INDEX e1

INDEX
Page numbers followed by f indicate figures, t indicate tables, and b indicate boxes. Boldface numbers refer to main discussions.

A Abscess (Continued) Acid-base balance, 741-744 Acne vulgaris, 2530-2532, 2550f

Abatacept, 167 neck, 2470 disorders of, 741-753. See also Acidosis; Acoustic neuroma, 1250, 2463
ABCA1 (ATP binding cassette A1), 1347t, perianal, 945-949 Alkalosis Acquired immunodeficiency syndrome
1348 peritonsillar, 2470, 2470t, 2471f clinical manifestations of, 743-744 (AIDS). See Human immunodeficiency
Abciximab, 176 retropharyngeal, 514t compensatory changes in, 744-745, virus (HIV) infection
in acute coronary syndrome, 430t tubo-ovarian, 1969 745t Acrivastine, 2512t
Abdomen. See also Abdominal pain Absence seizures, 2286t, 2288, 2290-2291, definition of, 741 Acrocyanosis, 497
Actinomyces infection of, 1969 2292t diagnosis of, 743-744, 744f, 744t Acrodermatitis chronica atrophicans, 1933
auscultation of, 833-837 Absolute risk reduction, e8-2 epidemiology of, 741-753 Acrodermatitis enteropathica, e225-6t-
caput medusae of, 954, 954f Abstinence, in infection prevention, 1799, hypovolemia and, 724 e225-7t
distention of, 838-839 2182 pathobiology of, 741-743 Acrodermatitis verruciformis, 2537
examination of, 25 Abulia, 2274 kidneys in, 742-743, 742f Acromegaly, 1436-1437
in abdominal pain, 833-837, 834t-837t Abuse lungs in, 741-742 clinical manifestations of, 1436-1437,
in cardiovascular disease, 252 alcohol. See Alcohol use/abuse Acid peptic disease. See Dyspepsia, functional 1436f
in cirrhosis, 1003 drug. See Drug abuse (nonulcer); Gastroesophageal reflux diagnosis of, 1437, 1437t
in gastrointestinal disease, 829 physical, 1413, 2229 disease (GERD); Peptic ulcer disease GRFoma and, 1296
in heart failure, 301 Acamprosate, in alcohol dependence Acidosis osteoarthritis in, 1749
in liver disease, 954-955, 954f-955f, treatment, 152-153, 152t metabolic, 744f, 745-752 pathobiology of, 1436
956t Acanthamoeba spp. infection, 2047, alcohol intoxication and, 746t, 747-752 treatment of, 1438b
in nutritional assessment, 1386t 2047t anion gap, 744f, 745, 746t ACTH. See Adrenocorticotropic hormone
in pelvic inflammatory disease, e307-3 corneal, 2435 in acute poisoning, 673 (ACTH)
in trauma, 690-691, 690f Acanthosis nigricans, 1195, 1196t, 1197f, potassium level in, 737 ACTH stimulation test, 1434t, 1440,
fluid in. See Ascites 1276, 1420 clinical manifestations of, 745 1468-1469
pain in. See Abdominal pain Acarbose, e237-7t, e237-8-e237-9 compensatory changes in, 744-745, ACTHoma, 1293t
palpation of, 25 Accelerated aerobic glycolysis, 646 745t Actigraphy, 2300-2301
in abdominal pain, 833-837 Accelerated idioventricular rhythm, 444 diabetic, 746t Actin, 320t, 1113, 1114f
in gastrointestinal disease, 829 Accessory pathway tachycardia, 353-355, diagnosis of, 744t Actinic keratoses, 2537
percussion of, 833-837 354f epidemiology of, 745 Actinomycosis, 1847-1851, 1847t,
Abdominal guarding, 833-837 Accidents. See Burn injury; Trauma; ethanol intoxication and, 747-752 1967-1969
Abdominal pain, 832 Traumatic brain injury ethylene glycol and, 746t, 747-748 abdominal, 1969
acute, 832-844, 834t-836t Acebutolol hyperchloremic, 744t, 748 cervicofacial, 1968, 1968f
clinical manifestations of, 832-844, in hypertension, 382t of nonrenal origin, 748 clinical manifestations of, 1849t,
834t-836t in stable myocardial ischemia, 423t of renal origin, 748-752, 749t, 750f 1968-1969
diagnosis of, 828, 831t-832t, 834t-836t, Acetaminophen, 135 isopropyl alcohol and, 748 CNS, 1969
836f, 837, 838f metabolism of, e152-1f lactic, 746-752, 746t, 1343t definition of, 1967-1969
differential diagnosis of, 834t-836t, 836f occult ingestion of, 673 methanol and, 746t, 748 diagnosis of, 1850t, 1969
in extra-abdominal conditions, 833 sodium in, 384-385 pathobiology of, 745 epidemiology of, 1967
in hospitalized patient, 837 toxicity of, 132, 674t-677t, 679t-683t, potassium level in, 737 vs. mycetoma, 2006-2007
imaging in, 837 981-982, 981t propylene glycol and, 748 pathobiology of, 1967-1968
patient history in, 832-833 Acetazolamide salicylate intoxication and, 746t, pelvic, 1969
physical examination in, 833-837, 837t in high-altitude syndromes, 575-576, 747-752 prognosis for, 1969
in special populations, 837 576b treatment of, 749b thoracic, 1968-1969, 1968f
in appendicitis, 921 potassium effects of, 739 uremic, 745-746 treatment of, 1849b-1850b, 1850t, 1969b
chronic, 837-838 Acetylcholine renal tubular. See Renal tubular acidosis Action potential, cardiac, 334-335, 334f-335f,
clinical manifestations of, 834t-836t in asthma, 531 (RTA) e52-1, e52-2f, e61-1f
diagnosis of, 831t-832t, 834t-836t, 837, in neuromuscular transmission, respiratory, 742, 744f, 744t, 752 Activated charcoal, in acute poisoning,
839f 2417-2418, 2418f compensatory changes in, 744-745, 679-684
in chronic pancreatitis, 941, 943, 943t Acetylcholine challenge, in Prinzmetals 745t Activated protein C
duration of, 832 angina, 424 in shock, 646, 648 recombinant
in female, 833 Acetylcholine receptor, 2417-2418, 2418f Aciduria, 1343t in DIC, 1146b-1147b
in liver disease, 952, 956t antibodies against, 2418-2420, 2419f orotic, 1345-1346 in septic shock, 664-665
location of, 836f deficiency of, 2419t, 2423 Acinetobacter baumannii infection, 1882, resistance to, 1149-1153
pathobiology of, 832 in neuromuscular transmission, 1882f, e290-3t in viral hemorrhagic fevers, 2154
postprandial, 1723 2417-2418, 2418f Acinetobacter spp. infection, 1881-1884, Activated protein C resistance, 1149-1153
Abetalipoproteinemia, 905, 1344t, 1348 Acetylcholinesterase deficiency, 2419t, e315-1t Activin, 1426, 1442
Abnormal uterine bleeding, e244-5-e244-8 2423 bloodstream, 1882 Activities of daily living (ADLs), in geriatric
ABO blood group N-Acetylcysteine bone, 1882 assessment, 101, 115
in blood transfusion, 1155 in acetaminophen toxicity, 679t-683t burn injury, 1882 Acupuncture, 179
in transplantation, 236 in contrast-related injury prevention, clinical manifestations of, 1882 Acute chest syndrome, in sickle cell disease,
Vibrio cholerae infection and, 1866 760 CNS, 1882, 2364 1070-1071, 1073, 1073t
Abortion, infection with, 1849, e304- Acetylhydrolase, in anaphylaxis, 1636 cutaneous, 1882, 1882f Acute coronary syndrome, 29, 425-434. See
2-e304-3 Acetylsalicylic acid. See Aspirin definition of, 1881-1883, e315-1t also Angina pectoris; Myocardial
Abscess Achalasia, 881, 881f, 1273 respiratory tract, 1882 infarction (MI)
abdominal, 834t-836t Achilles tendon soft tissue, 1882 biomarkers in, 427
in Crohns disease, 919 inflammation of, 1681 treatment of, 1883b definition of, 425
brain. See Brain abscess rupture of, 1681 urinary tract, 1882 diagnosis of, 426-427, 427t
cutaneous, 1816, 2544-2545, 2544f Achondroplasia, 1610 wound, 1882 differential diagnosis of, 428-429
epidural, 2373-2376, 2373t, 2374f Acid(s) Acitretin, 2511 electrocardiography in, 427
glomerulonephritis with, 767 gastric, 891 Acne, 1420 epidemiology of, 425
hepatic, 988t nonvolatile, 742 pyogenic arthritis with, 1671-1672 noninvasive testing in, 427
amebic, 988t, 990-996, 2045, 2046f urinary, 743 in women of reproductive potential, 1550t primary, 425
pyogenic, 988-996, 988t volatile, 741 Acne keloidalis, 2549, 2549f risk assessment in, 428, 428t, 429f
e2 INDEX
Acute coronary syndrome (Continued)
secondary, 425
substance abuse and, 427
treatment of, 429b-432b
Acute disseminated encephalomyelitis, 2354
Acute febrile syndrome, occupation-related,
573, 574t
Acute generalized exanthematous pustulosis,
2531, 2531f, 2535
Acute inflammatory demyelinating
polyneuropathy. See Guillain-Barr
syndrome
Acute intermittent porphyria, 1363, 1365t
clinical manifestations of, 1364-1365
diagnosis of, 1365-1366
drug-induced attacks in, 1365, 1366t
epidemiology of, 1363
lipid disorders and, 1352t
pathobiology of, 1363-1364, 1364f
precipitating factors in, 1365
safe drugs in, 1366t
treatment of, 1366b-1367b
Acute interstitial pneumonia, 554-555, 563,
563f
chest radiography in, 559t
clinical manifestations of, 554
definition of, 554
diagnosis of, 553f, 554
pathobiology of, 552t, 554
treatment of, 554b
Acute lung injury. See Lung injury, acute
Acute lymphoblastic leukemia (ALL),
1203-1209
biopsy in, 1205-1206, 1206f
Burkitt-like, 1207
classification of, 1204t
clinical manifestations of, 1205
cytogenetics of, 1205
hematopoietic cell transplantation in,
1207
immunophenotyping of, 1204-1205
morphology of, 1204
peripheral blood smear in, 1030, 1030f
Ph chromosome-positive, 1207, 1209
relapsed, 1207
treatment of, 202t, 1160, 1206-1207,
1207t
Acute motor and sensory axonal neuropathy.
See Guillain-Barr syndrome
Acute mountain sickness, 575-581, 575t
Acute myeloid leukemia (AML), 1203-1209
biopsy in, 1205-1206, 1206f
classification of, 1204t
clinical manifestations of, 1205
complications of, 1208
cytogenetics of, 1205
immunophenotyping of, 1204
infection with, 1208
morphology of, 1204
myelodysplastic syndrome evolution to,
1201
in older adults, 1208
peripheral blood smear in, 1030, 1030f
recurrent, 1208
treatment of, 1160, 1207-1208, 1207t
Acute phase response, 1652
Acute promyelocytic leukemia (APL), 1184,
1207t, 1208
Acute respiratory distress syndrome, 635
vs. cardiogenic pulmonary edema, 636,
636t
clinical manifestations of, 632t, 636
definition of, 635
diagnosis of, 636, 636t
after drowning, 574
epidemiology of, 635
etiology of, 635t
lung protective ventilation strategy in,
642
mechanical ventilation in, 642-643,
643f
pathobiology of, 636
PEEP in, 642-643
treatment of, 636b, 637f
Acute respiratory failure. See Respiratory
failure, acute
Acute stress disorder, 2240t, 2241
Acute tubular necrosis (ATN). See also
Kidney injury, acute
vs. acute interstitial nephritis, 773
ischemia-related, 758, 758t
recovery from, 761
toxin-related, 758-761
Acyclovir
adverse effects of, 2082
excretion of, 2083t
in herpes simplex encephalitis, 2378b
in herpesvirus infection, 2082, 2083t
in post-herpetic neuralgia, 2407
resistance to, 2082
Acyl-CoA dehydrogenase deficiency, 1343t
Acyl CoA oxidase deficiency, 1344t
Adalimumab, 165
in inflammatory bowel disease, 917t, 918
in psoriasis, 2518t
Adamkiewicz, artery of, occlusion of, 2268
ADAMTS13, 1129, 1129f
Addiction
drug, 140-142, 140t. See also Alcohol use/
abuse; Drug abuse
biochemistry of, 142
definition of, 140
genetic factors in, 140-141
neural plasticity and, 142
reward circuitry in, 141, 141f
risk factors for, 140-141
nicotine, 140t, 142-146, 144t. See also
Cigarette smoking
Addisons disease. See Adrenal insufficiency
Adefovir
adverse effects of, 2087, 2087t
in hepatitis B, 975b-976b, 976t,
2086-2087, 2086t-2087t
Adenoma
adrenal, 1466
ampulla of Vater, 1019
colonic, 910, 1283-1286, 1284f, 1284t
gastric, 1278
hepatic, 847f, 1298f, 1299-1303
oral contraceptives and, 1554
parathyroid, 1595. See also
Hyperparathyroidism, primary
pituitary. See Pituitary adenoma
rectal, 910
thyroid, e233-7
toxic, e233-7
Adenosine, 356t-357t
Adenoviral vector, 208
Adenovirus-associated virus vector, 209
Adenovirus infection, 2100-2102
clinical manifestations of, 2101-2102,
2101t
in common cold, 2089, 2089t. See also
Common cold
conjunctival, 2434, 2434f, 2434t
definition of, 2100-2102
diagnosis of, 2102
differential diagnosis of, 2106t
epidemiology of, 2100
gastrointestinal, 2101, 2101t
in immunocompromised host, 1778,
2102
ocular, 2101-2102
pathobiology of, 2100-2101
prevention of, 2102
respiratory, 2101-2102, 2101t
treatment of, 2102b
urinary tract, 2101, 2101t
Adherens junctions, 2498, 2499f
Adhesions, peritoneal, 927
Adhesive capsulitis, 1679
Adies tonic pupil, 2445, 2445f
Adipocytokines
in insulin resistance, 1413
in nonalcoholic fatty liver disease,
998
Adiponectin, 1413
Adipose tissue, 59
energy requirement of, 1412
estrogen synthesis by, 1380-1381
excess. See Obesity
inflammation of. See Panniculitis
metabolism of, obesity and, 1413
undernutrition effects on, 1389
Adolescent medicine, 59-63
approach to, 60-61
cancer in, 60
chronic illness in, 63
confidentiality in, 61
contraception in, 62
eating disorders in, 62
epilepsy in, 2290t, 2291
injury in, 60, 60t
patient approach in, 60-61
patient history in, 61
physical examination in, 61
physical growth in, 59, 59f-60f
pregnancy in, 61-62
preventive health care in, 61
psychosocial development in, 59
reproductive health care in, 61-62
review of findings in, 61
sexual activity in, 61
sexually transmitted diseases in, 62
substance abuse in, 62, 62t
vital statistics in, 59-60, 60t
Adrenal cortex, 1463-1470, 1463f
congenital hyperplasia of, 1467. See also
Congenital adrenal hyperplasia
disorders of, 1463
excess androgen secretion by, 1467
function of, 1463
hormones of. See Aldosterone;
Androgen(s); Cortisol
hyperfunction of, 1464-1469. See also
Cushings syndrome
hypofunction of, 1467. See also Adrenal
insufficiency
layers of, 1463, 1463f
metastatic disease of, 1467
nodules of, 1465
steroidogenesis in, 1512-1513, 1512f
Adrenal glands, 1463, 1463f. See also Adrenal
cortex; Adrenal medulla
aging-related changes in, 107
in shock, 653
Adrenal insufficiency, 1467
in adrenoleukodystrophy, 1467
anemia in, 1037
autoimmune, 1467
clinical manifestations of, 1468, 1468t
corticosteroid-induced, 161
diabetes insipidus and, e232-3-e232-4
diagnosis of, 1468-1469, 1468t
differential diagnosis of, 1469
in infection, 1467
pathobiology of, 1467-1469
preoperative assessment of, 2482
primary, 1467-1468, 1468t
secondary, 1468-1469, 1468t
treatment of, 1469b
weight loss with, 840t-841t
Adrenal medulla, 1470-1475
catecholamines of, 1470, 1471f
paraganglioma of, 1470-1475
pheochromocytoma of, 1470-1475. See
also Pheochromocytoma
Adrenalectomy
in Cushings syndrome, 1466
pituitary adenoma after, 1442
Adrenarche, 1521
premature, 1531
-Adrenergic receptor agonists
in asthma, 534-535
central nervous system effects of, 672t
in COPD, 541, 542t
-Adrenergic receptor antagonists
in benign prostatic hyperplasia, 807, 808t
in catecholamine-secreting tumors, 1474
in hypertension, 383t, 384
-Adrenergic receptor antagonists, 356t-357t
in acute coronary syndrome, 430t, 431
in alcohol dependence treatment, 152t
in catecholamine-secreting tumors, 1474
central nervous system effects of, 672t
in heart failure, 306f-307f, 307, 310t,
311-312
in hypertension, 383t, 384
in hypertrophic cardiomyopathy, 322-323
lipid disorders and, 1352t
metabolism of, genetic factors in, 187t
-Adrenergic receptor antagonists
(Continued)
perioperative, 2480, 2481t-2482t
in ST segment elevation MI, 443, 446-448,
447t
in stable myocardial ischemia, 419-421,
420f, 423t
in thyrotoxicosis, e233-8
toxic ingestion of, 674t-676t, 679t-683t
in ventricular arrhythmias, 367
Adrenocorticotropic hormone (ACTH),
1439
deficiency of, 1439-1440
ectopic secretion of, 1189-1192, 1190f,
1441, 1465-1466, 1465t
excess of, 1440-1442, 1440f, 1440t. See
also Cushings disease
hypertensive hypokalemic alkalosis
with, 739
petrosal sinus sampling of, 1437t, 1441,
1441t, 1466
plasma, 1441t, 1465
replacement of, 1434t
tests for, 1434t, 1437t, 1439-1440
tumor secretion of, 1296, 1435t,
1440-1442, 1440f, 1440t-1441t
vasopressin stimulation of, e232-2
Adrenocorticotropic hormone (ACTH)
stimulation test, 1434t, 1440,
1468-1469
Adrenoleukodystrophy, 1344t, 1467, 1469,
2354-2355
Adrenomyeloneuropathy, 2354-2355
Adult T-cell leukemia/lymphoma, 1203,
1216, 1226, 2137-2140
clinical manifestations of, 2138-2139,
2138t
diagnosis of, 2139
epidemiology of, 2137-2138
pathobiology of, 2137-2138, 2138f
pathogenesis of, 2137
prognosis for, 2139
treatment of, 2139b
Advance directive, 102, 104t
Advanced activities of daily living (AADLs),
in geriatric assessment, 101
Advanced cardiac life support, 346, 347f
in acute poisoning, 678-679, 678f
Advanced sleep phase syndrome, 2303
Adverse drug reaction, 131, 1638. See also
Drug allergy; Drug interactions
diagnosis of, 132
epidemiology of, 131
etiology of, 131-132, 132t
vaccine-related, 63-64
Adverse event, 43
Advice, 50. See also Counseling
Adynamic bone disease, 820
Aerophagia, 838
Affect, in older adults, 102, 104t
Afibrinogenemia, e177-4t, e177-8
Aflatoxins, 1300
African sleeping sickness, 2018-2021
clinical manifestations of, 2019
definition of, 2018-2021
diagnosis of, 2020, 2020f
East African, 2020
epidemiology of, 2018-2019, 2019f
pathobiology of, 2019
prevention of, 2020-2021
treatment of, 2020b, 2021t
West African, 2019-2020
African tick bite fever, 1956t, 2153t
African traditional healing, 179
Afterload, e52-6
in heart failure, 297
Agammaglobulinemia, X-linked, 1618-1621
enterovirus infection in, 2144
Aganglionosis, 866
Age/aging, 98-101. See also at Geriatric;
Older adults
antibacterial selection and, 1764-1765
atrial fibrillation and, 105-106
bladder changes with, 110
bone mineral density changes with, 1579,
1579f
cancer and, 1179, 1180f

Age/aging (Continued)
cardiovascular system effects of, 105-106,
256, e52-6
central nervous system effects of, 114, 114t
chronic disease and, 98, 99t
clinical sequelae of, 104-110
cognitive impairment and, 99
connective tissue changes with, e267-5
diverticula and, 106
drug effects and, 116, 116t, 129-130
endocrine system effects of, 107. See also
Menopause
eyelid changes with, 2426
fracture and, 1578
frailty and, 98-99
gastrointestinal system effects of, 106
health status and, 98-100, 99t, 100f
hearing loss with, 2463
hematopoietic system effects of, 107
hypertension and, 374-376, 375f
immune system effects of, 107
integumentary system effects of, 108-109,
108f-109f, 2542
mortality and, 98, 100t
multimorbidity and, 98
musculoskeletal system effects of, 107-108
nervous system effects of, 108
neuropsychiatric aspects of, 114-116,
114t-116t
nonspecific signs and symptoms and, 98
pathobiology of, 104-105, 105t
pharmacology of, 109, 129-130
physical disability and, 99
renal system effects of, 106-107
respiratory system effects of, 106
rheumatic disease and, 1648
serum albumin levels and, 109
skin changes with, 108-109, 108f, 2542
subclinical disease and, 98, 100t
thymus gland changes with, 107
urinary system effects of, 106-107
vasculitis with, 1721
vision changes with, 99t, 102, 104t, 108
Age-related macular degeneration, 197-198,
1668t, 2437-2438, 2437f-2438f, 2444
Aggrecan, e267-3
Agnogenic myeloid metaplasia, 1210
Agnosia, 2273-2274
Agoraphobia, 2240t, 2241
Agouti-related protein, 1412t
Agranulocytosis, 1084
antipsychotic-induced, 2493-2494
Agyria, 95, 95f
AICDA gene, 1619
AIDS (acquired immunodeficiency
syndrome). See Human
immunodeficiency virus (HIV)
infection
Air embolism, 602-603
in hemodialysis, 819
stroke and, 2318
Air pollution, 78, 78t
COPD and, 537
Air swallowing, 838
AIRE gene, e244-8
Airway. See also Lung(s); Respiratory system
management of
in acute poisoning, 676-678, 678f
in burns, 692
mucociliary escalator of, 588
obstruction of. See also Chronic
obstructive pulmonary disease
(COPD)
in asthma, 531. See also Asthma
bronchoscopy in, 617, 617f
in obstructive sleep apnea, 614
preoperative assessment of, 2484
stenting of, 617b-618b
structure of, e85-1, e85-2f
thermal injury to, 577-581
Akathisia, 2340
Akinesia, in Parkinsons disease, 2327
Alanine aminotransferase (ALT)
in alcoholic liver disease, 997
in liver disease, 955, 961-962, 965, 965f
in nonalcoholic fatty liver disease, 998
normal, 961
Albendazole, 2010
in echinococcosis, 2010, 2057
in hookworm disease, 2065t, 2066b
in hydatid cyst disease, 994b
in roundworm disease, 2009, e366-1b,
e366-1t
in trichinellosis, e366-1t, e366-2b
Albinism, 1342-1343
oculocutaneous, 1342-1343, 2547
Albrights hereditary osteodystrophy, 1342,
1598, 1598f
Albumin
serum
age-related levels of, 109
in ascites, 1004, 1004t
in gastrointestinal disease, 829
during hemodialysis, 820
in hypovolemia, 724
in liver disease, 963
in nephrotic syndrome, 762
postoperative, 2491
in thyroid hormone transport, e233-1
urinary, 709-710, 815
Albuterol
in asthma, 534
in COPD, 542t
in pregnancy, 1562b-1563b
Alcohol intoxication, 147-148
Alcohol use/abuse, 146-153, 146t
abstinence for, 997b-998b
acute effects of, 147-153
by adolescents, 62, 62t
at-risk drinking with, 146-147, 146t, 151
atrial fibrillation with, 354-355
behavioral effects of, 148t, 149
blood alcohol levels in, 2386
breast cancer and, 1380-1381
cardiovascular disease and, 147-149, 148t,
258, 1380
central nervous system effects of, 147-148,
148t
cerebellar degeneration and, 2386
cessation of, 55
chronic effects of, 148-149, 148t
chronic pancreatitis and, 941
clinical manifestations of, 147-153
compressive neuropathy and, 2386
definitions in, 146-147, 146t
dementia and, 2386
diabetes mellitus and, 1381
diagnosis of, 149, 150t
diarrhea with, 910
dilated cardiomyopathy with, 326
epidemiology of, 147
fetal alcohol syndrome and, 2386
folate deficiency with, 1078-1080
gastrointestinal tract effects of, 148t, 149,
889
gout and, 149
guidelines for, 1382t-1383t
in head and neck cancer, 1258
in heart failure, 313-314
hematopoietic effects of, 149
hepatic encephalopathy and, 2386
in hypertension, 381
hypertriglyceridemia and, 1352t
hypogonadism and, 149
infection and, 149
intoxication with, 147-148
ketoacidosis and, 149, 747-752
Korsakoff s syndrome and, 2384
laboratory findings in, 151
liver disease with, 147, 148t, 149,
996-999, 996t, 997f
Marchiafava-Bignami syndrome and, 2386
myopathy and, 2386
neoplastic effects of, 149
neurologic disorders with, 2385-2386
optic neuropathy and, 2386
osteoporosis and, 1580-1581
pancreatic effects of, 149, 937
pathobiology of, 147, 147f
patient history in, 150
peripheral neuropathy and, 2386
pharmacological treatment of, 152-153,
152t
physical examination in, 150
Alcohol use/abuse (Continued)
prevention of, 151b-153b, 152t
psychiatric effects of, 148t, 149
seizures and, 2386
treatment of, 151b-153b, 151t-152t
weight loss with, 840t-841t
Wernickes encephalopathy and,
2383-2384
withdrawal from, 148, 148f, 151, 672t
Alcohol withdrawal syndrome, 148, 148f,
148t, 672t
treatment of, 151
Alcoholic liver disease, 147, 148t, 149,
996-999, 996t, 997f. See also
Steatohepatitis
anemia in, 1038
HFE gene in, 1376-1377
Alcoholism, 146. See also Alcohol use/abuse
Aldesleukin, 1168t-1176t
Aldosterone
deficiency of, 739, 777, 1469
excess of, 1466, 1466t
hypertension with, 378t, 379
function of, 1463
in potassium secretion, 735
in sodium homeostasis, 717-718
synthesis of, e241-1f
Aldosterone antagonists
in heart failure, 306f-307f, 312, 312t
in ST segment elevation MI, 443
Alefacept, in psoriasis, 2513, 2518t
Alemtuzumab, 1168t-1176t
in kidney transplantation, 825
in multiple sclerosis, 2353
Alendronate, in Pagets disease, 1605t
Alexia, 2273-2274
Alfuzosin, in benign prostatic hyperplasia,
807, 808t
Aliskiren, in hypertension, 382t
Alkaline phosphatase, 962
in liver disease, 962, 965-966, 965f
Alkalosis
metabolic, 750-752
chloride-responsive, 744t, 751, 752b
chloride-unresponsive, 744t, 751, 752b
clinical manifestations of, 751
compensatory changes in, 744-745,
745t
diagnosis of, 744t, 751-752
epidemiology of, 750
nonrenal causes of, 744t, 750-751
pathobiology of, 750
renal causes of, 744t, 750-751
treatment of, 752b
postoperative, 2490
respiratory, 742, 744f, 752
compensatory changes in, 744-745,
745t
diagnosis of, 744t
Alkaptonuria, 1751
Alkylating agents, 1168t-1176t
in systemic lupus erythematosus,
1703-1704
All-trans-retinoic acid, 1168t-1176t
Allelic heterogeneity (allelic affinity), 191
Allen test, in thromboangiitis obliterans, 494
Allergens. See Allergy; Anaphylaxis
Allergic alveolitis, extrinsic. See
Hypersensitivity pneumonitis
Allergic angiitis. See Churg-Strauss syndrome
Allergic bronchopulmonary aspergillosis,
1991-1992, 1991t
bronchiectasis in, 548-549, 550f
diagnosis of, 1992-1993, 1993f
treatment of, 1994
Allergic contact dermatitis, 2506-2507,
2507f, 2515
Allergic rhinitis, 1622-1628, 2457
clinical manifestations of, 1623
definition of, 1622
diagnosis of, 1623
differential diagnosis of, 1623-1625, 1624f,
1624t
epidemiology of, 1622-1626
pathobiology of, 1622-1626, 1622t
perennial, 1612-1613, 1622-1623, 1622t
prevention of, 1626
INDEX e3
Allergic rhinitis (Continued)
seasonal, 1612-1613, 1622-1623, 1622t
systemic manifestations of, 1625-1626,
1625f
treatment of, 1626b-1628b, 1628t
Allergy, 22, 227-230, 1612-1615. See also
Allergic rhinitis; Anaphylaxis; Asthma;
Hypersensitivity reaction
angioedema in, 1613
Aspergillus, 1991-1992, 1991t
diagnosis of, 1992-1993
treatment of, 1994
cetuximab-related, 167
contrast media, 291
definition of, 1612
diagnosis of, 1612-1615, 1612t, 1614t
drug, 1638-1640. See also Drug allergy
eosinophilic esophagitis with, 880,
880f
epidemiology of, 1612
food, 1613
anaphylaxis with, 1633-1634, 1637
diarrhea with, 910
testing for, 1614, 1635
hygiene hypothesis of, 1612
insect, 1633-1634, 1637, 2077t, 2081
laboratory tests in, 1613-1614
latex, 1633-1634, 2484
pathobiology of, 1612
patient history in, 1612-1613
penicillin, 132, 1638-1639, 1640t, 1764,
1814t
pet, 1626
physical examination in, 1613
rituximab-related, 168
secretions in, 1613
vs. sensitization, 1612
transfusion-related, 1156t, 1157
urticaria in, 1613
Allergy testing, 1613-1614, 1614t, 1623
after anaphylaxis, 1635
in immunodeficiency disorders, 1615
in urticaria, 1630
Alloantibody inhibitors, in hemophilia,
e177-5-e177-10
Allodynia, 134
Allopurinol
adverse reactions to, 225t
in cancer therapy, 1167-1177
in gout, 1741
in nephrolithiasis prevention, 794
Alopecia, 2551, 2551t
cicatricial (scarring), 2553
diffuse, 2551-2553
fibrosing, 2553, 2553f
hereditary, 2553
minoxidil for, 2514
patchy, 2552-2553
patterned (androgenic), 2552
scarring, 2543
triangular, 2553
Alopecia areata, 2552, 2553f
Alosetron
in diarrhea, 912-913
in irritable bowel syndrome, 871t
Alpha-blockers. See -Adrenergic receptor
antagonists
Alport syndrome, 769
Alprazolam, 2242t
Alprostadil, in erectile dysfunction, 1528
ALPS (autoimmune lymphoproliferative
syndrome), 1619-1621, 1619t
ALS. See Amyotrophic lateral sclerosis (ALS)
Alteplase, in ST segment elevation MI,
439-441, 440t-441t
Alternative medicine. See Complementary
and alternative medicine (CAM)
Altitude, high
adaptation to, 753
disorders at, 575-581, 575t
Aluminum hydroxide, in hyperphosphatemia,
756b, 756t
Aluminum poisoning, 90t, 93-95
Alveolar-arterial oxygen gradient, 626, 627t
Alveolar filling disorders, 552-556, 553f
definition of, 552, 552t
interstitial lung disease with, 565
e4 INDEX
Alveolar hemorrhage, diffuse, 552t, 553f,
554-555
Alveolar hydatid disease, 2053t, 2057
Alveolar proteinosis. See Pulmonary alveolar
proteinosis
Alveolar space, e85-1
Alveolitis, allergic, extrinsic. See
Hypersensitivity pneumonitis
Alveolus (alveoli)
gas exchange at, e85-1
immune response of, e85-2
Alzheimers disease, 99t, 2277
-amyloidosis in, 2277
C. pneumoniae infection and, e326-6
cholinergic neurotransmission in,
2277-2278
clinical manifestations of, 2278
definition of, 2274t, 2277
diagnosis of, 2276f, 2277t, 2278, 2278f
differential diagnosis of, 2278-2279
epidemiology of, 114, 2277
familial, 2278
genetics of, 2278
neurofibrillary tangles in, 2277
vs. Parkinsons disease, 2329t
pathobiology of, 2277
prognosis for, 2279
risk factors for, 2277
treatment of, 2279b
visuospatial deficits in, 2278
wandering in, 2279b
Amanita poisoning, 981, 984
Amantadine
adverse effects of, 2085
in bronchitis, 587b
drug interactions with, 2086t
in influenza virus infection, 2085-2086,
2085t-2086t, 2100b
in influenza virus infection prevention,
2099, 2099t
influenza virus resistance to, 2086
Amblyopia, 2428. See also Blindness
Ambrisentan, in pulmonary hypertension,
395-396
Ambulatory monitoring, in arrhythmias,
342-343
Amebiasis, 2043-2047
asymptomatic, 2043-2044
cerebral, 2045
clinical manifestations of, 991,
2043-2047
colonic, 2044-2045, 2045f, 2046t
definition of, 2043
diagnosis of, 991, 1790f-1791f, 2046,
2046t
diarrhea in, 2044
dysentery in, 2044-2045, 2045f
epidemiology of, 990, 2043
hepatic, 990-996, 990t-992t, 994f, 2045,
2046f, 2046t
immune response to, 2043
pathobiology of, 991, 2043, 2044f
pericardial, 2045
prevention of, 2047
thoracic, 2045
treatment of, 2010, 2046b, 2046t
vs. viral hemorrhagic fever, 2153t
Amenorrhea, e244-6
definition of, e244-6
diagnosis of, e244-3f, e244-6-e244-8,
e244-7t
hypergonadotropic, e244-8-e244-14
laboratory tests in, e244-3f, e244-7-e244-8
pathobiology of, e244-6
American mountain fever, 2156-2161
American sylvatic typhus, 1956t
American trypanosomiasis. See
Trypanosomiasis, American
Amifostine, 1168t-1176t
Amikacin, 1809t-1811t, 1812
in kidney failure, 128t
Amiloride
in hypertension, 382t
in hypervolemia, 727t
Amino (N)-terminal pro-BNP, in heart
failure, 302
Aminoaciduria, hyperdibasic, 1341t
-Aminocaproic acid
in hemophilia, e177-5
hyperkalemia and, 737
Aminoglycosides, 1807t-1811t, 1808-1812,
1812f, 1814t
adverse effects of, 1814t
bacterial cell killing rate of, 1812
middle ear toxicity of, 1812
nephrotoxicity of, 1807, 1812f
resistance to, 1808t
-Aminolevulinic acid (ALA ) dehydratase-
deficient porphyria, 1364f, 1365t, 1369
N-Aminoparaquinoneamine, 980
5-Aminosalicylates, in inflammatory bowel
disease, 916-917, 917t
Amiodarone, 356t-357t
hepatotoxicity of, 981t
ocular effects of, 2442
in resistant tachyarrhythmias, 347
thyroiditis with, e233-10
in ventricular arrhythmias, 368
Amitriptyline
in depression, 2239t
in irritable bowel syndrome, 871t
in pain, 135-137, 136t
Amlodipine
in hypertension, 382t
in stable myocardial ischemia, 423t
Ammonia
blood, 962
renal handling of, 743
Ammoniagenesis, 743
Amnesia, 2270-2274
anoxic-ischemic encephalopathy and,
2271
causes of, 2271. See also Alzheimers
disease; Dementia
clinical manifestations of, 2271
diagnosis of, 2271-2274
global, transient, 2271
herpes simplex encephalitis and, 2271
hippocampal lesions in, 2270-2271
pathobiology of, 2270-2271
stroke and, 2271
thiamine deficiency and, 2271
Amniotic fluid embolism, 603
Amoxicillin, 126t, 1809t-1811t
Amoxicillin-clavulanic acid, 1809t-1811t
Amphetamines
abuse of, 156-157, 157b
central nervous system effects of, 672t
gastrointestinal complications of, 889
toxic ingestion of, 674t-677t
Amphotericin B, 1971-1973
acute reactions to, 1972
in aspergillosis, 1993b-1994b, 1993t
in blastomycosis, 1982b
in candidiasis, 1989b-1990b
in cryptococcosis, 1984b-1985b
in dematiaceous fungal infection, 2008b
formulations of, 1972-1973
in histoplasmosis, 1978b-1979b
lipid formulations of, 1973
mechanism of action of, 1971-1972
in mucormycosis, 1997
potassium effects of, 739
resistance to, 1972
spectrum of activity of, 1972
in sporotrichosis, 1986b
in visceral leishmaniasis, 2012-2013
Amphotericin B deoxycholate, 1972
Ampicillin, 1809t-1811t
Enterobacteriaceae resistance to, 1875,
1875t
Ampulla of Vater, disorders of, 1019, 1019f
Amygdala, stress effects on, 180
Amyl nitrite, in acute poisoning, 679t-683t
Amylase
pleural fluid, 609t
serum, 938-939
Amyloid angiopathy, intracerebral
hemorrhage and, 2323t, 2324
Amyloidosis, 1243-1246
in Alzheimers disease, 2277
autonomic dysfunction with, 2394
bleeding with, 1136, e177-9
cardiomyopathy in, 327, 330-333, 330f
Amyloidosis (Continued)
clinical manifestations of, 1243-1246,
1244t
cutaneous, 1602
definition of, 1243
diagnosis of, 1244-1246, 1245f
esophageal, 884
familial, 1246
in familial Mediterranean fever, 1669
gastric, 888
heart failure in, 302
hepatic, 986
hereditary, 320t
localized, 1246
myocardial, 1246
paraneoplastic, 1196t
prognosis for, 1245-1246
renal, 714f, 770
screening for, 1244
secondary, 1246
treatment of, 1245b
Amylophagia, 1041
Amyotrophic lateral sclerosis (ALS),
2343-2346
clinical manifestations of, 2344
definition of, 2343
diagnosis of, 2344, 2344t-2345t
differential diagnosis of, 2345t
dysphagia in, 2471
epidemiology of, 2343
laboratory testing in, 2344, 2344t
pathobiology of, 2343-2346
pathology of, 2343-2344
prognosis for, 2345
treatment of, 2345b
variants of, 2344
Anabolic agents
in burns, 693
in osteoporosis, 1585
Anabolic steroids
abuse of, 158
hepatotoxicity of, 983
hypogonadism with, 1524
lipid disorders and, 1352t
Anaerobic bacteria, non-spore-forming,
1847-1851. See also Actinomycosis
bloodstream infection with, 1848
bone infection with, 1849
clinical manifestations of, 1848-1849,
1849t
CNS infection with, 1848
cutaneous infection with, 1849
definition of, 1847-1849, 1847t, 1848f,
e305-1t
diagnosis of, 1849, 1849t-1850t
epidemiology of, 1848
head and neck infection with, 1849
intra-abdominal infection with, 1849
obstetric-gynecologic infection with, 1849
pathobiology of, 1848, 1848t
pleuropulmonary infection with, 1849
soft tissue infection with, 1849
treatment of, 1849b-1850b, 1850t
virulence factors in, 1848, 1848t
Anagen effluvium, 2551-2552
Anakinra, 166
in cryopyrinopathy, 1671
Anal cancer, 949
HPV infection and, 2217
Anal fissure, 946-949, 947f
Anal fistula, 946-949
Anal sphincter, 945
Anal transition zone, 945
Analbuminemia, 1344t
Analgesia. See also Pain, treatment of
combination, 138, 138f
in critical care, 624
patient-controlled, 137-138
in renal colic, 791-792
topical, 2512
Analgesics, 135-138. See also specific drugs
adjuvant, 135-137
nephropathy with, 774, 774f-775f
opioid, 137-138, 137t
in women of reproductive potential,
1550t
Analphalipoproteinemia, 1344t
Anaphylatoxins, 239-240, 243
receptors for, e49-1t
Anaphylaxis, 514t, 1613, 1633-1638
allergens in, 1633-1634, 1634t
aspirin-induced, 1634, 1637
autoimmunity and, 1634-1635
definition of, 1633
diagnosis of, 1634t, 1635-1636, 1636f
differential diagnosis of, 1636-1637
drug-induced, 132, 1634, 1637, 1639,
1640t
epidemiology of, 1633-1637
etiology of, 1633
exercise-dependent, 1634
food-induced, 1633-1634, 1637
insect sting-induced, 1633-1634, 1637
latex-induced, 1633-1634
mortality with, 1633
non-IgE-dependent, 1634, 1634t
pathobiology of, 1633-1637
pathophysiology of, 1635
perioperative, 2484
physical examination in, 1613
prevention of, 1637
progesterone-mediated, 1635, 1637
transfusion-related, 1156t, 1157
treatment of, 1637b, 1637f
Anaplasma phagocytophilum infection,
1961-1962, 1961t, 1962f
Anaplasmoses, 1960-1962, 1961t, 1965t
Anaplastic large cell lymphoma
cutaneous, 1226
systemic, 1226
Anastrozole, 1168t-1176t
Ancylostoma braziliense infection, 2065, 2065f
Ancylostoma caninum infection, 2065, 2065f
Ancylostoma duodenale infection, 2065-2066
treatment of, 2009, 2065t
Andersen-Tawil syndrome, 2412t, 2415
Andersens disease, 1356t
Androgen(s). See also Testosterone
congenital deficiency of, 1514, 1523,
1523t
deficiency of, 1523
excess of, 1467
insensitivity to, 1515-1516
synthesis of, e241-1f
Anemia, 1031-1039
in adrenal insufficiency, 1037
alcohol-related, 149
aplastic, 1083-1090. See also Aplastic
anemia
blood loss, 1034. See also Iron deficiency
anemia
in bone marrow disorders, 1036
of chronic disease, 1035f, 1036, 1036t,
1042-1043. See also Chronic disease,
anemia of
clinical manifestations of, 1032-1033,
1033f
complete blood count in, 1034
definition of, 1031
diagnosis of, 1031-1032, 1033t
bone marrow examination in, 1034
complete blood count in, 1034
laboratory evaluation in, 1033-1039
peripheral blood smear in, 1034. See
also Peripheral blood smear
reticulocyte count in, 1034
of endocrine hypofunction, 1037
in gastrointestinal disease, 829
in heart failure, 314-315
with hemodialysis, 819-820
hemolytic, 1038, 1038t. See also
Hemolytic anemia
HIV-associated, 2212, 2213t
in hypothyroidism, 1037
in infection, 1769
iron deficiency, 1039-1044. See also Iron
deficiency anemia
in kidney disease, 812, 817, 1037, 1037f
in liver disease, 963, 1037-1038
macrocytic, 1025f, 1028, 1028t, 1035,
1035t
in malaria, 2014
megaloblastic, 1075-1083, 1344t. See also
Megaloblastic anemia

Anemia (Continued)
microcytic, 1028, 1035, 1035f, 1035t,
1039-1044. See also Chronic disease,
anemia of; Iron deficiency anemia;
Sideroblastic anemia; Thalassemia
in myelodysplastic syndrome, 1201
normocytic, 1028, 1035t, 1036
in nutritional assessment, 1386t
in older adults, 1038
oxygen transport in, 1031-1033, 1032f
paraneoplastic, 1198
pathobiology of, 1031-1039
pernicious, 741, 1076. See also
Megaloblastic anemia; Vitamin B12
(cobalamin), deficiency of
physical findings in, 1033
postoperative, 2490
preoperative assessment of, 2483
sickle cell, 1066-1075. See also Sickle cell
disease
sideroblastic, 1043, 1365t. See also
Sideroblastic anemia
symptoms of, 1033
in systemic lupus erythematosus, 1702
in systemic sclerosis, 1711
treatment of, 1039
erythropoietin therapy in, 1039
red cell transfusion in, 1039
splenectomy in, 1039
Anergy, 221, 239
in sarcoidosis, 582
Anesthesia, 2483-2487
airway assessment for, 2484
anaphylaxis and, 2484
complications of, 2486
dexmedetomidine for, 2485
drug interactions and, 2484
intraoperative management of, 2484-2486,
2485t
in joint surgery, 1754
ketamine for, 2485
latex allergy and, 2484
local, cardiac toxicity of, 679t-683t
malignant hyperthermia and, 702, 704,
2412t, 2484
midazolam for, 2485
nausea after, 2486-2487
neuraxial, 2486
neuromuscular blockers for, 2486
opioids for, 2485
preoperative assessment for, 2483-2484
propofol for, 2484-2485
record review of, 2487
regional, 2486
risk of, 2477
in sickle cell disease, 1074
volatile anesthetics for, 2485-2486
vomiting after, 2486-2487
Anetoderma, 2542, 2543f
Aneurysm
aortic, 482-486
clinical manifestations of, 482
definition of, 482
diagnosis of, 482-483, 482f
epidemiology of, 482
pathobiology of, 482
prognosis for, 483
temporal arteritis and, 1729
treatment of, 483b
in autosomal dominant polycystic kidney
disease, 796-797
hypothalamic, 1429
in infective endocarditis, 467
intracranial, 2320-2326
fusiform, 2322
mycotic, 2322, 2375-2376
saccular, 2321-2326, 2322f
left ventricle, 267f-268f, 445-446
sinus of Valsalva, 405
visceral artery, 935
Angelman syndrome, 191-192
Angiitis, allergic. See Churg-Strauss syndrome
Angina. See also Angina pectoris;
Cardiovascular disease
echocardiography in, 282t-284t
in heart failure, 314-315
intestinal, 932
Angina (Continued)
microvascular, 424
Prinzmetals, 424
variant, 424
Angina pectoris, 246, 247t, 412-425. See also
Acute coronary syndrome;
Cardiovascular disease; Coronary heart
disease; Myocardial infarction (MI)
ambulatory electrocardiography in, 417
angiography in, 416f, 417-418, 418t
in aortic insufficiency, 461
in aortic stenosis, 455
bodily radiation of, 413-414
cardinal clinical features of, 413
chest radiography in, 417
clinical manifestations of, 413-425
computed tomographic angiography in,
417
definition of, 412-425
demand, 413
diagnosis of, 414, 415f-416f, 416t
differential diagnosis of, 418
duration of, 414
electrocardiography in, 414-417,
415f-417f, 416t
epidemiology of, 412
grading of, 412-413
laboratory testing in, 414
magnetic resonance imaging in, 417
noninvasive testing in, 414-417, 416t, 417f
nuclear imaging in, 417
pain in, 834t-836t
pathobiology of, 412-413
patient history in, 413-414, 413t-414t
physical examination in, 414
post-infarction, 444
prognosis for, 424-425
risk stratification in, 418, 419t
stress echocardiography in, 417
supply, 413
treatment of, 413, 418b-424b, 420f, 421t
angiotensin-converting enzyme
inhibitors in, 419
anticoagulants in, 419
antiplatelet agents in, 419
beta-blockers in, 419-421, 423t
calcium-channel blockers in, 419-421,
423t
enhanced external counterpulsation in,
421-422
lifestyle interventions in, 422f
lipid-lowering drugs in, 419
nitrates in, 419-421, 424t
nitroglycerin in, 414, 424t
ranolazine in, 419-421
revascularization in, 421t, 422
unstable, 246, 247t, 412. See also Acute
coronary syndrome; Myocardial
infarction (MI)
in women, 1548
Angiodysplasia, colonic, 934-937, 934f
Angioedema, 1344t. See also Urticaria
acquired, 1631-1632
in allergy, 1613
vs. anaphylaxis, 1636
definition of, 1628
diagnosis of, 1629-1633, 1630t, 1632f
hereditary, 1631-1633
pathobiology of, 1628-1629
treatment of, 1630b-1631b
visceral, 924
Angiogenesis
in cancer, 1187
inhibitors of, 166-167
Angiography
aortic, in trauma, 689, 690f
coronary, 292-294, 293f
in acute coronary syndrome, 428
in arterial anomalies, 292-294,
293f-294f
in cardiovascular disease, 255, 416f,
417-418, 418t
procedures with, 290t
in stenosis, 292, 293f
in fibromuscular dysplasia, 498, 498f
in gastrointestinal disorders, 848
in ischemic colitis, 933
Angiography (Continued)
in ischemic stroke, 2314
in neurologic disorders, 2235t
noncardiac, 294
in peripheral arterial disease, 489-490,
489f-490f
in polyarteritis nodosa, 1723, 1723f
in primary angiitis of central nervous
system, 1724
renal, 714, 784-785, 785f
in reversible cerebral vasoconstriction
syndrome, 1724-1725
in subarachnoid hemorrhage, 2321
Angiokeratoma, 1359, 1359f
Angioma. See Hemangioma
Angioplasty
coronary. See Percutaneous coronary
intervention (PCI)
in peripheral arterial disease, 491-492,
491f
Angiosarcoma
gastrointestinal, 935
pericardial, 333
Angiostrongyliasis, e366-1t, e366-3-e366-4
Angiotensin-converting enzyme (ACE), in
sarcoidosis, 584
Angiotensin-converting enzyme (ACE)
inhibitors
in chronic kidney disease, 814
in heart failure, 306f-307f, 307, 308t, 311
in hypertension, 381-384, 382t-383t
in ST segment elevation MI, 443, 446-448,
447t
in stable myocardial ischemia, 419
Angiotensin II, in chronic kidney disease,
814, 814t
Angiotensin receptor blockers
in chronic kidney disease, 814
in heart failure, 306f-307f, 307, 309t, 311
in hypertension, 381-384, 382t-383t
in ST segment elevation MI, 443
Angular cheilitis, 2452
Anhidrosis, 2393
drug-induced, 2394, 2394t
Anidulafungin, 1976
Aniline, methemoglobinemia with, 1032
Animal-related disease. See Zoonoses
Anion gap, 745
normal, 745
Anisakiasis, 2068
Ankle. See also Foot (feet)
disorders of, 1681
replacement of, 1757
sprain of, 1681
Ankle-brachial index (ABI), 487, 487f
Ankylosing spondylitis, 607, 1692-1693
clinical manifestations of, 1692-1693
diagnosis of, 1693-1696, 1693t
differential diagnosis of, 1694
epidemiology of, 1692
HLA associations in, 224-225, 225t,
1692-1696
imaging in, 1693-1694, 1693f
laboratory testing in, 1693
low back pain in, 1693
ocular manifestations of, 1693
oligoarthritis in, 1693
physical examination in, 1693
pulmonary manifestations of, 564
vs. rheumatoid arthritis, 1691t
tumor necrosis factor- inhibitors in,
165-166
uveitis in, 1693
Annelida envenomation, 699
Anomalous pulmonary venous return, 408
Anomia, 2272, 2272t
Anorectum. See Anus; Rectum
Anorexia. See also Anorexia nervosa
abdominal pain and, 833
diagnosis of, 831t-832t
in dying patient, 10t
hypothalamic, 1431
postoperative assessment of, 2488
Anorexia nervosa, 62, 1406-1407, 1407t
clinical manifestations of, 1407-1408
diagnosis of, 1408
epidemiology of, 1407
INDEX e5
Anorexia nervosa (Continued)
hypogonadism with, 1524
natural history of, 1408
pathobiology of, 1407-1409
prevention of, 1408
prognosis for, 1408
refeeding syndrome in, 1408
treatment of, 1408
weight loss with, 840t-841t
Anorgasmia, 1528
Anovulation, e244-9, e244-9t. See also
Amenorrhea
adrenal hyperfunction and, e244-11
anorexia nervosa and, e244-9
hyperprolactinemia and, e244-10
hypopituitarism and, e244-10
hypothalamic, e244-9
hypothalamic-pituitary unit failure and,
e244-10
isolated hypogonadotropic hypogonadism
and, e244-9-e244-10
luteal phase dysfunction and, e244-
11-e244-14
luteinized unruptured follicle syndrome
and, e244-11
polycystic ovary syndrome and,
e244-10-e244-14
Anserine bursitis, 1680
Antacids, diarrhea with, 908
Anterior choroidal artery, 2305, 2306f
Anterior cord syndrome, 2253, 2266
Anterior cruciate ligament tear, 26
Anterior drawer test, 26
Anterior horn cell disease. See Amyotrophic
lateral sclerosis (ALS)
Anthracyclines, dilated cardiomyopathy with,
326-327
Anthralin, 2511
Anthrax, 591, 1837-1839, 1965t-1966t
bioterrorist use of, 84-88, 84t-85t, 1837,
1839
clinical manifestations of, 1837-1838,
1838f, 1838t
cutaneous, 1837-1838, 1838f
definition of, 1837-1839
diagnosis of, 1838-1839
drug-resistant, 1839
epidemiology of, 1837
gastrointestinal, 1838
immunization against, 67t-70t, 74-75, 85,
1839
inhalational, 1837, 1838f, 1838t
meningeal, 1839, 2364
meningoencephalitic, 1838
pathobiology of, 1837
prevention of, 1839
prognosis for, 1839
treatment of, 1839b
vs. viral hemorrhagic fever, 2153t
virulence factors of, 1837
Anthropometry, upper arm, 1386, 1387t
Anti-D immunoglobulin, in idiopathic
thrombocytopenic purpura, 1128t
Anti-glomerular basement membrane
disease, 713, 768, 768f, 768t
Anti-infective therapy, 1762-1768. See also
Antibacterial agents; Antifungal agents;
Antiparasitic agents; Antiviral agents
Antiangiogenesis agents, 166-167
Antiarrhythmics, 356t-357t
heart failure and, 313
in resistant tachyarrhythmias, 347
in ST segment elevation MI, 443
in ventricular arrhythmias, 367
Antibacterial agents, 1762-1768, 1803-1815
in Acinetobacter infection, 1883b
in actinomycosis, 1969b
acute generalized exanthematous
pustulosis with, 2531, 2531f, 2535
in acute infectious diarrhea, 899-900
administration of, 1767
definitive, 1763
dosage for, 1804-1805, 1805f
empirical, 1763, 1766
formularies for, 1768
interchangeability and, 1768
monitoring of, 1767
e6 INDEX
Antibacterial agents (Continued)
Monte Carlo simulation for, 1805
route of, 1767
susceptibility testing for, 1763-1764,
1804
allergy to, 1764
aminoglycoside, 1807t-1811t, 1808-1812,
1812f, 1814t
antagonistic activity of, 1767, 1806
in anthrax, 85b, 85t, 1839b
in aspiration pneumonia, 594b
azalide, 1807t
in bacterial overgrowth, 865b-866b
bactericidal activity of, 1764, 1806
bacteriostatic vs. bactericidal, 1806, 1807t
in Bartonella infection, 1910b
in bronchiectasis, 549
in bronchitis, 587, 587b
in Campylobacter infection, 1870b
carbapenem, 1807t-1811t, 1808, 1814t
catheter coating with, e290-6
cephalosporin, 1807t-1811t, 1808, 1814t
in chancroid, 1865b
in chemotherapy-associated infection,
1776-1778, 1777f
in children, 1764-1765
in Chlamydia trachomatis infection,
e326-5b
in Chlamydophila pneumoniae infection,
e326-6b
in cholera, 1867b
classes of, 1808-1813, 1809t-1811t
clindamycin, 1812-1813
in Clostridium difficile infection, e304-2b
coexisting disease and, 1765
combination of, 1765-1767
antagonistic activity of, 1767, 1806
for empirical therapy, 1766
for polymicrobial infection, 1766
rationale for, 1765-1767
for resistance prevention, 1766, 1806
synergist benefits of, 1766-1767, 1766f
for toxicity reduction, 1766
dalfopristin, 1807t, 1813
daptomycin, 1807t-1811t, 1813
diarrhea with, 898
in diphtheria, 1834b
in diverticulitis, 922b-923b, 923t
dosage of, 1803-1805, 1805f
drug-drug interactions with, 1765
duration of, 1813
in ear infection, 2459b
in ehrlichiosis, 1961b
in Enterobacteriaceae infection, 1876b,
1876t
in Enterococcus infection, 1831b-1832b
in Erysipelothrix rhusiopathiae infection,
1841b
in Escherichia coli infection, 1873
in eye infection, 2435t
failure of, 1813-1815
formularies for, 1768
in gas gangrene, e304-3b
glycylcycline, 1807t-1811t
in gonococcal infection, e307-5b-e307-6b,
e307-5t
in granuloma inguinale, 1911b
in Haemophilus influenzae infection,
1862b-1863b
in health careassociated pneumonia, 595,
595b-596b
in Helicobacter pylori infection, 892, 892t
hepatic function and, 1765
hepatotoxicity of, 981
in hospital-acquired pneumonia,
595b-596b, 595t
in infective endocarditis, 468b-471b,
470t-471t
in inflammatory bowel disease, 918
interchangeability of, 1768
interstitial lung disease with, 558t
in intestinal bacterial overgrowth, 904b
ketolide, 1807t-1811t, 1812-1813
-lactam, 1807t-1811t, 1808, 1814t
in Legionnaires disease, 1905b-1906b,
1906t
in leprosy, 1953b-1954b
Antibacterial agents (Continued)
in leptospirosis, 1938b
lincosamide, 1809t-1811t
linezolid, 1807t-1808t, 1812-1813
in listeriosis, 1836b
after lung transplantation, 620
in Lyme disease, 1934b, 1935t
macrolide, 1807t-1811t, 1812-1813,
1814t
mechanism of action of, 1806, 1807t
in meningitis, 1854b, 2361b-2365b,
2362t-2363t
minimal inhibitory concentration of, 1804,
1805f
monitoring of, 1767
in Moraxella catarrhalis infection, 1864b
in mycetoma, 2007b
in Mycoplasma pneumoniae infection,
1916b
in nocardiosis, 1971b
in non-spore-forming anaerobic bacterial
infection, 1849b-1850b, 1850t
occupation and, 1765
in osteomyelitis, 1736b, 1736t
penicillin, 1807t-1811t, 1808, 1814t
in peritonitis, 926b, 926t
in pertussis, 1902b
pharmacodynamics of, 1767
pharmacokinetics of, 1806-1807
in pharyngitis, 2469
in plague, 1898b
in pneumonia, 591b-593b, 592t
in post-liver transplantation infection,
1010-1011
in pregnancy, 1764
prophylactic
in adult congenital heart disease, 408
in infective endocarditis, 472, 472t-473t
in Neisseria meningitidis infection,
1854-1855, 1854t, 2365
for surgery, e290-5
in urinary tract infection prevention,
1796
in prostatitis, 810b
in psittacosis, e326-6b
in pyogenic liver abscess, 989b
in Q fever, 1963b
quinolone, 1807t-1811t, 1812, 1814t
quinupristin/dalfopristin, 1807t-1811t,
1813
in relapsing fever, 1936b
renal function and, 1765
resistance to, 1762, 1803, 1805-1806,
1808t, e290-2, e290-2t-e290-3t,
e290-4f
bacterial burden and, 1805
bacterial error-prone replication and,
1805
bacterial hypermutation and, 1805
drug penetration and, 1805
efflux pump upregulation and,
1805-1806
in Enterobacteriaceae infection, 1875,
1875t
-lactamases and, 1806
mechanism of, 1806, 1808t
in pneumococcal pneumonia,
1821
porin channels and, 1806
prevention of, 1766, 1768, e290-
3-e290-4
contact isolation in, e290-4
drug cycling in, e290-4
drug stewardship in, e290-3
hand hygiene in, e290-3
hospital stay length in, e290-3
microbiologic surveillance in,
e290-3-e290-4
staffing strategies in, e290-3
in Pseudomonas infection, 1881
in Salmonella infection, 1884
in Stenotrophomonas maltophilia
infection, 1883b, 1884t
suppression of, 1806
testing for, 1763-1764
in Salmonella infection, 1886b-1887b
in scrub typhus, 1960b
Antibacterial agents (Continued)
selection of, 1764-1765, 1803-1804
culture for, 1804
Gram stain for, 1804
host factors in, 1764-1765
organism factors in, 1764
pharmacodynamics and, 1767
susceptibility testing for, 1804
in septic shock, 663-664, 664t
in shigellosis, 1890b
in sinusitis, 2457
in skin diseases, 2511
in spondyloarthropathies, 1691
in Staphylococcus aureus infection, 1819b,
1820
in Stenotrophomonas maltophilia infection,
1883b, 1884t
in Streptococcus pneumoniae infection,
1822b-1823b, 1823t
sulfonamide, 1807t-1808t, 1814t
susceptibility testing for, 1763-1764, 1804
in syphilis, e327-6b-e327-7b, e327-7t
tetracycline, 1807t-1811t, 1812-1813,
1814t
topical, 2511
toxicity of, 1813, 1814t
in trachoma, e326-2b
in tularemia, 1895b
in typhoid fever, 1887
in typhus, 1960b
in urinary tract infection, 1794b-1795b,
1795t
vancomycin, 1807t-1811t, 1813
in ventilator-associated pneumonia,
595b-596b, 595t
in women of reproductive potential, 1550t
in yersiniosis, 1900b
Antibiotics. See Antibacterial agents
Antibody (antibodies), 217. See also Immune
system; Immunoglobulin(s)
acetylcholine receptor, 2418-2420, 2419f
anticardiolipin, e177-9
antineutrophil cytoplasmic, 713, 768,
1655, 1722, 1725
antinuclear, 1653-1655, 1654t
in kidney disease, 712
in systemic lupus erythematosus, 1698,
1698f, 1703, 1703t
in systemic sclerosis, 1711
calcium channel, 2422
calcium-sensing receptor, 1597-1598
CCP, 1653
in Crohns disease, 916
in dermatomyositis, 1717
DNA, 1654
endomysial, 906
endothelial, 1722
in gastrointestinal disease, 832
gliadin peptide, 906
glomerular basement membrane, 713
HIV, 2175-2176, 2180-2181
Hu, 1193t, 1195
insulin, 1503
La, 1654-1655
in leptospirosis, 1938
monoclonal. See Monoclonal antibodies
in Mycoplasma pneumoniae infection,
1915
in paraneoplastic neurologic syndromes,
1193t, 1194
in polymyositis, 1717
rabies, 2378
red cell, 1045-1046, 1045f, 2213
RNP, 1654
Ro, 1654-1655
Saccharomyces cerevisiae, 916
in Sjgrens syndrome, 1713-1715
Sm, 1654
SOX1, 1193t, 1194-1200
streptococcal, 1827
in systemic sclerosis, 1708, 1708t
thyrotropin receptor, e233-2, e233-
6-e233-7
tissue transglutaminase, 906
VGCC, 1193t, 1194-1200
Yo, 1193t, 1195
Anticardiolipin antibody, e177-9
Anticholinergics
in asthma, 534-535
central nervous system effects of, 672t
in COPD, 541
in Parkinsons disease, 2330t-2332t
toxic ingestion of, 679t-683t
Anticoagulation, 171-177. See also
Fondaparinux; Heparin; Warfarin
in acute coronary syndrome, 430t,
431-432
antepartum, 1561b, 1561t
in atrial fibrillation, 358
in continuous venovenous hemofiltration,
820-821
in deep vein thrombosis, 502b-504b,
502t-503t, 503f
gastrointestinal complications of, 889
in hemodialysis, 818-819
perioperative, 2483, 2483t
preoperative, 2478t
side effects of, 504
in ST segment elevation MI, 438-439, 446-
448, 447f
in stable myocardial ischemia, 419
toxic ingestion of, 679t-683t
Anticonvulsants, 2291-2292, 2292t
in alcohol dependence treatment, 152t
central nervous system effects of, 672t
discontinuation of, 2293
hepatotoxicity of, 981, 983
in pain, 135-137, 136t
weight gain with, 1413t
Antidepressants, 2237b-2238b, 2239t
central nervous system effects of, 672t
in irritable bowel syndrome, 871t, 872
metabolism of, genetic factors in, 187t
in multiple sclerosis, 2353
preoperative, 2478t
in pruritus, 2502t
toxic ingestion of, 674t-677t
weight gain with, 1413t
in women of reproductive potential, 1551
Antidiarrheal agents, 912b-913b
Antidiuresis, e232-1
Antidiuretic hormone (ADH). See also
Vasopressin
syndrome of inappropriate secretion of,
730, 730t, 731f, e232-3
cancer-related, 1191-1192
drug-induced, 2495
Antidotes. See also Antitoxin; Antivenom
in acute poisoning, 679, 679t-683t
Antiemetic agents, 842b, 843t-844t
during chemotherapy, 1167-1177
in gastroparesis, 865b-866b
Antiepileptic agents. See Anticonvulsants
Antifreeze. See Ethylene glycol
Antifungal agents, 1971-1977
amphotericin B-based, 1971-1973
in aspergillosis, 1993b-1994b, 1993t
azole, 1973-1976
in blastomycosis, 1982b
in candidiasis, 1989b-1990b
in coccidioidomycosis, 1981b
combinations of, 1976-1977
in cryptococcosis, 1984b-1985b
in cutaneous infection, 2511-2512
in dematiaceous fungal infection, 2008b
echinocandin, 1976
flucytosine, 1973
in histoplasmosis, 1978b-1979b
in mucormycosis, 1997
in mycetoma, 2007b
in paracoccidioidomycosis, 1983b
prophylactic, 1990
in sporotrichosis, 1986b
Antigen-presenting cell, in allergic rhinitis,
1623
Antigen processing, 218, 218f
Antiglobulin (Coombs) test, 1048
Antihistamines
in allergic rhinitis, 1626
central nervous system effects of, 672t
in mastocytosis, 1644
in pruritus, 2512-2513, 2512t
in urticaria, 1630-1631
weight gain with, 1413t

Antihypertensive agents, 381-385, 382t-383t.
See also Hypertension
in acute severe hypertension, 387-388,
387f, 388t
in chronic kidney disease, 386-388
in diabetes, 386
drug interactions with, 384-385
estrogen replacement and, 387
in heart failure, 306f-307f
intravenous, 387-388, 388t
in ischemic heart disease, 387
in minority populations, 386
in older persons, 386
oral contraceptives and, 387
in pregnancy, 387, 1558b
in resistant hypertension, 387
selection of, 385-389, 385t, 386f
in stroke prevention, 386-387
in uncomplicated primary hypertension,
385-386, 385t
weight gain with, 1413t
Antileukotrienes, in asthma, 535
Antimalarial agents, 2016b-2017b, 2016t,
2511
Antimicrobial therapy, 1762-1768. See also
Antibacterial agents; Antifungal agents;
Antiviral agents
Antineoplastic agents. See Chemotherapy
Antineutrophil cytoplasmic antibodies, 713,
1655
in pauci-immune glomerulonephritis, 768
in rheumatic disease, 1655
in vasculitides, 1722, 1725
Antinuclear antibodies, 1653-1655, 1654t
in kidney disease, 712
pleural fluid, 609t
in systemic lupus erythematosus, 1698,
1698f, 1703, 1703t
in systemic sclerosis, 1711
Antioxidants
cancer and, 1380
coronary heart disease and, 1380
in enteral nutrition, 1392
in inflammation, 234f, 235
Antiparasitic agents, 2009-2013
in African sleeping sickness, 2020b, 2021t
in amebiasis, 2010, 2046b, 2046t
in ascariasis, 2009, 2065b, 2065t
in Chagas disease, 2012-2013,
e355-3b-e355-5b
in cryptosporidiosis, 2040b
in cutaneous infection, 2512
in echinococcosis, 2057
in enterobiasis, 2065t, 2067b
in fascioliasis, 2010, 2061t, 2063b
in filariases, e366-1t, e366-4, e366-5b
in flukes, 2010, 2063b
in giardiasis, 2042b
in helminth diseases, 2009-2010
in hookworm, 2065t, 2066b
in loiasis, 2009, e366-1t, e366-7b
in malaria, 2011-2012, 2016b-2017b,
2016t
in onchocerciasis, 2009, e366-1t,
e366-6b
in opisthorchiasis, 2061t, 2063b
in protozoal diseases, 2010-2012
in schistosomiasis, 2010, 2060b
in strongyloidiasis, 2009, 2065t, 2068b
in toxoplasmosis, 2012, e357-6b, e357-7t
in trichinellosis, e366-1t, e366-2b
in trichomoniasis, 2010, e361-4b
in trichuriasis, 2009, 2065t, 2066b
in Trypanosoma spp. diseases, 2012-2013
in visceral leishmaniasis, 2027-2028,
2027b-2028b
Antiphospholipid antibody syndrome, 715,
1655, 1702, e177-9-e177-10
hypercoagulability in, 1153
stroke and, 2317
Antiplatelet agents
in acute coronary syndrome, 430t, 431
in ischemic stroke prevention, 2319
in ST segment elevation MI, 442,
446-448
in stable myocardial ischemia, 419
Antipruritic agents, 2512-2513, 2512t
Antipsychotic agents, 2243b, 2243t
akathisia with, 2340
cardiomyopathy with, 2493
central nervous system effects of, 672t
choking with, 2493
dystonic reactions with, 2340
heart failure and, 313
hyperprolactinemia with, 2495
insulin resistance with, 2493
laryngeal dystonia with, 2493
lipid effects of, 1352, 1352t
metabolic syndrome with, 2492-2493
myocarditis with, 2493
neuroleptic malignant syndrome with,
2340, 2394, 2494, 2494t
neutropenia with, 2493-2494
serotonin syndrome with, 2494-2495
tardive dyskinesia with, 2340-2342
weight gain with, 1413t
Antipyretics, 135
Antiretroviral therapy, 2176-2177, 2186-2190
adverse effects of, 2196-2197
resistance to, 2187
Antiseizure agents. See Anticonvulsants
Antisocial personality disorder, 2245t
Antispasmodics, in irritable bowel syndrome,
871
Antistreptolysin O test, 1827
Antithrombin, 1121-1122
Antithrombin III deficiency, 1149-1153
Antithrombotic therapy, 171-177
in antiphospholipid antibody syndrome,
e177-10b
direct factor Xa inhibitors in, 174
direct thrombin inhibitors in, 173-174
fibrinolytic agents in, 176-177
guidelines for, 175t-176t
heparin in, 172-173, 173t
platelet-active drugs in, 174-176, 174f
vitamin K antagonists in, 171-172, 172f,
172t, 200-201
Antithymocyte globulin, in aplastic anemia,
1089
Antitoxin
anthrax, 1839, 1839b
botulism, e304-5b
diphtheria, 1834b, 1834t
1-Antitrypsin
deficiency of, 985-987, 986f
genetics of, 185t, 538, 985
serum, 540
stool, 912
Antituberculous agents, 1809t-1811t,
1945b-1946b, 1947t
in nontuberculous Mycobacterium spp.
infection, 1950b
Antivenom, 64t, 679t-683t
in coral snake envenomation, 696
in marine organism envenomation,
698t
in pit viper envenomation, 695-696, 696f,
696t
Antiviral agents, 2082-2089. See also specific
antiviral agents
in adenovirus infection, 2102b
adverse effects of, 2084t, 2087t
in cutaneous infection, 2512
in cytomegalovirus infection, 2112b,
2133b. See also Cytomegalovirus
(CMV) infection, treatment of
drug interactions with, 2084t, 2086t
in hepatitis virus infections, 2086-2089,
2086t-2087t
in herpes simplex virus infection,
2127b-2128b. See also Herpes
simplex virus (HSV) infection,
treatment of
in herpesvirus infections, 2082-2085,
2083t
in influenza virus infection, 2085-2086,
2085t-2086t, 2100b
mechanism of action of, 2082
in parainfluenza virus infection, 2095b
in poxvirus infections, 2121
in respiratory syncytial virus infection,
2092b
topical, 2512
INDEX e7
Antiviral agents (Continued) Aortic regurgitation (Continued)
in varicella-zoster virus infection, 2130b. physical examination in, 461
See also Varicella-zoster virus treatment of, 462b
infection, treatment of Aortic root dilation, 282t-284t
in viral hemorrhagic fevers, 2154 Aortic stenosis, 453-463, 454t
Antley-Bixler syndrome, 1515 angina in, 455
Antons syndrome, 2273, 2444-2445 bicuspid, 453
Anus, 945 clinical manifestations of, 455
abscess of, 945-949 congenital, 404
bleeding from. See Gastrointestinal diagnosis of, 455-456, 455f
bleeding, lower echocardiography in, 281, 281f, 282t-284t
cancer of, 949, 2217 epidemiology of, 453-460
fissure of, 946-949, 947f exercise and, 409t
fistula of, 946-949 heart failure and, 316, 455
warts of. See Warts, genital hemodynamics of, 291-292, 292f
Anxiety, 2236t murmur in, 253t
anticipatory, 2241 pathobiology of, 453-457
in dying patient, 10t preoperative assessment of, 2480
epidemiology of, 114 prognosis for, 456-457
pain and, 134, 138, 247t radiography in, 265f
in women of reproductive potential, rheumatic, 453
1550t syncope in, 455
Anxiety disorder(s), 2240-2241 treatment of, 456b, 456f
clinical manifestations of, 2240-2241, Aortic valve, e52-3
2241t area of, 281, 456
definition of, 2240, 2240t bicuspid, 398, 404, 453
diagnosis of, 2242 calcification of, 267
epidemiology of, 2240 radiology of, 267, 267f
generalized, 2240t, 2241 regurgitation at. See Aortic regurgitation
pathobiology of, 2240 replacement of, 456, 456f
prognosis for, 2242 stenosis of. See Aortic stenosis
treatment of, 2242b, 2242t tricuspid, 453
in women, 1551 unicuspid, 404
Anxiolytic agents, 2242b, 2242t Aortitis, in syphilis, e327-3
abuse of, 157 Aortography, 290t
Aorta Aortopulmonary window, 403
aging-related changes in, 105 Apatite-associated arthropathy, 1742, 1742f,
aneurysm of, 482-486 1742t
abdominal palpation for, 25 APC gene, 1281, 1285
clinical manifestations of, 482 APECED (autoimmune polyendocrinopathy
definition of, 482 with candidiasis and ectodermal
diagnosis of, 482-483, 482f dystrophy), 1619-1621, 1619t
epidemiology of, 482 Aphasia, 2271-2274
pain in, 834t-836t anomic, 2272, 2272t
pathobiology of, 482 Brocas, 2272, 2272t
prognosis for, 483 clinical manifestations of, 2271-2272
screening for, 53, 54t definition of, 2271
in syphilis, e327-3 diagnosis of, 2272
treatment of, 483b in frontotemporal dementia, 2282
coarctation of, 404 global, 2272, 2272t
diagnosis of, 404-405, 405f pathobiology of, 2271
hypertension with, 378t, 380 stroke and, 2272
magnetic resonance imaging in, 289, Wernickes, 2272, 2272t
289f Aphthous stomatitis, 2449, 2450f, 2470
treatment of, 405b Apical impulse, 25
cystic medial degeneration of, 482 Apixaban, 174
dissection of, 483-486 Aplasia cutis congenita, 2553
clinical manifestations of, 483-484, 484f Aplastic anemia, 1083-1090
definition of, 483, 483f acquired, 1084, 1090
diagnosis of, 484-485, 484f-485f vs. acute leukemia, 1206
echocardiography in, 282t-284t agranulocytic, 1084
magnetic resonance imaging in, 288-289 autoimmune, 1084
vs. myocardial infarction, 418 chemical-induced, 1085, 1085t
pain in, 246, 247t clinical manifestations of, 1086
pathobiology of, 483 clonal evolution in, 1090
prognosis for, 486 definition of, 1083
treatment of, 485b diagnosis of, 1087-1090, 1087f
echocardiography of, 282t-284t differential diagnosis of, 1088-1090
imaging of, 265, 282t-284t, 288-289, 289f drug-induced, 1084-1085, 1085t, 1088
Takayasus disease of, 1722-1723, e278-1f epidemiology of, 1083-1090, 1084t
Aortic arch Epstein-Barr virusrelated, 1084
anomalies of, 408 hepatitis-related, 1084
imaging of, 265 in hereditary bone marrow failure
right, 408 syndromes, 1085-1086, 1086t, 1090
Aortic insufficiency, in syphilis, e327-3 infection and, 1084, 1089
Aortic pressure, 291f, e52-5t laboratory findings in, 1087
in aortic stenosis, 292f in paroxysmal nocturnal hemoglobinuria,
in mitral stenosis, 292f 1085, 1088
Aortic regurgitation, 454t, 461 pathobiology of, 1083-1087
cardiogenic shock with, 657 pathogenesis of, 1084-1086
clinical manifestations of, 461 pathology of, 1083, 1084f
definition of, 461 pathophysiology of, 1083-1084
diagnosis of, 461-463 patient history in, 1086
echocardiography in, 281, 282t-284t physical examination in, 1086
murmur in, 253t in pregnancy, 1085
noninvasive evaluation in, 461-462, 462f prevention of, 1090
pathobiology of, 461 prognosis for, 1090
e8 INDEX
Aplastic anemia (Continued)
pure red cell, 1084-1085
radiation-induced, 1085
treatment of, 1089b
immunosuppressive therapy in, 1089
infection management in, 1089
selection of, 1087
stem cell transplantation in, 1087,
1088t, 1089, 1161
transfusions in, 1087, 1089
Apnea, 29. See also Sleep apnea
APOE gene, 2278
Apolipoprotein(s), 1346-1347, 1347t
Apolipoprotein A-IV, 1411t
Apolipoprotein E, 1347t, 1351-1352
in diabetic nephropathy, 781
Apomorphine
in erectile dysfunction, 1528
in Parkinsons disease, 2330t-2332t
Apoptosis
in cancer, 1186
in inflammation, 234-235, 234f, e47-1t
in liver, 1300
in myelodysplastic syndrome, 1200
in skin, 2501, 2501f
APP gene, 2278
Appearance, in cardiovascular disease
evaluation, 250
Appendicitis, 921-922
clinical manifestations of, 921
definition of, 921
diagnosis of, 921, 921f-922f, 921t
differential diagnosis of, 921, 921t
epidemiology of, 921
pain in, 834t-836t
pathobiology of, 921
perforation in, 921
prognosis for, 922
treatment of, 922b
vs. viral hemorrhagic fever, 2151
Appetite, 1411, 1411t-1412t. See also
Anorexia
Appetite depressants, stroke and, 2317-2318
Apraxia
dressing, 2273-2274
ideomotor, 2272
oculomotor, 2448
Aprepitant
in nausea and vomiting, 843t-844t
in pruritus, 2502t
APUDoma. See Pancreatic endocrine tumors
AquaMEPHYTON, 679t-683t
Aqueous, 2426
Arachnoid cyst, 1250-1251
Arachnoiditis, 2261-2262
Arbovirus infection, 2156-2161. See also
specific infections
central nervous system, 2161-2168,
2162t, 2366. See also Encephalitis,
arboviral
vs. viral hemorrhagic fever, 2153t
Argentine hemorrhagic fever, 2147-2156,
2148t-2149t
immunization against, 2155
Arginine, in enteral nutrition, 1392
Arginine-GHRH test, 1434t
Arginine vasopressin. See Vasopressin
Argyll Robertson pupil, 2436
Aripiprazole, 2243t
in Tourettes syndrome, 2338b
Aristolochic acid nephropathy, 774
Arm muscle thickness, 1386, 1387t
Aromatase deficiency, 1515
Aromatase inhibitors, in cancer, 1166
Arousal, disorders of, 2303
Array-based comparative genomic
hybridization, 192
Arrhythmias, 337-344. See also specific
arrhythmias
alcohol-induced, 149
ambulatory monitoring in, 342-343
clinical manifestations of, 337-344
diagnosis of, 339
echocardiography in, 344
electrocardiography in, 341-342, 342f-343f
electroencephalography in, 344
electrophysiologic studies in, 343
Arrhythmias (Continued)
event monitors in, 342-343
exercise testing in, 344
in heart failure, 302-303, 307
Holter monitors in, 342
implantable loop recorders in, 342-343
in Mycoplasma pneumoniae infection, 1915
neurologic testing in, 344
nutritional therapy and, 1391
palpitations with, 337-344, 340t
pathobiology of, e61-2f
postoperative, 2489-2490
preoperative assessment of, 2480-2481
presyncope with, 337-339
supraventricular, 348-359. See also
Bradyarrhythmias; Supraventricular
tachycardias
syncope with, 337-339, 338f, 338t-340t
ventricular, 359-368. See also Ventricular
fibrillation; Ventricular tachycardia
clinical manifestations of, 359
epidemiology of, 359
pathobiology of, 359, 359t, 360f
treatment of, 363b
types of, 361, 361f-362f
Arrhythmogenic right ventricular
cardiomyopathy, 319t-320t, 327
clinical manifestations of, 327
definition of, 327
diagnosis of, 327-328, 328t-329t
epidemiology of, 327
pathobiology of, 327
pathology of, 327
prognosis for, 329
treatment of, 329b
ventricular tachycardia in, 364-365, 365f
Arsenic
blood, 91
hair, 91
lung cancer and, 1265
toxic ingestion of, 677t, 679t-683t, 898
urinary, 91-92
Arsenic poisoning, 90-95
clinical manifestations of, 91
diagnosis of, 91-92
epidemiology of, 91
pathobiology of, 91
treatment of, 90t, 91b, 92t
Arsenic trioxide, 1168t-1176t
Artemether, in malaria, 2012, 2016t-2017t,
2017
Arterial blood gases. See Blood gases
Arterial gas embolism, 576-581
Arteriography. See Angiography
Arteriolar nephrosclerosis, hypertensive, 787
Arteriovenous fistula
murmur in, 253t
pulmonary, 403
Arteriovenous malformation
cerebral, 2322-2326, 2323t
hemolysis with, 1051t
spinal, 2268
Artery (arteries). See also specific arteries
coronary. See Coronary artery (arteries)
inflammation of. See Polyarteritis nodosa;
Takayasus arteritis; Temporal (giant
cell) arteritis; Vasculitis
oxygen content of, 627
in systemic sclerosis, 1707, 1707f
Artesunate, in malaria, 2012, 2016t-2017t,
2017
Arthritis. See also Osteoarthritis; Rheumatoid
arthritis
in acromegaly, 1749
in alkaptonuria, 1751
in autoimmune hepatitis, 1747
in cancer, 1750
carcinomatous, 1750
in celiac disease, 1748
in cystic fibrosis, 1751
in diabetes mellitus, 1749
enteropathic, 1696
definition of, 1696
diagnosis of, 1696
pathobiology of, 1696
vs. rheumatoid arthritis, 1691t
in Fabrys disease, 1751
Arthritis (Continued)
in familial Mediterranean fever, 1669
fungal, 1734
gouty, 1739, 1739f. See also Gout
in hemochromatosis, 1750-1751, 1750f
in hemoglobinopathy, 1748-1749
in hemophilia, 1748, e177-1-e177-2,
e177-2f
in hyperlipoproteinemia, 1749
in hypertrophic osteoarthropathy,
1749-1750, 1750f
in hypogammaglobulinemia, 1749
laboratory testing in, 1652-1653, 1652t,
1653f
in leukemia, 1750
Lyme, 1734, 1932, 1934
in lymphoma, 1750
in multicentric reticulohistiocytosis, 1751
in Mycoplasma hominis infection, 1734
in Mycoplasma pneumoniae infection, 1915
in older adults, 99t
in ovarian carcinoma, 1750
in Pagets disease, 1749
in pancreatic neoplasm, 1748
paraneoplastic, 1196t
in parathyroid disorders, 1749
in pigmented villonodular synovitis, 1752
in primary biliary cirrhosis, 1747
psoriatic, 1695-1696, 2518
diagnosis of, 1658f, 1695-1696, 1695f
differential diagnosis of, 1696
epidemiology of, 1695
genetics in, 1695
pathobiology of, 1695
vs. rheumatoid arthritis, 1687t, 1691t
treatment of, 165-166, 1696b
pyogenic, with pyoderma gangrenosum
and acne, 1668t, 1671-1672
reactive, 1683, 1694-1695
in Chlamydia trachomatis infection,
e326-4
definition of, 1694
diagnosis of, 1694-1695, 1695f
differential diagnosis of, 1695
epidemiology of, 1694
HIV infection and, 1695
pathobiology of, 1694
post-streptococcal, 1827
vs. rheumatoid arthritis, 1687t, 1691t
in shigellosis, 1889
in yersiniosis, 1900
in relapsing polychondritis, 1751
rheumatoid. See Rheumatoid arthritis
in sarcoidosis, 584, 1751, 1751f
septic, 1651, 1731-1733
anaerobic bacteria in, 1849
in bacterial meningitis, 2360
Candida, 1988
gonococcal, 1734-1736
Haemophilus influenzae in, 1862
nongonococcal, 1732-1733, 1732t,
1733f
Pseudomonas aeruginosa in, 1879
vs. reactive arthritis, 1695
Staphylococcus aureus in, 1817-1818
in systemic diseases, 1747-1752, 1748t
in systemic lupus erythematosus, 1699
in thyroid disorders, 1749
traumatic, 1753
tuberculous, 1734-1735
viral, 1734
in Whipples disease, 1747-1748
in X-linked agammaglobulinemia, 1618
Arthrocentesis, 1653, 1653f
in gout, 1739-1740, 1740f
in rheumatoid arthritis, 1687
in septic arthritis, 1732-1733, 1733f
Arthrodesis, 1755
Arthrography, 1658-1659
Arthrogryposis, 2419t, 2423
Arthroplasty, 1755-1756
ankle, 1757
computer navigation for, 1756
digit, 1757
elbow, 1757
hip, 1755-1756, 1755f, 1757f
implant technology in, 1756
Arthroplasty (Continued)
infection after, 1735, 1757
knee, 1756, 1757f
minimally invasive, 1756
in osteoarthritis, 1675-1676
peripheral nerve injury with, 1757
resurfacing, 1756
shoulder, 1756
spine, 1757
venous thromboembolism after, 1758
wrist, 1757
Arthropods, 2076-2081, 2076t-2077t, 2507,
2507f, 2548f. See also specific
arthropod-borne diseases
exaggerated bite reaction to, 2077, 2077f
vector, 2076t, 2077. See also Flea bite;
Mosquito bite; Tick bite
Arthroscopy, 1755
Arylsulfatase A deficiency, 1360
Asbestos bodies, 572, 573f
Asbestos exposure
benign, 572
bronchoalveolar lavage in, e85-6t
lung cancer and, 1265
pleural plaque with, 521, 521f, 572
Asbestosis, 568t, 572, 572f
epidemiology of, 567, e93-1f
pleural effusion in, 610
Ascariasis, 990t-992t, 2064-2065, 2064f
clinical manifestations of, 2064-2065
diagnosis of, 2065
epidemiology of, 2064
pancreatitis with, 938
prevention of, 2065
treatment of, 2009, 2065b, 2065t
Ascites, 954, 954f
in cirrhosis, 1001-1002, 1002f, 1004-1005
in gastrointestinal disease, 829
in heart failure, 300
in hypervolemia, 726
in liver disease, 952
malignant, 926, 926f
Asenapine, 2243t
Asian tapeworm, 2053t
Asparaginase, 1168t-1176t
Aspartate aminotransferase (AST)
in alcoholic liver disease, 997
in liver disease, 955, 961-962, 965, 965f
in nonalcoholic fatty liver disease, 998
normal, 961
Aspartylglucosaminuria, 1360
Aspergilloma, 1991, 1991f, 1994
Aspergillosis, 1990-1994
allergic, 1991-1992, 1991t
diagnosis of, 1992-1993
treatment of, 1994
alveolar, 1992
auditory canal, 1991
bronchopulmonary, allergic, 1991-1992,
1991t
bronchiectasis in, 548-549, 550f
diagnosis of, 1992-1993, 1993f
treatment of, 1994
chronic, 1991t, 1994
clinical manifestations of, 1990-1992
CNS, 1991
definition of, 1990-1994
diagnosis of, 1991f-1992f, 1992-1994
disseminated, 1991
endocardial, 1991
epidemiology of, 1990
invasive, 1990-1991, 1991t, 1992f
diagnosis of, 1992
treatment of, 1993, 1993t
prevention of, 1994
prognosis for, 1994
pulmonary, 591, 1990-1991
cavitary, 1991
chronic, 1991
necrotizing, 1991
sinus, 1991-1992
treatment of, 1975, 1993-1994, 1993t
Aspiration, 579-581
clinical manifestations of, 514t, 580
definition of, 579
diagnosis of, 580
enteral nutrition and, 1393

