the role of
aromatase inhibitor drugs to block synthesis of estrogen from adrenal androgens in
postmenopausal women and new treatment methods for dealing with tumors in which the HER-2
gene is amplified. In Chapters 17 and 18 several new items have been added, including material
on emergency contraception, a controversial subject but one with which the student should be
familiar. The section on neonatal hemolytic disease has been rewritten to reflect the growing
importance of ABO hemolytic disease, and two new cases have been added. Chapter 19
includes updated information on polycystic kidney disease, why nephron loss “overworks” and
damages surviving nephrons, and the expanded role of peritoneal dialysis to treat end-stage renal
disease. A section on gout-associated nephropathy has been added along with additional
photographs.
1
An Introduction to Human Disease, 7e
Leonard Crowley, MD
ISBN: 0-7637-4231-7~ Hardcover ~ 825 Pages ~ © 2007
Jones and Bartlett Publishers
Preface
Chapter 20 on the male reproductive system has been expanded to include material with
diagrams and photographs on testicular descent, cryptorchidism, testicular torsion, hydrocele, and
varicocele. Material on prostatic carcinoma and benign prostatic hyperplasia has been updated. A
section on erectile dysfunction has been added. In Chapter 21, the role of transjugular portalsystemic shunts in persons with cirrhosis is described, and a section on hepatic encephalopathy
has been added. In Chapter 22, the sections on acute and chronic pancreatitis, cystic fibrosis,
and ketoacidosis have been rewritten. In Chapter 23, the sections on chronic enteritis have been
rewritten to include updated concepts on pathophysiology and treatment. Chapter 24 has new
material on electrolyte disturbances associated with overhydration, recently documented in
Boston Marathon runners. The section on metabolic alkalosis has been expanded with a new case
study and diagram. Chapter 25 includes updated material on hypothyroidism and
hyperthyroidism, diabetes insipidus, pituitary tumors, and their treatment by transsphenoidal
resection. Chapter 26 has updated material on strokes, arbovirus infection, including current
information on West Nile virus, and a new section on Huntington’s disease. In Chapter 27, the
section on gout has been rewritten, and new photographs have been added. The sections on
rheumatoid arthritis and osteoporosis have also been updated.
Although the book has undergone considerable updating and rewriting, I have attempted to
retain the same basic format and orientation of the earlier editions, emphasizing the major
structural and functional changes of disease and the basic principles of treatment in a
straightforward, user-friendly manner. Normal structure and function are interrelated and so also
are the structural derangements associated with disease (pathology) and the accompanying
disturbances in organ function (pathophysiology). Moreover, if one has a clear concept of the
structural derangements associated with disease, one also has a better grasp of the relevant
pathophysiology and can usually also deduce the clinical manifestations of various diseases and
can also understand how treatment can influence the course of a disease.
I would like to thank the many persons teaching human disease courses who provided the
publisher and me with helpful suggestions and editorial comments that helped to improve this
edition. Special thanks also go to the staff at Jones and Bartlett Publishers for their enthusiasm,
help, and encouragement during the preparation of this edition.
Leonard Crowley
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An Introduction to Human Disease, 7e
Leonard Crowley, MD
ISBN: 0-7637-4231-7~ Hardcover ~ 825 Pages ~ © 2007
Jones and Bartlett Publishers
Preface
Preface to the First Edition
Purpose and Scope of the Book
This book is based on courses given for many years to students in nursing and other health
professions. It is designed to provide a solid foundation on which students can build for the
remainder of their professional careers. A fundamental knowledge of disease requires a clear
conception of both the structural and the functional changes caused by disease in tissues and
organs, as a basis for understanding the clinical manifestations and principles of treatment.
Consequently, to facilitate learning, many illustrations of the salient features of the more
important diseases have been included. Photographs of x-ray films, angiograms, and CT scans
also are used where appropriate because such studies are widely used by health professionals to
diagnose disease and evaluate response to therapy. A number of brief case studies have been
included so that students can more easily relate the clinical manifestations, diagnosis, and
treatment of a specific disease to an individual patient.
Organization
The book is organized into two main sections. The first section, comprising the first 12
chapters, deals with general concepts and with diseases affecting the body as a whole. The second
section, which includes the remaining 15 chapters, considers the various organ systems and their
diseases.
In the first section, Chapter 1 discusses manifestations of disease, classification,
diagnosis, and principles of treatment. Chapter 2 considers the organization and basic function of
cells and tissues in health and disease. Chapter 3 deals with genes, chromosomes, cell division,
and chromosome analysis, as well as the HLA system and its relation to disease. Chapters 4 and 5
consider the body’s defenses, the inflammatory reaction and the immune system, and their
disorders. Chapters 6 and 7 are concerned with the various pathogenic microorganisms and
parasites and the diseases they cause. This material is followed by a discussion of the
transmission and control of communicable diseases in Chapter 8 and includes discussion of the
clinically important sexually transmitted diseases. Chapter 9 considers congenital and hereditary
diseases, and Chapter 10 deals with tumors. Chapter 11 describes the coagulation of the blood
and conditions in which the blood does not clot normally. Chapter 12 considers conditions in
which the blood clots too readily and its attendant complications—thrombosis and embolism.