Aspiration (Continued)
fresh/salt water, 574-581
nosocomial infection and, e290-5
pathobiology of, 579-580
in pneumonia, 588
prevention of, 580
prognosis for, 580
treatment of, 580b
Aspiration pneumonia, 580, 593-594
clinical manifestations of, 593
diagnosis of, 593-594
epidemiology of, 593
microbiology of, 594
pathobiology of, 593
treatment of, 594b
Aspirin, 135, 168-171
in acute coronary syndrome, 430t
adverse effects of, 174
anaphylaxis with, 1634
antihypertensive interaction with, 384-385
antithrombotic action of, 170, 170t, 174
asthma and, 536
desensitization to, 1637
in ischemic stroke prevention, 2319
in kidney failure, 128t
pharmacokinetics of, 126t
preoperative, 2478t
prophylactic, 55
Reyes syndrome with, 983
in ST segment elevation MI, 438-439, 442,
446-448, 447t
in stable myocardial ischemia, 419
Assisted reproductive technologies, e244-13
Assisted suicide, 7-8, 7t
Association study, 197-199
Astemizole, 2512t
Asterixis, 955
Asthma, 531-537
acetylcholine in, 531
aspirin-exacerbated, 536
blood gas analysis in, 533
bronchiectasis in, 548
C. pneumoniae infection and,
e326-5-e326-6
chest radiography in, 533
clinical manifestations of, 532-533
vs. COPD, 540
definition of, 531
diagnosis of, 533, 533t, 1613
in pregnancy, 1562
differential diagnosis of, 533
electrocardiography in, 533
in emergency department, 536
eosinophilia in, 533
epidemiology of, 531-536
exhaled nitric oxide in, 533
genetics of, 531
heart failure and, 314-315
histamine in, 531
immunoglobulin E in, 533
irritant-induced, 569
leukotrienes in, 531-532
lipoxins in, 531-532
mediators of, 531-532
nitric oxide in, 532
occupation and, 76, 76t, 532, 567,
568t-569t, 569-574, 570f
in older adults, 99t
pathobiology of, 531-532, e47-1t
pathology of, 531
patient history in, 532
physical examination in, 532-533, 1613
physiologic changes in, 532, 532f
in pregnancy, 536, 1561-1562, e247-1f
preoperative assessment of, 2481
prognosis for, 536
pulmonary function tests in, 533, 533t,
e85-4t
respiratory failure in, 643-644
severe, 528t
sputum examination in, 533
status, 536
thoracic examination in, 532-533
treatment of, 533b-536b, 534f
-adrenergic agonists in, 534-535
anticholinergics in, 534-535
antileukotrienes in, 535
Asthma (Continued)
in aspirin-exacerbated disease, 536
control-driven, 536
corticosteroids in, 535, 535t
cromolyn sodium in, 536
in emergency department, 536
immunization in, 536
long-acting -adrenergic agonists in,
535
mepolizumab in, 535
monoclonal antibodies in, 535
omalizumab in, 535
in pregnancy, 536, e247-1f
radio frequency smooth muscle ablation
in, 536
in respiratory failure, 643-644
in status disease, 536
theophylline in, 535
vital signs in, 532
in women of reproductive potential, 1550t
work-exacerbated, 569-574
work-related, 532, 567, 568t, 570f
diagnosis of, 570f
sensitizer-induced, 567-574, 568t-569t
Astigmatism, 2428
Astrakhan fever, 1956t, 1958
Astrocytoma, 1251-1254
anaplastic, 1251
low-grade, 1251-1252
Astrovirus infection, 2145-2146, 2145t
ASXK1 gene, 1091t
Asystole, 347-348, 348f
post-shock, 371
Atacicept, 168
Ataxia, 2341-2342
alcohol-related, 2386
cerebellar, 2230t, 2341
Friedreichs, 2341-2342
in multiple sclerosis, 2349
sensory, 2230t, 2397-2398
Ataxia-telangiectasia, 1194t, 1344
Atelectasis, 550-552
definition of, 550
diagnosis of, 551, 551f
epidemiology of, 550-551
pathobiology of, 550-551
prevention of, 551b
rounded, 551, 551f
treatment of, 551b
Atelectrauma, 641
Atenolol
in alcohol dependence treatment, 152t
in hypertension, 382t
in stable myocardial ischemia, 423t
Atherosclerosis, 409-412. See also Coronary
heart disease; Myocardial infarction
(MI); Peripheral arterial disease
aging-related, 105-106
C. pneumoniae infection and, e326-5
chronic kidney disease and, 817
in diabetes mellitus type 2,
e237-12-e237-13, e237-13f
pathogenesis of, 410-411, 410f-411f,
e47-1t
plaque in
formation of, 410, 410f
rupture of, 411, 411f, 425-426, 434,
2311
progression of, 410-411
renal artery. See Renal artery stenosis
risk factors for, 409-410
stroke and, 2311. See also Stroke, ischemic
in systemic lupus erythematosus, 1701
treatment of, 411-412
Atomic bomb, 81
Atopic dermatitis, 2514-2515, 2515f, 2550f
HIV infection and, 2211
Atovaquone
in malaria, 2011, 2017
in Pneumocystis jirovecii pneumonia,
e349-4b-e349-7b, e349-6t
ATP binding cassette A1, 1347t, 1348
ATP-binding cassette transporters, 1012,
1012t
ATP6B1 gene, 802
ATP6N1B gene, 802
ATP7A gene, 1371
ATP7B gene, 1371-1372
ATR-16 syndrome, 1062
Atrax spider, 2079
Atresia
biliary, 1013
esophageal, 885
pulmonary, 403
tricuspid valve, 407-408
vaginal, 1517
Atrial fibrillation, 339, 340t, 352t, 354-355,
355f
age-related, 105-106
alcohol-related, 149
anticoagulation in, 358
in heart failure, 314-315
in hypertrophic cardiomyopathy, 323
ischemic stroke and, 2310-2311, 2319t
lone, 354-355
maze procedure in, 373
mini-maze procedure in, 373
paroxysmal, 354
post-infarction, 444
radio frequency ablation in, 372-373
treatment of, 175t-176t, 355, 357f, 358,
358t
in tropical endomyocardial fibrosis, 332
Atrial flutter, 339, 340t, 352t, 354, 354f
radio frequency ablation in, 372-373
treatment of, 355, 357-358
Atrial myxoma, 253t, 2315
Atrial natriuretic peptide (ANP), 718,
e232-2
Atrial pacemaker, wandering, 351, 351f
Atrial premature beats, 351, 351f
clinical manifestations of, 351
treatment of, 352b
Atrial septal defect, 400
diagnosis of, 400-401, 401f
epidemiology of, 398
exercise and, 409t
radiology of, 270f
treatment of, 401b
Atrial septostomy, in pulmonary
hypertension, 396
Atrial tachycardia, 339, 340t, 352-353, 352f
multifocal, 352t, 353f
treatment of, 355, 357-358
unifocal, 352t
Atrioventricular block, 349t, 350-355
causes of, 351t
clinical manifestations of, 350
diagnosis of, 350
first-degree, 339, 340t, 342, 350, 350f
high-degree, 350, 351f
post-infarction, 444-445
second-degree, 340t, 342, 350
Mobitz type I, 339, 342, 350, 350f
Mobitz type II, 342, 350, 350f
third-degree, 340t, 342, 350, 351f
treatment of, 350b
Atrioventricular canal defect, 407
Atrioventricular dissociation, 350, 352t
Atrioventricular junctional premature beats,
351, 351f
Atrioventricular junctional tachycardia, 339,
352t, 353, 353f
treatment of, 355
Atrioventricular nodal re-entrant tachycardia,
339, 340t, 352f-353f, 352t, 353
treatment of, 355, 357-358
Atrioventricular node, 272, 272f, e52-2f
Atrioventricular re-entrant tachycardia, 352f,
352t, 353-354, 354f
treatment of, 357-358
Atrium (atria), e52-2f, e52-3. See also Heart
left
enlargement of, 265-266, 266f
myxoma of, 289
radiology of, 264f
right, enlargement of, 266, 267f
Atropine, in acute poisoning, 679t-683t
Audiometry, 2462
in allergic rhinitis, 1614
AUDIT questionnaire, 150
Auditory system. See Hearing
Auer rods, 1030, 1030f, 1204
Aura, 2285
INDEX e9
Auscultation
abdominal, 833-837
cardiac, 251-252, 252f
murmurs on, 252, 253t-254t
opening snap on, 252
carotid artery, 2229
Australian funnel web spider, 2077t, 2079
Autism, 2389
Auto-PEEP, 640-641, 640f
Autoimmune disease, 227. See also Antibody
(antibodies); Hypersensitivity reaction;
Immune system and specific autoimmune
diseases
adrenal, 1467
antinuclear antibodies in, 1655
bronchiectasis in, 548
classification of, 228t
common variable immunodeficiency and,
1620
diabetes mellitus type 1 as, e236-4
endocrine dysfunction in, 1507-1508,
1508t
HLA associations with, 225, 225t
hypogonadism with, e244-9
infection and, 1775, 1775t
neutropenia in, 1103-1104
pericarditis with, 481
vertigo with, 2467
in women of reproductive potential, 1550t
Autoimmune hemolytic anemia. See
Hemolytic anemia, autoimmune
Autoimmune hepatitis, 979
Autoimmune lymphoproliferative syndrome
(ALPS), 1619-1621, 1619t
Autoimmune neuromyotonia, 2393
Autoimmune polyendocrinopathy with
candidiasis and ectodermal dystrophy
(APECED), 1619-1621, 1619t
Autoimmune polyglandular syndrome type 1,
1508-1509, 1508t, 1597
Autoimmune polyglandular syndrome type 2,
1508-1509, 1508t
Autoimmunity, 221-222
immunodeficiency and, 1616
Autoinflammatory disease, 1667-1672,
1668t
Automated external defibrillator, 346, 346t
Autonomic nervous system
cardiac effects of, e52-3-e52-4
disorders of, 2391-2396
acute, 2393
autoimmune, 2393, 2393t
bedside evaluation in, 2394-2395
blood pressure in, 2395, 2395t
brain lesions and, 2392
chronic, 2393
clinical manifestations of, 2393-2396
diagnosis of, 2394, 2395t
drug-induced, 2394, 2394t
epidemiology of, 2391
generalized, 2393-2396
in irritable bowel syndrome, 869,
e139-1f
laboratory testing in, 2395
paroxysmal, 2394
pathobiology of, 2391-2392
peripheral nerve lesions and,
2392-2393, 2392t
prognosis for, 2396
regional, 2394, 2396
spinal cord lesions and, 2392
treatment of, 2395b-2396b
Autonomy, 3-4
Avascular necrosis
in HIV infection, 2190
after liver transplantation, 1011
Avian influenza A, 589
Avoidance behavior, 2241
Avoidant personality disorder, 2245t
5-Azacytidine, 1168t-1176t
in myelodysplastic syndrome, 1202
Azalides, 1807t
Azatadine, 2512t
Azathioprine, 159t, 161-162
adverse effects of, 162t
in Behets syndrome, 1723
infection and, 162
e10 INDEX
Azathioprine (Continued)
in inflammatory bowel disease, 917, 917t
in kidney transplantation, 824f, 825,
825t
in lupus nephritis, 769-770
metabolism of, genetic factors in, 187t
in pruritus, 2502t
in systemic lupus erythematosus, 1704
Azithromycin, 1809t-1811t
Azoles, 1973-1976
Azoospermia. See Infertility, male
Azotemia
postoperative, 2490-2491
prerenal, 756-761, 757f. See also Kidney
injury, acute
Aztreonam, 1807t, 1809t-1811t
resistance to, 1808t
B Bacterial overgrowth, 904, 912t
B lymphocyte. See Lymphocyte(s), B
B19 parvovirus. See Parvovirus B19 infection
B-type natriuretic peptide, in heart failure,
302
Babesiosis, 990t-992t, e361-1
clinical manifestations of, e361-1
diagnosis of, e361-2, e361-2f
epidemiology of, e361-1
hemolysis with, 1051t
pathobiology of, e361-1
prevention of, e361-3
prognosis for, e361-3
treatment of, 2012, e361-3b
Babinskis sign, 2313
Bachmanns bundle, e52-2f
Bacillary angiomatosis, 1909-1910, 1909f,
1909t
HIV infection and, 2210, 2212-2213
Bacille Calmette-Gurin, 1947
associated immune reconstitution
inflammatory syndrome and, 2222t,
2223, 2223f
Bacillus anthracis. See Anthrax
Back injury, 690
occupation-related, 76t, 77
Back pain, 25-26, 139, 2258-2260
in ankylosing spondylitis, 1693, 1693t
assessment of, 25-26
chronic, 2260
clinical manifestations of, 2260
diagnosis of, 2260-2269, 2261t-2263t
differential diagnosis of, 2261-2262,
2263t
epidemiology of, 2259
in herniated disc, 2262t
imaging in, 2261
in osteoarthritis, 2262t
pathobiology of, 2260
prognosis for, 2263
red flags in, 2260, 2261t
referred, 2261
in scoliosis, 2262t
in spinal stenosis, 2262t
in spondylolisthesis, 2262t
in strain, 2262t
treatment of, 2262b-2263b
Baclofen, in multiple sclerosis, 2353
Bacteremia
Acinetobacter, 1882
Brucella, 1891
Campylobacter jejuni, 1869
enterococcal, 1831
Erysipelothrix rhusiopathiae, 1840
Haemophilus influenzae, 1862
hepatobiliary abnormalities in, 989
in meningitis, 2359
non-spore-forming anaerobic bacteria in,
1848
Pseudomonas aeruginosa, 1878-1880
Salmonella, 1885-1887
Staphylococcus aureus, 1816-1817, 1817t
Stenotrophomonas maltophilia, 1883
Bacteria. See also Bacteremia; Bacteriuria
genome of, 200, 1762
neutrophil killing of, 1114
disorders of, 1115, 1116t-1117t
of normal flora, 1761, 1847, 1847t, 1848f
Bacteria (Continued)
pathogenic, 1761. See also specific bacterial
infections
surveillance cultures of, e290-3-e290-4
Bacterial infection. See also Abscess; Sepsis
and specific infections
anaerobic. See Anaerobic bacteria,
non-spore-forming
bone. See Osteomyelitis
culture in. See Culture (microbe)
enteric. See Diarrhea, infectious
hospital-acquired. See Health care
associated infection
joint. See Arthritis, septic
muscle. See Myositis
pulmonary. See Pneumonia
sinus. See Sinusitis
treatment of. See Antibacterial agents
urinary tract. See Urinary tract infection
cobalamin deficiency in, 1077
Bacteriuria, 711, 1791-1792, 1792t. See also
Urinary tract infection
aging-related, 106
asymptomatic, 1792-1793
catheter-related, 1793-1794
Bacteroides fragilis infection, 1847-1851,
1850t
Bacteroides thetaiotaomicron infection,
1847-1851, 1850t
Bagassosis, 571t
Bakers cyst, 1680, 1684-1685, e272-1f
Balamuthia mandrillaris infection, 2047,
2047t
Balance
assessment of, 102-103
loss of, 2230. See also Dizziness; Vertigo
Balance training, 57
Balancing selection, 196
Balanitis, circinate, 1694-1695
Balantidium coli infection, 2010, e361-5t
Ballism, 2336, 2336t
Balloon aortic valvotomy, 456
Balsalazide, in inflammatory bowel disease,
917t
Bamboo spine, 1693-1694
Band 3, e164-1, e164-2f
Band cells, 1111, 1112f
Band heterotopia, 2387
BANK1 gene, 1697
Bannayan-Riley-Ruvalcaba syndrome. See
PTEN hamartoma syndrome
Barbiturates
abuse of, 157
central nervous system effects of, 672t
Bardet-Biedl syndrome, 796t, 800
Bariatric surgery, 1416
Barium study
in colorectal cancer, 1286t, 1287
in gastrointestinal disorders, 845, 846f
Barmah Forest virus, 2160
Baroreceptors, e232-1-e232-2
failure of, 2394
Barotrauma, 576-581, 641, 2318, 2462
Barretts esophagus, 878
cancer and, 1274
clinical manifestations of, 878
diagnosis of, 879
endoscopy in, 852, 852f, 877f, 879, 879f
epidemiology of, 878
pathobiology of, 878
prognosis for, 880
in systemic sclerosis, 1709
treatment of, 879b-880b, 879f
Bartonella bacilliformis infection, 1907-1908,
1907t-1909t, 1910
Bartonella henselae infection, 1906,
1907t-1909t, 1908, 1910, 1965t-1966t
hepatic, 995-996, 1908t-1909t, 1909-1910
Bartonella quintana infection, 1907-1908,
1907f, 1907t-1909t, 1910
Bartonella spp. infection, 1906-1911
definition of, 1906-1911
diagnosis of, 1909, 1909t
differential diagnosis of, 1910
endocardial, 468t, 1907t-1908t, 1908-1910
epidemiology of, 1907, 1907t
Bartonella spp. infection (Continued)
HIV infection and, 2210
prevention of, 1910, 2192t-2193t
prognosis for, 1910-1911
treatment of, 1910b
vasculoproliferative, 1909, 1909f
Bartters syndrome, 739, 750, 801-802, 801t,
e130-1f
Basal cell carcinoma, 26, 1332-1333
clinical manifestations of, 1333, 1333f
diagnosis of, 1333
epidemiology of, 1333
eyelid, 2431-2432, 2432f
HIV infection and, 2211
pathobiology of, 1333
prevention of, 1334
risk factors for, 1333
treatment of, 1333
Basal cell nevus syndrome, 1194t, 1333
Basal metabolic rate, 1411-1412
Basic calcium phosphate deposition, 1742,
1742f, 1742t
Basic life support, 345-346
Basilar artery, 2304f, 2305
occlusion of, 341, 2312, 2312t. See also
Stroke
Basilar artery migraine, 341
Basophil(s), 217
in allergic rhinitis, 1622-1623
corticosteroid effects on, 160
production of, e159-2f
Basophilic stippling, 1026f, 1028t
Basophilopenia, 1106
Bats, in viral hemorrhagic fever transmission,
2150
Bayes theorem, 32t, 33-34
Baylisascariasis, e366-2
Bazexs syndrome, 1196t, 1197
BCR-ABL fusion gene, 1209-1210, 1209f
Beaus lines, 2554, 2555f, 2555t
Beckers disease, 2412t, 2414
Beckers muscular dystrophy, 2413
Bedbugs, 2081, 2081f
Bee sting, 2081. See also Anaphylaxis
Beef tapeworm, 2053, 2053t
Beer potomania syndrome, 730
Behavior. See also Behavior change;
Behavioral therapy
alcohol effects on, 148t
cortical injury-related dysfunction of,
2273-2274
during sleep, 614, 2301, 2303
unhealthy, 50, 52t
Behavior change, 50-52, 55
followup-up for, 52
goals for, 50, 51t
interview for, 51-52, 52t
maintenance of, 52
model for, 50-52, 51f, 51t
plan for, 52
resistance to, 52, 52t
stages of, 50-52, 51f, 51t
Behavioral therapy
in alcohol dependence, 153
in insomnia, 2302b, 2302t
in obesity, 1415-1416
in smoking cessation, 143, 144t
in urinary incontinence, 112
Behets disease, 1668t, 1721t, 1723
colchicine in, 2511
esophageal involvement in, 884
gastrointestinal involvement in, 925, 934
HLA associations in, 1721
Bejel, 1929-1930
Belching, 838
Beliefs, patient, 178, 178t
Belimumab, 168
Bells palsy, 2408
vs. Lyme disease, 1934
Benazepril, in hypertension, 382t
Bence Jones protein, 713, 1236
Bendamustine, 1168t-1176t
Beneficence, 4
Benign epilepsy with centrotemporal spikes,
2291
Benign neonatal convulsions, 2290
Benign positional vertigo, 2465, 2468t
Benign prostatic hyperplasia (BPH),
805-810
clinical manifestations of, 806, 806f
definition of, 805
diagnosis of, 806-810
differential diagnosis of, 807
epidemiology of, 805
laboratory findings in, 807
pathobiology of, 805
physical examination in, 807
prevention of, 807
prognosis for, 808
treatment of, 807b-808b, 808t
Benign recurrent intrahepatic cholestasis,
961
Benzimidazole
in Chagas disease, e355-3-e355-4
in echinococcosis, 2057
Benzodiazepines, 2237b-2238b, 2242t
abuse of, 157
in alcohol dependence treatment, 152t
central nervous system effects of, 672t
in insomnia, 2302b
toxic ingestion of, 677t, 679t-683t
withdrawal from, 157b, 672t
Benztropine, in Parkinsons disease,
2330t-2332t
Bepridil, in stable myocardial ischemia, 423t
Beriberi, 2382, e225-2t-e225-5t
Bernard-Soulier syndrome, 1029, 1135
Beryllium
lung cancer and, 1265
poisoning with, 93-95
Beryllium disease, chronic, 567, 568t,
571-574, 572f, 572t
Best interests standard, 5-6
Beta-blockers. See -Adrenergic receptor
antagonists
Betaine, in homocystinuria, 1362b-1363b
Betamethasone, 161t. See also
Corticosteroid(s)
Betaxolol, in hypertension, 382t
Bevacizumab, 166-167, 1168t-1176t
Bexarotene, 2511
Bicalutamide, 1168t-1176t
Bicarbonate. See also Sodium bicarbonate
renal regulation of, 718-719, 719f,
742-743, 742f
serum, 745
in uric acid nephrolithiasis, 793-794
Bicipital tendinitis, 1679
Biclonal gammopathy, 1236
Biguanides, e237-7t, e237-8
Bile
bilirubin in, 957
composition of, 1011, 1012t
gallbladder storage of, 1016
post-transplantation leakage of, 1010
Bile acid(s), 1012, 1012f
malabsorption of, 866, 904, 909
secretion of, 1350
Bile acid sequestrants
in diabetes mellitus type 2, e237-7t,
e237-9
in lipid disorders, 1353t, 1354
mechanism of action of, 1350
Bile duct(s)
imaging of, 964
obstruction of, 958t, 963-964
post-transplantation stricture of, 1010
stones in, 855, 856f, 1017, 1018f
vanishing, 1015
Bile salts, 1012, 1012f, 1012t
deficiency of, 904
malabsorption of, 904, 909
Bilharziasis. See Schistosomiasis
Biliary cirrhosis, primary, 958f, 1000,
1014-1016
arthritis in, 1747
malabsorption in, 904
Biliary tract, 1011-1019. See also Bile duct(s);
Gallbladder
atresia of, 1013
endoscopy of, 855, 856f
HIV-related disease of, 2197t, 2199
tumors of, 1297t, 1302-1303, 1302f-1303f
ultrasonography of, 846
 INDEX e11
Bilirubin, 952 Bladder cancer, 1306-1309 Blood. See also Red blood cell(s); White Blood transfusion (Continued)
in autoimmune hemolytic anemia, clinical manifestations of, 1307 blood cell(s) indications for, 1155
1047-1048 cyclophosphamide and, 165 examination of. See Culture (microbe); irradiated cellular components for, 1155
in bile, 957 definition of, 1306 Peripheral blood smear leukocyte-reduced components for, 1155
decreased clearance of, 958t, 959-961. See diagnosis of, 1307 expectoration of. See Hemoptysis medical service for, 1154, 1154f
also Hyperbilirubinemia epidemiology of, 1306 glucose in. See Glucose, blood purpura with, 1131
enterohepatic circulation of, 957 metastatic, 1308 leukocyte-reduced, 1155 red cell components for, 1154-1155
excretion of, 957 muscle-invading, 1307 loss of. See Hemorrhage safety for, 1156-1157
increased production of, 958t, 959. See also pathobiology of, 1306-1307 pleural, 609t, 610 in septic shock, 663
Hyperbilirubinemia prognosis for, 1308 in stool, 832, 1035, 1286, 1286t in shock, 650-653
kinetics of, 958 staging of, 1307, 1308t transfusion of. See Blood transfusion in sickle cell disease, 1072, 1074
measurement of, 957-958 treatment of, 1307b-1308b typing of, 1155 in sideroblastic anemia, 1044
metabolism of, 956-957, 957f Bladder diary, 111, 112f universal precautions for, 2183, 2183t, in thalassemia, 1064b-1066b, 1065f
normal, 957 Bladder outlet obstruction, in benign 2503 typing for, 1155
unconjugated, 958 prostatic hyperplasia, 806-807 urinary. See Hematuria viral infection transmission with, 1157,
urinary, 963 Blastocystis hominis infection, e361-5t whole, 1154 1158f, 1158t
Binge-eating disorder, 1407-1409 Blastomycosis Blood-brain barrier, 2308 whole blood for, 1154
Bioethics, 4-9 North American, 1981-1982 Blood flow Blood urea nitrogen (BUN), 708-709
Biofeedback therapy, in constipation, 867b clinical manifestations of, in anemia, 1031 in chronic kidney disease, 813
Biologic agents, 165-168. See also 1981-1982 cerebral, 2304f, 2306-2308, 2307f-2308f, in gastrointestinal bleeding, 858
Monoclonal antibodies definition of, 1981-1982 2357 in prerenal azotemia, 759
terminology for, 165 diagnosis of, 1982 coronary, e52-3 Blood volume, arterial, effective, 721,
Biologic response modifiers, reactivation disseminated, 1981-1982 in heart failure, 297 721t
tuberculosis and, 1779 epidemiology of, 1981 pulmonary Blooms syndrome, 1194t, 1344
Biopsy. See at specific anatomic sites pathobiology of, 1981 balanced, 519 Blue bloaters, 539
Bioterrorism, 84-88 prognosis for, 1982 caudalization of, 519 Blue diaper syndrome, 1341t
anthrax, 84-88, 84t-85t pulmonary, 1981 centralization of, 519f Blue-ringed octopus envenomation, 698t,
botulism, 84t-85t, 87 treatment of, 1982b cephalization of, 519, 519f 699
brucellosis, 84t South American, 1982-1983 renal, 714 Blue rubber bleb nevus syndrome, 935
cholera, 84t clinical manifestations of, 1982-1983 Blood gases, e85-3t Bocavirus, in common cold, 2089
definition of, 84-85 definition of, 1982-1983 in acid-base disorders, 741-744, 744f, 744t Body dysmorphic disorder, 2244t
glanders, 84t diagnosis of, 1983 in acute respiratory failure, 632-633 Body mass
melioidosis, 84t epidemiology of, 1982 in asthma, 533 in adolescents, 59
plague, 84t-85t, 86-88, 591, 1896, 1899t pathobiology of, 1982 in critical care, 626 in nutritional support, 1387
planning for, 85 prognosis for, 1983 Blood pressure Body mass index (BMI), 1386, 1409t
pneumonia, 590-591 treatment of, 1983b abnormal, 27t-28t, 29 in obesity, 1409
psittacosis, 84t Blaus syndrome, 1668t, 1672 aging-related changes in, 105 in protein-energy malnutrition, 1390,
Q fever, 84t Bleeding. See also Bleeding disorders; ambulatory, 376-377, 376t, 377f 1390t
ricin toxin, 84t Hemorrhage in autonomic dysfunction, 2395, 2395t Boerhaaves syndrome, 885
shigellosis, 84t anemia with, 1034-1035 behavioral factors and, 376 Boils, 1773, 1816, 2544-2545, 2544f
smallpox, 84-88, 84t-86t esophageal. See Varix (varices), esophageal in cardiovascular risk stratification, 377, Bolivian hemorrhagic fever, 2147-2156,
tularemia, 84t, 591, 1894 gastrointestinal. See Gastrointestinal 378f 2148t-2149t
typhus, 84t bleeding cyclosporine effects on, 163-164 immunization against, 2155
vaccines for, 67t-70t, 74-75 heparin-related, 172-173 diastolic, 374, 374t, 375f Bone(s), 1578-1579. See also specific diseases
viral encephalitis, 84t uterine, e244-5-e244-8 diet and, 376 of bone
viral hemorrhagic fever, 84t-85t, 87-88, 87t warfarin-related, 172, 172t, 504 in emergency department, 388 aging-related changes in, 107
Biotin, e225-2t-e225-5t Bleeding disorders, 1121-1124. See also familial values for, 376 biology of, 1578-1580
deficiency of, 2385, e225-2t-e225-5t Coagulopathy high, 29. See also Hypertension biopsy of, in osteomalacia, 1589
Biotrauma, mechanical ventilation and, 641, evaluation of, 1122-1123, 1122t, 1123f home, 376-377 calcium in, 1576
642f in asymptomatic patient, 1123 low, 29. See also Hypotension cancer of, 1188, 1325-1327
Bipolar disorders, 840t-841t, 2238-2241, in hypercoagulable states, 1124, measurement of, 27, 53, 376-377 in chronic kidney disease, 812-814,
2240t 1124t normal, 28, 374t 817
Birt-Hogg-Dub syndrome, 1304 in preoperative patient, 1123 office, 376 enchondromatosis of, 1610
Birthmarks, 2548 laboratory testing in, 1122-1123 for physical examination, 24 fibrous dysplasia of, 1609
Bismuth poisoning, 90t, 94-95 malignancy-associated, 1199 in pregnancy, 1558 formation of, 1578-1579
Bismuth subsalicylate, in diarrhea, 899, patient history in, 1122 in shock, 647t fracture of. See Fracture(s)
912-913 physical examination in, 1122 in sickle cell disease, 1072 hereditary exostoses of, 1610
Bisoprolol platelet-associated. See Thrombocytopenia systolic, 374, 374t, 375f infarction of, 1605-1610, 1605t,
in heart failure, 310t purpuric. See Purpura target values for, 377t 1606f
in hypertension, 382t Bleeding time, 1123 white coat, 376-377 infection of. See Osteomyelitis
in stable myocardial ischemia, 423t Bleomycin, 1168t-1176t Blood transfusion, 1154-1158 ischemia of, 1605-1610, 1606f, 1651,
Bisphosphonates intralesional, 2513 acute hemolytic reaction to, 1051-1052, 1754
in cancer therapy, 1167-1177, 1327 Blepharitis, 2431, 2431f, 2434t 1156 after liver transplantation, 1011
gastric complications of, 889 Blepharospasm, 2429 acute lung injury with, 581, 1157. See also in sickle cell disease, 1071, 1073
in hypercalcemia of malignancy, 1189b, Blindness. See also at Vision, loss/ Lung injury, acute linear metaphyseal striations in,
1597b impairment of in acute respiratory failure, 633 1608-1609
in metastatic breast cancer, 1315, 1327 color, 2428 adverse reactions to, 1156, 1156t magnesium in, 1576
in osteoporosis, 1584-1585 cortical, 2273 allergic reaction to, 1157 metabolic disease of, 1576. See also
in Pagets disease, 1604b-1605b, 1605t night, 2429 in anemia, 1039 Osteomalacia; Osteoporosis
Bite. See Flea bite; Mosquito bite; Snake bite; river, 2009, e366-1t, e366-3t, in anemia of chronic disease, 1043 minerals in, 1576
Spider bite; Sting; Tick bite e366-5-e366-6, e366-6b in aplastic anemia, 1089 mixed sclerosing dystrophy of, 1609
Bivalirudin, 173-174 trachoma and, e326-2-e326-3 in autoimmune hemolytic anemia, 1049 in multiple myeloma, 1237-1238, 1238f,
in acute coronary syndrome, 430t, 432 vitamin A deficiency and, e225-2t-e225-5t bacterial contamination with, 1157 1240
in ST segment elevation MI, 442-443 Blister(s), 2525 blood availability for, 1154 necrosis of, 1605-1610, 1605t
BL22, in hairy cell leukemia, 1214b genetic disordermediated, 2529, circulatory overload with, 1157 in nutritional assessment, 1386t
Black hair, 2554 2529f CMV transmission prevention for, 1155 Pagets disease of, 1603-1605, 1604f,
Black skin, 2549, 2549f, 2549t hypersensitivity-mediated, 2526t, component storage for, 1158 1604t-1605t
Black widow spider bite, 679t-683t, 2077t, 2528-2532, 2528f crossmatching for, 1155 peak mass of, 1578-1579
2079 immune-mediated, 2525-2532, delayed reaction to, 1157 phosphate in, 1576
Bladder. See also at Urinary; Urine 2526f-2527f, 2526t dilutional thrombocytopenia with, 1131 progressive diaphyseal dysplasia of,
aging-related changes in, 106, 110 infection-mediated, 2526t, 2529-2532, errors in, 1156 1606-1610
in diabetes mellitus type 1, e236- 2529f febrile nonhemolytic reaction to, remodeling of, 1578, 1580, 1580f
15-e236-16 metabolic disorder-mediated, 2526t, 1156-1157 sarcoidosis of, 584, 585t
exstrophy of, 805 2528-2532, 2529f graft-versus-host disease with, 1157 sclerosis of, 1606, 1606t
in multiple sclerosis, 2349, 2353 Blister beetle, 2077t, 2080 guidelines for, 1155 focal, 1608-1610
neurogenic, 778, 805 BLK gene, 1697 HIV infection and, 2183 with hyperostosis, 1607-1610
stones in, 794 Bloating, 838-844 immunomodulatory effects of, 1155 spotted, 1608
e12 INDEX
Bone cancer, 1325-1327
metastatic, 1326
vs. hypercalcemia of malignancy, 1188
Bone marrow
aplasia of. See Aplastic anemia
aspiration/biopsy of
in acute leukemia, 1205-1206, 1206f
in anemia, 1034
in aplastic anemia, 1083, 1084f, 1087
in chronic myelogenous leukemia, 1210
in essential thrombocythemia, 1094f
in HIV infection, 2214
in Hodgkins lymphoma, 1229, 1229f
in mastocytosis, 1642, 1643f
in megaloblastic anemia, 1081-1082,
1082f
in multiple myeloma, 1238, 1238f
in myelodysplastic syndrome, 1201
in neutropenia, 1105, 1105f
in primary myelofibrosis, 1094f
in sideroblastic anemia, 1044, 1044f
disorders of
HIV infection and, 2212-2213
neutropenia with, 1103
fibrosis of. See Myelofibrosis
hereditary failure of, 1085-1086, 1086t
genetics of, 1086
treatment of, 1087, 1090
hypocellularity of. See Aplastic anemia
ionizing radiation injury to, 80
stimulation of, neutrophilia with, 1099
transplantation of. See Hematopoietic stem
cell transplantation
undernutrition effects on, 1389
Bone mineral density, 54, 1579, 1579f
age-related, 107, 1579, 1579f
body mass index and, 1578
decrease in. See Osteoporosis
DEXA scan for, 1549
increase in. See Hyperostosis;
Osteosclerosis
after liver transplantation, 1011
measurement of, 1582
in osteoporosis, 1577-1578, 1578f
Bone scan, in osteomalacia, 1588-1589,
1589f
Bonito poisoning, 700
BOOP (bronchiolitis obliterans organizing
pneumonia) of unknown cause. See
Cryptogenic organizing pneumonia
Borderline personality disorder, 2245t
Bordetella infection, 1900-1903. See also
Pertussis (whooping cough)
Borrelia burgdorferi, 1930-1933. See also Lyme
disease
Borrelia spp. infection. See Relapsing fever
Borreliosis, Lyme. See Lyme disease
Bortezomib, 1166-1167, 1168t-1176t
Bosentan, in pulmonary hypertension,
395-396
Bosutinib, in chronic myelogenous leukemia,
1213
Botfly, 2081
Botryomycosis, 2006-2007
Botulism, 64t, 2394, 2419t, e304-4
bioterrorist use of, 84t-85t, 87, e304-4
clinical manifestations of, e304-4
definition of, e304-4
diagnosis of, e304-4
differential diagnosis of, e304-4
epidemiology of, e304-4
food-borne, e304-4
vs. Guillain-Barr syndrome, 2402
iatrogenic, e304-4
infant, 2346, e304-4
vs. Lambert-Eaton myasthenic syndrome,
2422
vs. myasthenia gravis, 2421t
pathobiology of, e304-4
prevention of, e304-4-e304-5
prognosis for, e304-5
vs. spinal muscular atrophy type I, 2346
treatment of, e304-5b
wound, e304-4
Bouchards nodes, 1674, 1674f
Boutonneuse fever, 2153t
Bovine spongiform encephalopathy, 2381
Bowel. See Colon
Bowel habits, 828
Bowel sounds, 25
Boyles law, 576
Bradyarrhythmias, 349, 349t
clinical manifestations of, 350
diagnosis of, 339, 340t, 350
mechanisms of, 337, 339
treatment of, 347-348, 348f, 350b
Bradycardia, 29. See also Sinus bradycardia
in acute poisoning, 671
body temperature and, 1769
electrocardiography in, 342
post-infarction, 444-445
post-shock, 371
undernutrition and, 1389
Bradykinesia, in Parkinsons disease, 2327
Brain. See also at Cerebral
abscess of. See Brain abscess
aging-related changes in, 108
alcohol effects on, 147
amebic abscess of, 2045
aneurysm of, 2320-2326, 2322f,
2375-2376
autolysis of, 2309
biopsy of, in angiitis, 1724
blood flow in, 2304f, 2306-2308,
2307f-2308f
cognitive function of. See Cognition
edema of. See Cerebral edema
energy requirement of, 1412
executive function of, disorders of,
2273-2274
function of, in heart failure, 301
hemorrhage in. See Hemorrhage,
intracerebral; Stroke, hemorrhagic
hypoglycemia effects on, 1500, 1500f,
e236-12
infarction of. See Stroke
infection of. See Brain abscess;
Encephalitis; Meningitis
injury to. See Traumatic brain injury
linguistic function of. See Language
magnetic resonance imaging of, 2271f
metabolism in, 2306-2308
primary angiitis of, 1724, 1724t
reversible vasoconstriction syndrome of,
1724-1725, 1724t
reward circuits of, 141, 141f
stress effects on, 180
tumor of. See Brain tumor
undernutrition effects on, 1389
visual function of. See also Vision
cortical disorders of, 2273-2274
Brain abscess, 2371-2376
actinomycotic, 1969
clinical manifestations of, 2371-2372,
2372t
in compromised host, 1780
diagnosis of, 2372, 2372f
epidemiology of, 2371, 2371t
Mucor, 1996
nocardial, 1970, 1971f
non-spore-forming anaerobic bacteria in,
1848
pathobiology of, 2371
prognosis for, 2372-2373, 2373t
staphylococcal, 1818
toxoplasmic, 2195, e357-3-e357-4, e357-4f
treatment of, 2372b, 2373t
Brain death, 2295t, 2298, 2299t, 2309
Brain injury. See Stroke; Traumatic brain
injury
Brain natriuretic peptide, 456, e232-2
Brain stem
blood supply to, 2306, 2307f
occlusion of, 2312, 2312t, 2467
glioma of, 1251
lesions of, autonomic manifestations of,
2392
malformations of, 2387
Brain stem auditory evoked responses, 2234,
2234t, 2462
Brain tumor, 1246-1257
classification of, 1247t
clinical manifestations of, 1246-1247,
1247t, 1248f
Brain tumor (Continued) British antilewisite (BAL), 90t
computed tomography of, 1248, 1248f Brivudine, in herpes zoster, 2085
CSF analysis in, 1248 Brocas aphasia, 2272, 2272t
diagnosis of, 1248-1256, 1248f, 1248t Brodys disease, 2412t, 2415
differential diagnosis of, 1248-1249, 1249t Bromfenac, hepatotoxicity of, 981t
electroencephalography in, 1248 Bromocriptine
epidemiology of, 1246, 1247t in diabetes mellitus type 2, e237-7t,
extra-axial, 1250 e237-9
intra-axial, 1251, 1251f in hyperprolactinemia, 1439b
magnetic resonance imaging of, 1248, in Parkinsons disease, 2330t-2332t
1248f in premenstrual syndrome, e244-5
metastatic, 1252-1254, 1253f in prolactinoma, 1435
pathobiology of, 1246 Bromoderma, 2535
treatment of, 1249b-1250b, 1249t Brompheniramine, 2512t
Brainerds diarrhea, 901 Bronchial-associated lymphoid tissue,
Branched-chain -ketoacidemia, 1343t 220-221
Brazilian hemorrhagic fever, 2147-2156, Bronchial hyperresponsiveness, in COPD,
2148t-2149t 538
Brazilian purpuric fever, 1862 Bronchiectasis, 548-552
Brazilian wandering spider, 2077t, 2079 anatomic causes of, 548
BRCA1 gene, 35, 185, 1185, 1185f, 1309 in autoimmune disease, 548
BRCA2 gene, 35, 185, 1185, 1185f, 1309 vs. bronchitis, 586
Breakbone fever, 2157 clinical manifestations of, 514t, 548
Breast(s) vs. COPD, 540
benign lesions of, 1316 definition of, 548
biopsy of, 1310 diagnosis of, 548-552
cancer of. See Breast cancer epidemiology of, 548
development of, 59, 59f, e244-6, e244-6t genetics of, 548
examination of, 25 imaging of, 548-549, 549f-550f
fibrocystic disease of, 1316 in immune disease, 548
infection of, 1316, 2110 infection in, 548-549
inflammation of, 1316 pathobiology of, 548
lupus panniculitis of, 2541 prognosis for, 550
nonproliferative benign lesions of, 1316 radiography in, 518
pain in, 1310, 1316 treatment of, 549b-550b, 550t
Breast cancer, 1309-1316 Bronchioles, e85-1
alcohol and, 149 Bronchiolitis
bone metastasis in, 1189b vs. bronchitis, 586
chemoprevention of, 54t, 55 clinical manifestations of, 514t
clinical manifestations of, 1310 in COPD, 538
diagnosis of, 1310-1316, e184-2, e184-2f interstitial lung disease with, 559t, 562,
diet and, 1380-1381 562b, 562f
early-stage, 1310t-1311t Bronchiolitis obliterans, e85-1
adjuvant therapy in, 1311-1313, 1312t vs. COPD, 540-541
local treatment in, 1311 post-transplantation, e85-6t
epidemiology of, 1178, 1309-1310 unilateral (Swyer-James-McLeod
follow-up for, 1313, 1313t syndrome), 519, 552
genetics in, 185, 185t Bronchiolitis obliterans organizing
hypercalcemia with, 1188 pneumonia (BOOP) of unknown cause.
inoperable, 1313 See Cryptogenic organizing pneumonia
invasive, 1310t-1311t, 1311 Bronchioloalveolar cell carcinoma, 555
metastatic, 1161, 1310t, 1313-1315, 1314f, clinical manifestations of, 555
1327 definition of, 555
mortality from, 1549 diagnosis of, 553f, 555, 555f
nipple discharge in, 1310 pathobiology of, 552t, 555
obesity and, 1414 prognosis for, 555
oral contraceptives and, 1553 treatment of, 555b
pathobiology of, 1309-1310 Bronchitis
pregnancy and, 1315 acute, 586-587
prevention of, 1315 clinical manifestations of, 587
prognosis for, 1310-1311, 1311t definition of, 586
gene expression signature and, 201 diagnosis of, 587
risk for, 1309-1310, 1309t, 1316, 1549 epidemiology of, 586
screening for, 54, 1315-1316, 1316t pathobiology of, 586-587, 586f
staging of, 1310-1311, 1310t prognosis for, 587
supportive care in, 1315 treatment of, 587b
treatment of, 1311b-1315b, 1312t, 1314f bacteria in, 587
molecular markers in, 202t chronic, 586
trastuzumab in, 201-202, 202t, 1312 in COPD, 538. See also Chronic
triple-negative, 1310-1311 obstructive pulmonary disease
Breast milk jaundice, 959 (COPD)
Breath, shortness of. See also Dyspnea radiography in, 518
in dying patient, 10t Bronchoalveolar lavage, e85-5, e85-6t
in older adults, 106 in bronchiectasis, 549
Breath testing, 903t, 912 in diffuse alveolar hemorrhage, 554-555
Breathing. See also Dyspnea; Ventilation in HIV-infected patient, 2205-2207
apneustic, 2296 in hypersensitivity pneumonitis, 565
ataxic, 2296 in idiopathic pulmonary fibrosis, 561
in sleep apnea, 614 in interstitial lung disease, 560
work of, 628-629, 629f in Langerhans cell histiocytosis, 566
Brechenmacher fiber, 335 in Pneumocystis jirovecii pneumonia,
Brevetoxin, 700 e349-2-e349-4
Brief interventions, in smoking cessation, Bronchoconstriction, in asthma, 531-532. See
143, 144t also Asthma
Brill-Zinsser disease, 1956t Bronchodilators
Briquets syndrome, 2244t in asthma, 534-535
Bristle worm envenomation, 699 in COPD, 541, 542t
 INDEX e13
Bronchogenic carcinoma. See Lung cancer Bumetanide C5a, 243 Calcium (Continued)
Bronchogenic cyst, 551 in hypertension, 382t C5a receptor, 243 supplemental
Bronchoscopy, 617-618 in hypervolemia, 727, 727t C5a receptor antagonist, 244 in hypocalcemia, 1600b-1601b
in alveolar filling disorders, 553-554, 553f Bundle branch block C5b, 242 in malabsorption, 908t
in aspiration pneumonia, 594 electrocardiography in, 275, 275t, C cell, e233-1 in osteomalacia, 1590
in ateletasis, 551 276f-277f C-cell hyperplasia, 1601 in osteoporosis, 1583
in central airway obstruction, 617, 617f post-infarction, 444-445 C3 convertase, 241f, 242 total, 1576
in hemoptysis, 516 ST segment elevation MI and, 436-437 C5 convertase, 242 urinary, 709, 790, 1577
in HIV-infected patient, 2205-2207, 2207f Bundle branch re-entry ventricular C9 deficiency, 242 Calcium acetate, in hyperphosphatemia,
in pneumonia, 591 tachycardia, 365-368 c-kit receptor, e159-2 756b, 756t
in tuberculosis, 1945 Bundle of His, 272, 272f, 335 C-peptide, 1503t Calcium carbonate, in hyperphosphatemia,
Bronchospasm, exercise-induced, 669 Buprenorphine, 137-138, 137t C-peptide proinsulin, 1501-1503, 756t
Bronchus, 586f in opioid dependence treatment, 156 1502f Calcium-channel antagonists, 356t-357t
central obstruction of, 617, 617f Bupropion C-peptide suppression test, 1503 in acute coronary syndrome, 430t, 431
Brown-Squard syndrome, 2253, 2266 in depression, 2239t C-reactive protein, 217 in hypertension, 382t-383t, 384
Brown spider, 2077t, 2079, 2079f in smoking cessation, 144t, 145 in cardiovascular disease, 258, 414 in pulmonary hypertension, 395, 396f
Browns syndrome, 1686 Burkholderia cenocepacia infection, 1881 in rheumatic disease, 1652 in Raynauds phenomenon, 496b
Brucellosis, 84t, 995-996, 1891-1893 Burkholderia pseudomallei infection, 1881 in ST segment elevation MI, 437 in ST segment elevation MI, 444, 446-448
acute, 1892, 1892t Burkitts lymphoma, 1219t, 1222t, 1225, C-type lectin receptors (CD159), 215 in stable myocardial ischemia, 419-421,
in animals, 1891 2135 CA-19-9 420f, 423t
chronic, 1892, 1892t Burn injury, 691 in cholangiocarcinoma, 1302 toxic ingestion of, 674t-676t, 679t-683t
clinical manifestations of, 1892, 1892t Acinetobacter infection with, 1882 in pancreatic cancer, 1291 in ventricular arrhythmias, 367
culture in, 1892 airway management in, 692 Cabergoline Calcium channelopathy, 2415
definition of, 1891 anabolic agents in, 693 in hyperprolactinemia, 1439b Calcium chloride, in acute poisoning,
diagnosis of, 1892-1893 antithrombotic therapy in, 175t-176t in Parkinsons disease, 2330t-2332t 679t-683t
endocardial, 468t assessment of, 692, 692f in prolactinoma, 1435 Calcium disodium ethylenediaminetetraacetic
epidemiology of, 1891 carbon monoxide toxicity with, 691-692, Cachexia, 1385 acid (CaNa2EDTA), in lead poisoning,
immune response to, 1891-1892 691t cancer-related, 1199-1200 89b, 90t, 679t-683t
localized, 1892, 1892t electric current, 684-687, 685f-686f cardiac, 301 Calcium gluconate
meningeal, 2364 epidemiology of, 691 in dying patient, 10t in acute poisoning, 679t-683t
pathobiology of, 1891-1892 hemolysis with, 1051t CADASIL (cerebral autosomal dominant in hyperkalemia, 740-741
in pregnancy, 1891 hypermetabolic-sepsis phase of, 693 arteriopathy with subcortical infarcts in resistant tachyarrhythmias, 347
prevention of, 1893 hypermetabolic state in, 693 and leukoencephalopathy), 2279-2280, Calcium ion channel
prognosis for, 1893 infection in, 693, 693t 2318 antibodies to, 1193t, 1194-1200
relapsing, 1892, 1892t infraglottic injury with, 691t, 692 Cadmium cardiac, e52-1, e52-2f
standard tube agglutination test in, lightning, 686, 687f lung cancer and, 1265 disorders of, 2415
1892-1893 nutritional support in, 693 poisoning with, 92-95 Calcium pyrophosphate dihydrate (CPPD)
subacute, 1892, 1892t pathobiology of, 691 renal toxicity of, 775 deposition disease, 1741-1742
subclinical, 1892, 1892t postresuscitation phase of, 692 Caf-au-lait spots, in McCune-Albright clinical manifestations of, 1741, 1742f
treatment of, 1893b, 1893t Pseudomonas aeruginosa infection with, syndrome, 1609, 1609f definition of, 1741
Brugadas syndrome, 336-337, 365f, 366t, 1879-1881 CAGE questionnaire, 150, 150t diagnosis of, 1740f, 1741
367 resuscitation phase of, 691-692 Caisson disease, 2318 epidemiology of, 1741, 1741f
Brugia malayi infection, e366-3-e366-4, shock with, 692 Cajal, interstitial cells of, 862 pathobiology of, 1741
e366-3t size of, 692, 692f Calciferol. See Vitamin D vs. rheumatoid arthritis, 1687t
treatment of, 2009, e366-1t, e366-5b smoke inhalation injury with, 577-581, Calcification(s) treatment of, 1741b
Brugia timori infection, e366-3t, e366-4 691-692, 691t in apatite-associated arthropathy, 1742 Calcium-sensing receptor, 1597-1598
treatment of, 2009, e366-1t, e366-5b supraglottic injury with, 691t, 692 coronary artery, 268, 286, 286f-287f Calculi
Bruits treatment of, 691b-693b, 692f in kidney disease, 813-814 bile duct, 855, 856f, 1017, 1018f
abdominal, 25 water loss in, 692 metastatic, 1742 bladder, 794
carotid, 24 Bursae, 1677, 1677f myocardial, 267-268, 268f gallbladder. See Cholelithiasis
Bruns nystagmus, 2448 aspiration of, 1731 pericardial, 267-268, 268f, 479 renal. See Nephrolithiasis
BSND gene, 801-802 Bursitis, 1676-1681, 1676t-1677t in pleural plaque, 521, 521f California encephalitis, 2162t, 2168
BTK gene, 1618 anserine, 1680 in systemic sclerosis, 1708-1709 Caloric test, 2467-2468
Buboes iliopsoas, 1680 Calcinosis, tumoral, 1742 Calories, in parenteral nutrition, 1394-1395
in lymphogranuloma venereum, e326-4 ischial, 1680 Calcipotriol, 2511 Calorimetry, indirect, 628
in plague, 1897, 1897f ischiogluteal, 1680 Calcitonin CAM. See Complementary and alternative
Budd-Chiari syndrome, 935-936, 936f olecranon, 1679 aging-related changes in, 107 medicine (CAM)
Buddhism, 179 prepatellar, 1680 in hypercalcemia of malignancy, 1189b CAM-ICU assessment, in delirium, 119
Budesonide retrocalcaneal, 1681 in medullary thyroid cancer, 1601 Camerons ulcer, 886, 889
in COPD, 542t septic, 1731-1736 in osteoporosis, 1585 Campylobacter fetus infection, 1870
in inflammatory bowel disease, 917t treatment of, 1677b serum, 1602 Campylobacter hyointestinalis infection, 1870
in pregnancy, 1562b-1563b trochanteric, 1680, 1680f Calcitriol Campylobacter infection, 1868-1871
Buergers disease, 494-495, 1724 Buschke-Ollendorff syndrome, 1608, in hypercalcemia of malignancy, 1188 clinical manifestations of, 1869-1870,
clinical manifestations of, 494, 495f 2537-2538 in hypocalcemia, 1600-1601 1869t
definition of, 494 Busulfan in osteomalacia, 1590, 1590t definition of, 1868-1870
diagnosis of, 494-495 in essential thrombocythemia, 1095-1096 in renal osteodystrophy, 813, 817 diagnosis of, 1789-1790, 1870
epidemiology of, 494 hepatotoxicity of, 984 Calcium differential diagnosis of, 1870
gastrointestinal involvement in, 934 1,4-Butanediol, toxic ingestion of, 674t-676t deficiency of. See Hypocalcemia epidemiology of, 1868-1869
pathobiology of, 494 Butorphanol, 137-138 dietary pathobiology of, 1869
treatment of, 495b Butterfly rash, 1699, 1699f absorption of, 905, 1576 prevention of, 1870
Buffalopox, 2119-2120 Buttocks examination, in trauma, 691 guidelines for, 1383t treatment of, 1870b
Bufodienolides, toxicity of, 674t-676t, -Butyrolactone, toxic ingestion of, 674t-676t nephrolithiasis and, 789, 793 Campylobacter jejuni infection, 1868-1871,
679t-683t Bylers disease, 1012t osteoporosis and, 1381 1965t
Bulimia, 840t-841t excess of. See Hypercalcemia clinical manifestations of, 1869-1870,
Bulimia nervosa, 62, 1407, 1407t homeostasis of, 1576-1577, 1591-1593, 1869t
clinical manifestations of, 1407-1408 C 1593f definition of, 1868-1870
diagnosis of, 1408 C1 inhibitor parathyroid hormone in, 1591-1592, diagnosis of, 1870
epidemiology of, 1407 deficiency of, 1631-1633 1592f differential diagnosis of, 1870
natural history of, 1408 therapeutic, 1631 parathyroid hormone-related protein in, epidemiology of, 1868-1869
pathobiology of, 1407-1409 C3, 241-242, 241f 1593 in HIV-positive patient, 1870
prevention of, 1408 C3a, 243 vitamin D in, 1592-1593 lymphoma and, 1219
prognosis for, 1408 C3a receptor, 243 metabolism of, 1591-1600, 1593f pathobiology of, 1869
treatment of, 1408 C3a receptor antagonist, 244 in sarcoidosis, 584 in pregnant patient, 1870
Bullectomy, 618 C4a, 243 renal handling of, 719f, 720, 1577 prevention of, 1870
Bullous pemphigoid, 2525-2532, 2526f C5 selective arterial injection test with, prognosis for, 1870
Bullying, 60 deficiency of, 243-244 1504 treatment of, 1870b
Bumble bee sting, 2081. See also Anaphylaxis monoclonal antibody to, 243-244 serum, 1576, 1599-1600 Campylobacter lari infection, 1870
e14 INDEX
Campylobacter upsaliensis infection, 1870 Cancer (Continued) Cancer (Continued) Candidiasis (Continued)
Camurati-Engelmann disease, 1606-1610 hematopoietic stem cell transplantation in, thrombocytosis with, 1198 ophthalmic, 1988-1990
Canadian C-Spine Rule, 2255, 2255f 1161 thyroid, 1601-1603 oropharyngeal, 1987, 1989-1990, 2470
Canakimumab, 166 hereditary syndromes of, e184-1 tobacco and, 1180 osteoarticular, 1988-1990
Canavans disease, 185t, 2355 tumor suppressor genes in, 1185t, 1186 treatment of, 1164b-1177b pathobiology of, 1987
Cancer, 1164-1177. See also specific sites and HIV-related, 2214. See also Kaposis bone marrow transplantation in, 1167 peritoneal, 1988-1990
types of cancer sarcoma chemotherapy in, 1165-1167, 1165t, pharyngeal, 2470
absolute survival in, 1177 human chorionic gonadotropin 1168t-1176t, 1187 prevention of, 1990, 2192t-2193t
ACTH secretion in, 1189-1192 production with, 1190-1192 DNA vaccines in, 210 prognosis for, 1990
in adolescents, 60 hypercalcemia in, 1188-1192, 1189f, gene therapy in, 210 retinal, 1988f, 1989-1990
age and, 1179, 1180f 1596-1597 genetics in, e184-3 treatment of, 1975, 1989b-1990b
alcohol and, 149 hypercoagulable state with, 1152 hormonal therapy in, 1166, 1166t urinary tract, 1988-1990
ampulla of Vater, 1019 hypertension with, 1191 immunotherapy in, 1166, 1166t vulvovaginal, 1798-1799, 1987, 1989-1990
anemia with, 1198 hyperthermia treatment in, 669-670 monoclonal antibodies in, 1166-1167, Canker sores, 2449, 2450f
arsenic exposure and, 91 hypoglycemia with, 1191-1192 1166t Cannabinoid(s)
arthritis in, 1750 incidence of, 1177, 1179f in older adults, 1167 abuse of, 157
ascites with, 926, 926f infection with, 1180, 1774, 1775t-1776t, pain management in, 1167-1177, 1177f in pain, 136t
azathioprine and, 162 1776-1778, 1777f performance scale in, 1165t Cannabinoid antagonists, 145-146
biliary tract, 1302-1303 infectious agents and, 1180, 1181t pharmacogenomics in, 202t Cannon a waves, 355
biology of, 1184-1187, e47-1t insulin-like growth factor type II in, 1191 plan for, 1164 Capecitabine, 1168t-1176t
angiogenesis in, 1187 ischemic stroke and, 2316 in pregnancy, 1167 Capillaria hepatica infection, 990t-992t
apoptosis in, 1186 kidney, 1303-1309 radiation therapy in, 1164-1165 Capillaria philippinensis infection, 2065t,
drug resistance in, 1187 leukocytosis with, 1198 RNA interference in, 210 2068
energy metabolism in, 1186-1187 liver, 1300-1303 stem cell transplantation in, 1167 Capillaritis, pulmonary, idiopathic, 566
epigenetic changes in, 1186 after liver transplantation, 1011 supportive care in, 1167 Capillary leak syndrome, 1636-1637
immune evasion in, 1187 lung, 1264-1272 surgery in, 1164 Caplans syndrome, 573
multistage, 1184-1185, e184-1 lymphadenopathy in, 1107-1108 symptom management in, 1167-1177, Capnometry, 627, 627f
mutation in, 1184, 1185f, 1185t MASCC score in, 1776, 1776t 1177f Capsaicin, topical, 136t, 2502t, 2512
proteasomes in, 1187 medical resequencing study in, 199 targeted agents in, 1166-1167, 1166t Captopril
signal transduction in, 1185-1186, metastatic. See also Cancer of unknown tumor-specific proteins in, 210 in heart failure, 308t
1186f primary origin virotherapy in, 209 in hypertension, 382t
telomerase in, 1186 bone, 1188, 1326, 1581 tumor emboli in, 603 Caput medusae, 954, 954f
tumor suppressor genes in, 1185t, 1186 brain, 1252-1254, 1253f of unknown primary origin, 1334-1337 Carbamates
ubiquitinylation in, 1187 gastric, 1278 ureteral, 1308-1309 central nervous system effects of, 672t
bladder, 1306-1309 leptomeningeal, 1253, 1253f vaginal, 1320 toxic ingestion of, 674t-676t, 679t-683t
bone, 1325-1327 myocardial, 333 vasculitic neuropathy with, 2404 Carbamazepine, 2292t
breast, 1309-1316 orbital, 2442 vulvar, 1320 in alcohol dependence treatment, 152t
cachexia and, 1199-1200 spinal, 1254, 2269 weight loss with, 840t-841t in bipolar disorder, 2238b
celiac disease and, 907 molecular genetics of, 1184-1187 in women, 1549 in kidney failure, 128t
cervical, 1317 neutrophilia with, 1099 Cancer of unknown primary origin, in pain, 136t
cigarette smoking and, 1180 nickel exposure and, 93 1334-1337 pharmacokinetics of, 126t
cumulative incidence of, 1177-1178 non-neoplastic syndromes in, 1192-1200, biopsy in, 1334-1335 toxic ingestion of, 677t
cyclophosphamide and, 165 1192t-1194t. See also Paraneoplastic definition of, 1334 Carbapenems, 1807t, 1809t-1811t
cyclosporine and, 164 syndromes diagnosis of, 1334-1335, 1335t adverse effects of, 1814t
death from, 1177, 1179f obesity and, 1180 epidemiology of, 1334 resistance to, 1808t, 1875, 1875t
deep vein thrombosis with, 1198-1200 occupational exposures and, 76t, 77, 568t, treatment of, 1335b-1337b, 1336t Carbohydrate(s)
demographic factors in, 1179-1180, 1180f 574, 1181t, 1182 anaplastic lymphoma and, 1336 colonic bacterial fermentation of, 838
dermatomyositis and, 1718 ocular, 2441-2442 axillary lymph node metastases and, consumption guidelines for, 1382t-1383t
development of, 1184-1185, 1185f-1186f, in older adults, 99t 1335 in diabetes mellitus, 1381
e184-1 osteomalacia with, 1191, 1197 cervical adenopathy and, 1336 digestion of, 901, 902f
diagnosis of, 1164 osteopetrosis with, 1608 chemotherapy in, 1337 metabolism of, 1499-1501
in familial syndromes, e184-1-e184-2, pancreatic, 1289-1292 colon cancer profile and, 1336 disorders of, 2415
e184-2f peripheral neuropathy in, 2404-2405 extragonadal germ cell cancer syndrome in parenteral nutrition, 1395-1396, 1395t
molecular, 200t physical inactivity and, 1180 and, 1336 rapid intestinal transit of, 909
whole-genome RNA expression study pleural effusion in, 610 inguinal adenopathy and, 1336 unabsorbable, 908
in, 201, 201t polymyositis and, 1718 neuroendocrine carcinoma and, Carbohydrate loading, in acute intermittent
diarrhea and, 898 post-transplantation, 621, 1011, 1162 1336-1337 porphyria, 1366b-1367b
diet and, 1180, 1380-1381, 1381t, 1383t, posterior reversible encephalopathy in, peritoneal carcinomatosis and, 1335 Carbon dioxide
e225-9 1780 prostate-specific antigen elevation and, partial pressure of, 627, 627f
disseminated intravascular coagulation during pregnancy, 1167 1335 in acute respiratory failure, 631
with, 1146 prolactin production with, 1191-1192 single metastatic lesion and, 1335-1336 in critical care, 626
endocrine manifestations of, 1187-1192, prostate, 1322-1325 Candesartan end-tidal, 627, 627f
1188t race and, 1180 in heart failure, 309t transcutaneous, 627
endometrial, 1318 radiation-induced, 81, 81t, 1180-1181, in hypertension, 382t production of, 628
epidemiology of, 1177-1182 1181t Candidemia, 1987-1989 pulmonary elimination of, 741-742
causation in, 1178, 1180-1182, 1181t recombinant erythropoietin in, Candidiasis, 1986-1990 Carbon monoxide
demographic, 1179-1180 e159-3-e159-4 blood stream, 1987-1989 diffusion capacity for, e85-3t, e85-5
geographic, 1178, e183-1t recombinant granulocyte colony- clinical manifestations of, 1987-1990 poisoning with, 577-581, 679t-683t,
incidence in, 1177-1178, 1179f stimulating factor in, e159-4 definition of, 1986-1990 691-692, 691t
temporal, 1178-1179 relative survival in, 1177, 1179 diagnosis of, 1989 Carbon tetrachloride poisoning, 679t-683t
epigenetic changes in, 199-200 renal, 1303-1309 disseminated, 1987-1989, 1988f Carbonic anhydrase, 743
erythropoietin therapy in, 1043 renal pelvis, 1308-1309 endocardial, 1988 Carbonic anhydrase II deficiency, 801t-802t
esophageal, 1272-1278 screening for, 1178-1179 epidemiology of, 1986-1987 Carboplatin, 1168t-1176t
ethnicity and, 1180 sensorimotor neuropathy with, 2404 esophageal, 884, 885f, 1987, 2198 Carboxyhemoglobin, 677t
fever and, 1199-1200, 1772, 1772t, 1774, sex and, 1179, 1180f focal, 1988-1990 Carbuncle, 1816
1775t small intestine, 1278-1287 hepatosplenic, 989-996, 1988, 1988f Carcinoembryonic antigen (CEA)
gallbladder, 1019 socioeconomic status and, 1180 HIV infection and, 1987, 2192t-2193t, in medullary thyroid cancer, 1601
gastric, 1274-1275 splenomegaly in, 1109-1110 2198, 2210 in pancreatic cancer, 1291
gene expression signature in, 201, 201t staging of, 1164 meningeal, 1988-1989 Carcinoid crisis, 1510
genetics of, e184-1-e184-3 stem cells in, 1187 mucocutaneous, 1987, 1987f-1988f, 2451, Carcinoid syndrome, 1509-1511
geographic variation in, 1178 subacute sensory neuropathy with, 2508-2509, 2508f vs. anaphylaxis, 1636
growth hormone production with, 2404-2405 in autoimmune polyglandular syndrome cardiac manifestations of, 332-333, 1510
1191-1192 survival in, 1177, 1178t type 1, 1508, 1508t clinical manifestations of, 514t, 1510
head and neck, 1257-1264 syndrome of inappropriate antidiuretic chronic, 1987 desmoplastic reaction of, 1510
hematologic syndromes with, 1191 hormone secretion with, 1191-1192 vs. hairy leukoplakia, 2135-2136 diagnosis of, 1510
after hematopoietic stem cell temporal variation in, 1178-1179, 1179f treatment of, 1989 differential diagnosis of, 1510
transplantation, 1162 testicular, 1321-1322 in neutropenic host, 1779, 1987 gastrointestinal symptoms of, 1510

Carcinoid syndrome (Continued)
in pancreatic endocrine tumors, 1293t,
1297
pellagra of, 1510
prognosis for, 1511
pulmonary manifestations in, 1510
telangiectasia of, 1510
treatment of, 1510b-1511b
variants of, 1510
vasodilator paroxysms of, 1510
Carcinoid tumor, 1509-1511. See also
Carcinoid syndrome
bronchial, 1271
clinical manifestations of, 1510
flushing with, 1509
histamine of, 1509
large intestine, 1280
pathobiology of, 1509-1511
serotonin of, 1509-1510
small intestine, 1278-1279
tachykinins of, 1509
Carcinomatosis
lymphangitic, 514t
peritoneal, 926, 926t, 1335
Carcinomatous polyarthritis, 1750
Carcinosarcoma, uterine, 1318
Cardenolides, toxic ingestion of, 674t-676t
Cardiac. See also at Coronary; Heart;
Myocardial
Cardiac arrest, 344-348
adjunctive therapy in, 348
anoxic encephalopathy in, 2309
bradyarrhythmic, 347-348, 348f
long-term management after, 348
management of, 345-346
advanced cardiac life support in, 346,
347f
automated external defibrillator in, 346,
346t
basic life support in, 345-346
mechanisms of, 344. See also Ventricular
fibrillation; Ventricular tachycardia
tachyarrhythmic, 344-345, 346t, 347, 347f
warning symptoms of, 344
Cardiac catheterization, 289-295
in aortic regurgitation, 454t
in aortic stenosis, 454t, 456
in cardiogenic shock, 655-656
in cardiovascular disease, 255
complications of, 290-291, 291t
contraindications to, 290t
in dilated cardiomyopathy, 326
hemodynamic data on, 291-292, 291f
indications for, 289-290, 290t
in mitral regurgitation, 454t
in mitral stenosis, 454t, 457
in myocarditis, 325
in pericardial constriction, 480
post-infarction, 446
in pulmonary hypertension, 395
in restrictive cardiomyopathy, 330, 330f
setup for, e57-1f
technique of, 290
transseptal, 294
in valvular heart disease, 291-292, 292f
Cardiac cycle, 265, e52-5-e52-6, e52-5f
Cardiac glycosides, toxic ingestion of,
674t-676t, 679t-683t
Cardiac index, e52-5t
undernutrition and, 1389
Cardiac output, e52-6
in acute respiratory failure, 633
Cardiac pressures, 291-292, 291f
in valvular disease, 291-292, 291f-292f
Cardiac resynchronization therapy, in heart
failure, 306f-307f, 315
Cardiac risk assessment, 2477-2481, 2479f
aortic stenosis and, 2480
arrhythmias and, 2480-2481
echocardiography in, 2479
exercise testing in, 2479
heart failure and, 2480
hypertension and, 2480
patient history in, 2477
pharmacologic stress testing in, 2479,
2480t
physical examination in, 2477
Cardiac risk assessment (Continued)
procedure risk and, 2479
risk indices in, 2477-2479, 2479t
risk reduction strategies and, 2480,
2481t-2482t
Cardiac tamponade, 477
echocardiography of, 477-478, 478f
electrocardiography of, 477-478, 477f
trauma-related, 688
treatment of, 478-479, 478f-479f
Cardiac transplantation. See Heart
transplantation
Cardiac veins, 270-271, 271f
Cardiogenic shock. See Shock, cardiogenic
Cardiomyocytes, e52-1-e52-2, e52-3f
Cardiomyopathy, 318-333
alcoholic, 148-149
antipsychotic-induced, 2493
arrhythmogenic right ventricular,
319t-320t, 327
clinical manifestations of, 327
definition of, 327
diagnosis of, 327-328, 328t
differential diagnosis of, 328-329,
329t
epidemiology of, 327
pathobiology of, 327
pathology of, 327
prognosis for, 329
treatment of, 329b
cirrhotic, 1001-1002
dilated, 319f, 319t, 325
acquired, 325
alcoholic, 326
chemotherapy-related, 326-327
clinical manifestations of, 325-326
definition of, 325
diagnosis of, 326, 326t
endocrine, 327
epidemiology of, 325
family evaluation in, 326
genetics of, 297, 320t, 325
metabolic, 327
nonischemic, 316
ventricular tachycardia in, 364
pathobiology of, 325
peripartum, 327
prognosis for, 326
vs. restrictive cardiomyopathy, 327
treatment of, 326b
echocardiography in, 282t-284t
genetics of, 185t, 297, 320t, 325
after hematopoietic stem cell
transplantation, 1161
hypertrophic, 318-333, 319f, 319t
atrial fibrillation in, 323
cardiogenic shock with, 657
clinical manifestations of, 321
definition of, 318
diagnosis of, 321-333, 322f, 322t
family evaluation in, 322
genetics of, 320t
heart failure in, 316
medical therapy in, 322-323
pathobiology of, 318-319
pathology of, 319-321
pathophysiology of, 321
prognosis for, 324
sudden death in, 323
surgery in, 323
treatment of, 322b-323b, 323f
ischemic stroke and, 2311
left ventricular noncompaction, 331
magnetic resonance imaging in, 287-288,
288f
restrictive, 319f, 319t, 329-333
in amyloidosis, 330-333, 330f
clinical manifestations of, 329
definition of, 329
diagnosis of, 329-330, 330f
epidemiology of, 329
in hereditary hemochromatosis, 331
pathobiology of, 329, 329t
vs. pericardial constriction, 480t
prognosis for, 330
in sarcoidosis, 330
treatment of, 330b
Cardiomyopathy (Continued)
Takotsubo, 331, 657
trastuzumab and, 167
Cardiopulmonary arrest. See also Cardiac
arrest; Sudden death
in electric injury, 685, 686b
in lightning injury, 686-687
Cardiopulmonary resuscitation, 345-346
advanced cardiac life support in, 346, 347f
automated external defibrillator in, 346,
346t
basic life support in, 345-346
Cardiothoracic ratio, 265, 265f
Cardiotomy, pericarditis after, 480
Cardiovascular disease. See also Coronary
heart disease; Myocardial infarction
(MI)
arsenic exposure and, 91
biomarkers of, 258
costs of, 256
definition of, 256
epidemiology of, 256-260, 434
evaluation of, 246-255, 248f
abdominal examination in, 252
ambulatory electrocardiography in, 246,
249t, 255
appearance in, 250
auscultation in, 251-252, 252f,
253t-254t
cardiac catheterization in, 255
cardiac inspection in, 250-251
carotid pulse in, 250, 251f
chest pain in, 246, 247t. See also Angina
pectoris
claudication in, 249-250
clubbing in, 253, 255f
computed tomography in, 286-287,
286f-287f
cough in, 249-250
cyanosis in, 253, 255f
disability assessment in, 249t
dyspnea in, 246
echocardiography in, 249t, 255. See also
Echocardiography
edema in, 253, 254f
electrocardiography in. See
Electrocardiography (ECG)
electrophysiologic study in, 249t
exercise testing in, 246, 248t, 255
extremity examination in, 252-253
fatigue in, 249-250
jugular vein examination in, 250,
250f-251f, 251t
laboratory studies in, 253-255
magnetic resonance imaging in,
287-289, 288f
medical history in, 250
myocardial perfusion imaging in,
284-286, 285f
ophthalmologic examination in, 250
palpation in, 250-251
palpitations in, 246-249, 249t
patient history in, 246-250, 247t
PET in, 285-286
physical examination in, 250-255
skin examination in, 253, 255f
social history in, 250
SPECT in, 285-286
weakness in, 249-250
gene therapy in, 210
genetics in, 200t, 258
hemodialysis and, 820
hospitalization rates for, 256
incidence of, 256
mortality rate for, 256, 256f
in older adults, 99t
preoperative assessment of. See Cardiac
risk assessment
prevention of, 256
risk factors for, 256-258, 257t
age as, 256
alcohol use as, 258
cigarette smoking as, 257
diabetes mellitus as, 257
dyslipidemia as, 257
ethnicity as, 257
family history as, 258
INDEX e15
Cardiovascular disease (Continued)
fibrinolytic factors as, 258
gender as, 257
genetic factors as, 258
homocysteine as, 258
hypertension as, 257
individual, 256-258, 257t
infection as, 258
inflammation as, 258
kidney disease as, 258
left ventricular hypertrophy as,
258
obesity as, 257
physical inactivity as, 257-258
psychological factors as, 258
race as, 257
socioeconomic status as, 258
thrombotic factors as, 258
risk prediction for, 258, 259t-260t
blood pressure in, 377, 378f
subclinical, 98
in women, 1548
worldwide impact of, 256
Cardiovascular system. See also Heart
aging-related changes in, 105
alcohol effects on, 147-149, 148t
corticosteroid effects on, 161
in diabetes mellitus type 1, e236-15
disease of. See Cardiovascular disease
in endocrine disorders, 1421
NSAID effects on, 171
Cardioversion
direct current, 347, 347f
in post-infarction ventricular fibrillation,
444
transthoracic, 371
Cardioverter-defibrillator, implantable,
371-372
complications of, 372, 372f
in heart failure, 306f-307f, 315
indications for, 371
leads for, 371
in monomorphic ventricular tachycardia,
367, 368f
programming of, 371-372
pulse generator for, 371
in ST segment elevation MI, 443,
443f
Carneys complex, 1465
Carnitine
deficiency of, 1341t, 2415
in valproate-induced toxicity,
679t-683t
L-Carnitine, e225-1
Carnitine palmitoyltransferase I deficiency,
2415
Carnitine palmitoyltransferase II deficiency,
2415
-Carotene, e225-9t
in erythropoietic protoporphyria,
1368b-1369b
Carotid artery
examination of, 24, 250, 251f, 2229
external, 2304f, 2305
internal, 2304f, 2305
fibromuscular dysplasia of, 2316
occlusion of, 2310-2311, 2312t, 2319t.
See also Stroke, ischemic
stent placement in, 2319
Carotid body hypersensitivity, 341
Carotid endarterectomy, 2319
Carotid pulse, 24, 250, 251f
Carotid sinus massage, 337, 355
Carpal tunnel syndrome, 1710-1711,
2396-2397, 2408
Carrions disease, 1906-1907
Carteolol, in hypertension, 382t
Cartilage, 1673, e267-1f, e267-5
degeneration of. See Osteoarthritis
Carvedilol
in heart failure, 310t
in hypertension, 382t
in stable myocardial ischemia, 423t
Caspofungin, 1976
Cast(s), urinary, 711-712, 711f
Castlemans disease, 1228, 2216
Cat allergy, 1626
e16 INDEX
Cat-scratch disease, 1906, 1908, 1909t,
1965t-1966t
diagnosis of, 1909, 1909t
hepatic, 995-996
prognosis for, 1910-1911
treatment of, 1910
Cat tapeworm, 2053, 2053t
Cataplexy, 2301
Cataract, 2426, 2428-2429, 2436
congenital, 2441
post-traumatic, 2433
radiation-related, 1162
senile, 105
vitamin intake and, e225-9
Catecholaminergic polymorphic ventricular
tachycardia, 366t, 367
Catecholamines, 1470, 1471f. See also
Dopamine; Epinephrine;
Norepinephrine
drug interactions with, 1473, 1473t
tumor secretion of, 1470-1475, 1472t
Caterpillar sting, 2077t, 2081
Catheter/catheterization
antimicrobial-treated, e290-6
bladder, infection with, 1793-1794. See
also Urinary tract infection
cardiac. See Cardiac catheterization
infection with, e290-6-e290-7
Cauda equina syndrome, 2264-2265
Causation, e8-5
in cancer, 1178, 1180-1182, 1181t
Caustic injury, esophageal, 881
pill-induced, 880-881
Caveolin-3, 320t
Cavernous hemangioma, 1298, 1298f, 2322
Cavernous sinus thrombosis, 2374-2376
CBL gene, 1091t
CD28, 219
CD30-positive cutaneous lymphoproliferative
disorders, 1226
CD44, e267-4
CD59, 243
CD85, 215
CD158, 215
CD159, 215
CD (cluster of differentiation) markers,
e44-1t-e44-2t
Cefaclor, 1809t-1811t
Cefadroxil, 1809t-1811t
Cefazolin, 1809t-1811t
Cefdinir, 1809t-1811t
Cefditoren pivoxil, 1809t-1811t
Cefepime, 1809t-1811t
Cefixime, 1809t-1811t
Cefotaxime, 1809t-1811t
Cefoxitin, 1809t-1811t
Cefpodoxime proxetil, 1809t-1811t
Cefprozil, 1809t-1811t
Ceftazidime, 1809t-1811t
Ceftibuten, 1809t-1811t
Ceftizome, 1809t-1811t
Ceftriaxone, 1809t-1811t
Cefuroxime, 1809t-1811t
Cefuroxime axetil, 1809t-1811t
Celiac artery compression syndrome, 935
Celiac disease, 905-911
arthritis in, 1748
clinical manifestations of, 906
definition of, 905
diagnosis of, 906, 906f
extraintestinal manifestations of, 906
folate deficiency in, 1078
genetic aspects of, 906
HLA associations in, 225t
iron deficiency anemia in, 862
osteoporosis in, 1580-1581
pathobiology of, 905-906
prognosis for, 906-907
T-cell lymphoma and, 907, 1227
treatment of, 906b, 906f
vitamin D deficiency in, 1599
Cell therapy, 203-207
adult stem cells in, 204, 206f
in diabetes mellitus, 207
embryonic stem cells in, 203-204,
205f
in heart disease, 207
Cell therapy (Continued)
induced pluripotent stem cells in, 204,
206f
legal considerations in, 207
in muscular dystrophies, 207
in neurodegenerative disease, 204-205
in neuronal injury, 204-205
Cellphones, 1180-1181
Cellulitis, 1816, 2507-2508, 2545, 2545f
enterococcal, 1831
Haemophilus influenzae, 1862
orbital, 2430, 2434
preseptal, 2434, 2434f
Streptococcus pyogenes, 1825
Cellulose embolism, 603
Centipede bite, 2077t, 2079
Central congenital hypoventilation
syndrome, 528t, 529-530
Central cord syndrome, 2253, 2266, 2268
Central core myopathy, 2414, 2484
Central nervous system. See Brain; Spinal
cord
Central retinal artery occlusion, 2439, 2439f
Central retinal vein occlusion, 2439, 2439f
Central venous catheter, for parenteral
nutrition, 1396-1397
Central venous pressure (CVP), e52-5t
in hypovolemia, 724
Cephalexin, 1809t-1811t
Cephalosporins, 1807t, 1809t-1811t
adverse effects of, 1814t
resistance to, 1808t, 1875, 1875t
Cephradine, 1809t-1811t
Cerebellar ataxia, 2341-2342
Cerebellum
alcohol-related degeneration of, 2386
hemorrhage of, 2324-2325, 2325t. See also
Stroke, hemorrhagic
infarction of. See Stroke, ischemic
malformations of, 2387
paraneoplastic degeneration of, 1193t,
1195
Cerebral amyloid angiopathy, 2279-2280
Cerebral artery (arteries), 2304-2309,
2304f
anterior, 2304f-2306f, 2305, 2311, 2312t
dissection of, 2318
middle, 2304f-2305f, 2305-2306,
2311-2312, 2312t
occlusion of, 2311-2312, 2312t. See also
Stroke, ischemic
posterior, 2304f-2306f, 2306, 2312,
2312t
Cerebral autosomal dominant arteriopathy
with subcortical infarcts and
leukoencephalopathy (CADASIL),
2279-2280, 2318
Cerebral blood flow, 2304f, 2306-2308,
2307f-2308f
in meningitis, 2357
Cerebral cortex
malformations of, 2386
organization disorders of, 2387
Cerebral edema, 2309
cytotoxic, 2309
in fulminant liver failure, 1008
high-altitude, 575-581, 575t
vasogenic, 2309
Cerebral hypoxia, 2308
Cerebral ischemia, 2308, 2310-2320. See also
Stroke, ischemic
focal, 2308
global, 2308
pathology of, 2308-2309
Cerebral varix, 2322
Cerebral veins, 2306, 2307f
Cerebrospinal fluid (CSF). See also
Cerebrospinal fluid (CSF) examination
cells in, 2231t, 2359, 2359t
color of, 2231f, 2231t
glucose in, 2231, 2231t, 2359, 2359t
leakage of, 2361
pressure of, 1254-1255
in meningitis, 2358, 2359t, 2364
production of, 1254
protein in, 2231t, 2359, 2359t
spinal cord accumulation of, 2388
Cerebrospinal fluid (CSF) examination
in African sleeping sickness, 2020
in bacterial meningitis, 2358-2359, 2359t,
2364
in chemical meningitis, 2320-2321
in chronic inflammatory demyelinating
polyradiculoneuropathy, 2402
in cryptococcosis, 2223
in encephalitis, 2377
in enteroviral encephalitis, 2143
in enteroviral meningitis, 2142
in Guillain-Barr syndrome, 2401
in herpes simplex encephalitis, 2378
in ischemic stroke, 2314
in Lyme meningitis, 1933, 2359t
in multiple sclerosis, 2231, 2351
in Mycoplasma pneumoniae infection,
1915
in neurologic disorders, 2231-2232, 2231f,
2231t
oligoclonal banding in, 2231
in poliomyelitis, 2380
polymerase chain reaction test in,
2231
in progressive multifocal
leukoencephalopathy, 2113
in rabies, 2378
red blood cells in, 2231t, 2320-2321
in sagittal sinus thrombosis, 2375
in St. Louis encephalitis, 2167
in sarcoidosis, 585
in subarachnoid hemorrhage, 2320-2321
in tuberculosis, 1945, 2359t
in viral meningitis, 2367
in West Nile encephalitis, 2165-2166
white blood cells in, 2231t, 2359,
2359t
Cerebrovascular disease, 2304-2310. See also
Stroke
anatomy in, 2304-2306, 2304f-2307f
definition of, 2304, 2304f
dementia with. See Dementia, vascular
diet and, 1381t
edema in, 2309
epidemiology of, 2304-2309
hemorrhagic, 2309, 2320-2326. See also
Stroke, hemorrhagic
ischemic, 2308, 2310-2320. See also
Stroke, ischemic
pathobiology of, 2304-2309
Certolizumab, 165
in inflammatory bowel disease, 917t, 918
Ceruloplasmin, 1371
in Wilsons disease, 1371
Cerumen, impaction of, 2462
Cervical artery, dissection of, 2318
Cervical cancer, 1317
alcohol use and, 149
clinical manifestations of, 1317
diagnosis of, 1317-1320
epidemiology of, 1317
HLA association with, 225t
HPV infection and, 2121, 2123-2125,
2125f, 2217
oral contraceptives and, 1553
pathobiology of, 1317
prevention of, 1318
screening for, 54, 1317-1320, 1317f,
2124
treatment of, 1318b
Cervical distraction test, 2260-2261
Cervical intraepithelial neoplasia, 2121
diagnosis of, 2123
natural history of, 2124-2125, 2125f
Cervical mucus, ferning of, e244-1
Cervical spine
instability of, 1758
pain in. See Neck pain
rheumatoid arthritis of, 1685, e272-1f
stenosis of, 2263-2265
whiplash injury of, 2260, 2262t
Cervicitis, 1797t, 1799, e326-3f, e326-4
Cervix
cancer of. See Cervical cancer
Chlamydia trachomatis infection of,
e326-3f, e326-4
cyclic changes in, e244-1
Cervix (Continued)
human papillomavirus infection of. See
Human papillomavirus (HPV)
infection
intraepithelial neoplasia of, 2121,
2123-2125, 2125f
Cestode infection, 2052-2057. See also
specific cestodes
definition of, 2052-2057
treatment of, 2009-2010
Cetirizine, 2512t
Cetuximab, 167, 1168t-1176t
in colorectal cancer, 202t
CFTR gene, 545, 545t, 938, 941
Chagas disease, 324, e355-1-e355-5
acute, e355-2-e355-3
autonomic neuropathy in, 2394
cardiac, e355-2, e355-2f, e355-4-e355-5
chronic, e355-2-e355-3, e355-4f
clinical manifestations of, e355-2-e355-3
constipation in, 866
definition of, e355-1
diagnosis of, 2081, e355-3-e355-5
epidemiology of, e355-1-e355-5
gastrointestinal, e355-2, e355-4-e355-5
in Latin American, e355-1
pathobiology of, e355-1-e355-2, e355-2f
prevention of, e355-5
prognosis for, e355-5
reactivation of, e355-2-e355-3
treatment of, 2012-2013, e355-3b-e355-5b
in United States, e355-1
Chalazion, 2431, 2431f
Chancre, 1798, 2546, e327-1-e327-2,
e327-2f. See also Syphilis
Chancroid, 1798, 1864-1865
clinical manifestations of, 1864-1865,
1864f
definition of, 1864
diagnosis of, 1865
differential diagnosis of, 1865
epidemiology of, 1864
pathobiology of, 1864
prevention of, 1865
prognosis for, 1865
treatment of, 1865b
Change. See Behavior change
Channelopathy, 2230, 2412t, 2414
Chapare hemorrhagic fever, 2148t-2149t
Chaperones, for physical examination, 23
Charcoal, activated, in acute poisoning,
679-684
Charcot-Marie-Tooth disease, 2398, 2399t
clinical manifestations of, 2398-2400
definition of, 2398
diagnosis of, 2400
differential diagnosis of, 2400
epidemiology of, 2398
genetics of, 2398
pathobiology of, 2398-2406, 2400f
treatment of, 2401
type 1A, 190, 2398, 2399t
Charcots joint, 1749
Chdiak-Higashi syndrome, 1102t, 1103,
1115, 1116t-1117t
Cheese washers lung, 570-571
Cheilitis, angular, 2452
Chelation therapy
in aluminum poisoning, 90t, 93b
in arsenic poisoning, 90t, 91b, 92t
in bismuth poisoning, 90t
in hereditary hemochromatosis,
1375b-1376b
in iron toxicity, 679t-683t
in lead poisoning, 89b, 90t
in manganese poisoning, 90t
in mercury poisoning, 90t, 91b
mucormycosis risk with, 1995
in myelodysplastic syndrome, 1202
in sickle cell disease, 1074
in Wilsons disease, 986b, 1372b
Chemical(s)
aplastic anemia with, 1085
cancer with, 1181t
hemolysis with, 1051t
leukemia and, 1203-1204
lymphoma and, 1219

Chemical peels, 2513
Chemical sensitivity, 77
Chemokines, in inflammation, 232
Chemoprevention, 53t, 55
Chemotaxis, 1113-1114, 1114f
defects in, 1115, 1116t-1117t
Chemotherapy, 1165-1167, 1165t,
1168t-1176t
in acute lymphoblastic leukemia,
1206-1207
in acute myeloid leukemia, 1207-1208,
1207t
adjuvant, 1165
antiemetics with, 843t-844t, 1167-1177
in bladder cancer, 1307b-1308b
in breast cancer, 1312-1314, 1312t
in cancer of unknown primary origin,
1337
in carcinoid syndrome, 1511
in cervical cancer, 1318b
in chronic lymphocytic leukemia, 1217,
1217t
in colorectal cancer, 1288
combination, 1165-1166
diarrhea and, 898
dilated cardiomyopathy with, 326-327
in endometrial cancer, 1318b-1319b
in gastric cancer, 1276-1277
gastrointestinal complications of, 889
gene expression signatures in, 202
granulocyte colony-stimulating factor with,
e159-4
in head and neck cancer, 1262b-1263b
heart failure and, 314-315
hepatotoxicity of, 984
hypogonadism with, 1524, e244-9
interstitial lung disease with, 558t
in myelodysplastic syndrome, 1202
neoadjuvant, 1165
neutropenia with, 1775-1778, 1776t,
1777f
in non-Hodgkins lymphoma, 1224b,
1224t, 2216b
in ovarian cancer, 1319b
palliative, 1165
in pancreatic cancer, 1291b-1292b
posterior reversible encephalopathy with,
1780
secondary malignancy with, 1181-1182,
1181t
in testicular cancer, 1321b-1322b
thrombopoietin with, e159-4
toxicity of, 131
tumor resistance to, 1187
Cherry red spot, 1358t, 2438
CHES (chronic hyperplastic eosinophilic
sinusitis), 1625-1626, 1625f
Chest
examination of, 25
in trauma, 689, 689f-690f
flail, 606-607, e99-1f
occupation-related infection of, 568t
Chest pain, 246, 247t, 414, 415f, 434-435.
See also Angina pectoris
in acute pericarditis, 473, 474t
cardiac catheterization and, 291
differential diagnosis of, 247t, 418, 874,
874t
echocardiography in, 282t
esophageal source of, 873-874, 873t-874t
functional, 873-874, 873t
in hypertrophic cardiomyopathy, 321
in interstitial lung disease, 556
postoperative assessment of, 2488, 2488t
in pulmonary embolism, 474t
Chest physiotherapy, in bronchiectasis, 550
Chest radiography, 516
acinar nodules on, 518
in acute interstitial pneumonia, 554
in acute respiratory failure, 633, 633f
air bronchogram on, 517
in allergy, 1614
alveolar pattern on, 518
in amebiasis, 2046f
in angina pectoris, 417
in anthrax, 1837, 1838f
in aortic coarctation, 405, 405f
Chest radiography (Continued)
in aortic dissection, 484
in aortic regurgitation, 454t, 461
in aortic stenosis, 454t, 455
apical pulmonary disease on, 519-520,
520f
in aspiration pneumonia, 593-594
in asthma, 533
in atelectasis, 551, 551f
basilar pulmonary disease on, 519-520,
520f
in beryllium disease, 572b, 572f
bronchial patterns on, 518
in bronchioloalveolar cell carcinoma, 555
cardiac anatomy on, 264-265
cardiac calcification on, 267-268,
267f-268f
cardiac chamber enlargement on, 265-266,
266f-267f
cardiac veins on, 270-271, 271f
in Chagas disease, e355-2f
in chronic cough, 512
in coccidioidomycosis, 1980, 1980f
in COPD, 540, 540f
in cryptococcosis, 2203f
in cryptogenic organizing pneumonia, 563
decreased lung volumes on, 559t
in desquamative interstitial pneumonia,
562-563
diffuse alveolar damage on, 517, 517f
in diffuse alveolar hemorrhage, 554
in diffuse lung disease, 517-520, 517f-518f,
517t
diffuse pleural thickening on, 521
disease distribution on, 519-520, 520f,
520t
ground-glass opacity on, 517, 518f
in heart failure, 301
heart size on, 265, 265f
hilar adenopathy on, 559t
in HIV-infected patient, 2202-2203,
2202f-2206f
in Hodgkins lymphoma, 1231f
honeycombing on, 518, 559t
in hypersensitivity pneumonitis, 565
in idiopathic interstitial pneumonia, 559t
increased lung volumes on, 559t
in infective endocarditis, 466
in interstitial lung disease, 558, 559t
in Kaposis sarcoma, 2203, 2204f
Kerley A lines on, 517-518, 518f
Kerley B lines on, 517-518
Kerley C lines on, 517-518
in Langerhans cell histiocytosis, 566
large opacities on, 517f-518f, 517t
in Legionnaires disease, 1905, 1905f
linear patterns on, 517-518, 518f
in lipoid pneumonia, 580
in lung cancer, 1268
lung volume on, 519, 519f, 519t
lymph nodes on, 520, 520t
in lymphoid and lymphocytic interstitial
pneumonia, 563-564
malignant pleural disease on, 521
mediastinal adenopathy on, 559t
mediastinal stripes on, 522f
in mediastinal teratoma, 522f
micronodules on, 517, 559t
migratory infiltrates on, 559t
in mitral regurgitation, 454t, 459
in mitral stenosis, 454t, 457
in Mycoplasma pneumoniae infection, 1914,
1914f
in nocardiosis, 1970
in nonspecific interstitial pneumonia, 562
in nontuberculous Mycobacterium spp.
infection, 1949
normal, 559t
in pericardial effusion, 268, 269f, 477, 477f
in pleural disease, 520-521, 521f, 559t
in pleural effusion, 608, 608f
pleural plaques on, 521, 521f
in Pneumocystis jirovecii pneumonia, 2203,
2203f, e349-2, e349-3f
in pneumonia, 590, 590f
in pneumothorax, 521, 521f, 559t, 611,
611f
Chest radiography (Continued)
portable, 271, 516
in psittacosis, e326-6
in pulmonary alveolar proteinosis, 553,
553f
in pulmonary arterial hypertension, 270
in pulmonary edema, 269-270, 270f, 517,
518f
in pulmonary hypertension, 392, 393f
pulmonary nodules on, 520, 520f
pulmonary vasculature on, 268-271,
270f
in pyogenic liver abscess, 989
recurrent infiltrates on, 559t
in respiratory bronchiolitis-associated
interstitial lung disease, 562
reticular patterns on, 518, 518f
retrosternal clear space on, 265
in rheumatoid arthritis, 1686, 1686f
in sarcoidosis, 582-583, 582f, 583t
septal thickening on, 559t
in silicosis, 573, 573f
small opacities on, 517-519, 518t
in sporotrichosis, 1985-1986
in ST segment elevation MI, 437
in subpulmonic effusion, 521
in systemic sclerosis, 1710
in tetralogy of Fallot, 406, 406f
in trauma, 689, 689f
in tuberculosis, 590, 590f, 1941,
1942f-1943f, 2202-2203, 2203f
in varicella pneumonia, 517f
vascular patterns on, 519, 519f
Chest tube, in pleural effusion, 610b
Chest wall, 604-605
flail, 606-607
imaging of, 516-523
pectus excavatum of, 606-607
Cheyne-Stokes respiration, 528, 528t, 529f,
2296
in heart failure, 300-301
treatment of, 529b
Chiari malformation, 2388, 2388f
Chick peas, 2385
Chicken worker disease, 571t
Chickenpox. See Varicella-zoster virus
infection
Chigger mites, 2078
Chikungunya fever, 2159
Chilblains, 496-497, 497f, 668-669
Childbirth. See also Pregnancy
Clostridium sordellii infection with,
e304-2
Childhood absence epilepsy, 2290-2291
Childhood cerebral adrenoleukodystrophy,
2355
Children. See also Infant; Neonate
antibacterial agent precautions in,
1764-1765
aspirin use in, 983
epilepsy in, 2290-2291, 2290t
fluoroquinolones in, 1764-1765
gonococcal infection of, e307-4
hair disorders in, 2553
protein-energy malnutrition in,
1389-1390, 1390f, 1390t
Reyes syndrome in, 983
Chimera, 190
Chinese traditional medicine, 178
Chlamydia trachomatis infection, e326-
1-e326-2, e326-2t
cervical, e326-3f, e326-4
conjunctival, 2434, 2434t, e326-2-e326-4
diagnosis of, e326-5
epididymal, e326-4
lymphatic, e326-4
natural history of, e326-4-e326-5
neonatal, e326-4
oropharyngeal, e326-4
pelvic, e326-4
in pregnancy, e326-4
prevention of, e326-5
reactive arthritis in, e326-4
rectal, e326-4
sexually transmitted, e326-3, e326-3f
treatment of, e326-5b
urethral, e326-3, e326-3f
INDEX e17
Chlamydiae infection, e326-1-e326-7
in adolescents, 62
definition of, e326-1-e326-7
pathobiology of, e326-1, e326-1f
reactive arthritis and, 1694
screening for, 55
Chlamydophila pneumoniae infection, e326-2t,
e326-5
Chlamydophila psittaci infection, 468t, 1219,
e326-2t, e326-6-e326-7
Chlorambucil, 165, 1168t-1176t
Chloramphenicol, 1807t, 1809t-1811t
adverse effects of, 1814t
resistance to, 1808t
Chlordiazepoxide, 2242t
in alcohol dependence treatment, 152t
Chlorhexidine gluconate, for catheter
dressing, e290-6
Chloride channelopathy, 2414
Chloridorrhea, congenital, 751, 910,
1341t
2-Chlorodeoxyadenosine, in hairy cell
leukemia, 1214b
Chloroform poisoning, 679t-683t
Chloroma, 1205
Chloroquine
in malaria, 2011, 2016, 2016t
ocular effects of, 2442
in rheumatoid arthritis, 1689
Chlorpheniramine
in common cold, 2090t
in pruritus, 2502t, 2512t
Chlorpromazine, 2243t
ocular effects of, 2442
Chlorpropamide
in diabetes insipidus, e232-5b-e232-6b
in diabetes mellitus type 2, e237-7t
Chlorthalidone
in hypertension, 382t
in hypervolemia, 727, 727t
in nephrolithiasis prevention, 794
Choking, in psychiatric patient, 2493
Cholangiocarcinoma, 1302-1303
clinical manifestations of, 1302
diagnosis of, 1302, 1302f-1303f
epidemiology of, 1302
liver transplantation and, 1009
pathobiology of, 1302
prognosis for, 1303
treatment of, 1302b-1303b
Cholangiohepatitis, oriental, 1013
Cholangitis
bacterial, acute, 1017-1018, 1018f
pain in, 833
sclerosing
primary, 1013, 1014f
secondary, 1013, 1014t
Cholecystectomy, 1017
Cholecystitis
acalculous
acute, 1018-1019, 1018t
chronic, 1019
calculous, 834t-836t, 1016, 1017f, 1017t.
See also Cholelithiasis
ultrasonography in, 846, 846f
Cholecystokinin, 1411t
Choledochal cyst, 1013
Choledochocholedochostomy, 1010
Choledochojejunostomy, 1010
Choledocholithiasis, 1017, 1018f
Cholelithiasis, 1015-1016
asymptomatic, 1016
black pigment, 1016
brown pigment, 1016
cholesterol, 1016, 1016f
clinical manifestations of, 1016
definition of, 1015
diagnosis of, 1016-1019, 1017f, 1017t
epidemiology of, 1015
genetics of, 1016
obesity and, 1414
pain with, 1016
pancreatitis with, 937, 1018
pathobiology of, 1015-1016
in sickle cell disease, 1071
in -thalassemia intermedia, 1063-1064
treatment of, 1017b
e18 INDEX
Cholera, 84t, 1865-1868
clinical manifestations of, 1867
definition of, 1865-1868
diagnosis of, 1866t, 1867
epidemiology of, 1865-1866, 1866f
immunization against, 900, 1867-1868
pancreatic, 1293t, 1295-1297
pathobiology of, 1866-1867, 1866t
prevention of, 1867-1868
prognosis for, 1868
treatment of, 1867b, 1867t
Cholestasis, 1011-1016
clinical manifestations of, 1012-1013
diagnosis of, 1013
drug-induced, 982-983
familial, 961
infection-related, 989
intrahepatic, 1012t
of pregnancy, 987, 987t
pathobiology of, 1011-1012, 1012t
treatment of, 1013b, 1013t
Cholesteatoma, 2462
Cholesterol, 1346
in cardiovascular disease, 257
consumption guidelines for, 1383t
coronary heart disease and, 1380
hepatic metabolism of, 1012, 1012f
laboratory evaluation of, 1352-1353
measurement of, 53
reverse transport of, 1349, 1349f
Cholesterol absorption inhibitor, 1353t
Cholesterol embolism, 493-498, 2524-2525
clinical manifestations of, 493-494
definition of, 493
diagnosis of, 494
epidemiology of, 493
pathobiology of, 493
prognosis for, 494
purpura with, 2524-2525
treatment of, 494b
Cholesteryl ester transfer protein, 1347t,
1348
Cholestyramine
in bile acid malabsorption, 909b
in cholestasis, 1013b
micronutrient effects of, e225-8t
Choline, e225-1
Choline acetyltransferase deficiency, 2419t,
2423
Cholinesterase, blood, 677t
Chondrocalcinosis, 1741, 1742f. See also
Calcium pyrophosphate dihydrate
(CPPD) deposition disease
Chondrodysplasia punctata, rhizomelic,
1344t
Chondroitin, in osteoarthritis, 1675
Chondrosarcoma, 1326
Chordae tendineae, e52-3
Chordoma, 1250
Chorea, 2335, 2335t
Huntingtons, 2335-2342
Sydenhams, 2336
Choreoathetosis, 2337
Choristoma, 1428
Choroid, 2427f
Choroid plexus papilloma, 1252
Choroidal artery, 2305, 2306f
Choroidal dystrophy, 2440
Chromaffin cells, 1470
Chromium, e225-6t-e225-7t
deficiency of, e225-6t-e225-7t
lung cancer and, 1265
poisoning with, 94
Chromogranin A, in carcinoid syndrome,
1510
Chromomycosis, 2007-2008
clinical manifestations of, 2008
definition of, 2007t
diagnosis of, 2008
epidemiology of, 2008
treatment of, 2008b
Chromosome(s), 189-190, 190f
abnormalities of
in acute leukemia, 1205
in bladder cancer, 1307
in chronic lymphocytic leukemia, 1214
in chronic myelogenous leukemia, 1210
Chromosome(s) (Continued)
in multiple myeloma, 1237
in myelodysplastic syndrome, 1200
in non-Hodgkins lymphoma,
1220-1221, 1221t
in sex development disorders,
1516-1517, e244-8-e244-9
complex rearrangements of, 190
marker, 190
numerical aberrations of, 189-190
Philadelphia, 1205, 1209-1210, 1209f
ring, 190
structural aberrations of, 190
Chronic daily headache, 2250-2252
Chronic disease
in adolescents, 63
anemia of, 1036, 1036t, 1042-1043,
1198
clinical manifestations of, 1042
definition of, 1042
diagnosis of, 1035f, 1036-1037, 1041t,
1042-1043
epidemiology of, 1042
HIV infection and, 2212
kidney disease and, 812, 817
liver disease and, 1037-1038
pathobiology of, 1036, 1036f, 1042
prognosis for, 1043
rheumatoid arthritis and, 1687
treatment of, 1037b, 1043b
definition of, 44, 44t
infection and, 1762
malnutrition in, 1388, 1388t
management of, 44-47
community resources in, 46
delivery systems for, 46
follow-up care in, 46
goals of, 44-45
information systems in, 46
interventions in, 45
model of, 45-46
quality improvement in, 45, 47
self-management in, 46
specialists in, 46
in older adults, 98, 99t
Chronic eosinophilic pneumonia, 565
Chronic fatigue syndrome, 1745-1747
clinical manifestations of, 1746
diagnosis of, 1744t, 1746
differential diagnosis of, 1745t
epidemiology of, 1745
vs. fibromyalgia, 1744t
pathobiology of, 1746
treatment of, 1746b
Chronic granulomatous disease, 1115-1117,
1116t-1117t
clinical manifestations of, 1117
treatment of, 1117b
Chronic hyperplastic eosinophilic sinusitis
(CHES), 1625-1626, 1625f
Chronic infantile neurologic cutaneous and
articular (CINCA) syndrome, 1668t,
1670t, 1671
Chronic inflammatory demyelinating
polyradiculoneuropathy, 2401t, 2402
Chronic lymphocytic leukemia (CLL),
1214-1215, 1223
clinical manifestations of, 1215
cytogenetics of, 1214
definition of, 1214
diagnosis of, 1215, 1215f
differential diagnosis of, 1215-1216, 1216t
epidemiology of, 1214
hemolytic anemia with, 1047
natural history of, 1216
pathobiology of, 1214
peripheral blood smear in, 1030, 1030f
prognosis for, 1217-1218
staging of, 1216, 1216t
treatment of, 1160, 1216b-1217b, 1217t
Chronic mountain sickness, 575-581, 575t
Chronic myelogenous leukemia (CML),
1209-1218
biopsy in, 1210
blastic phase of, 1211-1212
clinical course of, 1210-1214, 1211f
clinical manifestations of, 1210
Chronic myelogenous leukemia (CML)
(Continued)
cytogenetics of, 1210
definition of, 1209
diagnosis of, 1210, 1210f
differential diagnosis of, 1210
epidemiology of, 1209
vs. leukemoid reaction, 1100
molecular pathogenesis of, 1209-1210,
1209f
monitoring of, 1212-1213
neutrophilia in, 1100
pathobiology of, 1209-1218
peripheral blood smear in, 1030,
1030f
prognosis for, 1213
treatment of, 1160, 1211b-1213b, 1211f,
1212t
imatinib mesylate in, 167
molecular markers in, 202t
Chronic myelomonocytic leukemia
(CMML), 1213-1214
Chronic obstructive pulmonary disease
(COPD), 537-544
airway responsiveness in, 538
1-antitrypsin deficiency and, 538
bronchiectasis in, 548
bronchiolitis in, 538
bronchitis in, 538
cardiac disease in, 543-544
cigarette smoking and, 537, 537f
clinical manifestations of, 514t, 539
clinical phenotypes in, 539
definition of, 537
diagnosis of, 539-544
1-antitrypsin levels in, 540
computed tomography in, 540, 541f
oximetry in, 540
pulmonary function tests in, 539-540,
540t
radiography in, 540, 540f
differential diagnosis of, 540-541
emphysema in, 537-538
epidemiology of, 537-538
exacerbation of, 528t, 543-544, 543t
flow-volume loop in, 539, 539f
gas exchange in, 539
genetic factors in, 538
giant bullae in, 618
HIV infection and, 2208
infection in, 538, 543-544
lung cancer and, 1265
mortality with, 537
occupational, 537, 568t, 569-570
pathobiology of, 538-539
pathophysiology of, 538-539
patient history in, 539
physical examination in, 539
preoperative assessment of, 2481
prognosis for, 544
pulmonary function tests in, e85-4t,
e85-5
pulmonary vascular resistance in, 538
respiratory failure in, 634-635
clinical manifestations of, 634
diagnosis of, 634
infection and, 634
treatment of, 634b-635b, 635t,
643-644
treatment of, 541b-544b, 541f
bronchodilators in, 541, 542t
corticosteroids in, 541-542, 542t
in exacerbations, 543-544, 543t
immunizations in, 542
oxygen therapy in, 542
pulmonary rehabilitation in, 542
smoking cessation in, 541
surgical, 542-543
tripod sign in, e103-1f
weight loss with, 840t-841t
Chronic pelvic pain syndrome, 808
Chronic progressive external
ophthalmoplegia, 2416
Chronic recurrent multifocal osteomyelitis,
1668t
Chronotherapy, 2302
Chronotropic incompetence, 349
Churg-Strauss syndrome, 1120, 1722t,
1725-1726
gastrointestinal involvement in, 934
interstitial lung disease with, 565-566
vasculitic neuropathy in, 2404-2405, 2405t
Chvosteks sign, 1599
Chylomicron(s), 1346, 1347t, 1348
Chylomicronemia syndrome, 1348,
1351-1352
Chylothorax, 609t, 610
CIAS1 gene, 1100
Cidofovir
adverse effects of, 2084-2085, 2084t
drug interactions with, 2084t
excretion of, 2083t
in herpesvirus infections, 2083t,
2084-2085
Cigarette smoking, 142-146
bladder cancer and, 1306
Buergers disease and, 1724
cancer and, 1180
cardiovascular disease and, 257
cessation of, 55
in COPD, 541, 541f
in hypertension, 381
chronic pancreatitis and, 941
clinical manifestations of, 143
COPD and, 537, 537f
education and, 18f
epidemiology of, 142-143
esophageal cancer and, 1273
head and neck cancer and, 1258
heart failure and, 313-314
HIV infection and, 2201
inflammatory bowel disease and, 913
ischemic stroke and, 2310, 2319t
lung cancer and, 1264
micronutrient interactions with, e225-8
neutrophilia with, 1099
nicotine dependence and, 143
pancreatic cancer and, 1289
pathobiology of, 143
pharmacologic treatment of, 144-146, 144t
prevalence of, 18, 18f
prevention of, 146
prognosis for, 146
psychosocial treatment of, 143, 144t
race/ethnicity and, 18f
rheumatoid arthritis and, 1683
treatment of, 143b-146b
in women, 1550t, 1551
Ciguatoxins, 698t, 699, 898
Ciliary body, 2426, 2427f
Cilostazol, 174
Cimetidine
in gastroesophageal reflux disease, 878t
in pruritus, 2512t
Cinacalcet, in hyperphosphatemia, 756b
Ciprofloxacin, 1809t-1811t
Circadian rhythm, 1427
disorders of, 2302-2303
Circle of Willis, 2304f, 2305
Circumcision
in chancroid prevention, 1865
in HIV infection prevention, 2182
in sexually transmitted disease prevention,
1799
Cirrhosis
biliary, primary, 1000, 1014-1016
arthritis in, 1747
jaundice in, 958f
malabsorption in, 904
hepatic, 999-1007. See also Liver disease
alcohol-related, 149
ascites in, 1001-1002, 1004-1005, 1004t
cardiopulmonary complications of,
1001-1002
causes of, 999-1000, 1000t
Child-Pugh-Turcotte score in, 1002t
clinical manifestations of, 1002, 1002f
compensated, 1002
complications of, 1001-1006, 1001f
computed tomography in, 1003, 1003f
decompensated, 1002-1003
definition of, 999, 1000f
diagnosis of, 1003, 1003f
diet and, 1381t

Cirrhosis (Continued)
encephalopathy in, 1001, 1003-1004,
1006
epidemiology of, 999-1006
in hepatitis B, 974, 976
hepatocellular carcinoma and, 1300
hepatopulmonary syndrome in,
1003-1004, 1006
hepatorenal syndrome in, 1001-1002,
1004-1006
hyperdynamic circulatory state in, 1001,
1001f
jaundice in, 1001
laboratory tests in, 1003
liver transplantation in, 1006, 1008. See
also Liver transplantation
MELD score in, 1002t
mortality rate for, 999
pathobiology of, 1000-1006, 1000f
peritonitis in, 1001-1004, 1006
physical examination in, 1003
portal hypertension in, 1001
portal pressure measurement in, 1003
portopulmonary hypertension in,
1002-1004, 1006
prevention of, 1006
prognosis for, 1006
transplantation in. See Liver
transplantation
treatment of, 1004b-1006b, 1005f
varices in, 1001-1006
weight loss with, 840t-841t
Cisplatin, 1168t-1176t
Citalopram
in depression, 2239t
in irritable bowel syndrome, 871t
in menopausal hot flushes, 1569t-1570t
Citrate, urinary, 709, 790
Cladribine, 1168t-1176t
Clarithromycin, 1809t-1811t
Claudication. See also Peripheral arterial
disease
intermittent, 487f, 488
vs. pseudoclaudication, 488t
neurogenic, 2264
vascular, 2264
CLCNKB gene, 801-802
Cleft lip/palate, 1428
Clemastine fumarate, 2512t
Clevidipine, in hypertensive emergency, 388t
Clindamycin, 1807t, 1809t-1811t, 1812-1813
adverse effects of, 1814t
resistance to, 1763-1764, 1808t
Clinical decision-making, 32-37
in chronic disease management, 46
cost-effectiveness analysis in, 36-37, 36t
laboratory tests for, 32-34, 32t-34t, 33f
selection of, 34-35, 35f
molecular information for, 202-203, 203t
strategy for, 35-37, 35t-36t
threshold approach to, 34
Clinical examination. See Physical
examination
Clinical trials, 2
case-control study design for, 40-41
case mix adjustment for, 41
cohort study design for, 40-41
cross-sectional study design for, 41
experimental, 39-40
nonexperimental, 40-41
observational study design for, 40
propensity scoring for, 41
Clock drawing, 2273
Clodronate, in Pagets disease, 1605t
Clofarabine, 1168t-1176t
Clofazimine, in leprosy, 1953-1954
Clomiphene test, 1434t
Clonal ignorance, 221
Clonazepam, 2242t
Clonidine
in alcohol dependence treatment, 152t
in diarrhea, 912-913
in hypertension, 382t
for menopausal hot flushes, 1569t-1570t
in smoking cessation, 144t
in Tourettes syndrome, 2338b
Clonorchiasis, 2061, 2061t
Clopidogrel, 174-176
in acute coronary syndrome, 430t
in ischemic stroke prevention, 2319
preoperative, 2478t
in ST segment elevation MI, 442, 447f,
447t
in stable myocardial ischemia, 419
Clorazepate, 2242t
Clostridium botulinum infection, e304-4. See
also Botulism
Clostridium difficile infection, e304-1-e304-7
clinical manifestations of, e304-1
definition of, e304-1
diagnosis of, 1788-1789, 1789t, e304-1
epidemiology of, e304-1
in hospitalized patient, 837, 898
pathobiology of, e304-1
prevention of, e304-1-e304-2
prognosis for, e304-2
toxin of, e304-1
treatment of, e304-2b
Clostridium novyi infection, e304-3
Clostridium perfringens infection,
e304-3-e304-4
type A, e304-7
type C, e304-6
Clostridium sordellii infection, e304-2-e304-4
Clostridium tetani infection, e304-5, e304-6t.
See also Tetanus
Cloxacillin, 1809t-1811t
Clozapine, 2243t
cardiomyopathy with, 2493
neutropenia with, 2493-2494
in Parkinsons disease, 2330t-2332t
Clubbing, 253, 255f, 1196t, 2554, 2554f
Cluster headache, 2247t, 2249-2252, 2250t
Clustrin, 243
Cnidaria envenomation, 698t, 699
Coagulation, 1121-1122, 1122f-1123f
disorders of. See Coagulopathy;
Disseminated intravascular
coagulation (DIC); Hemophilia
Coagulopathy, 1344t
in amyloidosis, e177-9
in antiphospholipid syndrome,
e177-9-e177-10
in bacterial meningitis, 2360
factor II, e177-4t, e177-9-e177-10
factor V, e177-4t, e177-8
factor VII, 1149, e177-4t, e177-9-e177-10
factor VIII, 1132, 1149, e177-1-e177-2,
e177-2f, e177-3t-e177-4t. See also
Hemophilia
factor IX, e177-1-e177-2
factor IX, e177-3t-e177-4t. See also
Hemophilia
factor X, e177-4t, e177-9-e177-10
factor XI, 1149, e177-4t, e177-7-e177-10
factor XII, e177-4t, e177-7-e177-8
factor XIII, 1123, e177-4t, e177-8
fibrinogen, e177-4t, e177-8
ischemic stroke and, 2316-2319
von Willebrand factor, 1131-1136. See
also Von Willebrands disease
Coarctation of aorta. See Aorta, coarctation of
Cobalamin. See Vitamin B12 (cobalamin)
Cobalt poisoning, 94
Cobb angle, 605, 605f
Cobra venom factor, 243
Cocaine
abuse of, 156-157
dilated cardiomyopathy with, 327
treatment of, 157b
central nervous system effects of, 672t
gastrointestinal complications of, 889
hepatotoxicity of, 981t
toxic ingestion of, 677t
Cocaine- and amphetamine-regulated
transcript, 1412t
Coccidioidomycosis, 1979-1981
clinical manifestations of, 1979t, 1980
definition of, 1979-1981
diagnosis of, 1980-1981
epidemiology of, 1979
extrapulmonary, 1980
hepatic, 990
HIV infection and, 1980, 2191t-2192t
INDEX e19
Coccidioidomycosis (Continued) Collagen vascular disease
pathobiology of, 1980 bronchiectasis in, 548
prognosis for, 1981 interstitial lung disease with, 564
pulmonary, 1980, 1980f laboratory testing in, 1653-1655
treatment of, 1981b Collagenases, in inflammation, 233t
Coccydynia, 1680 Collagenoma, 2537-2538
Cochlear disorders, 2463 Collagenous colitis, 910
Cockaynes syndrome, 1344 Colloid cyst, of third ventricle, 1252
Cockcroft-Gault formula, 709 Colon. See also Rectum; Small intestine
Cockroaches, 1626 adenomatous polyps of, 1283-1286, 1284f,
Codeine, 137t. See also Opioid(s) 1284t
Coenurosis, 2053t, 2057 aging-related changes in, 106
Coenzyme Q10 (ubiquinone) deficiency, angiodysplasia of, 934-937, 934f
2416 arteriovenous malformation of, 853-854,
Coffin-lid crystals, 712, 712f 854f
Cogans syndrome, 1723 bile salt wasting in, 904
Cognition bleeding from. See Gastrointestinal
aging-related changes in, 108 bleeding, lower
alcohol effects on, 148 cancer of. See Colorectal cancer
assessment of Chagas disease of, e355-2, e355-4-e355-5
Mini-Mental State Examination in, 115, diverticulitis of, 922-927
115t Escherichia coli of, 1871
in older adults, 102, 104t fluid and electrolyte transport in, 895, 896f
dysfunction/impairment of, 2270-2274. fluid reabsorption by, 863
See also Alzheimers disease; hamartomatous polyps of, 1283
Amnesia; Delirium; Dementia motility of, 863
aging and, 98 disorders of. See Constipation; Diarrhea
clinical manifestations of, 2270 non-neoplastic polyps of, 1283
definition of, 2270 obstruction of, 834t-836t
in fibromyalgia, 1743-1744 polyps of, 1283
in lysosomal storage disorders, colonoscopy in, 854
1358t computed tomography in, 847, 848f
mild, 2276-2277, 2276t endoscopic polypectomy in, 854, 854f
in older adults, 99, 100f pseudo-obstruction of, 837
executive, dysfunction of, 2273-2274 pseudopolyps of, 1283
Cognitive-behavioral therapy. See also in systemic sclerosis, 1709
Behavior change; Behavioral therapy villous adenoma of, 910
in hypertension, 381 volvulus of, 927
in smoking cessation, 143, 144t Colonoscopy, 854, 1284, 1286
COL1A1 gene, 1665, 1666t in angiodysplasia, 934, 934f
COL1A2 gene, 1665, 1666t in gastrointestinal bleeding, 860, 860f
Colchicine in inflammatory bowel disease, 915-916,
in Behets disease, 1723, 2511 920
in gout, 1740 in ischemic colitis, 933, 933f
in leukocytoclastic vasculitis, 2511 in occult gastrointestinal bleeding, 861f,
Cold, common. See Common cold 862
Cold agglutinin(s), in Mycoplasma infection, screening, 53, 1286-1287, 1286t
1913, 1913f, 1915-1916 virtual, 854, 1286t, 1287
Cold agglutinin disease, 1049 Colopathy, congestive, 935
clinical manifestations of, 1050 Color blindness, 2428
definition of, 1049 Color vision, 2428
diagnosis of, 1050 aging-related changes in, 108
epidemiology of, 1049 Colorado tick fever, 2156-2161
pathobiology of, 1049-1050 Colorectal cancer, 1280
red cell destruction in, 1050 classification of, e184-2
treatment of, 1050b clinical manifestations of, 1285, 1285f
Cold autoinflammatory disease, 231 Cronkhite-Canada syndrome and, 1283
Cold injury, 668-669 diagnosis of, 854, 1285-1286, 1286f,
clinical manifestations of, 668-669, e184-2f
668t epidemiology of, 1178, 1280
definition of, 668 familial adenomatous polyposis and, 1281,
diagnosis of, 668-669, 669f 1281f, 1281t
epidemiology of, 668, 668t Gardners syndrome and, 1282
pathobiology of, 668 genetics of, 185, 185t
prevention of, 669b hereditary, e184-1, e184-2f
treatment of, 669b inflammatory bowel disease and, 920
Cold sores, 2127, 2127f, 2530-2532 juvenile polyposis and, 1281t, 1283
Cold urticaria, 1100 after liver transplantation, 1011
Colesevelam metastatic, 1288-1289
in diabetes mellitus type 2, e237-7t, MUTYH-associated polyposis and, 1281t,
e237-9 1282
mechanism of action of, 1350 pain in, 834t-836t
Colic, renal, 778, 780, 791-792. See also pathobiology of, 1280-1281, 1285, 1285f
Nephrolithiasis Peutz-Jeghers syndrome and, 1281t,
Colitis 1282-1283
amebic, 2044-2045, 2045f, 2046t predispositions to, 1281, 1281f, 1281t
vs. Campylobacter jejuni infection, prognosis for, 1287
1870 PTEN hamartoma syndrome and, 1283
Clostridium difficile. See Clostridium difficile screening for, 53, 185, 1286-1287, 1286t
infection sites of, 1285, 1285f
collagenous, 910 staging of, 1287, 1287t
cytomegalovirus, 1780, 2132 surveillance for, 1287
Escherichia coli, 1873 treatment of, 202t, 1287b-1289b
ischemic, 933, 933f, 933t Turcots syndrome and, 1282
lymphocytic, 910 weight loss with, 840t-841t
ulcerative. See Ulcerative colitis in women, 1549
Collagen, e267-1t, e267-2-e267-3 Colpitis macularis, 1799
e20 INDEX
COLQ gene, 2423
Coma, 2294
clinical manifestations of, 2295,
2295t
diagnosis of, 2295-2297, 2296t
epidemiology of, 2294
FOUR Score scale for, 2295, 2295t
Glasgow Coma Scale for, 2253t
metabolic disorders and, 2294
neurologic examination in, 2229
pathobiology of, 2294, 2295t
prognosis for, 2297
structural disorders and, 2294
treatment of, 2297b, 2297t
Comet sign, 572
Common cold, 2089-2091, 2143
clinical manifestations of, 2090
cough in, 2090-2091
definition of, 2089-2091
diagnosis of, 2090
differential diagnosis of, 2090
epidemiology of, 2089
nasal congestion in, 2089-2090
pathobiology of, 2089-2090, 2090f
pathogens in, 2089-2091, 2089t
prevention of, 2091
prognosis for, 2091
rhinorrhea in, 2089-2091
sinusitis with, 2090
treatment of, 2090b-2091b, 2090t
Common variable immunodeficiency
(CVID), 1614-1615, 1620-1621
arthritis in, 1749
autoimmune disorders and, 1620
enterovirus infection in, 2144
HLA associations in, 225t
infection in, 1620
Commotio cordis, 689-690
Communication
about prognosis, 13, 14f
emotion in, 13
for error prevention, 43-44
interpreter for, 16-17
non-English languages and, 15-17
physician-dying patient, 13, 13t, 14f
race/ethnicity and, 15
Community
in chronic disease management, 46
physical activity in, 58
Community health care worker, 17
Comorbidity, 98-100, 100f
Compartment syndrome
in hemophilia, e177-2
pain in, 488t
in rhabdomyolysis, 703-704
Complement, 217, 227, 231, 239-244
abnormalities of, 231, 1655
activation of, 240-243
alternative pathway of, 241-242, 241f
anti-C5 inhibition of, 243-244
classical pathway of, 240-241, 241f
deficiency of, 1616-1621
infection and, 1617
inhibitors of, 243-244
in kidney disease, 712-713
lectin pathway of, 241, 241f
natural inhibitors of, 243
pathogenic effects of, 240, 240f, 240t,
1655
pleural fluid, 609t
regulation of, 242, 242t, e49-1f
soluble CR1 inhibition of, 244
in systemic lupus erythematosus, 1698,
1703
Complement fixation (CF) assay, in
histoplasmosis, 1978
Complementary and alternative medicine
(CAM), 3, 177-181
culture and, 178
indigenous medical systems and, 178-179
liver disease and, 953
mind-body distinction and, 179
in pain management, 139
self-healing and, 180
for stress reduction, 180
utilization of, 177-178, 178t
Complex regional pain syndrome, 2396
Compromised host. See also Cancer; Human
immunodeficiency virus (HIV)
infection; Immunodeficiency; Organ
transplantation
cutaneous syndromes in, 1778-1779,
1778t, 1779f
fever in, 1774-1780
evaluation of, 1774-1775, 1775t-1776t,
1778t
gastrointestinal syndromes in, 1778t, 1780
immunization in, 64
neurologic syndromes in, 1778t, 1780
sinopulmonary syndromes in, 1778t, 1779
Computed tomographic angiography (CTA)
in acute coronary syndrome, 427
in coronary artery disease, 286-287, 287f,
302, 416f, 417, 418t
in intestinal ischemia, 929
in liver transplantation, 847, 849f
in peripheral arterial disease, 489-490,
489f-490f
in pregnancy, 1561
in pulmonary embolism, 598-599
in renal artery stenosis, 379, 379f
Computed tomography (CT)
in abdominal pain evaluation, 837
in actinomycosis, 1968f
in acute interstitial pneumonia, 554, 563f
in acute pancreatitis, 938t, 939, 939f
in acute poisoning, 673
in acute respiratory failure, 633, 633f
in adhesion-related small bowel
obstruction, 928f
in alcoholic liver disease, 997
in anthrax, 1838-1839, 1838f
in aortic aneurysm, 482-483, 482f
in aortic dissection, 484, 485f
in aortic hematoma, 485, 485f
in appendicitis, 921, 921f-922f
in atelectasis, 551f
in bacterial meningitis, 2359-2360
in bladder cancer, 1307
in bone mineral density measurement,
1582
in brain tumors, 1248, 1248f
in bronchiectasis, 548-549, 549f
in bronchioloalveolar cell carcinoma, 555,
555f
cardiac, 255, 286-287, 286f-287f
in cerebral arteriovenous malformation,
2323
chest, 516
in chronic pancreatitis, 942, 942f
in cirrhosis, 1003, 1003f
in coccidioidomycosis, 1980, 1980f
in colorectal cancer, 1286
in colorectal polyps, 847, 848f
in coma, 2297
in COPD, 540, 541f
in cryptogenic organizing pneumonia, 563
in cystic echinococcosis, 2056
in desquamative interstitial pneumonia,
562-563, 563f
in diverticulitis, 922, 923f
in encephalitis, 2377
in fascioliasis, 2061, 2063
in fatty liver, 1300
in gastrointestinal disorders, 847,
848f-849f
in goiter, 612f
in head and neck cancer, 1259, 1259f
in hepatic amebic abscess, 991, 994f
in hepatic cavernous hemangioma,
1298-1299
in hepatic cysts, 1300
in hepatic echinococcal cyst, 994, 994f
in hepatic focal nodular hyperplasia, 1299
in herpes simplex encephalitis, 2378
in HIV dementia, 2219
in HIV-infected patient, 2203-2204, 2208f
in Hodgkins lymphoma, 1231f
in hypersensitivity pneumonitis, 565
in idiopathic pulmonary fibrosis, 560
in interstitial lung disease, 558-559
in intracerebral hemorrhage, 2325, 2325f
in ischemic stroke, 2313-2314, 2313f
of kidneys, 713-714, 714f
Computed tomography (CT) (Continued)
in Langerhans cell histiocytosis, 566
in lipoid pneumonia, 580, 581f
in liver disease, 847f, 955-956, 964
in lung cancer, 1268
of lymph nodes, 1108
in lymphangioleiomyomatosis, 566
in malignant ascites, 926, 926f
in mediastinal disease, 522
in melanoma, 1331
in myopathy, 2411-2412
in neck pain, 2261
in nephrolithiasis, 791, 791f
in neurocysticercosis, 2055, 2055f
in neurologic disorders, 2235, 2235t
in neutropenic colitis, 923, 924f
in nocardiosis, 1970, 1971f
in nonspecific interstitial pneumonia, 562
in nontuberculous Mycobacterium spp.
infection, 1949, 1950f
in obstructive uropathy, 779
in pancreatic cancer, 1290-1291
in pansinusitis, 2457, 2457f
in pericardial constriction, 479, 480f
in peritonitis, 925, 925f
in pheochromocytoma, 1473-1474, 1473f
in pleural effusion, 608, 608f-609f
in Pneumocystis jirovecii pneumonia,
e349-2, e349-3f
in pulmonary alveolar proteinosis, 553,
555f
in pulmonary mucormycosis, 1995, 1996f
in pulmonary sequestration, 552f
in pyogenic liver abscess, 988f, 989
in renal artery thromboembolism, 786,
786f
in renal cell carcinoma, 1303-1305
in respiratory bronchiolitis-associated
interstitial lung disease, 562, 562f
in respiratory disease, 516
in rheumatic disease, 1658
in rhinocerebral mucormycosis, 1995
in sarcoidosis, 583, 583f
in sinusitis, 1614
of spleen, 1110
in subacute sclerosing panencephalitis,
2112-2113
in subarachnoid hemorrhage, 2320, 2323
of thyroid gland, e233-2
in trauma, 689, 689f-690f
in traumatic brain injury, 2253-2254,
2254f, 2254t
in tuberculosis, 1943f
Computed tomography (CT) arthrography,
in rheumatic disease, 1658
Computed tomography (CT) colography, in
colorectal cancer, 1286t, 1287
Computed tomography (CT) myelography,
in neurologic disorders, 2235t
Computed tomography (CT) venography, in
pulmonary embolism, 599
Concussion. See Traumatic brain injury
Condom
female, 1552
in HIV infection prevention, 1799, 2182
male, 1552, 1799
Condylomata acuminata. See Warts, genital
Condylomata lata, e327-2-e327-3, e327-2f
Cone snail envenomation, 698-699, 698t
Confabulation, 2273-2274
Confidence interval, e8-4
Confidentiality, in adolescent medicine, 61
Conflicts of interest, 8-9, 8t
Confounding, e8-5
Congenital adrenal hyperplasia, 1467, 1512t,
1513-1515
diagnosis of, 1517-1518
11-hydroxylase deficiency and, 1514
17-hydroxylase deficiency and, 1513
21-hydroxylase deficiency and, 1513-1514,
1514f
3-hydroxysteroid dehydrogenase
deficiency and, 1513
lipoid, 1513
17,20-lyase deficiency and, 1513
management of, 1517-1518
treatment of, 1518b-1519b
Congenital heart disease
adult, 397-409
anomalous origin of coronary arteries
in, 405-406
anomalous venous connections in,
408
aortic arch anomalies in, 408
aortic coarctation in, 404, 405f
aortopulmonary window in, 403
arterioventricular canal defect in, 407
atrial septal defect in, 400, 401f
cardiac malpositions in, 408
clinical manifestations of, 398, 398f
complex, 397, 406-408, 406f
complications of, 399
congenitally corrected transposition of
great arteries in, 407
coronary artery fistula in, 405
definitions of, 397-409
endocarditis prophylaxis in, 408
epidemiology of, 397-408
exercise in, 408-409, 409t
genetics of, 397-398
incidence of, 398
isolated shunt lesions in, 400
left ventricular outflow tract obstruction
in, 404
native, 397
patent ductus arteriosus in, 402-403,
402f
patent foramen ovale in, 401
prevalence of, 398
pulmonary arteriovenous fistula in,
403
pulmonary hypertension in, 399
right-sided Ebsteins anomaly in, 407
right ventricular outflow tract
obstruction in, 403
simple, 397, 400-408, 401f-402f, 405f
sinus of Valsalva aneurysm in, 405
tetralogy of Fallot in, 406, 406f
transposition of great arteries in,
406-407
treatment of, 397, 398f, 398t,
399b-400b, 400f
tricuspid atresia in, 407-408
univentricular heart in, 407-408
valvular aortic stenosis in, 404
valvular pulmonary stenosis in, 404
ventricular septal defect in, 401-402
echocardiography in, 282t-284t
epidemiology of, 398
genetics of, 397-398
magnetic resonance imaging in, 289, 289f
Congenital nonspherocytic hemolytic
anemia, e164-6
Congenital pulmonary airway malformation,
551
Conjugate gaze, disorders of, 2448
Conjunctiva, 2426, 2427f. See also
Conjunctivitis
Chlamydia trachomatis infection of,
e326-2-e326-4
lymphoma of, 2442
malignant melanoma of, 2426
melanoma of, 2441
sarcoidosis of, 584
squamous cell carcinoma of, 2426
tularemia of, 1894
Conjunctivitis, 2429, 2429t, 2434t
adenoviral, 2101-2102, 2101t, 2434,
2434f, 2434t
allergic, 2434, 2434t
bacterial, 2434, 2434t, 2435f
in cat-scratch disease, 1908
Chlamydia trachomatis, e326-4
chlamydial, 2434, 2434t, e326-2-e326-4
Haemophilus influenzae in, 1862
hemorrhagic, 2143
Connective tissue, e267-1-e267-6
aging-related changes in, e267-5
cell receptors of, e267-4-e267-5
cells of, e267-1, e267-1t
degradation of, e267-5-e267-6
macromolecules of, e267-1-e267-5
proteins of, e267-1-e267-5
structures of, e267-5
 INDEX e21
Connective tissue disease, 1662-1667, 1662t. Copy-number variation, 189, 189f, 191-192, Coronavirus infection (Continued) Cortisol (Continued)
See also specific diseases 193f-194f, 199 prevention of, 2104 plasma, midnight, 1465
laboratory testing in, 1653-1655 Cor triatriatum, 408 SARS, 2104 replacement of, 1434t
myelopathy in, 2268 Coral snake envenomation, 695-696 treatment of, 2104b salivary, 1465
pulmonary hypertension in, 389 Coral sting, 698t, 699 Corrigans pulse, 461 midnight, 1437t
Consciousness, 2294 Coris disease, 1356t Cortical blindness, 2273 serum, 1190, 1468
altered/loss of, 2294-2299. See also Cornea, 2426, 2427f. See also Keratitis; Cortical veins, 2306, 2307f synthesis of, 1439, e241-1f
Cardiac arrest; Coma; Syncope; Keratoconjunctivitis Corticobasal degeneration, vs. Parkinsons undernutrition effects on, 1389
Vegetative state abrasion of, 2429, 2429t, 2433 disease, 2329t urinary, 1189-1190, 1190f, 1464-1465
in acute poisoning, 672t arch welder burn of, 2429 Corticosteroid(s), 159-161 Cortisone, 161t. See also Corticosteroid(s)
in minimally conscious state, 2298, clouding of, 1358t adverse effects of, 160-161, 162t aging-related changes in, 107
2298t genetic disease of, 2440-2442 in allergic rhinitis, 1627, 1628t Corynebacterium minutissimum infection,
in shock, 647, 647t infection of, 2429t in asthma, 535, 535t 2545
Constipation, 842, 866-867 Kayser-Fleischer ring of, 953-954, 1371, in autoimmune hemolytic anemia, 1049 Corynebacterium spp. infection, 1834t, 1835.
abdominal pain and, 833 1372f in bacterial meningitis, 2364 See also Diphtheria
aging-related, 106 pterygium of, 2432, 2433f in Behets syndrome, 1723 Cosmetics, 2514
in diabetes mellitus type 1, e236-15 recurrent erosion of, 2432-2433 in brain abscess, 2372b Cost(s)
diagnosis of, 831t-832t, 866, 867t stromal dystrophy of, 2440 in cancer, 1166 of cardiovascular disease, 256
diet and, 1381t Coronary artery (arteries) cardiovascular effects of, 161 of health careassociated infection, e290-1,
in dying patient, 10t angiography of, 292-294, 294f in chronic inflammatory demyelinating e290-2t
in endocrine disorders, 1420 anomalous origin of, 292-294, 294f, polyradiculoneuropathy, 2402b measurement of, 39
epidemiology of, 866 405-406 in COPD, 541-542, 542t Cost-benefit analysis, 39
in multiple sclerosis, 2349 calcification of, 268 cytokine effects of, 160 in clinical decision-making, 36-37
pathobiology of, 866 catheterization of. See Cardiac in De Quervains tenosynovitis, 1679, Cost-effectiveness analysis, 39
treatment of, 867b, 867f catheterization 1679f in clinical decision-making, 36-37, 36t
Consultation. See Medical consultation fistula of, 405 in Diamond-Blackfan anemia, 1089 Costochondritis, 418
Contact dermatitis obstruction of. See Atherosclerosis; in eosinophilic gastroenteritis, 912-913 Cotton mill fever, 574t
allergic, 2506-2507, 2507f, 2515 Coronary heart disease; Myocardial in focal segmental glomerulosclerosis, Cough, 512
drug-related, 2536 infarction (MI) 764b acute, 512, 513t
irritant, 2515 right, anomalous, 286-287, 286f formulations of, 160, 161t in bronchiectasis, 548
nickel, 93 Coronary artery bypass grafting (CABG), gastric complications of, 889 in bronchitis, 587
Contact isolation, e290-4 451-452, 451f genomic effects of, 159-160 chronic, 512, 513t
Continuous ambulatory peritoneal dialysis, in acute coronary syndrome, 432 in hypercalcemia of malignancy, 1189b in common cold, 2090-2091
821-822, 821f in angina pectoris, 452 in hypereosinophilia, 1120-1121 in heart failure, 249-250
infection with, 926-927 antithrombotic therapy in, 175t-176t in idiopathic pulmonary fibrosis, 561b in lung cancer, 1266
Continuous positive airway pressure (CPAP), in cardiogenic shock, 656f, 657 in idiopathic thrombocytopenic purpura, mechanical ventilation and, 640
638 with coexisting cardiac disease, 452 1128t in Mycoplasma pneumoniae infection,
in acute respiratory failure, 633-634 in failed percutaneous coronary in IgA nephropathy, 766b 1913-1914
Continuous venovenous hemofiltration intervention, 452 indications for, 160 postinfectious, 512
(CVVH), 820-821 in heart failure, 315 infection and, 160 syncope with, 341
Contraception, 1552-1555 indications for, 452 in inflammatory bowel disease, 917, 917t treatment of, 512b
for adolescents, 62 in myocardial infarction, 452 interleukin effects of, 160 whooping. See Pertussis (whooping
barrier, 1552, 1799 outcomes of, 452 in interstitial lung disease, 560t cough)
diaphragm for, 1552 vs. percutaneous coronary intervention, in kidney transplantation, 824f, 825, 825t Counseling, 53t
effectiveness of, 1552 452, 453f leukocyte effects of, 160 for alcohol use/abuse, 151, 151t
emergency, 1555 reoperation, 452 in liver transplantation, 1009-1010 for behavioral change, 50-52, 51f, 51t
female condom for, 1552 risks of, 451-452 in lupus nephritis, 769-770 genetic. See also Genetic testing
injectable contraceptives for, 1554-1555 in ST segment elevation MI, 438f, 452 mechanism of action of, 159, 159t in inborn errors of metabolism,
intrauterine devices for, 1555 in stable myocardial ischemia, 422-424, in membranous nephropathy, 764b-765b 1345
intravaginal ring for, 1554 452 metabolic effects of, 161 in opioid dependence treatment, 156
male condom for, 1552 Coronary heart disease. See also Acute in minimal change disease, 763b for physical activity, 58
oral, 1552-1554. See also Oral coronary syndrome; Cardiovascular in multiple sclerosis, 2353 in sexual development disorders, 1519
contraceptives disease; Myocardial infarction (MI) in nausea and vomiting, 843t-844t in sexually transmitted disease prevention,
subdermal implants for, 1555 angiography in, 286-287, 287f, 292, 293f nongenomic effects of, 160 1799
transdermal patch for, 1554 calcification in, 286, 286f-287f osteoporosis and, 161, 163f, 1585-1586 Courvoisiers sign, 1290
types of, 1552-1555 computed tomography in, 286, 286f in pain, 136t Cowdens syndrome (PTEN hamartoma
use of, 1552 diet and, 1381t in pemphigus, 2528b syndrome), 1194t, 1283, 2537, 2538f
Contracture, muscle, 2230 functional imaging in, 287 perioperative, 1758, 2482 Cowpox, 2117, 2120
Contrast media heart failure and, 302 in Pneumocystis jirovecii pneumonia, Coxiella burnetii infection. See Q fever
allergic reactions to, cardiac catheterization hypertension and, 387 e349-5-e349-6, e349-6f, e349-6t Coxsackievirus infection, 2140-2144. See
and, 291 magnetic resonance imaging in, 287, 288f in polymyalgia rheumatica, 1729, 1730b also Enterovirus infection
nephropathy with mortality from, 374f in pregnancy, 1562b-1563b group A, 2140t-2141t
cardiac catheterization and, 291 myocardial perfusion imaging in, 285, 285f preoperative, 2478t acute hemorrhagic conjunctivitis with,
prevention of, 760 nutrition and, 1380 in pruritus, 2502t 2143
in pregnancy, 1556 positron emission tomography in, 285-286 in radiation lung injury, 579b hand-foot-and-mouth disease with,
Conversion disorder, 2244t preoperative assessment of. See Cardiac in refractory idiopathic thrombocytopenic 2143
Conviction-Confidence Ruler, 50, 51f risk assessment purpura, 1129t group B, 2140t-2141t
Cooleys anemia, 1063 prevention of, 175t-176t, 1380 in sarcoidosis, 585b, 585t meningeal, 2142
Cooling therapy, in heat illness, 667b-668b, rheumatoid arthritis and, 1686 in septic shock, 664 myopericardial, 2143
668t risk assessment for, 1353 in spondyloarthropathies, 1691 pleurodynia in, 2144
Coombs test single-photon emission computed systemic effects of, 160 CR1, soluble, 244
direct (antiglobulin), 1048 tomography in, 285-286 in systemic sclerosis, 1711 Crab lice, 1797t, 2080
indirect, 1048 treatment of. See Coronary artery bypass in temporal arteritis, 1729, 1730b Crackles, 25
COPD. See Chronic obstructive pulmonary grafting (CABG); Percutaneous in vasculitic neuropathy, 2405b Cramps, 2230, 2410
disease (COPD) coronary intervention (PCI) weight gain with, 1413t in amyotrophic lateral sclerosis, 2344
Copepods, 2079 ventricular tachycardia in, 373 Corticotropin-releasing hormone (CRH), heat, 667
Copper, e225-6t-e225-7t in women, 1548 1412t, 1426 Cranberry products, 1796
deficiency of, 1043-1044, 2383t, 2385, work stress and, 179 biosynthetic, 1426 Cranial nerves, toxicant effects on, 672
e225-6t-e225-7t Coronavirus infection, 2102-2104 ectopic production of, 1189-1192 Craniopharyngioma, 1428
hepatic, 1372. See also Wilsons disease clinical manifestations of, 2103, 2104t Corticotropin-releasing hormone (CRH) Creatine kinase
toxicity of, e225-6t-e225-7t in common cold, 2089, 2089t. See also test, 1434t, 1437t, 1441t in myopathy, 2411
urinary, 1372 Common cold Cortisol in rhabdomyolysis, 703
Coproporphyria, hereditary, 1364f, 1365t, definition of, 2102-2104 deficiency of, 1439-1440. See also Creatinine
1369-1370 diagnosis of, 2104 Congenital adrenal hyperplasia in hypovolemia, 724
drugs and, 1366t epidemiology of, 2103 excess of. See Cushings disease; Cushings serum, 708
Coproporphyrinogen oxidase deficiency, non-SARS, 2104 syndrome in acute interstitial nephritis, 773
1364f, 1365t-1366t, 1369-1370 pathobiology of, 2103 function of, 1463 in acute kidney injury, 756, 759
e22 INDEX
Creatinine (Continued)
measurement of, 708-709
normal, 708-709
urinary, 709
Creatinine clearance, 708-709
calculation of, 709
in drug clearance evaluation, 129
CREST syndrome, 1705
antinuclear antibodies in, 1654t, 1655
gastrointestinal telangiectases in, 935
Creutzfeldt-Jakob disease, 2380-2382
iatrogenic, 2381
new-variant, 1966t
slowly progressive, 2381
sporadic, 2381
variant, 2381
CRH. See Corticotropin-releasing hormone
(CRH)
Cricoarytenoid joint, rheumatoid arthritis of,
1685
Cricopharyngeal bar, 882
Cricopharyngeal spasm, 2471
Crigler-Najjar syndrome, 957, 959, 960t
type 1, 959
type 2, 959
Crimean-Congo hemorrhagic fever,
2147-2156, 2148t-2149t, 2151t. See
also Viral hemorrhagic fevers
Critical care, 624-626. See also Dying patient
analgesia in, 624
discharge from, 624
evidence-based, 624-625
example of, 625t
fluid resuscitation in, 624
long-term outcomes of, 624
mechanical ventilation in, 638-645. See
also Mechanical ventilation
rationing of, 625
respiratory failure in, 629-638. See also
Respiratory failure
respiratory monitoring in. See Respiratory
system, monitoring of
sedation in, 624
in shock, 645-654. See also Shock
spontaneous breathing trials in, 624
team for, 624
Critical illness myopathy, 2406
Critical illness polyneuropathy, 2406
Crohns disease, 913-921, 1668t
abscess in, 919
antibodies in, 916
arthritis in, 1696, 1696t
clinical manifestations of, 914, 914t
colonoscopic surveillance in, 920
colorectal cancer and, 1281
complications of, 919-920
definition of, 913
diagnosis of, 915, 916f
epidemiology of, 913
esophageal involvement in, 884
extraintestinal features of, 914-915, 915t
fistula in, 914, 918-920
gastrointestinal distribution of, 914
genetics of, 913-916
magnetic resonance enterography in,
847-848, 850f
mucosal ulcers in, 914
obstruction in, 919
pathobiology of, 913-920
pathophysiology of, 914
perianal disease in, 920
pregnancy and, 920
prognosis for, 920
sclerosing cholangitis and, 1014t
treatment of, 916b-920b, 917t, 918f
medical, 916-919, 917t, 918f
surgical, 919
tumor necrosis factor- inhibitors in,
165-166
ustekinumab in, 166
ulcers in, 887-888, 888t
Cromolyn sodium
in allergic rhinitis, 1626-1627
in asthma, 536
Cronkhite-Canada syndrome, 1283
Crossed straight leg raise test, 2261
Croup, 2093, 2093f
Crush injury, 701t, 704 Culture (microbe) (Continued) Cyclosporine (Continued)
Crust, cutaneous, 2504t in HIV-associated pulmonary disease, infection and, 163
Crustaceans, 2079 2204 in inflammatory bowel disease, 917t
Cruzan case, 6 intestinal aspirate, 903t, 904 in kidney transplantation, 824f, 825, 825t
Cryoablation, of supraventricular in leptospirosis, 1938 in membranous nephropathy, 764b-765b
arrhythmias, 372 in mucormycosis, 1997 in minimal change disease, 763b
Cryoglobulin(s), 713, 1655 in mycetoma, 2006 in pruritus, 2502t
Cryoglobulinemia, 669, 1242-1243 in Neisseria gonorrhoeae infection, e307-2 renal toxicity of, 770
bleeding with, 1136 in nocardiosis, 1971 topical, 163
gastrointestinal involvement in, 934 in non-spore-forming anaerobic bacterial Cyclothymic disorder, 2239-2240
mixed, 770 infection, 1849, 1850t CYP2C9 gene, 200-201
type I, 713, 1243, 1243f in plague, 1898 Cypher, 320t
type II, 713, 1243 in pneumococcal pneumonia, 1822 Cyproheptadine, in pruritus, 2512t
type III, 713, 1243 in pneumonia, 590-591 Cyst(s)
vasculitis with, 1726, 2405t in pyogenic liver abscess, 989 arachnoid, 1250-1251
Cryopyrinopathy, 1671 in rhinosinusitis infection, 2456 Bakers, 1680, 1684-1685, e272-1f
Cryptococccal polysaccharide antigen in rubella, 2108 bronchogenic, 551
(CRAG) test, 1984, 2204 sputum, 590 choledochal, 1013
Cryptococcosis, 1983-1985 stool, 1789t, 1790, 1790f-1791f colloid, of third ventricle, 1252
clinical manifestations of, 1984-1985 in cholera, 1867 epidermal, 2537
CNS, 1975, 1984-1985 in Salmonella infection, 1886 esophageal, duplication, 886
cutaneous, 1984 in shigellosis, 1889-1890 hepatic
definition of, 1983-1985 in yersiniosis, 1900 benign, 1298f, 1300-1303
diagnosis of, 1984, 2204 surveillance, e290-3-e290-4 echinococcal, 990t-992t, 991-996, 994f
epidemiology of, 1983 in tuberculosis, 1945 mediastinal, 612
hepatic, 990 urine, 1793-1796 mesenteric, 927
HIV infection and, 2210, 2222t, 2223 in viral meningitis, 2367 mucin, 2537-2538
meningeal, 1975, 1984-1985 Curlings ulcers, 889 ovarian, 834t-836t, e244-10-e244-14. See
pathobiology of, 1983-1984 Cushing reflex, 28 also Polycystic ovary syndrome
prognosis for, 1985 Cushings disease, 1440-1442, 1465, 1465t pancreatic, 1290
pulmonary, 1984-1985, 2203, 2203f clinical manifestations of, 1440-1441, pericardial, 481
treatment of, 1984b-1985b 1440f, 1440t popliteal, 1680, 1684-1685, e272-1f
Cryptococcus gattii infection, 1983 diagnosis of, 1441-1442, 1441t, 1465 Rathkes cleft, 1428
Cryptogenic organizing pneumonia, 559t, pathobiology of, 1440 renal, 794-800. See also Kidney disease,
563, 563b treatment of, 1441b cystic
Cryptorchidism, 1516, 1518-1519 Cushings syndrome, 1464-1469, 1464f sebaceous, 2537
Cryptosporidiosis, 897-898, 2038-2040 cancer-related, 1189-1192, 1190f synovial, 1680, 1684-1685, e272-1f
in children, 2039-2040 clinical manifestations of, 1464, 1464t thoracic, 551
clinical manifestations of, 2038-2039 cortisol levels in, 1464-1465, 1464f Cystathionine -synthase deficiency,
definition of, 2038-2040 vs. Cushings disease, 1440 1151-1152, 1361-1363, 1362t
diagnosis of, 1790f-1791f, 2040 dexamethasone suppression test in, 1441t, Cysteamine, 801
epidemiology of, 2038 1465 Cystectomy, 1307
hepatic, 990t-992t diagnosis of, 1464-1467 Cystic adventitial disease, 498
in immunocompetent host, 2039 differential diagnosis of, 1465-1466, 1465t Cystic fibrosis, 544-548, 1341t
in immunocompromised host, 2040, 2199 factitious, 1465 adult diagnosis of, 546, 547t
pathobiology of, 2038, 2039f gastrinoma and, 1293 arthritis in, 1751
prevention of, 2040 after hematopoietic stem cell aspergillosis in, 1992
treatment of, 2040b transplantation, 1162 clinical manifestations of, 514t, 545
Crystal(s), 1737-1743 hypertension with, 378t definition of, 544-547
basic calcium phosphate. See Apatite- hypothalamic lesions and, 1430 diagnosis of, 546-547, 547t
associated arthropathy laboratory findings in, 1464-1465 epidemiology of, 544
calcium hydroxyapatite, in systemic obesity in, 1412-1413 exacerbation of, 546
sclerosis, 1708-1709 in pregnancy, 1558 gastrointestinal tract in, 546-547
calcium pyrophosphate dihydrate. See treatment of, 1466b genetics of, 196, 545, 545t
Calcium pyrophosphate dihydrate Cushings ulcers, 889 incidence of, 544
(CPPD) deposition disease Cutaneous larva migrans, 2547 infection in, 546-547
hemoglobin C, 1027f Cyanide antidote kit, 679t-683t intestine in, 545
synovial fluid, 1653, 1653f Cyanide poisoning, 578-581, 679t-683t, liver in, 545, 986
urate, 712, 712f, 1738-1739. See also Gout; 691-692, 2385 lungs in, 544, 546
Hyperuricemia Cyanosis, 253, 255f, 397, 626, 631-632 pancreas in, 545
urinary, 712, 712f central, 253, 397 pathobiology of, 544-546
Cubam receptors, 1075 peripheral, 253 prevention of, 547
Cuban tobacco-alcohol amblyopia, 2385 Cyclic citrullinated peptide, antibodies to, prognosis for, 547
Cubital tunnel syndrome, 2408 1653 Pseudomonas aeruginosa infection in, 1879
Cuff-leak volume, before extubation, 645 Cyclin D1, in esophageal cancer, 1273 reproductive tract in, 545
Cullens sign, 837t Cyclizine, in nausea and vomiting, 843t-844t screening for, 185t, 546
Cultural competence, 16-17, 16f Cyclooxygenase-1 (COX-1), 168 secondary organ involvement in, 545-546
Culture (human), healing practices and, inhibition of, 169-171, 169f-170f sinuses in, 544
178-179 Cyclooxygenase-2 (COX-2), 168 Stenotrophomonas maltophilia infection in,
Culture (microbe), 1804 in inflammation, 235 1883
in adenovirus infection, 2102 inhibition of, 169-171, 169f sweat glands in, 545
in anthrax, 1838 Cyclophosphamide, 159t, 162t, 164-165, treatment of, 547b
in bacterial meningitis, 2359 1168t-1176t gene therapy in, 210
in Bartonella infection, 1910 cystitis with, 165 Cystic fibrosis transmembrane conductance
in blastomycosis, 1982 dilated cardiomyopathy with, 326-327 regulator (CFTR), 544-545
body fluid, 590-591 hepatotoxicity of, 981t, 984 Cysticercosis, 2053t, 2054-2056
in brucellosis, 1892 infection and, 165 calcification in, 2054
in Candida infection, 1989 in systemic lupus erythematosus, cerebral, 1966t
in chancroid, 1865 1703-1704 clinical manifestations of, 2054, 2055f
in cytomegalovirus infection, 2132 in systemic sclerosis, 1711 definition of, 2054
definition of, 15 Cyclosporiasis, 1790f-1791f, 2010, diagnosis of, 2055, 2055f
in dematiaceous fungal infection, 2008 e361-4-e361-5, e361-4f epidemiology of, 2054
in disseminated gonococcal infection, Cyclosporine, 159t, 163-164 pathobiology of, 2054
e307-4-e307-5 adverse effects of, 162t prognosis for, 2055
in Erysipelothrix rhusiopathiae infection, in anaphylaxis, 1637 subarachnoid, 2055
1840 in Behets syndrome, 1723 treatment of, 2055b
in histoplasmosis, 1978 hepatotoxicity of, 981t ventricular, 2055

Cystine crystals, 712, 712f Danazol, in hereditary angioedema, 1632
Cystinosis, 801, 801t, 1360 Dancing eyes, 2448
Cystinuria, 791, 800-801, 801t, 1341t Dandy-Walker malformation, 2387
prevention of, 794 Dantrolene, 2484
Cystitis. See also Urinary tract infection Dapsone
clinical manifestations of, 1793-1796, in leprosy, 1953-1954
1793t in Pneumocystis jirovecii pneumonia,
diagnosis of, 1793-1796, 1795t e349-4b-e349-7b, e349-6t
differential diagnosis of, 1794 in skin diseases, 2511
epidemiology of, 1792 Daptomycin, 1807t-1811t, 1813
etiology of, 1793, 1793t Darbepoetin, 1167-1177
follow-up for, 1795 Dariers sign, 1642
hemorrhagic, 165, 2101, 2101t Dark-field examination, e327-4
pathobiology of, 1792-1793 Dasatinib, 167, 1168t-1176t
prognosis for, 1796 in chronic myelogenous leukemia,
treatment of, 1773, 1794, 1795t 1212-1213
Cystography, retrograde, in obstructive DASH (Dietary Approaches to Stop
uropathy, 780 Hypertension) diet, 1381
Cystoisospora (Isospora) belli infection, 2010, Data
e361-4-e361-5, e361-4f clinical sources of, 39
Cystoscopy, in bladder cancer, 1307 governmental sources of, 39
Cytarabine, 1168t-1176t measurement, 39, 40t
Cytochrome oxidase inhibitors, central quality measurement sources of, 39
nervous system effects of, 672t Daunorubicin, 326-327, 1168t-1176t
Cytochrome P-450, drug interactions with, Daycare, diarrhea and, 897t, 898
1765 DCC gene, 1285
Cytochrome P-450 oxidoreductase De Mussets sign, 461
deficiency, 1515 De Quervains tenosynovitis, 1679
Cytokine(s), 215t, 216 De Quervains thyroiditis, e233-9
in anaphylaxis, 1635 Dead space, pulmonary, 628
corticosteroid effects on, 160 Death. See also Dying patient
in diabetic nephropathy, 781 behavior-related causes of, 17-18, 18f
in heart failure, 298 brain, 2295t, 2298, 2299t, 2309
HLA associations with, 225t sudden. See also Cardiac arrest
in inflammation, 232, 234f, 235, e47-1t antipsychotic-induced, 2493
Cytokine release syndrome, 1638-1639 cardiac risk for, 361, 366, 366t
Cytomegalovirus (CMV) infection, family history of, 361
2111-2114, 2131-2133 in hypertrophic cardiomyopathy,
clinical manifestations of, 2132 323
congenital, 2132 refeeding and. See Refeeding syndrome
definition of, 2131-2133 Debranching enzyme defect, 1356t
diagnosis of, 2132-2133, 2133f Dbridement, in central airway obstruction,
encephalitic, 2111, 2377t 617b-618b
epidemiology of, 2131 Debrisoquin, metabolism of, 187t
esophageal, 884, 2198 Decerebrate posturing, 2296t, 2297
gastrointestinal, 1780, 2132 Decision-making
HIV infection and, 2132, 2192t-2193t, clinical. See Clinical decision-making
2198, 2224 patient, 5-7, 6t, 102. See also Informed
immune reconstitution inflammatory consent
syndrome and, 2222t, 2224 proxy, 5
immunization against, 64t Decitabine, in myelodysplastic syndrome,
myelitic, 2111 1202
neonatal, 2132 Decompression illness, 576-581
pathobiology of, 2131-2132, 2131f Decongestants, 1624, 1626
polyradiculomyelitic, 2111 Decontamination, in acute poisoning, 679
prevention of, 1155, 2132-2133 Decorticate posturing, 2296t, 2297
prognosis for, 2133 Deep brain stimulation, in Parkinsons
retinal, 2132, 2132f, 2192t-2193t, 2195, disease, 2333
2224, 2435 Deep vein thrombosis (DVT), 499-506
transfusion-transmitted, 1155 algorithms for, 500f, 501-502
in transplant recipients, 2132 in cancer, 1198-1200
treatment of, 2112b, 2133b clinical manifestations of, 499, 499f
cidofovir in, 2083t, 2084-2085, 2112b, compression ultrasonography in, 500-501,
2133b 501f
fomivirsen in, 2083t, 2085 contrast venography in, 500, 500f
foscarnet in, 2083t, 2085, 2112b, D-dimer test in, 501
2133b definition of, 499
ganciclovir in, 2083-2084, 2083t, 2112b, diagnosis of, 499-506, 500f, 500t
2133b differential diagnosis of, 502-505, 502t
valganciclovir in, 2083-2084, 2083t, epidemiology of, 499
2112b, 2133b HIV infection and, 2214
Cytotoxic T-lymphocyte antigen-4, 1508 magnetic resonance venography in, 501
pain in, 488t
pathobiology of, 499
D post-infarction, 446
D-zone test, 1763-1764 during pregnancy, 499, 502, 505, 1560
Dabigatran etexilate, 174 prevention of, 505
Dacarbazine, 1168t-1176t recurrent, 502, 504
Daclizumab, in asthma, 531 treatment of, 171-177, 175t-176t,
Dacrocyte, 1026f 502b-504b, 502t-503t, 503f
Dacryoliths, 2426 upper extremity, 505
Dactylitis Deer fly fever. See Tularemia
in psoriatic arthritis, 1695-1696 DEET (N,N-diethyl-3-methylbenzamide),
in reactive arthritis, 1694 2081
Dairy products, malabsorption of, 905 Defecation, 863, 864f. See also Constipation;
Dalbavancin, 1807t Diarrhea
Dalfopristin, 1807t, 1813 Deferoxamine, 90t. See also Chelation therapy
Defibrillation, 371
automated external defibrillator for, 346,
346t
complications of, 371
direct current cardioversion for, 347, 347f
indications for, 371
Degarelix, 1168t-1176t
Dehydration
aging-related, 106-107
in cholera, 1867
in hypercalcemia, 1594
vasopressin in, e232-2
Dehydroepiandrosterone (DHEA), 1463
Dehydroepiandrosterone sulfate, in
amenorrhea, e244-8
Dejerine-Sottas neuropathy, 2400
Delayed sleep syndrome, 2303
Delirium, 108, 117-121
in acute poisoning, 672t
clinical manifestations of, 119
definition of, 117, 117t
vs. dementia, 119-120, 2275
differential diagnosis of, 119-120
in dying patient, 10t
end-of-life care in, 120
epidemiology of, 114, 117
evaluation of, 118f, 119-121, 119t
laboratory findings in, 119
medical treatment of, 120
nonpharmacologic management in, 120
pathobiology of, 117-119
postoperative, 2489
prognosis for, 120
risk factors for, 117-119, 120t
treatment of, 120b
Delirium tremens, 148
Delta-delta measure, 745
Delusional disorder, 2243t, 2244
Delusory parasitosis, 2081
Dematiaceous fungal infection, 2007-2008
clinical manifestations of, 2008
definition of, 2007-2008, 2007t
diagnosis of, 2008
epidemiology of, 2008
pathobiology of, 2008
treatment of, 2008b
Dementia, 2274-2283. See also Alzheimers
disease
alcohol-related, 148, 2386
clinical manifestations of, 2275
definition of, 2274, 2274t
vs. delirium, 119-120, 2275
diagnosis of, 2275-2283, 2275f
differential diagnosis of, 2275-2276, 2276f
end-of-life care in, 2276
epidemiology of, 114, 2274
frontotemporal, 2281-2283
in amyotrophic lateral sclerosis, 2344
clinical manifestations of, 2282
definition of, 2281, 2281t
diagnosis of, 2282, 2282f
epidemiology of, 2281-2282
pathobiology of, 2282
prognosis for, 2283
treatment of, 2283b
HIV, 2218-2222
clinical manifestations of, 2219,
2219t-2220t
definition of, 2218
diagnosis of, 2219, 2220f, 2220t
epidemiology of, 2218
histopathology of, 2219, 2219f
pathobiology of, 2218-2219
prognosis for, 2220
treatment of, 2219b-2220b, 2221f
Lewy body, 2280-2281
vs. Alzheimers disease, 2278-2279
clinical manifestations of, 2280-2281
definition of, 2280, 2280t
diagnosis of, 2281
differential diagnosis of, 2281
epidemiology of, 2280
vs. Parkinsons disease, 2329t
pathobiology of, 2280
prognosis for, 2281
treatment of, 2281b
neuropsychiatric symptoms in, 2275
INDEX e23
Dementia (Continued)
pathobiology of, 2275
in prion diseases, 2381-2382, 2382t
prognosis for, 2276
vs. psychiatric disease, 2275
rapidly progressive, 2381-2382, 2382t
secondary, 2275-2276
semantic, 2282
urinary incontinence and, 111
vascular, 2279
vs. Alzheimers disease, 2279
atherosclerosis and, 2279
clinical manifestations of, 2280
definition of, 2279
diagnosis of, 2279t, 2280
epidemiology of, 2279
infarction and, 2279-2280
pathobiology of, 2279-2280
prevention of, 2280b
prognosis for, 2280
risk factors for, 2279
Demyelinating disease, 2347-2355, 2347t.
See also Multiple sclerosis
Dendritic cells, 216, 216f-217f, e159-2f,
e85-2
Dengue, 2148t-2149t, 2151t, 2157. See also
Viral hemorrhagic fevers
shock with, 2157
transmission of, 2150, 2157
Denileukin diftitox, in skin diseases, 2513
Denosumab
in bone metastasis, 1189b
Dense deposit disease, 765
Dense granule storage pool deficiency, 1135
Dent disease, 801t
Dental infection, non-spore-forming
anaerobic bacteria in, 1849
Dental procedures, antibiotic prophylaxis for,
408, 472, 472t-473t
Dentate line, 945
Deoxycoformycin, in hairy cell leukemia,
1214b
Deoxyribonucleic acid (DNA), 187-188
antibodies to, 1654
damage to. See Mutation(s) and specific
genes
methylation of, 199-200
in lung cancer, 1266
repair of, inborn errors of, 1344
therapeutic delivery of. See Gene therapy
Dependence
alcohol, 146t, 147, 151, 152t
drug, 140, 153, 153t. See also Addiction;
Drug abuse
Dependent personality disorder, 2245t
Depot medroxyprogesterone acetate
(DMPA), 1554-1555
Depression, 2237-2245
back pain in, 2261-2262
clinical manifestations of, 2236t-2237t,
2237
diagnosis of, 26, 2237
disease risk and, 179
in dying patient, 10t
epidemiology of, 114, 2237
in fibromyalgia, 1744-1745
in heart failure, 314-315
in older adults, 102, 104t, 114, 114t
pain and, 134, 138
pathobiology of, 2237
during pregnancy, 1550t, 1551
screening for, 53
treatment of, 2237b-2238b, 2238t-2239t
weight loss with, 840t-841t
in women, 1550-1551, 1550t
Dermablend, 2514
Dermal-epidermal junction, 2499f, 2500
Dermatitis. See also Skin, lesions of
actinic, chronic, 2516, 2516f
atopic, 2514-2515, 2515f, 2550f
HIV infection and, 2211
beetle-related, 2080
contact
allergic, 2506-2507, 2507f, 2515
drug-related, 2536
irritant, 2515
nickel, 93
e24 INDEX
Dermatitis (Continued)
eczematous, 2506-2507, 2506t, 2514,
2514t
nummular, 2514, 2514f
occupation-related, 76t, 77
perioral, 2531, 2531f
schistosome, 2059
seborrheic, 2515, 2515f, 2550f
HIV infection and, 2211
Dermatitis herpetiformis, 225t, 911, 2527,
2527f
Dermatochalasis, 2426
Dermatofibroma, 2537-2538
Dermatofibrosis lenticularis disseminata,
1608
Dermatomes, 2258, 2259f
Dermatomyositis, 1716-1720, 2417, 2417t
antinuclear antibodies in, 1654t
cancer and, 1718
clinical manifestations of, 1717-1718,
1717t, 1718f, 1719t
definition of, 1716, 1716t, e277-1f
diagnosis of, 1718, 2412
differential diagnosis of, 1719t
epidemiology of, 1716
esophageal, 884
genetic factors in, 1717
paraneoplastic, 1193t, 1196t, 1197-1198
pathobiology of, 1716-1717, e277-1f
prognosis for, 1720
pulmonary abnormalities in, 564
treatment of, 1719b-1720b
Dermatomyositis sine myositis, 1718
Dermatophytoses, 2521
Dermis, 2498, 2500
Dermographism, 1629
Descemets membrane, copper deposition in,
953-954, 1371, 1372f
Desflurane, hepatotoxicity of, 983
Desipramine
in depression, 2239t
in irritable bowel syndrome, 871t
in pain, 136t
Desmin, 320t
Desmocollin 2, 320t
Desmoglein 2, 320t
Desmoplakin, 320t
Desmopressin (DDAVP)
in diabetes insipidus, e232-5b-e232-6b
in hemophilia, e177-5
in hypopituitarism, 1434t
in von Willebrands disease, 1134
Desmosomes, 2498, 2499f
Desquamative interstitial pneumonia, 559t,
562, 563b, 563f
Desvenlafaxine
in depression, 2239t
in menopausal hot flushes, 1569t-1570t
Detrusor overactivity, 110, 113t
Detrusor-sphincter dyssynergia, 111
Detrusor underactivity, 111, 113t
Devics disease, 2354
Dexamethasone, 161t, 1168t-1176t
in high-altitude syndromes, 575-576
in nausea and vomiting, 843t-844t
Dexamethasone suppression test, 1190,
1437t, 1441, 1441t, 1465
Dexlansoprazole, in gastroesophageal reflux
disease, 878t
Dexmedetomidine, 2485
Dexrazoxane, 1168t-1176t
Dextroamphetamine, micronutrient effects
of, e225-8t
Dextrocardia, 408
Diabetes insipidus, 723, e232-3-e232-4
central, e232-3-e232-4
clinical manifestations of, e232-3-e232-4
definition of, e232-3
diagnosis of, e232-4-e232-7, e232-5f
dipsogenic, e232-4
etiologic diagnosis of, e232-5
gestational, e232-3-e232-4
hypothalamic lesions and, 1431
nephrogenic, 801t, e232-3-e232-4
pathobiology of, 2392, e232-3
physiologic diagnosis of, e232-4-e232-5,
e232-5f
Diabetes insipidus (Continued)
postoperative, e232-6, e232-6f
vs. primary polydipsia, e232-5
prognosis for, e232-6-e232-7, e232-6f
trauma-related, e232-6, e232-6f
treatment of, e232-5b-e232-6b
tumor-related, e232-5
Diabetes mellitus, 228t, e236-1-e236-17,
e237-1-e237-14
abdominal pain in, 834t-836t
amyotrophy in, 1749
cardiovascular disease and, 257
in cystic fibrosis, 545-546
diarrhea in, 910
diet and, 1381, 1381t, 1383t
dilated cardiomyopathy with, 327
endometrial cancer and, 1318
extremity blisters in, 2529
gastrointestinal tract motility in, 865
gestational, 1563, e237-1, e237-4
growth hormone in, 1436
heart failure and, 314-315
after heart transplantation, 509
HLA associations in, 225, 225t
hypertension with, 386
infection in, 782
ischemic stroke and, 2313, 2319t
after liver transplantation, 1011
neuropathy in. See Diabetic neuropathy
ocular examination in, 24
in older adults, 99t, 105
osteomyelitis in, 1735-1736
pancreatic cancer and, 1289
peripheral arterial disease in, 487
preoperative assessment of, 2482
renal disease in. See Diabetic nephropathy
retinal disease in. See Diabetic retinopathy
screening for, 54, 54t
stem cell therapy in, 207
type 1, e236-1-e236-17
arthritis in, 1749
autoimmune factors in, e236-4
autonomic neuropathy in,
e236-15-e236-16
classification of, e236-1, e236-2t
clinical manifestations of, e236-5
complications of, e236-8-e236-13
chronic, e236-12-e236-13
management of, e236-5
definition of, e236-1
diabetic ketoacidosis in, e236-
9-e236-13, e236-9t-e236-10t,
e236-11f
diagnosis of, e236-5
distal symmetrical polyneuropathy in,
e236-15
dyslipidemia in, 1352
environmental factors in, e236-4
epidemiology of, e236-1-e236-13
extremity ulcers in, e236-16, e236-16t
focal neuropathy in, e236-15
genetic factors in, e236-3-e236-4
hyperglycemia in, e236-8-e236-9,
e236-9t-e236-10t, e236-11f
hypoglycemia in, e236-12-e236-13
incidence of, e236-1
macular edema in, e236-13, e236-13t
mucormycosis risk with, 1995
nephropathy in, e236-14, e236-14f. See
also Diabetic nephropathy
neuropathy in, e236-15. See also
Diabetic neuropathy
pathobiology of, e236-1, e236-2f
pathogenesis of, e236-3, e236-4f
in pregnancy, 1557t, 1563, 1563f-1564f
prevalence of, e236-1
prevention of, e236-16
proximal motor neuropathy in, e236-15
renal disease in, e236-14, e236-14f. See
also Diabetic nephropathy
retinopathy in, 2438, e236-13,
e236-13t. See also Diabetic
retinopathy
treatment of, 1352b, e236-5b-e236-8b,
e236-5f
blood glucose monitoring in, e236-8,
e236-9t
Diabetes mellitus (Continued)
diet in, e236-7-e236-8, e236-7t
exercise in, e236-8
glycohemoglobin assay in, e236-8
insulin in, e236-5-e236-7, e236-6t,
e236-7f
lifestyle changes in, e236-7, e236-7t
pancreas/islet transplantation in,
e236-8
planning for, e236-8, e236-16t
pramlintide in, e236-6-e236-7
type 2, e237-1-e237-14
adipocyte-derived hormones in, e237-3
arthritis in, 1749
atherosclerosis in, e237-12-e237-13,
e237-13f
classification of, e237-1-e237-14,
e237-2t
complications of, e237-4-e237-5,
e237-11-e237-14
definition of, e237-1-e237-14
diagnosis of, e237-3-e237-4
dyslipidemia in, 1352, e237-13-e237-14
epidemiology of, e237-1
genetics of, e237-2
glucotoxicity in, e237-3
hyperosmolar hyperglycemic syndrome
in, e237-11-e237-14
hypertension in, e237-13
hyperuricemia in, 1738
hypoglycemia in, e237-11-e237-12
insulin resistance in, e237-2-e237-3
lipotoxicity in, e237-3
maturity-onset, e237-1
mucormycosis risk with, 1995
obesity and, 1413-1414
pathobiology of, e237-1-e237-2,
e237-2f
pathogenesis of, e237-2-e237-4, e237-3f
in pregnancy, 1557t, 1563, 1563f-1564f
prevention of, e237-11
renal disease in. See Diabetic
nephropathy
screening for, e237-4t
treatment of, 1352b, e237-4b-e237-10b,
e237-5t, e237-10f
diet in, e237-6
exercise in, e237-6
insulin in, e237-9-e237-10
oral glucose-lowering agents in,
e237-6-e237-9, e237-7f, e237-7t
in women, 1548-1549
weight loss with, 840t-841t
in women, 1548-1549, 1550t
Diabetic foot, e236-16
clinical manifestations of, e236-16
definition of, e236-16
prevention of, e236-16
treatment of, e236-16b, e236-16t
Diabetic ketoacidosis, 746-752, 746t,
e236-9-e236-13, e236-10t
clinical manifestations of, e236-9
diagnosis of, e236-9-e236-10, e236-14f
hypophosphatemia and, 755
pathobiology of, e236-9, e236-9t
in pregnancy, 1564
prevention of, e236-10-e236-12
treatment of, e236-10b-e236-12b,
e236-11f
Diabetic nephropathy, 781-783, e236-14
biopsy in, 782
clinical manifestations of, 781-783,
e236-14-e236-15
cytokines and, 781
epidemiology of, 781-783
genetics in, 781
glomerular filtration rate in, 781
hemodynamics in, 781
hormones and, 781
hyperglycemia and, 781
Kimmelstiel-Wilson lesion in, 782
natural history of, e236-14
pathobiology of, 781
in pregnancy, 1564
prevention of, 782
prognosis for, 783
risk factors for, e236-14
Diabetic nephropathy (Continued)
stages of, 781-782, 782f-783f
treatment of, 782b-783b, 783f,
e236-14b-e236-15b
Diabetic neuropathy, 2406, e236-15
acute asymmetrical, 2406-2407
autonomic, 2393, 2406, e236-15-e236-16
clinical manifestations of, 2406-2407,
e236-15-e236-16
definition of, 2406
diagnosis of, 2407-2408
distal symmetrical, 2406-2407, e236-15
epidemiology of, 2406
focal, e236-15
motor, e236-15
pathobiology of, 2406, e236-15
in pregnancy, 1564
treatment of, 2407b, e236-16b
Diabetic retinopathy, 2438, 2438f, e236-13,
e236-13t
nonproliferative, e236-13
proliferative, e236-13
treatment of, e236-13b-e236-14b
Diabetic stiff hand syndrome, 1749
Dialysis. See Hemodialysis; Peritoneal dialysis
Diamond-Blackfan anemia, 1086t, 1088-1089
diagnosis of, 1088-1089
treatment of, 1087, 1089-1090
DIAPERS mnemonic, 111t
Diaphragm (contraceptive), 1552
Diaphragm (muscle), 603
eventration of, 604
inadequate function of, 626
metastatic disease of, 604
paralysis of, 604, 604t-605t
tumors of, 604
weakness of, 604, 604t-605t
Diaphyseal dysplasia, progressive, 1606-1610
Diarrhea, 842, 895-913
abdominal pain and, 833
acute, 897
antibiotic-associated, 898
chemotherapy-related, 898
clinical manifestations of, 897
in daycare participants, 897t, 898
definition of, 895
diagnosis of, 899, 899f
in food-borne illness, 897-898, 897t
in food poisoning, 898
in heavy metal poisoning, 898
infectious, 897-898, 897t
nosocomial, 898
prevention of, 900
radiation-related, 898
in runners, 898
travel-related, 897t, 898, 1788, 1788t
treatment of, 899b-900b
in water-borne illness, 897-898, 897t
alcoholic, 910
in amebiasis, 2044
Brainerds, 901
in Campylobacter jejuni infection, 1869,
1869t
in carcinoid syndrome, 1510
in cholera, 1867
chronic, 900. See also Malabsorption
definition of, 895
diagnosis of, 900f-901f, 911
endoscopy in, 854
in HIV infection, 854, 901, 2195,
2198-2199
infectious, 900-901
inflammatory, 896-897, 909f, 910, 912
in intraluminal digestive disorders, 901,
903b
in mucosal absorption disorders,
904-905, 906f
secretory, 896, 897t, 909, 909f
idiopathic, 910
treatment of, 912b-913b
watery, 896, 908, 909f, 912
in Clostridium difficile infection, e304-1
in Clostridium perfringens type A infection,
e304-7
in collagenous colitis, 910
in cryptosporidiosis, 2038-2040
definition of, 895

Diarrhea (Continued)
in diabetes mellitus, 910, e236-15
diagnosis of, 831t-832t
electrolyte transport abnormalities in,
895-897, 896f
in endocrine disorders, 1420
in eosinophilic gastroenteritis, 910
epidemiology of, 895-912, 897t
factitious, 910
fluid transport abnormalities in, 895-897,
896f
in food allergy, 910
in gastrinoma, 1293
in graft-versus-host disease, 907
infectious, 1788-1791
clinical features of, 1788-1789, 1788t
in compromised host, 1780
diagnosis of, 1789t, 1790-1791,
1790f-1791f
epidemiology of, 1788, 1788t
Escherichia coli in. See Escherichia coli
infection, enteric
etiology of, 1788-1791
travel-related, 1788, 1788t
treatment of, 1789t, 1790b-1791b
laxative abuse and, 910
in lymphocytic colitis, 910
in mastocytosis, 1642
in measles, 2106
mortality and, 895
noninfectious, 1790t, 1791
nutritional therapy and, 1391, 1393
pathobiology of, 895-912, 897t
postoperative, 2488
in protein-losing enteropathy, 910
runners, 898
in Salmonella infection, 1885-1886
in shigellosis, 1889, 1889t
in systemic sclerosis, 1709
travelers, 897t, 898, 1788, 1788t
in villous adenoma, 910
in VIPoma, 1295
zoonoses-related, 1967t
Diastole, in heart failure, 296, 296t, 299,
316
Diazepam, 2242t
in alcohol dependence treatment, 152t
DIC. See Disseminated intravascular
coagulation (DIC)
Dicloxacillin, 1809t-1811t
Diencephalic syndrome, 2392
Dientamoeba fragilis infection, e361-5t
Diet. See also Food(s); Nutrition
accidents and, 1381t
breast cancer and, 1380-1381
cancer and, 1180, 1380-1381, 1381t,
1383t, e225-9
during cancer therapy, 1167
cardiovascular disease and, 1380
cerebrovascular disease and, 1381t
change in, 1382-1384, 1383t
colorectal cancer and, 1287, 1381
coronary heart disease and, 1380, 1381t
counseling on, 55
DASH, 1381
diabetes mellitus and, 1381, 1381t, 1383t,
e236-7-e236-8, e237-6, e236-7t
diverticular disease and, 1381, 1381t
in gastrointestinal disease evaluation,
828
guidelines for, 1380, 1382, 1382t-1383t,
1384f
in heart failure, 313-314
hypertension and, 257, 376, 1381, 1381t,
1383t
in irritable bowel syndrome, 871
ischemic stroke and, 2310
liver disease and, 1381t
lung cancer and, 1265, 1380
Mediterranean, 1380
in nephrolithiasis, 789-790, 793-794, 793t
neural tube defects and, 1381t, 1382
in obesity, 1381t, 1415
osteoporosis and, 1381, 1381t
in short-bowel syndrome, 908b
suicide and, 1381t
in Wilsons disease, 1372b
Dietary Approaches to Stop Hypertension
(DASH) diet, 1381
Dietary Guidelines for Americans, 1380,
1381t-1383t, 1382
Dietary reference intakes (DRIs), 1380
N,N-Diethyl-3-methylbenzamide (DEET),
2081
Diethylcarbamazine, 2010, e366-4
in loiasis, e366-1t, e366-7b
in lymphatic filariasis, e366-1t, e366-5b
Diethylstilbestrol, 1168t-1176t, 1515
Dieulafoys lesion, 861, 861f, 886, 935, 935f
Diffuse alveolar damage, 517, 517f, 636, 641,
641f. See also Acute respiratory distress
syndrome; Lung injury, acute
Diffuse alveolar hemorrhage, 554-555
clinical manifestations of, 554
definition of, 554
diagnosis of, 553f, 554-555
pathobiology of, 552t, 554
Diffuse cutaneous mastocytosis, 1642
Diffuse idiopathic skeletal hyperostosis
(DISH), 1742, 1742f
Diffuse infiltrative lymphocytosis syndrome,
1715
Diffuse large B-cell lymphoma, 1219t, 1222t,
1225, 1225t, 1227. See also Lymphoma,
non-Hodgkins
Diffusion capacity for carbon monoxide,
e85-3t, e85-5
in sarcoidosis, 584
DiGeorge velocardiofacial syndrome,
190-192
Digestion, 862-863, 901, 902f
flatus with, 838
Digit(s)
acrocyanosis of, 495
clubbing of, 253, 255f, 1196t, 2554, 2554f
frostbite of, 497, 497f
prostheses for, 1757
Raynauds phenomenon of. See Raynauds
phenomenon
in rheumatoid arthritis, 1684, 1684f-1685f
in sarcoidosis, 1751f
Digital rectal examination
in gastrointestinal disease, 829
in prostate cancer, 1323
Digital subtraction angiography, in peripheral
arterial disease, 489-490, 489f
Digitalis
in ST segment elevation MI, 443-444
toxic ingestion of, 679t-683t
Digitate dermatosis, 2520
Digoxin, 356t-357t
in heart failure, 306f-307f, 312-313
in kidney failure, 128t
pharmacokinetics of, 126t
potassium interaction with, 741
toxic ingestion of, 674t-677t, 679t-683t
Digoxin-specific antibody fragments,
679t-683t
Dihydroergotamine, in migraine headache,
2248b
Dihydropyridine, in hypertension, 383t
Dihydroxyacetone phosphate acyltransferase
deficiency, 1344t
1,25-Dihydroxyvitamin D, 1588
Dilated cardiomyopathy. See
Cardiomyopathy, dilated
Diloxanide furoate, in amebiasis, 2046t
Diltiazem
in acute coronary syndrome, 430t, 431
in hypertension, 382t
in stable myocardial ischemia, 423t
Dilution-method susceptibility testing, 1763
Dimenhydrinate, in nausea and vomiting,
843t-844t
D-Dimer
in deep vein thrombosis, 501-502
in pregnancy, 1561
in pulmonary embolism, 598, 598f
Dimercaprol, 90t, 679t-683t. See also
Chelation therapy
Dimercaptopropanesulfonate, 90t, 91b
Dimercaptosuccinic acid, 90t
Dinoflagellates, 698t, 699
Dipeptidyl peptidase-4 inhibitors, e237-9
Diphenhydramine
in nausea and vomiting, 843t-844t
in pruritus, 2512t
Diphenylpyraline, 2512t
Diphtheria, 1832-1835
clinical manifestations of, 1833-1835
cutaneous, 1833
definition of, 1832-1833
diagnosis of, 1833-1834
differential diagnosis of, 1834
epidemiology of, 1832-1833, 1833f
immunization against, 64t, 65f-66f,
67t-70t, 73, 1833-1835
neuropathy with, 2408
outbreaks of, 1833, 1833f
pathobiology of, 1833
prevention of, 1834-1835
respiratory, 1833
treatment of, 1834b, 1834t
Diphyllobothrium latum infection, 2052,
2053t
cobalamin deficiency and, 1077
treatment of, 2009-2010, 2052b
Diplopia, 2428
in myasthenia gravis, 2420
Dipylidium caninum infection, 2053, 2053t
Dipyridamole, 174
Direct current cardioversion, 347, 347f
Direct factor Xa inhibitors, 174
Direct fluorescent antibody test, in
Pneumocystis jirovecii pneumonia,
e349-3-e349-4, e349-4f
Direct renin inhibitors, 382t-383t, 384
Direct thrombin inhibitors, 173-174
Dirofilaria immitis infection, 2009, e366-8
Disability, cardiovascular, 249-250, 249t
Disc diffusion-method susceptibility testing,
1763
Disclosure, for informed consent, 5, 5t
Discoid lupus, 1699, 2553
Disease-modifying antirheumatic drugs,
1688-1689, 1688t
preoperative, 2478t
Disequilibrium, 2468, 2468t
Disopyramide, 356t-357t
Disseminated intravascular coagulation
(DIC), 1130, 1145-1148
clinical manifestations of, 1146,
1146f
definition of, 1145
diagnosis of, 1146
etiology of, 1145-1148, 1145t
infection and, 1146
vs. liver failure, 1146
malignancy-associated, 1199
pathobiology of, 1145-1148, 1145f
purpura with, 2524
treatment of, 1146b-1147b, 1147t
Distal hereditary motor neuropathy, 2398,
2399t
Disulfiram, in alcohol dependence treatment,
152t
Diuresis
alkaline, in rhabdomyolysis, 704
postobstructive, 780
solute, 734, 734t
water, 734, 734t
Diuretics
in heart failure, 309-311
in hypertension, 381, 382t-383t
in hypervolemia, 727-728, 727t, 728f
hypokalemia with, 736
hypovolemia with, 722-724
lipid disorders and, 1352t
in nephrolithiasis prevention, 794
Diverticulitis, 922-927
clinical manifestations of, 922
definition of, 922, 922t
diagnosis of, 922, 923f, 923t
diet and, 1381, 1381t
epidemiology of, 922
pain in, 834t-836t
pathobiology of, 922
prevention of, 923
prognosis for, 923
treatment of, 922b-923b, 923t
Diverticulosis, 922, 922t, 923f
INDEX e25
Diverticulum (diverticula)
calyceal, 804
epiphrenic, 882-883, 883f
esophageal, 882-883, 882f-883f
intestinal. See also Diverticulitis
age-related, 106
nutrition and, 1381, 1381t
mid-esophageal, 882
Zenkers, 882, 882f
Dix-Hallpike test, 2468
Dizziness, 2468, 2468t. See also Vertigo
in postconcussion syndrome, 2467
DMT-1 gene, 1373
DNA. See Deoxyribonucleic acid (DNA)
DNA repair gene, e184-1
Dobutamine, in shock, 649t
Docetaxel, 1168t-1176t
Docosanol, in herpesvirus infection, 2085
Dofetilide, 356t-357t
Dog allergy, 1626
Dog heartworm, e366-8
Dog roundworm, 990t-992t, e366-1-e366-8,
e366-1t
Dog tapeworm, 2053, 2053t
Dogbane ingestion, 674t-676t
Dhles body, 1027f, 1029-1030
DOK7 gene, 2423
Dolasetron, 843t-844t
Dolls-eye test, 2467
Domoic acid, 700
Domperidone, 865b-866b
Donath-Landsteiner autoantibody, 1050
Donepezil
in Alzheimers disease, 2279
in Parkinsons disease, 2330t-2332t
Donovanosis, 1911-1912, 1911f
Dopamine, 1470, 1471f
amphetamine effects on, 142
in cardiogenic shock, 656-657
cocaine effects on, 142
nicotine effects on, 142
in reward circuitry, 141-142
in septic shock, 665
in shock, 649t, 653
Doppler echocardiography, 279
Doripenem, 1809t-1811t
Dorsal midbrain syndrome, 2448
Double helix, 187-188
Down syndrome, 193f-194f, 1100
Doxazosin
in benign prostatic hyperplasia, 807, 808t
in hypertension, 382t
Doxepin
in depression, 2239t
in pruritus, 2502t, 2512-2513, 2512t
Doxorubicin, 1168t-1176t
dilated cardiomyopathy with, 326-327
Doxycycline, 1809t-1811t
in leptospirosis prevention, 1939
in malaria, 2011, 2016t
DPC4 gene, 1290
Dracunculiasis, e366-1t, e366-8
Dravets syndrome, 2290
Dressing, 2510
for catheter, e290-6
Dressing apraxia, 2273-2274
Dresslers syndrome, 610
Drinking. See Alcohol use/abuse
Driving, heart failure and, 313-314
Dronabinol, 843t-844t
Dronedarone, 356t-357t
in ventricular arrhythmias, 368
Droperidol, 843t-844t
Drotrecogin alfa, 1146b-1147b
Drowning, 574-581
Drug(s), 124-132. See also specific drug classes
absorption of, 124
drug interactions and, 130
abuse of. See Drug abuse
accumulation of, 126, 126f-127f
in kidney disease, 129
acute generalized exanthematous
pustulosis with, 2531, 2531f, 2535
acute intermittent porphyria with, 1365,
1366t
addiction to, 140-142, 140t. See also
Addiction; Drug abuse
e26 INDEX
Drug(s) (Continued)
administration of, 124
adulteration of, 154
adverse reactions to, 131, 1638. See also
Drug allergy; Drug interactions
diagnosis of, 132
epidemiology of, 131
etiology of, 131-132, 132t
akathisia with, 2340
anaphylaxis with, 132, 1634, 1637, 1639,
1640t
angioedema with, 1628-1629
aplastic anemia with, 1084-1085, 1085t,
1088
autonomic peripheral neuropathy with,
2392t
bioavailability of, 124
cancer with, 1181t
catecholamine interactions with, 1473,
1473t
clearance of, 124-125
cobalamin deficiency with, 1077
contact dermatitis with, 2536
decreased dose of, 127
dependence on, 140, 153, 153t. See also
Addiction; Drug abuse
diabetes insipidus with, e232-4
dialysis removal of, 128t, 129
diarrhea with, 898
discontinuation of, 127
distribution of, 124, 125f
drug interactions and, 130
dose of
clearance-related adjustment of, 129
decrease in, 127
increase in, 127, 127f
loading, 125-126, 129
maintenance, 126-127, 127f
dry eyes with, 2439, 2440t
dystonic reactions with, 2340
elimination of, 124-125, 125f-127f, 127
drug interactions and, 130-131
erythema multiforme with, 2528
esophagitis with, 880-881, 880t
fever with, 1772, 1773t
first-pass effect of, 124
folate deficiency with, 1078-1079
gastric ulcers with, 887, 888t, 889
gastrointestinal disease evaluation and, 828
gaze-evoked nystagmus with, 2448
gingival hyperplasia with, 2452, 2453f
in glucose-6-phosphate dehydrogenase-
deficient patient, e164-8, e164-8t
hair loss with, 2552t
half-life of, 125
hearing impairment with, 2463
in hemodynamic disease, 129
hepatotoxicity of, 953, 979-984, 981t. See
also Liver disease, drug-induced
hypercalcemia with, 1593-1594
hypercoagulability with, 1153
hyperpigmentation with, 2548
hyperprolactinemia with, 1430t
hypersensitivity reaction with, 2534-2543,
2534t
hypogonadism with, 1524
hypomagnesemia with, 754
hypophosphatemia with, 755
hypovolemia with, 723-724
idiopathic multifocal fibrosclerosis with,
1752t
immune hemolytic anemia with, 1047
immune responses to, 132
interstitial lung disease with, 558t, 565
interstitial nephritis with, 757, 757t, 771,
771t-772t
intracerebral hemorrhage and, 2323t, 2324
ischemic colitis with, 933, 933t
ischemic stroke with, 2317-2318
in kidney disease, 128-129, 128t
leukemia and, 1203-1204
leukocytoclastic vasculitis with, 2535
lipid effects of, 1352t
in liver disease, 129
loading dose of, 125-126
long QT syndrome with, 366, 366t
lupus-like syndrome with, 1697-1698
Drug(s) (Continued)
maintenance dose of, 126-127, 127f
melanonychia with, 2556, 2556f
metabolism of
drug interactions and, 130
genetic factors in, 186-187, 187t
hepatic, 980, 980t
methemoglobinemia with, 1032
micronutrient interaction with, e225-8,
e225-8t
monitoring of, 127-128, 128f
myelodysplastic syndrome with, 1200
myocarditis with, 325
myopathy with, 2416, 2416t
nephrotoxicity of, 774, 774f-775f
neuroleptic malignant syndrome with,
2340
neutropenia with, 1103, 1104f, 1105
neutrophilia with, 1099, 1099t, 2535
obesity and, 1412, 1413t
ocular effects of, 2442, 2442t
in older adults, 116, 116t, 129-130
osteoporosis with, 1580-1581
overdose of, 129
pancreatitis with, 937-938, 937t
parkinsonism with, 2329t
perioperative, 2477, 2478t, 2491
peripheral neuropathy with, 2408, 2408t
pharmacodynamics of, 125f
age-related changes in, 130
drug interactions and, 131
pharmacogenetics of, 200-201
pharmacokinetics of, 124-125, 125f, 126t
age-related changes in, 129-130
decreased dose and, 127
drug accumulation and, 126, 126f-127f
drug interactions and, 130-131
increased dose and, 127, 127f
loading dose and, 125-126
maintenance dose and, 126-127, 127f
photosensitivity reactions with, 2535,
2536t
platelet hypofunction with, 1136
pleural effusion with, 610
potassium effects of, 739-740
during pregnancy, 1550t, 1551, 1556
protein binding of, 126t, 128
pseudoporphyria with, 2528
psychoactive effects of, 115b-116b, 116t
rash with, 2534-2543, 2534t, 2535f-2536f,
2536t
renal toxicity of, 757-758, 757t
rhabdomyolysis with, 700-702, 701t
serotonin syndrome with, 1765, 2394,
2484, 2494-2495, 2494t
sideroblastic anemia with, 1043-1044
sinus node dysfunction with, 351t
sodium loss with, 722-723
stem cellderived platform screening for,
207
syndrome of inappropriate secretion of,
antidiuretic hormone with, 2495
systemic sclerosis with, 1706
teratogenicity of, 1550t, 1556, 1556f
testing for, in acute poisoning, 673, 677t
therapeutic index of, 127, 128f
therapeutic window of, 127, 128f
thrombocytopenia with, 1126-1127, 1126t
thyroiditis with, e233-10
tics with, 2338t
tolerance to, 128, 140
topical, 2510
toxic epidermal necrolysis with, 2535,
2536f
toxidromes with, 670-684, 670t, 677t. See
also specific drug exposures
urticaria with, 1628-1629
virilization with, 1515
volume of distribution of, 124
weight loss with, 840t-841t
in women of reproductive potential, 1550t,
1551
Drug abuse, 140-142, 140t, 2229. See also
Addiction; Alcohol use/abuse; Cigarette
smoking
acute coronary syndrome and, 427
by adolescents, 62, 62t
Drug abuse (Continued) Dumping syndrome, 866
adulterant-related complications of, 154 clinical manifestations of, 902
agent factors in, 154 diagnosis of, 902
amphetamine, 156-157 malabsorption with, 901
anabolic-androgenic steroid, 158 treatment of, 903b
anxiolytic, 157 Duodenum
clinical manifestations of, 154-155 fluid and electrolyte transport in, 895,
Clostridium sordellii infection with, 896f
e304-2 gastrinoma of, 1293
cocaine, 156-157 metastatic melanoma of, 846f
definition of, 153, 153t ulcers of, 886, 886f. See also Peptic ulcer
environmental factors in, 154 disease
epidemiology of, 153-154 stress, 889
hallucinogen, 158 Dupuytrens contracture, 953-954, 997, 997f
HIV infection and, 2183 Duroziezs sign, 461
host factors in, 154 Dust, occupational, 537
infective endocarditis and, 464, 1817 Dust mites, 1626
interstitial lung disease with, 558t Dutasteride, in benign prostatic hyperplasia,
intracerebral hemorrhage and, 2323t, 807, 808t
2324 Dwarf tapeworm, 2052, 2053t
ischemic stroke with, 2317-2318 treatment of, 2009-2010, 2053b
lifestyle-related complications of, 154-155 Dwarfism
marijuana, 157 Laron, 1342
opioid, 155 nutritional, 1390
pain and, 138 pituitary, 1344t
paraphernalia-related complications of, proportionate, 1342
154 Dying patient, 9-15. See also Critical care
pathobiology of, 154-155 communication with, 13, 13t, 14f
phencyclidine, 158 delirium in, 120
sedative-hypnotic, 157 family of, 12
treatment of, 155b hospice for, 9, 14
weight loss with, 840t-841t palliative care for, 9-14, 10t, 11f-12f. See
Drug addiction, 140-142, 140t. See also also Palliative care
Alcohol use/abuse; Drug abuse spiritual distress in, 11-12, 13t
biochemistry of, 142 Dysarthria, in amyotrophic lateral sclerosis,
definition of, 140 2344
genetic factors in, 140-141 Dysautonomia. See Autonomic nervous
neural plasticity and, 142 system, disorders of
nicotine, 140t, 142-146, 144t. See also Dysbetalipoproteinemia, 1351-1352
Cigarette smoking Dyschondroplasia, 1610
reward circuitry in, 141, 141f Dysentery
risk factors for, 140-141 amebic. See Amebiasis
Drug allergy, 1638-1640 bacillary. See Shigellosis
anaphylaxis with, 132, 1634, 1637, 1639, Dysesthesias, 2396-2397
1640t Dysfibrinogenemia, e177-4t, e177-8
antimicrobial selection and, 1764 Dysgerminoma, suprasellar, 1428
clinical manifestations of, 1639, 1639t Dyshidrosis, 2514, 2515f
definition of, 1638 Dyskeratosis congenita, 1086t, 1088
diagnosis of, 1639 diagnosis of, 1088
differential diagnosis of, 1639 neutropenia in, 1102t, 1103
epidemiology of, 1638-1640 treatment of, 1087, 1090
hepatotoxic, 983 Dyskinesia, paroxysmal, 2337
pathobiology of, 1638-1639 Dyslipidemia, 1350-1352, 1351f
prevention of, 1639, 1640f cardiovascular disease and, 257
prognosis for, 1639-1640 diabetic, 1352, e237-13-e237-14
risk for, 1638, 1638t, 1640t evaluation of, 1352-1353, 1352t
treatment of, 1639b, 1640f obesity and, 1414
Drug interactions, 130-131 prevention of, 1354
antimicrobial-related, 1765 risk assessment for, 1353
antiviral-related, 2084t, 2086t treatment of, 1351f, 1353b-1354b, 1353t
caspofungin-related, 1976 Dysmenorrhea, e244-4-e244-5
diagnosis of, 131, 131t Dysmetria
fluconazole-related, 1975 in multiple sclerosis, 2349
after heart transplantation, 510 ocular, 2448
itraconazole-related, 1974 Dyspepsia
pharmacodynamic, 131 diagnosis of, 831t-832t, 834t-836t, 842,
pharmacokinetic, 130-131 844f
posaconazole-related, 1976 endoscopy in, 852
prevention of, 131 in esophageal disease, 875
voriconazole-related, 1975 functional (nonulcer), 872
Drug rash with eosinophilia and systemic diagnosis of, 872t, 873-874
symptoms, 2534-2535, 2535f differential diagnosis of, 873
Dry eye(s), 2429, 2432, 2432f, 2434t epidemiology of, 872
differential diagnosis of, 1713, 1713t irritable bowel syndrome and, 872
drug-related, 2439, 2440t motility disorders and, 873
Dry eye syndrome, 2426, 2439 pathobiology of, 872-873
Dry mouth, 1713, 1713t, 2454, 2454t physical examination in, 873
Dual-energy x-ray absorptiometry (DEXA) treatment of, 873b
scan, 1549, 1582 Dysphagia, 2471
Dubin-Johnson syndrome, 957, 960, 960t, in amyotrophic lateral sclerosis, 2344
1012t bradykinetic, 2493
Duchennes muscular dystrophy, 2412 diagnosis of, 831t-832t
Duke criteria, for infective endocarditis, 467t, dyskinetic, 2493
468 endoscopy in, 852
Duloxetine in esophageal disease, 875
in depression, 2239t oropharyngeal, 881
in pain, 136t Dysphagia lusoria, 408, 886