In the second section, the individual organ systems and their diseases are considered in a
systematic manner, with emphasis on the more common and important diseases. Basic pathologic
physiology, pathology, and principles of diagnosis and treatment are discussed. Newer diagnostic
procedures and methods of treatment are emphasized. Chapter 13 describes diseases of the
cardiovascular system and includes an extensive discussion of coronary heart disease, one of the
most prevalent diseases in the developed nations of the world. Diseases of the hematopoietic and
lymphatic systems are considered together in Chapter 14, followed by diseases of the respiratory
system in Chapter 15. Chapters 16, 17, and 18 should be considered as a unit: diseases of the
breast, the female reproductive system, prenatal development, and diseases associated with
pregnancy.
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An Introduction to Human Disease, 7e
Leonard Crowley, MD
ISBN: 0-7637-4231-7~ Hardcover ~ 825 Pages ~ © 2007
Jones and Bartlett Publishers
Preface
Chapter 19, diseases of the urinary system, and Chapter 20, which is concerned with the male
reproductive system, are also best considered as a unit. Chapter 21 describes derangements of the
liver and biliary system. This is followed in Chapter 22 by diseases of the pancreas, including
diabetes mellitus. The upper and lower intestinal tracts and their diseases follow in Chapter 23.
Chapter 24 departs from the organ system approach and considers disturbances of fluid,
electrolyte, and acid–base balance. The material is introduced here rather than in the first section
because it is more easily understood and related to specific organ system diseases when
considered after Chapters 19 through 23. The final three chapters deal, respectively, with diseases
of the endocrine glands, nervous system, and musculoskeletal system.
Study Aids and Special Features
Various learning and study aids are included to enhance the usefulness of the book.
Learning objectives, review questions, and a detailed outline summary are provided for each
chapter. Literature for further study is listed at the end of each chapter, and a listing of general
references is included at the end of the book. These additional sources should prove useful to
students who wish to pursue a subject in greater detail. A glossary with a pronunciation guide is
appended to the end of the text. This may prove useful to students who have not already had a
course in medical terminology and can serve as a convenient reference for other students who
wish a quick review of a particular term. Words appearing in the glossary are set in boldface type
in the text for easy reference.
Acknowledgments
Many people helped with the book in various ways, and I would like to acknowledge
their assistance. Several colleagues at St. Mary’s Hospital in Minneapolis and in the Department
of Laboratory Medicine and Pathology at the University of Minnesota made suggestions and
comments. Colleagues in the Department of Family Practice and Community Health at the
University of Minnesota, at St. Paul–Ramsey Medical Center, and at the West Side Community
Health Center in St. Paul also provided helpful comments. Several of the concepts and clinical
cases used in the book were based on these clinical contacts and activities.
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An Introduction to Human Disease, 7e
Leonard Crowley, MD
ISBN: 0-7637-4231-7~ Hardcover ~ 825 Pages ~ © 2007
Jones and Bartlett Publishers
Preface
Resource Preview
Instructor’s ToolKit CD-ROM
ISBN: 0-7637-4221-X
Preparing for class has never been easier. This impressive resource will not only save you time
but also afford you more flexibility than ever before.
In addition, the resources on the Instructor’s ToolKit have been formatted so that you can
implement them into several of the most popular
online course management systems. Included on the CD-ROM are fully adaptable:
• Lecture Outlines: this complete and ready-to-use lesson plan outlines all of the topics covered in
the text.
• PowerPoint Presentations: provide a compelling way to make presentations that are educational
and engaging to your students. The slides can be modified and edited to fit your specific
classroom needs.
• Full-Color Image Bank: using photographs and illustrations from the text, you can incorporate
graphics into your PowerPoint presentations or present a specific image for further discussion.
• Test Bank: designed to help you create short quizzes or longer examinations, the computerized
test bank, created with Brownstone’s Diploma 6 test generator software, allows you to make up
tests quickly and easily by selecting, editing, organizing, and printing a test and answer key.
• Instructor’s Manual: this feature offers you a wealth of teaching tools including suggested
reading assignments, chapter summaries, and review and discussion questions.
Website
http://health.jbpub.com/humandisease/7e
This fully integrated website allows students and instructors to become active participants in the
learning process. The Human Disease eLearning site incorporates:
• Anatomy and Physiology Review with interactive figure labeling exercises.
• Animated Flashcards and crossword puzzles for quizzing and reviewing key terms.
• Interactive glossary, allowing students to search by term, chapter, or to browse alphabetically.
• Web links directing students to additional resources on the Internet.
Slide Set
ISBN 0-7637-1419-4
This set includes 80 full-color slides designed to assist you in emphasizing key points from the
text. The Slide Set also comes with 50 exam questions intended to stimulate classroom
discussion.
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