Dyspnea, 246 Echocardiography, 278-284
acute, 512 in acute coronary syndrome, 427
chronic, 512, 515f in acute pericarditis, 475
in COPD, 539 in angina pectoris, 416t, 417
evaluation of, 246, 512, 515f in aortic disease, 282t-284t
in heart failure, 300 in aortic dissection, 484, 484f
in hypertrophic cardiomyopathy, 321 in aortic regurgitation, 281, 282t-284t,
in lung cancer, 1266 454t, 462, 462f
nocturnal, paroxysmal, 300 in aortic stenosis, 281, 282t-284t, 454t,
postoperative assessment of, 2488, 455, 455f
2489t in atrial septal defect, 401, 401f
in pregnancy, 1562 in cardiac mass, 282t-284t
in pulmonary hypertension, 391-392 in cardiac tamponade, 477-478, 478f
treatment of, 512b in cardiogenic shock, 655
Dysthymic disorder, 2239 in cardiomyopathy, 282t-284t
Dystonia, 2336-2342 in cardiovascular disease, 249t, 255
adult-onset, 2336 in chest pain, 282t
age of onset of, 2336 in congenital heart disease, 282t-284t
clinical manifestations of, 2336 contrast, 280, 280f
definition of, 2336 in coronary artery disease, 282t-284t
diagnosis of, 2336 diastolic ventricular function on, 281
dopa-responsive, 2336 in dilated cardiomyopathy, 326
drug-related, 2340 Doppler, 279
heredodegenerative, 2336, 2337t in embolism, 282t
laryngeal, 2493 handheld, 280
myoclonus, 2336 in heart failure, 282t, 301-302
primary, 2336, 2337t in hypereosinophilic syndrome, 331
secondary, 2336, 2337t in hypertrophic cardiomyopathy, 321,
treatment of, 2337b-2338b 322f, 322t
in Wilsons disease, 2337 image planes for, 278, 278f
Dystonia-plus, 2336-2337, 2337t indications for, 282-284, 282t-284t
Dystrobrevin, 320t in infective endocarditis, 468, 469f
Dystroglycans, 320t intracardiac, 280
Dystrophin, 320t in ischemic stroke, 2313
Dystrophy limitations of, 279
corneal, 2440 measurements on, 279
muscular, 2412, 2412t in mitral regurgitation, 281, 282t-284t,
454t, 459, 459f
in mitral stenosis, 281, 282t-284t, 454t,
E 457, 457f
Eagle-Barrett syndrome, 805 in mitral valve prolapse, 461
Ear(s). See also Hearing in murmurs, 282t
anatomy of, 2458, 2458f in myocarditis, 324-325
Aspergillus infection of, 1991 normal, 284
barotrauma of, 576-577 in palpitations, 282t
examination of, 24 in pericardial disease, 282t-284t, 479
inflammation of. See Otitis externa; otitis principles of, 278
media in pulmonary embolism, 599-600
pain in, 2458. See also Otalgia in pulmonary hypertension, 282t-284t,
Pseudomonas aeruginosa infection of, 392-395, 393f-394f
1879 pulmonary pressure on, 281-282
East African sleeping sickness, 2020 in ST segment elevation MI, 437
Eastern equine encephalitis, 2162t, stress, 280, 281f
2163-2168 in syncope, 344
Eating disorder(s), 1406-1409 systolic ventricular function on, 280-281
adolescent, 62 three-dimensional, 280, 280f
clinical manifestations of, 1407-1408 transesophageal, 279, 279f
diagnosis of, 1408 transthoracic, 279
epidemiology of, 1407 in tricuspid regurgitation, 462
natural history of, 1408 in ventricular septal defect, 402
pathobiology of, 1407-1409 Echovirus infection, 2140-2144, 2140t-
prevention of, 1408 2141t. See also Enterovirus infection
prognosis for, 1408 meningeal, 2142, 2366
treatment of, 1408b Ecstasy (3,4-
Eating disorder not otherwise specified, methylenedioxymethamphetamine),
1407-1409 158, 2484
Ebola hemorrhagic fever, 87t, 2147-2156, Ecthyma, 2544
2148t-2149t, 2151t, 2152f. See also Viral Ecthyma gangrenosum, 1778, 1779f, 1879,
hemorrhagic fevers 2525
Ebsteins anomaly, right-sided, 407, 409t Ectodermal dysplasia, immunodeficiency-
EBV. See Epstein-Barr virus (EBV) infection related, 1619
Ecchymoses, in liver disease, 953-954 Ectopia
Echinacea, 2091 renal, 803
Echinocandins, 1976 ureteral, 804, 804f
Echinococcosis, 990t-992t, 991-996, 994f, Ectopic atrial rhythm, 351, 351f
2053t, 2055-2056 Ectopy, 340t
clinical manifestations of, 2056 Ectropion, 2430-2431, 2430f
definition of, 2055 Eculizumab, 244
diagnosis of, 2056 Eczema, 2514, 2514t. See also Dermatitis
epidemiology of, 2055-2056 Eczema vaccinatum, 2119
imaging of, 2056, 2056f Edema. See also Hypervolemia
treatment of, 2010, 2056b-2057b bowel wall, in heart failure, 300-301
Echinococcus multilocularis infection, in cardiovascular disease, 253, 254f
990t-992t, 2053t, 2057 vs. cellulitis, 2545
Echinococcus oligarthus infection, 2057 cerebral, 2309
Echinococcus vogeli infection, 2057 in fulminant liver failure, 1008
Echinodermata envenomation, 699 high-altitude, 575-581, 575t
Edema (Continued)
in heart failure, 300
macular, e236-9-e236-10, e236-13,
e236-13t
pitting, 254f
postoperative, 2490
pulmonary. See Pulmonary edema
subglottic, 2093, 2093f
Edrophonium (Tensilon) test, 2420-2421
Education
cigarette smoking and, 18, 18f
health status and, 98
patient, in heart failure, 313-314, 314t
E1F2B gene, e244-8
Effective arterial blood volume, 721, 721t
Effusion. See Pericardial effusion; Pleural
effusion
Effusion lymphoma, primary, 1225, 2216
Eflornithine, in African sleeping sickness,
2021t
EGR1 gene, 1200
Ehlers-Danlos syndrome, 1136, 1344-1345,
1664
atrophic skin in, 2542, 2542f
clinical manifestations of, 1664, 1665t
definition of, 1664
diagnosis of, 1664-1665
epidemiology of, 1664
esophageal involvement in, 884
pathobiology of, 1664
treatment of, 1665b
type IV, 935
Ehrlichia canis infection, 1961t, 1962
Ehrlichia chaffeensis infection, 1961-1962,
1961t
Ehrlichia ewingii infection, 1962, 1965t-1966t
Ehrlichioses, 1960-1962
definition of, 1960-1961
granulocytic, 1961-1962, 1961t, 1962f
monocytic, 1961-1962, 1961t, 1962f,
1965t-1966t
vs. viral hemorrhagic fever, 2153t
Eicosanoids, 232-233
Eisenmengers complex, 397, 402, 402b
Eisenmengers physiology, 397, 403
Eisenmengers syndrome, 397, 399
treatment of, 399b-400b
Ejaculatory insufficiency, 1528
Ejection fraction, e52-5t
Elastase-1 test, 903t
Elastin, e267-4
Elbow
arthritis of, 1685f
bursitis of, 1679
golfers, 1679
replacement of, 1757
tennis, 1679
Elderly persons. See at Age/aging; Geriatric;
Older adults
Electric current injury, 684-687
clinical manifestations of, 685-687, 686f
definition of, 684
epidemiology of, 684-685
muscle damage with, 685
neurologic examination in, 685-686
pathobiology of, 685, 685f
prognosis for, 686
remote organ damage with, 686
treatment of, 686b
Electrical alternans, 477, 477f
Electrical stimulation, in gastric motility
disorders, 866
Electrical storm, 367
Electrocardiography (ECG), 272-278
in acute coronary syndrome, 427
in acute pericarditis, 473-475, 474f, 474t
ambulatory, 246, 249t, 255
in amyloid cardiomyopathy, 330-331, 330f
in angina pectoris, 414-417, 415f, 416t,
417f
in aortic regurgitation, 454t, 461
in aortic stenosis, 454t, 455
in arrhythmias, 341-342, 342f-343f
in asthma, 533
in atrial fibrillation, 352t, 354, 354f-355f
in atrial flutter, 352t, 354, 354f
in atrial premature beats, 351, 351f
INDEX e27
Electrocardiography (ECG) (Continued)
in atrial septal defect, 401, 401f
in atrial tachycardia, 352-353, 352t, 353f
in AV nodal re-entrant tachycardia, 352t,
353, 353f
in AV re-entrant tachycardia, 352t, 354,
354f
axes for, 274-275, 274f
in Brugadas syndrome, 365f
in bundle branch block, 275, 275t,
276f-277f
in cardiac tamponade, 477-478, 477f
in cardiogenic shock, 655
chamber hypertrophy on, 275-277, 277f
computer-assisted readings of, 277-278
conduction abnormalities on, 275, 275f,
275t
in constrictive pericarditis, 479f
in dilated cardiomyopathy, 326
in drowning, 574
in ectopic atrial rhythm, 351f
in electric injury, 685
in first-degree AV block, 350f
in group B coxsackievirus infection, 2143
in heart failure, 301
in high-degree AV block, 350, 351f
in hypercalcemia, 1594
in hyperkalemia, 738, 738f
in hypertrophic cardiomyopathy, 321, 322t
in hypokalemia, 737, 737f
in hypomagnesemia, 754
in infective endocarditis, 466
interpretation of, 275-278, 275t
in ischemic stroke, 2313
J wave on, 668, 669f
in junctional premature beat, 351f
in junctional tachycardia, 353f
leads for, 273-274, 274f
in long QT syndrome, 365f
low QRS voltage on, 277, 277t
in mitral regurgitation, 454t, 459
in mitral stenosis, 454t, 457
in Mobitz I second-degree AV block, 350,
350f
in Mobitz II second-degree AV block, 350,
350f
in myocardial infarction, 427
in myocarditis, 324
normal, 272-275, 272f, 273t, 275f
P wave on, 272-273, 272f, 273t
in palpitations, 341-342
in pericardial effusion, 477, 477f
PP interval on, 273
PR interval on, 272-273, 272f, 273t
in pulmonary embolism, 599
in pulmonary hypertension, 392, 392f
QRS complex on, 272-273, 272f, 273t,
275, 275t
QT interval on, 273, 273t
repolarization abnormalities on, 277, 278t
in restrictive cardiomyopathy, 329, 330f
in right-sided Ebsteins anomaly, 407
RR interval on, 273
in sarcoidosis, 585
in sinoatrial exit block, 349f
in sinus arrhythmia, 349f
in sinus bradycardia, 349f
in sinus node re-entry, 352t
in sinus rhythm, 353f
in sinus tachycardia, 352f, 352t
in ST segment elevation MI, 435-437,
436f, 446
ST segment on, 272, 272f
in stable myocardial ischemia, 414, 415f
standard, 272
after subarachnoid hemorrhage, 2321
in subarachnoid hemorrhage, 2320
in syncope, 341-342
T wave on, 272-273, 272f
in tachy-brady syndrome, 349f
in tetralogy of Fallot, 406
in third-degree AV block, 351f
in tropical endomyocardial fibrosis, 332
U wave on, 272-273, 272f
in ventricular preexcitation, 354f
in wandering atrial pacemaker, 351f
waves of, 272, 272f
e28 INDEX
Electroconvulsive therapy, 2495-2496, 2495f
Electroencephalography (EEG), 2232-2233,
2232f, 2233t
in absence seizure, 2285f
in delirium, 119
in epilepsy, 2284f-2285f, 2287f-2288f,
2289-2290
in herpes simplex encephalitis, 2378
in subacute sclerosing panencephalitis,
2112
in syncope, 344
in temporal lobe epilepsy, 2284f
Electrolytes. See also specific electrolytes
in cystic fibrosis, 546
intestinal transport of, 895-897, 896f, 912
Electromagnetic radiation, 78, 78t, 79f, 83,
1180-1181
Electromyography (EMG), 2233-2234,
2234t
in amyotrophic lateral sclerosis, 2344
in myopathy, 2234, 2411
in neuromyotonia, 2423
in peripheral neuropathy, 2398
in radiculopathy, 2265
Electronystagmography, 2235
Electrophysiologic study, cardiac, 290t, 294,
343
Elliptocyte, 1025f, e164-3f, e164-4
Elliptocytosis, hereditary, 1025f, e164-3f,
e164-4-e164-5
Embden-Meyerhof pathway, e164-5f, e164-6
disorders of, e164-6
Embolism. See also Thrombosis
air, 602-603
in hemodialysis, 819
stroke and, 2318
amniotic fluid, 603
atheromatous (cholesterol), 493-494. See
also Cholesterol embolism
cardiac, 2311
cellulose, 603
cutaneous, 2525
fat, 602-603, 1758, 2318
with infective endocarditis, 467
intravascular device, 603
mesenteric artery, 929, 931t
paradoxical, 2311
pulmonary. See Pulmonary embolism
purpura with, 2524-2525
renal artery, 786-787
starch, 603
talc, 603
tumor, 603
Embolization, in lower gastrointestinal
bleeding, 860b
Emergency, informed consent and, 5
Emergency contraception, 1555
Emergency Department, asthma in, 536
Emery-Dreifuss muscular dystrophy, 2413
Emesis. See Vomiting
Emotional abuse, obesity and, 1413
Emotional disorders. See Psychiatric
disorders
Emphysema, 538, 1344t
centriacinar, 538
endoscopic management of, 619
in liver disease, 953
in older adults, 99t
panacinar, 538
pathogenesis of, 538
radiography in, 519f, 540f
Empty sella syndrome, 1433
Empty ventricle syndrome, 1637b
Empyema, 609-610
subdural, 1818, 2374
Emtricitabine, in hepatitis B, 2088
Enalapril
in heart failure, 308t
in hypertension, 382t
in ST segment elevation MI, 443
Enalaprilat, in hypertensive emergency, 388t
Enanthem, in enterovirus infection, 2143
Encephalitis, 2376-2379
arboviral, 2161-2168
clinical manifestations of, 2162
diagnosis of, 2162-2168
differential diagnosis of, 2162-2168
Encephalitis (Continued) Endocarditis (Continued) Endomyocardium, biopsy of, 294
epidemiology of, 2161, 2162t definition of, 464 Endophthalmitis, 2433-2434
vs. noninfectious diseases, 2163 diagnosis of, 467-468, 467t-468t, 469f Candida, 1988
pathobiology of, 2161-2162 disease-related risk for, 464, 464t fungal, 2435-2436
prevention of, 2163 Duke criteria for, 467t, 468 Pseudomonas aeruginosa, 1879-1881
treatment of, 2163b echocardiography in, 468, 469f Endoscopic retrograde
bioterrorism and, 84t emboli with, 467, 2375 cholangiopancreatography (ERCP),
brainstem, enterovirus 71, 2143 Enterobacteriaceae, 465, 470t 851, 964
California, 2162t, 2168 Enterococcus, 465, 470t, 1831-1832 in common bile duct stone, 855, 856f
clinical manifestations of, 2377 epidemiology of, 464-465 complications of, 852
CSF examination in, 2231t, 2377 Erysipelothrix rhusiopathiae, 1840 in pancreatitis, 856-857, 942, 942f
cytomegalovirus, 2111, 2377t funduscopic examination in, 466 in primary sclerosing cholangitis, 1014,
definition of, 2376 fungal, 465, 468t, 470t 1014f
diagnosis of, 2377-2379, 2377t HACEK strains in, 465, 468t, 470t Endoscopy, 831t-832t, 832, 851-857. See also
differential diagnosis of, 2377 Haemophilus influenzae, 1862 Colonoscopy
Eastern equine virus, 2162t, 2163-2168 health careassociated, 464-465 applications of, 851, 851t
enteroviral, 2142 Janeways lesions in, 466 in Barretts esophagus, 877f, 879, 879f
epidemiology of, 2376, 2376t laboratory findings in, 466 in biliary disease, 855, 856f
Epstein-Barr virus, 2377t Legionella, 468t in chronic diarrhea, 854
herpes B, 1966t Listeria, 1835 in colorectal neoplasms, 854, 854f, 856f,
herpes simplex virus, 2128, 2128f, 2231, microbiology of, 464-465, 470t 857, e136-1f
2377-2379, 2377t mitral valve prolapse and, 464, 464t complications of, 851-852, 851t
amnesia and, 2271 native valve, 471t-472t in corrosive ingestion, 855
epidemiology of, 2376 neurologic complications of, 2375 in Dieulafoys lesion, 935b, 935f
HIV. See Dementia, HIV Oslers node in, 466, 466f in dyspepsia, 852
Japanese, 2164-2168 pathobiology of, 465 in dysphagia, 852
louping ill, 2168 patient history in, 465-466 in esophageal cancer, 1273-1274
mumps virus, 2110, 2379 petechiae in, 466, 466f in esophageal food impaction, 855, 855f
Murray Valley, 2167 physical examination in, 466, 466f, 466t in esophageal mass, 855, 855f
nonviral, 2377 pneumococcal, 465, 2360 in gastric cancer, 1276, 1276f
pathobiology of, 2376 prognosis for, 472-473 in gastroesophageal reflux, 852, 852f, 876,
polymerase chain reaction in, 2377, 2377t prophylaxis against, 408, 472, 472t-473t 877f
Powassan virus, 2168 prosthetic valve, 464-465, 464t, 466f, in gastrointestinal bleeding, 858, 860
prognosis for, 2379 471t in heartburn, 852
rabies virus, 2378 Pseudomonas aeruginosa, 470t, 1880 indications for, 852-855
Rocio virus, 2167 renal complications of, 467, 767 in inflammatory bowel disease, 915-916,
St. Louis virus, 2162t, 2166-2168 vs. rheumatoid arthritis, 1687t 916f
tick-borne, 2167-2168 risk for, 464-465, 464t in inflammatory disease, 912
toxoplasmic, 2192t-2193t, 2204, e357-6, Roths spots in, 2438, 2439f in iron deficiency anemia, 854
e357-8 splinter hemorrhages in, 466 in lower gastrointestinal bleeding,
treatment of, 2379b Staphylococcus, 465, 470t, 1817, 1817f 853-854, 854f
Venezuelan equine virus, 2162t, 2164 Streptococcus, 465, 468t, 470t in malabsorption, 911
West Nile virus, 2162t, 2165, 2166f, 2377t stroke and, 467, 2311, 2375 in nonmalignant pancreatic disease,
Western equine virus, 2162t, 2163-2168 subacute, 229-230 856-857
Encephalitozoon (Septata) intestinalis substance abuse and, 464 in occult gastrointestinal bleeding, 854
infection, 2010, e361-5t surgery in, 471, 472t in pancreatic neoplasm, 855-856, 856f
Encephalomyelitis treatment of, 468b-471b, 470t-471t pancreatobiliary, 851t, 855-857, 856f
disseminated, acute, 2268, 2354 Tropheryma whippelii, 468t in peptic ulcer disease, 886f, 890-892
Lyme, 1932-1934 zoonoses-related, 1967t in small intestine cancer, 1280
paraneoplastic, 1193t, 1195, 2404 Lfflers, 331, 1120 ultrasonic transducer in, 851
postinfectious, 2106 thrombotic, nonbacterial, 332-333, 465 in upper gastrointestinal bleeding,
postvaccination, 2119 Endocrine system. See also specific glands and 852-853, 853f
Encephalopathy hormones Endosteal hyperostosis, 1607-1610
anoxic, 2271, 2309 aging-related changes in, 107 Endothelial cells
bismuth, 94 disorders of, 1427-1431. See also specific in hepatic cirrhosis, 1000-1001
hepatic, 952-953, 956t disorders in inflammation, 231-232
alcohol-related, 2386 cancer-related, 1187-1192, 1188t Endothelin, in heart failure, 298
in cirrhosis, 1001, 1003-1004, 1006 evaluation of, 1420-1422 Endothelium, neutrophil adherence to, 1112f,
electroencephalography in, 2232f, 2233 genetic testing in, 1420, 1422 1113
postoperative, 2491 laboratory tests in, 912, 1421-1422 defects in, 1100, 1115, 1116t-1117t
hypertensive, 2326 obesity in, 1412-1413 Endotracheal intubation, 640
lead, 89 physical examination in, 1420-1421, Energy
limbic, 1193t 1421t balance of, 1411
in Lyme disease, 1933 symptoms of, 1420, 1421t expenditure of, 1411-1412
metabolic, 2294, 2295t treatment of, 1422 imbalance in. See Obesity; Protein-energy
uremic, 2326 evaluation of, 1420-1422, 1421t malnutrition
Enchondromatosis, 1610 imaging of, 1422 intake of, 1411
ENCODE, 188 preoperative assessment of, 2482 metabolism of, in cancer, 1186-1187
End-of-life care. See Palliative care regulation of, 1423, 1423f, 1425-1431, undernutrition effects on, 1389
End-stage renal disease. See Kidney failure, 1425f Enhanced external counterpulsation, in
end-stage undernutrition effects on, 1389 refractory angina, 421-422
Endocardial cushion defect (atrioventricular Endocrine therapy Entacapone, in Parkinsons disease,
canal defect), 407 in breast cancer, 1312-1314 2330t-2332t
Endocarditis in cancer, 1166, 1166t, 1168t-1176t Entactin, in inflammation, 233t
echocardiography in, 282t-284t in prostate cancer, 1324 Entamoeba histolytica infection. See Amebiasis
infective, 464-473 in skin disease, 2513 Entecavir
Aspergillus, 1991 Endometrial cancer, 1318 adverse effects of, 2087, 2087t
vs. bacterial meningitis, 2360 clinical manifestations of, 1318 in hepatitis B, 975b-976b, 976t,
Bartonella, 468t, 1908-1910 epidemiology of, 1318 2086t-2087t, 2087
Brucella, 468t obesity and, 1414 Enteral nutrition. See Nutrition, enteral
Candida, 1988 oral contraceptives and, 1553 Enteric infection, 1788-1791. See also
Chlamydia psittaci, 468t treatment of, 1318b-1319b Diarrhea, infectious
clinical manifestations of, 465-473 Endometriosis, e244-4-e244-5 Enteric nervous system, 862, 896f,
complications of, 466-467 Endometrium 2391-2392. See also Autonomic nervous
continuing care in, 471 cancer of. See Endometrial cancer system
Coxiella burnetii, 468t, 1963 cyclic changes in, e244-1, e244-2f disorders of, 864
culture-negative, 468, 468t, 1908 Endomyocardial fibrosis, tropical, 332 Enteritis necroticans, e304-6

Enterobacteriaceae, 1874-1877. See also
Escherichia coli
antibiotic-resistant, 1875, 1875t
clinical manifestations of, 1875
definition of, 1874-1877, 1874t
diagnosis of, 1876
epidemiology of, 1874-1875
in infective endocarditis, 465, 470t
pathobiology of, 1875
prevention of, 1876-1877
prognosis for, 1877
treatment of, 1876b, 1876t
Enterobiasis, 2066-2067
treatment of, 2065t, 2067b
Enterococcus infection, 1830-1832
blood stream, 1831
clinical manifestations of, 1831
cutaneous, 1831
definition of, 1830-1832
diagnosis of, 1831
endocardial, 465, 470t, 1831-1832
epidemiology of, 1830
intra-abdominal, 1831
pathobiology of, 1830-1831
prevention of, 1832
prognosis for, 1832
soft tissue, 1831
treatment of, 1831b-1832b
urinary tract, 1831
vancomycin-resistant, 1830
Enterocolitis. See also Colitis
in compromised host, 1780
neutropenic, 923, 924f
pain in, 834t-836t
radiation, 910-911, 924
Salmonella, 1885-1887
Enterocystozoon bieneusi infection, e361-5t
Enteropathy
congestive, 935
gluten. See Celiac disease
protein-losing, in heart failure, 300-301
Enteropeptidase deficiency, 905
Enterostomy (jejunostomy), 866
Enterovirus infection, 2140-2144
acute flaccid paralysis in, 2142-2144
in B-cell immunodeficiency, 2144
clinical manifestations of, 2141-2142,
2141t
conjunctival, 2143
definition of, 2140-2144, 2140t
diagnosis of, 2142
differential diagnosis of, 2106t
enanthem in, 2143
encephalitic, 2142
epidemiology of, 2140-2141, 2140t
exanthem in, 2143
histopathology of, 2141
immune response to, 2141
meningeal, 2142, 2365-2366
myopericardial, 2143
myositis in, 2144
pathobiology of, 2141
pleurodynia in, 2144
respiratory tract, 2143
Enthesopathy, 1651
Entropion, 2429-2431, 2430f
Envenomation
marine organism, 697-699, 698t
snake bite, 694-697
Environment, assessment of, for geriatric
population, 103, 104t
Environmental disease, 75-78, 76t. See also
Occupational disease and specific
disorders
diarrhea with, 898
exposure assessment in, 75-76, e18-1f
hazardous exposures in, 77-88, 78t. See
also Hazardous exposures; Radiation
injury
principles of, 75-77
Environmental engineering, in inborn errors
of metabolism, 1345
Enzyme(s)
in digestion, 901, 902f
drug-metabolizing, 131, 132t
inborn errors of. See Inborn errors of
metabolism
Enzyme(s) (Continued)
in myopathy, 2411
recombinant, 1345-1346
Enzyme immunoassay
in Clostridium difficile infection, e304-1
in histoplasmosis, 1978
in syphilis, e327-5, e327-5t
Enzyme therapy, 903b
in chronic pancreatitis, 943, 944t
Eosinopenia, 1106
Eosinophil(s), 217
in allergic rhinitis, 1623
corticosteroid effects on, 160
development of, 1119, 1119f
excess of. See Eosinophilia
granules of, 1119
production of, 1119, 1119f, e159-2f
urinary, 711
Eosinophil cationic protein, 1119
Eosinophil-derived neurotoxin, 1119
Eosinophil peroxidase, 1119
Eosinophilia, 1100-1101, 1118-1121
in asthma, 533
clinical manifestations of, 1119-1121
definition of, 1118-1119, 1118t
diagnosis of, 1119-1121, 1120f
differential diagnosis of, 1119-1120
drug rash with, 2534-2535, 2535f
epidemiology of, 1119
in infection, 1769
in mastocytosis, 1642
monitoring of, 1120
in parasitic infection, 1120
pathobiology of, 1119, 1119f
primary, 1118t
prognosis for, 1121
reactive, 1118t, 1120-1121
in strongyloidiasis, 2068
treatment of, 1120b-1121b
tropical, e366-5
Eosinophilia-myalgia syndrome, 1706
Eosinophilic esophagitis, 880, 880f, 880t
Eosinophilic fasciitis, 1196t, 2542
Eosinophilic folliculitis, 2211, 2211f, 2532
Eosinophilic gastroenteritis, 910
Eosinophilic meningitis, 2368-2369, 2369t,
2371
Eosinophilic pneumonia, 565, e85-6t
Ephedra, 672t
Epicardial fat line, 268, 269f
Epicardial fat pad, 265
Epicondylitis
lateral, 1679
medial, 1679
Epidemic febrile polyarthritis, 2160
Epidermal growth factor receptor (EGFR), in
esophageal cancer, 1273
Epidermal growth factor receptor (EGFR)
inhibitors, 167
fixed drug eruption with, 2535, 2536f
Epidermis, 2498. See also Skin
apoptosis in, 2501, 2501f
cells of, 2498-2500, 2499f
differentiation of, 2498, 2501, 2501f
functions of, 2498-2499
germinative layer of, 2498, 2499f
granular layer of, 2498-2499, 2499f
spinous layer of, 2498, 2499f
Epidermodysplasia verruciformis, 2122
Epidermoid carcinoma, 1280-1281
Epidermolysis bullosa, 884, 2529, 2529f
Epidermolysis bullosa acquisita, 2527
Epidermolysis bullosa simplex, 2529
Epididymitis, e326-4
Epididymo-orchitis, 2110
Epidural abscess, 2373-2376, 2373t, 2374f
Epidural anesthesia, 2486
Epigenetics, 199-200
Epigenome, 199-200
Epiglottis, 514t
Epiglottitis, 2093, 2094f, 2470t, 2471
Haemophilus influenzae in, 1862
Epilepsy, 2283-2294, 2290t. See also
Seizure(s)
abdominal, 834t-836t
absence, 2286t, 2288, 2290-2291, 2292t
adolescent, 2290t, 2291
Epilepsy (Continued)
adult, 2290t, 2291
childhood, 2290-2291, 2290t
clinical manifestations of, 2285
definition of, 2283
diagnosis of, 2288
differential diagnosis of, 2288-2289
electroencephalography in, 2232-2233,
2232f, 2289-2290
epidemiology of, 2283
in female, 2293
focal, 2285-2286, 2287f, 2292t
generalized, 2283, 2286-2288, 2286t,
2288f, 2292t
genetic aspects of, 2284-2285
infantile, 2290, 2290t
magnetic resonance imaging in, 2290
magnetoencephalography in, 2290
neonatal, 2290, 2290t
pathobiology of, 2284-2285, 2284f-2285f
in pregnancy, 2293
prognosis for, 2293
risk factors for, 2283-2284
status, 2286, 2293
nonconvulsive, 2286, 2287f-2288f
in Sturge-Weber syndrome, 2390-2391
surgery for, 2292-2293
temporal lobe, 2284f, 2291
treatment of, 2291b-2293b, 2292t
vertigo in, 2467
Epileptic syndromes, 2290, 2290t
Epinephrine, 1470, 1471f
in anaphylaxis, 1637b
potassium effects of, 737
in shock, 649t, 653, 663
EpiPen, 1637
Epirubicin, 1168t-1176t
dilated cardiomyopathy with, 326-327
Episcleritis, 2440
Epistaxis, 2456f, 2458, 2458f
Eplerenone
in hypertension, 382t
in hypervolemia, 727-728, 727t
in ST segment elevation MI, 443
Epleys maneuver, 2466f
Epoprostenol, in pulmonary hypertension,
395-396, 396f
Epratuzumab, 167-168
Eprodisate, in amyloidosis, 770
Eprosartan, in hypertension, 382t
Epsilon-aminocaproic acid, in von
Willebrands disease, 1134
Epstein-Barr virus (EBV) infection, 2112,
2133-2136. See also Infectious
mononucleosis
aplastic anemia and, 1084
Burkitts lymphoma and, 2135
chronic, 2136
clinical manifestations of, 2134
CNS lymphoma and, 2135
complications of, 2134-2135
definition of, 2133
diagnosis of, 2134
differential diagnosis of, 2134
encephalitic, 2377t
epidemiology of, 2133
HIV infection and, 2209-2210
Hodgkins lymphoma and, 1228-1233,
2135
immune response to, 2134
nasopharyngeal carcinoma and,
2135
oral hairy leukoplakia and, 2135-2136
pathobiology of, 2133-2134
post-transplantation, 2135
prevention of, 2134b
prognosis for, 2134-2136
treatment of, 2134b
Eptifibatide, 176
in acute coronary syndrome, 430t
Epworth Sleepiness Scale, 2300,
2300t
Equilibrium, 2461
Equilibrium-vestibular system, 2464-2468
disorders of. See Vertigo
evaluation of, 2465-2468
physiology of, 2464-2465
INDEX e29
Erectile dysfunction, 1528
in diabetes mellitus type 1, e236-16
normal serum testosterone and, 1521
treatment of, 1521, 1528b
Ergocalciferol
in malabsorption, 2385
in osteomalacia, 1590, 1590t
Ergonovine challenge, in Prinzmetals angina,
424
Erlenmeyer flask deformity, 1358, 1359f,
1608, 1608f
Erlotinib, 167, 1166-1167, 1168t-1176t
in lung cancer, 202t
erm genes, 1763-1764
Error(s)
vs. adverse event, 43
blood transfusion, 1156
epidemiology of, 43
hospital-related, 37
patterns of, 2487
prevention of, 43-44
Swiss cheese model of, 43
systems thinking approach to, 43
Ertapenem, 1809t-1811t
Eructation, 838
Erysipelas, 1816, 1825, 2545, 2545f
Erysipeloid, 1840-1841, 1840f, 1966t
Erysipelothrix rhusiopathiae infection,
1840-1841
clinical manifestations of, 1840, 1840f
definition of, 1840-1841
diagnosis of, 1840
epidemiology of, 1840
pathobiology of, 1840
prevention of, 1841
treatment of, 1841b
Erythema
diffuse, 1771
erysipeloid, in familial Mediterranean
fever, 1669
figurate, 2521, 2521t
palmar, 953-954, 954f, 1003
paraneoplastic, 1196t
toxic, 2545
Erythema annulare centrifugum, 2521
Erythema chronicum migrans, 2521
Erythema elevatum diutinum, 2540-2541
Erythema gyratum repens, 1196t, 2521
Erythema induratum, 2541, 2542f
Erythema infectiosum, 2115, 2115f, 2116t,
2523, 2523f. See also Parvovirus B19
infection
Erythema marginatum, 2533, 2533f
Erythema migrans, in Lyme disease,
1931-1934, 1932f
Erythema multiforme, 1640, 2528-2532,
2528f
in Mycoplasma pneumoniae infection, 1914,
1914f
oral lesions in, 2449
phenytoin-related, 983
Erythema nodosum, 1771, 2541, 2541f,
2541t
in sarcoidosis, 583, 585t
Erythema nodosum leprosum, 1953-1954
Erythrasma, 2545
Erythroblastosis fetalis, 64t
Erythrocyte. See Red blood cell(s)
Erythrocyte sedimentation rate (ESR), 713
Erythrocytosis, 1092-1094, 1094t
Erythroderma, 1196t, 2507
Erythromelalgia, 497-498, 1092, 1092f, 1152
paraneoplastic, 1196t
Erythromycin, 1809t-1811t
in diphtheria, 1834b
in motility disorders, 865b-866b
Erythroplakia, 1258, 1258f, 2450f
Erythropoiesis, 1032, e159-1, e159-2f
testosterone in, 1037
in -thalassemia intermedia, 1063-1064
Erythropoietic porphyria, congenital, 1364f,
1365t, 1369-1370
Erythropoietic protoporphyria, 1364f,
1368-1370
clinical manifestations of, 1365t, 1368
definition of, 1368
diagnosis of, 1368
e30 INDEX
Erythropoietic protoporphyria (Continued)
pathobiology of, 1365t, 1368
treatment of, 1368b-1369b
Erythropoietic stimulating agent, in
myelodysplastic syndrome, 1202
Erythropoietin, 1168t-1176t, e159-1
in erythropoiesis, 1032
during hemodialysis, 820
recombinant, e159-3-e159-4
in anemia, 1039
in anemia of chronic disease, 1043
in anemia of renal insufficiency, 1037b,
1037f
in cancer, 1167-1177
in sideroblastic anemia, 1044
serum, 1093-1094
tumor production of, 1191
Escherichia coli infection
antibiotic-resistant, 1875, 1875t, e290-3t
enteric, 1871-1874
antibiotic resistance of, 1873, e290-3t
clinical manifestations of, 1873
definition of, 1871-1874, 1871t
diagnosis of, 1789-1790, 1873
differential diagnosis of, 1873
diffusely adherent, 1871t, 1873
enteroadherent, 1871t
enteroaggregative, 1871t
clinical manifestations of, 1873
pathobiology of, 1872-1873
enterohemorrhagic, 1871t
clinical manifestations of, 1873
pathobiology of, 1872
sigmoidoscopy in, 1873
enteroinvasive, 1871t
clinical manifestations of, 1873
pathobiology of, 1872
enteropathogenic, 1871t
clinical manifestations of, 1873
pathobiology of, 1872
enterotoxigenic, 1871t
clinical manifestations of, 1873
pathobiology of, 1872
epidemiology of, 1872
infectious dose in, 1872
pathobiology of, 1872-1873
prevention of, 1873
prognosis for, 1874
travel-related, 898
treatment of, 1873b
virulence factors in, 1871-1872,
1875
peritoneal, 1874
urinary tract, 1874
Escherichia coli O157:H7 infection, 897
Escitalopram, in depression, 2239t
Escobars syndrome, 2419t
Esmolol
in hypertensive emergency, 388t
in stable myocardial ischemia, 423t
Esomeprazole, in gastroesophageal reflux
disease, 878t
Esophageal cancer, 1272-1278
adenocarcinoma, 1273-1274
clinical manifestations of, 1274-1275
diagnosis of, 1274
epidemiology of, 1273-1274
pathobiology of, 1274
risk factors for, 1272t, 1274
staging of, 1274t
treatment of, 1274b
classification of, 1272
squamous cell, 1272-1273
clinical manifestations of, 1273-1274
diagnosis of, 1273
epidemiology of, 1272-1273
pathobiology of, 1273
prognosis for, 1273
risk factors for, 1272t, 1273
staging of, 1274t
treatment of, 1273b
Esophageal reflux, 247t, 2471. See also
Gastroesophageal reflux disease
(GERD)
Esophageal sphincter
birds beak appearance of, 881, 881f
hypertensive, 882
Esophagitis, 880-886
bacterial, 884-885
caustic, 881
eosinophilic, 880, 880f, 880t
pill-induced, 880-881, 880t
Esophagography
in achalasia, 881, 881f
barium, 845
in esophageal spasm, 882, 882f
Esophagus, 874-886
aging-related changes in, 106
alcohol effects on, 148t, 149
in amyloidosis, 884
atresia of, 885
Barretts. See Barretts esophagus
in Behets disease, 884
cancer of. See Esophageal cancer
candidiasis of, 884, 885f, 1987
caustic injury to, 881
Chagas disease of, e355-2, e355-4-e355-5
congenital abnormalities of, 885-886
corkscrew, 882, 882f
in Crohns disease, 884
cytomegalovirus infection of, 884, 2198
in dermatomyositis, 884
diffuse spasm of, 882, 882f
diseases of, 874-886. See also specific
diseases
symptoms of, 875
diverticula of, 882-883, 882f-883f
duplication cyst of, 886
in dystrophic epidermolysis bullosa, 884
in Ehlers-Danlos syndrome, 884
emergency disorders of, 885-886
endoscopy of, 855, 855f
fistula of, 885
food impaction in, 855f, 875
foreign bodies in, 885
functional testing of, 875
herpes simplex virus infection of, 884
heterotopic gastric mucosal patch of,
885
human papillomavirus infection of, 885
iatrogenic perforation of, 885
infection of, 884-886
inflammation of. See Esophagitis
in lichen planus, 884
motor disorders of, 881-886, 881f-882f
motor functions of, 875
mucosa of, 876
in mucous membrane pemphigoid, 884
nutcracker, 882
in pemphigus vulgaris, 884
peristaltic dysfunction of, 876
ring of, 883, 883f
endoscopy in, 855, 855f
in eosinophilic esophagitis, 880, 880f
rupture of, 885
Schatzkis ring of, 883, 883f
in scleroderma, 883-884
in skin disorders, 884
strictures of, 877f, 878
in systemic lupus erythematosus, 884
webs of, 883, 883f
Esotropia, 2428
Estramustine, 1168t-1176t
Estrogen(s). See also Hormone replacement
therapy; Oral contraceptives
adipose tissue synthesis of, 1380-1381
age-related changes in. See Menopause
in cancer therapy, 1168t-1176t
lipid disorders and, 1352t
metabolic effects of, 1553
synthesis of, e241-1f
therapeutic, 1434t
Eszopiclone, 2242t
Etanercept, 165
in psoriasis, 2518t
Ethacrynic acid
in hypertension, 382t
in hypervolemia, 727
Ethambutol, 1809t-1811t
ocular effects of, 2442
Ethanol, 147, 147f. See also Alcohol use/
abuse
toxic ingestion of, 677t
ketoacidosis with, 747-752
Ethics, 4-9
in cell therapy, 207
dilemmas in, 4
in gene therapy, 210
in genetic testing, 186
informed consent in, 4-6
Ethnicity
cancer and, 1180
cardiovascular disease and, 257
cigarette smoking and, 18f
communication and, 15
health care access and, 15-17, 15t
health care quality and, 15-16, 16t
health status and, 15
hypertension and, 375, 375f
pneumococcal pneumonia and, 1820
Ethosuximide, 2292t
Ethylene glycol
central nervous system effects of, 672t
intoxication with, 674t-677t, 679t-684t,
747-748
Etidronate, in Pagets disease, 1605t
Etoposide, 1168t-1176t
Eulenburgs disease, 2414-2415
Eumycetoma. See Mycetoma
Euthanasia, 7-8, 7t
Event monitors, 342-343
Everolimus, 1168t-1176t
Evidence-based medicine, 3, 42
clinical pathways in, 42
practice guidelines in, 42
Evoked potentials, 2234-2235, 2234f
in multiple sclerosis, 2351-2352
Ewings sarcoma, 1326
Exanthem, 2522, 2522t. See also Rash; Skin,
lesions of
differential diagnosis of, 1770-1771, 1771t
in enterovirus infection, 2143
in erythema infectiosum, 2523, 2523f
fever and, 1770-1771
in HIV infection, 2209
in Kawasaki disease, 2522-2532
in measles, 2105, 2105f, 2523
in neutropenic host, 1778
in roseola, 2523
in rubella, 2108, 2108f, 2523
in scarlet fever, 2522
in toxic shock syndrome, 2522
Exanthem subitum (roseola), 2106t, 2523
Exanthematous pustulosis, acute, 2531,
2531f, 2535
Executive cognitive dysfunction, 2273-2274
Exemestane, 1168t-1176t
Exenatide, e237-7t, e237-9
Exercise. See also Physical activity
in adult congenital heart disease, 408-409,
409t
anaphylaxis with, 1634
bronchospasm with, 669
cardiac function with, e52-6
in cardiovascular disease, 257-258
in diabetes mellitus type 1, e236-8
in diabetes mellitus type 2, e237-6
epidemiology of, 1410
in fibromyalgia, 1745
fluid loss with, 723
glycogenolysis during, 1355
in heart failure, 300, 302, 313-314
heatstroke with, 667, 667t
in hypertension, 381
in myofascial pain, 1744b-1745b
in obesity treatment, 1415
in pain management, 139
in peripheral arterial disease, 490
potassium levels with, 735
rhabdomyolysis with, 700-702, 701t-702t
Exercise prescription, 58
Exercise testing. See Stress testing
Exophthalmos, 2430, 2430f, e233-6-e233-7,
e233-6f
Exostoses, multiple, hereditary, 1610
Exotoxin. See Toxin(s)
Exotropia, 2428
Expiratory pressure, maximal, 628
Expiratory reserve volume, e85-3t
Extracorporeal shock wave lithotripsy
(ESWL), 792, 1017
Extremely low frequency electromagnetic
fields, 83
Extremities. See also Foot (feet)
examination of
in cardiovascular disease, 252-253, 254f
in trauma, 691
Extrinsic allergic alveolitis. See
Hypersensitivity pneumonitis
Extubation, 645
Eye(s), 2426-2442. See also Cornea; Lens;
Pupil(s); Retina; Vision
amblyopia of, 2428
in ankylosing spondylitis, 1693
anterior chamber of, 2426, 2427f
anterior segment of, 2426
Candida infection of, 1988-1990, 1988f
Cogans syndrome of, 1723
drug effects on, 2442, 2442t
dry, 2426, 2429, 2432, 2432f, 2434t. See
also Sjgrens syndrome
differential diagnosis of, 1713, 1713t
esotropia of, 2428
examination of, 24, 2427-2442, 2427f,
2427t
in cardiovascular disease evaluation, 250
in endocrine disorders, 1421
in nutritional assessment, 1386t
exotropia of, 2428
in Fabrys disease, 1359
foreign body sensation in, 2429
in Graves disease, e233-6-e233-7,
e233-6f
hemorrhage in, 2433, 2433f
infectious disorders of, 2434-2442
inflammatory disorders of, 2433-2442,
2434t
ionizing radiation injury to, 80
Loa loa in, e366-7, e366-7f
misalignment of, 2428, 2447-2448, 2447f
movements of, 2446-2448, 2447t
abnormalities in, 2447-2448, 2447f,
2447t
in coma, 2297
examination of, 2447
internuclear pathways in, 2446
in locked-in syndrome, 2298
in multiple sclerosis, 2349
nuclear pathways in, 2446
nystagmography for, 2468
positional tests for, 2468
supranuclear pathways in, 2446, 2447t
onchocerciasis of, e366-5-e366-6
pain in, 2428, 2429t
posterior chamber of, 2426, 2427f
posterior segment of, 2426
Pseudomonas aeruginosa infection of,
1879-1881
in pseudoxanthoma elasticum, 1667
red, 24, 2428, 2429t
sarcoidosis of, 584-585, 585t
in sickle cell disease, 1071
structure of, 2426, 2427f
in systemic lupus erythematosus, 1701
toxoplasmosis of, e357-3-e357-4, e357-4f,
e357-6
trauma to, 2433, 2433f
tuberculosis of, 2436
tumors of, 2441-2442
vaccinia autoinoculation of, 2119, 2120f
varicella-zoster virus infection of, 2130
vascular abnormalities of, 2438-2439,
2439f
Eyelid(s), 2426
abnormalities of, 2430-2442
baggy, 2426
basal cell carcinoma of, 2431-2432,
2432f
benign neoplasms of, 2431
chalazion of, 2431, 2431f
droopy, 2429, 2430f
in myasthenia gravis, 2420
ectropion of, 2430-2431, 2430f
entropion of, 2429-2431, 2430f
hemangioma of, 2441
inflammation of, 2431, 2431f
sebaceous gland carcinoma of, 2431
skin of, 2426

Eyelid(s) (Continued) Familial dysalbuminemic hyperthyroxinemia,
squamous cell carcinoma of, 2432 e233-1
twitching of, 2429 Familial glucose-galactose malabsorption
Ezetimibe, in lipid disorders, 1354 syndrome, 1341
Familial hypercholesterolemia, 1342,
1350-1352
F Familial hyperlipidemia, 1350-1352, 1749
F wave, 2233 Familial hypertriglyceridemia, 1351
Fabrys disease, 321, 1359 Familial isolated pituitary adenoma
clinical manifestations of, 1359, 1359f, syndrome, 1433
1751 Familial juvenile polyposis, 1281t, 1283
cornea verticullata in, 2442 Familial Mediterranean fever, 1115,
diagnosis of, 1359 1116t-1117t, 1668-1672, 1668t, 1670t
glomerular disease in, 769 Familial paraganglioma, 1472
ischemic stroke in, 2318 Familial periodic paralysis
treatment of, 1359b-1360b hyperkalemic, 741
Face. See also Head and neck hypokalemic, 741
examination of, 24 Family, of dying patient, 12
Facial paralysis, 2408 Family history, 23
Facioscapulohumeral muscular dystrophy, Famotidine
2413 in gastroesophageal reflux disease, 878t
Factitious disorder, 2244 in pruritus, 2512t
Cushings syndrome, 1465 Fanconis anemia, 1086t, 1088, 1344
diarrheal, 910 diagnosis of, 1088
hypoglycemic, 1504 head and neck cancer and, 1258
Factor B, inactivation of, 244 hypophosphatemia with, 755
Factor II, deficiency of, e177-4t, e177- in multiple myeloma, 1238
9-e177-10 neutropenia in, 1102t, 1103
Factor V, deficiency of, e177-4t, e177-8 potassium secretion in, 736
Factor V Leiden, 1149-1153 treatment of, 1087, 1090
screening for, 185 Farmers lung, 570-571, 571t
Factor VII Farnesoid X receptor, 1350
deficiency of, e177-4t, e177-9-e177-10 Farsightedness, 108, 2427-2428, 2427f
excess of, 1149 Fascicular block, 275, 275t, 276f-277f
Factor VIII Fasciitis
alloantibodies to, e177-5-e177-10 eosinophilic, 2542
autoantibodies to, e177-6-e177-10 necrotizing, 2545
deficiency of, 1132, e177-1-e177-2, plantar, 1681
e177-2f, e177-3t-e177-4t, e177-9. See Fasciitis-polyarthritis, paraneoplastic, 1196t
also Hemophilia Fascioliasis, 990t-992t, 2060
excess of, 1149 treatment of, 2010, 2061t, 2063b
replacement of, e177-2b-e177-4b, Fasciolopsiasis, 2061t, 2062-2063
e177-3t-e177-4t Fast, seventy-two-hour, 1501-1503, 1501t,
Factor IX 1502f, 1503t
alloantibodies to, e177-5-e177-10 Fat(s)
autoantibodies to, e177-6-e177-10 body. See Adipose tissue; Obesity
deficiency of, e177-1-e177-2, e177-2f, dietary
e177-3t-e177-4t. See also Hemophilia in enteral nutrition, 1392
excess of, 1149 guidelines for, 1382t-1383t
replacement of, e177-2b-e177-4b, lung cancer and, 1265
e177-3t-e177-4t metabolism of, 1348
Factor X, 1121 hepatic. See Liver disease, fatty
deficiency of, e177-4t, e177-9-e177-10 Fat embolism, 602-603
Factor Xa inhibitors postoperative, 1758
in deep vein thrombosis, 504 stroke and, 2318
direct, 174 Fatal familial insomnia, 2381
in ST segment elevation MI, 442 Fatigue
Factor XI in anemia, 1033
deficiency of, e177-4t, e177-7-e177-10 in cardiovascular disease, 249-250
excess of, 1149 chronic, 1744t, 1745-1747
Factor XII, deficiency of, e177-4t, e177-7 in dying patient, 10t
Factor XIII, deficiency of, 1123, e177-4t, in fibromyalgia, 1743, 1745
e177-8 in heart failure, 300
Fagerstrom Test for Nicotine Dependence, in liver disease, 952
143 in multiple sclerosis, 2349
Faint/fainting in myopathy, 2409
near, 2468, 2468t in neurologic disorders, 2230
neurocardiogenic. See Syncope, Fatty acid metabolism, disorders of, 2415
neurocardiogenic Fatty liver. See Liver disease, fatty;
Fall(s) Steatohepatitis
assessment for, 99t, 102-103 FBN1 gene, 1663
evaluation after, 108 Fc receptors, 215-216, 216f, 227
prevention of, 108 FCGR2A gene, 1697
risk for, 105, 107-108 FCGR3A gene, 1697
Fallot, tetralogy of, 406, 406f Febrile neutrophilic dermatosis, 1196t, 1771,
Famciclovir 1779, 2533, 2535, 2541f
adverse effects of, 2082 Febrile polyarthritis, epidemic, 2160
excretion of, 2083t Febrile seizures, 2290, 2293
in herpesvirus infection, 2082-2083, Febrile syndrome, occupation-related, 573,
2083t 574t
Familial adenomatous polyposis, 1281, Febuxostat, in gout, 1741
1281f, 1281t Fecal continence, 863, 864f
genetics of, 185t Fecal elastase-1 test, 903t
small intestine neoplasm and, 1279 Fecal incontinence, 844, 947-949, 948f
Familial cold autoinflammatory syndrome, in multiple sclerosis, 2349
1668t, 1670t Fecal lactoferrin test, 1789t
Familial cold urticaria, 1100 Fecal leukocyte test, 1789t
Fecal occult blood test, 862
in chronic bleeding, 1035
in colorectal cancer, 1286, 1286t
in gastrointestinal disease, 832
in liver disease, 963
FECH gene, 1368
Fees, physician, 8-9
Felodipine
in hypertension, 382t
in stable myocardial ischemia, 423t
Feltys syndrome, 1104, 1686
Femoral artery stenosis, 491-492, 491f
Femur, Erlenmeyer flask deformity of, 1358,
1359f, 1608, 1608f
Fenfluramine, micronutrient effects of,
e225-8t
Fenoldopam mesylate, in hypertensive
emergency, 388t
Fentanyl, 137t, 674t-676t
Ferning, of cervical mucus, e244-1
Ferritin, serum, 1041, 1041t
in gastrointestinal disease, 829-832
in thalassemia, 1064
Ferrochelatase deficiency, 1364f, 1365t,
1368-1370
Ferrous sulfate, in iron deficiency anemia,
1041
Fertility. See also Infertility
lead poisoning and, 89
after oral contraceptive use, 1553
Fetal cell transplantation, in Parkinsons
disease, 2333
Fetal testicular regression syndrome, 1517
-Fetoprotein, in hepatocellular carcinoma,
1301
Fetus. See also Pregnancy
development of, 1556f
maternal diabetes effects on, 1564
radiation effects on, 81
syphilis in, e327-4
Fever, 28, 1768-1774
in bacterial meningitis, 2360
cancer-related, 1199-1200
in compromised host, 1774-1780
drug-related, 1772, 1773t, 1814t
in endocrine disorders, 1420
in enteric infection, 1788t, 1789
evaluation of, 1769-1770
in gastrointestinal disease, 829
hepatosplenomegaly and, 1771-1772,
1772t
in HIV infection, 2194-2195
in hospitalized patient, 1770, 1770t. See
also Health careassociated infection
in influenza virus infection, 2097-2098
in liver disease, 952
lymphadenopathy and, 1771-1772,
1771t
musculoskeletal complaints and, 1771
neutropenia-related, 1775-1776, 1776t
treatment of, 1776-1778, 1777f
occupation-related, 568t
in outpatients, 1770
pathobiology of, 1768-1769, 1769f
persistent, 1777
postoperative, 2490
rash with, 1770-1771, 1771t
relapsing. See Relapsing fever
tachycardia with, 28
transfusion-related, 1156-1157, 1156t
travel-related, 1769-1770, 1769t
of unknown origin, 1772, 1772t
Fexofenadine, 2502t, 2512t
Fiber
colorectal cancer and, 1381
hemorrhoids and, 945b
Fibrates, in lipid disorders, 1353t, 1354
Fibrillary glomerulopathy, 770
Fibrillin, e267-4
Fibrin, 1121, 1122f
Fibrin-stabilizing factor deficiency,
e177-8
Fibrinogen
cardiovascular disease and, 258
deficiency of, e177-4t, e177-8
excess of, 1149
Fibrinolysis, primary, 1146
INDEX e31
Fibrinolytic agents, 176-177
in ST segment elevation MI, 439-442,
440t-441t
Fibroblast, in inflammation, 231-232
Fibroblast growth factor-23, in renal
osteodystrophy, 813
Fibroelastoma, papillary, 333
Fibrogenesis imperfecta ossium,
1606-1610
Fibromuscular dysplasia
extremity, 498, 498f
ischemic stroke and, 2316
renal, 379, 379f
Fibromyalgia, 1743-1747
central sensitivity syndromes in, 1744
vs. chronic fatigue syndrome, 1744t
clinical manifestations of, 1743-1747
cognitive dysfunction in, 1743-1744
diagnosis of, 1744, 1744t
endocrine dysfunction in, 1745
epidemiology of, 1743
exercise in, 1745
fatigue in, 1743, 1745
pain in, 1743-1745
pathobiology of, 1743
patient history in, 1744-1747
prognosis for, 1745
psychological disorders in, 1744-1745
sleep disorder in, 1743, 1745
treatment of, 1744b-1745b, 1744t
Fibronectin, e267-4
Fibrosclerosis. See Idiopathic multifocal
fibrosclerosis
Fibrosis. See also Cirrhosis
bone marrow. See Myelofibrosis
pulmonary. See Pulmonary fibrosis,
idiopathic
systemic, 1708. See also Scleroderma
nephrogenic, 850f, 1712
gadolinium-associated, 847, 1657
Fibrous dysplasia, 1609
Fick equation, 627, 1031f
Fifth disease, 2115, 2115f, 2116t
Fight-or-flight response, e52-3-e52-4
Filariasis, e366-3-e366-4, e366-3t
clinical manifestations of, e366-3-e366-4
definition of, e366-3-e366-4
diagnosis of, e366-4
lymphatic, e366-1t, e366-4, e366-5b,
e366-5f
treatment of, e366-4
tropical pulmonary eosinophilia in,
e366-5
zoonotic, e366-8
Filgrastim, 1168t-1176t
Finances. See also Cost(s)
health care, 18-20, 19f
patient, 103, 104t
Finasteride, in benign prostatic hyperplasia,
807, 808t
Finger(s)
acrocyanosis of, 495
clubbing of, 253, 255f, 1196t
frostbite of, 497, 497f
jersey, 1679-1680
prostheses for, 1757
Raynauds phenomenon of. See Raynauds
phenomenon
in rheumatoid arthritis, 1684,
1684f-1685f
in sarcoidosis, 1751f
Fingernails. See Nail(s)
Fingolimod, in multiple sclerosis, 2353
Finkelstein test, 1679
FIP1L1-PDGFRA fusion gene, 331
Fire ant sting, 2081
Fish oils
in enteral nutrition, 1392
in lipid disorders, 1353t, 1354
Fish poisoning, 698t, 699-700, 898
Fish stings, 697, 698t
Fish tapeworm infection, 2052, 2053t
cobalamin deficiency and, 1077
treatment of, 2009-2010, 2052b
Fissure
anal, 946-949, 947f
cutaneous, 2504t
e32 INDEX
Fistula
anal, 946-949
aortoenteric, 935
arteriovenous, 403
atrial-esophageal, 885
coronary artery, 405
in Crohns disease, 914, 918-920
otic, 2466
tracheoesophageal, 885
Fixed drug eruption, 2535, 2536f
Flail arm syndrome, 2344
Flail chest, 606-607, e99-1f
Flashing lights sensation, 2429
Flatus, 838
Flea bite, 2080
in plague transmission, 1896
in typhus, 1959-1962
Flea-borne spotted fever, 1956t, 1959
Flecainide, 356t-357t
Flies, 2080-2081, 2158
Flinders Island spotted fever, 1956t, 1958
Floaters, 108, 2426, 2429
Flock-workers lung, 568t
Floppy infant, 2414
Flow-volume curve, in asthma, 532, 532f
Flow-volume loop, in respiratory diseases,
514f
Floxuridine, 1168t-1176t
FLT3 gene, 1201
Flt3 ligand, e159-2
Flu. See Influenza virus infection
Fluconazole, 1974-1975
adverse effects of, 1975
in AIDS, 1975
in candidiasis, 1975, 1989b-1990b
in coccidioidomycosis, 1981b
in cryptococcal meningitis, 1975
drug interactions with, 1975
formulations of, 1974
in hepatosplenic candidiasis, 990b
in neutropenia, 1975
Flucytosine, 1973
in cryptococcosis, 1984b-1985b
in dematiaceous fungal infection, 2008b
Fludarabine, 1168t-1176t
red cell autoantibodies with, 1047
Fluid(s)
abdominal. See Ascites
accumulation of. See Edema
colonic absorption of, 863
intake of, nephrolithiasis and, 790, 793
intestinal transport of, 895-897, 896f
in parenteral nutrition, 1394-1395
Fluid overload, after nutritional therapy, 1391
Fluid retention, in protein-energy
malnutrition, 1385
Fluid therapy
in acute diarrhea, 899
in burns, 692
in cardiac arrest, 348
in cholera, 1867b
in critical care, 624
in diabetic ketoacidosis, e236-10, e236-11f
in Escherichia coli infection, 1873b
in heat illness, 667b-668b
in hypercalcemia of malignancy, 1189b,
1597b
in hypernatremia, 733b
in hypotension, 29
in hypovolemia, 724b-725b
hypovolemia with, 723
in rhabdomyolysis, 703-704, 703b-704b
in septic shock, 663
in shock, 649-650, 650f, 653t
viral hemorrhagic fevers, 2154
Flukes, 2058-2063. See also specific flukes
diagnosis of, 2063
intestinal, 2061t, 2062-2063
liver, 2060-2063, 2061t
lung, 2061t, 2062-2063
prevention of, 2063
treatment of, 2010, 2063b
Flumazenil
in benzodiazepine toxicity, 679t-683t
in venlafaxine toxicity, 679t-683t
Fluorescent treponemal antibody absorption
(FTA-ABS) test, e327-5, e327-5t
Fluorine, e225-6t-e225-7t
deficiency of, e225-6t-e225-7t
Fluoroscopy
in gastrointestinal disorders, 845
in rheumatic disease evaluation, 1656
5-Fluorouracil, 1168t-1176t
in cancer, 202t
dilated cardiomyopathy with, 326-327
topical, 2513
Fluoxetine
in depression, 2239t
in irritable bowel syndrome, 871t
in menopausal hot flushes, 1569t-1570t
in premenstrual syndrome, e244-5
Fluoxymesterone, 1168t-1176t
Fluphenazine, 2243t
in Tourettes syndrome, 2338b
Flurazepam, 2242t
Flushing
vs. anaphylaxis, 1636
in carcinoid tumor, 1509-1510
in mastocytosis, 1642
in menopause, 1565-1571, 1566f, 1567t,
1569t-1570t
in rosacea, 2531
Flutamide, 1168t-1176t
Fluticasone
in bronchiectasis, 549-550
in COPD, 542t
Fluvoxamine, in pruritus, 2502t
Fly bite, 2080-2081, 2158
FMR1 gene, 2388, e244-8
Foam cells, 1358t
Focal cortical dysplasia with balloon cells,
2387
Focal nodular hyperplasia, of liver,
1299-1303
Focal segmental glomerulosclerosis, 764,
764f
Focused abdominal sonography in trauma
(FAST), 690-691, 690f
Folate, 1075, e225-2t-e225-5t, e225-9t
absorption of, 905, 1077-1078
cobalamin interactions with, 1078
deficiency of, 1341t, 2383t, 2384,
e225-2t-e225-5t
alcohol-related, 1078-1080
in celiac disease, 1078
cerebral, 1078
classification of, 1076t
clinical manifestations of, 1079
diagnosis of, 1079-1083, 1079f,
1081t
etiology of, 1082
hereditary, 1078
laboratory tests in, 1080-1082, 1081t
neural tube defects and, 1381t, 1382
nutritional, 1078
pathogenesis of, 1078-1079
patient history in, 1080
physical examination in, 1080
pregnancy and, 1078
prognosis for, 1082-1083
treatment of, 1082b, 1083t
in tropical sprue, 1078
excretion of, 1078
metabolism of, 1078
physiology of, 1077-1078
prophylactic, 1082
recommended daily allowance for, 1075
requirement for, e225-8-e225-9
serum, 1081, 1081t
transport of, 1077-1078
Folic acid. See also Folate
cancer and, 1380
in malabsorption, 908t
supplemental, 1077-1078, 1082
Folinate
in methanol toxicity, 679t-683t
in methotrexate toxicity, 679t-683t
Follicle-stimulating hormone (FSH),
1425-1426, 1442
in amenorrhea, e244-3f, e244-7-e244-8
ovarian effects of, e244-1-e244-2, e244-2f
tests for, 1434t, 1437t
therapeutic, 1434t
tumor production of, 1443
Folliculitis, 1816, 2531-2532, 2544
eosinophilic, 2211, 2211f
Pityrosporum, 2507, 2507f, 2532
Pseudomonas, 2532, 2532f, 2544-2546
pustular, eosinophilic, 2532
staphylococcal, 2210, 2210f
Folliculitis decalvans, 2553
Folliculogenesis, e244-1-e244-4
disorders of, e244-11
Fomepizole
in ethylene glycol toxicity, 679t-683t
in methanol toxicity, 679t-683t
Fomivirsen, in CMV infection, 2085
Fondaparinux, 173
in acute coronary syndrome, 432
in deep vein thrombosis, 502t, 503
Food(s). See also Diet; Nutrition
allergy to, 1613
anaphylaxis with, 1633-1634, 1637
diarrhea with, 910
testing for, 1614, 1635
cyclosporine interaction with, 163
esophageal impaction of, 855f, 875
in gastrointestinal disease evaluation,
828
guidelines for, 1382t-1383t
intake of
deficient. See Eating disorder(s);
Malnutrition; Protein-energy
malnutrition
excess. See Obesity
malabsorption of. See Malabsorption
mercury in, 89-90
obesity and, 1410, 1410t
safety guidelines for, 1382t
thermic effect of, 1412
Food-borne illness. See also Diarrhea,
infectious
Angiostrongylus spp., e366-3-e366-4
clinical manifestations of, 897-898. See also
Diarrhea
Clostridium botulinum, e304-4. See also
Botulism
Clostridium perfringens type A, e304-7
enteropathogenic Yersiniae, 1898-1899
epidemiology of, 895, 897t
Escherichia coli, 1872. See also Escherichia
coli infection, enteric
Fasciola hepatica, 2060, 2061t
Giardia lamblia, 2040-2043. See also
Giardiasis
Listeria monocytogenes, 1835-1836
Paragonimus spp., 2062
Salmonella, 1884-1885
shellfish, 698t, 700, 898
Staphylococcus, 1816
Toxoplasma gondii, e357-1-e357-9. See
also Toxoplasmosis
Trichinella, e366-2-e366-6
Foot (feet). See also Ankle
diabetic, e236-16
disorders of, 1681
examination of, 26
keratoderma blennorrhagicum of,
1694-1695, 1695f
livedo reticularis of, 493, 493f
osteoarthritis of, 1674-1675, 1674f
pernio of, 496-497, 497f
rash on, 1771, 1771t
rheumatoid arthritis of, 1684
thromboangiitis obliterans of, 494-498,
495f
Foot-and-mouth disease, 1965t
Forbes disease, 1356t
Forced expiratory volume in 1 second
(FEV1), e85-3t, e85-5
in asthma, 533, 533t
in COPD, 537, 537f, 539-540, 540t
in sarcoidosis, 584-585
Forced vital capacity (FVC), e85-3t, e85-5
in COPD, 539, 539f, 540t
Forearm test, in rhabdomyolysis, 703
Foreign body
esophageal, 885
ocular, 2429
Forgetting, 2271. See also Amnesia
Formoterol, in COPD, 542t
Fosaprepitant, in nausea and vomiting,
843t-844t
Foscarnet
adverse effects of, 2084t, 2085
cytomegalovirus resistance to, 2085
drug interactions with, 2084t
excretion of, 2083t
in herpesvirus infections, 2083t, 2085
Fosinopril, in hypertension, 382t
FOUR Score scale, 2295, 2295t
FOXL2 gene, e244-8
Fracture(s)
in electric current injury, 686
osteoporotic, 1578, 1581
prevention of, 108
stress, 1681
Fragile X syndrome, 2388
Frailty, 98-100, 99t, 100f
Francisella tularensis infection. See Tularemia
Frataxin, 320t
FRAX assessment, in osteoporosis,
1582-1583
Fresh-frozen plasma, in liver failure, 1148b
Friction rub, in acute pericarditis, 473
Friedreichs ataxia, 2341-2342
Frontal lobe disorders, 2273-2274
Frontotemporal lobar degeneration,
2281-2283, 2281t
vs. Alzheimers disease, 2278-2279
Frostbite, 497, 668-669
clinical manifestations of, 497, 497f
pathobiology of, 497
treatment of, 497b
Frozen shoulder, 1679
Fructose, 838
watery diarrhea with, 908
Fructose-1,6-bisphosphate deficiency, 1343t
Fructose intolerance, 801t, 1343t
Fructosuria, 1343t
FSHR gene, e244-8
FTA-ABS (fluorescent treponemal antibody
absorption) test, e327-5, e327-5t
Fulvestrant, 1168t-1176t
Functional residual capacity, e85-3t
Functional status, in older adult, 101, 104t
Funduscopy, in infective endocarditis, 466
Fungal infection. See also specific fungal
infections
acute leukemia and, 1208
cutaneous, 2511-2512, 2542, 2544t, 2546
dematiaceous, 2007-2008, 2007t
endocardial, 465, 468t, 470t
endophthalmic, 2435-2436
hepatic, 989-990
HIV infection and, 2195, 2210
joint, 1734
nail, 2556
in neutropenia, 1778-1780
pericardial, 481
urinary tract, 1795
Funnel web spiders, 2077t, 2079
Furosemide
in hypertension, 382t
in hypervolemia, 727, 727t
Furuncle, 1773, 1816, 2544-2545, 2544f
Furuncular myiasis, 2081
Fusobacterium necrophorum infection, 1850t
Fusobacterium nucleatum infection,
1847-1851, 1850t
Futility, 6-7
G
Gabapentin, 2292t
in menopausal hot flushes, 1569t-1570t
in pain, 136t
in pruritus, 2502t
in restless legs syndrome, 2341b
Gait
abnormal, 2230, 2230t
antalgic, 2230t
dystonic, 2230t
hemiparetic, 2230t
hysterical, 2230t
in manganese poisoning, 92
in multiple sclerosis, 2349
in older adults, 103
 INDEX e33
Gait (Continued) Gastric emptying, 862-863 Gastrointestinal bleeding (Continued) Gastrointestinal tract. See also Colon; Small
Parkinsonian, 2230t accelerated, 866 endoscopy in, 852-853, 858, 858t intestine; Stomach
in peripheral neuropathy, 2398 slowed, 863, 864t, 865f. See also prognosis for, 860 aging-related changes in, 106
spastic, 2230t Gastroparesis treatment of, 858b-860b, 859f, 859t alcohol effects on, 148t, 149
steppage, 2230t therapeutic, in acute poisoning, 679 endoscopy in, 853, 853f bleeding from. See Gastrointestinal
unsteadiness of, 2230 Gastric outlet obstruction, 894-895, 894f ulcer-related. See Peptic ulcer disease, bleeding
waddling, 2230t Gastric residual volume, 1393 bleeding in diffuse large B-cell lymphoma of, 1227
Galactomannan, 1992 Gastric ulcers, 886. See also Peptic ulcer Gastrointestinal bypass surgery, disease of. See Gastrointestinal disease
Galactorrhea, 1438 disease malabsorption with, 901 enteric nervous system of, 896f
Galactosemia, 1343t drug-related, 887, 888t, 889 Gastrointestinal disease, 828-844 infection of. See Diarrhea, infectious;
cataract in, 2441 in hyperhistaminic syndrome, 889 abdominal examination in, 829 Gastroenteritis
-Galactosidase A, 320t malignant, 887, 888t abdominal pain in, 832, 834t-837t, 836f, ischemia of. See Intestinal ischemia
deficiency of, 1359, 1359f stress, 889 838f-839f motility of. See Gastrointestinal motility
Galanin, 1412t Gastrin, serum, 891, 1294 antibody tests in, 832 neuroenteric system of, 862, 864
Gallavardins phenomenon, 455 Gastrinoma, 751, 1292-1297, 1293t biopsy in, 848 NSAID effects on, 171, 887, 888t
Gallbladder clinical manifestations of, 1293 bleeding in. See Gastrointestinal bleeding refeeding effects on, 1391
cancer of, 1019 definition of, 1292-1293 bloating in, 838-844 shock-related dysfunction of, 647, 647t
inflammation of. See Cholecystitis diagnosis of, 891, 1293-1294 blood tests in, 829-832 toxicant effects on, 673
pain in, 247t differential diagnosis of, 1294 in Chagas disease, e355-2 tuberculosis of, 1943-1944
palpation of, 955 epidemiology of, 1292-1293 clinical history in, 828, 831t-832t undernutrition effects on, 1389
parenteral nutrition effects on, extrapancreatic, 1293 in common variable immunodeficiency, Gastroparesis, 864-867, 864t, 2393
1397 imaging in, 1294 1620 in diabetes mellitus type 1, e236-15
stones in. See Cholelithiasis in MEN 1, 1293, 1506 in compromised host, 1778t, 1780 diagnosis of, 865, 865f
Gallium nitrate, in hypercalcemia of pathobiology of, 1293 constipation in, 842 in systemic sclerosis, 1709
malignancy, 1189b peptic ulcers in, 888-889, 888t in cystic fibrosis, 546-547 treatment of, 865b-866b
Gallstones. See Cholelithiasis prognosis for, 1294 diarrhea in, 842 Gastropathy, congestive, 935
GALT gene, e244-8 treatment of, 1294b dietary history in, 828 GATA1 gene, 1100
Gamekeepers thumb, 1679 Gastritis, 886. See also Peptic ulcer disease digital rectal examination in, 829 Gaucher cells, 1359f
Gammaretroviral vectors, 208 alcoholic, 149, 889 distention in, 838-839 Gauchers disease, 1358
Gammopathy atrophic, 1275 dyspepsia in, 842, 844f clinical manifestations of, 1358, 1359f
biclonal, 1236 epidemiology of, 887 endoscopy in, 831t-832t, 832 diagnosis of, 1358
monoclonal, 2401t, 2403-2405 erosive, 886, 886f family history in, 829 intersitital lung disease with, 566
of undetermined significance, H. pylori in, 887 fever in, 829 treatment of, 1359b
1234-1236, 1235f, 1236t Gastrocolic response, 863 functional, 828, 832, 838, 839f, 868-874, GAVE (gastric antral vascular ectasia), 935,
Ganciclovir Gastroduodenitis, lymphocytic, 888 e139-1f 1709, 1711
adverse effects of, 2084, 2084t Gastroenteritis, 1788-1791. See also gas in, 838-844 Gaviscon, in gastroesophageal reflux disease,
CMV resistance to, 2084 Diarrhea, infectious general survey in, 829 878t
drug interactions with, 2084t adenoviral, 2101, 2101t in HIV-infected patient, 2196-2199. See Gaze, conjugate, disorders of, 2448
excretion of, 2083t astrovirus, 2145-2146, 2145t also Human immunodeficiency virus Gaze-evoked nystagmus, 2448
in herpesvirus infection, 2083-2084, Campylobacter jejuni, 1868-1871, 1869t (HIV) infection, gastrointestinal Gefitinib, 167
2083t diagnosis of, 1773 manifestations of in lung cancer, 202t
Gangliocytoma, 1428 eosinophilic, 910 imaging of, 831t-832t, 832, 845-850 Gelatinases, in inflammation, 233t
Ganglioglioma, 1252 norovirus, 2144-2147, 2145t computed tomography in, 847-848, Gemfibrozil, in stable myocardial ischemia,
Ganglion rotavirus, 2144-2147, 2145t 849f 419
knee, 1659f sapovirus, 2145-2146 endoscopic, 851. See also Endoscopy Gemifloxacin, 1809t-1811t
wrist, 1679 Yersiniae, 1898 fluoroscopy in, 845, 846f rash with, 1765
Gangliosidoses, 1344 Gastroesophageal junction magnetic resonance imaging in, Gender
Gangrene, gas, e304-3-e304-4 intestinal metaplasia at, 879 847-848, 849f-850f cardiovascular disease and, 257
Ganisetron, in nausea and vomiting, Mallory-Weiss tear of, 857, 857f, 885 positron emission tomography in, hypertension and, 375
843t-844t Gastroesophageal reflux disease (GERD), 849-850, 850f lung cancer and, 1265
Gap delta, 745 875-880 radiography in, 845, 845f rheumatic disease and, 1648
Gardner-Diamond syndrome, 1136 clinical manifestations of, 876, 876f, 2471 radionuclide, 849-850, 850f vasculitis and, 1721
Gardners syndrome, 1194t, 1282 definition of, 875 ultrasonography in, 845-846, Gender identity, 1517
Gas(es) diagnosis of, 876, 877f 846f-847f Gender role, 1517
gastrointestinal, 838-844 endoscopy in, 852, 852f, 876, 877f immunodeficiency and, 1616 Gendicine, 210
irritant toxicity of, 578-581 epidemiology of, 875 involuntary weight loss in, 839, 840t-841t, Gene(s), 187-188, 188f. See also Genetics and
pleural. See Pneumothorax esophageal adenocarcinoma and, 1274 841f specific genes
Gas embolism, 576-581, 2318 manometry in, 876 laboratory studies in, 829-832, 831t-832t HLA. See Human leukocyte antigens
Gas exchange, e85-1 obesity and, 876, 1414 in mastocytosis, 1642 (HLAs)
in acute respiratory failure, pain in, 834t-836t medication history in, 828 linkage disequilibrium of, 224-226
630-635 pathobiology of, 875-876 Mucor, 1996 mutation in, 190-192, 191f. See also
in COPD, 539 prognosis for, 878 nausea in, 841-842 Mutation(s)
Gas gangrene, e304-3-e304-4 strictures with, 877f, 878 neuroenteric, 864 therapeutic delivery of. See Gene therapy
Gastrectomy in systemic sclerosis, 1709 past medical history in, 828 Gene expression, 201-202, 201t
cobalamin deficiency and, 1076 treatment of, 876b-878b, 877f, 878t pelvic examination in, 829 Gene expression signature, 201-202, 201t
gastric cancer and, 1275 in women of reproductive potential, 1550t physical examination in, 829, 831t-832t Gene therapy, 207-210
malabsorption with, 901 Gastrointestinal bleeding, 842-844, 857-862 social history in, 828-829 adenoviral vectors for, 208
ulcers after, 889 epidemiology of, 857-862 stool examination in, 832 adenovirus-associated virus vector for,
Gastric analysis, 891 in hemophilia, e177-2 in systemic lupus erythematosus, 1701 209
Gastric antral vascular ectasia (GAVE), 935, hypovolemia with, 723-724 in systemic sclerosis, 1709 in cancer, 210
1709, 1711 in liver disease, 953, 1147 vascular, 928. See also Intestinal ischemia cardiovascular conditions, 210
Gastric cancer, 1275 lower, 860-862 vital signs in, 829 in cystic fibrosis, 210
achalasia with, 881 diagnosis of, 831t-832t, 860, 860t vomiting in, 841-842 delivery methods for, 208-209
clinical manifestations of, in diverticular disease, 922 Gastrointestinal motility, 862-863, 863f ethics of, 210
1275-1278 endoscopy in, 853-854, 854f disorders of, 862-868 gamma retroviral vectors for, 208
diagnosis of, 1276, 1276f-1277f epidemiology of, 860 in carcinoid syndrome, 1510 in hematologic disorders, 210
epidemiology of, 1275 prognosis for, 861 colonic, 866-867, 867f, 867t in hemophilia, e177-6
genetics of, 1275 treatment of, 860b, 860f definition of, 862-867 herpes simplex virus type 1 vector for, 209
laboratory tests in, 1276 obscure/occult, 844, 861-862, 861f in functional dyspepsia, 873 in inborn errors of metabolism, 1346
paraneoplastic syndromes in, 1276 definition of, 861 in irritable bowel syndrome, 869 in inherited immunodeficiency, 209
pathobiology of, 1275 diagnosis of, 861-862, 861f, 862t pathobiology of, 862-867 lentiviral vectors for, 209
physical examination in, 1276 endoscopy in, 854 rapid transit, 866-867, 909 naked DNA for, 208
prognosis for, 1277 epidemiology of, 861 slow transit, 863, 864t, 865f nonviral vectors for, 208
risk factors for, 1275, 1275t treatment of, 861f weight loss with, 840t-841t oncolytic viruses for, 209
staging of, 1276t upper, 857-858 Gastrointestinal stromal tumor (GIST) plasmid DNA for, 208
treatment of, 1276b-1277b clinical manifestations of, 857, 857f gastric, 1278 recombinant vaccinia virus vector for, 209
ulcers with, 887 diagnosis of, 831t-832t, 857-858, 858t small intestine, 1278-1279, 1279f retroviral vectors for, 208-209
e34 INDEX
Gene therapy (Continued)
virus-like particle vector for, 209
in Wilsons disease, 1373
Genetic disorders, 184, 185t. See also specific
disorders
acquired. See Cancer
association studies of, 197-198
clinical decision making in, 202-203, 203t
diagnosis of, 186
early-onset forms of, 197
family-based linkage analysis in, 197
gene expression in, 201-202, 201t
genome-wide association study in, 199
inheritance of, 192
management of, 185
medical resequencing in, 199
metabolic profiling in, 202
monogenic, 196-197
pharmacogenetics and, 200-201
pharmacogenomics in, 201-202, 202t
population studies of, 186
proteomics in, 202
treatment of, 184
X-linked, 192
Genetic polymorphism, 188
Genetic testing, 186. See also Genetics
advances in, 184
for disease stratification, 186
for drug assessment, 186-187, 187t
in endocrine disorders, 1422
ethical issues in, 186
in hereditary cancer, e184-2
in paraganglioma, 1472
in pheochromocytoma, 1472
predictive value of, 186
for risk assessment, 186
Genetic variation, 188-189, 189f
assay of, 192-193
chromosomal aberrations and, 189-190
disease risk and, 195
familial aggregation of, 195
mutation and, 190-192, 191f
studies of, 197-198
Genetics, 2, 184-187. See also Human
leukocyte antigens (HLAs)
in acute leukemia, 1204
in Alzheimers disease, 2278
in 1-antitrypsin deficiency, 185t, 538, 985
in arrhythmogenic right ventricular
cardiomyopathy, 327
in asthma, 531
in breast cancer, 185, 185t
in bronchiectasis, 548
in cancer, e184-1-e184-3, e184-2f
in cardiomyopathy, 185t, 297, 320t
in cardiovascular disease, 200t, 258
in celiac disease, 906
in Charcot-Marie-Tooth disease, 2398
in cholelithiasis, 1016
in chronic lymphocytic leukemia, 1214
in chronic myelogenous leukemia, 1210
clinical applications of, 199-203, 199f,
200t
in colorectal cancer, 185, 185t
in congenital heart disease, 397-398
in COPD, 538
in Crohns disease, 913-916
in cystic fibrosis, 196, 545, 545t
in dermatomyositis, 1717
in diabetic nephropathy, 781
in dilated cardiomyopathy, 297, 320t
disease and, 184-187, 185f, 185t
in drug addiction, 140-141
in drug-induced liver disease, 980
in drug metabolism, 186-187, 187t
in epilepsy, 2284-2285
in gastric cancer, 1275
in hemochromatosis, 185t, 1373-1374
in hereditary bone marrow failure, 1086
in hereditary elliptocytosis, e164-4
in hereditary spherocytosis, e164-2
in Hodgkins lymphoma, 1229
in hypertension, 376
in inborn errors of metabolism, 1341t,
1343t
in infection, 1762
in inflammatory bowel disease, 913-916
Genetics (Continued)
in irritable bowel syndrome, 869
in leprosy, 1951-1952
in long QT syndrome, 185t, 337
in Marfan syndrome, 185t, 1663
in mastocytosis, 1641
in melanoma, 1330
in multiple myeloma, 1237
in multiple sclerosis, 2347-2348
in myelodysplastic syndrome, 1200-1201
in nephrolithiasis, 790
in non-Hodgkins lymphoma, 1218-1228,
1221t
in obesity, 1410
in obstructive sleep apnea, 613
in osteoarthritis, 1672
in pancreatitis, 938, 941
in paroxysmal nocturnal hemoglobinuria,
1050
in pheochromocytoma, 1470-1472
in polymyositis, 1717
population studies in, 186
in primary immunodeficiency, 1615
in prion disease, 2381
in psoriatic arthritis, 1695
in renal cell carcinoma, 1304, 1304t
in rheumatoid arthritis, 1682, 1682t
risk assessment studies in, 186
in scleroderma, 1706
in sickle cell disease, 1067t, 1068f, 1072
in sideroblastic anemia, 1043
in spondyloarthropathies, 1692-1696
stigma and, 3-4
in thalassemia, 1060-1061, 1060t
in ulcerative colitis, 913-916
Genitalia
ambiguous. See Sexual development,
disorders of
development of, 1512f-1513f
examination of, 26
Genome
HIV virus, 2178-2179, 2179f, 2181
human, 187, 188t, 199-201
microbial, 200, 1762
Genome-wide association study, 197-199
Gentamicin, 1809t-1811t, 1812
Geophagia, 1041
GERD. See Gastroesophageal reflux disease
(GERD)
Geriatric assessment, 101-104. See also Age/
aging; Older adults
cognitive examination in, 102
components of, 101-103
for drug therapy, 116, 116t
environmental assessment in, 103
financial assessment in, 103
functional status examination in, 101,
104t
hearing examination in, 102
incontinence screening in, 103
life expectancy in, 101, 102t
medication review in, 103
mobility disorders in, 102-103
mood disorders in, 102
in neuropsychiatric disorders, 114-116,
114t-115t
nutrition review in, 103
patient goals in, 101
preventive services in, 103
social support assessment in, 103
strategic approach to, 103, 104t
vision examination in, 102
Geriatric Depression Scale, 114, 114t
Germ cell tumor
ovarian, 1320
testicular, 1321-1322
German measles. See Rubella (German
measles)
Germinal center, 220f, 221
Gerstmann-Strassler-Scheinker syndrome,
2381
Gestational diabetes insipidus, e232-3-e232-4
Gestational diabetes mellitus, 1563, e237-1
Gestational thrombocytopenia, 1130
GH secretagogue receptor, 1426
GHR gene, 1342
Ghrelin, 1411t
Giant cell arteritis, 486, 934. See also
Temporal (giant cell) arteritis
Giant cell myocarditis, 325
Giardiasis, 2040-2043
clinical manifestations of, 2042
definition of, 2040-2042, 2041f
diagnosis of, 2042
epidemiology of, 2041
malabsorption with, 907
pathobiology of, 2041-2042
prevention of, 2042
treatment of, 2010, 2042b
vs. viral hemorrhagic fever, 2153t
Gigantism, 1436-1437
Gilberts syndrome, 957, 959, 960t, 2491
Gingiva
hyperplasia of, 2452, 2453f
papilloma of, 2452-2453, 2453f
Gingivostomatitis, 2127, 2127f, 2530-2532
Gitelmans syndrome, 739, 750, 801-802,
801t
Gla protein, e267-4
Glanders, 84t, 1881, 1965t
Glands of Zeis, carcinoma of, 2431
Glanzmann thrombasthenia, 1135
Glasgow-Blatchford score, 858
Glasgow Coma Scale, 2253, 2253t
Glatiramer acetate, in multiple sclerosis, 2353
Glaucoma, 2436, 2444
acute, 2429t
angle-closure, 2429, 2437, 2437f
open-angle, 2436-2437, 2436f
post-traumatic, 2433
pseudoexfoliative, 2437
secondary, 2437
Glimepiride, 126t
in diabetes mellitus type 2, e237-7t
Glioblastoma, 1251-1254, 1251f
Glioma, 1251-1254
brain stem, 1251
optic, 1251
Glipizide, in diabetes mellitus type 2, e237-7t
Gliptins, e237-9
Global aphasia, 2272, 2272t
Globe
prominent, 2430, 2430f
rupture of, 2433
Globin genes, 1060-1061, 1066, 1068f
Globoid cell leukodystrophy, 2355
Glomerular filtration rate (GFR), 708
in cardiovascular disease, 258
in chronic kidney disease, 810, 815
in diabetic nephropathy, 781
inulin for, 709
Glomerulonephritis
acute, 757-758, 757f, 766-770
in Alport syndrome, 769
anti-glomerular basement membrane, 768,
768f, 768t
with endocarditis, 767
in Henoch-Schlein purpura, 767
immune complex, 768
in immunoglobulin A nephropathy,
766-770, 766f
membranoproliferative, 765, 765f
paraneoplastic, 1199
pauci-immune, 768
post-streptococcal, 713, 767, 767f, 1827
rapidly progressive, 759, 768, 768t, 769f
vasculitis-associated, 768
with visceral abscess, 767
Glomerulopathy
fibrillary, 770
immunotactoid, 770
Glomerulosclerosis
Kimmelstiel-Wilson, 782
segmental, focal, 764, 764f
Glomerulus (glomeruli), 708
disorders of, 761-770. See also specific
disorders
clinical manifestations of, 761
definition of, 761
diagnosis of, 761
epidemiology of, 761
pathobiology of, 761
structure of, 716, 717f
Glossopharyngeal neuralgia, 2252
Gloves, 2183-2184
GLP-1 agonists, in diabetes mellitus type 2,
e237-7t
Glucagon
in -adrenergic receptor antagonist
toxicity, 679t-683t
in anaphylaxis, 1637b
in calcium-channel antagonist toxicity,
679t-683t
in hypoglycemia, 1504b
plasma, 1294
Glucagon-like peptide, 1411t
Glucagon-like peptide-1 receptor agonists,
e237-9
Glucagon test, 1434t
Glucagonoma, 1293t, 1294-1297,
1504-1505, 1505t
clinical manifestations of, 1294, 1295f
definition of, 1294
diagnosis of, 1294-1295
pathobiology of, 1294
prognosis for, 1295
treatment of, 1295b
Glucocerebrosidase
deficiency of, 1358, 1359f
recombinant, 1345-1346, 1359b
Glucocorticoids. See also Corticosteroid(s)
deficiency of, 1439-1440. See also
Congenital adrenal hyperplasia
excess of. See Cushings disease; Cushings
syndrome
function of, 1463
lipid disorders and, 1352t
osteoporosis and, 1585-1586
replacement of, 1469b
in rheumatoid arthritis, 1688, 1688t
topical, 2510, 2510t-2511t
Glucosamine, in osteoarthritis, 1675
Glucose. See also Hyperglycemia;
Hypoglycemia
in -adrenergic receptor antagonist
toxicity, 679t-683t
blood
in chronic kidney disease, 812
in diabetes mellitus type 1, e236-8,
e236-9t
parenteral nutrition and, 1397
postoperative, 2491
in pregnancy-associated diabetes
mellitus, 1563-1564
preoperative assessment of, 2482
in calcium-channel antagonist toxicity,
679t-683t
cerebral metabolism of, 2306-2308
CSF, 2231, 2231t, 2359, 2359t
fasting, e237-3-e237-4
impaired, e237-1
in hyperkalemia, 740-741
metabolism of
cerebral, 2306-2308
corticosteroid effects on, 161
oral contraceptive effects on, 1553
plasma, e237-3
in hyponatremia, 729
pleural fluid, 609t
regulation of
in fasted state, 1500
in fed state, 1500
serum, 1499-1503, 1502f, 1503t
in ST segment elevation MI, 444
urinary, 710, 1341t
Glucose-6-phosphatase, 1355, 1355f, 1356t
Glucose-6-phosphate, 1355
Glucose-6-phosphate dehydrogenase
(G6PD), 131-132, e164-7f
dapsone effects on, 2511
Glucose-6-phosphate dehydrogenase
(G6PD) deficiency, 1116t-1117t, 1117,
e164-7, e164-7f, e164-8t
clinical manifestations of, e164-8, e164-8t
diagnosis of, e164-9
pathobiology of, e164-8
treatment of, e164-9b
Glucose-6-phosphate transporter defect,
1356t
Glucose-galactose malabsorption, 1341,
1341t

Glucose intolerance, e237-1
nutritional therapy and, 1391
Glucose phosphate isomerase deficiency,
e164-7
Glucose suppression test, 1437t
Glucose tolerance test, e237-3
Glucose transporters, defects of, 1341,
1341t-1342t
-Glucosidase defect, 1356t
Glucosidase inhibitors, in diabetes mellitus
type 2, e237-7t
Glutaconic aciduria, 1343t
Glutamine, in enteral nutrition, 1392
-Glutamyl transpeptidase, 962
-Glutamylcysteine synthetase deficiency,
e164-9
Glutaric aciduria, 1343t
Glutathione, metabolism of, disorders of,
e164-9
Glutathione reductase deficiency,
1116t-1117t
Glutathione synthetase deficiency,
1116t-1117t, 1117, e164-9
Gluten-sensitive enteropathy. See Celiac
disease
GLUTs (glucose transporters), defects in,
1341, 1341t-1342t
Glyburide, in diabetes mellitus type 2,
e237-7t
Glycogen, 1355, 1355f
Glycogen branching enzyme defect, 1356t
Glycogen phosphorylase defects, 1356t
Glycogen storage disease(s), 1354-1357
clinical manifestations of, 1355, 1356t
complications of, 1356
definition of, 1354-1355
epidemiology of, 1355
neutropenia in, 1102t, 1103
pathobiology of, 1355
treatment of, 1355b-1356b, 1356t
Glycohemoglobin, 1503, e236-8
Glycophorins, e164-1, e164-2f
Glycoprotein IIB/IIIA inhibitors, in ST
segment elevation MI, 442
Glycoproteins, e267-4
Glycosaminoglycan, dermal deposition of,
e233-6-e233-7
Glycosuria, 710, 1341t
Glycosylphosphatidylinositol
deficiency of, 1050
synthesis of, 1050
Glycylcyclines, 1807t, 1809t-1811t
resistance to, 1808t
Glycyrrhizic acid, 739
GM-CSF, 215t, 1111
Gnathostomiasis, e366-1t, e366-3
Goiter, 611-612, 612f, e233-10
multinodular, toxic, e233-7
Gold
in pemphigus vulgaris, 2511
in rheumatoid arthritis, 1689
Golfers elbow, 1679
Golimumab, 165
Gonad(s). See also Ovary (ovaries); Testis
(testes)
biopsy of, 1518
development of, 1511, 1512f
ionizing radiation injury to, 80
mixed dysgenesis of, 1516, 1534
pure dysgenesis of, e244-8
Gonadotropin(s), 1442. See also Follicle-
stimulating hormone (FSH);
Luteinizing hormone (LH)
deficiency of, 1429-1430
secretion of, 1427
tests for, 1437t
tumor production of, 1435t, 1443
Gonadotropin-releasing hormone, 1425-1426
therapeutic, 1426
Gonorrhea, e307-2-e307-5. See also Neisseria
gonorrhoeae infection
clinical manifestations of, e307-2-e307-5,
e307-2f
diagnosis of, e307-2-e307-5
epidemiology of, e307-1
follow-up for, e307-6
HIV infection and, 2198
Gonorrhea (Continued)
pathobiology of, e307-1
prevention of, e307-5
rectal, e307-3-e307-5
screening for, 54t, 55
treatment of, e307-5b-e307-6b, e307-5t
Gonyautoxins, 698t, 700
Goodpastures syndrome, 228t, 229, 768,
768t
diagnosis of, 554-555, 713
diffuse alveolar hemorrhage in, 554
Goods syndrome, 1620
Gordons syndrome, 740, 749, 801t
Gorlins syndrome, 1194t, 1333
Goserelin acetate, 1168t-1176t
in prostate cancer, 1324
Gottrons papules, 1718, 1718f
Gottrons sign, 1718
Gout, 1737-1742
acute, 1739-1740, 1739f
alcohol use and, 149
atypical, 1739
chronic (advanced), 1739, 1740f, 1741
classic, 1739, 1739f-1740f
clinical manifestations of, 1739-1742
crystal deposition in, 1738-1739
definition of, 1737
diagnosis of, 1739-1740, 1740f
epidemiology of, 1737, 1737f
heart failure and, 314-315
nephrolithiasis and, 790
paraneoplastic, 1196t
pathobiology of, 1737-1739, 1738f
prevention of, 1740b-1741b
radiography in, 1740
vs. rheumatoid arthritis, 1687t
saturnine, 1739
tophi in, 1739, 1740f
treatment of, 1740b-1741b
urate overproduction in, 1738, 1738t
urate underexcretion in, 1737-1738, 1738f,
1738t
G6PD gene, e164-8
Graafian follicle, e244-1-e244-5
Gradient diffusion-method susceptibility
testing, 1763
Graft-versus-host disease, 235-238
after hematopoietic stem cell
transplantation, 1161-1162
infection and, 1779
malabsorption with, 907
mechanisms of, 237-238
prevention of, 238, 238t
transfusion-related, 1157
Grains, dietary, 1383t
Gram stain, 1804
in bacterial meningitis, 2358
in Campylobacter jejuni infection, 1870
in gonococcal infection, e307-2
in pneumococcal pneumonia, 1822
sputum, 590
Granular casts, 711-712, 711f
pigmented, 711-712, 711f
Granule(s)
eosinophil, 1119
neutrophil, 1112, 1112f, 1112t
defects in, 1115
Granulocyte-colony-stimulating factor
(G-CSF), 215t, 1111-1112, e159-1
in cancer, e159-4
in neutropenia, 1105b-1106b
Granulocyte-colony-stimulating factor
(G-CSF) receptor, 1102-1103
Granuloma
in common variable immunodeficiency,
1620
hepatic, 995, 995t
renal, 772-773
in sarcoidosis, 582
in tuberculosis, 1940-1941
Granuloma inguinale, 1911-1912, 1911f
Granulomatosis, Wegeners. See Wegeners
granulomatosis
Granulopoiesis, 1111-1112, 1112f
Granulosa cell tumor, 1320
Grapefruit, cyclosporine interaction with,
163
Graves disease, 228t, 229, e233-5-e233-7
dermopathy of, e233-6-e233-7
ophthalmopathy of, 2430, 2430f,
e233-6-e233-7, e233-6f
Gray platelet syndrome, 1135
Great arteries
complete transposition of, 406-407, 409t
congenitally corrected transposition of,
407
Green nail syndrome, 1880
Grey Turners sign, 837t
GRFoma, 1293t, 1296-1297
Griscelli syndrome type 2, 1102t, 1103
GRN gene, 2282
Ground itch, 2066
Growth
adolescent, 59, 59f-60f
iron requirement for, 1041
Growth factors, in lung cancer, 1266
Growth hormone (GH), 1435-1436
aging-related changes in, 107
deficiency of, 1429, 1436
excess of, 1436-1437, 1436f, 1437t
replacement of, 1434t, 1436b
serum, in obesity, 1414
tests for, 1434t, 1437t
tumor production of, 1191-1192, 1435t,
1436-1437, 1436f
undernutrition effects on, 1389
Growth hormone-releasing hormone, 1426
tumor secretion of, 1296-1297
Growth hormone (GH) resistance, 1342
Growth hormone (GH) secretagogue
receptor, 1426
Guanabenz, in hypertension, 382t
Guanfacine
in hypertension, 382t
in Tourettes syndrome, 2338b
Guillain-Barr syndrome, 2393, 2393t, 2401
acute respiratory failure in, 636
after Campylobacter jejuni infection, 1870
clinical manifestations of, 2401
CSF examination in, 2231t
definition of, 2401, 2401t
diagnosis of, 2401
differential diagnosis of, 2401-2402
epidemiology of, 2401
F wave in, 2233
pathobiology of, 2401
prognosis for, 2402
vs. rhabdomyolysis, 703
treatment of, 2402b
Guinea worm infection, e366-8
Gummas, e327-3
Gums. See Gingiva
Gustation. See Taste
Gut-associated lymphoid tissue, 220-221
H 1068-1069
H2-receptor antagonists, in gastroesophageal
reflux disease, 876b-878b, 877f, 878t
H reflex, 2233
HACEK (Haemophilus spp, Actinobacillus
actinomycetemocomitans,
Cardiobacterium hominis, Eikenella
corrodens, and Kingella spp) strains, in
infective endocarditis, 465, 468t, 470t
Hadronyche spider, 2079
Haemophilus aphrophilus infection, 1863
Haemophilus ducreyi infection, 1798,
1864-1865, 1864f
Haemophilus influenzae infection, 1861-1864,
1863t
bloodstream, 1862
clinical manifestations of, 1862-1864
conjunctival, 1862
definition of, 1861-1862
endocardial, 1862
epidemiology of, 1861
in epiglottitis, 1862
immune response to, 1861-1862
immunization against, 1863
joint, 1862
meningeal, 1862, 2361-2363, 2362t, 2365
obstetric/gynecologic, 1862
in otitis media, 1862
INDEX e35
Haemophilus influenzae infection (Continued)
pathobiology of, 1861-1862
pericardial, 1862
prevention of, 1863
pulmonary, 1862
sinus, 1862
soft tissue, 1862
tracheobronchial, 1862
treatment of, 1862b-1863b
Haemophilus parainfluenzae infection, 1863
Haemophilus paraphrophilus infection, 1863
Hair, 2500, 2501f
aging-related changes in, 108-109
arsenic in, 91
cycle of, 2551
excessive growth of, 2554
loss of, 2551, 2551t-2552t
normal, 2551
in nutritional assessment, 1386t
pediatric disorders of, 2553
racial differences in, 2554
transplantation of, 2513
undernutrition effects on, 1389
Hair follicle, 2498, 2499f, 2500, 2501f, 2551
Hairy cell leukemia, 1213-1214, 1214f,
1216t
Hairy leukoplakia, oral, 2451, 2451f
Epstein-Barr virus infection and,
2135-2136
HIV infection and, 2209-2210
Half-life, drug, 125, 125f
Hallucinogenic agents
abuse of, 158
central nervous system effects of, 672t
Halofantrine, in malaria, 2016-2017
Haloperidol, 2243t
in Tourettes syndrome, 2338b
Halos, 2429
Halothane, hepatotoxicity of, 983
Hamartoma, hypothalamic, 1428
Hamman-Rich syndrome. See Acute
interstitial pneumonia
Hand(s). See also Digit(s)
examination of, 26
in hemochromatosis, 1750-1751, 1750f
hygiene for, 2183-2184
in Enterobacteriaceae infection
prevention, 1876
in infection prevention, e290-3
in shigellosis prevention, 1890
in hypertrophic osteoarthropathy, 1750f
joint disorders of, 1679-1680
osteoarthritis of, 1673-1674, 1674f
prostheses for, 1757
rheumatoid arthritis of, 1684, 1684f-1685f
in sarcoidosis, 1751f
Hand-arm vibration syndrome, 495
Hand-foot-and-mouth disease, 2143
Hand-foot syndrome, in sickle cell disease,
Hansens disease. See Leprosy
Hantavirus infection, 1965t, 2148t-2149t,
2150, 2151t. See also Viral hemorrhagic
fevers
Haplotype, 188, 196
Haptoglobin, serum, 1038-1039, 1047-1048
Hard metal disease, 568t
Harderoporphyria, 1369-1370
Harlequin syndrome, 2394
Hartnups syndrome, 1341t
Hashimotos thyroiditis, e233-3
Hazardous exposures. See also Occupational
disease
aluminum, 93-95
arsenic, 90-95
assessment of, 75-76, e18-1f
beryllium, 93-95
cadmium, 92-95
chromium, 94
cobalt, 94
disorders with, 76, 76t
dose of, 76
electromagnetic radiation, 78, 78t
herbicide, 78, 78t
infrared radiation, 82
lead, 88-95, 88t
manganese, 92-95
e36 INDEX
Hazardous exposures (Continued)
mercury, 89-95
metal, 76t, 77
mineral dust, 78, 78t
mold, 78, 78t
nickel, 93-95
organohalide, 77, 78t
particulate matter, 78, 78t
pesticide, 78, 78t
selenium, 94-95
silver, 95
solvent, 76t, 77
timing of, 76
uranium, 95
zinc, 95
HBB gene, 1072
HCTZ, in hypertension, 382t
Head. See also Brain; Neck; Traumatic brain
injury
Actinomyces infection of, 1968, 1968f
enlargement of, 2229
examination of, in trauma, 689
non-spore-forming anaerobic bacterial
infection of, 1849
pain in. See Headache
tremor of, 2334
Head and neck cancer, 1257-1264
clinical manifestations of, 1258-1259,
1258f
definition of, 1257
diagnosis of, 1259, 1259f
epidemiology of, 1257-1264
hypopharynx, 1257, 1260t-1261t
larynx, 1257, 1260t-1261t
nasopharynx, 1257-1258
oral cavity, 1257-1264, 1260t-1261t
oropharynx, 1257, 1260t-1261t
paranasal sinus, 1258-1259
pathobiology of, 1258
prognosis for, 1263-1264
salivary gland, 1258, 1263
staging of, 1259, 1260t-1261t
treatment of, 1262b-1263b, 1263t
with unknown primary site, 1259-1261,
1262f
Head-thrust test, 2467
Headache, 2246-2252
in brain abscess, 2372
clinical manifestations of, 2246,
2247t
cluster, 2247t, 2249-2252, 2250t
daily, 2250-2252
definition of, 2246
diagnosis of, 2246, 2246t
in endocrine disorders, 1420
epidemiology of, 2246
in glossopharyngeal neuralgia, 2252
in intracranial hypertension, 2251
in intracranial hypotension, 2251
migraine, 2247-2252, 2247t-2248t
pathobiology of, 2246
in pituitary adenoma, 1433
prevention of, 2247, 2248t
prognosis for, 2247
secondary causes of, 2246t, 2251-2252
sinus, 1625, 2251
in subarachnoid hemorrhage, 2320
in temporal arteritis, 2251
tension-type, 2247t, 2248-2252
treatment of, 2246b
in trigeminal neuralgia, 2251-2252
in women of reproductive potential,
1550t
Health care
access to, 15-17, 15t, 1548
cultural competence in, 16-17, 16f
demand factors in, 19
economic issues in, 18-20, 19f
measurement of, 37-41. See also
Measurement
navigation guide to, 17
payment for, 19-20
quality of. See Quality of care
safety of, 43-44
supply factors in, 18-19
technology in, 19
value of, 44
Health careassociated infection,
e290-1-e290-8
antibiotic-resistant, e290-2, e290-2t-
e290-3t, e290-4f
prevention of, e290-3-e290-4
contact isolation in, e290-4
drug cycling in, e290-4
drug stewardship in, e290-3
hand hygiene in, e290-3
hospital stay length in, e290-3
microbiologic surveillance in,
e290-3-e290-4
staffing strategies in, e290-3
blood stream, e290-2t, e290-6-e290-7
catheter-related, e290-6-e290-7
costs of, e290-1, e290-2t
endocardial, 464-465
epidemiology of, e290-1, e290-7
fever in, 1770, 1770t
in health care workers, e290-7-e290-8
historical perspective on, e290-1
prevention of, e290-7
pulmonary, e290-2t, e290-5
surgical site, e290-2t, e290-5-e290-6
transmission of, e290-2
treatment of, 1773-1774
urinary tract, e290-1-e290-2, e290-2t,
e290-4-e290-5
Health care workers
HIV infection in, 2183-2185
patient transmission from, 2185
prevention of, 2183-2185, 2183t-2184t
infection in, e290-7-e290-8
Health examination, periodic, 52-56
Health insurance system, 4
Healthcare outcomes, 37-38, 41, 41t
combined, 38
comparative effectiveness in, 41
intermediate/surrogate, 38
studies of, 39-41, 41t. See also Clinical
trials
Hearing, 2461
evaluation of, 2462, 2463f
audiometry in, 2462
bedside, 2462
in older adults, 102, 104t
screening, 55
loss/impairment of, 2461-2462
acoustic neuroma and, 2463
in acute poisoning, 671
aging-related, 108, 2463
aminoglycoside-induced, 1812
audiometry in, 2462
in bacterial meningitis, 2358
beside diagnosis of, 2462
central, 2462-2463
cochlear damage and, 2463
in Cogans syndrome, 1723
conductive, 2462
diagnosis of, 2462
drug-related, 2463
hereditary, 2462
localization of, 2462
Menieres disease and, 2463
in neurofibromatosis type 2, 2389
noise-induced, 2463
in older adults, 99t
pathobiology of, 2462
sensorineural, 2462-2463
occupation-related, 76t, 77
treatment of, 2463b
physiology of, 2461-2462
Heart. See also at Cardiac; Cardio-;
Cardiovascular; Coronary artery
(arteries)
afterload of, e52-6
age-related changes in, e52-6
anatomy of, 264-265, 264f, e52-2f,
e52-3-e52-4
auscultation of, 251-252, 252f
blood flow of, e52-3
carcinoid of, 332-333
Chagas disease of, e355-2, e355-2f
conduction system of, 272, 272f, 334-337,
335f, 348-349, e52-1, e52-1, e61-1f,
e52-2f
abnormal automaticity of, 336
Heart (Continued)
delayed afterdepolarizations in, 336
depolarization-induced automaticity in,
336
early afterdepolarizations in, 336
in heart failure, 297
congenital disease of. See Congenital heart
disease
contractile cells of, e52-1-e52-2
contractile cycle of, e52-5-e52-6, e52-5f,
e52-5t
development of, e52-1, e52-1f
electrical activity of, 334-337, 334f-335f,
348-349, e52-1, e52-2f, e61-1f
embolism from, 2311
energetics of, 1412, e52-4-e52-5
examination of, 25
excitation-contraction coupling in, e52-2
exercise effect on, e52-6
imaging of, 264-271. See also Chest
radiography; Computed tomography
(CT); Echocardiography; Magnetic
resonance imaging (MRI);
Myocardial perfusion imaging;
Positron emission tomography
(PET); Single-photon emission
computed tomography (SPECT)
portable, 271
innervation of, 335-336
malposition of, 408
metabolic regulation of, e52-3-e52-4
preload of, e52-6
preoperative assessment of. See Cardiac
risk assessment
pressure-volume area of, e52-4-e52-5
pressure-volume relationships of,
e52-5-e52-6, e52-6f
prosthetic valves for, 463b, 463f, 463t
sarcoidosis of, 288, 288f, 584-585, 585t
size of, 265, 265f
structure of, e52-1-e52-3
in systemic sclerosis, 1710
toxicant effects on, 672-673
tumors of, 282t-284t, 332-333, 332t
ultrastructure of, e52-2-e52-3
undernutrition effects on, 1389
univentricular, 407-408
work of, e52-4-e52-6
Heart block. See Atrioventricular block
Heart disease. See also Heart failure
congenital. See Congenital heart disease
coronary. See Coronary heart disease;
Myocardial infarction (MI);
Myocardial ischemia
valvular, 453-464. See also specific valvular
diseases
carcinoid syndrome and, 1510
echocardiography of, 281, 282t-284t
ischemic stroke and, 2311
in systemic lupus erythematosus, 1701
Heart failure, 295-303, e52-6
abdominal examination in, 301
abdominal systems in, 300-301
acute decompensation in, 298-300, 298f,
299t, 316-317, 316t
aortic stenosis and, 316, 455
appearance in, 301
arginine vasopressin in, 298
arrhythmia assessment in, 302-303
ascites in, 300
cachexia in, 301
cardiac examination in, 301
causes of, 295-296, 296t
central nervous system manifestations in,
301
chest radiography in, 301, 518f
Cheyne-Stokes breathing in, 528, 529f
chronic, 297-300, 297t
clinical evaluation of, 300
clinical manifestations of, 298
coronary artery disease assessment in, 302
cough in, 249-250
cytokine activation in, 298
definition of, 295, 303
diagnosis of, 300
diastolic function in, 296, 296t, 299, 316
differential diagnosis of, 302-303
Heart failure (Continued)
dyspnea in, 246, 300
echocardiography in, 282t, 301-302
electrocardiography in, 301
end-of-life care in, 318
endothelin in, 298
epidemiology of, 295-296, 303
exercise capacity assessment in, 302
exercise intolerance in, 300
extremity examination in, 301
fatigue in, 300
follow-up testing in, 303
gastrointestinal symptoms in, 300-301
heart rate in, 297
heart rhythm in, 297
heart sounds in, 301
high-output, 296, 296t
hypertension and, 303-307
incidence of, 295
jugular vein examination in, 301
laboratory testing in, 302
left-sided, 298-299
left ventricular ejection fraction in, 296
left ventricular function assessment in, 302
left ventricular remodeling in, 298, 307
management of, 303-318
ACE inhibitors in, 307, 308t, 311
in acute decompensation, 316-317, 316t
aldosterone antagonists in, 312, 312t
angiotensin receptor blockers in, 307,
309t, 311
-adrenergic receptor blockers in, 307,
310t, 311-312
cardiac resynchronization therapy in,
315
clinical trials for, 303, 304t-305t
comorbid disorders and, 314-315
digoxin in, 312-313
dilated cardiomyopathy and, 316
diuretics in, 309-311
education in, 313-314, 314t
follow-up for, 317
hydralazine in, 313
hypertrophic cardiomyopathy and, 316
implantable cardioverter-defibrillator in,
315
isosorbide dinitrate in, 313
multidisciplinary, 313-315
omega-3 polyunsaturated fatty acids in,
313
preserved left ventricular ejection
fraction and, 316
pulmonary edema in, 316-317, 317f
stage-specific, 303-318, 306f-307f
stem cell therapy in, 207
surgery in, 315
valvular heart disease and, 316
mitral regurgitation in, 316
in Mycoplasma pneumoniae infection, 1915
myocardial biopsy in, 302
myocardial blood flow in, 297
myocardial oxygen requirement in, 297
natriuretic peptides in, 298, 302
neck examination in, 301
neurohormonal responses in, 297-298
orthopnea in, 300
palpation in, 250-251
paroxysmal nocturnal dyspnea in, 300
pathobiology of, 296-301, 296t-297t, 297f
pericardial effusion in, 300
physical examination in, 301
pleural effusion in, 300-301
post-infarction, 445
preoperative assessment of, 2480
with preserved systolic function, 299,
299t, 316
prevalence of, 295
prevention of, 295
prognosis for, 318
progression of, 298
pulmonary edema in, 300
pulmonary examination in, 301
rales in, 301
renal physiology in, 298
renin-angiotensin-aldosterone system in,
298
right-sided, 298-299

Heart failure (Continued)
risk for, 295-296, 295f, 303-307
sleep disorders in, 301
stage(s) of, 295-296, 295f
A, 295-296, 295f, 303-307,
306f-307f
B, 295-296, 295f, 306f-307f, 307
C, 295-296, 295f, 306f-307f, 308
D, 306f-307f, 308
management for, 303-318, 306f-307f
sympathetic nervous system in,
297-298
systolic function in, 296, 296t
thyroid function tests in, 302
tricuspid regurgitation in, 301
ventricular afterload in, 297
ventricular arrhythmias in, 363
ventricular preload in, 297
vital signs in, 301
weight loss with, 840t-841t
Heart-lung transplantation, 620
Heart murmurs
in anemia, 1033
in aortic regurgitation, 461
in aortic stenosis, 455
continuous, 252, 253t
diastolic, 252, 253t
echocardiography in, 282t
examination for, 25
grade of, 252
in mitral regurgitation, 459
in mitral stenosis, 457
in mitral valve prolapse, 460-461
in stable myocardial ischemia, 414
systolic, 252, 253t-254t
Heart rate, 349, e52-6. See also Pulse
abnormal. See Arrhythmias; Palpitations
aging-related changes in, 105
in heart failure, 297
Heart sound(s), 251-252, 252f
in aortic regurgitation, 461
in aortic stenosis, 455
examination of, 25
first, 252f
fourth, 252, 392
in heart failure, 301
in kidney disease, 708
in mitral regurgitation, 459
in mitral stenosis, 457
in pulmonary hypertension, 392
second, 252f, 392
in ST segment elevation MI, 435
third, 252, 252f, 392
Heart transplantation, 506-510
in Chagas disease, e355-4-e355-5
diabetes mellitus after, 509
donor for, 507
drug interactions after, 510
functional outcome of, 510
health maintenance after, 509
in heart failure, 315
hemodynamic outcome of, 510
hyperlipidemia after, 509-510
hypertension after, 509
infection after, 508-509
number of, 507f
outcome of, 510, 510f
recipient evaluation for, 506-507, 507t
recipient management after, 507-510
early, 507-508
immunosuppression in, 508
long-term, 508-510
recipient management before, 507
rejection after, 508, 508t
renal insufficiency after, 509
surgical considerations in, 507
surveillance after, 509-510
vasculopathy after, 509
Heart valves
disease of, 453-464. See also specific
valvular diseases
carcinoid syndrome and, 1510
echocardiography of, 281, 282t-284t
ischemic stroke and, 2311
in systemic lupus erythematosus,
1701
prosthetic, 463b, 463f, 463t
Heartburn. See also Gastroesophageal reflux
disease (GERD)
in acid peptic disease, 890
diagnosis of, 831t-832t, 842, 844f
endoscopy in, 852
in esophageal disease, 875
HIV infection and, 852
Heat exhaustion, 667, 667b-668b, 668t
Heat illness, 666-669
clinical manifestations of, 667
definition of, 666
diagnosis of, 667
epidemiology of, 666, 667t
pathobiology of, 666-667
treatment of, 667b-668b, 668t
Heat rash, 667
Heat shock, 666-667
Heatstroke, 667, 667t
Heavy chain disease, 1242
-Heavy chain disease, 1242
-Heavy chain disease, 1242
-Heavy chain disease, 1242
HEEADSSS assessment, 61
Heerfordts syndrome, 584
Height vertigo, 2465
Heinz body hemolytic anemia, 1066, e164-7f
Helicobacter cinaedi infection, 1870
Helicobacter fennelliae infection, 1870
Helicobacter heilmannii infection, 889
Helicobacter pylori infection
cancer and, 1180, 1275
eradication of, 892, 892t
lymphoma and, 1219
in peptic ulcer disease, 887, 887f, 891
testing for, 891
Vibrio cholerae infection and, 1866
HELLP syndrome, 987, 987t, 1051t, 1130
Helminth infection. See also specific infections
cestode, 2052-2057
eosinophilia in, 1119-1120
filarial, e366-3-e366-4
fluke, 2060-2063
hepatic, 990t-992t, 991-996
nematode, 2064-2068, e366-1-e366-8
schistosomal, 2058-2060
treatment of, 2009-2010
Hemangioblastoma, 1252
Hemangioendothelioma, 935
Hemangioma
cavernous, 849f, 1298
cutaneous, 2539, 2539f
eyelid, 2441
gastrointestinal, 935
Hemarthroses, in hemophilia, e177-1-e177-2,
e177-2f, e177-4-e177-5
Hematochezia, 833, 860-862, 860f, 860t
Hematocrit, 1031t
in septic shock, 663
in sickle cell disease, 1067t, 1068
Hematoma
aortic, 483-486, 485b, 485f
epidural, 2254f
in hemophilia, e177-2
subdural, 2254f, 2315
Hematopoiesis, e159-1-e159-4, e159-2f
Hematopoietic growth factors, 1111,
e159-1-e159-3
clinical applications of, e159-3-e159-4
Hematopoietic stem cell(s), e159-1, e159-2f
Hematopoietic stem cell transplantation,
1158-1162. See also Organ
transplantation
in acute lymphoblastic leukemia, 1160,
1207
in acute myelogenous leukemia, 1160
in acute myeloid leukemia, 1208
after acute myocardial infarction, 1161
adenovirus infection after, 2102
allogeneic, 1159, 1159t-1160t
in aplastic anemia, 1087, 1088t, 1089,
1161
autologous, 1159, 1159t-1160t
in cancer, 1167
cardiotoxicity of, 1161
in chronic lymphocytic leukemia, 1160
in chronic myelogenous leukemia, 1160,
1211-1212
Hematopoietic stem cell transplantation
(Continued)
complications of, 1161-1162
endocrine dysfunction after, 1162
graft rejection with, 1162
graft-versus-host disease with, 1161-1162
hepatic toxicity of, 1161
HLA typing for, 226
in Hodgkins disease, 1160
hypogonadism after, 1162
indications for, 1159-1161, 1160f
infection and, 1161, 1774-1775, 1775t
infertility after, 1162
in multiple myeloma, 1160, 1239
in myelodysplastic syndromes, 1160-1161,
1202
in non-Hodgkins lymphoma, 1159-1160
in nonmalignant conditions, 1161
parainfluenza virus infection and, 2094
in primary myelofibrosis, 1097
pulmonary toxicity of, 1161
renal toxicity of, 1161
respiratory syncytial virus infection after,
2092
secondary malignancy after, 1162
in sickle cell disease, 1074
in solid tumors, 1161
syngeneic, 1159
in thalassemia, 1065-1066
veno-occlusive disease with, 1161
Hematopoietic system, e159-1-e159-4,
e159-2f
aging-related changes in, 107
alcohol effects on, 149
Hematuria, 710-711, 711f, 761
abdominal pain and, 833
in bladder cancer, 1307
in glomerular disease, 761
Heme
bilirubin conversion from, 956-957, 957f
biosynthetic pathway of, 1043, 1043f,
1363-1370, 1364f, 1365t
urinary, 710
Heme oxygenase, 956-957
Hemicrania continua, 2247t, 2249-2250,
2250t
Hemifacial spasm, 2341
Hemin, in acute intermittent porphyria,
1366b-1367b
Hemiptera, 2081, 2081f
Hemispatial neglect, 2273-2274
Hemochromatosis, 320t, 984-987, 985f,
1373-1377, 1374t
cardiomyopathy in, 327, 331
clinical manifestations of, 984-985, 1374,
1375t, 1750-1751, 1750f
definition of, 1373-1377
diagnosis of, 985, 985f, 1374-1375, 1375t,
1376f
early diagnosis of, 185
epidemiology of, 984, 1373-1377
family screening for, 1376
genetics of, 185t, 1373-1374
heart failure in, 302
HLA associations in, 225t, 226
hypogonadism with, 1524
joint involvement in, 1750-1751, 1750f
pathobiology of, 984, 1373-1375
pathophysiology of, 1373-1374
population screening for, 1376
prevention of, 1376-1377
prognosis for, 1376
treatment of, 1375b-1376b
Hemodialysis, 818-821
in acute poisoning, 684, 684t
air embolus with, 819
anemia with, 819-820
anticoagulation for, 818-819
bone disease and, 820-821
cardiovascular complications of, 820
complications of, 819-820
continuous, 820-821
in diabetic nephropathy, 783
dialysate solution for, 819
dialysis dose for, 820
for drug removal, 129
erythropoietin administration with, 820
INDEX e37
Hemodialysis (Continued)
hemodialyzers for, 818, 819f
indications for, 818, 818t
infection during, 819
malnutrition with, 820
in septic shock, 665
vascular access for, 818
infection with, 819
Hemodynamics, cardiac, e52-5-e52-6,
e52-5f-e52-6f, e52-5t
Hemofiltration, in hypervolemia, 728
Hemoglobin, 1060-1061, 1066, 1068f
in bleeding, 724
disorders of, 1344t
genetics of, 185t
in sickle cell disease, 1066-1068, 1067t,
1068f
in thalassemia, 1060-1061, 1060t
in gastrointestinal bleeding, 858
glycated, 1503
iron content of, 1040
normal values for, 1031t
oxygen binding to, 1031-1032, 1032f
in septic shock, 663
Hemoglobin C, 1074
Hemoglobin F, hereditary persistence of,
1060t, 1064
Hemoglobin H disease, 1061-1062
Hemoglobin Koln, 1074
Hemoglobin S, 1066-1068. See also Sickle cell
disease
Hemoglobinuria, 1038-1039, 1046t
cold, paroxysmal, 1050, 1051t
march, 1051t
nocturnal, paroxysmal, 1050, 1051t
Hemolysis. See also Hemolytic anemia
chemical-induced, 1051t
in nutritional assessment, 1386t
transfusion-related, 1051-1052, 1156-1157
Hemolytic anemia, 1038
acquired, 1048t
autoimmune, 228t, 1045-1052, 1051t
antiglobulin test in, 1048
causes of, 1047
in chronic lymphocytic leukemia,
1217
clinical manifestations of, 1047
diagnosis of, 1047-1049, 1048f
disease associations of, 1047
drug-induced, 1047
hemolysis rate in, 1046
with IgG antibodies, 1045, 1045f-1046f,
1046t
laboratory findings in, 1047-1049
patient history in, 1047
peripheral blood smear in, 1047,
1048f
physical examination in, 1047
treatment of, 1048b-1049b
classification of, 1038, 1038t, 1048t
diagnosis of, 1038-1039, 1038t
differential diagnosis of, 1048t
drug-induced, 1051t
Heinz body, 1066
immune-mediated, 1048t, 1051t. See also
Hemolytic anemia, autoimmune
in cold agglutinin disease, 1049, 1051t
in paroxysmal cold hemoglobinuria,
1050, 1051t
in paroxysmal nocturnal
hemoglobinuria, 1050
in transfusion reaction, 1050
microangiopathic, 1048f, 1048t
nonspherocytic, congenital, e164-6
pathobiology of, 1038
peripheral blood smear in, 1028-1029,
1028t
red cell enzyme defect-related, e164-6,
e164-7f
glucose-6-phosphate dehydrogenase,
e164-7, e164-7f, e164-8t
-glutamylcysteine synthetase,
e164-9
glutathione synthetase, e164-9
pyrimidine 5-nucleotidase, e164-7,
e164-7f
pyruvate kinase, e164-6, e164-7f
e38 INDEX
Hemolytic anemia (Continued)
red cell membrane defect-related,
e164-1-e164-2, e164-3f, e164-3t
elliptocytic, e164-3f, e164-4-e164-5
pyropoikilocytic, e164-3f, e164-4
spherocytic, e164-2-e164-5, e164-3f,
e164-3t
stomatocytic, e164-3f, e164-5
treatment of, 1039
in Wilsons disease, 1372
Hemolytic transfusion reaction, 1051-1052,
1156-1157
Hemolytic-uremic syndrome, 715,
1130-1131, 1668t, 1872
cancer and, 1199
hemolysis with, 1051t
renal failure and, 787-788
Hemophilia, e177-1-e177-2
acquired, e177-6-e177-10
arthritis in, 1748
clinical manifestations of, e177-1-e177-2,
e177-2f
definition of, e177-1
differential diagnosis of, e177-2
epidemiology of, e177-1
in females, e177-1
gene therapy in, e177-6-e177-10
genetics of, e177-1
hemarthroses in, 1748
hepatitis C and, e177-5
hepatitis G and, e177-5
infection and, e177-5
pathobiology of, e177-1-e177-2
prevention of, e177-6
prognosis for, e177-6
treatment of, e177-2b-e177-4b,
e177-3t-e177-4t
Hemophilus ducreyi infection. See Chancroid
Hemoptysis, 249-250, 512-515
evaluation of, 514t, 515-516, 516t
in lung cancer, 1266
Hemorrhage. See also Bleeding
in alcoholic liver disease, 1038
alveolar
bronchoalveolar lavage in, e85-6t
diffuse, 552t, 553f, 554-555
anemia with, 1034-1035
cerebellar, 2324-2325, 2325t
in electric current injury, 686
in essential thrombocythemia, 1092
gastrointestinal. See Gastrointestinal
bleeding
intracerebral, 2309, 2320-2326. See also
Stroke, hemorrhagic
amyloid angiopathy and, 2323t, 2324
cerebellar, 2324-2325, 2325t
clinical manifestations of, 2324-2325
definition of, 2323, 2323t
diagnosis of, 2325, 2325f
drug-related, 2323t, 2324
epidemiology of, 2323
in hemophilia, e177-1-e177-2
hypertension and, 2323t, 2324, 2324f
lobar, 2325
pathobiology of, 2323-2324, 2324f
pontine, 2324-2325, 2325t
prognosis for, 2326
putaminal, 2324-2325, 2325t
thalamic, 2324-2325, 2325t
treatment of, 2325b
iron deficiency anemia with, 1040-1041
in leptospirosis, 1938
ocular, 2433, 2433f
retinal, in Waldenstrms
macroglobulinemia, 1242f
shock with, 647, 648t, 650-653, 650f-652f
spinal, 2268
splinter, 253, 255f, 2555
in infective endocarditis, 466
subarachnoid, 2320-2326. See also
Subarachnoid hemorrhage
variceal
in cirrhosis, 1001-1006
esophageal, 853, 853f, 857, 857f,
858b-860b, 859f
Hemorrhagic fever. See Viral hemorrhagic
fevers
Hemorrhagic fever with renal syndrome,
2147-2156, 2148t-2149t, 2151t. See
also Viral hemorrhagic fevers
immunization against, 2155
Hemorrhoids, 945-949, 945b, 946f, 946t
Hemosiderosis, pulmonary, idiopathic, 565
Hemostasis, 1121-1122
Hemothorax, 609t, 610
Hemotympanum, 2459, 2459f
Hendra virus infection, 1966t
Henoch-Schlein purpura, 767, 1726
clinical manifestations of, 767, 925, 934,
1136, 1726, 2525
pathology of, 1722t
Henrys law, 576
Heparin, 172-173, 173f
in acute coronary syndrome, 430t,
431-432
in antiphospholipid antibody syndrome,
e177-10b
for complement inhibition, 243
in disseminated intravascular coagulation,
1146b-1147b
low-molecular-weight, 173, 173f, 173t
in acute coronary syndrome, 430t, 432
in deep vein thrombosis, 502-503, 502t,
503f
in ST segment elevation MI, 442
in septic shock, 665
in ST segment elevation MI, 438-439, 442
thrombocytopenia with, 1127, 1127f,
1127t
unfractionated
in deep vein thrombosis, 503, 503f,
503t
in ST segment elevation MI, 442
Hepatic artery, 952
aneurysmal dilation of, 936-937
thrombosis of, 936
Hepatic glycogen synthase defect, 1356t
Hepatic iron index, 1375
Hepatitis. See also Hepatitis A; Hepatitis B;
Hepatitis C; Hepatitis D; Hepatitis E
acute, 966-973
aplastic anemia with, 1084
clinical manifestations of, 966-967,
966f, 967t, 968f
diagnosis of, 967, 967t
fulminant, 967
pain in, 834t-836t
pathobiology of, 966
prognosis for, 967
treatment of, 967b
alcoholic, 149, 996-997. See also
Steatohepatitis, alcoholic
autoimmune, 979, 1014t, 1747
cholestatic, 982
chronic, 973-979
biopsy in, 973
clinical manifestations of, 973
definition of, 973
diagnosis of, 973, 973t
cryptogenic, 979
herpes, in pregnancy, 987
ischemic, 936
ketoconazole-associated, 1974
lupoid, 1701
parvovirus B19-related, 2116
in secondary syphilis, e327-3
Hepatitis A, 966t, 967-973, 968f
cholestatic, 968
clinical manifestations of, 968
diagnosis of, 968, 968f
epidemiology of, 967
hemophilia treatment and, e177-5
HIV infection and, 2191t-2192t
immunization against, 54t, 64t, 65-71,
65f-66f, 67t-70t, 968
for travel, 1801, 1801t
pathobiology of, 967
prognosis for, 968
transmission of, 967
Hepatitis B
acute, 966t, 968-973, 969f, 969t
clinical manifestations of, 969
diagnosis of, 969, 969f, 969t
epidemiology of, 968
Hepatitis B (Continued)
fulminant, 970
pathobiology of, 968-969
prognosis for, 970
treatment of, 969b
chronic, 973t, 974-979
clinical manifestations of, 974
diagnosis of, 974-975, 974t, 975f
epidemiology of, 974
pathobiology of, 974
prevention of, 975b-976b
prognosis for, 976
treatment of, 975b-976b, 976t
adefovir in, 2086-2087, 2086t
emtricitabine in, 2088
entecavir in, 2086t-2087t, 2087
interferons in, 2086t-2087t,
2088-2089
lamivudine in, 2086t-2087t,
2087-2088
telbivudine in, 2086t-2087t, 2088
tenofovir in, 2088
hepatocellular carcinoma and, 1300-1301
HIV infection and, 2191t-2192t,
2198-2199, 2217, 2224
immune complexes in, 229-230
immune reconstitution inflammatory
syndrome and, 2222t, 2224
immunization against, 54t, 64t, 65f-66f,
66, 67t-70t, 969-970
HLA associations in, 225t
for travel, 1801-1802, 1801t
occupational transmission of, e290-8
Hepatitis C, 713
acute, 966t, 970-973, 971f, 971t
clinical manifestations of, 970-971, 971t
diagnosis of, 971, 971f
epidemiology of, 970
pathobiology of, 970
prevention of, 971
prognosis for, 971
treatment of, 971b
chronic, 973t, 976-979
clinical manifestations of, 977
diagnosis of, 977
epidemiology of, 976
hepatocellular carcinoma and, 1300
HFE gene in, 1377
pathobiology of, 977
prognosis for, 978
treatment of, 977b-978b, 978f
interferons in, 2086t-2087t,
2088-2089
ribavirin in, 2086t-2087t, 2088
hemophilia treatment and, e177-5
HIV infection and, 2198-2199, 2217, 2224
HLA associations in, 225t
immune reconstitution inflammatory
syndrome and, 2222t, 2224
lymphoma and, 1219
occupational transmission of, e290-8
osteosclerosis in, 1608
Hepatitis D
acute, 966t, 972-973
autoimmune, 973t
chronic, 973t
cryptogenic, 973t
Hepatitis E
acute, 966t, 972-973
chronic, 978-979
Hepatitis G, e177-5
Hepatocellular carcinoma, 1300-1303
alcohol and, 149
cirrhosis and, 1006
clinical manifestations of, 1301
diagnosis of, 1298f, 1301, 1301f
epidemiology of, 1300
hepatitis B and, 974, 2217
hepatitis C and, 978, 2217
HIV infection and, 2217
liver transplantation for, 1008. See also
Liver transplantation
pathobiology of, 1300-1301
prevention of, 1301
prognosis for, 1302
vs. pyogenic abscess, 989
treatment of, 1301b-1302b
Hepatocytes, 952
alcohol effects on, 996
dysfunction of, 952
Hepatoerythropoietic porphyria, 1364f,
1365t, 1369
Hepatomegaly, 954-955, 955f. See also Liver
disease
Hepatopulmonary syndrome, 953
in cirrhosis, 1003-1004, 1006
liver transplantation and, 1008-1009
Hepatorenal syndrome, 1001-1002,
1004-1006
Hepatosplenomegaly
fever and, 1771-1772, 1772t
in lysosomal storage disorders, 1358t
Hepatotoxicity. See Liver disease, drug-
induced
Hepcidin, 1040, 1042, 1373-1374, 1374f
in -thalassemia intermedia, 1063-1064
HER2 gene, 1310-1311
Herbal medicine. See Complementary and
alternative medicine (CAM)
Herbicides, 78, 78t
lymphoma and, 1219
Hereditary angioedema, 1631-1633, 1668t
Hereditary hemorrhagic telangiectasia, 935,
1136, 1136f
Hereditary multiple exostoses, 1610
Hereditary nonpolyposis colon cancer, 1281t,
1282, e184-1
clinical manifestations of, 1282
diagnosis of, 1282
genetics of, 185t
pathobiology of, 1282
treatment of, 1282b
Hereditary sensory and autonomic
neuropathy, 2394t, 2398
Hereditary spastic paraplegia, 2342, 2342t
Heritability, 195. See also Inheritance
Hermansky-Pudlak syndrome, 1103, 1135
intersitital lung disease with, 567
neutropenia in, 1102t
Hermaphroditism, 1517. See also Sexual
development, disorders of
Hernia
groin, 927
hiatal, 883
reflux and, 876
incisional, 927
strangulated, 834t-836t
Heroin. See Opioid(s)
Herpangina, 2143
Herpes gestationis, 2526, 2526f
Herpes simplex virus (HSV) infection,
2125-2128
clinical manifestations of, 2127-2128,
2127f
corneal, 2127, 2434t, 2435, 2435f
definition of, 2125-2128, 2126f
diagnosis of, 2127
encephalitic, 2128, 2128f, 2231,
2377-2379, 2377t
amnesia and, 2271
epidemiology of, 2125-2126
esophageal, 884
genital, 1798, 2126-2127
HIV infection and, 2127, 2198, 2209,
2209f, 2224
in immunocompromised host, 2127
keratoconjunctival, 2127
latent, 2126-2127, 2127f
meningeal, 2365-2366
amnesia and, 2271
clinical manifestations of,
2366-2367
pathobiology of, 2366
recurrent, 2370
treatment of, 2368b
mucocutaneous, 2127, 2449, 2450f, 2506f,
2508-2509, 2509f, 2530-2532
treatment of, 2512
neonatal, 2128
oropharyngeal, 2127, 2127f
pathobiology of, 2126-2127,
2126f-2127f
prevention of, 2128
transmission of, 2126

Herpes simplex virus (HSV) infection
(Continued)
treatment of, 2127b-2128b
acyclovir in, 2082, 2083t
cidofovir in, 2084-2085
docosanol in, 2083t, 2085
famciclovir in, 2082-2083, 2083t
foscarnet in, 2083t, 2085
ganciclovir in, 2083-2084
idoxuridine in, 2085
penciclovir in, 2082-2083, 2083t
trifluorothymidine in, 2085
trifluridine in, 2083t
valacyclovir in, 2082, 2083t
valganciclovir in, 2083-2084
vidarabine in, 2083t, 2085
Herpes simplex virus vector, 209
Herpes zoster. See Zoster
Herpes zoster oticus, 2408
Herpesvirus 6, in multiple sclerosis, 2348
Herpesvirus 8. See also Kaposis sarcoma
lymphoproliferative disease and, 1219,
2216-2217
Herpesvirus 2 hepatitis, in pregnancy, 987
Herpetic whitlow, 2127
Hers disease, 1356t
HESX1 gene, 1428
Heterochromia iridis, 2433
Heterodisomy, 192
Heterozygosity, 191, 195-196, 196t
Heubner, recurrent artery of, 2305
Hexachlorobenzene, porphyria cutanea tarda
with, 1367
Hexokinase deficiency, e164-7
-Hexosaminidase A deficiency, 185t, 1360
Hexose monophosphate shunt, e164-5f,
e164-6
disorders of, e164-7, e164-7f
Heydes syndrome, 1134-1135
HFE gene, 226, 984, 1373-1374, 1376-1377
High altitude
adaptation to, 753
disorders at, 575-581, 575t
Hills sign, 461
Hilum overlay sign, 268, 269f
Hip, 1678f
disorders of, 1680
inflammatory arthritis of, 1753, 1754f
osteoarthritis of, 1674, 1674f
replacement of, 1755-1756, 1755f, 1757f
infection after, 1735
Hip protector, 108
Hippocampal sclerosis
vs. Alzheimers disease, 2278-2279
mesial temporal lobe epilepsy with, 2291
Hippocampus
in Alzheimers disease, 2277-2278
in memory, 2270, 2271f
stress effects on, 180
Hippocratic Oath, 4
Hirschsprungs disease, 867, 1602
Hirsutism, 2554
Hirudin, 173-174
in ST segment elevation MI, 442-443
Hirugen, 173-174
Histamine
in asthma, 531
carcinoid secretion of, 1509
hypersecretion of, 889
in inflammation, 233
in mastocytosis, 1641
in spoiled fish, 700
Histiocytic necrotizing lymphadenitis, 1228
Histoplasmosis, 1965t, 1977-1979
clinical manifestations of, 1977-1979
definition of, 1977-1979
diagnosis of, 591, 1978
disseminated, 1978-1979
epidemiology of, 1977
gastrointestinal, 925
hepatic, 990
HIV infection and, 2191t-2192t, 2204
pathobiology of, 1977
prognosis for, 1979
pulmonary
acute, 1977
chronic, 1977
Histoplasmosis (Continued)
complications of, 1978
differential diagnosis of, 1977
mediastinitis with, 1978
pericarditis with, 1978
treatment of, 1978
treatment of, 1978b-1979b
Histrionic personality disorder, 2245t
HIV infection. See Human immunodeficiency
virus (HIV) infection
Hives. See Urticaria
Hoarseness, 1266, 2471
Hodgkin-Reed-Sternberg cells, 1229, 1229f
Holiday heart, 354-355
Hollenhorst plaque, 494
Holmes-Adie syndrome, 2394
Holt-Oram syndrome, 400-401
Holter monitor, 342
Homicide, in adolescents, 60
Homo sapiens, 196
Homocysteine
cardiovascular disease and, 258
in cobalamin deficiency, 1081
metabolism of, 1151, 1361, 1361f, e179-1f
Homocystinuria, 1343t, 1361-1363
clinical manifestations of, 1361-1362,
1362t
definition of, 1361
diagnosis of, 1362
epidemiology of, 1361-1363
ischemic stroke and, 2318
pathobiology of, 1361, 1362t
prognosis for, 1363
treatment of, 1362b-1363b
Homozygosity, 191
Honeycombing, on chest radiography, 518
Hookworm infection, 2065-2066
treatment of, 2065t, 2066b
Hoovers sign, 626
Hordeolum, 2431, 2431f
Horders spots, e326-6
Hormone(s). See also specific hormones
action of, 1423-1424
autocrine actions of, 1423
measurement of, 1421-1422
paracrine actions of, 1423
receptors for, 1423-1424, 1424f-1425f
synthesis of, 1423
therapeutic, 1422. See also Endocrine
therapy; Hormone replacement
therapy
transport of, 1423-1425
tumor-related production of, 1187-1192
Hormone replacement therapy, 55,
1567-1568, 1568t
in breast cancer survivors, 1315
endometrial cancer and, 1318
hypercoagulability with, 1153
hypertension and, 387
ischemic stroke and, 2310
myocardial infarction and, 446-448
in osteoporosis, 1584
risks of, 1567-1568, 1569t
side effects of, 1567-1568
in urinary tract infection prevention, 1796
Horners syndrome, 2312, 2445-2446, 2446f,
2446t
Hospice, 9, 14. See also Palliative care
Hospitalism, 2
Hospitalization
abdominal pain and, 837
for cardiovascular disease, 256
Clostridium difficile infection and, 837, 898
complications of, 37
delirium and. See Delirium
diarrhea during, 898
infection during. See Health care
associated infection
for respiratory syncytial virus infection,
2091
Hot flushes, 1565-1571
definition of, 1565
diagnosis of, 1567, 1567t
epidemiology of, 1565-1566, 1566f
natural history of, 1566
pathobiology of, 1566-1567
treatment of, 1567b-1568b, 1568t-1570t
House mouse mites, 2078
Housemaids knee, 1680
Howell-Jolly body, 1024f, 1097f, 1109, 1109f
HPV infection. See Human papillomavirus
(HPV) infection
HTLV-1 infection. See Human T-cell
lymphotropic virus type 1 (HTLV-1)
infection
HTLV-2 infection. See Human T-cell
lymphotropic virus type 2 (HTLV-2)
infection
Human African trypanosomiasis. See
Trypanosomiasis, African
Human chorionic gonadotropin (HCG),
tumor-related, 1190-1192
Human genome, 187, 188t, 199-201
Human Genome Diversity, 188
Human Genome Project, 184, 187
Human immunodeficiency virus (HIV),
2177-2181
discovery of, 2177
type 1, 2177-2181, 2181f. See also Human
immunodeficiency virus (HIV)
infection
biologic properties of, 2177-2178,
2177f-2178f
genome of, 2178-2179, 2179f, 2181
life cycle of, 2177-2178, 2178f
structure of, 2177-2179, 2177f, 2179f
type 2, 2181, 2181f
vaccine development and, 2185
Human immunodeficiency virus (HIV)
infection, 2170-2175
adenoviral infection and, 2101t, 2102
anal cancer and, 2217
anemia and, 2212, 2213t
anorectal disorders and, 2198
antibodies in, 2175-2176, 2180-2181
atopic dermatitis and, 2211
autoimmune disease and, 2225
autonomic disturbances in, 2394
avascular necrosis and, 2190
bacillary angiomatosis and, 1909, 2210,
2212-2213
bacterial pneumonia and, 2202, 2202f,
2204-2205
bartonellosis and, 2192t-2193t, 2210
basal cell carcinoma and, 2211
bone marrow disorders and, 2212-2214
bronchiectasis and, 548
Campylobacter jejuni infection and, 1870
candidiasis and, 1987, 2192t-2193t, 2198,
2210
CD4+ T cells in, 2176, 2179, 2187-2188,
2187t, 2200-2201, 2201t, 2214
treatment-related increase in, 2176-2177
+
CD8 T cells in, 2176, 2214
cell tropism in, 2179
cervical cancer and, 2217
Chagas disease and, e355-3
chronic diarrhea and, 854, 901, 2195,
2197t, 2198-2199
chronic obstructive pulmonary disease
and, 2208
cigarette smoking and, 2201
coccidioidomycosis and, 1980,
2191t-2192t
cryptococcosis and, 1983, 2192t-2193t,
2203-2204, 2203f, 2210, 2223
cryptosporidiosis and, 2040, 2199
cutaneous manifestations of, 2209-2212,
2212t
infectious, 2209-2210, 2209f-2210f,
2209t
inflammatory, 2211, 2211f
metabolic, 2212, 2212f
neoplastic, 2210-2211, 2211f. See also
Kaposis sarcoma
cytomegalovirus infection and, 2111,
2132, 2132f, 2192t-2193t, 2198,
2224
dementia and, 2218-2222, 2219f-2221f,
2219t-2220t
dermatophyte infection and, 2210
diffuse infiltrative lymphocytosis
syndrome and, 1715
dyslipidemia and, 1749
INDEX e39
Human immunodeficiency virus (HIV)
infection (Continued)
eosinophilic folliculitis and, 2211, 2211f
epidemiology of, 2170-2175
in Asia and the Pacific, 2171f, 2173
in Eastern Europe and Central Asia,
2171t, 2173-2174, 2173f
global, 2170, 2171f, 2171t
in Latin America and the Caribbean,
2171t, 2174
in sub-Saharan Africa, 2171t,
2172-2173
in United States, 2171t, 2174-2175,
2174f
in Western Europe, 2174
Epstein-Barr virus infection and,
2209-2210
esophageal diseases in, 2198
fungal infection and, 2195, 2210
gastrointestinal manifestations of,
2196-2199, 2197t
anorectal, 2197t, 2198
colonic, 2198-2199
esophageal, 2197t, 2198
evaluation of, 2199
hepatic, 2197t, 2198
malignant, 2197t, 2199
medication-related, 2196-2197
metabolic, 2197, 2197t
nutritional, 2197, 2197t
oral, 2197t, 2198
gonorrhea and, 2198
Haemophilus influenzae infection and, 1861
heartburn and, 852
hematologic manifestations of, 2212,
2213t
hepatitis A and, 2191t-2192t
hepatitis B and, 2191t-2192t, 2198-2199,
2217
hepatitis C and, 2198-2199, 2217
hepatobiliary manifestations of, 2197t,
2199
hepatocellular cancer and, 2217
herpes simplex virus infection and, 2127,
2198, 2209, 2209f, 2224
herpes zoster infection and, 2209
herpesvirus 8related lymphoproliferative
disease and, 2216-2217
histoplasmosis and, 2191t-2193t, 2204
historical perspective on, 2170
HLA associations in, 225, 225t
Hodgkins lymphoma and, 1232-1233,
2217
HTLV-1 infection and, 2137
human papillomavirus infection and,
2191t-2192t, 2198, 2209
hyperlactatemia and, 2190
hyperlipidemia and, 1352
hypogonadism and, 1524
immune reconstitution inflammatory
syndromes and, 2177, 2195, 2208,
2211, 2222-2225. See also Immune
reconstitution inflammatory
syndromes
immune thrombocytopenia and, 2214
immunization and, 2194, 2199
immunopathogenesis of, 2175-2177,
2176f, 2179-2181
chronic immune activation in, 2176,
2176f
innate immune response in, 2175-2176,
2176f
influenza and, 2191t-2192t
iron deficiency and, 2213
Isospora belli infection and, 2192t-2193t
Kaposis sarcoma and, 2198, 2207, 2214,
2224
cutaneous, 2210-2211, 2211f, 2215,
2215f, 2539, 2540f
gastrointestinal, 2199, 2215
oral, 2198
pulmonary, 2203, 2204f, 2207, 2207f,
2215
treatment of, 2215b
leishmaniasis and, 2027-2028
leprosy and, 1953
life expectancy in, 2170, 2171f
e40 INDEX
Human immunodeficiency virus (HIV)
infection (Continued)
lipid levels in, 2190
lipodystrophy and, 2190, 2212, 2212f,
2212t
liver disease and, 2198
lung cancer and, 1265, 2207
lymphocytic interstitial pneumonitis and,
2208
lymphoma and, 1218-1219, 1227, 2195,
2207, 2215
malabsorption and, 907
malaria and, 2014
malignant melanoma and, 2211
meningeal, 2367
metabolic syndrome and, 2197, 2197t
mitochondrial dysfunction and, 2190
molluscum contagiosum and, 2209
multicentric Castlemans disease and,
2216
myelopathy and, 2220-2221, 2221t
myopathy and, 2221-2222
natural history of, 2175, 2175f, 2179-2180,
2179f-2180f
natural killer cells in, 2175
nephropathy and, 713, 770
neurologic manifestations of, 2218-2222,
2218t, 2407. See also Dementia, HIV
myelopathic, 2220-2221, 2221t
myopathic, 2221-2222
neuropathic, 2221
neutropenia and, 2213
nonspecific interstitial pneumonitis and,
2207-2208
nontuberculous mycobacteria infection
and, 2194, 2223, 2223f
nutritional deficiencies and, 2213
obesity and, 2197, 2197t
oncologic manifestations of, 2195-2196,
2214. See also Kaposis sarcoma
onychomycosis and, 2210
opportunistic infection and, 2176-2177
bone marrow, 2212-2213
CNS, 2195
fever in, 2194-2195
fungal, 2195
gastrointestinal, 2195
immune reconstitution inflammatory
syndromes and, 2177, 2208,
2222-2225. See also Immune
reconstitution inflammatory
syndromes
malabsorption with, 907
management of, 2194-2195
parasitic, 2195
prevention of, 2190-2194, 2191t-2193t
pulmonary, 2200-2201, 2200t-2201t.
See also Pneumocystis jirovecii
pneumonia
recurrence of, 2201
retinal, 2195
wasting in, 2194-2195
oral hairy leukoplakia and, 2209-2210
oral manifestations of, 2198, 2449, 2450t
pancreatic manifestations of, 2197t
papular pruritic eruption of, 2211
parasitic infection and, 2195, 2199
parvovirus B19 infection and, 2212-2213
peripheral neuropathy and, 2221
plasmablastic lymphoma and, 2217
Pneumocystis jirovecii pneumonia and,
e349-1-e349-9. See also Pneumocystis
jirovecii pneumonia
postexposure prophylaxis for, 2184-2185,
2184t
pregnancy and, 2196
prevention of, 2182-2185, 2182t-2184t
blood transfusion and, 2183
drug abuse and, 2183
HAART in, 2182-2183
occupational, 2183-2185, 2183t-2184t
postexposure prophylaxis for,
2184-2185, 2184t
sexual activity and, 2182-2183, 2182t,
2185
primary effusion lymphoma and, 2135,
2216
Human immunodeficiency virus (HIV)
infection (Continued)
progressive multifocal
leukoencephalopathy and, 2195,
2223-2224
prophylactic fluconazole in, 1975
prurigo nodularis and, 2211
psoriasis and, 2211
pulmonary arterial hypertension and, 2208
pulmonary manifestations of, 2199-2208
blood culture in, 2204
bronchoscopy in, 2205-2207, 2207f
CD4+ cell count in, 2200-2201, 2201t
complications of, 2207-2208
computed tomography in, 2203-2204,
2204f, 2208f
CT-guided transthoracic needle
aspiration in, 2207
definition of, 2199-2208, 2200t
diagnosis of, 2200-2208, 2200t, e398-1t
imaging in, 2202-2204
infection and, 2201
laboratory testing in, 2200-2202
malignant, 2200t, 2207
patient history in, 2201
pulmonary function testing in, 2204
radiography in, 2202-2203, 2202f-2206f
serologic testing in, 2204
signs of, 2202
sputum examination in, 2204-2205
symptoms of, 2201-2202
thoracentesis in, 2207
travel and, 2201
rash in, 2209
reactive arthritis and, 1695
red blood cell antibodies and, 2213
retinitis and, 2195
sarcoidosis and, 2208, 2225
scabies and, 2210
screening for, 54t, 55
seborrheic dermatitis and, 2211
seroconversion-related rash in, 2209
sexually transmitted diseases and, 1797
squamous cell carcinoma and, 2211
Staphylococcus aureus infection and, 2210,
2210f
Streptococcus pneumoniae infection and,
2191t-2192t
syphilis and, 2198, 2210, 2210f, e327-4
thrombosis and, 2214
thrombotic thrombocytopenic purpura
and, 2214
tinea and, 2210
toxoplasmosis and, 2191t-2192t,
2194-2195, 2204, e357-6
transmission of, 2182-2185
blood transfusion, 2183
prevention of, 2183
from health care worker, 2185
intravenous, 2183
prevention of, 2183
occupational, 2183-2185, e290-
7-e290-8
prevention of, 2183-2185,
2183t-2184t
sexual, 2182-2183
prevention of, 2182-2183, 2182t,
2185
tissue-related, 2183
prevention of, 2183
treatment of, 2185-2196
anemia with, 2213
antiretroviral therapy in, 2180,
2186-2190
adverse effects of, 2196-2197
avascular necrosis with, 2190
CD4+ count and, 2187-2188, 2187t
complications of, 2190
CSF-plasma drug ratios for, 2220t
hepatotoxicity of, 2190, 2198
hyperlactatemia with, 2190
immune reconstitution inflammatory
syndromes and, 2222-2225. See
also Immune reconstitution
inflammatory syndromes
initiation of, 2186-2189, 2187t-
2188t, 2188f
Human immunodeficiency virus (HIV)
infection (Continued)
lactic acidosis with, 2196
lipid levels with, 2190
lipodystrophy with, 2190
mitochondrial dysfunction with,
2190
regimen for, 2188t, 2189
resistance to, 2187
unsuccessful regimen for, 2189-2190
global response for, 2170-2172, 2171f
immune reconstitution inflammatory
syndromes and, 2195, 2208, 2211
Pneumocystis jirovecii pneumonia and,
e349-6-e349-7
response to, 2176-2177
tuberculin skin test in, 1944, 2201
tuberculosis and, 1945, 2191t-2192t, 2194,
2201-2203, 2202f-2203f, 2208,
2222-2223
varicella-zoster virus infection and, 2130,
2191t-2192t
wasting in, 2194-2195, 2197t, 2199
white blood cell disorders and, 2213-2214
in women, 1551
Human leukocyte antigens (HLAs), 197,
222-226
in Behets disease, 1721
bone marrow transplantation and, 226
in celiac disease, 906
class I, 222-223, 222f, 223t, e45-1f
class II, 222-223, 223t, e45-1f
in dermatomyositis, 1717
determinant selection and, 226
disease associations of, 224-226, 225t
genetic map of, 223-224, 223f
in narcolepsy, 2301
nomenclature for, 224, 224t
in polymyalgia rheumatica, 1728
in polymyositis, 1717
in rheumatoid arthritis, 1682, 1682t
in sarcoidosis, 582
in Sjgrens syndrome, 1713
in spondyloarthropathies, 1692-1696
structure of, 222-224, 222f
in temporal arteritis, 1728
in transfusion-related acute lung injury,
581
in transplantation, 236
typing of, 224, 224t
Human papillomavirus (HPV) infection,
2121-2125
in adolescents, 62
cancer and, 1186, 2217
clinical manifestations of, 2122-2123
cutaneous, 2121-2125, 2523-2524, 2537
clinical manifestations of, 2122, 2524f
diagnosis of, 2123, 2123f
differential diagnosis of, 2123
epidemiology of, 2122
pathobiology of, 2122
treatment of, 2124b
definition of, 2121-2125
diagnosis of, 2123, 2123f
epidemiology of, 2121-2122
esophageal, 885
genital, 948-949, 949f, 1798
cervical cancer and, 1317, 2121,
2123-2125, 2125f
clinical manifestations of, 2123
diagnosis of, 2123, 2123f
epidemiology of, 2121-2122
pathobiology of, 2122
prognosis for, 2124-2125, 2125f
screening for, 2124
treatment of, 2089, 2124b, 2124t
HIV infection and, 2191t-2192t, 2198,
2209, 2217
immunization against, 65f-66f, 66-71,
67t-70t, 1318, 1549, 2123-2124,
2124t
nasal, 2457
oropharyngeal cancer and, 1257-1258,
1261
pathobiology of, 2122
prevention of, 2123-2125, 2124t
prognosis for, 2124-2125, 2125f
Human papillomavirus (HPV) infection
(Continued)
screening for, 2124
treatment of, 2124b, 2124t
Human T-cell lymphotropic virus type 1
(HTLV-1) infection, 1203, 1216, 1219,
2136-2140
adult T-cell leukemia/lymphoma and,
2137-2140, 2138f, 2138t
definition of, 2136-2140
disease associations of, 2139
epidemiology of, 2136
HIV infection and, 2137
myelopathy/tropical spastic paraparesis
and, 2139-2140, 2268
pathobiology of, 2137-2140
perinatal transmission of, 2136t, 2137
sexual transmission of, 2136-2137, 2136t
transfusion transmission of, 2137
transmission of, 2136-2137, 2136t
Human T-cell lymphotropic virus type 2
(HTLV-2) infection
definition of, 2136-2140
epidemiology of, 2136
injection drug use and, 2137
transfusion transmission of, 2137
transmission of, 2136-2137, 2136t
Humidifier fever, 573, 574t
Humidifier lung, 570-571, 571t
Hunger, 1411
Hungry bone syndrome, 1595b-1596b
Hunters syndrome, 1360, 1662-1667, 1662t
Hunting reaction, 497
Huntingtin, 2335
Huntingtons disease, 185t, 2335-2342
Hurlers syndrome, 1662-1667, 1662t
Hrthle cell carcinoma, e233-12-e233-13
Hutchinsons sign, 2556, 2556f
Hyaline casts, 711-712, 711f
Hyaluronic acid, e267-3
Hydatid disease, 2053t
alveolar, 2053t, 2057
cystic, 990t-992t, 991-996, 994f, 2053t,
2055-2056, 2056f
Hydralazine
in heart failure, 306f-307f, 313
in hypertension, 382t, 384
in hypertensive emergency, 388t
metabolism of, 187t
Hydrocalycosis, 804
Hydrocalyx, 804
Hydrocele, in lymphatic filariasis, e366-5
Hydrocephalus, 1255, 1255t
in bacterial meningitis, 2356-2357
vs. Lewy body disease, 2281
lumbar puncture and, 2232
otitic, 2318
vs. Parkinsons disease, 2329t
in subarachnoid hemorrhage, 2321
Hydrochlorothiazide
in hypervolemia, 727, 727t
in nephrolithiasis prevention, 794
Hydrocodone, 137t. See also Opioid(s)
Hydrocortisone, 161t
in ACTH deficiency, 1440
replacement of, 1469b
Hydrocytosis, e164-3f, e164-5
Hydrofluoric acid ingestion, 679t-683t
Hydrogen breath test, 903t
Hydrogen sulfide poisoning, 679t-683t
Hydromorphone, 137t
Hydronephrosis, 776. See also Urinary tract,
obstruction of
Hydrops fetalis, 1062, 2116
Hydrothorax, in liver disease, 953
Hydroxocobalamin, in cyanide poisoning,
679t-683t
Hydroxyapatite crystal deposition disease,
1742, 1742f, 1742t
-Hydroxybutyrate, 1502-1503, 1502f, 1503t
-Hydroxybutyrate
central nervous system effects of, 672t
toxic ingestion of, 674t-676t
Hydroxychloroquine
ocular effects of, 2442
in porphyria cutanea tarda, 1368b
in rheumatoid arthritis, 1688t, 1689

Hydroxyethyl starch, 624, 653t
5-Hydroxyindoleacetic acid (5-HIAA), in
carcinoid syndrome, 1509f, 1510
1-Hydroxylase, in renal osteodystrophy, 813
11-Hydroxylase deficiency, 1514
17-Hydroxylase deficiency, 1513, e244-8
21-Hydroxylase deficiency, 1513-1514, 1514f
3-Hydroxysteroid dehydrogenase deficiency,
1513
Hydroxyurea, 1168t-1176t
in essential thrombocythemia, 1095-1096
in polycythemia vera, 1095-1096
in primary myelofibrosis, 1096-1097
in sickle cell disease, 1072, 1073t
25-Hydroxyvitamin D, serum, 1588
Hydroxyzine, 2512t
Hygiene hypothesis, of allergy, 1612
Hymenolepis nana, 2009-2010, 2052, 2053t
Hymenoptera stings, 2077t, 2081. See also
Anaphylaxis
Hypalgesia, 2230-2231
Hyper-immunoglobin E (IgE) syndrome,
1115, 1116t-1117t
Hyper-immunoglobulin M (IgM) syndrome,
1619-1621, 2144
Hyper-immunoglobulinemia D (IgD) with
periodic fever syndrome, 1668t,
1670-1672, 1670t
Hyperaldosteronism, 1466, 1466t
glucocorticoid-remediable, 801t, 1467
in pregnancy, 1558
Hyperalgesia, 134, 2230-2231
opioid abuse and, 156
Hyperbaric oxygen therapy, in carbon
monoxide poisoning, 679t-683t
Hyperbilirubinemia, 956-958. See also
Jaundice
acquired, 959-960
differential diagnosis of, 958t, 962
hereditary, 959, 960t
mixed, 960, 960t
neonatal, G6PD deficiency and, e164-8
postoperative, 2491
unconjugated, 952, 959
Hypercalcemia, 1593-1600
clinical manifestations of, 1594
diagnosis of, 1593t, 1594, 1594f
drug-induced, 1593-1594
of malignancy, 1188-1192, 1189f,
1596-1597
in multiple myeloma, 1238, 1240
in pancreatic endocrine tumors, 1293t,
1296-1297
pathobiology of, 1593-1594, 1593t
in primary hyperparathyroidism,
1594-1597
in renal cell carcinoma, 1304
renal effects of, 774
Hypercalciuria, 790
absorptive, 793
resorptive, 793
Hypercapnia, 528, 528t, 530f
permissive, 643-644
Hypercholesterolemia, familial, 1342,
1350-1352
Hypercoagulable states, 1124, 1124t,
1148-1154
primary, 1148t, 1149-1153
activated protein C resistance and,
1149-1153
antithrombin III deficiency and,
1149-1153
clinical manifestations of, 1149-1150,
1150f, 1150t
diagnosis of, 1150, 1150t
protein C deficiency and, 1149
protein S deficiency and, 1149
prothrombin G20210A mutation and,
1149
treatment of, 1151b, 1151t
secondary, 1151-1153, 1152f
antiphospholipid antibody syndrome
and, 1153
hormone replacement therapy and,
1153
hyperhomocysteinemia and, 1151-1152
immobilization and, 1153
Hypercoagulable states (Continued)
malignancy and, 1152
myeloproliferative disorders and, 1152
oral contraceptives and, 1153
paroxysmal nocturnal hemoglobinuria
and, 1152
postoperative state and, 1153
pregnancy and, 1153
stroke and, 2316
trauma and, 1153
Hypercortisolism, 1440-1442, 1441t,
1464-1469. See also Cushings disease;
Cushings syndrome
ectopic ACTH secretion and, 1189-1192,
1190f
Hyperemesis gravidarum, 987, 987t
Hypereosinophilic syndromes, 331,
1100-1101, 1118-1121, 1118t, 1120f.
See also Eosinophilia
Hyperesthesia, 2230-2231
Hyperexplexia, 2340
Hypergastrinemia, 888-889, 888t, 891
Hyperglobulinemia, false-positive FTA-ABS
test in, e327-5
Hyperglycemia. See also Hypoglycemia
in diabetes mellitus, 781, e236-8-e236-9,
e236-9t-e236-10t. See also Diabetes
mellitus
hypothalamic activation in, 1431
vs. ischemic stroke, 2315
nutritional support and, 1391
parenteral nutrition and, 1397
in septic shock, 665
teratogenicity of, 1563, 1563f-1564f
Hypergonadism. See Puberty, precocious
Hyperhistaminic syndromes, 889
Hyperhomocysteinemia, 1079, 1151-1152,
1361
Hyperinsulinemia, in nonalcoholic fatty liver
disease, 998
Hyperkalemia, 736
acidosis with, 737
in acute poisoning, 679t-683t
causes of, 739, 740t
clinical manifestations of, 738, 738f
diagnosis of, 738
hypertensive syndromes with, 740
hypotensive syndromes with, 739-740
normotensive syndromes with, 739-740
postoperative, 2490
prognosis for, 741
renal effects of, 735
renal tubular acidosis and, 748-749, 749t
treatment of, 740-741
Hyperlactatemia, HIV infection and, 2190,
2196
Hyperlipidemia. See also Dyslipidemia
arthritis in, 1749
familial, 1350-1352, 1749
after heart transplantation, 509-510
ischemic stroke and, 2310, 2313, 2319t
after liver transplantation, 1011
Hyperlucent lungs, 551-552
Hypermagnesemia, 679t-683t, 754
Hypermelanosis. See Hyperpigmentation
Hypermetabolism, in burn injury, 693
Hypernatremia, 732-734
clinical manifestations of, 733
definition of, 732
diagnosis of, 733
epidemiology of, 720, 732-733, 732t
hypervolemic, 732
hypovolemic, 732-733
normovolemic, 732
pathobiology of, 732-733
postoperative, 2490
treatment of, 733b
Hyperopia, 2427-2428, 2427f
Hyperorality, 2274
Hyperornithinemia, 1343t
Hyperosmolar hyperglycemic syndrome,
e236-8-e236-9, e237-11-e237-14,
e236-9t-e236-10t
Hyperostosis, 1606-1610
endosteal, 1607-1610
focal, 1608-1610
osteosclerosis with, 1607-1610
Hyperoxaluria, 790, 1344t
Hyperparathyroid jaw-tumor syndrome, 1595
Hyperparathyroidism
diagnosis of, 1594, 1594f
vs. hypercalcemia of malignancy, 1188
hypertension with, 380
hypophosphatemia with, 755
in MEN 1, 1506-1507
nephrolithiasis and, 790
osteitis fibrosa cystica in, 1749
primary, 1594-1597
clinical manifestations of, 1595
definition of, 1594
diagnosis of, 1595
epidemiology of, 1594-1595
nephrolithiasis and, 1595
pathobiology of, 1595
treatment of, 1595b-1596b, 1596t
secondary
in chronic kidney disease, 812, 812f
hemodialysis and, 820
Hyperpathia, 134
Hyperphosphatemia, 755-756, 756t
hypocalcemia and, 1599
in renal osteodystrophy, 812-813, 812f
Hyperpigmentation, 2547t, 2548-2549
circumscribed, 2548-2549
diffuse, 2548
drug-related, 2548
inflammatory, 2548-2549, 2548f
linear, 2548
reticulated, 2548
Hyperprolactinemia, 1438-1439
antipsychotic-induced, 2495
hypothalamic, 1430, 1430t
idiopathic, 1430
Hypersensitivity pneumonitis, 564-567,
1992-1993
bronchoalveolar lavage in, e85-6t
chronic, 571
clinical manifestations of, 564
diagnosis of, 565
epidemiology of, 564
occupation-related, 568t, 570-571, 571t
pathobiology of, 564
treatment of, 565b
Hypersensitivity reaction, 227-230. See also
Allergy; Anaphylaxis
drug-related, 2534-2543, 2534t, 2535f
type I, 227-228, 228f, 228t
type II, 228-229, 228t, 229f
type III, 228t, 229-230, 229f
type IV (delayed-type), 228t, 230, 230f
Hypersomnia, 2300, 2300t
Hypersplenism, 1104, 1110
Hypertension, 29, 373-389
in acute poisoning, 671
aging and, 374-376, 375f
in aortic dissection, 484
arteriolar nephrosclerosis in, 787
in autosomal dominant polycystic kidney
disease, 796
behavioral factors in, 376
cardiovascular disease risk with, 257, 374f,
377, 378f
in chronic kidney disease, 812, 814
clinical manifestations of, 376
cyclosporine and, 163-164
definition of, 373, 374t
in diabetes mellitus type 2, e237-13
diagnosis of, 376-380, 376t, 377f
diet and, 257, 376, 1381, 1381t, 1383t
drug-resistant, 387
in emergency department, 388
encephalopathy with, 2326
endometrial cancer and, 1318
epidemiology of, 373-380
gender and, 375
genetic factors in, 376
in heart failure, 303-307
after heart transplantation, 509
hyperkalemic, 740
in hyperthyroidism, 380
in hypervolemia, 726
hypokalemic, 738-739, 739t
intracerebral hemorrhage and, 2323t,
2324, 2324f
INDEX e41
Hypertension (Continued)
intracranial, 1255, 1255t-1256t
headache and, 2251
idiopathic, 1255-1256
treatment of, 1256b, 1256t
after liver transplantation, 1011
malignant, 2326
mineralocorticoid-induced, 379-380, 380f
neurogenic, 380
nocturnal, 377
obesity and, 376, 1414
in older adults, 99t
paraganglioma and, 380
pathobiology of, 375-376
pheochromocytoma and, 380
postoperative, 2489
in pregnancy, 1557-1564
preoperative assessment of, 2480
prevention of, 380b-389b
prognosis for, 388-389
pulmonary. See Pulmonary hypertension
race/ethnicity and, 375, 375f
renovascular, 378t, 379, 379f
retinopathy of, 387-388, 387f, 2438, 2438f
secondary, 375, 377-380, 378t
severe, acute, 387-388
in sickle cell disease, 1072
stroke and, 374f, 2310, 2319t
systolic, 374-375
in older adults, 386
systolic and diastolic, 374-375
treatment of, 374, 374f, 380b-389b
lifestyle modification in, 381
pharmacologic therapy in, 381-385,
382t-383t
target blood pressure in, 377t
tumor-related, 1191
in women of reproductive potential, 1550t
Hypertensive arteriolar nephrosclerosis, 787
Hypertensive emergency, 29, 387-388
Hypertensive urgency, 387-388
Hyperthermia, 28, 666-669, 667t
in acute poisoning, 671
hypothalamic, 1431
malignant, 702, 704, 2412t, 2484
in multiple sclerosis, 2349
in older adult, 105
treatment of, 668t
Hyperthyroidism, e233-6-e233-7. See also
Graves disease; Thyrotoxicosis
adenoma-related, e233-7
definition of, e233-5
dilated cardiomyopathy with, 327
exophthalmos in, 250
hypertension with, 380
mild, e233-9
myopathy in, 1749
in older adult, 105
in pregnancy, 1557t, e233-9
preoperative assessment of, 2482
subclinical, e233-9
weight loss with, 840t-841t
Hypertrichosis, 2554
Hypertrichosis lanuginosa, 1196t
Hypertriglyceridemia
in diabetes mellitus, 1352
familial, 1351
parenteral nutrition and, 1397
secondary, 1352t
Hypertrophic cardiomyopathy. See
Cardiomyopathy, hypertrophic
Hypertrophic osteoarthropathy, 1196t, 1197,
1198f, 1607-1610, 1749-1750, 1750f
Hyperuricemia, 775, 1737-1742. See also
Gout
asymptomatic, 1739
pathobiology of, 1737-1739
Hyperuricosuria, 790
Hyperventilation
neurogenic, central, 2296
for vertigo evaluation, 2467
Hyperviscosity syndrome, 1242, 1242f
stroke and, 2316
Hypervolemia, 725-726
clinical manifestations of, 726
definition of, 725
diagnosis of, 726
e42 INDEX
Hypervolemia (Continued)
epidemiology of, 725, 726t
pathobiology of, 725-726
primary sodium retention and, 726
secondary sodium retention and, 726
treatment of, 726b-728b, 727t, 728f
Hypesthesia, 2230-2231
Hyphema, 2433, 2433f
Hypoaldosteronism, 1469
hyporeninemic, 777
primary, 739
secondary, 739
Hypobetalipoproteinemia, 1348
Hypocalcemia, 1597
in acute poisoning, 679t-683t
in chronic kidney disease, 1599
clinical manifestations of, 1599
definition of, 1597
diagnosis of, 1599-1600, 1600f
in dilated cardiomyopathy, 327
in hyperphosphatemia, 1599
in hypoproteinemia, 1599
normal parathyroid hormone activity and,
1598-1600
in osteomalacia, 1588
in pancreatitis, 1599
in parathyroid hormone deficiency,
1597-1598
in parathyroid hormone resistance, 1598,
1598f
pathobiology of, 1597
in rhabdomyolysis, 704
in sepsis, 1599
treatment of, 1600b-1601b
in vitamin D deficiency, 1599
Hypochlorhydria, Vibrio cholerae infection
and, 1866
Hypochondriasis, 34, 2244t
Hypocitraturia, 790
Hypocomplementemia, 1344t, 2525
Hypocretin, 1412t
Hypocretin-1, 2301
Hypoelectrolytemia, in cystic fibrosis, 546
Hypogammaglobulinemia, 64t, 1344t
arthritis in, 1749
bronchiectasis in, 548
Campylobacter infection and, 1869
Hypoglycemia, 1499-1505. See also
Hyperglycemia
C-peptide suppression test in, 1503
cancer-related, 1191-1192
classification of, 1501, 1501t
clinical manifestations of, 1500-1501,
1500f
definition of, 1499
in diabetes mellitus type 1,
e236-12-e236-13
in diabetes mellitus type 2,
e237-11-e237-12
diagnosis of, 1501-1504, 1501t
factitial, 1504
in healthy-appearing patient, 1501-1504,
1501t, 1502f, 1503t
in ill-appearing patient, 1501t, 1504
insulin antibodies in, 1503
in insulinoma, 1504
mixed-meal test in, 1503
pancreatogenous, 1504
pathobiology of, 1499-1501
recovery from, 1500
selective arterial calcium injection
stimulation test in, 1504
serum glucose in, 1501
seventy-two-hour fast test in, 1501-1503,
1501t, 1502f, 1503t
in shigellosis, 1889
vs. stroke, 2315
sulfonylurea-induced, 1503, 1503t
treatment of, 1504b
Hypogonadism
alcohol-related, 149
female, e244-8-e244-14
autoimmune disease and, e244-9
autosomal gene mutations and, e244-8
chemotherapy and, e244-9
genetic abnormalities and,
e244-8-e244-9
Hypogonadism (Continued)
gonadal dysgenesis and, e244-8
radiation therapy and, e244-9
resistant ovary syndrome and,
e244-8-e244-9
trisomy X and, e244-8
Turners syndrome and, e244-8
X chromosome mutations and,
e244-8
after hematopoietic stem cell
transplantation, 1162
in HIV infection, 2212
in hyperprolactinemia, 1438
hypogonadotropic, 1442-1443,
1523-1524, 1523t
congenital, 1442-1443, 1516
secondary, 1432t, 1443
treatment of, 1426
hypothalamic, 1429
male, 1523, 1523t
anorexia nervosa and, 1524
autoimmune, 1524
clinical manifestations of, 1523-1524
definition of, 1523
diagnosis of, 1524-1525
drug-induced, 1524
hypogonadotropic, 1523t, 1524
illness and, 1524
laboratory tests in, 1523-1524
mumps and, 1524
patient history in, 1523
physical examination in, 1523
pituitary tumors and, 1524
primary, 1523t, 1524
radiation injury to, 1524
stress and, 1524
systemic disease and, 1524
toxin-induced, 1524
trauma and, 1524
treatment of, 1525b, 1525t
weight loss and, 1524
osteoporosis with, 1580, 1586
Hypokalemia, 736, 2383t
causes of, 738, 739t
clinical manifestations of, 737-738, 737f
in diabetic ketoacidosis, e236-10
diagnosis of, 738
diuretics and, 736, 738, 739t
hypertension with, 379, 738-739
hypomagnesemia and, 737, 754
hypotension with, 739
hypovolemia and, 724
in leukemia, 741
in pernicious anemia, 741
postoperative, 2490
prognosis for, 741
renal effects of, 735
treatment of, 740-741
Hypomagnesemia, 753-754, 753t, 1597
in diabetic ketoacidosis, e236-10
familial, with hypercalciuria, 801t
hereditary, 754
hypocalcemia and, 1597, 1600
hypokalemia and, 737
isolated, 801t
Hypomelanosis. See Hypopigmentation
Hyponatremia, 728-730
chronic, 731
clinical manifestations of, 728, 729f
definition of, 728
diagnosis of, 729-730
drug-induced, 2495
epidemiology of, 720, 728
hypertonic, 728
hypervolemic, 728, 729f, 730
hypotonic, 728, 731
hypovolemic, 729-732, 729f
normovolemic, 729f, 730, 731f, 732
postoperative, 2490
after subarachnoid hemorrhage, 2321
treatment of, 731b-732b
Hypoparathyroidism, 1597-1598
autoimmune, 1597-1598
clinical manifestations of, 1599
idiopathic, 1597
myopathy in, 1749
treatment of, 1600-1601
Hypopharynx, 2469, 2469f
cancer of, 1257, 1260t-1261t
Hypophosphatemia, 755-756, 755t
in diabetic ketoacidosis, e236-10
dilated cardiomyopathy with, 327
osteomalacia with, 1590
Hypophosphatemic rickets, 755, 1341t
Hypophysitis, lymphocytic, 1433
Hypopigmentation, 2547-2549, 2547t
circumscribed, 2547-2549, 2548f
congenital, 2548
diffuse, 2547
guttate, 2547, 2548f
linear, 2547
postinflammatory, 2547-2548
Hypopituitarism, 1432
diagnosis of, 1434t
pathobiology of, 1432-1433, 1432t
in traumatic brain injury, 1429
treatment of, 1433b, 1434t
Hypopnea, 613
Hypoproteinemia, hypocalcemia and,
1599
Hyposthenuria, in sickle cell disease, 1071
Hypotension, 29. See also Anaphylaxis;
Syncope
in acute poisoning, 671
in aortic dissection, 484
in bacterial meningitis, 2364-2365
cardiac catheterization and, 291
in diabetes mellitus type 1, e236-15
in gastrointestinal bleeding, 858
hyperkalemic, 739-740
hypokalemic, 739
intracranial, 1256, 1256t
headache and, 2251
in mastocytosis, 1642
in older adults, 2393
orthostatic, 341, 2395, 2395t
postoperative, 2489
postprandial, 2394
postural, 106, 341
in shock, 647. See also Shock
in snake bite, 694
Hypothalamic-pituitary-adrenal axis
corticosteroid effects on, 161
in functional gastrointestinal disease,
e139-1f
in irritable bowel syndrome, 869
suppression of, 1468
Hypothalamic-pituitary-gonadal axis
female, e244-3f, e244-4, e244-10
male, 1519-1520, 1519f
Hypothalamic-pituitary-thyroid axis, 1423,
1423f, 1432
Hypothalamus
disorders of, 1427-1428, 1427t, 2392
ACTH deficiency with, 1430
adrenal insufficiency with, 1468
anorexia with, 1431
diabetes insipidus with, 1431
embryopathic, 1428
growth hormone deficiency with, 1429
hyperglycemia with, 1431
hypergonadism with, 1429
hyperprolactinemia with, 1430
hypogonadism with, 1429-1430
hypothyroidism with, 1430
infiltrative, 1428-1429
inflammatory, 1428-1429
irradiation-induced, 1429
neoplastic, 1428
obesity with, 1431
pituitary dysfunction with, 1429-1431
temperature dysregulation with, 1431
traumatic, 1429
vascular, 1429
hormones of, 1425-1426. See also specific
hormones
neuroendocrine organization of, 1425,
1425f
Hypothermia, 29, 668-669, 668t, 669f
in acute poisoning, 671
drowning-related, 574-575
hypothalamic, 1431
in older adult, 105
paroxysmal, 669
Hypothermia (Continued)
therapeutic, 669-670
in cardiac arrest, 348
trauma-related, 669
treatment of, 669b, 669t
Hypothyroidism, e233-2-e233-3
anemia of, 1037
central, 1443
clinical manifestations of, e233-3-e233-5
complications of, e233-4-e233-5
congenital, e233-3
definition of, e233-2
diagnosis of, e233-3-e233-4, e233-4f
dilated cardiomyopathy with, 327
epidemiology of, e233-3
gland removal and, e233-3
heart failure and, 314-315
after hematopoietic stem cell
transplantation, 1162
hypertension with, 380
hypothalamic, 1430
lipid disorders and, 1352t
mild, e233-5
myopathy in, 1749
pathobiology of, e233-3, e233-3t
in pregnancy, 1557t
preoperative assessment of, 2482
screening for, 54
secondary, e233-2-e233-3, e233-3t
subclinical, e233-5
treatment of, e233-4b-e233-5b, e233-4t
Hypouricemia, 1341t
Hypoventilation
alveolar, 632
controlled, 643-644
Hypoventilation syndromes, 528, 528t, 530f
acquired, 529-530
clinical manifestations of, 530, 530f
congenital, 528t, 529-530
treatment of, 530b
Hypovolemia, 722-723
clinical manifestations of, 723-724
definition of, 722, 722t
diagnosis of, 724
differential diagnosis of, 724
epidemiology of, 722-723, 723t
extrarenal causes of, 723, 723t
laboratory tests in, 724
pathobiology of, 723-734
post-infarction, 445
relative, 722-723, 723t, 725
renal causes of, 723, 723t
treatment of, 724b-725b
Hypoxemia, 626, 627t, 630-631, 630t. See
also Respiratory failure
clinical manifestations of, 631-632, 632t
in high-altitude diseases, 575
in interstitial lung disease, 558
oxygen therapy in, 29-30
in transfusion-related acute lung injury,
581
Hypoxia, 630t. See also Respiratory failure
cerebral, 2308, 2315. See also Coma;
Stroke
in high-altitude syndromes, 575
Hypoxia-induced factor (HIF) 1, e159-1
I
I-cell disease, 1343-1344, 1662t
Ibutilide, 356t-357t
Icterus, scleral, 953-954, 953f
Idarubicin, 1168t-1176t
Ideomotor apraxia, 2272
Idiopathic guttate hypomelanosis, 2547,
2548f
Idiopathic interstitial pneumonias, 560,
561f-563f, 561t
Idiopathic juvenile osteoporosis, 1666
Idiopathic monomorphic ventricular
tachycardia, 365-368
Idiopathic multifocal fibrosclerosis,
1752-1753
clinical manifestations of, 1752
definition of, 1752
diagnosis of, 1752-1753
drug-related, 1752t

Idiopathic multifocal fibrosclerosis
(Continued)
epidemiology of, 1752
pathobiology of, 1752
prognosis for, 1753
treatment of, 1753b
Idiopathic pulmonary capillaritis, 566
Idiopathic pulmonary fibrosis. See Pulmonary
fibrosis, idiopathic
Idiopathic pulmonary hemosiderosis, 554,
565
Idiopathic tumoral calcinosis, 1742
Idioventricular rhythm, 361, 364
Idoxuridine
drug interactions with, 2084t
in herpesvirus infection, 2085
Ifosfamide, 1168t-1176t
dilated cardiomyopathy with, 326-327
Igbo-ora virus, 2160
IKZF1 gene, 1091t
Ileum, disorders of, malabsorption with, 904
Ileus, adynamic, 837
Iliopsoas bursitis, 1680
Iliotibial band syndrome, 1680
Illicit drug use. See Drug abuse
Iloperidone, 2243t
Iloprost, in thromboangiitis obliterans, 495b
Imatinib mesylate, 167, 1168t-1176t
in cancer, 1166-1167
in chronic myelogenous leukemia, 1211,
1211f, 1212t
in hypereosinophilia, 1120
hypophosphatemia with, 755
in leukemia, 167, 202t
in mastocytosis, 1644
in myelodysplastic syndrome, 1202
Iminoglycinuria, 1341t
Imipenem, 1809t-1811t
Imipramine
in depression, 2239t
in pain, 135-137, 136t
Imiquimod, 2089
topical, 2513
Immobilization
pressure sores with, 109, 109f
venous thrombosis with, 1153
Immune complexes, 231
in glomerulonephritis, 768
in systemic lupus erythematosus, 1698
in type III hypersensitivity reaction,
229-230, 229f
in vasculitides, 1720, 1722
Immune dysregulation diseases, 1619-1621,
1619t
Immune globulin, 63
cytomegalovirus, 64t
hepatitis B, 64t, 970
intravenous
in idiopathic thrombocytopenic
purpura, 1128t
in Kawasaki disease, 1724
in multifocal motor neuropathy,
2403b-2404b
in systemic lupus erythematosus,
1704
rabies, 64t, 2378b-2379b
Rh, 64t
tetanus, 64t
vaccinia, 64t
varicella-zoster, 64t
Immune plasma transfusion, in viral
hemorrhagic fevers, 2154
Immune reconstitution inflammatory
syndromes, 2177, 2195, 2208, 2211,
2222-2225, 2222t
BCG-associated, 2223, 2223f
clinical manifestations of, 2222-2225
cryptococcosis and, 2223
cytomegalovirus and, 2224
definition of, 2222
epidemiology of, 2222
hepatitis B and, 2224
hepatitis C and, 2224
herpes simplex virus and, 2224
human herpesvirus 8 and, 2224
JC virus and, 2223-2224
Mycobacterium tuberculosis and, 2222-2223
Immune reconstitution inflammatory
syndromes (Continued)
nontuberculous mycobacteria and, 2223,
2223f
paradoxical, 2222
pathobiology of, 2222
Pneumocystis jirovecii and, 2223, 2224f
prevention of, 2224
prognosis for, 2224-2225
treatment of, 2224b
unmasking, 2222
Immune system, 214-222. See also Antibody
(antibodies)
adaptive, 214, 217-222, 226-230
activation of, 217-218, 218f
antigen processing in, 218, 218f
antigen-specific receptors in, 217-218
autoimmunity and, 221-222
B cells of, 220, 220f
cellular elements of, 218-221, 218f
effector mechanisms of, 227
lymphoid tissue in, 220-221
memory lymphocytes in, 221
T cells of, 218-220, 218f
tolerance and, 221-222
aging and, 104, 107
in allergic rhinitis, 1622-1623
in allergy, 1612
in amebiasis, 2043
in anaphylaxis, 1633, 1635
in atherosclerosis, 410, 410f
in brucellosis, 1891-1892
in cancer, 1187
in enterovirus infection, 2141
in Epstein-Barr virus infection, 2134
in Haemophilus influenzae infection,
1861-1862
in HIV infection, 2175-2176, 2176f
in influenza virus infection, 2097
innate, 214-217, 230
activation of, 214-216, 216f. See also
Inflammation
basophils of, 217
cellular elements of, 216-217, 216f-217f
cytokines in, 215t, 216, 216f
dendritic cells of, 216, 216f-217f
eosinophils of, 217
Fc receptors in, 215-216, 216f
in infection, 1762
inflammasome and, 231
macrophages of, 216, 216f
MHC class I-recognizing receptors in,
215, 216f
monocytes of, 216
natural killer cells of, 216f, 217
neutrophils of, 217
pattern recognition receptors in,
214-215, 216f, 230-231
soluble factors in, 217
in irritable bowel syndrome, 869
in leprosy, 1951, 1951f
in malaria, 2015
in non-Hodgkins lymphoma, 1219-1220,
1219t, 1220f, 1222
in respiratory infection, 588
of respiratory system, e85-2, e85-3f
in rheumatoid arthritis, 1683
in septic shock, 658-665, 660f
in Sjgrens syndrome, 1715
in Staphylococcus aureus infection, 1816
undernutrition effects on, 1389
Immunity. See also Immune system
adaptive, 214
innate, 214, 1762
Immunization, 55, 63-75
active, 63-65
acute disseminated encephalomyelitis
with, 2268
adenovirus, 2102
adverse reactions to, 63-64
anthrax, 67t-70t, 74-75, 85, 1839
cholera, 900, 1867-1868
coronavirus, 2104
cytomegalovirus, 64t
diphtheria, 64t, 65f-66f, 67t-70t, 73,
1833-1835
Eastern equine encephalitis, 2163
Immunization (Continued)
Haemophilus type b, 1863
hepatitis A, 54t, 64t, 65-71, 65f-66f,
67t-70t, 968
for travel, 1801, 1801t
hepatitis B, 54t, 64t, 65f-66f, 66, 67t-70t,
969-970
for travel, 1801-1802, 1801t
in HIV-infected patients, 2194, 2199
human papillomavirus, 65f-66f, 66-71,
67t-70t, 1318, 1549, 2123-2124,
2124t
in immunocompromised host, 64
influenza, 65f-66f, 67t-70t, 71, 591,
2098-2099, 2098t
in asthma, 536
in COPD, 542
for travel, 1801t, 1802
Japanese encephalitis virus, 67t-70t, 74,
2165
for travel, 1801t, 1802
measles, 64t, 65f-66f, 67t-70t, 71-72,
2106-2107
adverse effects of, 2107
contraindications to, 2107
meningococcal, 54t, 65f-66f, 67t-70t,
71-72, 1855
for travel, 1801t, 1802
mumps, 65f-66f, 67t-70t, 72-73,
2110-2111
norovirus, 2147
parainfluenza virus, 2095
parvovirus B19, 2116
passive, 63, 64t
pertussis, 65f-66f, 67t-70t, 72, 1902
pneumococcal, 55, 65f-66f, 67t-70t, 72,
1822-1823
in asthma, 536
poliomyelitis, 67t-70t, 72, 2380
for travel, 1801t, 1802
vaccine-derived polioviruses and, 2141
pregnancy and, 64-65
rabies, 64t, 67t-70t, 73
for travel, 1801t, 1802
recommendations for, 64, 64t, 65f-66f,
67t-70t
in rheumatoid arthritis, 1689
Rift Valley fever, 2155
rotavirus, 2147
route of, 63
rubella, 65f-66f, 67t-70t, 73-74, 2109
smallpox, 67t-70t, 74, 86, 2121
Tdap (tetanus, diphtheria, acellular
pertussis), 55, 65f-66f
tetanus, 64t, 65f-66f, 67t-70t, 73, e304-6,
e304-6t
timing of, 63
for travel, 900, 1801-1802, 1801t
typhoid, 67t-70t, 74, 1887
for travel, 1801t, 1802, 1887
vaccinia, 64t
varicella, 54t, 55, 64t, 65f-66f, 67t-70t,
73-74, 2130
Venezuelan equine encephalitis, 2164
viral hemorrhagic fevers, 2155
Western equine encephalitis, 2164
yellow fever, 67t-70t, 74, 2155
for travel, 1801t, 1802
zoster, 2131
Immunodeficiency, 1614. See also Human
immunodeficiency virus (HIV)
infection
diagnosis of, 1614
epidemiology of, 1614
gene therapy in, 209
hematopoietic stem cell transplantation
for, 1161
laboratory tests in, 1615
lymphoma and, 1218-1219, 1219t
patient history in, 1614-1615, 1615t
physical examination in, 1615
primary, 1615-1622
autoimmunity and, 1616
clinical manifestations of, 1615
definition of, 1615-1621
family history in, 1616
gastrointestinal disease and, 1616
INDEX e43
Immunodeficiency (Continued)
genetics of, 1615
infection in, 1614, 1616
lymphatic system in, 1616
pathobiology of, 1615-1621
Immunodeficiency with hyper-
immunoglobulin M, 1619-1621
Immunodeficiency with thymoma, 1620
Immunodysregulation with
polyendocrinopathy, enteropathy, and
X-linked inheritance (IPEX) syndrome,
1619-1621, 1619t
Immunoglobulin(s). See also Immune
globulin
polyclonal, 1234, 1234f
serum, 1233-1237
Immunoglobulin A (IgA)
deficiency of, 1620-1621
arthritis in, 1749
in celiac disease, 906
HLA associations in, 225t
in kidney disease, 713
in rotavirus infection, 2146
secretory, enteral nutrition and, 1392
undernutrition effects on, 1389
Immunoglobulin A (IgA) bullous dermatosis,
2527
Immunoglobulin A (IgA) nephropathy,
766-770, 766f
Immunoglobulin D (IgD), excess of, 1668t,
1670-1672, 1670t
Immunoglobulin E (IgE). See also Allergy
in allergic rhinitis, 1622-1623
in aspergillosis, 1992
assessment of, 1613-1614, 1614t
in asthma, 533
excess of, 1115, 1116t-1117t
receptors for, 227
in type I hypersensitivity reactions,
227-228, 228f, 228t
in work-related asthma, 568
Immunoglobulin G (IgG), 1045-1046, 1045f
in autoimmune hemolytic anemia, 1045
in cytomegalovirus infection, 2132
in occupational hypersensitivity
pneumonitis, 571
receptors for, 227
in toxoplasmosis, e357-4-e357-5, e357-5t
in type II hypersensitivity reactions, 228t,
229f
in type III hypersensitivity reactions, 228t,
229-230, 229f
Immunoglobulin G (IgG) subclass
deficiency, 1621
Immunoglobulin-like transcript receptors
(CD85), 215
Immunoglobulin M (IgM)
in cold agglutinin disease, 1049
elevated levels of, 1619-1621, 2144
in measles, 2106
in Mycoplasma infection, 1913, 1913f,
1915
in parvovirus B19 infection, 2116, 2116t
in rubella, 2108
in toxoplasmosis, e357-4-e357-5, e357-5t
in type II hypersensitivity reaction, 229
Immunologic memory, 221
Immunophenotyping
in acute leukemia, 1204-1205
in Hodgkins lymphoma, 1229-1230
Immunosuppressive agents, 159-165. See also
specific drugs and drug classes
adverse effects of, 161t, 163f
in aplastic anemia, 1089
in autoimmune hemolytic anemia, 1049
fever and, 1774-1775, 1775t
in heart transplantation, 508
in kidney transplantation, 824-825, 824f,
825t
in liver transplantation, 1009-1010
mechanisms of action of, 159t
in myelodysplastic syndrome, 1202
in organ transplantation, 159-165, 159t,
161t-162t, 239, 1774-1775
hypertension with, 380
in skin disease, 2513
Immunotactoid glomerulopathy, 770
e44 INDEX
Immunotherapy
in allergic rhinitis, 1628
in cancer, 1166, 1166t
in renal cell carcinoma, 1305-1306
in skin disease, 2513
Impetigo, 1816, 1825, 2529, 2529f, 2544,
2544f
Inborn errors of metabolism, 1340-1346
blood-circulating protein defects and,
1344, 1344t
cytosolic enzyme impairment and,
1342-1343, 1343t
definition of, 1340
historical perspective on, 1340-1341
lysosomal disorders and, 1343-1344
matrix protein abnormalities and,
1344-1345
micronutrient effects of, e225-8
mitochondrial protein defects and, 1343,
1343t
mucopolysaccharide defects and, 1344
nuclear protein defects and, 1344
pathobiology of, 1340-1341, 1340t
pathophysiology of, 1340-1341, 1340t
peroxisome defects and, 1344, 1344t
plasma membrane receptor protein
dysfunction and, 1341-1345
plasma membrane transporter protein
mutations and, 1341, 1341t-1342t
transplantation in, 1346
treatment of, 1345b-1346b, 1345t
urea cycle disorders and, 1343
Incidence, e8-2
Incisional hernia, 927
Inclusion body myositis, 1717t, 2417, 2417t,
e277-1f
Incontinence. See Fecal incontinence;
Urinary incontinence
Indapamide, in hypertension, 382t
Indian red scorpion, 2079
Indomethacin, in diarrhea, 912-913
Induced pluripotent stem cells, 204, 206f
Infant. See also Neonate
botulism in, e304-4
of diabetic mother, 1410
folate deficiency in, 1078
immunization in. See Immunization
inborn errors of metabolism in,
1340-1346. See also specific disorders
micronutrients for, e225-1
myoclonic seizures in, 2290
parainfluenza virus infection in, 2093
respiratory syncytial virus infection in,
2091-2092
seizures in, 2290, 2290t
-thalassemia major in, 1063
Infarction
bone, 1605-1610, 1605t, 1606f
cerebral. See Stroke
hypothalamic, 1429
myocardial. See Myocardial infarction
(MI)
pituitary, 1433
renal artery, 785-786, 786f
splenic, 467, 1110
Infection, 1761-1762. See also specific
infections
antimicrobial agents in, 1762-1768,
1772-1773. See also Antibacterial
agents; Antifungal agents; Antiviral
agents
resistance to. See Antibacterial agents,
resistance to
antimicrobial resistance in. See
Antibacterial agents, resistance to
bronchial. See Bronchitis
chronic disease and, 1762
in compromised host, 1774-1780
corticosteroids and, 160
cyclophosphamide and, 165
cyclosporine and, 163
definition of, 1761
diarrhea with. See Diarrhea, acute;
Diarrhea, infectious
diverticular. See Diverticulosis
emerging, 1762
endocardial. See Endocarditis
Infection (Continued)
enteric, 1788-1791. See also Diarrhea,
infectious
esophageal. See Esophagitis
fever with, 1768-1774. See also Fever
genetic factors in, 1762
host reaction to, 1762
innate immunity in, 1762
lymphadenopathy in, 1107-1108, 1107t.
See also Lymphadenopathy
lymphocytosis in, 1100
mechanisms of, 1761
mortality from, 1761
neutropenia-associated, 1103, 1775-1776,
1775t-1776t
management of, 1776-1778, 1777f
neutrophilia with, 1098, 1769
nosocomial, e290-1-e290-8. See also
Health careassociated infection
fever in, 1770, 1770t
treatment of, 1773-1774
in older adults, 107
in outpatient, 1772-1773
pericardial. See Pericarditis
peripheral blood smear in, 1030-1031,
1031t
in phagocytic cell defects, 1111-1118,
1116t-1117t, 1617, 1617t
polymicrobial, 1766
prostate gland. See Prostatitis
pulmonary. See Influenza virus infection;
Pneumonia; Sarcoidosis;
Tuberculosis
rhabdomyolysis with, 702
sexually transmitted, 1796-1800. See also
Sexually transmitted diseases
sites of, 1803-1804, 1804t
sociopolitical effects of, 1761
thyroid gland. See Thyroiditis
transfusion-transmitted, 1157, 1158f,
1158t
transmission of, 1761
transplantation-related, 508-509, 620,
1010-1011, 1161, 1774-1775, 1775t
travel-related, 1769-1770, 1769t. See also
Travel/traveler
urinary tract, 1791-1796. See also Urinary
tract infection
Infectious mononucleosis, 2133-2136,
2469-2470, 2470f
vs. acute leukemia, 1206
clinical manifestations of, 2134
complications of, 2134-2135
definition of, 2133
diagnosis of, 2134
differential diagnosis of, 2106t
epidemiology of, 2133
pathobiology of, 2133-2134
prevention of, 2134b
prognosis for, 2134-2136
treatment of, 2134b
Inferior vena cava, interruption of, 408
Infertility
female, e244-11-e244-14
definition of, e244-11-e244-12
diagnosis of, e244-12, e244-12t
pelvic inflammatory disease and, e307-3
treatment of, e244-12b-e244-13b
after hematopoietic stem cell
transplantation, 1162
male, 1525-1528
definition of, 1525
diagnosis of, 1526-1528, 1526f-1527f,
1527t
epidemiology of, 1526
pathobiology of, 1526
treatment of, 1528b
Inflammasome, 231, 1671
Inflammation, 230-235
acute phase response to, 1652
anemia of, 1042-1043. See also Chronic
disease, anemia of
antioxidants in, 235
apoptosis in, 234-235
in asthma, e47-1t
in atherosclerosis, e47-1t
bronchial. See Bronchitis
Inflammation (Continued)
in cancer, e47-1t
cardiovascular disease and, 258
cellular response in, 231-232
complement in, 242
cyclooxygenase-2 in, 235
cytokines in, 232, 235, e47-1t
eicosanoids in, 232-233
histamine in, 233
initiation of, 230-231
kinins in, 233
leukotrienes in, 232-233
myocardial. See Myocarditis
neutrophilia in, 1098-1099
nutritional effects of, 1385
pericardial. See Pericarditis
prostaglandins in, 232
prostanoids in, 235
protease inhibitors in, 235
proteases in, 233-234, 233t, e47-1t
reactive nitrogen in, 233
reactive oxygen in, 233
in rheumatic disease, 1652, e47-1t. See also
Arthritis; Rheumatic disease;
Rheumatoid arthritis
soluble mediators in, 232-233, 235
in systemic lupus erythematosus, e47-1t
tissue damage in, 233-234, 233t
tissue repair in, 234-235, 234f
Inflammatory bowel disease, 913-921
clinical manifestations of, 914, 914t-915t
definition of, 913
diagnosis of, 915, 915t, 916f
differential diagnosis of, 911, 915, 915t
epidemiology of, 913
genetics of, 913-916
pain in, 834t-836t
pathobiology of, 913-920
pathophysiology of, 914
prognosis for, 920
pseudopolyps in, 1283
treatment of, 916b-920b, 917f-918f, 917t
weight loss with, 840t-841t
Infliximab, 165
in inflammatory bowel disease, 917t, 918
in psoriasis, 2518t
Influenza syndrome, 2097-2098
Influenza virus infection, 589-590,
2095-2100
antigenic variation in, 2095-2096, 2095t
bacterial superinfection with, 2098
clinical manifestations of, 2097-2099
in common cold, 2089, 2089t. See also
Common cold
definition of, 2095-2100, 2095t-2096t,
2096f
diagnosis of, 2098-2099
emerging, 589
epidemic, 2096-2097, 2097t
epidemiology of, 2095-2097
HIV infection and, 2191t-2192t
immune response to, 2097
immunization against, 65f-66f, 67t-70t, 71,
591, 2098-2099, 2098t
in asthma, 536
in COPD, 542
for travel, 1801t, 1802
influenza syndrome in, 2097-2098
interpandemic, 2096-2097
mortality with, 2097, 2097t
nonrespiratory complications of, 2098
in older adults, 99t, 2098
pandemic, 2095t, 2097
pathobiology of, 2097
pathology of, 2097
precautions with, 2100
prevention of, 2099-2100
prognosis for, 2100
prophylactic antiviral agents in, 2099,
2099t
respiratory complications of, 2098
transmission of, 2097
treatment of, 2085-2086, 2100b
amantadine in, 2085-2086, 2085t-2086t,
2100b
oseltamivir in, 2085t-2086t, 2086,
2100b
Influenza virus infection (Continued)
peramivir in, 2085t, 2086, 2100b
ribavirin in, 2100b
rimantadine in, 2085-2086, 2085t-
2086t, 2100b
zanamivir in, 2085t-2086t, 2086, 2100b
vs. viral hemorrhagic fever, 2153t
zoonotic strains in, 2096
Informed consent, 4-6, 5t
Infradian rhythm, 1427
Infrared radiation exposure, 82
Infundibular stenosis, 403
Infundibuloneurohypophysitis, 1433
Ingrown toenail, 2556
INHA gene, e244-8
Inhalational anesthetics, 2485-2486
Inheritance, 192. See also Chromosome(s);
Gene(s); Genetics
disease risk and, 195
maternal, 1343
Mendelian, 192
multifactorial, 184, 185f
nonmendelian, 192
Inhibin, 1426
Injury, 687-688. See also Burn injury;
Trauma; Traumatic brain injury
in adolescents, 60, 60t
exercise-related, 58
prevention of, 55
travel-related, 1800-1801
Inlet patch, 885
Inotropes
in cardiogenic shock, 656-657
in ST segment elevation MI, 443-444
Insect(s), 2076-2081, 2076t-2077t, 2507,
2507f, 2548f. See also specific insect-borne
diseases
exaggerated bite reaction to, 2077, 2077f
Insect repellant, 1801
Insomnia, 2301
in obstructive sleep apnea, 614
primary, 2301t
secondary, 2301t
treatment of, 2302b, 2302t
Inspiratory pressure, maximal, 628
Instrumental activities of daily living
(IADLs), in geriatric assessment, 101
Insulin, 1411t
in -adrenergic receptor antagonist
toxicity, 679t-683t
aging-related changes in, 107
antibodies to, 1503
in calcium-channel antagonist toxicity,
679t-683t
in carbohydrate metabolism, 1499-1500
in diabetes mellitus type 1, e236-5-e236-7,
e236-6t, e236-7f
in diabetes mellitus type 2, e237-
9-e237-10
in diabetic ketoacidosis, e236-10, e236-11f
in hyperkalemia, 740-741
perioperative, 2482
plasma, 1501-1503, 1502f, 1503t
in septic shock, 665
Insulin-like growth factor I, 1435-1436
Insulin-like growth factor II, 1191
Insulin receptor substrate-1, 1424
Insulin resistance, 1342, 1413
antipsychotic agents and, 2493
in chronic kidney disease, 812
in diabetes mellitus type 2, e237-2-e237-3,
e237-13f
in nonalcoholic fatty liver disease, 998
Insulin tolerance test, 1434t, 1440
in growth hormone deficiency, 1436
Insulinoma, 1191, 1293t, 1500-1501,
1504-1505, 1505t
-hydroxybutyrate in, 1502-1503, 1502f,
1503t
in MEN 1, 1506
Integrin(s), 214, e267-4, e267-4t
Integrin IIb3 (GPIIb-IIIa) receptor
antagonists, 176
Interferon-, 215t, 1168t-1176t, 2088-2089
adverse effects of, 2087t, 2088-2089
dilated cardiomyopathy with, 326-327
drug interactions with, 2087t

Interferon- (Continued)
in hairy cell leukemia, 1214b
in hepatitis B, 975b-976b, 976t, 2086t,
2088
in hepatitis C, 977b-978b, 978f,
2086t-2087t, 2088
in hepatitis D, 978b
in hypereosinophilia, 1120-1121
in mastocytosis, 1644
in melanoma, 1332
sarcoidosis with, 585
in skin diseases, 2513
in systemic lupus erythematosus, 1698,
e274-1f
Interferon-, 215t
in multiple sclerosis, 2353
sarcoidosis with, 585
Interferon-, 215t
deficiency of, 1617
Interferon- receptor 1, defects in,
1116t-1117t, 1117
Interleukin(s), corticosteroid effects on, 160
Interleukin-1 inhibitors, 166
Interleukin-1 receptor antagonist, deficiency
of, 1668t, 1671
Interleukin-1, 215t
Interleukin-1, 215t, 1412t
Interleukin-2, 215t, e159-1-e159-2
Interleukin-2 receptor blockers, in kidney
transplantation, 825
Interleukin-3, 215t, 1111
Interleukin-4, 215t, e159-1-e159-2
Interleukin-5, 215t, e159-1-e159-2
Interleukin-6, 215t
in hyperparathyroidism, 1595
Interleukin-6 inhibitors, 166
Interleukin-7, 215t, e159-1-e159-2
Interleukin-9, 215t
Interleukin-10, 215t
Interleukin-11, 215t
Interleukin-12, 215t
deficiency of, 1617
Interleukin-12 inhibitor, 166
Interleukin-13, 215t
Interleukin-15, e159-1-e159-2
Interleukin-16, 215t
Interleukin-17, 215t
Interleukin-18, 215t
Interleukin-23, 215t
Interleukin-23 inhibitor, 166
Intermittent claudication, 487f, 488
vs. pseudoclaudication, 488t
Internal medicine, 2
International HapMap, 188, 196
International normalized ratio (INR), 955
International Prostate Symptom Score
(IPSS), 806, 806f
Internuclear ophthalmoplegia, 2448, 2448f
in multiple sclerosis, 2349
Intersex. See Sexual development, disorders
of
Interstitial lung disease. See Lung disease,
interstitial
Interstitial pneumonia
acute. See Acute interstitial pneumonia
desquamative, 562, 563b, 563f
nonspecific, 562
Interstitial pneumonitis
lymphocytic, HIV infection and, 2208
nonspecific, HIV infection and, 2207-2208
Interventricular septum, e52-2f
Intervertebral disc, e267-5
herniation of, 2262t. See also Back pain
Interview
for alcohol use, 150, 150t
for behavior change, 51-52, 52t
Intestinal flukes, 2061t, 2062-2063
Intestinal ischemia, 928
chronic, 932
clinical manifestations of, 929
diagnosis of, 929-937, 930f-931f
diarrhea with, 911
enteral nutrition and, 1393
epidemiology of, 928
nonocclusive, 932
pain in, 834t-836t
pathobiology of, 929
Intestinal ischemia (Continued)
predisposition to, 928t
prognosis for, 929
superior mesenteric artery embolism and,
929, 931t
superior mesenteric artery thrombosis
and, 931
superior mesenteric vein thrombosis and,
932, 932t
treatment of, 929b
ulcers with, 889
weight loss with, 840t-841t
Intestinal metaplasia, at gastroesophageal
junction, 879
Intestine. See also Colon; Gastrointestinal
tract; Small intestine
bacterial flora of
in irritable bowel syndrome, 869
normal, 1761, 1847-1848, 1847t, 1848f
in cystic fibrosis, 545
ionizing radiation injury to, 80
ischemia of. See Intestinal ischemia
obstruction of, in cystic fibrosis, 546
Intimate partner violence, 1571-1574, 1572t
causes of, 1571-1573, 1572t
clinical manifestations of, 1572
definition of, 1571
epidemiology of, 1571-1573
pregnancy and, 1572
prevention of, 1573
prognosis for, 1573
screening for, 1572-1573
treatment of, 1573b
Intoxication. See Alcohol use/abuse;
Poisoning
Intra-aortic balloon counterpulsation, in
cardiogenic shock, 657
Intracavernosal injection, in erectile
dysfunction, 1528
Intracerebral hemorrhage. See Hemorrhage,
intracerebral; Stroke, hemorrhagic
Intracranial hypertension, 1255,
1255t-1256t, 2251
headache and, 2251
Intracranial hypotension, 1256, 1256t, 2251
Intracranial pressure (ICP)
decrease of, 1256, 1256t
elevation of, 1255, 1255t-1256t
Intralipid, 2486
in anesthetic toxicity, 679t-683t
Intraocular pressure, 2426
Intrauterine device (IUD), 1555
Intravaginal ring, 1554
Intraventricular septum, e52-3
Intrinsic factor deficiency, 1076
Intussusception, intestinal, 927
Inulin, 709
Iodine, e225-6t-e225-7t
deficiency of, e233-10, e225-6t-e225-7t,
e233-3
radioactive
therapeutic, e233-8
thyroid uptake of, e233-2, e233-7,
e233-8t
recommended daily intake of, e233-1
toxicity of, e225-6t-e225-7t
Iododerma, 2535
Ion channels, cardiac, 334-337, 334f, e52-1,
e52-2f
IPEX (immunodysregulation with
polyendocrinopathy, enteropathy, and
X-linked inheritance) syndrome,
1619-1621, 1619t
Ipratropium bromide
in common cold, 2090-2091, 2090t
in COPD, 542t
IRAK1 gene, 1697
Irbesartan, in hypertension, 382t
IRF5 gene, 1697
Irinotecan, 187t, 1168t-1176t
Iris, 2427f
heterochromia of, 2433
melanoma of, 2441, 2442f
Iritis, 2429t, 2440
Iron, e225-6t-e225-7t
absorption of, 905
body levels of, 1064
Iron (Continued)
deficiency of, e225-6t-e225-7t. See also
Iron deficiency anemia
megaloblastic anemia and, 1080
dietary
absorption of, 1040
inadequate, 1041
hepatic, 1040, 1040f
homeostasis of, 1040, 1374f
in mucormycosis, 1995
plasma, 1040, 1040f
supplemental, 1041b-1042b
in anemia of chronic disease, 1043
in malabsorption, 908t
total, 1041
toxicity of, 677t, 679t-683t,
e225-6t-e225-7t
in women, e225-1-e225-2
Iron deficiency anemia, 1039-1044
blood loss and, 861, 1040-1041
clinical manifestations of, 1041
diagnosis of, 1041, 1041t
endoscopy in, 854
epidemiology of, 1039-1040
evaluation of, 862
growth and, 1041
in hiatal hernia, 883
HIV infection and, 2213
in hookworm infection, 2066
inadequate iron intake and, 1041
pathobiology of, 1040-1043, 1040f
peripheral blood smear in, 1040f
prognosis for, 1042
refractory, 1042
treatment of, 1041b-1042b
Iron overload, e225-6t-e225-7t
classification of, 1373, 1374t
hereditary. See Hemochromatosis
in sickle cell disease, 1074
in thalassemia, 1064, 1064b-1066b, 1065f
in -thalassemia intermedia, 1063-1064
Irritable bowel syndrome, 868-869
autonomic nervous system in, 869
clinical manifestations of, 869
definition of, 868, 868t
diagnosis of, 868t, 869-873, 870f
differential diagnosis of, 870
epidemiology of, 869
extra-intestinal conditions and, 869
functional dyspepsia and, 872
gastrointestinal motility in, 869
genetic factors in, 869
hypothalamic-pituitary-adrenal axis in, 869
intestinal flora in, 869
mucosal immune activation in, 869
pathobiology of, 869
prognosis for, 872
psychiatric comorbidity in, 869
treatment of, 870b-872b, 871t
Isaacs syndrome, 2415, 2422-2423
Ischemia. See Intestinal ischemia; Myocardial
infarction (MI); Myocardial ischemia;
Osteonecrosis; Stroke, ischemic
Ischemia-reperfusion injury, after liver
transplantation, 1010
Ischemic penumbra, 2308
Ischial bursitis, 1680
Ischiogluteal bursitis, 1680
Ishikawas sign, 498
Islet cell(s)
failure of, 1413-1414
transplantation of, in diabetes mellitus
type 1, e236-8
Islet cell tumor. See Pancreatic endocrine
tumors
Isobutyric aciduria, 1343t
Isocarboxazid, in depression, 2239t
Isochromosome, 190
Isoflurane, hepatotoxicity of, 983
Isoimmune neutropenia, 1104
Isoniazid, 1809t-1811t
metabolism of, genetic factors in, 187t
pyridoxine interaction with, e225-8t
toxic ingestion of, 679t-683t
Isopropyl alcohol, toxicity of, 748
Isosorbide-5-mononitrate, in stable
myocardial ischemia, 424t
INDEX e45
Isosorbide dinitrate
in heart failure, 313
in stable myocardial ischemia, 424t
Isotretinoin, 2511
Isovaleric acidemia, 1343t
Isradipine
in hypertension, 382t
in stable myocardial ischemia, 423t
Israeli spotted fever, 1956t, 1958
IT15 gene, 2335
Itching. See Pruritus
ITGAM gene, 1697
Ito cells, 1000
Itraconazole, 1974
adverse effects of, 1974
in blastomycosis, 1982b
in coccidioidomycosis, 1981b
in dematiaceous fungal infection, 2008b
drug interactions with, 1974
formulations of, 1974
in histoplasmosis, 1978b-1979b
in sporotrichosis, 1986b
uses of, 1974
IUD (intrauterine device), 1555
Ivermectin, 2010
in lice, 2080b
in onchocerciasis, 2009
in roundworm disease, 2009
J
J wave, 668, 669f
Jaccouds arthropathy, 1699
Jacobsen/Paris-Trousseau syndrome, 1029
JAK2 gene, 1091-1092, 1091t
James fiber, 335
Janeways lesions, 253, 255f, 466
Japanese encephalitis virus infection,
2164-2168
immunization against, 67t-70t, 74, 1801t,
1802
Japanese spotted fever, 1956t, 1958
Jarisch-Herxheimer reaction, e327-6-e327-7
Jaundice, 952, 956-958
abdominal pain and, 833
in biliary tract disease, 960-961
breast milk, 959
in cirrhosis, 1001
differential diagnosis of, 958t, 962
in familial cholestasis syndromes, 961
fever and, 1771-1772, 1772t
in liver disease, 960-961
neonatal, G6PD deficiency and, e164-8
postoperative, 961
in pregnancy, 961
in primary biliary cirrhosis, 958f
ultrasonography in, 846
zoonoses-related, 1967t
Jaw, osteonecrosis of, 1605-1610, 1606f
JC polyomavirus infection, 2112-2114,
2113f, 2223-2224, 2377t
Jejunitis, ulcerative, 924
Jellyfish envenomation, 698t, 699
Jersey finger, 1679-1680
Jet lag, 2303
Jobs syndrome, 1115, 1116t-1117t
Joint(s). See also specific joints
arthritis of. See Arthritis; Osteoarthritis;
Rheumatoid arthritis
magnetic resonance imaging of, e267-1f
prosthetic, 1755-1756
ankle, 1757
digit, 1757
elbow, 1757
hip, 1755-1756, 1755f, 1757f
infection with, 1735, 1818
knee, 1756, 1757f
shoulder, 1756
spine, 1757
wrist, 1757
surgical treatment of, 1753-1758
anesthesia for, 1754
arthrodesis in, 1755
arthroplasty in, 1755-1756, 1755f-1757f
arthroscopy in, 1755
assessment for, 1754
cervical spine instability and, 1758
e46 INDEX
Joint(s) (Continued)
computer navigation in, 1756
fat embolism with, 1758
immunosuppressive therapy and,
1758
indications for, 1753-1754, 1753f-1754f
infection prevention for, 1757
minimally invasive, 1756
osteotomy in, 1754-1755
peripheral nerve injury with, 1757
resurfacing arthroplasty in, 1756
synovectomy in, 1755
venous thromboembolism with, 1758
Jouberts syndrome, 2387
Jugular veins
assessment of, 250, 250f-251f, 251t
in heart failure, 301
in pulmonary hypertension, 392
in supraventricular tachycardias, 355
distention of, 250, 250f
septic thrombophlebitis of, 2470
Jumpers knee, 1680
Justice, 4
Juvenile idiopathic arthritis, 1668t, 1669
Juvenile myelomonocytic leukemia, 1200
Juvenile myoclonic epilepsy, 2291
Juvenile polyposis, 1281t, 1283
K in diabetic nephropathy, 782
KAL1 gene, 1428
Kala-azar, 2026f, 2026t, 2027-2030
Kallmanns syndrome, 1428, 1516
Kaolin-pectin, in diarrhea, 912-913
Kaposis sarcoma, 2214
clinical manifestations of, 2215
cutaneous, 2210-2211, 2211f, 2215, 2215f,
2539, 2540f
epidemiology of, 2214
gastrointestinal, 2199, 2215
immune reconstitution inflammatory
syndrome and, 2224
oral, 2198
pathobiology of, 2214-2215
pulmonary, 2203, 2204f, 2207, 2207f,
2215
treatment of, 2215b
Karelian fever, 2161
Karnofsky performance scale, 1165t
Kasabach-Merritt syndrome, 1051t, 1298
Kawasaki disease, 1721t, 1724, 2522-2532
Kayser-Fleischer ring, 953-954, 1371, 1372f
KCNJ1 gene, 801-802
Kehrs sign, 837t
Keloids, 2543, 2549, 2549f
Kennedys disease, 2346
Kent bundle, 335
Kepivance, 1168t-1176t
Keratinocytes, 2498
epidermal differentiation and, 2498
Keratitis
Acanthamoeba, 2435
gonococcal, 2435
herpetic, 2127, 2434t, 2435, 2435f
pseudomonal, 1879-1881, 2435
Keratoconjunctivitis. See also Conjunctivitis
epidemic, 2101-2102, 2101t
Keratoconjunctivitis sicca, 2439
cyclosporine in, 163
in rheumatoid arthritis, 1686
Keratoconus, 2428
Keratoderma blennorrhagicum, 1694-1695,
1695f
Keratolytics, 2513
Keratosis
actinic, 2537, 2537f
seborrheic, 2537, 2537f
Keratosis pilaris, 1613
Keraunoparalysis, 686-687
Kerley A lines, 269-270, 517-518, 518f
Kerley B lines, 269-270, 517-518
Kerley C lines, 517-518
Keshans disease, e225-6t-e225-7t
Ketamine, 140t, 2485
Ketoacidosis
alcoholic, 149, 746t, 747-752
diabetic. See Diabetic ketoacidosis
Ketoconazole, 1973-1974
adverse effects of, 1974
formulations of, 1973-1974
in paracoccidioidomycosis, 1983b
uses of, 1974
Ketolides, 1807t, 1809t-1811t, 1812-1813
resistance to, 1808t
Ketone bodies, fasting-related, 1388
17-Ketosteroid reductase deficiency 5, 1514
Kidney(s), 716-720. See also Kidney disease;
Kidney failure, end-stage; Kidney injury,
acute and at Nephro-; Renal
abnormalities of, 804f
in acid-base balance, 742-743, 742f
acute failure of. See Kidney injury, acute
agenesis of, 803
aging-related changes in, 105-107, 109
aminoglycoside toxicity to, 1807, 1812f
ammonia handling by, 743
amphotericin B deoxycholate toxicity to,
1972
amyloid deposition in, 714f, 770
anatomy of, 716, 716f-717f
angiography of, 714
antiviral agent effects on, 2084-2085, 2087
aplastic, 803
biopsy of, 714-715, 714f
in acute interstitial nephritis, 773, 773t,
774f
in interstitial nephritis, 774
blood flow in, 714
cadmium effects on, 92
calcium handling by, 719f, 720, 1577
calculi of. See Nephrolithiasis
cancer of. See Renal cell carcinoma
computed tomography of, 713-714, 714f
congenital malformations of, 802-805,
804f
cyclosporine effects on, 163-164
development of, 802, 802t
abnormalities of, 802-805, 803f
drug effects on, 757-758, 757t
dysplasia of, 803
ectopic, 803
energy requirement of, 1412
evaluation of. See Kidney disease, diagnosis
of
in Fabrys disease, 1359
failure of. See Kidney disease, chronic;
Kidney failure, end-stage; Kidney
injury, acute
functions of, 716-720, 811, 811t
hereditary disorders of, 716-718
glomerular filtration rate of. See
Glomerular filtration rate (GFR)
in heart failure, 298
horseshoe, 803, 804f
hypoplasia of, 803
infective endocarditis effects in, 467
lead effects on, 89
magnesium handling by, 741-753,
1577
magnetic resonance angiography of, 714,
714f
malformations of, 802-805, 804f
malrotation of, 803
microstructure of, 716, 717f
papillary necrosis of, 715
pH regulation by, 718-719, 719f
phosphate handling by, 719f, 720,
754-755, 1577
potassium handling by, 719, 735, 736f
sarcoidosis of, 584, 585t
in shock, 647t, 648
sodium handling by, 716-718, 718f,
723
stones of. See Nephrolithiasis
structure of, 716, 716f-717f
supernumerary, 803
tumors of, 1303-1309, 1303t
ultrasonography of, 713, 713f
undernutrition effects on, 1389
vasopressin insensitivity of. See Diabetes
insipidus, nephrogenic
water handling by, 718, 718f, 728, 729f
in Wilsons disease, 1372
Kidney disease, 708-716
acute. See Kidney injury, acute
amyloid, 714f
antibacterial selection and, 1765
calculous. See Nephrolithiasis
chronic, 715-716, 810-818. See also
Kidney failure, end-stage
anemia in, 812, 817
atherosclerosis in, 817
bone disease in, 812-814, 817
cardiovascular disease and, 258
clinical manifestations of, 814, 814t
definition of, 715, 716t, 810, 811t
in diabetes mellitus, 812
diagnosis of, 814
endocrine disorders and, 812
epidemiology of, 810, 811t
extraosseous calcification and, 814
heart failure and, 314-315
after heart transplantation, 509
hypertension with, 377-379, 378t,
386-388, 812
hypocalcemia and, 1599
imaging in, 815
laboratory tests in, 815, 815t
metabolic acidosis in, 745-746
in multiple myeloma, 774-775, 1238,
1240
pathobiology of, 811-817, 811t
preoperative assessment of, 2483
prognosis for, 817
progression of, 813-814, 814t
stages of, 716t, 811t, 815, 815f
steady-state considerations in, 811-817
in systemic sclerosis, 1710
tradeoff hypothesis of, 811-812, 812f
treatment of, 816b-817b, 816f
uremic toxin accumulation in, 813, 813f
weight loss with, 840t-841t
cyclosporine-related, 163-164
cystic, 794-800
acquired, 794-795, 796t, 800
in Bardet-Biedl syndrome, 796t, 800
definition of, 794-795
epidemiology of, 794-795
medullary, 796t, 799
in nephronophthisis, 799-800
in oral-facial-digital syndrome, 796t,
800
simple, 794-795, 796t
in tuberous sclerosis, 796t, 800
in von Hippel-Lindau syndrome, 796t,
800
in diabetes mellitus. See Diabetic
nephropathy
diagnosis of, 708-716
biopsy in, 714-715, 714f
cardiovascular signs in, 708, 709f
imaging in, 713-714, 713f-714f
laboratory tests in, 708-712, 710t,
711f-712f
neurologic signs in, 708, 709f
patient history in, 708-716
physical examination in, 708
serology in, 712-713
drug administration in, 128-129, 128t
glomerular, 761-770. See also
Glomerulonephritis and specific
diseases
in leptospirosis, 1938
lipid disorders and, 1352t
after lung transplantation, 621
malignancy-associated, 1199
in Mycoplasma pneumoniae infection, 1915
nephritis. See Nephritic syndrome;
Nephritis
nephrotic. See Nephrotic syndrome
obstructive, 776-780. See also Urinary
tract, obstruction of
in older adults, 99t
polycystic, 104, 185t, 794-795, e129-1f
autosomal dominant, 795-800, 795f,
796t, 797f, e129-1f
autosomal recessive, 795f, 796t,
798-800
in sickle cell disease, 788, 1071, 1072t,
1074
Kidney disease (Continued)
in systemic lupus erythematosus, 769-770,
769f, 769t, 1699-1701, 1700f,
1700t
in systemic sclerosis, 1710
tuberculous, 1944
tubulointerstitial, 715, 715t, 771-776. See
also Nephritis and specific diseases
vascular, 715, 783-789. See also Renal
artery and specific diseases
Kidney failure
acute. See Kidney injury, acute
chronic. See Kidney disease, chronic
end-stage, 810-818
anemia in, 1037, 1037f
in diabetes mellitus, 781-783. See also
Diabetic nephropathy
epidemiology of, 761, 810
treatment of, 810-818. See also
Hemodialysis; Kidney
transplantation; Peritoneal dialysis
Kidney injury, acute, 715, 756-761. See also
Kidney disease, chronic
clinical manifestations of, 759
definition of, 756
diagnosis of, 759, 759t
drug-related, 757, 757t
epidemiology of, 756-761
after hematopoietic stem cell
transplantation, 1161
intrinsic, 757, 757f, 757t
diagnosis of, 759-760, 759t
pathobiology of, 758-759, 758f, 758t
treatment of, 760b
in multiple myeloma, 1240
pathobiology of, 758
postrenal, 757-758, 757f
diagnosis of, 759t, 760
pathobiology of, 759
treatment of, 760b
prerenal, 756-761, 757f
diagnosis of, 759, 759t
pathobiology of, 758
treatment of, 760b
prevention of, 760, 760f
prognosis for, 760-761
in rhabdomyolysis, 704
in septic shock, 665, 665f
treatment of, 760b
zoonoses-related, 1967t
Kidney transplantation, 822-826
Chagas disease after, e355-2-e355-3
deceased donor for, 823
in diabetic nephropathy, 783
donor for, 822-823
immunosuppression for
alemtuzumab in, 825
induction, 824-825, 824f, 825t
interleukiin-2 receptor blockers in, 825
maintenance, 825, 825t
OKT3 in, 825
polyclonal antibodies in, 824-825
living donor for, 822-823
prognosis for, 825-826
recipient evaluation for, 822
rejection in, 823-824, 823f, 824t
tissue typing for, 823
Kikuchis disease, 1228
Killer cell immunoglobulin-like receptors
(CD158), 215, 226
Kimmelstiel-Wilson glomerulosclerosis, 782
Kininogen deficiency, 1344t, e177-7-e177-8
Kinins, in inflammation, 233
KIT gene, 863, 1641, 1643-1644
Klebsiella granulomatis infection, 1911-1912,
1911f
Klebsiella pneumoniae infection, 1874-1875
antibiotic resistant, 1875, 1875t, e290-3t
prognosis for, 1877
treatment of, 1876b
Klinefelters syndrome, 1516
Klippel-Trenaunay syndrome, 935
Klotho, in renal osteodystrophy, 813
Knee
disorders of, 1659f, 1680-1681
osteoarthritis of, 1674, 1674f
pain in, 26

Knee (Continued)
replacement of, 1756, 1756f-1757f
infection after, 1735
rheumatoid arthritis of, 1684-1685,
e272-1f
Koilonychia, 2554, 2554f
Konzo, 2385
Kopliks spots, 2105, 2105f, 2523
Korsakoff s syndrome, 148, 2271, 2384
Kostmanns syndrome, 1102
Krukenbergs tumor, 1276
Kupffer cells, alcohol effects on, 996
Kuru, 2381
Kussmauls sign, 479
Kwashiorkor, 1385, 1390, 1390f
Kyasanur Forest disease, 87t, 2148t-2149t,
2151t, 2155. See also Viral hemorrhagic
fevers
Kyphoscoliosis, 605-607
clinical manifestations of, 605
diagnosis of, 605, 605f
epidemiology of, 605
hypercapnia in, 528t
pathobiology of, 605
prognosis for, 606
secondary, 606
treatment of, 605b-606b
L blood, 88-89
L-selectin, 1113
Labetalol
in hypertension, 382t
in hypertensive emergency, 388t
in stable myocardial ischemia, 423t
Laboratory tests, 32-37
false-negative, 34f
false-positive, 35, 35f
hypochondriasis and, 34
multiple, 34
ordering of, 32-34, 34f, 34t
performance characteristics of, 32t, 33
predictive value of, 32t-33t, 33
sensitivity of, 32t-33t, 33, 35, 35f
somatization disorders and, 34
specificity of, 33, 33t
threshold approach to, 34
Labyrinthine concussion, 2466
Lachman maneuver, 26
Lacrimal glands, 2426
autoimmune disease of. See Sjgrens
syndrome
tumors of, 2442
-Lactams, 1807t-1811t, 1808, 1814t
Lactase deficiency, 905, 909
Lactate, in shock, 646
Lactate dehydrogenase (LDH), 962
in autoimmune hemolytic anemia,
1047-1048
in bacterial meningitis, 2359
in HIV infection, 2202
Lactic acid, in bacterial meningitis, 2359
Lactic acidosis, 746-752, 746t, 1343t
Lactulose, in irritable bowel syndrome, 871t
Lacunes, 2310
Lambert-Eaton myasthenic syndrome, 1193t,
1194-1200, 2393t, 2419t, 2422
repetitive stimulation study in, 2233
Lamin A/C, 320t
Laminin, e267-4
Lamivudine
adverse effects of, 2087t, 2088
drug interactions with, 2087t
in hepatitis B, 975b-976b, 976t,
2086t-2087t, 2087-2088
Lamotrigine, 2292t
Langerhans cell, 216, 2499f, 2500-2501
Langerhans cell histiocytosis, 2538-2539,
2539f
bronchoalveolar lavage in, e85-6t
hypothalamic, 1428-1429
pulmonary, 566, 566b
Language, disorders of, 2271-2274, 2272t
Lansoprazole, in gastroesophageal reflux
disease, 878t
Lanthanum carbonate, in
hyperphosphatemia, 756b, 756t
Lapatinib, 167, 1168t-1176t
Laquinimod, in multiple sclerosis, 2353
Large granular lymphocyte syndrome, 1104
Large intestine. See Colon
Laron dwarfism, 1342
Larva migrans
cutaneous, 2065-2066, 2065f, 2547
ocular, e366-1
visceral, e366-1
Larynx
cancer of, 1257, 1260t-1261t
iatrogenic injury to, 514t
tremor of, 2334
Laser therapy, 2513
LASIK (laser in situ keratomileusis),
2427-2428
Lassa fever, 87b, 87t, 2147-2156,
2148t-2149t, 2151t, 2152f. See also Viral
hemorrhagic fevers
Latent autoimmune diabetes of adulthood,
e237-1
Lateral sinus thrombosis, 2375, 2375f
Latex allergy, 2484
Latrodectus spiders, 2077t, 2079
Laxatives, 867b
abuse of, 910
in irritable bowel syndrome, 871-872, 871t
watery diarrhea with, 908
Lead
renal effects of, 775
toxic ingestion of, 677t, 679t-683t
Lead poisoning, 88-95
cardiovascular manifestations of, 88-95
clinical manifestations of, 88-95, 88t
diagnosis of, 89
epidemiology of, 88, 88t
hematologic manifestations of, 89
nervous system manifestations of, 89
pathobiology of, 88
renal manifestations of, 89
reproductive system manifestations of, 89
treatment of, 89b, 90t
Lebers hereditary optic neuropathy, 1343t,
2416, 2444
Lecithin-cholesterol acyltransferase, 1347t,
1348
Lectin pathway, 241, 241f
Leeches, 2077t, 2081
Leflunomide, 159t, 165
in rheumatoid arthritis, 1688-1689, 1688t
Left atrial appendage, dilation of, 266, 266f
Left atrial pressure, e52-5t
Left ventricle. See Ventricle (cardiac), left
Left ventricular assist device
in cardiogenic shock, 657
in heart failure, 306f-307f, 315
Left ventricular ejection fraction, in heart
failure, 296
Left ventricular hypertrophy, 258, 275-277,
277f
Left ventricular noncompaction, 331
Left ventricular pressure, 291f, e52-5t
in aortic stenosis, 292f
in mitral regurgitation, 292f
in mitral stenosis, 292f
Left ventriculography, 290, 290t, 294, 294f
Leg(s). See also Foot (feet)
atheromatous emboli of, 493-498
examination of
in cardiovascular disease, 252-253, 254f
in trauma, 691
fibromuscular dysplasia of, 498, 498f
livedo reticularis of, 493
livedoid vasculopathy of, 493, 493f
post-thrombotic syndrome of, 506
superficial thrombophlebitis of, 505-506,
505f
thromboangiitis obliterans of, 494-498
vascular disease of. See Deep vein
thrombosis; Peripheral arterial
disease
venous ulcers of, 506
Legal issues, in stem cell therapy, 207
Legionellosis, 1903-1906
clinical manifestations of, 1904
definition of, 1903-1906, 1903f
Legionellosis (Continued)
diagnosis of, 591, 1904-1905, 1905f
differential diagnosis of, 1905
epidemiology of, 1903-1904, 1904t
in infective endocarditis, 468t
pathobiology of, 1904
prognosis for, 1906
treatment of, 1905b-1906b, 1906t
Legionnaires disease. See Legionellosis
Leighs disease, 1343t, 2416
Leiomyoma, gastric, 1278
Leishmaniasis, 2025-2030
cutaneous, 1965t, 2026f, 2028,
2029f
diffuse, 2026f, 2030
disseminated, 2027
recidivans, 2030
treatment of, 2013, 2030b, e356-1f
definition of, 2025
epidemiology of, 2025, 2026f, 2026t
hepatic, 990t-992t
mucosal, 2028, 2029f-2030f
pathobiology of, 2027
prevention of, 2030
prognosis for, 2030
treatment of, 2012-2013
visceral, 2026f, 2026t, 2027-2030
HIV infection and, 2027-2028
treatment of, 2027b-2028b
Lemierres syndrome, 2470
Lenalidomide, 1168t-1176t
in myelodysplastic syndrome, 1202
Lennox-Gastaut syndrome, 2291
Lens, 2426, 2427f
ionizing radiation injury to, 80
opacification of. See Cataract
Lentiviral vectors, 209
LEOPARD syndrome, 321
Lepidopterids, 2077t, 2081
Lepirudin, 173-174
Leprechaunism, 1342
Leprosy, 1950-1954
in animal species, 1965
biopsy in, 1953
borderline forms of, 1951f, 1952
clinical examination in, 1953
clinical manifestations of, 1952, 1952f,
2394, 2407-2408
definition of, 1950-1954
diagnosis of, 1953
epidemiology of, 1951
genetics of, 1951-1952
HIV infection and, 1953, 2222t,
2223
immunology of, 1951, 1951f
lepromatous, 1951f-1952f, 1952, 2540,
2540f
nerve damage of, 1951
orchitis with, 1524
pathobiology of, 1951-1954
prevention of, 1954
prognosis for, 1954
reactional states in, 1952-1954
skin smears in, 1953
treatment of, 1953b-1954b, 2408
tuberculoid, 1951f-1952f, 1952
Leptin, 1411t
in obesity, 1411
undernutrition effects on, 1389
Leptomeninges, metastases of, 1253-1254,
1253f
Leptospirosis, 1937-1939, 1966t
clinical manifestations of, 1938, 1938f
definition of, 1937-1939
diagnosis of, 1938
differential diagnosis of, 1938
epidemiology of, 1937
pathobiology of, 1937, 1937f
prevention of, 1938-1939
prognosis for, 1939
treatment of, 1938b
vs. viral hemorrhagic fever, 2153t
Lesch-Nyhan syndrome, 1343t
Leser-Trlat, sign of, 1196t
Letrozole, 1168t-1176t
Leucine aminopeptidase, 962
Leucovorin, 1168t-1176t
INDEX e47
Leukemia
acute, 1203-1209. See also Acute
lymphoblastic leukemia (ALL);
Acute myeloid leukemia (AML)
chemicals and, 1203-1204
classification of, 1204, 1204t
clinical manifestations of, 1205
clonality of, 1204
complications of, 1208
cytogenetics of, 1205
definition of, 1203-1208
diagnosis of, 1205-1206, 1206f
differential diagnosis of, 1206
drugs and, 1203-1204
epidemiology of, 1203-1204
genetics of, 1204
immunotyping of, 1204-1205
incidence of, 1203
mixed phenotype, 1204-1205
molecular biology of, 1205
morphology of, 1204
pathobiology of, 1204-1206
radiation and, 1203
treatment of, 1206b-1208b, 1207t
undifferentiated, 1204-1205
viruses and, 1203
arthritis in, 1750
chronic, 1209-1218. See also Chronic
lymphocytic leukemia (CLL);
Chronic myelogenous leukemia
(CML); Chronic myelomonocytic
leukemia (CMML)
eosinophilic, 1642
hairy cell, 1213-1214, 1214f, 1216t
hypokalemia in, 741
plasma cell, 1241
Leukemoid reaction, 1098, 1099f
vs. acute leukemia, 1206
vs. chronic myelogenous leukemia, 1100,
1210
Leukocoria, 2430, 2430t
Leukocyte. See White blood cell(s)
Leukocyte adhesion deficiency, 1100, 1115,
1116t-1117t
Leukocyte alkaline phosphatase, 1100, 1210
Leukocyte esterase, urinary, 710
Leukocytoclastic angiitis/vasculitis, 1196t,
1722t, 1726, 2525, 2525f, 2533
drug-related, 2535
Leukocytosis, 1098-1106
in chronic myelogenous leukemia, 1210
eosinophil, 1100-1101
lymphocyte, 1100, 1101t
monocyte, 1100, 1101t
neutrophil, 1098-1106, 1099t. See also
Neutrophilia
paraneoplastic, 1198
peripheral blood smear in, 1029-1030
postoperative, 2490
Leukodystrophy, 2354
Leukoencephalopathy. See Progressive
multifocal leukoencephalopathy
Leukoerythroblastic reaction, 1099, 1099f
Leukonychia, 2554-2555, 2555f
Leukopenia
basophil, 1106
eosinophil, 1106
lymphocyte, 1106
monocyte, 1106
mycophenolate mofetil and, 162-163
neutrophil, 1101. See also Neutropenia
peripheral blood smear in, 1029-1030
Leukoplakia, 1258, 1258f
hairy, 2451, 2451f
Epstein-Barr virus infection and,
2135-2136
HIV infection and, 2209-2210
Leukotriene(s)
in asthma, 531-532
in inflammation, 232-233
Leukotriene C4, in anaphylaxis, 1635
Leukotriene modifiers, in allergic rhinitis,
1626
Leuprolide acetate, 1168t-1176t
in prostate cancer, 1324
Levator muscle, 2426
Levetiracetam, 2292t
e48 INDEX
Levocardia, 408
Levodopa
micronutrient effects of, e225-8t
in Parkinsons disease, 2328-2333,
2330t-2332t
Levofloxacin, 1809t-1811t
Levonorgestrel, 1555
Lewis-Sumner syndrome, 2403-2405
Lewy body disease, 2280-2281, 2280t
vs. Alzheimers disease, 2278-2279
vs. Parkinsons disease, 2329t
Leydig cell agenesis, 1516
Lhermitte sign, 2231, 2349
Libido, decrease in, 1528
Lice, 2079-2080
body, 2080, 2080f
clinical manifestations of, 2546-2547
head, 2080
pubic, 1797t, 2080
in relapsing fever transmission, 1936
treatment of, 2512, 2547
in typhus, 1959-1962
Lichen amyloidosis, 1602
Lichen myxedematosus, 1236
Lichen nitidus, 2520
Lichen planopilaris, 2519, 2553, 2553f
Lichen planus, 2505, 2519-2521, 2519f
esophageal, 884
oral, 2451, 2451f, 2505
Lichenification, 2504t, 2506-2507
Lichtenberg figures, 686-687, 687f
Liddles syndrome, 739, 801t, 802
Lidocaine
in drug adulteration, 154
in kidney failure, 128t
patch, 136t
pharmacokinetics of, 126t
in resistant tachyarrhythmias, 347
Life expectancy, 98
Life support
advanced, 346, 347f
basic, 345-346
Life table, 101, 102t
Lifespan, radiation exposure and, 81
Ligament(s), e267-1f, e267-5
Ligaments, aging-related changes in, 107
Ligand regulated transporters, 1424
Light chain assay, 1234
Light chain deposition disease, 770
Lightheadedness, 246-249. See also Dizziness;
Syncope; Vertigo
Lightning injury, 686
clinical manifestations of, 686-687,
687f
treatment of, 687b
Likelihood ratio, 32t-33t, 33
Lily of the valley, toxic ingestion of,
674t-676t
LIM binding domain 3, 320t
LIM protein, 320t
Limb-girdle muscular dystrophy, 2414
Limulus assay, in aspergillosis, 1992
Lincosamides, 1809t-1811t
Lindane, in lice, 2080b
Linear immunoglobulin A bullous
dermatosis, 2527
Linezolid, 1807t, 1809t-1811t, 1812-1813
drug interactions with, 1765
resistance to, 1808t
Linkage disequilibrium, 196, 224-225
Lionfish envenomation, 697
Lipase, serum, 938-939
Lipid(s)
digestion of, 901, 902f
disorders of, 1350-1352, 1351f,
1352t-1353t
evaluation of, 53, 1352-1353, 1352t
fasting, in ST segment elevation MI, 437,
446-448
in HIV infection, 2190
metabolism of, 1346-1354
disorders of, 1350-1352, 1351f
evaluation of, 1352-1353, 1352t
prevention of, 1354
risk assessment for, 1353
treatment of, 1351f, 1353b-1354b,
1353t
Lipid(s) (Continued)
endogenous, 1348-1349, 1349f
exogenous, 1348
nuclear receptors and, 1350
oral contraceptive effects on, 1553
normal levels of, 1353
in parenteral nutrition, 1395t, 1396
red cell membrane, e164-1
transport of, 1346-1348, 1347t
Lipid storage disorders, 986, 1357t
Lipodystrophy, 2190, 2212, 2212f, 2212t
Lipohyalinosis, 2310
Lipoid adrenal hyperplasia, 1513
Lipoid nephrosis. See Minimal change disease
Lipoid pneumonia, 580-581, 581f
Lipolysis, impairment of, 902
Lipoma, 1250
Lipoprotein(s), 1346
atherogenic phenotype of, 410
disorders of. See Dyslipidemia;
Hyperlipidemia
high-density, 1346, 1347t, 1349, 1349f
antiatherogenic action of, 410
in cardiovascular disease, 257
intermediate-density, 1346, 1347t,
1348-1349, 1349f
laboratory evaluation of, 1352-1353
low-density, 1346, 1347t, 1348-1349,
1349f
cardiovascular disease and, 257, 1380
in plaque formation, 410, 410f
reduction of, 1380
very low density, 1346, 1347t, 1348-1349,
1349f
Lipoprotein (a), 1347t
Lipoprotein lipase, 1347t, 1348
Lipoxins, in asthma, 531-532
Liraglutide, e237-7t, e237-9
Lisinopril
in heart failure, 308t
in hypertension, 382t
in ST segment elevation MI, 443
Lissencephaly, 2387
Listeriosis, 1835-1836, 1966t
clinical manifestations of, 1835-1836
definition of, 1835-1836
diagnosis of, 1836
epidemiology of, 1835
meningeal, 1835-1836, 2356, 2362t,
2363-2364
pathobiology of, 1835
prevention of, 1836
prognosis for, 1836
treatment of, 1836b
Lisuride, in Parkinsons disease,
2330t-2332t
Lithium
in bipolar disorder, 2238b
central nervous system effects of, 672t
in kidney failure, 128t
pharmacokinetics of, 126t
toxic ingestion of, 674t-677t, 684t
Lithotripsy, in pancreatic duct stones,
943
Livedo reticularis, 493, 493f, 669
Livedoid vasculopathy, 493, 493f
Liver. See also Liver disease; Liver failure
and at Hepatic; Hepatitis; Hepato-
abscess of, 988t
amebic, 988t, 990-996, 2045, 2046f,
2046t
pyogenic, 988-996, 988t
adenoma of, 1299-1303, 1554
alcohol effects on, 147, 148t, 149
apoptosis in, 1300
atrophy-hypertrophy complex of, 1302,
1302f
Bartonella henselae infection of, 995-996,
1908t-1909t, 1909-1910
bilirubin disposition and, 957, 957f
biopsy of, 956, 963
in 1-antitrypsin deficiency, 985,
986f
in alcoholic liver disease, 997
bleeding with, 1147
in hepatic adenoma, 1300
in hepatitis, 973, 975, 975f
Liver (Continued) Liver disease (Continued)
in hereditary hemochromatosis, 985, biopsy in, 963. See also Liver, biopsy of
985f, 1375 chronic, 953. See also Cirrhosis, hepatic
in nonalcoholic fatty liver disease, cirrhotic. See Cirrhosis, hepatic
998-999, 999f clinical manifestations of, 952-953, 956t
biotransformation in, 980 coagulation tests in, 962-963
blood supply of, 952 cryptogenic, 979
cancer of. See Hepatocellular carcinoma in cystic fibrosis, 546, 986
Candida infection of, 1988, 1988f diet and, 1381t
cavernous hemangioma of, 849f, 1298 drug-induced, 953, 979-984, 981t
cholesterol metabolism by, 1012, 1012f cholestatic, 982-983
cobalamin stores in, 1075 clinical manifestations of, 981
copper accumulation in. See Wilsons definition of, 979-980
disease diagnosis of, 981
cyst of differential diagnosis of, 984
benign, 1300-1303 epidemiology of, 980
echinococcal, 2053t, 2055-2056, 2056f genetics and, 980
in cystic fibrosis, 545 hepatocellular, 981-982, 983t
drug clearance in, 962 in HIV infection, 2190
drug effects on. See Liver disease, immunoallergic, 983
drug-induced pathobiology of, 980-984, 980t, 982f
enlargement of. See Hepatomegaly sex steroid-related, 983
evaluation of, 25, 829, 952-966, 955f, steatotic, 983
956t, 958t, 965f treatment of, 984b
preoperative, 2482 duration of, 953
focal fat of, 77, 1300-1303. See also Liver encephalopathy in, 952-953, 956t
disease, fatty enzyme tests in, 961-962
focal nodular hyperplasia of, 1298f, in erythropoietic protoporphyria, 1368
1299-1303 evaluation of, 952-966, 956t, 958t
functions of, 952 in asymptomatic patient, 964-966, 965f
infection-related dysfunction of, family history in, 953
1771-1772, 1772t fatigue in, 952
lipid metabolism in, 1348-1349, 1349f fatty, 996-999, 996t, 1300-1303. See also
magnetic resonance imaging of, 847, 849f Steatohepatitis
mass lesions of, 958t, 1297-1303, 1297t, alcoholic, 149, 996-999, 996t
1298f. See also specific hepatic tumors etiology of, 77
palpation of, 829, 954-955, 955f nonalcoholic, 986, 998-999, 998f-999f
percussion of, 954-955 fever in, 952
sarcoidosis of, 584-585, 585t gastrointestinal bleeding in, 953
shock, 647 -glutamyl transpeptidase in, 962
T-cell lymphoma of, 1227 in heart failure, 300
toxicant effects on, 673 hematologic tests in, 963
transplantation of. See Liver hereditary, 984-987, 985t
transplantation in HIV-infected patient, 2198
trauma to, 690f icterus in, 953-954, 953f
tumors of, 1297-1303, 1297t. See also imaging in, 955-956, 964, 964f
specific tumors infectious, 987-996
benign, 1298 amebic, 988t, 990-996, 990t-992t, 994f
evaluation of, 1297-1303, 1298f bacterial, 988-996, 988f, 988t
malignant, 1300-1303, 1301f Candida, 989-996
metastatic, 1191 echinococcal, 990t-992t, 991-996, 994f
ultrasonography of, 846 fungal, 989
undernutrition effects on, 1389 granulomatous, 995, 995t
veno-occlusive disease of, after helminth, 990t-992t, 991-996
hematopoietic stem cell mycobacterial, 995
transplantation, 1161 parasitic, 990-996, 990t-992t
weight of, aging-related changes in, 106 schistosomal, 990t-992t, 994-996
Liver disease, 952-956 viral. See Hepatitis
abdominal examination in, 954-955, zoonotic, 995-996
954f-955f jaundice in, 956-958. See also Jaundice
abdominal pain in, 952, 956t laboratory studies in, 955, 956t, 963-964,
acute, 953 964f, 964t
alanine aminotransferase in, 961-962, 965 lactate dehydrogenase in, 962
albumin level in, 963 leucine aminopeptidase in, 962
alcoholic, 953, 996-999 in lipid storage diseases, 986
clinical manifestations of, 997, 997f metabolic, 986-987. See also specific
definition of, 996 diseases
diagnosis of, 997 mucocutaneous findings in, 953-954
epidemiology of, 996 neoplastic, 1297-1303, 1297t. See also
pathobiology of, 996-997 specific tumors
prognosis for, 998 benign, 1298
risk factors for, 996-997, 996t evaluation of, 1297-1303, 1298f
treatment of, 997b-998b malignant, 1191, 1300-1303, 1301f
alkaline phosphatase in, 962, 965-966, neuropsychiatric alterations in, 955
965f in older adults, 99t
aminotransferases in, 961-962, 965 organ system review in, 953
ammonia level in, 962 pain in, 952, 956t
amyloid, 986 paraneoplastic, 1199
anemia of, 1037-1038 parenteral nutrition and, 1397
antibacterial selection and, 1765 partial thromboplastin time in, 963
approach to, 952-956, 953f-954f patient history in, 952-953, 963-964, 964t
arthralgia in, 953 pharmacokinetics in, 129
ascites in, 952, 954f physical examination in, 953-955, 963-964,
aspartate aminotransferase in, 961-962, 964t
965 platelet hypofunction and, 1136
asterixis in, 955 in porphyria, 986
in asymptomatic patient, 964-966, 965f in pregnancy, 986-987, 987t

Liver disease (Continued)
preoperative assessment of, 2482
prothrombin time in, 962-963
pruritus in, 952
risk factors for, 953
sarcoid, 995, 995t
in sickle cell disease, 1071
stool examination in, 963
in -thalassemia intermedia, 1063-1064
toxin-induced, 979-984
TPN-induced, 987
transjugular pressure measurement in, 956
transplantation for. See Liver
transplantation
urine examination in, 963
in Wilsons disease, 1371
Liver failure, 1007-1011
acute
fulminant, 1008
subfulminant, 1008
transplantation for, 1007-1008. See also
Liver transplantation
bleeding in, 1147, 1147t
clinical manifestations of, 1147
diagnosis of, 1147-1148
pathobiology of, 1147, 1147t
vs. disseminated intravascular coagulation,
1146
after hematopoietic stem cell
transplantation, 1161
Liver flukes, 2060-2063, 2061t
oriental, 2061, 2061t
Liver transplantation, 1007-1011
in acute failure, 1008
biliary complications of, 1010
bone mineral density after, 1011
cancer after, 1011
in cirrhosis, 1006
coagulation and, 1147
complications of, 1010
contraindications to, 1008-1009
CT angiography in, 847, 849f
delayed ischemia-reperfusion injury after,
1010
diabetes mellitus after, 1011
donor allocation for, 1008
in hepatocellular carcinoma,
1301b-1302b
hyperlipidemia after, 1011
hypertension after, 1011
indications for, 1007-1009, 1007t
infection after, 1010-1011
listing for, 1008
living donor, 1009
management after, 1009-1011
portal vein thrombosis with, 1010
in primary sclerosing cholangitis,
1014b
referral for, 1007-1008
rejection after, 1010
split-liver, 1009
survival rates for, 1007t, 1009t
technique of, 1009
in Wilsons disease, 1372b
Liver X receptors, 1350
LMB2, in hairy cell leukemia, 1214b
LNK gene, 1091t
Locked-in syndrome, 2295t, 2298
Locus heterogeneity, 196
Loeys-Dietz syndrome, 1664
Lfflers endocarditis, 331, 1120
Lfgrens syndrome, 582-584, 586
Loiasis, e366-3t, e366-7-e366-8,
e366-7f
treatment of, 2009, e366-1t, e366-7b
Long QT syndrome
acquired, 366, 366t
antipsychotics and, 2493
congenital, 366-367, 366t
electrocardiography in, 365f
genetics of, 185t, 337
opioid abuse and, 155-156
Long-term care facility, diarrhea in, 898
Lonomia caterpillars, 2081
Loop recorders, 342-343
implantable, 342-343
Loose anagen hair syndrome, 2553
Loperamide
in acute diarrhea, 899
in irritable bowel syndrome, 871t
in small intestine dysmotility, 866
Loratadine, 2502t, 2512t
Lorazepam, 2242t
in alcohol dependence, 152t
in nausea and vomiting, 843t-844t
Losartan
in heart failure, 309t
in hypertension, 382t
Louping ill encephalitis, 2168
Louse-borne relapsing fever, 1935-1937,
1936f
vs. viral hemorrhagic fever, 2153t
Low back pain. See Back pain
Low-density lipoprotein receptor, 1347-1348,
1347t
Low-density lipoprotein receptor-related
protein, 1347t, 1348
Lowe syndrome, 801t
Loxosceles spiders, 2077t, 2079, 2079f
LRRK2 gene, 2326
Lubiprostone, 867b, 871t
Lucey-Driscoll syndrome, 959
Lugols solution, in thyrotoxicosis, e233-8
Lujo hemorrhagic fever, 2148t-2149t, 2151t.
See also Viral hemorrhagic fevers
Lumbar puncture, 2231-2232. See also
Cerebrospinal fluid (CSF) examination
Lumbar spine
pain in. See Back pain
stenosis of, 2263-2265
Lumefantrine, in malaria, 2012, 2016-2017,
2016t-2017t
Lumpectomy, 1311
Lung(s). See also at Pulmonary; Respiratory;
Ventilation
aging-related changes in, 105-106
biopsy of, e85-5
in asbestosis, 572, 573f
in cancer, 1267, 1267f
in histoplasmosis, 1978
in Mycoplasma infection, 1913
in sarcoidosis, 584
cancer of. See Lung cancer
carcinoid tumors of, 1271
in cystic fibrosis, 544, 546. See also Cystic
fibrosis
elasticity of, 538-539
examination of, 25
hyperlucent, 551-552
imaging of, 516-523. See also Chest
radiography
injury to. See Lung injury
lymphoma of, 1272
mesothelioma of, 1272
neuroendocrine tumors of, 1271
popcorn, 568t
preoperative assessment of, 2481-2482
sarcoma of, 1272
toxicant effects on, 673
transplantation of. See Lung
transplantation
trapped, 610
undernutrition effects on, 1389
Lung cancer, 1264-1272
achalasia with, 881
cigarette smoking and, 1264
clinical manifestations of, 1266
definition of, 1264
diagnosis of, 1267, 1267f-1268f
diet and, 1265, 1380
DNA methylation in, 1266
environmental tobacco smoke and, 1264
epidemiology of, 1178, 1264-1270, 1264t
epigenetics in, 1266
extrathoracic spread of, 1266-1267
family history in, 1265
gender and, 1265
gene expression signature in, 201
growth factors in, 1266
HIV infection and, 1265, 2207
imaging in, 1267f, 1268-1270
intrathoracic spread of, 1266
mediastinal tissue evaluation in,
1268-1270
Lung cancer (Continued)
metastatic, 1266-1267
radiography of, 520, 520f
surgical treatment of, 618
occupation-related, 77, 568t, 574, 574t
oncogenes in, 1266
paraneoplastic syndromes in, 1267. See
also Paraneoplastic syndromes
pathobiology of, 1265-1266, 1265f
pathology of, 1267-1268
preexisting lung disease and, 1265
prevention of, 1271
prognosis for, 201, 1271, 1271t
race and, 1265
radon and, 1264-1265
risk factors for, 1264-1266
screening for, 1271
staging of, 1267, 1268f, 1269t
tobacco and, 1264
treatment of, 618, 1268f, 1270b-1271b,
1270t
molecular markers in, 202t
in non-small cell cancer, 1270-1271,
1270t
in small cell cancer, 1270t, 1271
tumor suppressor genes in, 1266
in women, 1549
Lung disease. See also Lung cancer; Lung
injury
infectious. See also Influenza virus
infection; Pneumonia; Sarcoidosis;
Tuberculosis
in asthma, 536
in bronchiectasis, 548-549
in COPD, 538, 543-544, 543t, 634
in cystic fibrosis, 546-547
HIV-related, 2200-2201, 2200t-2201t.
See also Pneumocystis jirovecii
pneumonia
interstitial, 556-567, 556t, 557f, 558t. See
also specific diseases
bronchoalveolar lavage in, 560
chest radiography in, 558, 559t
classification of, 556t
clinical manifestations of, 556-557
with collagen vascular disease, 564
computed tomography in, 558-559
definition of, 556
diagnosis of, 557-567, 557f
drug-induced, 558t, 565
epidemiology of, 556
exercise testing in, 559
in genetic disorders, 566-567
laboratory testing in, 558
occupational, 76-77, 76t, 565. See also
specific disorders
pathobiology of, 556
patient history in, 557
physical examination in, 557
pulmonary function tests in, 559
respiratory bronchiolitis-associated,
559t, 562, 562b, 562f
in systemic sclerosis, 1709-1710
treatment of, 560b, 560t
vasculitides with, 565-567
video-assisted thoracoscope biopsy in,
560
neoplastic. See Lung cancer
obstructive. See Asthma; Chronic
obstructive pulmonary disease
(COPD)
occupational, 567-574, 568t. See also
specific diseases
Lung flukes, 2061t, 2062-2063
Lung injury
acute, 635
clinical manifestations of, 632t, 636
definition of, 635
epidemiology of, 635
etiology of, 635, 635t
pathobiology of, 636
treatment of, 636b, 637f, 638t
aspiration-related, 579-581
barotrauma-related, 576-581
carbon monoxideinduced, 577-581
cyanide-induced, 578-581
drowning-related, 574-581
INDEX e49
Lung injury (Continued)
after hematopoietic stem cell
transplantation, 1161
oxygen-induced, 578-581
radiation-induced, 579-581
smoke-related, 577-581
transfusion-related, 518f, 581, 1157
ventilator-induced, 641, 641f
Lung sounds, 25
Lung transplantation, 619-621
antibiotic prophylaxis after, 620
bilateral, 620, 620t
in bronchiectasis, 550
contraindications to, 620t
in COPD, 542-543
in idiopathic pulmonary fibrosis, 561b
immunosuppression for, 620
indications for, 620t
infection after, 620
living donor, 620
vs. lung volume reduction surgery, 619t
malignancy after, 621
mortality after, 621, 621f
nonpulmonary complications of, 621
osteoporosis after, 621
prognosis for, 621, 621f
in pulmonary hypertension, 396
recipient evaluation for, 620
rejection of
acute, 621
chronic, 621
renal insufficiency after, 621
single-lung, 620, 620t
Lung volume(s), 519, 519f, 519t
in COPD, 540
Lung volume reduction surgery, 618-619,
619f, 619t
in COPD, 542-543
Lupus. See also Systemic lupus erythematosus
(SLE)
discoid, 1699
neonatal, 1702
Lupus anticoagulant, 1655, e177-9-e177-10.
See also Antiphospholipid antibody
syndrome
Lupus nephritis, 769-770, 769f, 769t,
1699-1701, 1700f, 1700t
Lupus panniculitis, 1699, 2541
Lupus pernio, 583, 583f, 585t
Luteal phase dysfunction, e244-11-e244-14
Luteinized unruptured follicle syndrome,
e244-11
Luteinizing hormone (LH), 1425-1426, 1442
ovarian effects of, e244-1-e244-2, e244-2f
tests for, 1434t, 1437t
therapeutic, 1434t
tumor production of, 1297, 1443
Luteinizing hormone-releasing hormone
(LHRH) agonists
in breast cancer, 1312
in prostate cancer, 1324
Luteoma, 1515
17,20-Lyase deficiency, 1513
Lyme disease, 1930-1935, 1966t
acrodermatitis chronic atrophicans in,
1933
arthritis in, 1734, 1932
cardiac, 1932
chronic, 1934-1935
clinical manifestations of, 1931, 1932f,
1932t
coinfection with, 1935
cranial neuropathy in, 1932
culture in, 1933
definition of, 1930-1935
diagnosis of, 1933-1935, 1933t
differential diagnosis of, 1933-1934
disseminated, 1932
epidemiology of, 1930-1931
erythema migrans in, 1931-1934, 1932f,
2521
laboratory testing in, 1933, 1933t
lymphocytoma in, 1932
lymphoma and, 1219
meningeal, 1932, 2359t, 2369
neurologic, 1932-1934, 2407
pathobiology of, 1931, 1931f
e50 INDEX
Lyme disease (Continued)
post-treatment symptoms in, 1934
prevention of, 1935
reinfection in, 1935
skin examination in, 1933
treatment of, 1934b, 1935t
Lymph nodes, 220-221, 1107
aspiration/biopsy of, 1108
on chest radiography, 520, 520t
enlargement of. See Lymphadenopathy
evaluation of, 24, 1108, 1108t
in lung cancer, 1268-1270
physiology of, 1107
Lymphadenitis
in filariasis, e366-4
necrotizing, histiocytic, 1228
in toxoplasmosis, e357-3
in tuberculosis, 1943
Lymphadenopathy, 1107-1111
aspiration/biopsy in, 1108
in cancer of unknown primary origin,
1336
in cat-scratch disease, 1908
differential diagnosis of, 1107-1108, 1107t,
1109t
evaluation of, 1108-1109, 1108t-1109t
fever and, 1771-1772, 1771t
in Hodgkins lymphoma, 1229
imaging of, 1108, 1108t
in infection, 1107-1108, 1107t
in malignancy, 1107, 1107t
in non-Hodgkins lymphoma, 1221,
1221f
in nonmalignant immune system
disorders, 1107, 1107t
in onchocerciasis, e366-6
in plague, 1897, 1897f
in systemic lupus erythematosus,
1701-1702
in toxoplasmosis, e357-3, e357-5
in tularemia, 1894
in West African sleeping sickness, 2019
Lymphangioleiomyomatosis, 566, 566b
Lymphangitic carcinomatosis, 514t
Lymphangitis-associated rickettsiosis (LAR),
1956t, 1958
Lymphatic filariasis, e366-4
acute lymphadenitis in, e366-4
clinical manifestations of, e366-4
definition of, e366-4
diagnosis of, e366-5
elephantiasis in, e366-4-e366-5, e366-5f
epidemiology of, e366-4
hydrocele in, e366-5
pathobiology of, e366-4
prevention of, e366-5
treatment of, e366-1t, e366-5b
Lymphatic system. See also Lymph nodes
in immunodeficiency disorders, 1616
impaired drainage of, malabsorption and,
908
ionizing radiation injury to, 80
Lymphedema, after breast cancer treatment,
1315
Lymphocyte(s)
B, 214, 220
deficiency of, 1618, 1618t
development of, 220, 220f
differentiation of, 220, 220f
memory, 221
production of, e159-2f
stimulation of, 220
therapeutic targeting of, 167-168
in graft rejection, 236t
repertoire of, 214
in systemic lupus erythematosus, 1702
T, 214, 218-220
activation of, 219
in allergic rhinitis, 1623
in allergy, 1612
alveolar, e85-2
anergy of, 239
in atherosclerosis, 410, 410f
CD4+, 219
in HIV-infected patient, 2176-2177,
2179, 2187-2188, 2187t,
2200-2201, 2201t, 2214
Lymphocyte(s) (Continued)
CD8+, 219
in HIV-infected patient, 2176, 2214
cytotoxic, 219, 227
deficiency of, 1617-1621, 1617t
deletion of, 238-239, 238t
development of, 218-219, 218f, 221
in diabetes mellitus type 1, e236-4
differentiation of, 219
eosinophil activation of, 1119
in graft rejection, 237-238, 237f
homeostasis of, 219-220
hyperstimulation of, 221
memory, 221, 227
negative selection of, 221
positive selection of, 221
production of, e159-2f
regulatory, 219, 221
self-reactivity of, 221
suppression of, 239
therapeutic targeting of, 167
Lymphocyte-associated function antigen-1,
1113
Lymphocytic choriomeningitis, 1966t,
2366-2367, 2379
Lymphocytic hypophysitis, 1433
Lymphocytic infundibuloneurohypophysitis,
e232-5
Lymphocytic interstitial pneumonitis, HIV
infection and, 2208
Lymphocytic thyroiditis, e233-9-e233-10
Lymphocytoma, in Lyme disease, 1932
Lymphocytopenia, 1106
Lymphocytosis, 1100, 1101t
in chronic lymphocytic leukemia, 1215,
1216t
in infection, 1769
large granular, 1216t
Lymphogranuloma venereum, e326-4
Lymphoid and lymphocytic interstitial
pneumonia, 559t, 563, 564b
Lymphoid tissue, 220-221
Lymphoma
effusion, primary, 1225, 2216
Hodgkins, 1228-1233
advanced-stage, 1231t, 1232
classification of, 1229, 1229t
clinical manifestations of, 1229
complications of, 1232-1233, 1233t
definition of, 1228
diagnosis of, 1229-1230, 1229f
differential diagnosis of, 1230
epidemiology of, 1228
Epstein-Barr virus and, 1228-1233,
2135
genetics in, 1229
HIV infection and, 1232-1233
imaging in, 1230, 1231f
immunophenotype of, 1229-1230
laboratory testing in, 1230
limited-stage, 1231-1232
in older adults, 1233
pathobiology of, 1228-1233
physical examination in, 1230, 1230f
positron emission tomography in, 1230
in pregnancy, 1232
refractory, 1232
relapsed, 1232, 1233t
staging of, 1230-1231, 1230t-1231t
treatment of, 1160, 1231b-1233b, 1232t
large intestine, 1281
leukemic phase of, 1216t
non-Hodgkins, 1218-1228
anaplastic, 1336
arthritis in, 1750
Burkitts, 1219t, 1222t, 1225, 2135
classification of, 1220-1221, 1221t
clinical manifestations of, 1221-1222,
1221f, 1222t
CNS, 1227, 1252, 2135
conjunctival, 2442
cutaneous, 1225, 2539-2540
definition of, 1218
diagnosis of, 1222, 1222t
differential diagnosis of, 1222, 1228
diffuse large B-cell, 1219t, 1222t, 1225,
1225t, 1227
Lymphoma (Continued)
environmental exposures and, 1219
epidemiology of, 1218, 1218f
follicular, 1219t, 1222t, 1224
gastric, 1277-1278
genetics of, 1218-1228, 1221t
head and neck, 1261
HIV-related, 1218-1219, 1227, 2195,
2207, 2215
central, 2215
clinical manifestations of, 2215-2216
diagnosis of, 2216
peripheral, 2215
treatment of, 2216b
immune system abnormalities and,
1218-1219, 1219t
infectious agents and, 1219, 1219t
intravascular large B-cell, 1225
lymphoplasmacytic, 1219t, 1222t,
1226
MALT, 1219t, 1222t, 1224
mantle cell, 1219t, 1222t, 1225
mature B-cell, 1223-1228
mediastinal large B-cell, 1219t, 1222t,
1225
nodal marginal zone B-cell, 1219t,
1222t, 1226
occupational exposures and, 1219
in older adults, 1227
orbital, 2442
pathobiology of, 1218-1228, 1219t
pathology of, 1219-1220, 1219t,
1220f
peripheral T-cell, 1219t, 1222t, 1226
unspecified, 1226
plasmablastic, 1225, 2217
post-transplantation, 1227
precursor B-cell, 1223
precursor T-cell, 1223
in pregnancy, 1227
primary effusion, 1225, 2216
prognosis for, 1222-1223, 1223t
pulmonary, 1272
small intestine, 1279, 1279f
small lymphocytic, 1219t, 1222t, 1223
splenic marginal zone, 1226
staging of, 1222-1223, 1223t
T-cell, 1226
angioimmunoblastic, 1227
enteropathy-type, 907, 1227
extranodal, 1227
hepatosplenic, 1227
subcutaneous panniculitis-like, 1227
unspecified, 1226
testicular, 1227
of thyroid gland, e233-12f, e233-14
treatment of, 1159-1160, 1223b, 1224t
Lymphomatoid granulomatosis, 2135
Lymphomatoid papulosis, 1226
Lymphoproliferative disease
autoimmune, 1619-1621, 1619t
cutaneous, 1226
herpesvirus 8related, 2216-2217
post-transplantation, 2135
X-linked, 1218-1219, 2135
Lymphotoxin-, 215t
LYN gene, 1697
Lynch syndrome. See Hereditary
nonpolyposis colon cancer
Lysergic acid diethylamide (LSD) abuse, 158
Lysinuria, 1341t
Lysinuric protein intolerance, 1341t
Lysosomal acid maltase defect, 1356t
Lysosomal-associated membrane protein 2,
320t
Lysosomal disorders, 1343-1346
Lysosomal storage diseases, 1357-1361,
1357t-1358t
Lysosomal transport disorders, 1357t
M in epilepsy, 2290
M (monoclonal) proteins, 1234, 1234f,
2403
Mackerel poisoning, 700
Macrocyte, 1025f, 1079, 1080f
Macrolides, 1807t-1811t, 1812-1813, 1814t
Macrophage(s), 216, 216f
alveolar, 588, e85-2
in antibody-mediated red cell destruction,
1046, 1046f
disorders of, 1116t-1117t, 1117
Macrophage antigen-I, 1113
Macroprolactin, 1438
Macula, 2427f
age-related degeneration of, 197-198,
1668t, 2437-2438, 2437f-2438f,
2444
dysfunction of, 2429
Macular edema, e236-13, e236-13t
Madura foot, 2005-2007, 2006f
Maffuccis syndrome, 1610
Magnesium, 753-754
deficiency of, 753-754, 753t, 2383t
diarrhea with, 908
dietary, 753
absorption of, 1577
guidelines for, 1383t
excess of, 754
homeostasis of, 1576-1577
in malabsorption, 908t
metabolism of, 753
in nephrolithiasis prevention, 794
renal handling of, 1577
serum, 753, 1576
nutritional therapy and, 1391
in ST segment elevation MI, 444
total, 1576
urinary, 754, 1577
Magnesium ammonium phosphate crystals,
712, 712f
Magnesium carbonate, in
hyperphosphatemia, 756t
Magnesium hydroxide, in
hyperphosphatemia, 756t
Magnetic resonance angiography (MRA)
in intestinal ischemia, 929
of kidneys, 714, 714f
in neurologic disorders, 2235t
in peripheral arterial disease, 489-490,
489f
in renal artery stenosis, 784-785, 784f
Magnetic resonance
cholangiopancreatography (MRCP),
847, 964
in choledocholithiasis, 1018f
in pancreatic cancer, 847, 850f
Magnetic resonance enterography (MRE), in
Crohns disease, 847-848, 850f
Magnetic resonance imaging (MRI)
in acute pancreatitis, 939
in acute pericarditis, 475, 476f
in alcoholic liver disease, 997
in angina pectoris, 417
in autosomal dominant polycystic kidney
disease, 798
in bacterial meningitis, 2359-2360
in bladder cancer, 1307
of brain, 2271f
in brain abscess, 2372, 2372f
in brain tumors, 1247t, 1248, 1248f
in breast cancer, 1316
cardiac anatomy on, 264f
cardiovascular, 287-289
in aortic dissection, 288-289
in cardiomyopathy, 287-288, 288f
in congenital heart disease, 289, 289f
contraindications to, 287
in coronary artery disease, 287, 288f
indications for, 287
in masses, 289, 289f
in myocarditis, 288, 288f
in pericardial disease, 288-289, 289f
pulse sequences for, 287
in sarcoidosis, 288, 288f
in cavernous sinus thrombosis, 2374
in cobalamin deficiency, 1077
in encephalitis, 2377
in fatty liver, 1300
in frontotemporal dementia, 2282, 2282f
gadolinium for, 1657
in gastrointestinal disorders, 847-848
in glioblastoma, 1251f

Magnetic resonance imaging (MRI)
(Continued)
in hepatic adenoma, 1299
in hepatic cavernous hemangioma, 847,
849f, 1298-1299
in hepatic cysts, 1300
in hepatic focal nodular hyperplasia, 1299
in hepatocellular carcinoma, 1301, 1301f
in herpes simplex encephalitis, 2378
in HIV dementia, 2219, 2220f
in intracerebral hemorrhage, 2325
in ischemic stroke, 2314, 2314f
in Japanese encephalitis, 2165
of joint, e267-1f
in lateral sinus thrombosis, 2375f
in liver disease, 955-956
in low back pain, 2261
in low-grade glioma, 1248f
of lymph nodes, 1108
in mediastinal disease, 522
in meningioma, 1250
in mild cognitive impairment, 2277
in multiple sclerosis, 2350-2351,
2351f-2352f
in myelopathy, 2267
in myopathy, 2411-2412
in neck pain, 2261
in neurologic disorders, 2235, 2235t
in nonalcoholic fatty liver disease,
998-999, 998f
in obstructive uropathy, 780
in osteoarthritis, 1675
in pain assessment, 135
in pheochromocytoma, 1473-1474
in pituitary adenoma, 1250
of pituitary gland, 1431-1432
in primary angiitis of central nervous
system, 1724
in progressive multifocal
leukoencephalopathy, 2113, 2114f
in pulmonary embolism, 599
in pulmonary mucormycosis, 1995, 1996f
in rabies, 2378
in radiculopathy, 2265
in renal cell carcinoma, 1303-1304
in respiratory disease, 516-517
in rheumatic disease, 1656-1657,
1658f-1659f
in rhinocerebral mucormycosis, 1995
in spinal epidural abscess, 2373, 2374f
in spinal stenosis, 2264
in ST segment elevation MI, 437
in subdural empyema, 2374
of thyroid gland, e233-2
in tick-borne encephalitis, 2167
in vertebral osteomyelitis, 1817, 1817f
Magnetic resonance venography (MRV), in
deep vein thrombosis, 501
Magnetoencephalography, in epilepsy, 2290
Mahaim fiber, 335
Major basic protein, 1119
Major histocompatibility complex (MHC),
222-226. See also Human leukocyte
antigens (HLAs)
class I, 215, 218, 218f
class II, 218, 218f
genes for, 223-224, 223f
in sarcoidosis, 582
in transplantation, 236, 236t
Malabsorption, 901. See also Malnutrition;
Protein-energy malnutrition
in abetalipoproteinemia, 905
bile acid, 904
bile salt, 909
in bile salt deficiency, 904
in celiac disease, 905-911, 906f
classification of, 1388, 1388t
clinical manifestations of, 902
diagnosis of, 901f, 902, 902t-903t, 911-912
in enteropeptidase deficiency, 905
flatus with, 838
in Giardia lamblia infection, 907
glucose-galactose, 909
in graft-versus-host disease, 907
in HIV infection, 907
in ileal disease/resection, 904
impaired lipolysis in, 902, 902t, 903b
Malabsorption (Continued)
impaired micelle formation in, 902t, 904
impaired nutrient delivery in, 902t, 908
in intestinal bacterial overgrowth, 904
in lactase deficiency, 905
in lymphatic system dysfunction, 902t,
908
micronutrient effects of, e225-7-e225-8
mucosal, 902t, 904-905
in pancreatic lipase deficiency, 902
in pancreatitis, 902
in short-bowel syndrome, 907-908
surgery and, 901
treatment of, 908t
in tropical sprue, 907
vitamin deficiencies in, 829-832
weight loss with, 840t-841t
in Whipples disease, 907
Malar rash, 1699, 1699f
Malaria, 2013-2018
anemia in, 2014
antigen detection test in, 2016
vs. babesiosis, e361-2
clinical manifestations of, 2015
complications of, 2015
definition of, 2013-2018
diagnosis of, 2015-2017
endemic, 2013
epidemiology of, 2013-2014
fever in, 2014
genetic factors in, 2015
hemolysis with, 1051t
HIV infection and, 2014
HLA associations in, 225t
immune response to, 2015
pathobiology of, 2014-2015, 2014f
pathogen in, 2013
peripheral blood smear in, 2016
polymerase chain reaction test in, 2016
prevention of, 2013-2014, 2017, 2018t
for traveler, 1801-1803
prognosis for, 2018
severe, 2015, 2017
transmission of, 2013
in traveler, 2013, 2017-2018
treatment of, 2011-2012, 2016b-2017b,
2016t
antibacterials in, 2017
artemether in, 2012, 2016t-2017t,
2017
artesunate in, 2012, 2016t-2017t, 2017
atovaquone in, 2011, 2017
chloroquine in, 2011, 2016, 2016t
doxycycline in, 2011, 2016t
halofantrine in, 2016-2017
lumefantrine in, 2012, 2016-2017,
2016t-2017t
mefloquine in, 2011, 2016-2017,
2016t-2017t
primaquine in, 2011, 2016t, 2017
proguanil in, 2011, 2016t, 2017
quinidine in, 2012, 2016t, 2017
quinine in, 2012, 2016t
sulfadoxine-pyrimethamine in, 2017,
2017t
uncomplicated, 2015
vs. viral hemorrhagic fever, 2153t
Malathion, 2080b, 2547
Maldigestion, 1388, 1388t, e225-7-e225-8.
See also Malabsorption
Malignancy. See Cancer and specific
malignancies
Malignant hyperthermia, 702, 704, 2412t,
2484
Malignant melanoma. See Melanoma
Malingering, 2244
Mallory-Weiss tear, 857, 857f, 885
Malnutrition. See also Malabsorption;
Protein-energy malnutrition
autonomic disturbances with, 2394
during hemodialysis, 820
in HIV-infected patient, 2213
infection-related, 1761
measles-related, 2106, 2106b
neutropenia with, 1104
in older adults, 104t
shigellosis-related, 1889
Malnutrition (Continued)
vitamin deficiencies in. See at specific
vitamins
weight loss with, 840t-841t
MALT lymphoma, 887, 1219t, 1222t, 1224,
1277-1278
Maltese cross form, e361-2, e361-2f
Mammaprint assay, 1310-1311
Mammography, 54
Mandible, mesenchymal tumors of, 1595
Manganese, e225-6t-e225-7t
deficiency of, e225-6t-e225-7t
poisoning with, 90t, 92-95
toxicity of, e225-6t-e225-7t
Manganese madness, 92
Mangled Extremity Severity Score (MESS),
704
Mania, 2236t, 2238-2241, 2240t
Mannitol
in acute liver failure, 1008
in increased intracranial pressure, 1255b,
1256t
in rhabdomyolysis, 704
Mannose-binding lectin, 217, 241
Manometry, esophageal, 875
in achalasia, 881
in reflux disease, 876
Mansonella ozzardi infection, e366-1t,
e366-3t, e366-7
Mansonella perstans infection, e366-1t,
e366-3t, e366-7
Mansonella streptocerca infection, e366-1t,
e366-3t, e366-8
Maple bark strippers lung, 570-571, 571t
Maple syrup urine disease, 1343
Marantic endocarditis, 332-333
Marasmus, 1385, 1390, 1390f
Marble bone disease, 1607-1610
Marburg hemorrhagic fever, 87t, 2147-2156,
2148t-2149t, 2151t, 2350. See also Viral
hemorrhagic fevers
March fracture, 1681
March hemoglobinuria, 1051t
Marchiafava-Bignami syndrome, 2386
Marfan syndrome, 1344-1345, 1663
aortic dissection in, 246, 1663-1664
clinical manifestations of, 1664
definition of, 1663
diagnosis of, 1664
epidemiology of, 1663
genetics of, 185t, 1663
ischemic stroke in, 2318
pathobiology of, 1663-1664
pathology of, 1663-1664
treatment of, 1664b
Marijuana, 140t, 157, 677t
Marine organism envenomation, 697-699,
698t, 898
anemone, 699
blue-ringed octopus, 698t, 699
box jellyfish, 698t, 699
bristle worm, 699
cone snail, 698-699, 698t
coral, 699
jellyfish, 698t, 699
lionfish, 697, 698t
Portuguese man-of-war, 698t, 699
scorpionfish, 697, 698t
sea anemone, 698t
sea nettle, 698t
sea snake, 697, 698t
sea urchin, 699
stingray, 697-698, 698t
stonefish, 697
weeverfish, 697, 698t
Marine organism poisoning, 698f, 698t,
699-700
brevetoxin, 700
ciguatoxin, 698t, 699
domoic acid, 700
gonyautoxin, 698t, 700
palytoxin, 699-700
saxitoxin, 698t, 700
scombrotoxin, 700
tetrodotoxin, 698t, 699
Maroteaux-Lamy syndrome, 1360,
1662-1667, 1662t
INDEX e51
Mast cell(s)
in allergic rhinitis, 1622-1623
in anaphylaxis, 1635
in mastocytosis, 1641, 1643
in pruritus, 2502
in type I hypersensitivity reaction, 227,
228f, 228t
in urticaria/angioedema, 1628-1629
Mastalgia, 1316
Mastectomy, 1311
prophylactic, 1315
Mastitis, 1316, 2110
Mastocytoma, 1642
Mastocytosis, 1640-1645, 1641t
biopsy in, 1642, 1643f
clinical manifestations of, 1641, 1641f
cutaneous, 1640-1642, 1641f, 1644
definition of, 1640
diagnosis of, 1642, 1643f
epidemiology of, 1640-1645
gastrointestinal symptoms in, 1642
genetics of, 1641
hematologic symptoms in, 1642
musculoskeletal symptoms in, 1642
pathobiology of, 1641-1645
prognosis for, 1645
systemic, 1630, 1640, 1642
vs. anaphylaxis, 1637
categories of, 1644, 1644f
diagnosis of, 1642-1645, 1643f
treatment of, 1644b-1645b
WHO criteria for, 1642-1644, 1643t
Matrilysins, in inflammation, 233t
Matrix metalloproteinases (MMPs), 1673,
e267-6, e267-6t
in inflammation, 233-234, 233t
Maturity-onset diabetes of the young, 185t,
e237-1
May-Hegglin anomaly, 1029
May-Thurner syndrome, 499
Mayaro fever, 2160
Mayer-Rokitansky-Kster-Hauser syndrome,
1517
Maze procedure, 373
Mazzotti reaction, e366-6
McArdles disease, 1356t, 2415
McBurneys sign, 837t
McCune-Albright-Sternberg syndrome, 1342
McCune-Albright syndrome, 1507-1509,
1609, 1609f
pathogenesis of, 1507
pituitary adenoma in, 1433
MCKD1 gene, 799
MCKD2 gene, 799
MDMA (3,4-
methylenedioxymethamphetamine),
158, 2484
Mean, statistical, e8-1, e8-4
Mean arterial pressure, 645
Mean corpuscular hemoglobin (MCH),
1031t
Mean corpuscular hemoglobin concentration
(MCHC), 1031t
in hereditary spherocytosis, e164-3
Mean corpuscular volume (MCV), 1031t
Measles, 2105-2107
clinical manifestations of, 2105-2107,
2105f, 2523
complications of, 2106
definition of, 2105
diagnosis of, 2106
differential diagnosis of, 2106, 2106t
epidemiology of, 2105
German. See Rubella (German measles)
immunization against, 64t, 65f-66f,
67t-70t, 71-72, 2106-2107
pathobiology of, 2105
postexposure prophylaxis against, 2107
prevention of, 2106-2107
prognosis for, 2107
transmission prevention in, 2107
treatment of, 2106b
vs. viral hemorrhagic fever, 2153t
Measure(s), 38t. See also Statistics
absolute vs. relative, e8-3
adequately specified, 37, 38t
condition-specific, 38-39
e52 INDEX
Measure(s) (Continued) Medical consultation (Continued) Mediterranean diet, 1380 Memory (Continued)
cost, 39 curbside, 2475-2476 Mediterranean fever, familial, 1115, immediate, 2270, 2270t
general, 38-39 effective, 2475, 2476t 1668-1672, 1668t, 1670t impairment/disorders of. See also
intermediate outcome, 38 informal, 2475-2476 Mediterranean spotted fever, 1956t, 1958 Alzheimers disease; Amnesia;
interpretable, 37-38 mandatory, 2476 Medroxyprogesterone acetate, 1168t-1176t Dementia
outcome, 37-38, 41, 41t medical-medical, 2474 in menopausal hot flushes, 1569t-1570t in Korsakoff s syndrome, 2384
patient-oriented, 38-39 for obstetrician, 2474 Medullary cystic kidney disease, 796t, 799 in older adults, 99, 100f, 108
process, 37-38 postoperative, 2474, 2487-2492 Medullary sponge kidney, 796t, 799-800 neural substrates of, 142
questionnaire-based, 39 for alkalosis, 2490 Medullary thyroid carcinoma, 1601-1603 procedural, 2270t
reliable, 37 ambiguity in, 2491 Medulloblastoma, 1252 REM sleep consolidation of, 2300
resource use, 39 for anemia, 2490 Mefloquine, in malaria, 2011, 2016-2017, working, 2270t
responsiveness of, 37 anesthesia record review in, 2487 2016t-2017t Menarche, 59
types of, 38-39 for anorexia, 2488 MEFV gene, 1668-1669 Mendel, Gregor, 187
utility, 39 for azotemia, 2490-2491 Megacolon, 866 Mendelsohns syndrome, 580
validity of, 37 for blood glucose abnormalities, 2491 chagasic, e355-2 Menieres disease, 2463, 2466, 2468t
Measurement, 37-41 for chest pain, 2488, 2488t toxic, 920 Meningioma, 1250
case mix adjustment for, 41 for delirium, 2489 Megaesophagus, e355-2 spinal, 1254
data for, 39, 40t for diarrhea, 2488 Megaloblastic anemia, 1075-1083. See also Meningitis, 2355-2371
experimental study design for, 39-40 for dyspnea, 2488, 2489t Folate, deficiency of; Vitamin B12 aseptic, 2368-2369, 2368t
nonexperimental study design for, 40-41 for edema, 2490 (cobalamin), deficiency of chronic, 2368t-2370t, 2369
standards of, 37-38, 38t for fever, 2490 clinical manifestations of, 1079 definition of, 2365
study design for, 39-41 for hyperbilirubinemia, 2491 definition of, 1075-1083 infectious, 2367t, 2368-2369. See also
Mebendazole, 2010 for hypertension, 2489 diagnosis of, 1079-1083, 1080f, 1081t, Meningitis, viral
in roundworm disease, 2009 for hypoalbuminemia, 2491 1082f in leptospirosis, 1938
Mecamylamine, in smoking cessation, 144t for hypotension, 2489 epidemiology of, 1075 noninfectious, 2368t-2370t, 2369
Mechanical ventilation, 638-645 for leukocytosis, 2490 iron deficiency and, 1080 bacterial, 2355-2371, 2368t
in acute respiratory distress syndrome, medications in, 2491 neutropenia with, 1104, 1104f Acinetobacter in, 1882, 2364
636, 638t, 642-643, 643f mistake patterns and, 2487 pathobiology of, 1075-1079, 1076t anthrax in, 1839, 2364
adjuncts to, 644 for multiple problems, 2491 peripheral blood smear in, 1080, 1080f, arthritis with, 2360
in apnea, 29 order checking in, 2487 1104f bacteremia with, 2359
assist/control, 639 for platelet count abnormalities, 2490 prognosis for, 1082-1083 brain swelling in, 2364
assisted, 639 for potassium abnormalities, 2490 treatment of, 1082b, 1083t cerebral blood flow in, 2357
in asthma, 643-644 preventive care in, 2488 Megaloblastosis, 1080, 1080f cerebral edema in, 2356-2357
auto-PEEP with, 640-641, 640f priorities for, 2491 Megarectum, 866 vs. chemical meningitis, 2360
complications of, 640-641, 642f prophylaxis recommendations in, Megaureter, 804, 804f clinical manifestations of, 2357-2365,
controlled, 639 2487-2488 Megestrol acetate 2357t
controlled ventilation, 638 recovery focus in, 2487 in cancer therapy, 1167, 1168t-1176t, coagulopathy in, 2360
in COPD, 635, 643-644 redundancy in, 2491 1199-1200 complications of, 2360
definition of, 638 for seizures, 2489 in menopausal hot flushes, 1569t-1570t in compromised host, 1780
in diaphragmatic weakness and paralysis, for sodium abnormalities, 2490 Meglumine antimoniate, in visceral contact prophylaxis in, 2365
604b, 605t for tachycardia, 2489-2490 leishmaniasis, 2027-2028 cortical thrombophlebitis in, 2356-2357
discontinuation of, 625, 644-645, 644f team psychology and, 2487 Meibomian glands, 2426 corticosteroids in, 2364
spontaneous breathing test for, 624 for vomiting, 2488 carcinoma of, 2431 cranial nerve injury in, 2356-2357
hemodynamic compromise with, 640 for weakness, 2488-2489 Meigs syndrome, 610 CSF cell count in, 2359
high-frequency, 639 preoperative, 2474, 2477-2483 Melanin, 2499, 2506t, 2508, 2508f CSF examination in, 2231t, 2358-2359,
initiation of, 641-642, 642t cardiac assessment in, 2477-2481, Melanin-concentrating hormone, 1412t 2359t, 2364
intermittent mandatory, 639 2479f, 2479t-2482t Melanocyte(s), 2499-2500, 2538, 2539f CSF glucose in, 2359, 2359t
intubation in, 640, 643-644 endocrine assessment in, 2482 -Melanocyte-stimulating hormone, 1412t CSF pressure in, 2358, 2359t
lung injury with, 641, 641f hematologic assessment in, 2483, 2483t Melanoma, 1329-1334 CSF protein in, 2359, 2359t
negative-pressure, 638 laboratory tests in, 2477, 2478t clinical manifestations of, 1330-1331, definition of, 2355-2356
neurally adjusted ventilatory assist, 639 liver assessment in, 2482 1331f, 1331t diagnosis of, 2358
noninvasive, 643 medications in, 2477, 2478t conjunctival, 2426, 2441 differential diagnosis of, 2360, 2367t
noninvasive positive-pressure, 639-640 neurologic assessment in, 2483 cutaneous, 26, 1330, 1331f, 1331t, 2504 vs. endocarditis, 2360
PEEP in, 638, 642-643 patient history in, 2477 diagnosis of, 1331, 2504 endocarditis with, 467, 2360
pneumonia with. See Pneumonia, physical examination in, 2477 duodenal, 846f epidemiology of, 2356
ventilator-associated pulmonary assessment in, 2481-2482 epidemiology of, 1329 focal cerebral signs in, 2358
position in, 644 renal assessment in, 2483 genetics of, 1330 Gram-stained smear in, 2358
positive-pressure, 638-640 risk assessment in, 2477 HIV infection and, 2211 Haemophilus influenzae in, 1862,
pressure-control, 639 for primary care physicians, 2474-2475, iris, 2441, 2442f 2361-2363, 2362t, 2365
pressure-support, 639 2475t nail, 2556, 2556f head trauma and, 2357-2358
proportional assist, 639 for psychiatrist, 2474, 2492-2496, 2492t, pathobiology of, 1329-1333 hydrocephalus in, 2356-2357
in septic shock, 663 2494t, 2495f prevention of, 1332 hypotension in, 2364-2365
volume-controlled, 639 rapid response team for, 2474, 2475t prognosis for, 1331 Klebsiella in, 2356
Mechanics hands, 1718 request for, 2474 retinopathy with, 1193t latex agglutination test in, 2359
Mechlorethamine, 1168t-1176t subspecialty, 2474-2475, 2475t risk factors for, 1330, 1330f Listeria in, 1835-1836, 2356, 2362t,
Meclizine, in nausea and vomiting, 843t-844t trilateral deliberative model of, 2476 small intestine, 1279 2363-2364
MECP2 gene, 2388-2389 Medical history, 22-23, 23t staging of, 1331, e210-1t meningococcal, 1851-1855, 2356,
Median, statistical, e8-1 Medical intervention, termination treatment of, 1332b 2358. See also Neisseria meningitidis
Median arcuate ligament syndrome, 935 (withholding/withdrawing) of, 6-7, 6t, uveal, 1331, 2441 infection
Mediastinal stripes, 522f 14f Melanonychia, 2556, 2556f clinical manifestations of, 1853
Mediastinitis, 612 Medications. See also Drug(s) Melanosis, 2506t, 2508 diagnosis of, 1853-1854
in histoplasmosis, 1978 aging-related metabolism of, 109 Melarsoprol, in African sleeping sickness, treatment of, 1854b, 2361, 2362t
Mediastinoscopy, in HIV-infected patient, nonadherence to, in older adults, 109 2020b, 2021t mortality rate for, 2365
2207 review of, 103, 104t Melasma, 2548-2549, 2548f neurologic findings in, 2358
Mediastinum, 611 sensitivity to, in older adults, 109 Melioidosis, 84t, 1881 neutrophils in, 2357
compartments of, 522-523, 522t, e99-1f Medicine, 2-4 Melorheostosis, 1609-1610 non-spore-forming anaerobic bacteria
cysts of, 612 approach to, 2 Melphalan, 1168t-1176t in, 1848
imaging of, 521-523, 522f conflicts of interest in, 8-9, 8t Memantine, in Alzheimers disease, 2279 papilledema in, 2358
masses of, 611-612 cultural context of, 15-17 Membrane attack complex, 242-243, e49-1f, vs. parameningeal infection, 2360
clinical manifestations of, 611, 612f errors in. See Error(s) e49-1t pathobiology of, 2356-2357
diagnosis of, 611-612, 612t ethics in, 4-9, 5t-7t Membranoproliferative glomerulonephritis, pathogenesis of, 2357
pathobiology of, 611 historical perspective on, 2 765, 765f pathology of, 2356-2357
treatment of, 612b patient approach in, 2-3 Membranous nephropathy, 764, 765f patient history in, 2357
teratoma of, 522f professionalism in, 3-4, 3t Memory, 2270, 2270t physical findings in, 2357-2358, 2357t
Medical consultation, 2474-2477 socioeconomic issues in, 17-20, 37 declarative, 2270, 2270t pneumococcal, 2356, 2361, 2362t
comanagement and, 2476 team approach to, 3 drug addiction and, 142 polymerase chain reaction in, 2359
consultant responsibilities in, 2476 Meditation, 179-180 hippocampus in, 2270, 2271f postoperative, 2358

Meningitis (Continued)
prevention of, 2365-2366
prognosis for, 2365
prolonged fever with, 2360
Pseudomonas aeruginosa in, 1879-1881,
2364
rash in, 2358
recurrent, 2360-2361
vs. Rocky Mountain spotted fever, 2360
shock in, 2360
staphylococcal, 1818, 2356, 2363
Stenotrophomonas maltophilia in, 1883
streptococcal, 2356
vs. subarachnoid hemorrhage, 2360
syphilitic, e327-3, e327-5-e327-6
treatment of, 2361b-2365b, 2362t-
2363t
ventriculitis in, 2356-2357
vs. viral meningitis, 2367, 2367t
cancer-related, 2369
Candida, 1988-1990
chemical, 2320-2321, 2369
vs. bacterial meningitis, 2360
chronic, 2370
chronic, 2368-2369, 2369t
infectious, 2369
intermittent, 2370
noninfectious, 2369-2370, 2370t
persistent with neutrophil
predominance, 2370, 2370t
cryptococcal, 1975, 1984-1985
eosinophilic, 2368-2369, 2369t, 2371
fungal, 2368t
CSF examination in, 2231t, 2359t
differential diagnosis of, 2367t
Lyme disease, 1932, 2359t, 2369
Mollarets, 2370
in Mycoplasma pneumoniae infection, 1915
noninfectious, 2368t, 2369-2370, 2370t
protozoal, 2367t-2368t
sarcoid, 2369-2370
syphilitic, 2369
tuberculous, 1943, 2231t, 2355-2356,
2359t, 2369
viral, 2365, 2366t, 2368t
arbovirus, 2366
vs. bacterial meningitis, 2367, 2367t
CSF examination in, 2231t, 2359t, 2367
culture in, 2367
definition of, 2365
diagnosis of, 2367-2371
differential diagnosis of, 2367
echovirus, 2142
enterovirus, 2142, 2365-2366
epidemiology of, 2365
group B coxsackievirus, 2142
herpes simplex virus, 2365-2367, 2368b
HIV, 2367
lymphocytic choriomeningitis virus,
2366-2367
mumps, 2110, 2366-2367
pathobiology of, 2366
polymerase chain reaction in, 2367
prognosis for, 2368
treatment of, 2368b
in Wegeners granulomatosis, 2369-2370
Meningococcal infection. See Neisseria
meningitidis infection
Meningococcal vaccine, 54t, 65f-66f, 67t-70t,
71-72, 1855
Meningococcemia, 1853. See also Neisseria
meningitidis infection
cutaneous lesions in, 1853, 1853f, 2545,
2546f
vs. viral hemorrhagic fever, 2153t
Meningoencephalitis, 2376
anthrax, 1838
Bartonella, 1909t
in compromised host, 1780
cryptococcal, 1984
in Mycoplasma pneumoniae infection, 1915
syphilitic, e327-4
Menopause, 105, 107, 1565-1571
biology of, 1565
bone loss and, 1579, 1579f. See also
Osteoporosis
definition of, 1565, 1566f
Menopause (Continued)
epidemiology of, 1565
sleep disturbance in, 1571
vaginal dryness in, 1568-1571, 1568t
vasomotor symptoms in, 1565-1571,
1566f, 1567t, 1569t-1570t
Menstrual cycle, 1442, e244-1
follicular phase of, e244-1, e244-2f
luteal phase of, e244-1-e244-2, e244-2f
ovulatory phase of, e244-1-e244-2, e244-2f
Menstruation
absence of, e244-3f, e244-6, e244-7t
painful, e244-4-e244-5, e244-5t
Mental capacity, for informed consent, 5
Mental status. See also Cognition
changes in. See also Coma; Delirium;
Dementia
in myocardial infarction, 98
in older patient, 117-121
postoperative, 2489
Mental status examination
in aging-related neuropsychiatric disorders,
114-116, 114t
in dementia, 2275
in executive cognitive dysfunction, 2274
Menthol, topical, 2502t, 2512-2513
Meperidine, 137t
Mepolizumab
in asthma, 535
in hypereosinophilia, 1120-1121
6-Mercaptopurine, 161-162, 187t,
1168t-1176t
in inflammatory bowel disease, 917, 917t
Mercury, blood, 90
Mercury poisoning, 89-95, 677t, 679t-683t
clinical manifestations of, 90
definition of, 89
diagnosis of, 90
epidemiology of, 89
pathobiology of, 89-90
treatment of, 90t, 91b
Merkel cell, 2500
Merkel cell carcinoma, 2538, 2538f
Meropenem, 1809t-1811t
Mesalamine, in inflammatory bowel disease,
917t
Mescaline abuse, 158
Mesenteric artery, ischemia of, 928
clinical manifestations of, 929
diagnosis of, 929-937, 930f
diarrhea with, 911
embolic, 929, 931t
epidemiology of, 928, 928t
nonocclusive, 931f, 932
pathobiology of, 929
prognosis for, 929
thrombotic, 931
treatment of, 930f, 931b
ulcers with, 889
Mesenteric vein, thrombus of, 929, 931f, 932,
932t
Mesentery
cysts of, 927
inflammation of, 927
Mesial temporal lobe epilepsy, 2291
Mesna, 1168t-1176t
Mesocardia, 408
Mesothelioma, 572, 610-611, 1272
clinical manifestations of, 611
diagnosis of, 611
epidemiology of, 610-611
occupation-related, 77
pathobiology of, 610-611
treatment of, 611b
MET gene, 1304
Metabolic equivalent (MET), 1412
Metabolic profiling, 202
Metabolic rate, in burn injury, 693
Metabolic syndrome, 376, 1381
antipsychotic-induced, 2492-2493
in HIV-infected patient, 2197, 2197t
pulmonary function tests in, e85-4t
Metabolism
cardiovascular, e52-3-e52-5
inborn errors of. See Inborn errors of
metabolism
Metabolomics, 202
Metachromatic leukodystrophy, 1360, 2355
Metal(s)
exposure to, 77, 78t, 88-95. See also specific
metals
trace, e225-1. See also specific trace elements
Metal fume fever, 574t
Metal workers lung, 570-571, 571t
Metamorphopsia, 2429
Metamyelocyte, 1111, 1112f
Metapneumovirus, in common cold, 2089,
2089t. See also Common cold
Metastases. See Cancer, metastatic
Metavinculin, 320t
Metered-dose inhaler, in asthma, 534, 534f
Metformin, e237-7t, e237-8
Methadone, 137t, 156. See also Opioid(s)
Methamphetamine abuse, 156-157
Methanol
central nervous system effects of, 672t
intoxication with, 674t-677t, 679t-684t
ketoacidosis with, 748
Methemoglobin, 677t, 1032
Methemoglobinemia, 253, 679t-683t, 1032
Methicillin-resistant Staphylococcus aureus
(MRSA) infection, 1815, 1815t
HIV infection and, 2210
prevention of, 1819-1820
Methimazole, in thyrotoxicosis, e233-8
Methionine, malabsorption of, 1341t
Methionine synthase, 1075
Methotrexate, 165, 1168t-1176t
in Behets syndrome, 1723
hepatotoxicity of, 981t
in inflammatory bowel disease, 917, 917t
perioperative, 1758, 2478t
in rheumatoid arthritis, 1688, 1688t
in spondyloarthropathies, 1691
in systemic lupus erythematosus, 1704
in systemic sclerosis, 1711
toxic ingestion of, 679t-683t
Methylacyl CoA racemase deficiency, 1344t
Methylcellulose, in diarrhea, 912-913
Methylcrotonic aciduria, 1343t
Methyldopa
in hypertension, 382t
in menopausal hot flushes, 1569t-1570t
Methylene blue, 679t-683t, 1032
3,4-Methylenedioxymethamphetamine
(MDMA), 158, 2484
Methylenetetrahydrofolate reductase
deficiency, 1362, 1362t
Methylmalonic acid, serum, 1081
Methylmalonic aciduria, 1343t
Methylmalonyl-coenzyme A (CoA) mutase,
1075
Methylnaltrexone, in opiate-induced
constipation, 867b
Methylprednisolone, 161t. See also
Corticosteroid(s)
in inflammatory bowel disease, 917t
Metoclopramide
in motility disorders, 865b-866b
in nausea and vomiting, 843t-844t
Metolazone
in hypertension, 382t
in hypervolemia, 727, 727t
Metoprolol
in heart failure, 310t
in hypertension, 382t
in hypertensive emergency, 388t
in stable myocardial ischemia, 423t
Metronidazole, 1807t, 1809t-1811t,
2010-2011
adverse effects of, 1814t
in amebiasis, 991b, 2046t
in giardiasis, 2042b
in trichomoniasis, e361-3b
Metyrapone test, 1434t, 1440
Mevalonic aciduria, 1343t
MI. See Myocardial infarction (MI)
Micafungin, 1976
Micelles, impaired formation of, 904
Micro-RNA, 188
Microalbuminuria, 709
in chronic kidney disease, 815
Microangiopathy, thrombotic, 770
Microbiome, 200
INDEX e53
Microcyte, 1024f
Microdeletion syndromes, 191-192
Microduplication syndromes, 191-192
Micronutrients, e225-1-e225-10. See also
specific minerals and vitamins
drug-mediated effects on, e225-8, e225-8t
inborn errors of metabolism and, e225-8
in infants, e225-1
malabsorption of, e225-7-e225-8. See also
Malabsorption
in older adults, e225-2-e225-7
optimal intake of, e225-1, e225-8
in parenteral nutrition, 1396
in pregnancy, e225-1
recommended dietary allowances for,
e225-1, e225-2t-e225-7t
requirements for, e225-1, e225-2t
toxin effects on, e225-8
Micropenis, 1512t, 1516
Microscopic polyangiitis, 1725
Microsomal transfer protein, 1348
Microvascular angina, 424
Microwave radiation exposure, 82
Micturition, 776, 776f
urethral obstruction and, 777-778
Midazolam, for anesthesia, 2485
Miglitol, e237-7t, e237-8-e237-9
Migraine, 2247-2252
atypical, 1625
clinical manifestations of, 2248
definition of, 2247
diagnosis of, 2248
epidemiology of, 2247
flashing lights with, 2429
vs. ischemic stroke, 2315
pathobiology of, 2247
prevention of, 2248, 2248t
prognosis for, 2248
vs. seizure, 2289
treatment of, 2247t, 2248b
vertigo in, 2466
Mild cognitive impairment, 2276-2277,
2276t
Miliaria rubra, 667
Milk, malabsorption of, 905
Milk-alkali syndrome, 1593-1594
Miller-Fisher syndrome, 2401, 2421
Millipede bite, 2077t, 2079
Milrinone, in shock, 649t
Miltefosine, in visceral leishmaniasis,
2012-2013, 2027-2028
Milwaukee shoulder, 1742
Mind-body distinction, 179-180
Mindfulness practice, 180
Mineral(s)
dietary, e225-1. See also specific dietary
minerals
dust-related, 78, 78t
Mineral oil, pulmonary inflammation with,
580
Mineralocorticoids
deficiency of, 1469
excess of, 801t, 1466, 1466t
hypertension with, 378t, 379-380, 380f
function of, 1463
Mini-Cog Test, 115, 115t, 119
Mini-Mental State Examination, 102, 115
Minimal change disease, 763, 763f
Minimal inhibitory concentration (MIC),
1804, 1805f
Minimally conscious state, 2295t, 2298,
2298t
Minocycline, 1809t-1811t
in rheumatoid arthritis, 1689
Minoxidil, 2514
in hypertension, 382t
Miosis, in acute poisoning, 671, 671f
Mirtazapine
in depression, 2239t
in pruritus, 2502t
Missing-self hypothesis, 215
Mistakes. See Error(s)
Mites, 2077-2078, 2077t, 2078f
oil mount for, 2508-2509, 2509f
Mitochondrial disorders, 192, 1343, 1343t
Mitochondrial DNA depletion syndrome,
2416
e54 INDEX
Mitochondrial encephalomyopathy with
lactic acidosis and strokelike episodes,
2416
Mitochondrial myopathy, 2413t, 2415-2416
Mitomycin, 1168t-1176t
renal toxicity of, 770
Mitoxantrone, 1168t-1176t
in multiple sclerosis, 2353
Mitral regurgitation, 454t, 458-460
cardiogenic shock with, 657
clinical manifestations of, 459
diagnosis of, 459, 459f
echocardiography in, 281, 282t-284t
epidemiology of, 458
grading of, 292
in heart failure, 316
hemodynamics of, 292, 292f
murmur in, 253t
pathobiology of, 458-459, 458f
post-infarction, 445-446
treatment of, 459b-460b, 460f
Mitral stenosis, 454t, 457
cardiac catheterization in, 457
clinical manifestations of, 457
diagnosis of, 457, 457f
echocardiography in, 281, 282t-284t, 454t,
457, 457f
epidemiology of, 457
hemodynamics of, 292, 292f
murmur in, 253t
pathobiology of, 457
physical examination in, 457
radiology of, 270f
treatment of, 458b
Mitral valve, e52-3
calcification of, 267
disease of. See Mitral regurgitation; Mitral
stenosis; Mitral valve prolapse
radiology of, 267, 267f
repair of, 460, 460f
replacement of, 460
Mitral valve area, 292
Mitral valve prolapse, 460
definition of, 460
diagnosis of, 460-461
infective endocarditis and, 464, 464t
murmur in, 253t
noninvasive evaluation of, 461
patient history in, 460
physical examination in, 460-461
prognosis for, 461
treatment of, 461b
Mixed connective tissue disease, 1705
antinuclear antibodies in, 1654t
pulmonary abnormalities in, 564
Mixed essential cryoglobulinemia, 228t,
229-230
Mixed gonadal dysgenesis, 1516, 1534
Mixed-meal test, 1503
Mixed sclerosing bone dystrophy, 1609
MLL gene, 1200
Moexipril, in hypertension, 382t
Moisturizer, 2513
Molar tooth sign, 2387
Mold exposures, 78, 78t
Mollarets meningitis, 2370
Mollusc envenomation, 698-699, 698t
Molluscum contagiosum, 2117-2121, 2117t,
2537, 2537f
clinical manifestations of, 2120, 2523
diagnosis of, 2120
epidemiology of, 2118
HIV infection and, 2209
treatment of, 2121
Molybdenum, e225-6t-e225-7t
deficiency of, e225-6t-e225-7t
Monday morning fever, 578
Monilethrix, 2553
Monkeypox, 1966t, 2117-2121
clinical manifestations of, 2119, 2119f
diagnosis of, 2120
epidemiology of, 2117
prognosis for, 2121
treatment of, 2121
Monoamine oxidase inhibitors
central nervous system effects of, 672t
in depression, 2239t
Monoamine oxidase inhibitors (Continued)
in Parkinsons disease, 2330t-2332t
preoperative assessment of, 2484
in smoking cessation, 144t
Monoclonal antibodies, 165
in acute coronary syndrome, 430t
in ankylosing spondylitis, 165-166
anti-C5, 243-244
anti-epidermal growth factor receptor, 167
anti-factor B, 244
anti-interleukin, 166
anti-tumor necrosis factor-, 165-166
antiangiogenesis, 166-167
antilymphocyte, 167-168
in asthma, 531, 535
in autoimmune hemolytic anemia, 1049
in bone metastasis, 1189b
in breast cancer, 201-202, 202t, 1312
in cancer, 1166-1167, 1166t
in chronic lymphocytic leukemia, 1217
in colorectal cancer, 202t
in hairy cell leukemia, 1214b
in hypereosinophilia, 1120-1121
hypomagnesemia with, 754
in inflammatory bowel disease, 917t, 918
in kidney transplantation, 825
in multiple sclerosis, 2353
perioperative, 1758
in psoriasis, 2518b, 2518t
in refractory idiopathic thrombocytopenic
purpura, 1129t
in respiratory syncytial virus infection,
2092b
in rheumatoid arthritis, 1688t, 1689
in skin diseases, 2513
in spondyloarthropathies, 1691-1692
in systemic lupus erythematosus, 1704
Monoclonal gammopathy, 2401t, 2403-2405
Monoclonal gammopathy of undetermined
significance, 1234-1235
clinical manifestations of, 1235
definition of, 1234-1235, 1236t
diagnosis of, 1235
disease associations in, 1235-1236
epidemiology of, 1235, 1235f
light chain, 1236
pathobiology of, 1235
prognosis for, 1236
progression of, 1237t
Monoclonal (M) proteins, 1234, 1234f, 2403
Monocyte(s), 216
corticosteroid effects on, 160
production of, e159-2f
Monocyte colony-stimulating factor
(M-CSF), e159-2
Monocytopenia, 1106
Monocytosis, 1100, 1101t
Monogamy, in sexually transmitted disease
prevention, 1799
Mononeuritis multiplex, 2404-2405,
2405t
Monosodium urate monohydrate deposition.
See Gout
Monosomy 7 syndrome, 1200
Montelukast, in allergic rhinitis, 1626
Mood disorders, 2236t-2237t, 2237
assessment for, 102, 104t
drug abuse and, 154
opioid abuse and, 156
Mood stabilizers
in bipolar disorder, 2238b
neutropenia with, 2494
weight gain with, 1413t
Moorens ulcer, 2440
Moraxella catarrhalis infection, 1863
clinical manifestations of, 1863-1864,
1863t
definition of, 1863
pathobiology of, 1863
treatment of, 1864b
Morning stiffness, 1649, 1686
Morphea, 2508, 2508f, 2542-2543, 2543f
Morphine, 137-138, 137t, 674t-676t. See also
Opioid(s)
Morquios syndrome, 1360, 1662-1667,
1662t
Morrisons pouch, fluid collection in, 690f
Mortality
in aging population, 98, 100t
in cardiovascular disease, 256, 256f
nutrition and, 1380-1382, 1381t
Morvans syndrome, 2393t
Mosaicism, 190, 192
Mosquito bite, 2076t, 2080-2081
in Chikungunya fever transmission, 2159
in dengue, 2157
in malaria, 2014, 2014f
in onyong-nyong fever transmission,
2159-2160
protection against, 1801
in Rift Valley fever transmission, 2158
in Ross River fever virus transmission,
2160
in viral encephalitis transmission, 2162t
in viral hemorrhagic fever transmission,
2150
in West Nile fever transmission,
2157-2158
Mosquito repellent, 1801
Moths, 2081
Motion sickness, 841-842, 843t-844t, 2465
Motivational interventions
in drug abuse, 154
interviewing for, 51-52, 52t
in smoking cessation, 143, 144t
Motor neuron disease. See also Amyotrophic
lateral sclerosis (ALS)
definition of, 2343, 2343t
in frontotemporal dementia, 2282
lower, 2258, 2343, 2343t
paraneoplastic, 1193t
upper, 2258, 2343, 2343t
Mounier-Kuhn syndrome, 548
Mountain fever, 2156-2161
Mountain sickness, 575-581, 575t
Mouth. See also Gingiva; Tooth (teeth)
aging-related changes in, 106
angular cheilitis of, 2452
blue lesions of, 2450t
cancer of, 1257-1264, 1260t-1261t
candidiasis of, 1987, 1987f, 2451-2452,
2452f
connective tissue hyperplasias of, 2452,
2453f, 2453t
dry, 2454, 2454t. See also Sjgrens
syndrome
differential diagnosis of, 1713, 1713t
epithelial tumors of, 2452-2453, 2453f,
2453t
examination of, 24
in megaloblastic anemia, 1080
in nutritional assessment, 1386t
geographic tongue of, 2451, 2451f
hairy leukoplakia of, 2451, 2451f
lichen planus of, 2451, 2451f
mucoceles of, 2453
mucocutaneous diseases of, 2452
papilloma of, 2452-2453, 2453f
pigmentation of, 2452, 2452t
reactive hyperplasia of, 2452, 2453t
red lesions of, 2450t, 2451
squamous cell carcinoma of, 2450, 2450f
syphilis of, 2451
ulcers of
acute, 2449, 2449t, 2450f
chronic, 2450
white lesions of, 2450-2451, 2450t
Movement(s)
disorders of, 2333-2342
hyperkinetic, 2333-2342, 2334t. See
also specific disorders
hypokinetic, 2333. See also Parkinsons
disease
spontaneous, 2230
Moxifloxacin, 1809t-1811t
Moyamoya disease, 2318
MPL gene, 1091, 1091t
MTHFR gene, 1151
Mucin cyst, 2537-2538
Muckle-Wells disease, 231, 1668t, 1670t
Mucocele
nasal, 2457
oral, 2453
Mucociliary escalator, 588
Mucolipidoses, 1357t, 1662-1667, 1662t
Mucopolysaccharidoses, 1344, 1357t, 1360,
1662-1667, 1662t
clinical manifestations of, 1663
definition of, 1662
diagnosis of, 1663
epidemiology of, 1662
pathobiology of, 1662-1663
pathology of, 1663
treatment of, 1663b
Mucormycosis, 1994-1997
cerebral, 1996
clinical manifestations of, 1995-1997
culture in, 1997
cutaneous, 1995-1996
definition of, 1994
diagnosis of, 1996
disseminated, 1996
epidemiology of, 1994-1995
gastrointestinal, 1996
histopathology of, 1996
pathobiology of, 1995
pulmonary, 1995, 1996f
renal, 1996
rhinocerebral, 1995
risk factors for, 1994-1995
soft tissue, 1995-1996
treatment of, 1997b
Mucosa-associated lymphoid tissue (MALT),
220-221
Mucosa-associated lymphoid tissue (MALT)
lymphoma, 1219t, 1222t, 1224, 1277
ulcers with, 887
Mucositis, fever and, 1775-1776
Mucous membrane pemphigoid, 884,
2526-2532
Mucus, cervical, e244-1
Mucus retention cyst, 2453, 2457
Muehrckes lines, 2554-2555, 2555f
Muir-Torre syndrome, 1282
Mllerian ducts, persistent, 1516
Multicentric Castlemans disease, 2216
Multicentric reticulohistiocytosis, 1751
Multidetector computed tomography
(MDCT), 286-287
Multifocal fibrosclerosis. See Idiopathic
multifocal fibrosclerosis
Multifocal leukoencephalopathy. See
Progressive multifocal
leukoencephalopathy
Multifocal motor neuropathy, 2401t,
2403-2405
Multiminicore disease, 2484
Multinational Association of Supportive Care
in Cancer (MASCC) score, 1776, 1776t
Multiple endocrine neoplasia type 1 (MEN
1), 185t, 1505-1509
definition of, 1505
diagnosis of, 1506-1507
gastrinoma in, 1293, 1506
hyperparathyroidism in, 1506-1507, 1595
insulinoma in, 1506
pancreatic disease in, 1506
pathogenesis of, 1506
pituitary disease in, 1433, 1506
prognosis for, 1506
screening for, 1506-1507
Multiple endocrine neoplasia type 2A (MEN
2A), 1506-1507
cancer in, 1601t
cutaneous lichen amyloidosis in, 1602
definition of, 1506-1507
diagnosis of, 1507-1509
Hirschsprungs disease in, 1602
medullary thyroid cancer in, 1506-1507,
1601
parathyroid disease in, 1595, 1602
pathogenesis of, 1507
pheochromocytoma in, 1470-1471,
1506-1507, 1602
prophylactic thyroidectomy in, 1602-1603
Multiple endocrine neoplasia type 2B
(MEN 2B), 1506-1507
cancer in, 1194t, 1601t
definition of, 1506-1507
diagnosis of, 1507-1509
medullary thyroid cancer in, 1601-1602

Multiple endocrine neoplasia type 2B
(MEN 2B) (Continued)
pathogenesis of, 1507
pheochromocytoma in, 1470-1471
prognosis for, 1507
prophylactic thyroidectomy in, 1602-1603
screening for, 1507
Multiple myeloma, 1236-1237
bone involvement in, 1237-1238, 1238f,
1240
clinical manifestations of, 1237, 1237t
complications of, 1240
cytogenetic abnormalities in, 1237
definition of, 1236, 1236t
diagnosis of, 1237-1243
epidemiology of, 1237
hepatic involvement in, 1238
hypercalcemia in, 1238, 1240
imaging in, 1238, 1238f
infection in, 1238, 1240
laboratory findings in, 1237-1238, 1238f
neurologic involvement in, 1238, 2403
nonsecretory, 1241
ocular, 2442
osteoporosis and, 1581
pathobiology of, 1237
patient history in, 1237
physical examination in, 1237
prognosis for, 1240, 1240t
relapsed, 1240
renal involvement in, 774-775, 1238, 1240
smoldering (asymptomatic), 1236t, 1241
staging of, 1240t
treatment of, 1160, 1238b-1240b, 1239f
Multiple sclerosis, 228t, 2347-2355
acute progressive, 2350
C. pneumoniae infection and, e326-6
clinical manifestations of, 2348-2355
CSF examination in, 2231, 2351
cytokines in, 2348
definition of, 2347
diagnosis of, 2350, 2350t
differential diagnosis of, 2348t, 2352
dysphagia in, 2471
epidemiology of, 2347
evoked potential testing in, 2234, 2234f,
2351-2352
fatigue in, 2349
genetics of, 2347-2348
heat sensitivity in, 2349
HLA associations in, 225t
magnetic resonance imaging in,
2350-2351, 2351f-2352f
motor abnormalities in, 2349
optical coherence tomography in, 2352,
2352f
opticospinal, 2354
organ dysfunction in, 2349
pathobiology of, 2347-2348
pathogenesis of, 2348
pathology of, 2348
pattern reversal visual evoked responses in,
2234, 2234f
plaques in, 2348, 2350-2351, 2351f
pregnancy and, 2350
primary progressive, 2350
prognosis for, 2354
progressive relapsing, 2350
relapsing remitting, 2350
secondary progressive, 2350
sensory abnormalities in, 2349
sexual dysfunction in, 2349
somatosensory evoked responses in, 2235
treatment of, 2352b-2354b
visual abnormalities in, 2349
Multiple sleep latency test, 2300
Multiple system atrophy, 2329t, 2392
Multiplex ligation-dependent probe
amplification, 192
Multivitamins. See also individual vitamins
diarrhea with, 908
Mumps, 1524, 2109-2111, e244-9
clinical manifestations of, 2110-2111,
2110f
definition of, 2109-2111
diagnosis of, 2110
differential diagnosis of, 2110
Mumps (Continued)
encephalitic, 2110
epidemiology of, 2109
immunization against, 65f-66f, 67t-70t,
72-73, 2110-2111
meningeal, 2110, 2366-2367
orchitis in, 2110
parotitis in, 2110, 2110f
pathobiology of, 2109-2110
in pregnancy, 2110
prevention of, 2110-2111
treatment of, 2110b
Munchausens syndrome, 2244
Mupirocin, in Staphylococcus aureus infection
prevention, 1820
Murine typhus, 1956t, 1959-1962
Murphys sign, 837t, 955
Murray Valley encephalitis, 2167
Muscle(s)
aging-related changes in, 107
biopsy of, 2412
contracture of, 2230
cramps in, 2230, 2410
disease of. See Myopathy
disintegration of. See Rhabdomyolysis
electric injury to, 685, 685f
energy requirement of, 1412
examination of, 2410, 2411t
function of, 2409
pain in, 2230, 2409
post-polio atrophy of, 2380
stiffness of, 2410
structure of, 2409, 2410f
tetany of, 2230
undernutrition effects on, 1389
weakness of. See Weakness
Muscular dystrophy, 2412, 2412t
congenital, 2414
stem cell therapy in, 207
Musculoskeletal system. See Connective
tissue; Joint(s); Muscle(s); Spine
Mushroom ingestion, 679t-683t
Mushroom workers lung, 570-571, 571t
Mutation(s), 190-192, 191f, 1340. See also
Genetic disorders and specific genes and
genetic disorders
autosomal dominant, 192
autosomal recessive, 192
cancer-related, 199, 200t, 1184
cardiovascular diseaserelated, 200t
copy-number variation and, 191-192
dynamic, 191
microdeletion and, 191-192
microduplication, 191-192
nonsynonymous, 191
rate of, 196
single nucleotide, 191
transition, 191
X-linked, 192
MUTYH-associated polyposis, 1281t, 1282
MVK gene, 1671
Myasthenia gravis, 228t, 229, 2418
clinical manifestations of, 2420, 2420f
diagnosis of, 2420-2421, 2421t
differential diagnosis of, 2421
epidemiology of, 2418
generalized
with acetylcholine receptor antibodies,
2420
with muscle-specific kinase antibodies,
2420
treatment of, 2421-2422
HLA associations in, 225t
neonatal, 2418, 2419t, 2421, 2421t
ocular, 2420-2421
ophthalmoparesis in, 2448
pathobiology of, 2418-2423, 2419f, 2419t
prognosis for, 2422
repetitive stimulation study in, 2233
thymoma in, 2420-2421
treatment of, 2421b-2422b
Myasthenic syndromes, congenital, 2419t,
2421, 2421t, 2423
Mycetoma, 2005-2007, 2457
clinical manifestations of, 2005-2006,
2006f
definition of, 2005-2007
Mycetoma (Continued)
diagnosis of, 2006
differential diagnosis of, 2006-2007
epidemiology of, 2005, 2006f
natural history of, 2005-2006
pathogenesis of, 2005
prevention of, 2007
prognosis for, 2007
treatment of, 2007b
Mycobacterium leprae, 1950-1951. See also
Leprosy
Mycobacterium marinum infection, 2546
Mycobacterium spp. infection,
nontuberculous, 1948-1950
clinical manifestations of, 1948-1950
cutaneous, 1949, 2546
definition of, 1948-1950, 1948t
diagnosis of, 1949-1950, 1950f
disseminated, 1948-1949
epidemiology of, 1948
HIV infection and, 2191t-2193t, 2194,
2222t, 2223, 2223f
lymphatic, 1949
pathobiology of, 1948, 1949f
prevention of, 1950
prognosis for, 1950
pulmonary, 1949, 1950f
rapidly growing, 1948, 1948t
slowly growing, 1948, 1948t
soft tissue, 1949
treatment of, 1950b
Mycobacterium tuberculosis, 1939-1941,
1940f. See also Tuberculosis
Mycophenolate mofetil, 159t, 162-163
adverse effects of, 162t
infection and, 162-163
in kidney transplantation, 824f, 825,
825t
in lupus nephritis, 769-770
in minimal change disease, 763b
in systemic lupus erythematosus, 1704
in systemic sclerosis, 1711
Mycoplasma infection, 1912-1916
arthritis in, 1734
cardiac complications of, 1915
clinical manifestations of, 1913
definition of, 1912-1916
dermatologic complications of, 1914-1915,
1914f
diagnosis of, 1915-1916
epidemiology of, 1912, 1912t
extrapulmonary, 1914
hematopoietic complications of, 1915
musculoskeletal complications of, 1734,
1915
neurologic complications of, 1915
pathobiology of, 1912-1913, 1913f
prevention of, 1916
renal complications of, 1915
respiratory, 1913-1914, 1914f
secondary prevention of, 1916
susceptibility to, 1915
treatment of, 1916b
Mycoplasma pneumoniae infection,
1912-1916, 1912t, 1913f-1914f
Mycosis fungoides, 1226, 2520-2521, 2521f,
2539-2540
Myelin, disorders of, 2347-2355, 2347t. See
also Multiple sclerosis
Myelitis
cytomegalovirus, 2111
transverse, 2349, 2354
Myeloblast, 1111, 1112f
Myeloblastoma, 1205
Myelocyte, 1111, 1112f, e61-1f
Myelodysplastic syndrome, 1200-1203
classification of, 1202, 1202t
clinical manifestations of, 1201
cytogenetic abnormalities in, 1200
definition of, 1200
diagnosis of, 1201, 1201f
differential diagnosis of, 1201-1202, 1201t
epidemiology of, 1200
epigenetics of, 1200-1201
pathobiology of, 1200-1203
point mutations in, 1201
prognosis for, 1202t, 1203
INDEX e55
Myelodysplastic syndrome (Continued)
therapy-related, 1200
treatment of, 1160-1161, 1202b
Myelofibrosis, 1095, 1095t
primary, 1090-1098
clinical manifestations of, 1092
definition of, 1090-1091
diagnosis of, 1092, 1093f-1094f, 1093t
epidemiology of, 1091
pathobiology of, 1091-1097, 1091t
prognosis for, 1097
treatment of, 1096-1097, 1096t
Myelography, 2235t
Myelokathexis, 1102t, 1103
Myelopathy, 2262t, 2265-2267, 2266t
acute, 2267
anterior cord syndrome in, 2266
Brown-Squard syndrome in, 2266
central cord syndrome in, 2266
chronic, 2267
clinical manifestations of, 2266-2267
in connective tissue disease, 2268
conus medullaris syndrome and, 2267
definition of, 2265
diagnosis of, 2267
differential diagnosis of, 2267, 2269
embolic, 2268
epidemiology of, 2265-2266, 2266t
HIV-associated, 2220-2221, 2221t
imaging in, 2267
infectious, 2267
inflammatory, 2267-2268
ischemic, 2268
metabolic, 2268
neoplastic, 1193t, 2269
posterior cord syndrome in, 2266
spondylotic, 2268
subacute, 2267
treatment of, 2267b
vascular, 2267-2268, 2268f
Myelopathy/tropical spastic paraparesis,
2139-2140
clinical manifestations of, 2139, 2268
diagnosis of, 2139
epidemiology of, 2139
pathobiology of, 2139
pathogenesis of, 2137
prognosis for, 2139
treatment of, 2139b
Myeloperoxidase deficiency, 1116t-1117t,
1117
Myeloproliferative disorders, 1090-1091,
1090t, 1093f. See also Myelofibrosis;
Polycythemia vera; Thrombocythemia,
essential
thrombosis in, 1152
transient, in Down syndrome, 1100
MYH gene, 1282
MYH9 gene, 787
Myiasis, 2081
Myocardial infarction (MI), 434-448. See
also Cardiovascular disease
alveolar pulmonary edema after, 270f
calcification in, 267-268, 268f
cardiogenic shock in, 654-658, 654f, 654t,
656f
diagnosis of, 246, 248f
echocardiography in, 282t-284t
epidemiology of, 412
hematopoietic stem cell transplantation
after, 1161
hospitalization rates for, 256
idioventricular rhythms in, 364
mortality from, 412
mural thrombi with, 2311
non-ST segment elevation, 425, 426f
angiography in, 428
atypical presentation of, 426
biomarkers in, 427
clinical manifestation of, 426-433
diagnosis of, 426-427, 427t
differential diagnosis of, 428-429
electrocardiography in, 427
epidemiology of, 425
noninvasive testing in, 427
pathobiology of, 425-433
physical examination in, 426
e56 INDEX
Myocardial infarction (MI) (Continued)
plaque rupture in, 425-426
risk assessment in, 428, 428t
symptoms of, 426
thrombus formation in, 426
treatment of, 175t-176t, 429b-432b,
430t, 433f
antianginal, 430t, 431
anticoagulants in, 430t, 431-432
antiplatelet agents in, 430t, 431
complications of, 432
integrated approach to, 432
lipid-lowering agents in, 430t, 432
revascularization in, 432
triage in, 428, 429f
in women, 426
oral contraceptives and, 1553
pain in, 246, 247t, 434-435, 474t,
834t-836t. See also Angina pectoris
pathobiology of, 411, 411f, 425-433
pericarditis after, 473, 475t, 480-481
postoperative assessment of, 2488, 2488t
prevention of, 446-448, 447f, 447t
aspirin in, 170, 170t, 174, 175t-176t
in sickle cell disease, 1072
silent, 98, 417, 424
ST segment elevation, 425, 426f, 434-448
atrial fibrillation after, 444
atypical, 435
bradycardia after, 444-445
bundle branch block and, 436-437
cardiac catheterization after, 446
cardiogenic shock with, 439t, 445
chest pain after, 444
chest radiography in, 437
chronic phase, 436
clinical manifestations of, 434-437
complications of, 444-446
conduction delays after, 444-445
definition of, 434
diagnosis of, 435-437
differential diagnosis of, 437, 437t
early acute phase, 435, 436f
echocardiography in, 437
electrocardiography after, 446
electrocardiography in, 435-437
epidemiology of, 434
evolved acute phase, 436
heart block after, 444-445
heart failure after, 445
hemodynamics in, 439t
laboratory tests in, 437
left circumflex pattern in, 436
left ventricular aneurysm after, 445-446
left ventricular dysfunction after, 445
left ventricular free wall rupture after,
445-446
magnetic resonance imaging in, 437
mechanical complications of, 445-446
mitral valve regurgitation after, 445-446
noninvasive stress testing after, 446
pain in, 434-435
painless, 435
pathobiology of, 434, 435t
patient education after, 448
patient history in, 434-435
physical examination in, 435
prevention of, 446-448, 447f, 447t
radionuclide imaging in, 437
recurrent, prevention of, 446-448, 447f,
447t
right ventricular, 436, 439t, 445
risk stratification after, 446
septal rupture after, 445-446
T wave inversion in, 436
thromboembolic complications of, 446
treatment of, 175t-176t, 438b-448b,
438f, 439t-440t
-adrenergic receptor blockers in,
443
antiarrhythmic agents in, 443
antiplatelet therapy in, 442
antithrombin therapy in, 442-443
calcium channel blockers in, 444
coronary artery bypass grafting in,
438f
coronary care unit, 439, 440t
Myocardial infarction (MI) (Continued)
emergency department, 438-439
fibrinolytic therapy in, 439-441,
440t-441t
glucose control in, 444
implantable cardioverter-defibrillator
in, 443, 443f
inotropes in, 443-444
lipid-lowering therapy in, 444
magnesium in, 444
nitrates in, 443
percutaneous coronary intervention
in, 438f, 439, 441, 441t
prehospital, 438
recanalization therapy in, 439
renin-angiotensin-aldosterone system
inhibitors in, 443
step-down unit, 439
troponins in, 437
true posterior, 436, 436f
ventricular arrhythmias after, 444
volume depletion after, 445
ventricular tachycardia and, 363, 366,
366t
Myocardial ischemia. See also Acute coronary
syndrome; Myocardial infarction (MI)
pain with. See Angina pectoris
stable, 412-425
clinical manifestations of, 413-425,
413t-414t
diagnosis of, 414, 415f
electrocardiography in, 414, 415f
heart murmurs in, 414
laboratory testing in, 414, 415t
nonatherosclerotic causes of, 413-414
noninvasive testing in, 414-417,
416f-417f, 416t
pathobiology of, 412-413
physical examination in, 414
prognosis for, 424-425
risk stratification in, 418, 419t
silent, 417, 424
treatment of, 413, 418b-424b, 420f,
421t
angiotensin-converting enzyme
inhibitors in, 419
antiplatelet agents in, 419
beta-blockers in, 419-421, 423t
calcium-channel blockers in,
419-421, 423t
lifestyle interventions in, 422f
lipid-lowering agents in, 419
nitrates in, 419-421, 424t
nitroglycerin in, 419-421, 424t
revascularization in, 421-422, 421t
Myocardial perfusion imaging, 284-286
in angina pectoris, 416t, 417
in coronary artery disease, 285, 285f
radionuclides for, 284-285
Myocarditis, 324
active, 324
antipsychotic-induced, 2493
borderline, 324
cardiogenic shock with, 657
Chagas, e355-2f
clinical manifestations of, 324
definition of, 324
diagnosis of, 324-325
in diphtheria, 1833
drug-related, 325
epidemiology of, 324
giant cell, 325
immune-mediated, 325
in leptospirosis, 1938
lymphocytic, 327
magnetic resonance imaging in, 288,
288f
pathobiology of, 324, 324t
persistent, 324
prognosis for, 325
resolving/resolved, 324
toxoplasmosis, 325
treatment of, 325b
viral, 324-325, 324t
Myocardium. See also Heart
biopsy of, in heart failure, 302
blood flow of, in heart failure, 297
Myocardium (Continued)
contractility of, e52-6. See also Cardiac
cycle
contusion of, 689-690
hibernation of, 655
inflammation of. See Myocarditis
ischemia of. See Myocardial infarction
(MI); Myocardial ischemia
noninflammatory disease of. See
Cardiomyopathy
oxygen requirement of, in heart failure,
297
stunning of, 655
tumors of, 332, 332t
Myoclonic epilepsy with ragged-red fibers,
1343t, 2416
Myoclonus, 2339-2342
classification of, 2339t
clinical manifestations of, 2339
definition of, 2339
diagnosis of, 2339
nocturnal, 2341
ocular, 2448
paraneoplastic, 1193t
pathobiology of, 2339
Myofascial pain, 1746, 1746t
Myofibrillar myopathy, 2414
Myofibroblasts, in systemic sclerosis, 1708
Myoglobin, in rhabdomyolysis, 703
Myoglobinuria, 703, 1046t
Myokymia, in multiple sclerosis, 2349
Myonecrosis, clostridial, e304-3-e304-4
Myopathy, 2409-2417. See also specific
diseases
acquired, 2409t, 2416-2417, 2416t-2417t
clinical manifestations of, 2409-2417
congenital, 2414
critical illness, 2406
definition of, 2409
diagnosis of, 2411, 2411t
biopsy in, 2412
genetic tests in, 2412
imaging in, 2411-2412
laboratory testing in, 2412
neurophysiologic tests in, 2234, 2411
serum enzymes in, 2411
epidemiology of, 2409, 2409t
hereditary, 2409t, 2412, 2412t-2413t
HIV-associated, 2221-2222
inflammatory, 1651, 2416-2417, 2417t.
See also Dermatomyositis;
Polymyositis
definition of, 1716
differential diagnosis of, 1719t
ion-channel, 2412t, 2414
metabolic, 2413t, 2415
mitochondrial, 2413t, 2415-2416
vs. myasthenia gravis, 2421, 2421t
vs. nerve disease, 2411t
pathobiology of, 2409, 2410f
patient history in, 2409-2417
physical examination in, 2410, 2411f,
2411t
in systemic lupus erythematosus, 1699
toxic, 2416, 2416t
Myopericarditis, 481
enteroviral, 2143
in Lyme disease, 1932
Myopia, 2427-2428, 2427f
pathologic, 2428
Myosin, 320t
Myosin binding protein C, 320t
Myositis, 1716. See also Dermatomyositis;
Polymyositis
cancer-associated, 1717t
connective tissue, 1717t
enteroviral, 2144
inclusion body, 1717t, 2417, 2417t,
e277-1f
infection-related, 1771
juvenile, 1717t
pathogenesis of, 1717
in systemic sclerosis, 1710-1711
tropical, 1816
Myotonia, 2410
acetazolamide-responsive, 2412t
potassium-aggravated, 2414-2415
Myotonia congenita, 2414
Myotonia fluctuans, 2412t
Myotonia permanens, 2412t
Myotonic dystrophy, 250, 2410, 2411f, 2414
Myotubular myopathy, 2414
Myozenin 2, 320t
MyPyramid, 1382, 1384f
Myxedema. See also Hypothyroidism
diabetes insipidus and, e232-3-e232-4
Myxedema coma, e233-5
Myxoma, 289, 289f, 333
ischemic stroke and, 2315
N
Nabilone, 843t-844t
Nadolol
in hypertension, 382t
in stable myocardial ischemia, 423t
Naegleria fowleri infection, 2047, 2047t
Nafcillin, 1809t-1811t
Nageottes nodule, 2404
Nail(s), 2500
Beaus lines of, 2554, 2555f, 2555t
clubbing of, 2554, 2554f
detachment of, 2555, 2556f
fungal infection of, 2556
inflammation of, 2555-2556
lichen planus of, 2519
longitudinal grooves/striations of, 2554
melanoma of, 2556, 2556f
melanonychia of, 2556, 2556f
Muehrckes lines of, 2554-2555, 2555f
normal, 2554
in nutritional assessment, 1386t
pigmentary disorders of, 2556
pitting of, 2554, 2555f
in psoriatic arthritis, 1695-1696, 1695f
splinter hemorrhage at, 2555
spoon, 2554, 2554f
whitish discoloration of, 2554-2555, 2555f
yellow, 2555, 2555f
Nail-fold capillaroscopy, 496
Nail-patella syndrome, 769
Nairobi eye, 2080
Nalbuphine, 137-138
Naloxone, in opioid toxicity, 679t-683t
Naltrexone
in alcohol dependence treatment, 152,
152t
in opioid dependence treatment, 156
in pruritus, 2502t
in smoking cessation, 144t
Narcissistic personality disorder, 2245t
Narcolepsy, 2301-2303
NARES (non-allergic rhinitis with
eosinophilia syndrome), 1625
Nasal congestion. See Rhinitis
Naso-oropharynx, e85-1
Nasogastric tube, in gastrointestinal bleeding,
858
Nasolacrimal duct, 2426
Nasopharynx, 2469, 2469f
cancer of, 1257-1258, 2135, 2469
disease of, 2469-2471
Natalizumab, 167
in inflammatory bowel disease, 917t, 918
in multiple sclerosis, 2353
Nateglinide, e237-7t, e237-8
Native American traditional healing, 178-179
Natriuretic peptides, in heart failure, 298,
302
Natural killer cells, 216f, 217
production of, e159-2f
in transplantation, 236-237, e48-1f
Natural selection, 196
Nausea, 831t-832t, 841-842. See also
Vomiting
chemotherapy-related, 1167-1177
in dying patient, 10t
postoperative, 2486-2487
treatment of, 842b, 843t-844t
Near-drowning, 574
Nearsightedness, 2427-2428, 2427f
Nebivolol
in heart failure, 310t
in hypertension, 382t
 INDEX e57
Necator americanus infection, 2009, Neisseria meningitidis infection (Continued) Nephrolithiasis (Continued) Neurofibromatosis
2065-2066, 2065t immunization against, 54t, 65f-66f, hyperoxaluria in, 790 type 1, 1194t, 2389, 2389f, 2389t
Neck. See also Head 67t-70t, 71-72, 1855 in hyperparathyroidism, 1595 cutaneous, 2538, 2538f
abscess of, 2470 for travel, 1801t, 1802 hyperuricosuria in, 790 genetics of, 185t
Actinomyces infection of, 1968, 1968f pathobiology of, 1851-1853, 1852f hypocitraturia in, 790 intersitital lung disease with, 566
cancer of. See Head and neck cancer prevention of, 1854-1855, 1854t pathobiology of, 790-791 ischemic stroke in, 2318
examination of, 24 prognosis for, 1855 pathogenesis of, 790-791 paraganglioma in, 1472
in heart failure, 301 treatment of, 1854b, 2361, 2362t prevention of, 792-793, 793t pheochromocytoma in, 1472
in nutritional assessment, 1386t Nelfinavir, drug interactions with, 1765 dietary, 793-794, 793t type 2, 185t, 2389, 2390t
in trauma, 689 Nelsons syndrome, 1442 medical, 794 Neuroleptic malignant syndrome, 2340,
non-spore-forming anaerobic bacterial Nemaline myopathy, 2414 risk factors for, 789-790 2394, 2494, 2494t
infection of, 1849 Nematodes. See also specific nematode struvite, 790-792 Neurologic disorders, 2228-2235. See also
pain in. See Neck pain infections supersaturation in, 790 specific disorders
rheumatoid arthritis of, 1685, e272-1f intestinal, 2064-2068 systemic diseases and, 790, 790t acute, 2229. See also Coma; Seizure(s);
whiplash injury of, 2262t treatment of, 2009, 2065t treatment of, 780, 791b-792b, 792f Stroke
Neck pain, 2258-2260 tissue, e366-1-e366-8 uric acid, 712f, 790 in acute poisoning, 671-672, 672t
clinical manifestations of, 2260 treatment of, 2009, e366-1t prevention of, 793-794 alcohol-related, 2385-2386
diagnosis of, 2260-2269, 2261f-2262f, NEMO syndrome, 1619 Nephron(s). See also Kidney(s) autonomic, 2391-2396. See also
2261t-2262t Neonatal-onset multisystem inflammatory disorders of. See Nephropathy Autonomic nervous system, disorders
in disc herniation, 2262t disease, 231, 1668t, 1671 function of, 716 of
epidemiology of, 2259 Neonate. See also Infant structure of, 716, 717f in bacterial meningitis, 2358
imaging in, 2261 alloimmune thrombocytopenia in, 1131 Nephronophthisis, 796t, 799-800 C. pneumoniae infection and, e326-6
in myelopathy, 2262t Chlamydia trachomatis infection in, e326-4 Nephropathy. See also at Kidney(s) clinical manifestations of, 2228-2229
NEXUS Low-Risk Criteria in, 2260, cystic fibrosis screening for, 546 analgesic, 774, 774f-775f congenital, 2386-2391
2261f cytomegalovirus infection in, 2132 aristolochic acid, 774 developmental, 2388
in osteoarthritis, 2262t diarrhea in, 909 cadmium, 775 diagnosis of, 2228-2229. See also
pathobiology of, 2260 group A streptococcal infection in, 1828 contrast-induced Neurologic examination
prognosis for, 2263 hepatitis B immune globulin for, 970 cardiac catheterization and, 291 balance in, 2230
red flags in, 2260, 2261t herpes simplex virus infection in, 2128 prevention of, 760 brain stem auditory evoked responses
referred, 2261 isoimmune neutropenia in, 1104 diabetic. See Diabetic nephropathy in, 2234
in strain, 2262t jaundice in, G6PD deficiency and, e164-8 hereditary, 800, 801t chief complaint in, 2228
treatment of, 2262b-2263b lupus in, 1702 collecting duct, 801t-802t, 802 in comatose patient, 2229
Necrolytic migratory erythema, 1196t, 1294, maternal diabetes effects on, 1564, 1564f distal tubule, 801-802, 801t CSF examination in, 2231-2232, 2231t
1295f myasthenia gravis in, 2418, 2419t, 2421, proximal tubule, 800-802, 801t electroencephalography in, 2232-2233,
Necrosis. See also Myonecrosis; 2421t HIV-associated, 713, 770 2233t
Osteonecrosis Pseudomonas aeruginosa infection in, 1880 lead, 775 electromyography in, 2233-2234,
avascular seizures in, 2290, 2290t light chain, in multiple myeloma, 1238 2234t
in HIV infection, 2190 syphilis in, e327-4, e327-6 membranous, 764, 765f electronystagmography in, 2235
after liver transplantation, 1011 tetanus in, e304-5 obstructive, 776. See also Urinary tract, evoked potentials in, 2234-2235
cutaneous, warfarin-induced, 172, 1150, toxoplasmosis in, e357-4f, e357-6 obstruction of F wave in, 2233
1150f unconjugated hyperbilirubinemia in, 959 sickle cell, 788, 1071, 1072t, 1074 fatigue in, 2230
neuronal, 2308 Neoplasm. See Cancer and specific sites and Nephrosclerosis, arteriolar, hypertensive, gait in, 2230, 2230t
renal. See Acute tubular necrosis (ATN) types 787 general examination in, 2229
Necrotizing fasciitis, 1816, 1826, 2545 Neostigmine, in coral snake envenomation, Nephrotic syndrome, 715, 762-770 H reflex in, 2233
Needles 696 biopsy in, 714, 714f imaging in, 2235, 2235t
safety precautions for, 2184 Nephrectomy, 1305, e203-1f clinical manifestations of, 762, 762t muscle pain in, 2230
unsterile, 154 Nephritic syndrome, 715, 766-770 definition of, 762 nerve conduction study in, 2233,
Negri bodies, 2378 Nephritis diagnosis of, 762, 762t-763t 2233t
Neimann-Pick disease type C, 1360 interstitial epidemiology of, 762, 762t neurologic examination in, 2229
Neisseria gonorrhoeae infection, acute, 757, 757t, 760b, 771, 773, 773t, in focal segmental glomerulosclerosis, 764, patient history in, 2228-2229
e307-1-e307-6 774f 764f pattern reversal visual evoked responses
clinical manifestations of, e307-1-e307-2 biopsy in, 773-774, 773t, 774f idiopathic, 762-770, 763f-765f in, 2234, 2234f
corneal, 2435 chronic, 771, 773-774, 774f-775f in light chain deposition disease, 770 repetitive stimulation study in, 2233
culture in, e307-2 drug-related, 771, 771t-772t in membranous nephropathy, 764, 765f sensory symptoms in, 2230-2231
definition of, e307-1-e307-2 granuloma in, 772-773 minimal change, 763, 763f somatosensory evoked responses in,
diagnosis of, e307-2-e307-5, e307-2f obstruction-related, 774 in nail-patella syndrome, 769 2234-2235
disseminated, 2525, 2545, 2546f, lupus, 769-770, 769f, 769t, 1699-1701, pathobiology of, 762 spontaneous movements in, 2230
e307-4-e307-5, e307-4f 1700f, 1700t secondary, 762, 762t weakness in, 2229-2230, 2230t
epidemiology of, e307-1 vs. nephrotic syndrome, 762t in sickle cell disease, 1071 Epstein-Barr virus infection and, 2135
female genital tract, e307-3-e307-5, tubulointerstitial, 771-776 in syphilis, e327-3 in HIV-infected patient, 2218-2222,
e307-5t definition of, 771 treatment of, 763b 2218t, 2407
joint, 1734-1736 epidemiology of, 771-772, 771t-772t Nerve agent poisoning, 679t-683t paraneoplastic, 1192-1200, 1193t
microscopy in, e307-2, e307-2f pathobiology of, 772-776 Nerve block physical abuse and, 2229
nucleic acid amplification test in, vascular injury and, 774 in chronic pancreatitis, 943 preoperative assessment of, 2483
e307-2 Nephrocalcinosis, 774 in pain management, 138-139 substance abuse and, 2229
oral, 2450 in hyperparathyroidism, 1595 Nerve conduction study, 2233, 2233t Neurologic examination, 2229
pathobiology of, e307-1 Nephrogenic fibrosing dermopathy, in chronic inflammatory demyelinating in botulism, e304-4
pediatric, e307-4 2542-2543, 2543f polyradiculoneuropathy, 2402 in cobalamin deficiency, 1080
pelvic inflammatory disease and, Nephrogenic systemic fibrosis, 1712 in myopathy, 2411 in coma, 2229, 2296-2297, 2296t
e307-3-e307-5 gadolinium-associated, 847, 1657 in peripheral neuropathy, 2398 in electric current injury, 685-686
pharyngeal, e307-4-e307-5 upper extremities in, 850f in vasculitic neuropathy, 2405 in endocrine disorders, 1421
prevention of, e307-5 Nephrolithiasis, 789-794 Nerve sheath tumors, 1254 in ischemic stroke, 2313
prognosis for, e307-5 calcium oxalate, 790 Nesiritide, in hypervolemia, 727-728 motor, 2229-2230, 2260t
rectal, e307-3-e307-5 prevention of, 793 Netilmicin, 1809t-1811t in coma, 2296t, 2297
screening for, 54t, 55 chronic, 791 Neural plasticity, in drug addiction, 142 in multiple sclerosis, 2349
treatment of, e307-5b-e307-6b, e307-5t clinical manifestations of, 791 Neural tube defects, diet and, 1381t, 1382 in myelopathy, 2267
urogenital, 1797t, e307-2-e307-5, e307-2f, colic in, 778, 780, 791 Neuralgia in myopathy, 2410
e307-5t cystine, 791, 800-801, 801t glossopharyngeal, 2252 in nutritional assessment, 1386t
Neisseria meningitidis infection, 1851-1855, prevention of, 794 trigeminal, 2251-2252 in peripheral neuropathy, 2397-2398
2356, 2358 definition of, 789, 789f Neuritis in radiculopathy, 2265
carrier state in, 1852-1855, 1854t diagnosis of, 791, 791f-792f, 793, 793t optic, 2354, 2444, 2444t reflexes in, 2229, 2260t
clinical manifestations of, 1853, 1853f, dietary factors in, 789-790, 793-794, 793t vestibular, 2465-2466, 2468t sensory, 2229-2231
2545, 2546f differential diagnosis of, 791 Neurocutaneous disorders, 2389 in multiple sclerosis, 2349
definition of, 1851-1855 epidemiology of, 789-794 Neurocysticercosis, 2009-2010, 2054-2056, in spinal disorders, 2258, 2260t
diagnosis of, 1853-1854 fluid intake and, 790 2055f Neurolysis, in chronic pancreatitis, 943
epidemiology of, 1851, 1852f genetics in, 790 Neuroendocrinology, 1425-1431 Neuroma, acoustic, 1250, 2463
genetic factors in, 1853 hypercalciuria in, 790 Neurofibrillary tangles, 2277 Neuromuscular blockers, 2486
e58 INDEX
Neuromuscular junction disease, 2417-2423
definition of, 2417-2418, 2419t
vs. myopathy, 2411t
Neuromyelitis optica, 2354
Neuromyotonia, 2415, 2422-2423
paraneoplastic, 1193t
Neuron(s)
migration disorders of, 2387
proliferative disorders of, 2386-2387
Neuronal ceroid-lipofuscinoses, 1360
Neuropathy. See Peripheral neuropathy
Neuropeptide Y, 1412t
Neuropsychiatric disorders. See also
Neurologic disorders; Psychiatric
disorders
aging-related, 114-116. See also
Alzheimers disease; Dementia;
Depression
diagnosis of, 114-116, 114t
epidemiology of, 114
functional assessment in, 115
mental status examination in, 114-116
treatment of, 115b-116b
Neuroretinitis, in cat-scratch disease, 1908
Neurosarcoidosis, 584-585, 584t-585t
Neurosyphilis, e327-3t, e327-7
clinical manifestations of, e327-3-e327-4
diagnosis of, e327-5-e327-6
Neurotensin, 1412t
Neurotoxic shellfish poisoning, 698t, 700
Neutropenia, 1101, 1102t
antipsychotic-induced, 2493-2494
bone marrow injury and, 1103
candidiasis with, 1987
in Chdiak-Higashi syndrome, 1103
clinical manifestations of, 1105
congenital, 1102-1103, 1102t
constitutional, 1101-1102
cyclic, 1102t, 1103
diagnosis of, 1105, 1105f
drug-induced, 1103, 1104f, 1105,
2493-2494
in dyskeratosis congenita, 1103
enterocolitis and, 923, 924f
in Fanconis anemia, 1103
fever during, 1775-1778, 1775t-1776t,
1777f
in glycogen storage disease Ib, 1103
in Griscelli syndrome II, 1103
in Hermansky-Pudlak syndrome II, 1103
HIV infection and, 2213
hypersplenism and, 1104
idiopathic, chronic, 1104-1105
immune-mediated, 1103-1104
increased margination and, 1104
infection and, 1103, 1775-1776,
1775t-1776t
cutaneous syndromes with, 1778-1779,
1778t, 1779f
gastrointestinal syndromes with, 1778t,
1780
management of, 1776-1778, 1777f
neurologic syndromes with, 1778t,
1780
respiratory syndromes with, 1778t,
1779
in myelodysplastic syndrome, 1201
in myelokathexis, 1103
neonatal, isoimmune, 1104
in nutritional deficiency, 1104, 1104f
primary, 1101-1103
prophylactic fluconazole in, 1975
Pseudomonas aeruginosa infection with,
1877-1878, 1880
secondary, 1103-1105
in Shwachman-Diamond syndrome, 1103
treatment of, 1105b-1106b
Neutrophil(s), 217, 1098
aging-related changes in, 107
bacterial killing by, 1111t, 1114
disorders of, 1115, 1116t-1117t
chemotaxis of, 1113-1114
defects in, 1115, 1116t-1117t
chronic meningitis with, 2370, 2370t
circulation of, 1113
corticosteroid effects on, 160
defects of, 1617, 1617t
Neutrophil(s) (Continued)
deficiency of. See Neutropenia
development of, 1098, 1098f, 1111-1112,
1112f
diapedesis of, 1113
endothelial wall adherence of, 1113
defects in, 1115, 1116t-1117t
excess of. See Neutrophilia
extracellular traps of, 1114
granules of, 1112, 1112f, 1112t
defects in, 1115
hypersegmented, 1029f
life span of, 1113
margination of, 1098, 1104, 1113
in meningitis, 2357
Pelger-Hut anomaly of, 1027f, 1100
phagocytosis by, 1112f, 1114
production of, e159-1, e159-2f
respiratory burst of, 217
toxic granulation of, 1027f
Neutrophil elastase, 1102
Neutrophil extracellular traps, 1114
Neutrophilia, 1098-1106, 1101f
bone marrow stimulation and, 1099
in chronic myelogenous leukemia, 1100
cigarette smoking and, 1099
in Down syndrome, 1100
drug-induced, 1099, 1099t, 2535
in familial cold urticaria, 1100
hereditary, 1099-1100
idiopathic, chronic, 1100
infection and, 1098, 1099f, 1769
inflammation and, 1098-1099
in leukocyte adhesion deficiency, 1100
in myeloproliferative disorders, 1100
nonhematologic malignancy and, 1099,
1099f
in Pelger-Hut anomaly, 1100
postsplenectomy, 1100
primary, 1099-1100, 1099t
secondary, 1098-1099, 1099t
stress and, 1099
Neutrophilic dermatosis, febrile, 1196t, 1771,
1779, 2533, 2535, 2541f
Nevus (nevi), 2538, 2539f
benign, 1330, 1330f, 1331t
dysplastic, 1330, 1330f, 1331t
spider, in liver disease, 953-954
Nevus anemicus, 2548
Nevus depigmentosus, 2548
New World arenaviridae, 87b, 87t
Newborn. See Neonate
Nexavar, 1168t-1176t
Next-generation sequencing, 192-193,
193f-194f
NEXUS Low-Risk Criteria, 2260, 2261f
Niacin (vitamin B3), e225-2t-e225-5t,
e225-9t
deficiency of, 2383t, e225-2t-e225-5t
toxicity of, 981t, e225-2t-e225-5t
Nicardipine
in hypertension, 382t
in hypertensive emergency, 388t
in stable myocardial ischemia, 423t
Nickel
lung cancer and, 1265
poisoning with, 93-95
Niclosamide, in tapeworm infection, 2053t
Nicotine
addiction to, 140t, 142-146. See also
Cigarette smoking
central nervous system effects of, 143
dependence on, 143
dopamine effects of, 142
Nicotine gum, 144, 144t
Nicotine inhaler, 144t, 145
Nicotine lozenge, 144, 144t
Nicotine nasal spray, 144t, 145
Nicotine replacement therapy, 144-145, 144t
Nicotine vaccine, 144t, 145-146
Nicotinic acid, in lipid disorders, 1353t,
1354
Niemann-Pick disease, 567
Nifedipine
in high-altitude syndromes, 575-576
in hypertension, 382t
in stable myocardial ischemia, 423t
Nifurtimox, in Chagas disease,
e355-3-e355-4
Night blindness, 2429
Nilotinib, 167, 1168t-1176t
in chronic myelogenous leukemia,
1212-1213
Nilutamide, 1168t-1176t
Nipah virus infection, 1966t
Nipple discharge, 1310
Nisoldipine
in hypertension, 382t
in stable myocardial ischemia, 423t
Nitazoxanide, 2010-2011
in cryptosporidiosis, 2040b
in tapeworm infection, 2053t
Nitrates
in heart failure, 306f-307f
in ST segment elevation MI, 443
in stable myocardial ischemia, 419-421,
424t
Nitrendipine, in stable myocardial ischemia,
423t
Nitric oxide
in asthma, 532
exhaled fraction of, in asthma, 533
inhalation of, with mechanical ventilation,
644
in pulmonary hypertension, 395-396
Nitric oxide synthase, in diabetic
nephropathy, 781
Nitric oxide synthases, 233
Nitroblue tetrazolium (NBT) test, 1114
Nitrofurantoin, 1809t-1811t
Nitrogen, reactive, in inflammation, 233
Nitrogen mustard, 1168t-1176t
Nitroglycerin
in acute coronary syndrome, 430t, 431
in hypertensive emergency, 388t
in ST segment elevation MI, 446-448,
447t
in stable myocardial ischemia, 419-421,
424t
N-Nitroso compounds, in gastric cancer,
1275
Nitrous oxide, 2486
cobalamin deficiency with, 1077
Nitzschia algae, domoic acid of, 700
Nizatidine
in gastroesophageal reflux disease, 878t
in pruritus, 2512t
NLRP3 gene, 1671
No-reflow phenomenon, in ischemic stroke,
2309
Nocardiosis, 1970-1971
clinical manifestations of, 1970
CNS, 1970, 1971f
culture in, 1971
cutaneous, 1970
definition of, 1970
diagnosis of, 1970-1971
epidemiology of, 1970
histopathology of, 1970-1971
imaging in, 1970, 1971f
pathobiology of, 1970
prognosis for, 1971
pulmonary, 1970, 1971f
treatment of, 1971b
Nocturia, 106
NOD2/CARD15 gene, 913, 1672
Nod-like receptor (NLR) proteins, 231
Nodular heterotopia, 2387
Nodule(s)
adrenal, 1465
cardiac, in systemic lupus erythematosus,
1701
cutaneous, 1771, 2504t, 2506t, 2508,
2508f, 2536-2537, 2536t, 2540-2541
Nageottes, 2404
onchocercoma, e366-6
pulmonary, 520, 520f
in rheumatoid arthritis, 1686, 1686f
solitary, 618, 1267, 1269f. See also Lung
cancer
rheumatoid, 1685-1686, 1685f-1686f
in scabies, 2078
in systemic lupus erythematosus, 1699
thyroid, e233-11, e233-12f
Noise
exposure to, 77
hearing loss with, 2463
Non-allergic rhinitis with eosinophilia
syndrome (NARES), 1625
Non-Hodgkins lymphoma. See Lymphoma,
non-Hodgkins
Nonaka myopathy, 2414
Nonbacterial thrombotic endocarditis,
332-333
Nonexercise activity thermogenesis, 1412
Nonmaleficence, 4
Nonpolyposis colon cancer, 1281t, 1282,
1344
Nonspecific interstitial pneumonia, 559t, 562
diagnosis of, 562
treatment of, 562b
Nonspecific interstitial pneumonitis, HIV
infection and, 2207-2208
Nonsteroidal anti-inflammatory drugs
(NSAIDs), 135, 169-171, 169f
antihypertensive interaction with, 384-385
in back pain, 2262b-2263b
cardiovascular complications of, 171
drug interactions with, 170-171
gastrointestinal complications of, 171, 887,
888t, e36-1f
diagnosis of, 891
prevention of, 892-893
treatment of, 892
in gout, 1740
hepatotoxicity of, 981
iron interaction with, e225-8t
in migraine headache, 2248b, 2248t
in osteoarthritis, 1675, 1676t
in rheumatoid arthritis, 1688
small intestinal ulcerations with, 924
in spondyloarthropathies, 1691
topical, 2511
vascular complications of, 171
Nontropical sprue. See Celiac disease
Noonans syndrome, 321
Norepinephrine, 1412t, 1470, 1471f
in cardiogenic shock, 656-657
in heart failure, 297-298
in septic shock, 663
in shock, 649t, 653
Norovirus infection, 1789-1790, 2144-2147
clinical manifestations of, 2146
diagnosis of, 2146-2147
epidemiology of, 2145t, 2146
pathobiology of, 2146
treatment of, 2147b
North American blastomycosis, 1981-1982
Nortriptyline
in depression, 2239t
in pain, 135-137, 136t
in smoking cessation, 144t
Nose
bleeding from, 2456f, 2458, 2458f
examination of, 24, 2456, 2456f
inflammation of. See Rhinitis
mucocele of, 2457
packing of, 2458
polyps of, 2456-2457, 2456f
NPHP genes, 799
NREM sleep, 2299, 2300t
Nuclear receptors, 1424-1425, 1425f
in lipid metabolism, 1350
Nucleic acid amplification test, in Neisseria
gonorrhoeae infection, e307-2
Number needed to treat, e8-2
Nummular dermatitis, 2514, 2514f
Nurse cells, e366-2, e366-2f
Nutcracker esophagus, 882
Nutrition, 1380-1384
alcohol effects on, 148
assessment of, 1384-1388
body mass index in, 1386
body weight in, 1385
clinical history in, 1385
composite screening tools in, 1387
goals of, 1384
in older adults, 103
physical examination in, 1385-1386,
1386t
serum proteins in, 1386-1387

Nutrition (Continued)
upper arm anthropometry in, 1386,
1387t
weight in, 1385, 1386t
weight loss in, 1385
breast cancer and, 1380-1381
cancer and, 1380-1381, 1383t
colorectal cancer and, 1381
congenital neural tube defects and, 1382
coronary heart disease and, 1380
in cystic fibrosis, 547
diabetes mellitus and, 1381, 1383t
diverticular disease and, 1381, 1381t
enteral, 1391-1394
absent provision of, 1392
aspiration with, 1393
complications of, 1393-1394
diarrhea with, 1393
evaluation of, 1393
formula for, 1393
gastric residual volume in, 1393
indications for, 1391-1392
infection and, e290-5
initiation of, 1392-1393
intestinal ischemia with, 1393
physiologic effects of, 1392, 1392t
protocol for, 1393, 1393t
sudden death with, 1394
tube occlusion with, 1393
guidelines for, 1380, 1382, 1382t-1383t,
1384f
in heart failure, 313-314
historical perspective on, 1380
in HIV infection, 2199
hypertension and, 1381, 1383t
in inborn errors of metabolism,
1345-1346
lung cancer and, 1380
micronutrients in, e225-1, e225-2t-e225-7t
morbidity and, 1380-1382, 1381t
mortality and, 1380-1382, 1381t
obesity and, 1381
osteoporosis and, 1381
parenteral, 1394-1397
all-in-one infusion for, 1396
blood glucose and, 1397
calories in, 1394-1395
carbohydrates for, 1395-1396, 1395t
cholestatic liver disease with, 1397
complications of, 1397
fluids in, 1394-1395
formulations for, 1395-1396, 1395t
gallbladder stasis with, 1397
Harris-Benedict equation for, 1395
hyperglycemia with, 1397
hypertriglyceridemia with, 1397
indications for, 1394, 1394t-1395t
infusion rate for, 1396
lipids for, 1395t, 1396
liver disease with, 987
micronutrients for, 1396
protein for, 1395t, 1396
refeeding syndrome with, 1397
steatosis with, 1397
total, 987, 1395
vascular access for, 1396-1397
in spinal cord injury, 2257
therapeutic. See Nutrition, enteral;
Nutrition, parenteral; Nutritional
support
Nutritional support, 1385. See also Nutrition,
enteral; Nutrition, parenteral
assessment for, 1387
caloric need measures in, 1387
energy expenditure measures in,
1387
lean body mass in, 1387
total body water in, 1387
in burn injury, 693
lean tissue restoration with, 1387
in septic shock, 665
Nystagmography, 2468
Nystagmus, 2447t, 2448
in coma, 2297
gaze-evoked, 2448
positional tests for, 2468
rebound, 2448
O Occupational disease (Continued)
Obesity, 1381, 1409-1417
adipocytes in, 1411
animal models of, 1411
basal metabolic rate in, 1411-1412
breast cancer and, 1380-1381
cancer and, 1180, 1380, 1414
cardiovascular disease and, 257
classification of, 1409, 1409t
colorectal cancer and, 1381
constitutional influences on, 1410
definition of, 1409-1417, 1409t
diabetes mellitus and, 1381
diagnosis of, 1414-1417, 1415f
diet and, 1381t
dilated cardiomyopathy with, 327
disease-related, 1412-1413
dyslipidemia and, 1414
endocrine manifestations of, 1414
endometrial cancer and, 1318
energy intake in, 1411, 1411t-1412t
environmental contributors to, 1410-1411
epidemiology of, 1409
epigenetic effects of, 1410
esophageal adenocarcinoma and, 1274
etiology of, 1409-1410
food intake in, 1410, 1410t
gastrointestinal disorders and, 1414
genetic aspects of, 1410
in HIV-infected patient, 2197, 2197t
hypertension and, 376, 1414
hypothalamic, 1431
insulin resistance in, 1413
ischemic stroke and, 2310
islet cell failure in, 1413-1414
leptin in, 1411
mechanical complications of, 1414
medication-related, 1412, 1413t
metabolic complications of, 1413-1414
nonalcoholic fatty liver disease and, 986
obstructive sleep apnea and, 613, 1414
in older adults, 99t
pathobiology of, 1409-1413
pathophysiology of, 1413-1417
physical activity and, 1410-1412
prevalence of, 1409
prevention of, 1416-1417
psychosocial aspects of, 1413
pulmonary function with, 607
reflux and, 876
social networks and, 178
surgery for, 1416
malabsorption with, 901
treatment of, 1414b-1416b, 1415f
behavior modification in, 1415-1416
diet in, 1415
pharmacotherapy in, 1416, 1416t
physical activity in, 1415
surgery in, 1416
type 2 diabetes mellitus and, 1413-1414
waist circumference in, 1409
in women, 1549-1550
Obesity-hypoventilation syndrome, 528t
Obestatin, 1411t
Obsessive-compulsive disorder, 2240t-2241t,
2241, 2245t
Obstipation, aging-related, 106
Obstructive sleep apnea. See Sleep apnea,
obstructive
Obturator sign, 837t
Occupation. See also Occupational disease
shift work with, 2303
stress with, 179
Occupational disease, 75-78, 76t. See also
specific disorders
asbestos-related, 572, 573f
asthmatic, 532, 567, 568t-569t, 569-574,
570f
beryllium-related, 567, 571-574, 572f,
572t
exposure assessment in, 75-76, 567, e18-1f
febrile, 573, 574t
hazardous exposures in, 77-88, 78t. See
also Hazardous exposures; Radiation
injury
HIV, 2183-2185
infectious, e290-7-e290-8
neoplastic, 76t, 77, 568t, 574, 1181t, 1182,
1219, 1306
principles of, 75-77
pulmonary, 565, 567-574, 568t
silicosis-related, 573, 573f, 573t
systemic sclerosis and, 1706
Occupational history, 22
Ochronosis, 1751
Ockelbo disease, 2161
Ocrelizumab, 167-168
OCTN1 gene, 913-914
Octopus envenomation, 698t, 699
Octreotide, 1168t-1176t
in carcinoid syndrome, 1511
in dumping syndrome, 903b
in glucagonoma, 1295b
in motility disorders, 865b-866b
in sulfonylurea toxicity, 679t-683t
in VIPoma, 1295b
Ocular bobbing, 2297, 2448
Ocular dysmetria, 2448
Ocular flutter, 2448
Oculomotor apraxia, 2448
Oculopharyngeal muscular dystrophy, 2414
Odds, 32, 32t
Odds ratio, 32t, 33, e8-3
vs. risk ratio, e8-3
Odynophagia, 831t-832t
Oesophagostomum bifurcum infection, 2068
Ofatumumab, 167-168, 1168t-1176t
in chronic lymphocytic leukemia, 1217
OKT3, in kidney transplantation, 824f, 825
Olanzapine, 2243t
Older adults. See also at Age/aging; Geriatric
activity guidelines for, 57-58
acute myeloid leukemia in, 1208
adrenal androgen deficiency in, 1523
anemia in, 1038
assessment of. See Geriatric assessment
cancer treatment in, 1167
cataract in, 105
cobalamin deficiency in, 1075-1076
delirium in, 117-121. See also Delirium
dementia in. See Alzheimers disease;
Dementia
diabetes mellitus in, 105
drugs in, 116, 116t, 129-130
gait disorder of, 2230t
Hodgkins lymphoma in, 1233
hyperthermia in, 105
hyperthyroidism in, 105
hypotension in, 2393
hypothermia in, 105
lymphoma in, 1227
mental status changes in. See Alzheimers
disease; Delirium; Dementia
micronutrients in, e225-2-e225-7
non-Hodgkins lymphoma in, 1227
osteoporosis in, 1579
pain management in, 139
parainfluenza virus infection in, 2094
pressure sores in, 109, 109f
purpura in, 108, 108f
respiratory syncytial virus infection in,
2091-2092
systolic hypertension in, 386
testosterone deficiency in, 1522, 1522f
water balance in, e232-2
Oleander ingestion, 674t-676t, 679t-683t
Olecranon bursitis, 1679
Olfaction, 2460-2461
disorders of, 2460-2461
clinical manifestations of, 2461
diagnosis of, 2461
pathobiology of, 2460-2461, 2461t
Oligodendroglioma, 1252
Oligomeganephronia, 803
Oligomenorrhea, 1438, e244-6
Oligosaccharidoses, 1357t
Oligozoospermia. See Infertility, male
Olliers disease, 1610
Olmesartan, in hypertension, 382t
Olsalazine, in inflammatory bowel disease,
917t
Omalizumab, in asthma, 535
Omega-3 fatty acids, 313, 1380
INDEX e59
Omeprazole
folate interaction with, e225-8t
in gastrinoma, 1294
in gastroesophageal reflux disease, 878t
vitamin B12 interaction with, e225-8t
vitamin D interaction with, e225-8t
Omsk hemorrhagic fever, 87t, 2147-2156,
2148t-2149t, 2151t. See also Viral
hemorrhagic fevers
immunization against, 2155
Onchocerciasis, 2009, e366-1t, e366-3t,
e366-5-e366-6, e366-6b
Onchocercoma, e366-6
Onchodermatitis, e366-6
Oncogenes, 1266, e184-1
Oncolytic viruses, in gene therapy, 209
Oncotype Dx assay, 1310-1311
Ondansetron, 843t-844t
One-hand, two-feet syndrome, 2521
Onycholysis, 2555, 2556f
Onychomadesis, 2554, 2555t
Onychomycosis, 2556
Onyong-nyong fever, 2159
Oophorectomy
in premenstrual syndrome, e244-5
prophylactic, 1315, 1319
Oophoritis, mumps, 2110
Ophthalmopathy, Graves, e233-6-e233-7,
e233-6f
Ophthalmoplegia, internuclear, 2448, 2448f
in multiple sclerosis, 2349
Ophthalmoscopy, 24
Opioid(s), 137-138, 137t
abuse of, 140t, 142-146, 155
chronic pain and, 156
clinical manifestations of, 155-156
epidemiology of, 155
pathobiology of, 155
physical dependence and, 155
QT interval prolongation with, 155-156
treatment of, 156b
for anesthesia, 2485
central nervous system effects of, 672t
in diarrhea, 912-913
endogenous, 1426-1427
in migraine headache, 2248b, 2248t
overdose of, 528t
preoperative assessment of, 2484
toxic ingestion of, 674t-677t, 679t-683t
withdrawal from, 155-156
central nervous system effects of, 672t
Opisthorchiasis, 990t-992t, 2061, 2061t,
2063, 2063b
Opsoclonus, 2448
paraneoplastic, 1193t
Optic chiasm, lesions of, 2444
Optic disc
edema of, 2438, 2439f, 2444
in bacterial meningitis, 2358
vs. neuritis, 2444t
examination of, 24
Optic nerve, 2426, 2427f
atrophy of, e327-4
glioma of, 1251
lesions of, 2444
Optic neuritis, 2354, 2444
in multiple sclerosis, 2349
vs. papilledema, 2444t
Optic neuropathy
ischemic, 2444
Lebers, 1343t, 2416, 2444
nonarteritic, 2439
septic, 2426
Optical coherence tomography, in multiple
sclerosis, 2352, 2352f
Oral antihyperglycemic agents, 558t,
e237-6-e237-9, e237-7f, e237-7t
Oral cavity. See Mouth
Oral contraceptives, 1552-1554
amenorrhea after, e244-6
breast cancer and, 1553
cervical cancer and, 1553
complications of, 1553-1554
constituents of, 1552-1553
contraindications to, 1554
delayed fertility and, 1553
endometrial cancer and, 1553
e60 INDEX
Oral contraceptives (Continued)
estrogen-related metabolic effects of, 1553
glucose effects of, 1553
health risks with, 1553-1554
hepatotoxicity of, 981t, 1554
hypercoagulability with, 1153
hypertension and, 387
initiation of, 1554
ischemic stroke and, 2310
lipid effects of, 1553
metabolic effects of, 1553
myocardial infarction and, 1553
ovarian cancer and, 1553
progestin-related metabolic effects of, 1553
rheumatoid arthritis incidence and,
1682-1683
safety of, 1551
surveillance for, 1554
thrombosis and, 1553
Oral-facial-digital syndrome, 796t, 800
Oral hairy leukoplakia, 2451, 2451f
Epstein-Barr virus infection and,
2135-2136
HIV infection and, 2209-2210
Oral hygiene, in infection prevention, e290-5
Oral rehydration solution
in acute diarrhea, 899
in cholera, 1867b
Orbit, 2426-2427
cellulitis of, 2430
lymphoma of, 2442
metastatic tumors of, 2442
pseudotumor of, 2430, 2440
tumors of, 2441
Orchiectomy, 1321, 1324
Orchitis, 1524, 2110
Orexins, 1412t
Organ transplantation, 235-239. See also
Heart transplantation; Kidney
transplantation; Liver transplantation;
Lung transplantation
adenovirus infection after, 2102
alloreactivity in, 237, 237f
antigens in, 236-237, 236t
blood group antigens in, 236-237
costimulatory blockade in, 239
cytomegalovirus infection after, 2132
definition of, 235-236
donor T-cell depletion in, 238, 238t
graft-versus-host disease in, 237-238
immune tolerance in, 239
immunosuppressive drugs in, 159-165,
159t, 161t-162t, 239
infection after, 508-509, 620, 1010-1011,
1161, 1774-1775, 1775t
infection and, 1774-1775
lymphoma after, 1218-1219, 1227
major histocompatibility antigens in, 236,
236t
minor histocompatibility antigens in, 236
natural killer cells in, 236-237, e48-1f
rejection in, 237-238, 237f
alloreactivity in, 237, 237f
prevention of, 239
T lymphocytes in, 237-238, 237f
toxoplasmosis after, e357-2, e357-6
Organic dust toxic syndrome, 574t
Organohalides, exposure to, 77, 78t
Organophosphorus compounds, toxicity of,
672t, 674t-676t, 679t-683t
Oriental cholangiohepatitis, 1013
Oriental liver fluke, 2061, 2061t
Orientia tsutsugamushi infection, 1960-1962
Orlistat, in obesity, 1416
ORMDL3 gene, 531
Orobuccolinguomasticatory dyskinesia, 2340
Orogastric tube, in gastrointestinal bleeding,
858
Oropharynx, 2469, 2469f
aphthous stomatitis of, 2470
benign squamous papilloma of, 2470,
2471f
cancer of, 149, 1257, 1260t-1261t
Candida infection of, 1987, 1987f, 1989,
2470
Chlamydia trachomatis infection of, e326-4
disease of, 881, 2469-2471
Oropharynx (Continued)
HPV-related cancer of, 1257-1258, 1261
tularemia of, 1895
tumors of, 2470, 2471f
Oroya fever, 1907-1908, 1907t-1909t
treatment of, 1910
Orthopnea, 246
in heart failure, 300
Orthopoxvirus infection. See Monkeypox;
Smallpox
Ortners syndrome, 457
Oscillopsia, in multiple sclerosis, 2349
Oseltamivir
in influenza virus infection, 2085t-2086t,
2086, 2100b
in influenza virus infection prevention,
2099, 2099t
Osler-Weber-Rendu syndrome, 935, 1136,
1136f
Oslers node, 466, 466f
Osmolality, 720, e232-1
plasma, 729, e232-1, e232-2f
urinary, 724, e232-1, e232-2f
Osmoreceptor, dysfunction of, e232-3
Osmostat, e232-1, e232-2f
Osmotic gap, stool, 912
Osteitis fibrosa cystica, 820, 1595
Osteoarthritis, 1672-1676
in acromegaly, 1749
clinical manifestations of, 1673
definition of, 1651, 1672
diagnosis of, 1675-1676
end-stage, 1753, 1753f
epidemiology of, 1672-1676
of foot, 1674-1675, 1674f
generalized, 1675
genetic factors in, 1672
of hand, 1673-1674, 1674f
of hip, 1674, 1674f
of knee, 1674, 1674f
laboratory testing in, 1675
magnetic resonance imaging in, 1675
pain in, 1673, 1675
pathobiology of, 1672-1675, 1673f,
1674t
pathogenesis of, 1673, 1673f
pathology of, 1672-1673
radiography in, 1675, 1753f
vs. rheumatoid arthritis, 1687t
risk factors for, 1672
secondary, 1651
of spine, 1674f, 1675, 2262t
treatment of, 1675b-1676b, 1676t
in women, 1551
Osteoarthropathy, hypertrophic, 1196t, 1197,
1198f, 1607-1610, 1749-1750, 1750f
Osteoblasts
in osteomalacia, 1588-1589, 1589f
in Pagets disease, 1603-1604
Osteocalcin, e267-4
Osteoclasts, in Pagets disease, 1603-1604
Osteodystrophy, hereditary, Albrights, 1342,
1598, 1598f
Osteogenesis imperfecta, 1344-1345, 1665
clinical manifestations of, 1665-1666,
1666t
definition of, 1665
diagnosis of, 1666-1667
epidemiology of, 1665
pathobiology of, 1665-1666
treatment of, 1666b
Osteomalacia, 1587-1591, e225-2t-e225-5t
in bile salt wasting, 904
biopsy in, 1589
clinical manifestations of, 1588
definition of, 1587, 1587t
diagnosis of, 1588-1589, 1588f-1589f
epidemiology of, 1587
hemodialysis and, 820
hypophosphatemic, 1590, 1591t
oncogenic, 755, 1590
pain in, 1588
pathobiology of, 1587-1588
prevention of, 1590
in primary biliary cirrhosis, 904
prognosis for, 1591
in sickle cell disease, 1073
Osteomalacia (Continued)
treatment of, 1589b-1590b, 1590t-1591t
tumor-induced, 1191, 1197
Osteomyelitis, 1735-1736
Acinetobacter, 1882
anaerobic bacteria in, 1849
Candida, 1988-1990
clinical manifestations of, 1736
definition of, 1735
diagnosis of, 1736
epidemiology of, 1735
vs. mycetoma, 2006-2007
pathobiology of, 1735
prevention of, 1736
prognosis for, 1736
Pseudomonas aeruginosa, 1879
in sickle cell disease, 1071
Staphylococcus aureus, 1817
treatment of, 1736b, 1736t
vertebral, 1817, 1817f, 1942f, 1944
Osteonecrosis, 1605-1610, 1606f, 1651,
1754
after liver transplantation, 1011
in sickle cell disease, 1071, 1073
Osteopathia striata, 1608-1609
Osteopenia
in cystic fibrosis, 545
in liver disease, 953
Osteopetrosis, 1607-1610, 1608f
Osteopoikilosis, 1608
Osteopontin, e267-4
Osteoporosis, 1549, 1577-1587
alcohol use and, 1580-1581
in ankylosing spondylitis, 1693-1694
in bile salt wasting, 904
biomarkers in, 1583
bone densitometry in, 1582
cancer-related, 1581
classification of, 1579
clinical manifestations of, 1581-1582,
1582f
computed tomography in, 1582
corticosteroids and, 161, 163f
in cystic fibrosis, 545-546
definition of, 1577-1578, 1578f
DEXA scan in, 1582
diagnosis of, 1582-1583
diet and, 1381, 1381t
drug-induced, 1580-1581
epidemiology of, 1578-1586, 1578t
FRAX assessment of, 1582-1583
glucocorticoid-induced, 1585-1586
after hematopoietic stem cell
transplantation, 1162
after lung transplantation, 621
in mastocytosis, 1642
in men, 1586
in multiple sclerosis, 2353
in older adults, 1579
vs. osteogenesis imperfecta, 1666
vs. osteomalacia, 1588
pathobiology of, 1579
pathogenesis of, 1580-1586
prevention of, 1549
screening for, 54
secondary, 1580-1582, 1581t, 1586
in sickle cell disease, 1073
treatment of, 1583b-1585b
anabolic agents in, 1585
bisphosphonates in, 1584-1585
calcitonin in, 1585
calcium in, 1583
estrogen replacement therapy in, 1584
physical activity in, 1584
selective estrogen receptor modulators
in, 1584
strontium ranelate in, 1585
vitamin D in, 1583-1584
Osteosarcoma, 1325-1326
Osteosclerosis, 1606
focal, 1608-1610
hepatitis Cassociated, 1608
with hyperostosis, 1607-1610
Osteotomy, 1754-1755
Otalgia, 2458, 2458t
clinical manifestations of, 2458
definition of, 2458
Otalgia (Continued)
diagnosis of, 2458-2459
differential diagnosis of, 2459
imaging in, 2459
laboratory testing in, 2459
pathobiology of, 2458, 2458f
patient history in, 2458
physical examination in, 2458-2459,
2459f
treatment of, 2459b
Otitic hydrocephalus, 2318
Otitis externa, 2459, 2459b
Otitis media, 2459f, 2462
Haemophilus influenzae in, 1862
Pseudomonas aeruginosa in, 1879-1881
Streptococcus pyogenes in, 1825
treatment of, 2459b
Otomycosis, 1991
Otosclerosis, 2462
Ouch-ouch disease, 775
Outcomes. See Healthcare outcomes
Ovarian cancer, 1549
arthritis in, 1750
epithelial, 1319
clinical manifestations of, 1319
epidemiology of, 1319
prevention of, 1319
treatment of, 1319b
genetics of, 185t
germ cell, 1320
nonepithelial, 1320
oral contraceptives and, 1553
stromal, 1320
Ovary (ovaries), 1529-1534. See also
Menstrual cycle
aging-related changes in, 107
anatomy of, 1529-1530, 1530f
cancer of. See Ovarian cancer
cysts of, 834t-836t, e244-10-e244-14.
See also Polycystic ovary syndrome
definition of, 1529-1534
development of, 1511, 1512f, 1529,
1529f-1530f
failure of, e244-8-e244-14
function of, 1530-1531, 1531f
graafian follicle of, e244-1-e244-5
ionizing radiation injury to, 80
neuroendocrine regulation of, e244-3f,
e244-4
physiology of, 1529-1534
at puberty, 1530-1531
steroidogenesis in, 1512-1513, 1514f,
e244-3f, e244-4
torsion of, 834t-836t
Overweight, 1409-1417, 1409t. See also
Obesity
Ovulation, e244-1-e244-2, e244-2f
absence of, e244-9, e244-9t. See also
Anovulation
Oxacillin, 1809t-1811t
Oxalate
crystals of, 712, 712f
dietary, 790
urinary, 709, 790
Oxaliplatin, 1168t-1176t
Oxamniquine, in schistosomiasis, 2060b
Oxazepam, 2242t
in alcohol dependence treatment, 152t
Oxcarbazepine, 2292t
Oximetry, in COPD, 540
Oxycodone, 137t, 674t-676t. See also
Opioid(s)
Oxygen
alveolar pressure of, at high-altitude, 575
arterial, 627
partial pressure of
in acute respiratory failure, 630-631,
631f-632f
in critical care, 626
hemoglobin binding to, 1031-1032, 1032f
inspired fraction of, 631, 632f
myocardial, in heart failure, 297
reactive, in inflammation, 233
systemic delivery of, 627, 645-653, 646f
failure of. See Shock
therapeutic. See Mechanical ventilation;
Oxygen therapy
 INDEX e61
Oxygen (Continued) Pain (Continued) Pancreas (Continued) Pancreatitis (Continued)
tissue transport of, 1031-1033, 1031f neuropathic, 133-134, 133t-134t in cystic fibrosis, 545 pain in, 834t-836t
toxicity of, 578-581 nociceptive, 133-134, 133t-134t function of, tests for, 903t pancreatic duct obstruction and, 938
Oxygen saturation, 27 pathobiology of, 133-134 inflammation of. See Pancreatitis pathobiology of, 937-944, 937t
abnormal, 27t-28t, 29-30 pathologic, 134 intraductal papillary mucinous neoplasm patient history in, 939
normal, 27t patient history of, 134 of, 1290 prevention of, 940
respiratory rate and, 28 perceived, 2258-2260 islet cell tumors of. See Pancreatic prognosis for, 940-941
Oxygen therapy peripheral, 133t endocrine tumors Ranson criteria in, 938t, 939
in acute respiratory failure, 633-634, 637f peripheral sensitization in, 134 MRCP of, 847, 850f severity of, 938t, 939
in COPD, 542 peritoneal, 832-833 mucinous cystic neoplasm of, 1290 trauma and, 938
hyperbaric, in carbon monoxide physical examination in, 134-135 transplantation of, in diabetes mellitus treatment of, 940b
poisoning, 679t-683t prevention of, 139 type 1, e236-8 chronic, 941
in hypopneic patient, 29-30 psychosocial history in, 134 Pancreatic cancer, 1289-1292. See also alcohol use and, 941
in septic shock, 663 radicular, 2258-2260, 2259f, 2265 Pancreatic endocrine tumors autoimmune, 941
Oxyhemoglobin association-dissociation red flags in, 135 arthritis and, 1748 cancer and, 944
curve, 630, 631f referred, 2258-2261 biomarkers in, 1291 cigarette smoking and, 941
Oxymetazoline, in common cold, 2090t severity of, 134 chronic pancreatitis and, 944 clinical manifestations of, 941
Oxytocin, 1412t, e232-2-e232-3 in sickle cell disease, 1068-1069, clinical manifestations of, 1290-1292 definition of, 941
1072-1073 definition of, 1289 diagnosis of, 941-942, 941t, 942f
somatic, 133, 133t diagnosis of, 855-856, 856f, 1290-1292, enzyme therapy in, 943, 944t
P thermal stimuli in, 134 1291f epidemiology of, 941
p16 gene, 1290, 1290f treatment of, 135b-139b differential diagnosis of, 1290 genetics in, 941
p53 gene, 1290, 1290f combination therapies in, 138, 138f epidemiology of, 1289-1290 malabsorption in, 902
p53 protein, 1184-1185, 1185f complementary and alternative imaging in, 1290-1291 pain in, 834t-836t, 941, 943, 943t
P values, e8-4-e8-5 therapies in, 139 pathobiology of, 1290, 1290f pathobiology of, 941
Pacemaker, 369-370 interventional therapies in, 138-139 thrombophlebitis in, 1199f prevention of, 944
battery for, 369 nerve blocks in, 138-139 treatment of, 1291b-1292b prognosis for, 944
complications of, 370 in older adults, 139 weight loss with, 840t-841t pseudocyst with, 944, 944f
implant site for, 369, 369f opioids in, 137-138, 137t Pancreatic cyst, 1290 treatment of, 903b, 943b-944b, 943t
indications for, 370, 370t for palliative care, 9 Pancreatic duct obstruction, 938 tropical, 941
leads for, 369 pharmacologic, 135-138, 136t-137t Pancreatic endocrine tumors, 1292-1297, endoscopic retrograde
pacing modes for, 369, 369f physical therapies in, 139 1504-1505, 1505t cholangiopancreatography in,
temporary, 370 psychological, 138, 138t ACTH-secreting, 1293t, 1296 856-857
Pachydermoperiostosis, 1607-1610 spinal cord stimulation in, 139 carcinoid syndrome with, 1297 gallstone, 1018
Pacific funnel web spiders, 2077t, 2079 surgery in, 139 definition of, 1292, 1293t, 1504 hypocalcemia and, 1599
Paclitaxel, 1168t-1176t in urinary tract obstruction, 778 epidemiology of, 1292 pleural effusion in, 610
Pagets disease of bone, 1196t, 1603-1605 visceral, 133, 133t, 832-833 functional, 1292-1297, 1293t Pancreatography, 851
clinical manifestations of, 1604, 1604t, enhanced perception of, 868 gastrin-secreting, 1292-1297, 1293t, 1506 Pancytopenia, 1087
1749 Pain disorder, 2244t glucagon-secreting, 1293t, 1294-1297, Panhypophysitis, 1433
definition of, 1603 Painful legs and moving toes, 2341 1295f, 1505t Panic disorder, 2240t, 2241
diagnosis of, 1604 Palatal tremor, 2339 growth hormonereleasing factor vs. anaphylaxis, 1636
epidemiology of, 1603 Paliperidone, 2243t secreting, 1293t, 1296-1297 vs. seizure, 2289
etiology of, 1603 Palivizumab, in respiratory syncytial virus -hydroxybutyrate in, 1502-1503, 1502f, Panitumumab, 167
pathobiology of, 1603-1604, 1604f infection, 2092b 1503t in colorectal cancer, 202t
prognosis for, 1605 Palliative care, 9-15, 10t hypoglycemia with, 1500-1501 Panniculitis, 2541, 2542f
treatment of, 1604b-1605b, 1605t anorexia in, 10t insulin-secreting, 1191, 1293t, 1500-1501, fungal, 2542
Pagophagia, 1041 anxiety in, 10t 1504-1505, 1505t lupus, 1699, 2541
Pain, 133-140 cachexia in, 10t -hydroxybutyrate in, 1502-1503, mesenteric, 927
abdominal. See Abdominal pain constipation in, 10t 1502f, 1503t pancreatic, 1748, 2541
in acid peptic disease, 889-890 in delirious patient, 10t, 120 luteinizing hormonesecreting, 1297 Pantoprazole, in gastroesophageal reflux
acute, 133 in dementia, 2276 nonfunctional, 1292, 1293t, 1296-1297 disease, 878t
in aortic dissection, 483-484 depression in, 10t parathyroid hormonerelated peptide Pantothenic acid, e225-2t-e225-5t
assessment of, 134-139 fatigue in, 10t secreting, 1296-1297 deficiency of, 2383t, e225-2t-e225-5t
in palliative care, 9, 10t, 11f-12f goal of, 9 pathobiology of, 1292, 1504-1505 Pap smear, 1317-1320, 1317f
in physical examination, 24 in heart failure, 318 renin-secreting, 1297 Papanicolaou (Pap) screening, 54
back. See Back pain vs. hospice, 9 somatostatin-secreting, 1293t, 1295-1297, Papillary fibroelastoma, 333
biliary, 1016, 1017t nausea in, 10t 1505t Papillary muscles, 253t, e52-3
breast, 1310, 1316 pain assessment for, 9, 10t, 11f-12f VIP-secreting, 1293t, 1295-1297, 1505t Papilledema, 2438, 2439f, 2444
cancer, 1167-1177, 1177f patients goals and, 12-14 Pancreatic enzymes in bacterial meningitis, 2358
central, 133t in prostate cancer, 1324 in digestion, 901, 902f vs. neuritis, 2444t
central sensitization in, 134, 1743. See also psychological suffering in, 9-12, 10t replacement of, 903b, 943, 944t Papilloma
Fibromyalgia shortness of breath in, 10t Pancreatic insufficiency choroid plexus, 1252
chemical stimuli in, 134 spiritual distress in, 10t cobalamin deficiency in, 1077 nasal, 2457
chest. See Angina pectoris; Chest pain timing of, 9 in cystic fibrosis, 545 oral, 2452-2453, 2453f
chronic, 133-135 Pallor, in anemia, 1033 Pancreatic intraepithelial neoplasia, 1290, oropharyngeal, 2470, 2471f
opioid abuse and, 156 Palms 1290f Papillomavirus infection. See Human
psychopathology and, 138, 138t erythema of, 953-954, 954f, 1003 Pancreatic lipase deficiency, 902 papillomavirus (HPV) infection
classification of, 133, 133t rash of, 1771, 1771t Pancreatic panniculitis, 1748 Pappenheimer bodies, 1026f
definition of, 133-139 Palonosetron, 843t-844t Pancreatic pseudocyst, 856-857, 944, 944f Papular pruritic eruption, 2211
dysfunctional, 133-134 Palpation Pancreatitis Papules, 2504t, 2522, 2522t, 2536-2537,
ear, 2458, 2458t. See also Otalgia abdominal, 25, 829, 833-837 acute, 937-944 2539-2540
eye, 2428, 2429t cardiac, 250-251 alcohol use and, 937 Paracentesis, 1004
in fibromyalgia, 1743-1745. See also gallbladder, 955 APACHE-II score in, 938t, 939 Paracoccidioidomycosis, 1982-1983
Fibromyalgia hepatic, 829, 954-955, 955f autoimmune, 938 acute-subacute (juvenile), 1982-1983
head. See Headache splenic, 829 BISAP score in, 938t, 939 chronic (adult), 1983
imaging in, 135 Palpitations, 282t, 337-344 clinical manifestations of, 938, 938t diagnosis of, 1983
in irritable bowel syndrome, 871t ambulatory monitoring in, 342-343 complications of, 940, 940t hepatic, 990
knee, 26 electrocardiography in, 341-342 definition of, 937 prognosis for, 1983
leg, 488, 488t in hypertrophic cardiomyopathy, 321 diagnosis of, 938 treatment of, 1983b
in liver disease, 952 Palytoxin, 699-700 drug-induced, 937-938, 937t Paraganglioma, 1470-1475
in mastocytosis, 1642 Pamidronate epidemiology of, 937 clinical manifestations of, 1472-1473,
mechanical stimuli in, 134, 2258-2259 in cancer therapy, 1167-1177 gallstones and, 937 1472t
mechanisms of, 134 in hypercalcemia of malignancy, 1189b genetics in, 938 definition of, 1470
mixed, 133, 133t in Pagets disease, 1605t idiopathic, 938 differential diagnosis of, 1473
musculoskeletal, 1648, 1650f, 2230, 2409 Pancreas imaging of, 939, 939f epidemiology of, 1470
myofascial, 1746, 1746t alcohol effects on, 148t, 149 infection and, 938 familial, 1472
neck. See Neck pain cancer of. See Pancreatic cancer necrotizing, 937, 940 genetic testing in, 1472
e62 INDEX
Paraganglioma (Continued)
hypertension with, 380
malignant, 1475
pathobiology of, 1470-1473
Paragonimiasis, 2061t, 2062-2063
Parainfluenza virus infection, 2092-2095
clinical manifestations of, 2093-2095,
2093f-2094f
in common cold, 2089, 2089t. See also
Common cold
definition of, 2092-2095
diagnosis of, 2094
epidemiology of, 2093
immunization against, 2095
in immunocompromised patients, 2094
in older adults, 2094
primary, 2093
reinfection, 2094
treatment of, 2095b
Paralysis
in botulism, e304-4
diaphragmatic, 604, 604t-605t
facial, 2408
flaccid, in enterovirus infection,
2142-2144, 2380
of locked-in syndrome, 2298
polio. See Poliomyelitis
in rabies, 2378, 2380
sleep, 2301
tick, 2078, 2402
Paralytic shellfish poisoning, 698t, 700
Parameningeal infection, 2369. See also Brain
abscess
vs. bacterial meningitis, 2360
Paramyotonia congenita, 2412t, 2414-2415
Paramyxovirus infection, 1603
Paranasal sinuses, cancer of, 1258-1259
Paraneoplastic syndromes, 1192-1200
autonomic, 2393, 2393t
cachexia, 1199-1200
definition of, 1192
dermatologic, 1194t, 1195-1200, 1196t,
1197f
diagnosis of, 1192, 1192t
epidemiology of, 1192
fever, 1199-1200
hematologic, 1198, 1199f
hepatic, 1199
neurologic, 1192-1200, 1193t,
2404-2405
pathobiology of, 1192
renal, 1199
rheumatologic, 1196t, 1197-1200, 1198f
vasculitic, 2404
Paranoid personality disorder, 2245t
Parapoxvirus infection, 2117t
clinical manifestations of, 2120
diagnosis of, 2120
epidemiology of, 2117-2118
treatment of, 2121
Parapsoriasis, 2520, 2520f
Parasite infection. See also specific infections
clinical manifestations of, 514t
cutaneous, 2512, 2544t, 2546-2549
eosinophilia in, 1119-1120
hepatic, 990-996, 990t-992t
HIV infection and, 2195, 2199
stool examination in, 1789t, 1790,
1790f-1791f
Parasitosis, delusory, 2081
Parasomnias, 2303
in Lewy body disease, 2281
in obstructive sleep apnea, 614
Parasympathetic nervous system, 2391-2392.
See also Autonomic nervous system
cardiac effects of, e52-3-e52-4
Parathyroid glands, 1591-1592
adenoma of, 1595. See also
Hyperparathyroidism, primary
carcinoma of, 1595
hyperplasia of, 1602
surgical destruction of, 1597
Parathyroid hormone (PTH), 1591-1592
actions of, 1591-1592
availability abnormalities of, 1597-1598
in calcium homeostasis, 1592
excess of. See Hyperparathyroidism
Parathyroid hormone (PTH) (Continued)
in hypercalcemia of malignancy, 1188,
1189f
regulation of, 1591
in renal osteodystrophy, 812-813, 812f
resistance to, 1341-1342
hypocalcemia and, 1598, 1598f
secretion of, 1591
serum, 1594-1595, 1594f
synthesis of, 1591
synthetic, in osteoporosis, 1585
Parathyroid hormonerelated protein, 1593
in hypercalcemia of malignancy, 1188
tumor secretion of, 1296-1297
Paresthesias, 2230-2231, 2349
Parinauds syndrome, 1908, 2448
Parkin, 2326-2327
Parkinsonism, 2333
differential diagnosis of, 2327t, 2329t
drug-induced, 2329t
manganese-induced, 92
vascular, 2329t
Parkinsons disease, 2326-2333
akinesia in, 2327
clinical manifestations of, 2327
complications of, 2328, 2328t
diagnosis of, 2328, 2328t-2329t
differential diagnosis of, 2328, 2328t-2329t
epidemiology of, 2326
motor symptoms of, 2327
pathobiology of, 2326-2333
pathology of, 2327
postural disturbances in, 2327
prognosis for, 2333
rigidity in, 2327
stem cell therapy in, 204-205
treatment of, 2328b-2333b, 2330t-2332t
behavioral side effects of, 141
Paromomycin
in amebiasis, 2046t
in giardiasis, 2042b
in leishmaniasis, 2027-2028
Paronychia, 2555-2556
Parotid gland. See also Salivary glands
enlargement of, 2454
Parotitis
mumps, 2110, 2110f
recurrent, 2454
Paroxetine
in depression, 2239t
in irritable bowel syndrome, 871t
in menopausal hot flushes, 1569t-1570t
in pruritus, 2502t
Paroxysmal cold hemoglobinuria, 1050,
1051t
Paroxysmal hemicrania, 2247t, 2249-2250,
2250t
Paroxysmal hypothermia, 669
Paroxysmal nocturnal dyspnea, 246, 528
in heart failure, 300
Paroxysmal nocturnal hemoglobinuria, 1050,
1051t
aplastic anemia in, 1085, 1088
thrombosis in, 1152
Partial thromboplastin time (PTT), 963
activated (aPTT), 1123, 1123f
in liver failure, 1147-1148
Particulate matter exposure, 78, 78t
Parvovirus B19 infection, 2114-2116
in adults, 2115
arthropathy with, 2115, 2116t
in children, 2115, 2115f
clinical manifestations of, 2115-2116,
2115f, 2523, 2523f
definition of, 2114-2116
diagnosis of, 2116, 2116t
epidemiology of, 2114
hepatitis with, 2116
HIV infection and, 2212-2213
hydrops fetalis with, 2116, 2116t
in immunocompromised host, 1778
pathobiology of, 2114-2115
persistent, 2115-2116
prevention of, 2116
transient aplastic crisis with, 2115, 2115f,
2116t
treatment of, 2116b
Past medical history, 22
Patellar tendinitis, 1680
Patent ductus arteriosus, 402-403, 402f
diagnosis of, 403
epidemiology of, 398
exercise and, 409t
murmur in, 253t
treatment of, 403b
Patent foramen ovale, 2311
adult, 401, 401b
Paterson-Brown Kelly syndrome, 1273
Pathergy, 1723
Pathogen-associated molecular patterns, 214
Patient
adolescent. See Adolescent medicine
approach to, 2-3
dying. See Dying patient; Palliative care
health/disease beliefs of, 178-179, 178t
informed consent from, 4-6
older. See Older adults
personhood of, 3
Patient Health Questionnaire (PHQ-9), for
depression, 102
Patient history
in adolescent medicine, 61
in periodic health examination, 52-53
Patient Self-Determination Act, 6
Pattern recognition receptors, 214-215, 216f,
230-231
Pattern reversal visual evoked responses,
2234, 2234f
Pavlovian conditioning, 141
Pay for performance (P4P), 43
Pazopanib, 1168t-1176t
PCSK9 (proprotein convertase subtilisin-
like/kexin type 9), 1347t, 1348
PDGF gene, 1304
PDGFR gene, 1200
Pearsons syndrome, 2416
Pectus excavatum, 265, 606-607
Pediculosis, 2079-2080
body, 2080, 2080f
head, 2080
pubic, 1797t, 2080
treatment of, 2512
Pelger-Hut anomaly, 1027f, 1100
Peliosis hepatis, 1908t-1909t, 1909-1910
Pelizaeus-Merzbacher disease, 2355
Pellagra, e225-2t-e225-5t
in carcinoid syndrome, 1510
Pelvic examination, 26
in endocrine disorders, 1421
in gastrointestinal disease, 829
in trauma, 691
Pelvic inflammatory disease, 1799,
e307-3-e307-5, e326-4
Pemetrexed, 1168t-1176t
Pemphigoid
bullous, 2525-2532, 2526f
mucous membrane, 884, 2526-2532
Pemphigus, 2527-2532, 2527f
paraneoplastic, 1196-1197, 1196t
Pemphigus vulgaris, 228t, 229, 2527-2532,
2527f
esophageal involvement in, 884
gold for, 2511
Penbutolol, in hypertension, 382t
Penciclovir
adverse effects of, 2082
in herpesvirus infection, 2082-2083, 2083t
herpesvirus resistance to, 2083
Pencil cells, 1025f, 1028
Penicillamine
in systemic sclerosis, 1711
in Wilsons disease, 1372b
zinc effects of, e225-8t
Penicillin, 1807t, 1809t-1811t
adverse effects of, 1814t
allergy to, 132, 1638-1639, 1640t, 1764,
1814t
in diphtheria, 1834b
Enterobacteriaceae resistance to, 1875,
1875t
in nonsyphilitic treponematoses, 1930b
resistance to, 1808t
in scarlet fever, 2522
in syphilis, e327-6b-e327-7b, e327-7t
Penicillin G, 1809t-1811t
in kidney failure, 128t
pharmacokinetics of, 126t
Penicillin V, 1809t-1811t
Penis
erection of, 1520-1521, 1521f
painful, 1071, 1073
examination of, 26
Pennyroyal oil poisoning, 679t-683t
Pentamidine
in African sleeping sickness, 2021t
in Pneumocystis jirovecii pneumonia,
e349-4b-e349-7b
in visceral leishmaniasis, 2027-2028
Pentasaccharides, 173
Pentastomiasis, 2079
Pentazocine, 137-138
Pentose phosphate pathway, e164-5f, e164-6
Pentostatin, 1168t-1176t
Peptic ulcer disease, 886-895
bleeding in, 857-858, 858t, 859f, 890,
893-894
Blatchford scoring of, 893t
Rockall scoring of, 894t
treatment of, 858b-860b, 859f, 893-894,
893t
clinical manifestations of, 889-890, 890t
definition of, 886, 886f
diagnosis of, 890, 890t
differential diagnosis of, 888t
endoscopy in, 886f, 890-892
epidemiology of, 887-895
H. pylori in, 887, 887f, 891
in hypergastrinemic syndromes, 888-889,
888t, 891
idiopathic, 887, 892
intractable, 894
mortality with, 894, 894t
pain in, 247t, 834t-836t, 889-890
pathobiology of, 887-892, 887f
perforation in, 889f, 894
physical examination in, 890
prevention of, 892-895
prognosis for, 893
stenosis with, 894-895, 894f
in systemic inflammatory disorders,
887-888, 888t
treatment of, 892b, 892t
Peptide receptors, 1424, 1424f
Peptostreptococcus infection, 1847-1851,
1850t
Peramivir
in influenza virus infection, 2085t, 2086,
2100b
in influenza virus infection prevention,
2099t
Percutaneous coronary intervention (PCI),
448-453, 451f
in acute coronary syndrome, 432
antithrombotic therapy in, 175t-176t
in cardiogenic shock, 656f, 657
complications of, 449-450
vs. coronary artery bypass grafting, 452,
453f
discharge after, 450
in heart failure, 315
intravascular ultrasound in, 292, 293f
vs. medical therapy, 450-451
patient selection for, 449
preoperative, 2480
restenosis after, 449-450
in ST segment elevation MI, 438f, 439,
441-442, 441t
in stable myocardial ischemia, 422-424
stent selection for, 450
technical considerations in, 448-449,
449f-450f
thrombosis after, 449-450
Percutaneous endoscopic gastrostomy
(PEG), 855
Percutaneous endoscopic jejunostomy (PEJ),
855
Percutaneous transhepatic cholangiography,
964
Percutaneous ventricular pacing, 270-271,
271f
Perennial rhinitis. See Allergic rhinitis

Performance scales, 1165t
Pergolide, in Parkinsons disease,
2330t-2332t
Perianal abscess, 945-949
Pericardial constriction, 479
clinical manifestations of, 479
diagnosis of, 479, 479f-480f
differential diagnosis of, 480, 480t
epidemiology of, 479
pathobiology of, 479
vs. restrictive cardiomyopathy, 480t
treatment of, 480b
Pericardial effusion, 476-481
clinical manifestations of, 477, 477f
diagnosis of, 477-478, 477f-478f
echocardiography in, 282t-284t
epidemiology of, 476-477, 476t
in heart failure, 300
after hematopoietic stem cell
transplantation, 1161
pathobiology of, 477
prognosis for, 479
radiology of, 268, 269f
with tamponade, 478-479
treatment of, 478b-479b, 478f-479f
without tamponade, 478
Pericardial friction rub, 473
Pericardial knock, 479
Pericardiocentesis, 294, 478-479, 478f-479f,
481
Pericarditis
acute, 473-481
vs. angina pectoris, 418
clinical manifestations of, 473
diagnosis of, 473-475, 474f, 474t-475t,
476f
epidemiology of, 473
pathobiology of, 473, 474t
prognosis for, 476
treatment of, 475t, 476b, 476f
autoimmune, 481
bacterial, 481
calcific, 267-268, 268f
echocardiography in, 282t-284t
effusive-constrictive, 480
fungal, 481
Haemophilus influenzae in, 1862
in histoplasmosis, 1978
infectious, 481
malignant, 475t, 481
pain in, 247t
post-myocardial infarction, 473, 475t,
480-481
post-radiation, 481
Staphylococcus aureus in, 1817
in systemic lupus erythematosus,
1701
tuberculous, 481, 1943
uremic, 475t, 481
Pericardium
amebiasis of, 2045
benign cysts of, 481
congenital absence of, 481
fluid in. See Pericardial effusion
inflammation of. See Pericarditis
magnetic resonance imaging of, 288-289,
289f
tumors of, 333
Perindopril, in hypertension, 382t
Perineum, examination of, in trauma, 691
Periodic alternating gaze, 2297
Periodic fever with aphthous stomatitis,
pharyngitis, and cervical adenopathy,
1668t
Periodic health examination, 52-56
disease screening in, 53-55, 53t-54t
history in, 52-53
risk assessment in, 52-53
Periodic leg movements, 2341
Periodic paralysis
in Andersen-Tawil syndrome, 2415
hyperkalemic, 2412t, 2414-2415, 2415t
familial, 741
hypokalemic, 2412t, 2415, 2415t
familial, 741
secondary, 2415t
Periostitis, 1651
INDEX e63
Peripheral arterial disease, 486-492 Peripheral neuropathy (Continued) Persistent mllerian duct syndrome,
acute ischemia in, 489t autoimmune, 2397t, 2403 1516
clinical manifestations of, 488 autonomic, 2392-2393, 2392t-2393t, 2397 Persistent vegetative state, 2295t, 2297,
diagnosis of, 489, 489t, 491f biopsy in, 2398 2298t
pathobiology of, 487-488 clinical manifestations of, 2396-2397 Personal genomics, 200
treatment of, 490, 491f compressive, 2408 Personality disorders, 2236t, 2244, 2245t
ankle-brachial index in, 487, 487f alcohol-related, 2386 alcohol use and, 149
chronic ischemia in critical illness, 2406 drug abuse and, 154
clinical manifestations of, 488-489, 488t definition of, 2396 pain and, 134
diagnosis of, 489 diabetic, 2406. See also Diabetic Personalized medicine, 1340
pathobiology of, 488 neuropathy Pertussis (whooping cough), 1900-1903,
treatment of, 490-492 diagnosis of, 2397-2398, 2397f, 2397t 1965t
clinical manifestations of, 488-489, 488t diphtheria-associated, 2408 catarrhal phase of, 1901
critical ischemia in, 489, 492 electromyography in, 2398 clinical manifestations of, 1901
definition of, 486-487 hereditary, 2398, 2399t, 2400f complications of, 1901
diagnosis of, 489-492, 489f-490f, 489t HIV-associated, 2221 convalescent phase of, 1901
epidemiology of, 487-492, 487f immunologic, 2401, 2401t definition of, 1900-1902
imaging of, 489-490, 489f-490f infectious, 2397t, 2407-2408 diagnosis of, 1901-1902, 1902f
pathobiology of, 487-488 inflammatory, 2397t, 2401, 2401t epidemiology of, 1901
prognosis for, 492, 492f in kidney disease, 708 immunization against, 65f-66f, 67t-70t, 72,
revascularization for, 491-492, 491f laboratory testing in, 2398 1902
risk factors for, 487 lead-related, 89 incubation period of, 1901
treatment of, 175t-176t, 490b-492b, 491f in Lyme disease, 1933 paroxysmal phase of, 1901
Peripheral blood smear, 1024-1031, 1031t metabolic, 2397t, 2406 pathobiology of, 1901
in acute lymphoblastic leukemia, 1030, MGUS-associated, 1235 prevention of, 1902
1030f monoclonal gammopathy with, prognosis for, 1902
in acute myeloid leukemia, 1030, 1030f 2403-2405 treatment of, 1902b
in African trypanosomiasis, 2020, 2020f motor, 2397, 2397t Pesticide exposure, 78, 78t
in anemia, 1028-1029, 1028t, 1034 multifocal, 2403-2405 Pet allergy, 1626
anisocytosis on, 1024f vs. myopathy, 2411t Petechiae
in aplastic anemia, 1087 nerve action potential study in, 2398 in infection, 1771
in autoimmune hemolytic anemia, 1047, nerve conduction study in, 2233, 2233t, in infective endocarditis, 466, 466f
1048f 2398 in liver disease, 953-954
basophilic stippling on, 1026f neurologic examination in, 2397-2398 in meningococcal disease, 2045, 2046f
cellular agglutination on, 1027f neurologic testing in, 2398 Peutz-Jeghers syndrome, 1281t, 1282-1283
in chronic lymphocytic leukemia, 1030, paraneoplastic, 1193t, 2404-2405 clinical manifestations of, 1283, 1283f
1030f, 1215, 1215f pathobiology of, 2396 pathobiology of, 1283
in chronic myelogenous leukemia, 1030, quantitative sensory testing in, 2398 treatment of, 1283b
1030f, 1210, 1210f reflexes in, 2398 Pfiesteria piscicida poisoning, 898
in congenital nonspherocytic hemolytic sensorimotor, 2404 pH, 741
anemia, e164-6 sensory, 2231, 2397, 2397t in acute respiratory failure, 633
dacrocytes on, 1026f toxicant-induced, 672, 2397t in critical care, 626
Dhles body on, 1027f, 1029 vasculitic, 2404-2405, 2405t gastric, e290-5
elliptocytes on, 1025f Peripheral venous disease. See Deep vein pleural fluid, 609t
in hairy cell leukemia, 1213, 1214f thrombosis (DVT) renal regulation of, 718-719, 719f
hemoglobin C crystals on, 1027f Peritoneal carcinomatosis, 926, 926t, 1335 stool, 912
in hereditary spherocytosis, e164- Peritoneal dialysis, 821-822 urinary, 710, 743
2-e164-3, e164-3f, e164-3t complications of, 821-822 vaginal, 1798
Howell-Jolly bodies on, 1024f dialysis dose for, 821 Phaeohyphomycosis, 2007-2008
hypochromia on, 1024f in hypervolemia, 728 clinical manifestations of, 2008
in hypochromic microcytic anemia, 1039, infection with, 821-822 definition of, 2007-2008, 2007t
1040f, 1041 mechanical complications of, 822 diagnosis of, 2008
indications for, 1024-1028, 1027t metabolic complications of, 822 epidemiology of, 2008
in leukemoid reaction, 1098, 1099f peritonitis with, 926-927 pathobiology of, 2008
in lymphatic filariasis, e366-5 prognosis for, 822 treatment of, 2008b
macrocyte on, 1025f, 1079, 1080f technique of, 821, 821f Phagocyte(s). See also Macrophage(s);
in malaria, 2016 Peritoneum Monocyte(s); Neutrophil(s)
in megaloblastic anemia, 1080, 1080f, adhesions of, 927 disorders of, 1111-1118, 1617, 1617t
1104f carcinomatosis of, 926, 926t, 1335 clinical manifestations of, 1114-1115,
microcyte on, 1024f infection/inflammation of. See Peritonitis 1115t
in myelodysplastic syndrome, 1201, 1201f tuberculosis of, 926 diagnosis of, 1117, 1118f
normal, 1024f Peritonitis, 925-927 Phagocytosis, 1112f, 1114. See also
Pappenheimer bodies on, 1026f bacterial, spontaneous, 1001-1004, 1006 Neutrophil(s)
Pelger-Hut anomaly on, 1027f Candida, 1988-1990 Phagosomes, 217
in platelet disorders, 1029, 1029f clinical manifestations of, 925 Phalens sign, 2408
polychromasia on, 1024f with continuous ambulatory dialysis, Pharmacodynamics. See Drug(s),
polychromatic cells on, 1024f 926-927 pharmacodynamics of
in primary myelofibrosis, 1092, 1094f definition of, 925 Pharmacogenetics, 200-201
in pyruvate kinase deficiency, e164-7, diagnosis of, 925, 925f Pharmacogenomics, 131, 132t, 201-202,
e164-7f dialysis-related, 821-822 202t, e42-1t
red cell fragments on, 1025f epidemiology of, 925 Pharmacokinetics. See Drug(s),
in relapsing fever, 1936, 1936f Escherichia coli, 1874 pharmacokinetics of
rouleaux on, 1026f fungal, 2008 Pharyngitis, 2469-2470, 2470f, 2470t
schistocytes on, 1025f, 1048f pain in, 834t-836t acute, 2101
in sickle cell disease, 1025f, 1069f, 1072 pathobiology of, 925 diagnosis of, 1773
spherocyte on, 1025f treatment of, 926b, 926t streptococcal, 1824-1825, 1824f, 1824t
stomatocyte on, 1026f tuberculous, 1943 Pharyngoconjunctival fever, 2101, 2101t
target cells on, 1024f-1025f Peritonsillar abscess, 2470, 2470t, 2471f Pharynx, 2469, 2469f. See also Nasopharynx;
teardrop-shaped cells on, 1026f Permethrin, 2080b, 2547 Oropharynx
in thalassemia minor, 1024f Pernicious anemia, 741, 1076. See also candidiasis of, 2470
toxic granulation on, 1027f Megaloblastic anemia; Vitamin B12 gonococcal infection of, e307-4-e307-5
in white blood cell disorders, 1027f, (cobalamin), deficiency of inflammation of. See Pharyngitis
1029-1030 Pernio, 496-497, 497f Phenacetin, 135
Peripheral nerve, biopsy of, 2398, 2403, 2405 Peroxisomal diseases, 1344, 1344t Phencyclidine
Peripheral neuropathy, 2396-2409 Peroxisome proliferator-activated receptors abuse of, 140t, 158
in acute intermittent porphyria, 1364 (PPARs), 1350 toxic ingestion of, 677t
alcoholic, 2386 Perphenazine, 2243t Phenelzine, in depression, 2239t
e64 INDEX
Phenobarbital, 2292t
in kidney failure, 128t
pharmacokinetics of, 126t
toxic ingestion of, 677t, 684t
Phenoxybenzamine, in catecholamine-
secreting tumors, 1474
Phentolamine, in hypertensive emergency,
388t
Phenylephrine
potassium effects of, 737
in shock, 649t, 653
Phenylketonuria, 1342, 1343t
Phenytoin, 187t, 2292t
erythema multiforme with, 983
hepatotoxicity of, 983
hypersensitivity reaction to, 2535f
in kidney failure, 128t
pharmacokinetics of, 126t
toxic ingestion of, 677t
Pheochromocytoma, 1470-1475
vs. anaphylaxis, 1636
clinical manifestations of, 1472-1473,
1472t, 1473f
definition of, 1470
diagnosis of, 1473-1475, 1474f
differential diagnosis of, 1473, 1473t
dilated cardiomyopathy with, 327
epidemiology of, 1470
genetic testing in, 1472
genetics of, 1470-1472
hypertension with, 378t, 380
imaging of, 1473-1474
laboratory findings in, 1473
malignant, 1475
in MEN 2A, 1506-1507, 1602
pathobiology of, 1470-1473
in pregnancy, 1475, 1558
treatment of, 1474b-1475b
Philadelphia chromosome, 1205, 1209-1210,
1209f
Phlebitis, lymphocytic, 888
Phlebotomus fever, 2158
Phlebotomy
in hereditary hemochromatosis, 985b,
1375b-1376b
in porphyria cutanea tarda, 1364f, 1368b
Phobia, 2240t, 2241-2242
Phosgene, 578
Phosphate
dietary, 1576-1577
fractional excretion of, 755
homeostasis of, 1576-1577
in hypophosphatemic osteomalacia, 1591t
renal handling of, 719f, 720, 1577
serum, 1576
total, 1576
urinary, 1577
Phosphatidylcholine, 1012, 1012t
Phosphatonins, 755
Phosphodiesterase-5 inhibitors
in erectile dysfunction, 1528
in high-altitude syndromes, 576b
Phosphodiesterase inhibitors, in thrombosis,
174
Phosphofructokinase deficiency, 1356t,
e164-7
Phospholamban, 320t
Phosphorus
deficiency of, 755-756, 755t
dietary, 754-755
excess of, 755-756, 756t
metabolism of, 754-756
plasma, 754-755
nutritional therapy and, 1391
Phosphorylase kinase defect, 1356t
Photoallergy, 2516
Photodermatoses, 2515, 2516t
Photopheresis, in Szarys syndrome, 2513
Photophobia, 2429
Photosensitivity
in congenital erythropoietic porphyria,
1369
drug-related, 2535, 2536t
in erythropoietic protoporphyria, 1368
in porphyria cutanea tarda, 1367
Phototherapy, 2513
in circadian rhythm disorders, 2302-2303
Phototoxicity, 2516 Pinworms, 2065t, 2066-2067 Plasmablastic lymphoma, 1225, 2217
PHOX2B gene, 529 Pioglitazone Plasmacytoma
Physical abuse, 2229 in diabetes mellitus type 2, e237-7t extramedullary, 1241
obesity and, 1413 in nonalcoholic fatty liver disease, 999b solitary, 1236t, 1241
Physical activity, 56-58. See also Exercise Piperacillin/tazobactam, 1809t-1811t Plasmapheresis
aerobic, 56 Pirfenidone, in idiopathic pulmonary fibrosis, in systemic lupus erythematosus, 1704
baseline, 56 561b in thrombotic thrombocytopenic purpura,
colorectal cancer and, 1381 Piriform sinus cancer, 1259 1130b
community-level interventions for, 58 PIT1 gene, 1431 Plasminogen activator inhibitor,
counseling on, 55, 58 Pit viper envenomation, 694-696, 696f, 696t cardiovascular disease and, 258
definition of, 56-58 Pituitary adenoma, 1250, 1428, 1433-1434 Plasmodium spp., 2013-2014, 2014f. See also
energy expenditure in, 1412 ACTH-producing, 1435t, 1440-1442, Malaria
epidemiology of, 56-58 1440f, 1440t-1441t, 1465 Platelet(s), 1029f
guidelines for, 57, 57t, 1382t after bilateral adrenalectomy, 1442 activation of, 1121
health-enhancing, 56 clinical manifestations of, 1433-1434, deficiency of. See Thrombocytopenia
intensity of, 56, 56t 1435t destruction of, 1125
levels of, 56, 56t gonadotropin-producing, 1435t, 1443 giant, 1029f
in obesity, 1410-1411, 1415 growth hormoneproducing, 1435t, gray, 1135
in osteoporosis, 1584 1436-1437, 1436f, 1437t hypofunction of
preventive health benefits of, 56-57, hypogonadism with, 1524 acquired, 1136
57b-58b, 57t hypopituitarism with, 1432-1434 drug-related, 1136
risk management for, 57-58 infarction with, 1433 hereditary, 1135
vs. sitting time, 57 in MEN 1, 1506 liver disease and, 1136
types of, 56 nonfunctioning, 1435t, 1444 immune-mediated destruction of, 1125
volume of, 56-57 pathobiology of, 1433 on peripheral blood smear, 1029, 1029f
Physical disability, 98-100, 99t, 100f prolactin-producing, 1435t, 1438-1439, production of, 1125, e159-2f
Physical examination, 22-27 1524 qualitative disorders of, 1135-1136
abdomen, 25 TSH-producing, 1435t, 1444, e233-7 sequestration of, 1125
of adolescent, 61 Pituitary apoplexy, 1433 storage pool disorders of, 1135
in alcohol use evaluation, 150 Pituitary gland transfusion of. See Platelet transfusion
breast, 25 anterior, 1431-1444 Platelet-activating factor, in anaphylaxis,
chaperones for, 23 adenoma of. See Pituitary adenoma 1635-1636
chest, 25 anatomy of, 1431 Platelet-active drugs, 174-176, 174f
genitalia, 26 embryology of, 1431 Platelet count
head and neck, 24 feedback regulation of, 1432 in cirrhosis, 1003
heart, 25 hormone deficiency of, 1432, 1432t, in gastrointestinal disease, 829
history and, 22-23, 23t 1434t postoperative, 2490
liver, 25 imaging of, 1431-1432 Plateletendothelial cell adhesion
lungs, 25 infiltrative disease of, 1433 molecule-1, 1113
musculoskeletal, 25-26 disorders of, adrenal insufficiency with, Platelet transfusion, 1125-1131, 1155-1156
neck, 24 1468 in acute leukemia, 1208
in pain assessment, 134-135 hormones of, 1425-1426 in aplastic anemia, 1089
psychiatric evaluation and, 26 deficiencies of. See Hypopituitarism complications of, 1125-1126
quantitative information for, 22, 23t secretion of, 1427 contraindications to, 1126
rectum, 26 hypothalamic disease effects on, dose for, 1156
review of systems in, 23, 23t 1429-1431 threshold for, 1155-1156, 1156f
skin, 26 neuroendocrine organization of, 1425, viral hemorrhagic fevers, 2154
spleen, 25 1425f Pleiotropic effects, 1340-1341
summary of, 26 neuroendocrine regulation of, 1427 Pleura, 607
vital signs, 23-24 posterior, e232-1-e232-7 diffuse thickening of, 521
Physical fitness, health-related, 56 anatomy of, e232-1-e232-7, e232-2f imaging of, 520-521
Physical inactivity hormones of, e232-1-e232-7, e232-2f. tumors of, 521
cancer and, 1180 See also Oxytocin; Vasopressin Pleural effusion, 607-611
cardiovascular disease and, 257-258 PITX2 gene, 1428, 1431 in asbestosis, 610
Physical therapy Pityriasis lichenoides, 2520 bloody, 609t, 610
in critical care, 624 Pityriasis rosea, 2519-2521, 2519f chylous, 609t, 610
in pain management, 139 vs. secondary syphilis, e327-5 clinical manifestations of, 608
Physician Pityriasis rubra pilaris, 2518-2521 diagnosis of, 608-611, 608f-609f, 609t
communication by. See Communication Pityrosporum folliculitis, 2532 in Dresslers syndrome, 610
consultation with. See Medical pK, 741 drug-related, 610
consultation PKD1 gene, 795-798 epidemiology of, 607-608
race/ethnicity of, 15-16 PKD2 gene, 795-798 exudative, 609, 609t
Physician-assisted suicide, 7-8 PKHD1 gene, 798 in heart failure, 300-301
Physician Orders for Life-Sustaining Placenta, steroidogenesis in, 1513 imaging of, 520-521
Treatment, 102 Plague, 1895-1900, 1965t infective, 609-610
Physiologic oxygen supply dependency, 646 in animals, 1896 malignant, 610
Physostigmine, in anticholinergic agent bioterrorism with, 84t-85t, 86-88, 591, in Meigs syndrome, 610
toxicity, 679t-683t 1896, 1899t in Mycoplasma pneumoniae infection, 1914
Pica, 1041 bubonic, 1897, 1897f in pancreatitis, 610
Picks disease, 2282 clinical manifestations of, 1897-1898 parapneumonic, 609
Piebaldism, 2548 definition of, 1895-1900, 1896f pathobiology of, 607-608, 607t-608t
PIGA gene, 1050 diagnosis of, 1898 in pneumonia, 590
Pigmentation. See Hyperpigmentation; differential diagnosis of, 1898 in rheumatoid arthritis, 1686
Hypopigmentation epidemiology of, 1896, 1896f subpulmonic, 521
Pigmented villonodular synovitis, 1752 pathobiology of, 1897, 1897f in systemic inflammatory disorders, 610
Pill-induced esophagitis, 880-881, 880t pneumonic, 1897-1898, 1898b, 1899t transudative, 609
Pimecrolimus, 2502t, 2513 prevention of, 1898 in trapped lung, 610
Pimozide, in Tourettes syndrome, 2338b prognosis for, 1898 treatment of, 610b
Pindolol septicemic, 1897, 2153t tuberculous, 610
in hypertension, 382t treatment of, 1898b, 1899t in uremia, 610
in stable myocardial ischemia, 423t Plakoglobin, 320t Pleural plaque, 521, 521f
Pineal region tumor, 1250-1251 Plakophilin-2, 320t asbestos-related, 521, 521f, 572
Ping-Pong gaze, 2297 Plantar fasciitis, 1681 Pleural pressure, in asthma, 532
Pinguecula, 2432, 2433f Plantar warts. See Warts, nongenital Pleurisy, 834t-836t
PINK1 gene, 2326 Plasma cell disorders, 1233-1243, 1234t, Pleuritis, in systemic lupus erythematosus,
Pink puffers, 539 1236t, 1238f 1701
Pinta, 1929-1930 Plasma cell leukemia, 1241 Pleurodynia, 2144

Plummer-Vinson syndrome, 1041, 1273
PML gene, 1184
PMS (premenstrual syndrome), e244-5,
e244-5t
Pneumatosis cystoides, in systemic sclerosis,
1709
Pneumoconiosis
asbestos, 567, 568t, 572, 573f, e93-1f
epidemiology of, 567
silica, 567, 568t, 573, 573f, 573t, e93-1f
Pneumocystis jirovecii pneumonia,
e349-1-e349-9
clinical manifestations of, 2201-2202,
e349-2
definition of, e349-1-e349-8
diagnosis of, 2201-2207, 2203f, 2205f,
e349-2-e349-4, e349-2f-e349-4f
differential diagnosis of, e349-4
drug-resistant, e349-7
epidemiology of, e349-1
ground-glass opacities in, 2203-2204,
2204f
HAART therapy and, e349-6-e349-7
imaging in, 2203-2204, 2203f-2206f
immune reconstitution inflammatory
syndrome and, 2222t, 2223, 2224f
vs. nonspecific interstitial pneumonitis,
2207-2208
pathobiology of, e349-1-e349-2
prevention of, 2191t-2193t, 2193-2194,
e349-7-e349-8
prognosis for, e349-8
treatment of, e349-4b-e349-7b,
e349-5f-e349-6f, e349-6t
Pneumomediastinum, 612
Pneumonia, 587-596
aspiration, 593-594
anaerobes in, 1849
clinical manifestations of, 593
diagnosis of, 593-594
epidemiology of, 593
microbiology of, 594
pathobiology of, 593
treatment of, 594b
atypical, 1912. See also Pneumonia,
Mycoplasma pneumoniae
bacterial, 588-589, 592t. See also
Pneumonia, community-acquired;
Pneumonia, health careassociated
Acinetobacter, 1882
Chlamydophila pneumoniae, e326-5
Enterobacteriaceae, 1874-1875
Francisella tularensis, 1895
Haemophilus influenzae, 1862
in HIV-infected patient, 2202, 2202f,
2204-2205
Klebsiella pneumoniae, 1874-1875
Legionella pneumophila, 1903-1906.
See also Legionellosis
Pseudomonas aeruginosa, 1879-1880
Staphylococcus aureus, 1818
Stenotrophomonas maltophilia, 1883
Streptococcus pyogenes, 1825
community-acquired, 588-596
aerosolized droplet inhalation in, 588
bacterial, 588-589, 592t
bioterrorism and, 590-591
blood-borne, 588
bronchoscopy in, 591
chest radiography in, 590, 590f
clinical manifestations of, 588
culture in, 590-591
definition of, 588
diagnosis of, 588, 1773
differential diagnosis of, 588
epidemiology of, 588
Gram stain in, 590
immunologic studies in, 591
laboratory findings in, 590-591
mortality with, 588
oropharyngeal aspiration in, 588
pathobiology of, 588-596
prevention of, 591
risk for, 589, 589t
sputum culture in, 590
Staphylococcus aureus, 1818
travel-related, 589, 589t
Pneumonia (Continued)
treatment of, 591b-593b, 592t, 1766
viral, 589-591, 593
in compromised host, 1778t, 1779
fungal
Blastomyces, 1981
Coccidioides, 1980, 1980f
Mucorales, 1995, 1996f
Nocardia, 1970, 1971f
health careassociated, 594-596, e290-5
clinical manifestations of, 595
diagnosis of, 595
epidemiology of, 594, 594t
pathobiology of, 594-595
prevention of, 596
Staphylococcus aureus, 1818
treatment of, 595b-596b, 595t
lipoid, 580-581, 581f
Mycoplasma pneumoniae, 1912-1916
clinical manifestations of, 1913,
1913f-1914f
diagnosis of, 1915-1916
epidemiology of, 1912
extrapulmonary complications of, 1914,
1914f
pathobiology of, 1912-1913
prevention of, 1916
treatment of, 1916b
occupation-related, 568t
pain in, 247t, 834t-836t
pneumococcal, 1820-1823
clinical manifestations of, 1821
definition of, 1820-1823
diagnosis of, 1821-1822, 1822t
epidemiology of, 1820
immunization against, 55, 65f-66f,
67t-70t, 72, 1822-1823
in asthma, 536
pathobiology of, 1820-1821, 1821f,
1821t
prognosis for, 1823
treatment of, 1822b-1823b, 1823t
Pneumocystis jirovecii. See Pneumocystis
jirovecii pneumonia
ventilator-associated, 594-596, 640,
e290-5
clinical manifestations of, 595
diagnosis of, 595
epidemiology of, 594, 594t
pathobiology of, 594-595
Staphylococcus aureus in, 1818
treatment of, 595b-596b, 595t, 1813
viral. See also Influenza virus infection
adenovirus, 2101, 2101t
cytomegalovirus, 2132
enteroviral, 2144
measles, 2106
respiratory syncytial virus in, 2092,
2092b
walking, 1914
Pneumonitis
hypersensitivity, 564-567, 565b
interstitial
lymphocytic, HIV infection and, 2208
nonspecific, HIV infection and,
2207-2208
in toxoplasmosis, e357-3
Pneumoperitoneum, 845f
Pneumothorax, 611
clinical manifestations of, 611, 611f
epidemiology of, 611
imaging of, 521, 521f
pathobiology of, 611
spontaneous, 247t, 618
tension, 521, 521f
trauma-related, 688
treatment of, 611b
Podagra, 1739, 1739f
POEMS syndrome, 1197, 1236t, 1241, 2403
Pogosta disease, 2161
Poikilothermy, 1431
Poisoning. See also Hazardous exposures;
Occupational disease
acute, 670-684
antidotes for, 679t-683t
cardiopulmonary examination in,
672-673
INDEX e65
Poisoning (Continued) Polycystic ovary syndrome (Continued)
dermatologic examination in, 673 pathobiology of, e244-10
diagnosis of, 670-684, 670t treatment of, e244-11b
ENT examination in, 671 Polycystin-1, 795
epidemiology of, 670 Polycystin-2, 795
gastrointestinal examination in, 673 Polycythemia, 1092-1094
hemodialysis for, 684t congenital, 1094
imaging in, 673 Polycythemia vera, 1090-1098
laboratory testing in, 673, 674t-677t vs. chronic myelogenous leukemia, 1210
miosis in, 671, 671f clinical manifestations of, 1092, 1092t
neurological examination in, 671-672, definition of, 1090-1091
672t diagnosis of, 1092, 1093f, 1093t
patient history in, 670-684 epidemiology of, 1091
physical examination in, 670-673, pathobiology of, 1091-1097, 1091t
670t prognosis for, 1097
prognosis for, 684 thrombosis in, 1152
treatment of, 674t-676t, 676b-684b, treatment of, 1095b-1097b, 1096t
678f, 679t-684t Polydipsia, e232-4
vital signs in, 671 primary, e232-3-e232-4
aluminum, 93-95 vs. diabetes insipidus, e232-5
arsenic, 90-95, 92t psychogenic, 2495
autonomic neuropathy with, 2394 Polyethylene glycol, in irritable bowel
beryllium, 93-95 syndrome, 871t
bismuth, 94-95 Polymer fume fever, 574t
cadmium, 92-95 Polymerase chain reaction (PCR)
carbon monoxide, 577-581 in aspergillosis, 1992
chromium, 94 in babesiosis, e361-2
chronic, 88-95, 88t in bacterial meningitis, 2359
cobalt, 94 in Bartonella infection, 1910
cyanide, 578-581, 679t-683t, 691-692 in bronchitis, 587
food. See Food-borne illness in Chagas disease, e355-3
lead, 88-95, 88t in Clostridium difficile infection, e304-1
manganese, 92-95 in giardiasis, 2042
marine organism, 698t, 699-700, 898 in herpes simplex encephalitis, 2377t,
mercury, 89-95, 90t 2378
nickel, 93-95 in Lyme disease, 1933
selenium, 94-95 in malaria, 2016
silver, 95, 95f in meningococcal meningitis, 1854
snake bite, 694-697 in Mycoplasma pneumoniae infection,
uranium, 95 1915-1916
zinc, 95 in plague, 1898
Poliomyelitis, 2379-2380. See also in pneumococcal pneumonia, 1822
Enterovirus infection in Pneumocystis jirovecii pneumonia,
clinical manifestations of, 2380 e349-3-e349-4
definition of, 2379 in septic arthritis, 1732-1733
diagnosis of, 2380 in severe acute respiratory syndrome, 2104
differential diagnosis of, 2380 in toxoplasmosis, e357-5-e357-6, e357-5t
epidemiology of, 2379 in varicella-zoster virus infection, 2130
immunization against, 67t-70t, 72, 2380 in viral encephalitis, 2377t, 2378
for travel, 1802 in viral meningitis, 2359t, 2367
vaccine-derived polioviruses and, 2141 Polymicrogyria, 2387
mortality with, 2142b Polymorphic light eruption, 2515-2516,
muscular atrophy after, 2380 2516f
pathobiology of, 2141, 2379 Polymorphism, 188, 1340
prevention of, 2380 Polymyalgia rheumatica, 1728-1731
treatment of, 2380b clinical manifestations of, 1728-1729
vaccine-associated, 2379 definition of, 1728
vaccine-derived, 2141, 2379 diagnosis of, 1729-1730, 1729f
Poliovirus infection, 2140t. See also differential diagnosis of, 1730
Poliomyelitis epidemiology of, 1728
subclinical, 2142 pathobiology of, 1728
Polyangiitis, microscopic, 1725 vs. rheumatoid arthritis, 1687t
Polyarteritis nodosa, 1721t-1722t, treatment of, 1730b
1723-1724, 2541 Polymyositis, 1716-1720, 2417, 2417t
biopsy in, 1723, 1723f antinuclear antibodies in, 1654t
gastrointestinal involvement in, 925, 934 cancer and, 1718
paraneoplastic, 1196t clinical manifestations of, 1717-1718,
vasculitic neuropathy in, 2404-2405, 2405t 1719t
Polyarthritis definition of, 1716, 1716t
carcinomatous, 1750 diagnosis of, 1718
febrile, epidemic, 2160 differential diagnosis of, 1719t
paraneoplastic, 1196t epidemiology of, 1716
zoonoses-related, 1967t genetic factors in, 1717
Polyarthropathy, paraneoplastic, 1196t paraneoplastic, 1193t, 1196t, 1197-1198
Polycyclic aromatic hydrocarbons, 1265, pathobiology of, 1716-1717
1306 prognosis for, 1720
Polycystic kidney disease, 104, 185t, 794-795 pulmonary abnormalities in, 564
autosomal dominant, 795-800, 795f, 796t, treatment of, 1719b-1720b
797f Polyp(s)
autosomal recessive, 795f, 796t, 798-800 colonic, 1283
Polycystic ovary syndrome, 1533-1534, adenomatous, 1283-1286, 1284f, 1284t.
1550t, e244-7-e244-8, See also Colorectal cancer
e244-10-e244-14 hamartomatous, 1283
clinical manifestations of, e244-10 nonadenomatous (non-neoplastic),
definition of, e244-10 1283
diagnosis of, e244-10-e244-11 gastric, 1278
obesity and, 1414 nasal, 2456-2457, 2456f
e66 INDEX
Polypectomy, 854, 854f, 1284b
Polyposis syndromes, 185t, 1281, 1281t
Polyradiculomyelitis, cytomegalovirus, 2111
Polysomnography, 614, 614f-615f, 2300
Polyunsaturated fatty acids, omega-3, 313,
1380
Polyuria, 734, 734t, e232-4. See also Diabetes
insipidus
Pompes disease, 1356t, 2415
Pontiac fever, 1903
clinical manifestations of, 1904
diagnosis of, 1905
epidemiology of, 1904
pathobiology of, 1904
Popcorn lung, 568t
Popliteal artery entrapment syndrome, 498
Popliteal cyst, 1680, 1684-1685, e272-1f
Pork tapeworm, 2053t, 2054
Porphobilinogen, urinary, 1365-1366, 1365t
Porphobilinogen deaminase deficiency, 1363,
1364f, 1365t
Porphyria, 1363-1371. See also Acute
intermittent porphyria; Porphyria
cutanea tarda
ALA dehydratase-deficient, 1364f, 1365t,
1369
classification of, 1363
definition of, 1363-1370
diagnosis of, 1370-1371, 1370t
dual, 1370
erythropoietic, congenital, 1364f, 1365t,
1369-1370
hepatoerythropoietic, 1364f, 1365t, 1369
liver disease in, 986
variegate, 1364f, 1365t-1366t, 1369-1370
Porphyria cutanea tarda, 1367-1370
clinical manifestations of, 986, 1367, 2517,
2517f, 2528, 2529f
definition of, 1367
diagnosis of, 1365t, 1368
HFE gene in, 1377
pathobiology of, 1364f, 1367
pathophysiology of, 1365t
treatment of, 1364f, 1368b, 2528
Porphyrin
plasma, 1370
urinary, 1370
Porphyromonas spp. infection, 1847-1851,
1850t
Portacaval shunt, drug toxicity and, 129
Portal hypertension, 952, 1001, 1001f, 1003
Portal pressure, 1003
Portal vein, 952
thrombosis of, 936
after liver transplantation, 1010
ultrasonography of, 846, 847f
Portopulmonary hypertension
in cirrhosis, 1002-1004, 1006
liver transplantation and, 1008-1009
Portuguese man-of-war, 698t, 699
Posaconazole, 1975-1976
adverse effects of, 1976
drug interactions with, 1976
formulations of, 1975-1976
indications for, 1976
in mucormycosis, 1997
Positive airway pressure (PAP), in
obstructive sleep apnea, 614-616, 615f
Positive end-expiratory pressure (PEEP), 638
in acute respiratory failure, 633-634, 637f
auto-, 640-641, 640f
Positron emission tomography (PET)
in colorectal cancer, 1286
in gastrointestinal disorders, 849-850, 850f
in head and neck cancer, 1259
in Hodgkins lymphoma, 1230, 1231f
in lung cancer, 1268
of lymph nodes, 1108
in melanoma, 1331
in metastatic gastrointestinal stromal
tumor, 850f
in multiple myeloma, 1238, 1238f
of myocardium, 285-286
in neurologic disorders, 2235t
in respiratory disease, 517
of spleen, 1110
of thyroid gland, e233-2
Post-herpetic neuralgia, 2407
Post-streptococcal glomerulonephritis, 713,
767, 767f, 1827
Post-thrombotic syndrome, 506
Post-transplantation lymphoproliferative
disease, 2135
Post-traumatic stress disorder, 26, 2240t,
2241
Postcardiotomy syndrome, 480
Postconcussion syndrome, 2467
Posterior cord syndrome, 2266
Posterior cortical atrophy, 2278
Posterior leukoencephalopathy syndrome,
2444-2445
Posterior reversible encephalopathy, 1780
Postherpetic neuralgia, 133t, 136t,
2130-2131
Postnasal drip, 513f, 514t
Postoperative consultation, 2474, 2487-2492
for alkalosis, 2490
ambiguity in, 2491
for anemia, 2490
anesthesia record review in, 2487
for anorexia, 2488
for azotemia, 2490-2491
for blood glucose abnormalities, 2491
for chest pain, 2488, 2488t
for delirium, 2489
for diarrhea, 2488
for dyspnea, 2488, 2489t
for edema, 2490
for fever, 2490
for hyperbilirubinemia, 2491
for hypertension, 2489
for hypoalbuminemia, 2491
for hypotension, 2489
for leukocytosis, 2490
medications in, 2491
mistake patterns and, 2487
for multiple problems, 2491
order checking in, 2487
for platelet count abnormalities, 2490
for potassium abnormalities, 2490
preventive care in, 2488
priorities for, 2491
prophylaxis recommendations in,
2487-2488
recovery focus in, 2487
redundancy in, 2491
for seizures, 2489
for sodium abnormalities, 2490
for tachycardia, 2489-2490
team psychology and, 2487
for vomiting, 2488
for weakness, 2488-2489
Postperfusion syndrome, hemolysis with,
1051t
Postpolio syndrome, 2142b, 2380
Posture/posturing
decerebrate, 2296t, 2297
decorticate, 2296t, 2297
in Parkinsons disease, 2327
Potassium, 734-741
consumption guidelines for, 1382t-1383t
deficiency of. See Hypokalemia
in diabetic ketoacidosis, e236-10,
e236-11f
dietary, 734
digoxin interaction with, 741
excess of. See Hyperkalemia
exercise effects on, 735
external balance of, 735, 737
functions of, 735
homeostasis of, 735
in hypokalemia, 740
internal balance of, 735-737, 737t
intracellular-to-extracellular ratio of, 735
postoperative, 2490
renal handling of, 719, 735, 736f
secretion of, 735-736
serum, 734-741
nutritional therapy and, 1391
urinary, 709-710, 735, 738
Potassium-channel blockers, in ventricular
arrhythmias, 367
Potassium citrate, in nephrolithiasis
prevention, 794
Potassium hydroxide examination, in skin
infection, 2508-2509, 2508f
Potassium iodide (SSKI), 81b
in sporotrichosis, 1986b
in thyrotoxicosis, e233-8
Potassium ion channel, e52-1, e52-2f
Potassium phosphate, 755b
Potassium secretory channels, 736
Potocki-Lupski syndrome, 191
Potocki-Shaffer syndrome, 191
Poultry, Campylobacter jejuni contamination
of, 1870
Powassan virus encephalitis, 2168
Poxvirus infections, 2117-2121, 2117t
clinical manifestations of, 2118-2121
definition of, 2117-2121
diagnosis of, 2120
epidemiology of, 2117
prognosis for, 2121
treatment of, 2121b
PPD (purified protein derivative) test, 54t
Prader-Willi syndrome, 191-192, 1516
Pralatrexate, 1168t-1176t
Pralidoxine, in organophosphorus compound
toxicity, 679t-683t
Pramipexole
in Parkinsons disease, 2330t-2332t
in restless legs syndrome, 2341b
Pramlintide, in diabetes mellitus,
e236-6-e236-7, e237-7t
Pramoxine, 2502t, 2512-2513
Prasugrel, 174-176
in ST segment elevation MI, 442, 447t
Praziquantel, 2010
adverse effects of, 2010
in schistosomiasis, 995b, 2060b
in tapeworm infection, 2009, 2053t
Prazosin, in hypertension, 382t
Precious puberty. See at Puberty
Predictive value, 32t
Prednisolone, 161t. See also Corticosteroid(s)
in high-altitude syndromes, 575-576
Prednisone, 161t, 1168t-1176t. See also
Corticosteroid(s)
in inflammatory bowel disease, 917t
in pain, 136t
Preeclampsia, 987, 1130, 1558-1564
definition of, 1558
diagnosis of, 1559
epidemiology of, 1558
pathobiology of, 1558-1559, 1559f
prevention of, 1560
prognosis for, 1560
treatment of, 1559b-1560b, 1560t
Pregabalin
in pain, 136t
in pruritus, 2502t
Pregnancy, 1555-1565
adolescent, 61-62
antibacterial agents in, 1764
antihypertensives in, 1558b
aplastic anemia in, 1085
asthma in, 536, 1557t, 1561-1562,
e247-1f
autoimmune disease and, 1557t
breast cancer and, 1315
brucellosis in, 1891
Campylobacter jejuni infection in, 1870
cancer during, 1167
cardiac disease in, 1557t
cardiomyopathy with, 327
Chlamydia trachomatis infection in, e326-4
cyclophosphamide and, 165
cyclosporine effects in, 164
deep vein thrombosis in, 499, 502, 505,
1560
depression during, 1550t, 1551
diabetes insipidus in, e232-3-e232-4
diabetes mellitus in, 1557t, 1563,
1563f-1564f, e237-1
disseminated intravascular coagulation
during, 1146
dyspnea in, 1562
ectopic, 834t-836t
epilepsy in, 1557t, 2293
fatty liver disease in, 987, 987t
folate deficiency in, 1078
Pregnancy (Continued)
Haemophilus influenzae infection in, 1862
HELLP syndrome in, 987, 987t
hemoglobin A1C in, 1563, 1563f
hepatic disease in, 986-987, 987t
herpes gestationis in, 2526, 2526f
HIV infection and, 2196
Hodgkins lymphoma in, 1232
hypercoagulability in, 1153
hyperemesis gravidarum in, 987, 987t
hypertension in, 387, 1557-1564, 1557t
hyperthyroidism in, e233-9
hyponatremia in, 730
immunization during, 64-65
inflammatory bowel disease and, 920
intimate partner violence and, 1572
intrahepatic cholestasis of, 987, 987t
ischemic stroke and, 2316
jaundice in, 961
luteoma in, 1515
lymphocytic hypophysitis in, 1433
lymphocytic thyroiditis after,
e233-9-e233-10
lymphoma in, 1227
medications during, 1550t, 1551, 1556
micronutrients in, e225-1
multiple sclerosis and, 2350
mumps in, 2110
non-Hodgkins lymphoma in, 1227
pheochromocytoma in, 1475
physiologic changes of, 1556, 1557t
preeclampsia in, 987, 1558-1564, 1559f
prevention of. See Contraception; Oral
contraceptives
pulmonary edema in, 1562
pulmonary embolism in, 601-602, 1560
radiation exposure in, 1556, 1557t
relapsing fever in, 1936
rubella in, 2108
seizures in, 1557t, 2293
sickle cell disease and, 1071
syphilis in, e327-6
systemic lupus erythematosus and, 1702
systemic sclerosis and, 1711
thrombocytopenia in, 1130-1131
thromboembolic disease in, 1557t, 1560,
1561t
thrombophilia in, 1560
thyroid disease in, 1557t
toxoplasmosis in, e357-2, e357-5-e357-8,
e357-6b, e357-7t
undernutrition during, 1410
Prehypertension, 373-374
Prekallikrein deficiency, 1344t,
e177-7-e177-8
Preload, e52-6
in heart failure, 297
Premature atrial contractions, 337
Premature ejaculation, 1528
Premature ventricular beat, 361, 361f
Premature ventricular contractions, 340t, 361
electrocardiography in, 361f-362f
epidemiology of, 359
in heart failure, 363
after myocardial infarction, 363
palpitations with, 337
ventricular dysfunction with, 363
Prematurity, retinopathy of, 2441
Premenstrual syndrome, e244-5, e244-5t
Prenatal diagnosis
of hemophilia, e177-6
of sexual development disorders, 1519
of toxoplasmosis, e357-4f, e357-6
Preoperative consultation, 2474, 2477-2483
cardiac assessment in, 2477-2481, 2479f,
2479t-2482t
endocrine assessment in, 2482
hematologic assessment in, 2483, 2483t
laboratory tests in, 2477, 2478t
liver assessment in, 2482
medications in, 2477, 2478t
neurologic assessment in, 2483
patient history in, 2477
physical examination in, 2477
pulmonary assessment in, 2481-2482
renal assessment in, 2483
risk assessment in, 2477

Prepatellar bursitis, 1680
Presbycusis, 108, 2463
Presbyopia, 2426-2427
Prescription, exercise, 58
Presenilin, 2278
Pressure sores, 109, 109f
Pressure-time product, 629
Pressure-volume area, cardiac, e52-4-e52-5
Pressure-volume diagram, cardiac,
e52-4-e52-5, e52-5f
Pressure-volume loop, cardiac, e52-5, e52-5f
Presyncope, 337-339
Prevalence, e8-2
Preventive health care, 2247, 2248t. See also
Immunization; Screening
acute kidney injury, 760, 760f
acute pancreatitis, 940
for adolescents, 61
African sleeping sickness, 2020-2021
alcohol use/abuse, 151b-153b, 152t
allergic drug reaction, 1639
allergic rhinitis, 1626
anaphylaxis, 1637
anorexia nervosa, 1408
anthrax, 1839
antibacterial resistance, 1766, 1768,
e290-3-e290-4
aplastic anemia, 1090
aspergillosis, 1994
aspiration, 580
atelectasis, 551b
babesiosis, e361-3
bacterial meningitis, 2365-2366
Bartonella infection, 1910
botulism, e304-4-e304-5
breast cancer, 54t, 55, 1315
brucellosis, 1893
bulimia nervosa, 1408
Campylobacter jejuni infection, 1870
candidiasis, 1990
cardiovascular disease, 175t-176t, 256,
1380
catheter-related infection, e290-6-e290-7
cervical cancer, 1318
Chagas disease, e355-5
chancroid, 1865
Chlamydia trachomatis infection, e326-5
cholera, 1867-1868
chronic pancreatitis, 944
cirrhosis, 1006
Clostridium difficile infection, e304-
1-e304-2
cold injury, 669b
colorectal cancer, 1287, 1287b-1289b
common cold, 2091
cryptosporidiosis, 2040
cystic fibrosis, 547
cystinuria, 794
cytomegalovirus infection, 2132-2133
decompression illness, 577
deep vein thrombosis, 505
diabetes mellitus type 1, e236-16
diabetes mellitus type 2, e237-11
diabetic nephropathy, 782
diarrhea, 900
drowning, 574
drug allergy, 1639, 1640f
Enterobacteriaceae infection, 1876-1877
fall, 108
fracture, 108
for geriatric population, 103, 104t
gonorrhea, e307-5
gout, 1740b-1741b
graft-versus-host disease, 238, 238t
group A streptococcal infection, 1827
health careassociated infection, e290-7
health careassociated pneumonia, 596
heart failure, 295
hemochromatosis, 1376-1377
hemophilia, e177-6
hepatitis A, 968
hepatitis B, 969-970, 975b-976b
hepatitis C, 971
hepatitis E, 972
herpes simplex virus infection, 2128
high-altitude disease, 575-576
HIV infection, 2182-2185, 2182t-2184t
Preventive health care (Continued)
hospital-acquired pneumonia, 596
HTLV-1 infection, 2139-2140
hypertension, 380b-389b
immune reconstitution inflammatory
syndromes, 2224
infective endocarditis, 472, 472t-473t
injury, 55
intimate partner violence, 1573
ischemic stroke, 2319b, 2319t
leishmaniasis, 2030
leprosy, 1954
leptospirosis, 1938-1939
listeriosis, 1836
loiasis, e366-7
lung cancer, 1271
Lyme disease, 1935
lymphatic filariasis, e366-5
malaria, 1801-1803, 2017, 2018t
medullary thyroid carcinoma, 1602-1603
melanoma, 1332
mosquito bite, 1801
mycetoma, 2007
Mycoplasma pneumoniae infection, 1916
myocardial infarction, 170, 170t, 174,
175t-176t, 446-448, 447f, 447t
Neisseria meningitidis, 1854-1855, 1854t
nephrolithiasis, 792-793, 793t
nonalcoholic fatty liver disease, 999
onchocerciasis, e366-7
osteomalacia, 1590, 1591t
osteomyelitis, 1736
osteoporosis, 1549
ovarian cancer, 1319
pancreatitis, 940, 944
peptic ulcer disease, 892-895
plague, 1898
Pneumocystis jirovecii pneumonia,
2191t-2192t, e349-7-e349-8, e349-8t
pneumonia, 591
preeclampsia, 1560
pregnancy. See Contraception
prostate cancer, 1323
psittacosis, e326-7
pulmonary embolism, 602
radiation injury, 82
relapsing fever, 1936-1937
respiratory syncytial virus infection, 2092
rhabdomyolysis, 703
Salmonella infection, 1887
septic shock, 663, 663t
sexually transmitted disease, 1799
shigellosis, 1890
skin cancer, 1334
Staphylococcus aureus infection, 1819-1820
stroke, 386-387
strongyloidiasis, 2068
surgical-site infection, e290-6
syphilis, e327-7
tick bite, 1801, 1895, 1957, 2078-2079,
e361-3
toxocariasis, e366-1
toxoplasmosis, e357-6-e357-8, e357-8t
trachoma, e326-2-e326-3
trichinellosis, e366-2
trichomoniasis, e361-4
tsetse fly bite, 2021
tuberculosis, 1947
urinary incontinence, 113
urinary tract infection, 1795-1796
urticaria, 1631
vancomycin-resistant Enterococcus
infection, 1832
vascular dementia, 2280b
ventilator-associated pneumonia, 596
viral hemorrhagic fevers, 2154
yersiniosis, 1900
Prevotella spp. infection, 1847-1851, 1850t
Priapism, in sickle cell disease, 1071, 1073
Primaquine, in malaria, 2011, 2016t, 2017
Primary angiitis of central nervous system,
1724, 1724t
Primary biliary cirrhosis, 1014-1016
arthritis in, 1747
jaundice in, 958f
malabsorption in, 904
Primary ciliary dyskinesia, 548-549, 549f
Primary effusion lymphoma, 1225, 2216
Primary lateral sclerosis, 2345t
Primary sclerosing cholangitis, 1013, 1014f
Prinzmetals angina, 424
Prion disease, 2380-2382
clinical manifestations of, 2381-2382
definition of, 2380
diagnosis of, 2381-2382, 2382t
epidemiology of, 2380-2381
genetics of, 2381
infectiously acquired forms of, 2381
pathobiology of, 2381
pathology of, 2381
prevention of, 2382
sporadic, 2381
treatment of, 2382b
PRNP gene, 2381
Pro-opiomelanocortin (POMC), 1427
Probability, 32, 32t-33t
test result impact on, 33-34, 33f, 33t
Probenecid, in gout, 1741
Probiotics
in acute diarrhea, 899
in irritable bowel syndrome, 871t
Procainamide, 356t-357t
in kidney failure, 128t
pharmacokinetics of, 126t
Procalcitonin, in bacterial meningitis, 2359
Procarbazine, 1168t-1176t
Prochlorperazine, in nausea and vomiting,
843t-844t
Proctitis
Chlamydia trachomatis, e326-4
in ulcerative colitis, 919
Professionalism, 3-4, 3t, 42
Progeria, 1344
Progesterone
anaphylaxis and, 1635, 1637
synthesis of, e241-1f
Progestin. See also Oral contraceptives
injectable, 1554-1555
metabolic effects of, 1553
Prognosis, communication about, 13, 14f
Progressive diaphyseal dysplasia, 1606-1610
Progressive familial intrahepatic cholestasis,
961
Progressive multifocal leukoencephalopathy,
2112-2114, 2195, 2377t
clinical manifestations of, 2113
definition of, 2112
diagnosis of, 2113, 2114f
epidemiology of, 2112-2113
pathobiology of, 2113, 2113f, 2223-2224
prognosis for, 2114
treatment of, 2112b
Progressive muscular atrophy, 2345t
Progressive rubella panencephalitis, 2112
Progressive supranuclear palsy, 2281, 2329t
Proguanil, in malaria, 2011, 2016t, 2017
Proinsulin, 1503t
Prolactin, 1438
in amenorrhea, e244-3f, e244-7
deficiency of, 1438
excess of, 1430, 1430t, 1438-1439
tests for, 1437t
tumor production of, 1191-1192, 1435t,
1438-1439, 1524
Prolactin inhibitory factor, 1426
Prolactin-releasing factor, 1426
Prolymphocytic leukemia, 1215, 1216t
Promethazine
in nausea and vomiting, 843t-844t
in pruritus, 2512t
Promyelocyte, 1111, 1112f
PROP1 gene, 1431
Propafenone, 356t-357t
Propensity scoring, 41
Propionibacterium acnes infection,
1847-1851, 1850t
Propionic aciduria, 1343t
Propofol, 2484-2485
Propoxyphene, 137t
Propranolol
in alcohol dependence treatment, 152t
in anxiety, 2242t
in hypertension, 382t
in stable myocardial ischemia, 423t
INDEX e67
Proprotein convertase subtilisin-like/kexin
type 9, 1347t, 1348
Proptosis, 2430, 2430f
Propylene glycol intoxication, 748
Propylthiouracil, in thyrotoxicosis, e233-8
Prosopagnosia, 2273-2274
Prostaglandin(s), 168-171
biosynthesis of, 168, 169f
in heart failure, 298
in inflammation, 232
Prostaglandin D2, in anaphylaxis, 1635
Prostaglandin E1, in erectile dysfunction,
1528
Prostaglandin H synthase pathway, 168-169
inhibition of, 169-171
Prostanoids, 168-171
assessment of, 168-169
biosynthesis of, 168, 169f
in inflammation, 232, 235
Prostate cancer, 1322-1325
castration-resistant, 1324
clinical manifestations of, 1323
definition of, 1322
diagnosis of, 1323
epidemiology of, 1178, 1322
palliative care in, 1324
pathobiology of, 1322-1323
prevention of, 1323
prognosis for, 1324-1325
recurrent, 1324
risk factors for, 1322
screening for, 54
staging of, 1323
treatment of, 1166, 1323b-1324b, 1325t
Prostate gland, 805, 806f
benign hyperplasia of, 805-810
clinical manifestations of, 806, 806f
definition of, 805
diagnosis of, 806-810
differential diagnosis of, 807
epidemiology of, 805
laboratory findings in, 807
pathobiology of, 805
physical examination in, 807
prevention of, 807
prognosis for, 808
treatment of, 807b-808b, 808t
examination of, 26
inflammation of. See Prostatitis
obstruction of, heart failure and, 314-315
Prostate-specific antigen (PSA), 54, 54t, 807,
1322-1323
Prostatectomy
in benign prostatic hyperplasia, 808
in prostate cancer, 1323-1324, 1325t
Prostatitis, 808-810
clinical manifestations of, 808-809, 809f
definition of, 808, 808t
diagnosis of, 809-810
differential diagnosis of, 810
epidemiology of, 808
pathobiology of, 808
prognosis for, 810
treatment of, 810b
Prostatodynia, 808, 808t
Prosthetic heart valves, 463b, 463f, 463t
hemolysis with, 1051t
infective endocarditis and, 464-465,
464t-465t, 471t
Prosthetic joint. See Joint(s), prosthetic
Protease(s), in inflammation, 233-234, 233t,
e47-1t
Protease inhibitors
drug interactions with, 1765
in inflammation, 235
lipid disorders and, 1352t
statin interaction with, 1352
Proteasomes, in cancer, 1187
Protein(s)
in ascites, 1004, 1004t
Bence Jones, 713
CSF, 2231t, 2359, 2359t
dietary
digestion of, 901, 902f
nephrolithiasis and, 793
urea nitrogen excretion for, 815, 815t
diversity in, 1340, 1340t
e68 INDEX
Protein(s) (Continued)
drug binding to, 126t, 128
intestinal loss of, 912
in parenteral nutrition, 1395t, 1396
red cell membrane, e164-1-e164-5,
e164-2f
urinary, 709-710, 761. See also Proteinuria
Protein 4.1, e164-1, e164-2f
Protein C
activated
recombinant
in DIC, 1146b-1147b
in septic shock, 664-665
resistance to, 1149-1153
in viral hemorrhagic fevers, 2154
deficiency of, 1149
Protein-energy malnutrition, 1388-1391
adult, 1390, 1390t
body composition and, 1389
body water and, 1389
body weight in, 1385
bone marrow effects of, 1389
brain effects of, 1389
cardiac effects of, 1389
cutaneous effects of, 1389
definition of, 1388
endocrine effects of, 1389
energy metabolism in, 1389
gastrointestinal effects of, 1389
hair effects of, 1389
hepatic effects of, 1389
immune effects of, 1389
metabolic response in, 1388-1389
muscle effects of, 1389
pathobiology of, 1388
pediatric, 1389-1390, 1390f, 1390t
pulmonary effects of, 1389
renal effects of, 1389
secondary, 1388, 1388t
treatment of, 1391b
weight loss in, 1385
Protein-energy undernutrition
(hypoalbuminemic malnutrition), 1385
Protein-losing enteropathy
diarrhea with, 910
in heart failure, 300-301
Protein S deficiency, 1149
Protein-to-creatinine ratio, 709
Proteinosis, alveolar. See Pulmonary alveolar
proteinosis
Proteinuria, 709-710
in acute interstitial nephritis, 773
Bence Jones, 713, 1236
in diabetic nephropathy, 782, 782f
epidemiology of, 761
in glomerular disease, 761
Proteoglycans, e267-1t, e267-3-e267-4
Proteome, 202
Proteomics, 202
Prothrombin, G20210A mutation of, 1149
Prothrombin time (PT), 962-963, 1123,
1123f
in liver failure, 1147-1148
Proton magnetic resonance spectroscopy,
2235t
Proton pump inhibitors
in Barretts esophagus, 879b-880b
in gastroesophageal reflux disease,
876b-878b, 877f, 878t
in peptic ulcer bleeding, 858-860
Protoporphyria
erythropoietic, 1364f, 1365t, 1368-1370
X-linked, 1365t, 1368
Protoporphyric hepatopathy, 1368
Protoporphyrin, erythrocyte, 1370
Protoporphyrinogen oxidase deficiency,
1364f, 1365t-1366t, 1369-1370
Protozoal diseases, 2010-2012
Cryptosporidium. See Cryptosporidiosis
Entamoeba histolytica. See Amebiasis
Giardia lamblia. See Giardiasis
Plasmodium spp. See Malaria
Trichomonas. See Trichomoniasis
PRSS1 gene, 938, 941
Prucalopride, 867b
Prune-belly syndrome, 805
Prurigo nodularis, 953-954, 954f, 2211
Pruritus, 2502, 2502t
in liver disease, 952
in onchocerciasis, e366-6, e366-6b
paraneoplastic, 1196t
treatment of, 2502, 2502t
in urticaria, 1629
Pruritus ani, 947
Pseudo-Hurler polydystrophy, 1662t
Pseudo-Pelger-Hut phenomenon, 1201,
1201f
Pseudo-pseudo gout, 1742, 1742f, 1742t
Pseudoaneurysm, renal artery, 690f
Pseudoathetosis, 2266, 2397
Pseudoclaudication, 488, 488t
Pseudocyst, pancreatic, 856-857, 944,
944f
Pseudoephedrine, in common cold, 2090,
2090t
Pseudofracture, in osteomalacia, 1588,
1588f
Pseudogout. See Calcium pyrophosphate
dihydrate (CPPD) deposition disease
Pseudohemoptysis, 513
Pseudohyperphosphatemia, 755-756
Pseudohypoaldosteronism, 739-740, 749,
801t
Pseudohyponatremia, 728
Pseudohypoparathyroidism, 1341-1342,
1598, 1598f
Pseudomonas aeruginosa infection,
1877-1881
antibiotic-resistant, 1881
biofilms in, 1878
bloodstream, 1878-1880
bone, 1879
burn-related, 1879-1881
clinical manifestations of, 1878-1880
CNS, 1879-1881
cutaneous, 1879-1880
definition of, 1877
ear, 1879-1881
ecthyma gangrenosum in, 1778, 1779f,
1879
endovascular, 1880
epidemiology of, 1877
exotoxin A in, 1878
host factors in, 1877-1878
in infective endocarditis, 470t
joint, 1879
meningeal, 1879-1881, 2364
neonatal, 1880
in neutropenia, 1880
ocular, 1879-1881, 2435
pathobiology of, 1877-1878
respiratory tract, 1879-1880
soft tissue, 1879-1880
treatment of, 1880b-1881b
urinary tract, 1879-1881
virulence factors in, 1878, 1878t
Pseudomonas fluorescens infection, 1881
Pseudomonas folliculitis, 2532, 2532f, 2544
Pseudomycetoma, 2006-2007
Pseudoporphyria, 2528
Pseudothrombocytopenia, 1122-1125
Pseudothrombophlebitis, 1680, 1684-1685
Pseudotumor, orbital, 2430, 2440
Pseudoxanthoma elasticum, 935, 1666-1667,
2537-2538
acquired, 1667
Psilocybin abuse, 158
Psittacosis, 84t, 1965t, e326-6-e326-7
vs. viral hemorrhagic fever, 2153t
Psoas sign, 837t
Psoriasis, 2505, 2505f, 2507, 2508f,
2517-2521. See also Arthritis, psoriatic
clinical manifestations of, 2517-2518,
2517f-2518f, 2550f
diagnosis of, 2518
epidemiology of, 2517
erythrodermic, 2517-2518
guttate, 2517-2518
HIV infection and, 2211
HLA associations in, 225t
inverse, 2517-2518
palmoplantar, 2517-2518
pathobiology of, 2517
pustular, 2517-2518, 2531
Psoriasis (Continued)
treatment of, 2511, 2518b, 2518t
alefacept in, 2513, 2518t
tumor necrosis factor- inhibitors in,
165-166
ustekinumab in, 166, 2518t
Psychiatric disorders, 2236-2245
assessment of, 26, 2236, 2236t, 2245,
2245t
cognitive, 2236, 2236t. See also Delirium;
Dementia
comorbidity and, 2236
definition of, 2236, 2236t
vs. dementia, 2275
in fibromyalgia, 1744-1745
irritable bowel syndrome and, 869
medical consultation for, 2492-2496,
2492t, 2494t, 2495f
chief complaint in, 2492
secondary, 2236
treatment of, 2236-2237
agranulocytosis with, 2493-2494
cardiomyopathy with, 2493
choking with, 2493
complications of, 2492-2496, 2492t
electroconvulsive therapy in,
2495-2496, 2495f
hyperprolactinemia with, 2495
hyponatremia with, 2495
laryngeal dystonia with, 2493
metabolic syndrome with, 2492-2493
myocarditis with, 2493
neuroleptic malignant syndrome with,
2494, 2494t
neutropenia with, 2493-2494
polydipsia with, 2495
prolonged QTc interval with, 2493
serotonin syndrome with, 2494-2495,
2494t
sudden death with, 2493
Psychogenic polydipsia, e232-4
Psychogenic seizures, 2289
Psychophysiologic dizziness, 2468, 2468t
Psychosis, 2236t, 2242
Psychosocial development, 59
Psychosocial disease, 179-180. See also Stress
Psychotropic drugs. See also Antipsychotic
agents
complications of, 2492-2496, 2492t
in geriatric patients, 115b-116b, 116t
metabolic syndrome with, 2492-2493
PTEN gene, 1309
PTEN hamartoma syndrome, 1283
Pterygium, 2432, 2433f
Ptosis, 2420, 2429, 2430f
PTPN22 gene, 1682, 1697
Pubarche, premature, 1531
Puberty, 59, 60f
female, 1530-1531, 1530f, e244-6t
asynchronous, 1531, 1532t, 1533
delayed, 1531, 1532t, 1533
heterosexual, 1531-1534, 1532t
isosexual, 1531
precocious, 1430, 1531, 1532t
diagnosis of, 1531
imaging in, 1533
laboratory tests in, 1532-1534
physical examination in, 1531
treatment of, 1533b
male, 1521, 1521f, 1521t
delayed, 1521-1522
precocious, 1430, 1522
pseudo-precocious, 1522
precocious, 1430
female, 1531, 1532t, 1533b
male, 1522
Pubic hair, 59, 60f
Pubic lice, 1797t, 2080
Puestow procedure, 943
Pufferfish poisoning, 698t, 699, 898
Pulmonary alveolar proteinosis, 552-555
bronchoalveolar lavage in, e85-6t
clinical manifestations of, 553
diagnosis of, 553, 553f, 555f
epidemiology of, 552-553
pathobiology of, 552t, 553
treatment of, 553b-554b
Pulmonary artery, 265, 268-271, 270f
infarction of, vs. angina pectoris, 418
Pulmonary artery catheter, 2480
Pulmonary artery pressure, 281-282, e52-5t
Pulmonary atresia, 403
Pulmonary blood pressure, 389
Pulmonary congestion, cardiac
catheterization and, 291
Pulmonary edema
vs. ARDS, 636, 636t
clinical manifestations of, 514t
in heart failure, 300, 316-317, 317f
high-altitude, 575-581, 575t
imaging in, 269-270, 270f, 517, 518f
in pregnancy, 1562
transfusion-related, 1157
Pulmonary embolism, 596-603
vs. angina pectoris, 418
chest pain in, 474t
clinical manifestations of, 514t
definition of, 596
echocardiography in, 282t
nonthrombotic, 602-603
pain in, 247t
in pregnancy, 1560
tachypnea with, 29
thrombotic, 596-603
angiography in, 599
in cancer, 601
caval filters in, 601
chronic thromboembolic pulmonary
hypertension with, 602
clinical manifestations of, 597
computed tomographic angiography in,
598-599, 598f
computed tomographic venography in,
599
D-dimer test in, 598, 598f
diagnosis of, 597-603, 598f-599f
echocardiography in, 599-600
electrocardiography in, 599, 600f
epidemiology of, 596
laboratory testing in, 599-600
magnetic resonance imaging in, 599
pathobiology of, 596-597, 597f
in pregnancy, 601-602
prevention of, 602
prognosis for, 602
treatment of, 171-177, 175t-176t,
600b-602b, 600t-601t
ultrasonography in, 599
ventilation-perfusion scan in, 599
Wells prediction rule in, 598t
Pulmonary fibrosis
idiopathic, 556, 560-567
bronchoalveolar lavage in, e85-6t
chest radiography in, 559t
clinical manifestations of, 560
diagnosis of, 560-561, 561f, 561t
epidemiology of, 560
prognosis for, 562
radiography in, 518, 518f
treatment of, 561b
pulmonary function tests in, e85-4t
Pulmonary function tests, e85-3-e85-5,
e85-3t-e85-4t
in asthma, 533, 533t
in bronchiectasis, 549
in bronchitis, 587
in COPD, 537, 537f, 539-540, 540t
in diaphragmatic weakness and paralysis,
604
in HIV-infected patient, 2204
in idiopathic pulmonary fibrosis, 560
in interstitial lung disease, 559
preoperative, 2481-2482
in pulmonary hypertension, 395
in sarcoidosis, 584-585
Pulmonary hypertension, 389-397
in adult congenital heart disease, 399
vs. angina pectoris, 418
classification of, 390t
clinical manifestations of, 391-396
in connective tissue disease, 389
definition of, 389
diagnosis of, 392-395, 392f-394f
drug-induced, 389

Pulmonary hypertension (Continued)
echocardiography in, 282t-284t
epidemiology of, 389-390
follow-up for, 394t, 396
heritable, 389-390
HIV infection and, 2208
idiopathic, 389-390
imaging in, 270, 519, 519f
in left heart disease, 389-390, 395
in lung disease, 390-391
mortality with, 391
pain in, 247t
pathobiology of, 390-396, 391f
pathophysiology of, 391
patient history in, 391-392
physical examination in, 392
prognosis for, 396, 397t
right atrial enlargement in, 266, 267f
right ventricular enlargement in, 266,
267f
in sickle cell disease, 1071, 1073, 1073t
in systemic sclerosis, 1710, 1712
in systemic-to-pulmonary shunt, 389
in -thalassemia intermedia, 1063-1064
thromboembolic, 390-391, 395
treatment of, 394t, 395b-396b, 396f
Pulmonary nodule(s). See also Lung cancer
radiography of, 520, 520f
in rheumatoid arthritis, 1686, 1686f
solitary, 618, 1267, 1269f
Pulmonary rehabilitation, in COPD, 542
Pulmonary sequestration, 551, 552f
Pulmonary valve, e52-3
Pulmonary valve regurgitation, 253t
Pulmonary valve stenosis, 253t, 463
congenital, 404, 404b
Pulmonary veins, 268-271, 270f
anomalies of, 408
Pulse
abnormal, 27t-28t
carotid, 24, 250, 251f
decrease in, 29
elevation of, 29
jugular vein, 250, 251f, 251t
measurement of, 27
for physical examination, 23-24
Pulse oximetry, 27, 626-627, 627f
abnormal, 27t-28t, 29-30
normal, 27t
respiratory rate and, 28
Pulse pressure, in shock, 647t
Pulse-temperature dissociation, 28
Pulseless disease, 486. See also Takayasus
arteritis
Pulseless electrical activity, 344, 347-348,
348f. See also Cardiac arrest
Pulsus alternans, 301
Pulsus paradoxus
in cardiac tamponade, 477
in shock, 647t
Punique virus, 2158
Pupil(s), 2427f, 2428
abnormalities of, 2445-2446, 2445f-2446f
Adies, 2445, 2445f
Argyll Robertson, 2436
enlarged, 2445, 2446f
examination of, 2427, 2427f, 2445
in coma, 2296, 2296t
large, 2430
miotic, in acute poisoning, 671, 671f
physiology of, 2445, 2445f
small, 2430, 2445-2446, 2446f, 2446t
white, 2430, 2430t
Pure tone testing, 2462
Pure white cell aplasia, 1104
Purified protein derivative (PPD), 1944
Purpura, 2507f, 2524, 2524t
emboli and, 2524-2525
infection-related, 1771
nonpalpable, 2524-2532, 2524f, 2524t
palpable, 2524t, 2525-2532, 2525f
psychogenic, 1136
senile, 108, 108f, 1136
solar, 2524
steroid, 2524
systemic causes of, 2524
thrombus and, 2524
Purpura (Continued)
vasculitic, 2507, 2525, 2525f
in Wegeners granulomatosis, 1725,
1725f
Purpura fulminans, 2524, 2524f
Pyelography, in obstructive uropathy, 780
Pyelonephritis. See also Urinary tract
infection
clinical manifestations of, 1793-1796,
1793t
diagnosis of, 1793-1796, 1795t
differential diagnosis of, 1794
epidemiology of, 1792
etiology of, 1793, 1793t
follow-up for, 1795
pathobiology of, 1792-1793
prognosis for, 1796
radiography in, 1794
treatment of, 1794, 1795t
Pyknodysostosis, 1608-1610
Pyoderma gangrenosum, 2543
Pyogenic arthritis with pyoderma
gangrenosum and acne, 1668t,
1671-1672
Pyomyositis, 1771, 1816
Pyrantel pamoate, in roundworm disease,
2009
Pyrazinamide, 1809t-1811t
Pyridoxine (vitamin B6), e225-2t-e225-5t,
e225-9t
deficiency of, 2383t, 2384, e225-2t-
e225-5t
in ethylene glycol toxicity, 679t-683t
in homocystinuria, 1362b-1363b
in isoniazid toxicity, 679t-683t
in monomethylhydrazine mushroom
poisoning, 679t-683t
toxicity of, 2385, e225-2t-e225-5t
Pyrilamine, in pruritus, 2512t
Pyrimethamine, in toxoplasmosis, e357-7t
Pyrimidine 5-nucleotidase deficiency,
e164-7, e164-7f
Pyropoikilocytosis, hereditary, 1026f,
e164-3f, e164-4
Pyruvate kinase deficiency, e164-6, e164-7f
Pyuria, 1794
PYY, 1411t
Q neoplastic, 81, 81t
Q fever, 84t, 995-996, 1962, 1965t
clinical manifestations of, 1963
definition of, 1962
diagnosis of, 1963, 1963t
endocardial, 468t, 1963
epidemiology of, 1963
treatment of, 1963b
vs. viral hemorrhagic fever, 2153t
QT interval prolongation. See Long QT
syndrome
Quadriceps tendon rupture, 1680-1681
Quality-adjusted life years, 35
Quality of care, 15-16, 16t, 42-43, 42t
in chronic disease management, 45, 47
definition of, 42, 42t
Donabedians triad of, 42, 42t
environment for, 42-43
improvement of, 43
measurement of, 37-41. See also
Measure(s); Measurement
problems with, 42
Queensland tick typhus, 1956t, 1958
Questionnaire, for occupational/
environmental exposures, e18-1f
Questionnaires, 39
for depression, 102
for occupational/environmental exposures,
75-76
Quetiapine, 2243t
in Parkinsons disease, 2330t-2332t
Quinapril, in hypertension, 382t
Quinckes pulse, 461
Quinidine, 356t-357t
in malaria, 2012, 2016t, 2017
Quinine
in drug adulteration, 154
in malaria, 2012, 2016t
Quinolones, 1807t, 1809t-1811t, 1812
adverse effects of, 1814t
resistance to, 1808t
Quinupristin/dalfopristin, 1807t-1811t, 1813
R in ventricular arrhythmias, 373
R protein, 1075
Rabeprazole, in gastroesophageal reflux
disease, 878t
Rabies, 1966t, 2378
clinical manifestations of, 2378
diagnosis of, 2378
epidemiology of, 2378
immunization against, 64t, 67t-70t, 73
for travel, 1801t, 1802
pathology of, 2378
treatment of, 2378b-2379b
Race
cancer and, 1180
cardiovascular disease and, 257
cigarette smoking and, 18f
communication and, 15
health care access and, 15-17, 15t
health care quality and, 15-16, 16t
health status and, 15
hypertension and, 375, 375f
lung cancer and, 1265
Racecadotril, in acute diarrhea, 899
Radiation
electromagnetic, 78, 78t, 79f
extremely low frequency, 83
infrared, 79f, 82
ionizing, 79, 79t
annual exposure to, 79t
toxic exposure to. See Radiation injury
microwave, 79f, 82
radio frequency, 82
therapeutic. See Radiation therapy
ultraviolet, 79f, 82, 108, 1180-1181,
2501-2502
Radiation injury, 78-83
clinical manifestations of, 80-81, 80t
definition of, 78-83
diagnosis of, 81-82
epidemiology of, 78-79
heritable effects and, 81
life span and, 81
localized, 81
pathobiology of, 79, 79t
pathogenesis of, 79-80
pericardial, 481
prenatal, 81
prevention of, 82
prognosis for, 82
pulmonary, 579-581
regional, 81
treatment of, 81b
whole body, 80-81, 80t, 1085
Radiation syndrome, 80-81, 80t
Radiation therapy, 1164-1165
cancer after, 1180-1181, 1181t
cataracts with, 1162
in chronic lymphocytic leukemia, 1217
in colorectal cancer, 1288
in Cushings syndrome, 1466
diarrhea with, 898
enterocolitis with, 910-911, 924
in head and neck cancer, 1262b-1263b
hypogonadism after, 1524, e244-9
hypopituitarism after, 1432
hypothalamic dysfunction after, 1429
leukemia and, 1203, 1209
in multiple myeloma, 1240
neutropenia with, 1103
in pituitary adenoma, 1435
in prostate cancer, 1324
thyroid nodules after, e233-11
Radiculopathy, 2264-2265
cervical, 418, 2265b
clinical manifestations of, 2265
definition of, 2264
diagnosis of, 2265
differential diagnosis of, 2265
imaging in, 2265
lumbar, 2265b
INDEX e69
Radiculopathy (Continued)
in multiple myeloma, 1238
pathobiology of, 2264-2265
treatment of, 2265b
Radio frequency catheter ablation, 372-373
in supraventricular arrhythmias, 372-373
Radio frequency radiation, 82
Radio frequency smooth muscle ablation, in
asthma, 536
Radiography. See also Chest radiography
in achalasia, 881, 881f
in ankylosing spondylitis, 1693-1694,
1693f-1694f
in chondrocalcinosis, 1742f
in chronic pancreatitis, 902
in diffuse idiopathic skeletal hyperostosis,
1742f
in epiglottitis, 2094f
in epiphrenic diverticulum, 883f
in esophageal spasm, 882, 882f
in fibrous dysplasia, 1609, 1609f
in gastric lymphoma, 1277
in gastrointestinal disorders, 831t-832t,
832, 845, 845f
in gout, 1740
in hemochromatosis, 1750f
in hypertrophic osteoarthropathy, 1750f
in inflammatory bowel disease, 916
in intestinal ischemia, 929
in liver disease, 955
in malabsorption, 911
in mastocytosis, 1642
in multiple myeloma, 1238, 1238f
in neck pain, 2261
in osteoarthritis, 1675, 1685f, 1753f
in osteomalacia, 1588, 1588f
in osteopetrosis, 1608, 1608f
in osteoporotic fracture, 1581-1582, 1582f
in osteosclerosis, 1606
in Pagets disease, 1604f
in perforated peptic ulcer, 889f, 894
in pneumoperitoneum, 845f
in pregnancy, 1556, 1557t
in psoriatic arthritis, 1696
in reactive arthritis, 1695, 1695f
in rheumatic disease, 1656, 1656f, 1657t,
1658f
in rheumatoid arthritis, 1656, 1656f,
1685f, e272-1f
in Schatzkis ring, 883f
in septic arthritis, 1732-1733
in Staphylococcus aureus infection, 1817,
1817f
in stress fracture, 1681
in viral croup, 2093f
in Zenkers diverticulum, 882f
Radionuclide imaging
in gastrointestinal disease, 849-850, 850f
in hepatic adenoma, 1299
in hepatic cavernous hemangioma, 1299
in hepatic focal nodular hyperplasia, 1299
of left ventricular function, 286
in rheumatic disease, 1658f-1659f, 1659
in ST segment elevation MI, 437
Radon, cancer and, 1180-1181, 1264-1265
Rales (crackles)
in heart failure, 301
in interstitial lung disease, 556-557
Raloxifene
in breast cancer prevention, 1315
in osteoporosis, 1584
prophylactic, 55
Ralstonia infection, 1881
Ramipril
in heart failure, 308t
in hypertension, 382t
in ST segment elevation MI, 443
Ramsay Hunt syndrome, 2467
Range of motion, in pain assessment, 135
Ranibizumab, 166-167
Ranitidine
in gastroesophageal reflux disease, 878t
in pruritus, 2512t
Ranke complex, 1941
RANKL (receptor activator of nuclear
factor-B ligand), 1580, 1580f
e70 INDEX
Ranolazine, in stable myocardial ischemia,
419-421
Rapamycin. See Sirolimus
Rapid plasma reagin (RPR) test,
e327-4-e327-5, e327-5t
Rapid response team, for consultation, 2474,
2475t
Rapoport-Luebering shunt, e164-6
RAR gene, 1184
RAS-MAPK pathway, 320t
Rasagiline, in Parkinsons disease, 2328,
2330t-2332t
Rash. See also Exanthem; Skin, lesions of
allopurinol-related, 1741
in bacterial meningitis, 2358
in chickenpox, 2129, 2129f
in dermatomyositis, 1718, 1718f
differential diagnosis of, 86, 1770
drug-related, 1814t, 2106t, 2534-2543,
2534t
in enterovirus infection, 2143, 2366
in familial Mediterranean fever, 1669
fever and, 1770-1771, 1771t
gemifloxacin-related, 1765
in glucagonoma, 1294, 1295f
in HIV infection, 2209
mite-induced, 2078
in monkeypox, 2119, 2119f
in neutropenic host, 1778-1779
occupation-related, 76t, 77
in psittacosis, e326-5
in Rocky Mountain spotted fever,
1956-1957
in secondary syphilis, e327-2, e327-2f
in smallpox, 2118, 2118f
in systemic lupus erythematosus, 1699,
1699f
in typhoid fever, 1886
in viral hemorrhagic fever, 2151
in zoster, 2129, 2129f
Rate, e8-1-e8-2
Rathkes cleft cyst, 1428
Ratio, statistical, e8-1-e8-2
Raynauds phenomenon, 495-496, 669
clinical manifestations of, 495f, 496
definition of, 495
diagnosis of, 496
epidemiology of, 495
in Mycoplasma pneumoniae infection, 1915
paraneoplastic, 1196t
pathobiology of, 495
primary, 495, 496t
prognosis for, 496
secondary, 495, 496t
in systemic lupus erythematosus, 1701
in systemic sclerosis, 1707, 1709-1712,
1709f
treatment of, 496b
Reactive airways dysfunction syndrome, 532,
569
Reactive nitrogen intermediates, 233
Reactive oxygen intermediates, 233
Receiver operating characteristic (ROC)
curve, 35, 35f
Receptor(s)
acetylcholine, 2417-2418, 2418f
antidiuretic, e232-1
antigen-specific, 217-218
cubam, 1075
cytokine, 1424, 1424f
epidermal growth factor, 1273
extracellular matrix, e267-4-e267-5
farnesoid X, 1350
Fc, 215-216, 216f, 227
follicle-stimulating hormone, 1442
GH secretagogue, 1426
granulocyte-colony-stimulating factor,
1102-1103
hormone, 1423-1424, 1424f-1425f
liver X, 1350
low-density lipoprotein, 1347-1348, 1347t
MHC class-recognizing, 215
nuclear, 1350, 1424-1425, 1425f
olfactory, 2460
pattern recognition, 214-215, 216f,
230-231
peptide, 1424, 1424f
Receptor(s) (Continued)
peroxisome proliferator-activated, 1350
pre-B cell, 220
ryanodine, e52-2
T-cell, 217-218
taste, 2460
thyroid hormone, e233-1
toll-like, 230-231
transferrin, 1041, 1041t
tyrosine kinase, 1424, 1424f
Recommended dietary allowances (RDAs),
1380, e225-1, e225-2t-e225-7t
Rectum, 945
abscess of, 945-949
bleeding from. See Gastrointestinal
bleeding, lower
Chlamydia trachomatis infection of,
e326-4
examination of, 26
in evacuation disorders, 867t
in gastrointestinal disease, 829
gonococcal infection of, e307-3-e307-5,
e307-5t
hemorrhoids of, 945-949, 946f, 946t
prolapse of, 947-949, 948f
villous adenoma of, 910
Recurrent artery of Heubner, 2305
Red blood cell(s). See also at Peripheral
blood smear
antibodies to, 1046, 1046f
HIV infection and, 2213
aplasia of, 1084-1085
casts of, 711-712, 711f
CSF, 2231t, 2320-2321
deficiency of. See Anemia
dysmorphic, 710-711, 711f
Embden-Meyerhof pathway of, e164-5f,
e164-6
energy metabolism of, e164-5-e164-9,
e164-5f
examination of. See Peripheral blood smear
hemoglobin of. See Hemoglobin
hexose monophosphate shunt of,
e164-6-e164-7
IgG antibodies to, 1045-1046, 1045f
isomorphic, 710-711, 711f
life cycle of, 1046
in liver disease, 963
lysis of. See Hemolysis; Hemolytic anemia
membrane of. See Red blood cell
membrane
metabolism of, disorders of, e164-6,
e164-7f
normal, 1024f, 1031t
parvovirus B19-related aplasia of, 2115,
2115f
pleural fluid, 609t
production of, e159-1, e159-2f
splenic processing of, 1109
teardrop, 1099, 1099f
transfusion of, 1154-1155. See also Blood
transfusion
urinary, 710-711, 711f, 761, 833, 1307
Red blood cell distribution width, 1031t
Red blood cell membrane, e164-1-e164-5
defects of, e164-1-e164-2
elliptocytic, e164-3f, e164-4-e164-5
pyropoikilocytic, e164-3f, e164-4
spherocytic, e164-2-e164-5, e164-3f,
e164-3t
stomatocytic, e164-3f, e164-5
integral proteins of, e164-1
lipids of, e164-1
peripheral proteins of, e164-1
proteins of, e164-1-e164-5, e164-2f
Red eye, 24, 2428, 2429t
5-Reductase deficiency, 1514
5-Reductase inhibitors, in benign prostatic
hyperplasia, 807, 808t
Reef fish poisoning, 698t, 699
Refeeding. See also Nutrition, enteral;
Nutrition, parenteral
in protein-energy malnutrition, 1391
Refeeding syndrome
in anorexia nervosa, 1408
enteral nutrition and, 1394
parenteral nutrition and, 1391, 1397
Reflex(es), 2229, 2260t
baroreceptor, e232-1-e232-2
failure of, 2394
Cushing, 28
in endocrine disorders, 1421
H, 2233
in peripheral neuropathy, 2398
vestibulo-ocular, 2296t, 2297, 2447,
2467
Reflex seizures, 2291
Reflux. See Gastroesophageal reflux disease
(GERD)
Refsums disease, 1344t
Refusal, right of, 6, 6t
Regenerative medicine. See Cell therapy;
Organ transplantation
Regurgitation, in esophageal disease, 875
Rehydration solution
in acute diarrhea, 899
in cholera, 1867b
Reifensteins syndrome, 1516
Reiters syndrome, 1694-1695
Relapsing fever, 1935-1937
clinical manifestations of, 1936
definition of, 1935-1937
diagnosis of, 1936, 1936f
epidemiology of, 1936
pathobiology of, 1936
prevention of, 1936-1937
prognosis for, 1937
treatment of, 1936b
vs. viral hemorrhagic fever, 2153t
Relapsing polychondritis, 1751
Relative odds, 41
Relative risk, e8-2
Relative risk reduction, e8-2
Relaxation therapy, in hypertension, 381
REM sleep, 2299-2300, 2300t
REM sleep behavior disorder, 2281,
2303
Renal artery
atheroembolic disease of, 786-787
clinical manifestations of, 787
diagnosis of, 787
epidemiology of, 786-787
pathobiology of, 786-787
prognosis for, 787
treatment of, 787b
atherosclerosis of. See Renal artery stenosis
fibromuscular dysplasia of, 379, 379f.
See also Renal artery stenosis
epidemiology of, 784
pathobiology of, 784
prognosis for, 785
treatment of, 785b
pseudoaneurysm of, 690f
thromboembolic occlusion of, 785-786,
786f, 786t
clinical manifestations of, 786
diagnosis of, 786
epidemiology of, 785
pathobiology of, 785
prognosis for, 786
treatment of, 786b
Renal artery stenosis, 783-786
clinical manifestations of, 784, 784t
definition of, 783
in diabetes mellitus, 782
diagnosis of, 784-785, 784f-785f
epidemiology of, 783-784
hypertension with, 378t, 379, 379f
magnetic resonance angiography of,
714f
pathobiology of, 784
prognosis for, 785
treatment of, 785b
Renal calculi. See Nephrolithiasis
Renal cell carcinoma, 1303-1309
clinical manifestations of, 1304, 1305t
definition of, 1303, 1303t
diagnosis of, 1304-1305
epidemiology of, 1303-1304
metastatic, 1305-1306
pathobiology of, 1304, 1304t
prognosis for, 1306, e203-1f
staging of, 1305t
treatment of, 1305b-1306b
Renal failure
acute. See Kidney injury, acute
chronic. See Kidney disease, chronic;
Kidney failure, end-stage
Renal osteodystrophy, 812-813
clinical manifestations of, 814
hemodialysis and, 820-821
treatment of, 817
Renal papilla, necrosis of, 715
Renal pelvis
cancer of, 1308-1309, 1308t
duplication of, 804
Renal replacement therapy. See Hemodialysis;
Peritoneal dialysis
Renal tubular acidosis (RTA)
clinical manifestations of, 749
distal (type 1), 739, 748, 749t, 801t-802t,
802, 1341t
diagnosis of, 749, 750f
prognosis for, 750
treatment of, 749b
hyperkalemic (type 4), 748-749, 749t
in diabetes mellitus, 782
diagnosis of, 749, 750f
prognosis for, 750
treatment of, 749b
proximal (type 2), 748, 749t, 802t,
1341t
diagnosis of, 749, 750f
prognosis for, 750
treatment of, 749b
Renal vein thrombosis, 788-789, 788t
Renin
deficiency of, 1469
excess of, 1469
tumor secretion of, 1297
Renin-angiotensin-aldosterone system, in
heart failure, 298
Renography, 714
Reovirus, in cancer therapy, 209
Repaglinide, e237-7t, e237-8
Repetitive elements, 188t, 189
Repetitive stimulation study, 2233
Reproductive tract. See also Ovary (ovaries);
Testis (testes)
development of, 1511-1512, 1512f-1513f.
See also Sexual development
Reserpine, in hypertension, 382t
Residual volume, e85-3t
Resistant ovary syndrome, e244-8-e244-9
Reslizumab, in hypereosinophilia,
1120-1121
Respiration(s). See also Ventilation
abnormal, 27t
in amyotrophic lateral sclerosis, 2344,
2345b
Cheyne-Stokes, 2296
in coma, 2296, 2296t
in COPD, 539, 539f
decreased, 29
definition of, 629-630
increased, 29
measurement of, 27
in myasthenia gravis, 2420
for physical examination, 24
pulse oximetry and, 28
undernutrition effects on, 1389
Respiratory acidosis, 742, 744f, 744t, 752
compensatory changes in, 744-745, 745t
Respiratory alkalosis, 742, 744f, 744t, 752
compensatory changes in, 744-745, 745t
Respiratory bronchiolitis-associated
interstitial lung disease, 559t, 562, 562b,
562f
Respiratory burst, in bacterial killing, 1114
Respiratory compliance, 628, 628f
Respiratory disease, 512-516. See also specific
diseases
aspirin-exacerbated, 536
biopsy in, e85-5
bronchoalveolar lavage in, e85-5, e85-6t
cough in, 512, 513f, 513t
dyspnea in, 512, 514f-515f
hemoptysis in, 512-515, 514t, 516t
imaging in, 516-523. See also Chest
radiography
infectious. See Respiratory tract infection

Respiratory disease (Continued)
ventilatory function in, e85-3-e85-5,
e85-3t-e85-4t
wheezing in, 512, 514t
Respiratory drive, 628
Respiratory failure
acute, 629-638
abbreviations in, 629t
in acute lung injury, 635, 635t, 636b,
637f
blood gases in, 632-633
classification of, 630t
clinical manifestations of, 631
computed tomography in, 633,
633f
in COPD, 634-635, 635t
definition of, 629-630
diagnosis of, 631, 632t
pathobiology of, 630-635, 631f
pathophysiology of, 631, 632f
radiography in, 633, 633f
supportive measures in, 634
treatment of, 633b-634b
without lung disease, 636
chronic, 630
Respiratory muscles, 628
Respiratory quotient, 628
Respiratory rate, 27, 27t
in asthma, 532
in cardiovascular disease, 250
decreased, 29
increased, 29
Respiratory syncytial virus infection,
589-590, 2091-2092
clinical manifestations of, 2092
in common cold, 2089, 2089t. See also
Common cold
definition of, 2091-2092
diagnosis of, 2092
epidemiology of, 2091
pathobiology of, 2091-2092
prevention of, 2092
prognosis for, 2092
treatment of, 2092b
Respiratory system, e85-1-e85-7. See also at
Lung(s); Pulmonary
aging-related changes in, 106
assessment of, e85-3-e85-5, e85-3t-e85-4t,
e85-6t
host defenses of, e85-2, e85-3f
ionizing radiation injury to, 80
monitoring of, 626-629
arterial oxygen in, 627
blood gas analysis in, 626
capnometry in, 627
carbon dioxide production
measurement in, 628
compliance measurement in, 628,
628f
minute ventilation in, 628
physical examination for, 626
pulse oximetry in, 626-627, 627f
respiratory drive in, 628
respiratory muscle strength
measurement in, 628
systemic oxygen delivery in, 627
transcutaneous carbon dioxide
measurement in, 627
work of breathing measurement in,
628-629, 629f
occupation-related injury to, 76t, 77
structure of, e85-1-e85-2, e85-2f
Respiratory tract infection. See also Influenza
virus infection; Pneumonia;
Tuberculosis
Acinetobacter spp., 1882
adenoviral, 2101-2102, 2101t
in compromised host, 1778t, 1779
Cryptococcus neoformans, 1984-1985, 2203,
2203f
enteroviral, 2143
Haemophilus influenzae, 1862
Mycoplasma, 1913-1914, 1914f
nontuberculous Mycobacterium spp.
infection, 1949, 1950f
Pseudomonas aeruginosa, 1879-1880
Staphylococcus aureus, 1818
Respiratory tract infection (Continued)
Stenotrophomonas maltophilia, 1883
Streptococcus pyogenes, 1824-1825, 1824f,
1824t
Restless legs syndrome, 2302, 2340-2342
Restrictive cardiomyopathy. See
Cardiomyopathy, restrictive
RET gene, 863, 1507, 1601-1602
Reteplase, 177
in ST segment elevation MI, 439-441,
440t-441t
Reticulocyte count, 1031t, 1034
Reticulohistiocytosis, multicentric, 1751
Retina, 2426, 2427f. See also Retinitis;
Retinopathy
Candida infection of, 1987-1988, 1988f
cytomegalovirus infection of, 2132, 2132f,
2192t-2193t, 2195, 2224, 2435
detachment of, 2437, 2444
examination of
in cardiovascular disease evaluation, 250
in cerebrovascular disease evaluation,
2313
in subarachnoid hemorrhage, 2320
hemorrhage of
at high-altitude, 575-581, 575t
in Waldenstrms macroglobulinemia,
1242f
ischemia of, in systemic lupus
erythematosus, 1701
light-induced injury to, 82
pigmentary degeneration of, 2444
Roths spots of, 250, 2438, 2439f
tear of, 2429, 2444
toxoplasmosis of, 2195, e357-3-e357-4,
e357-4f, e357-6
varicella-zoster virus infection of, 2195
Retinal artery occlusion, 250, 2439, 2439f
Retinal vein occlusion, 2439, 2439f
Retinitis
Bartonella, 1908t-1909t
in cat-scratch disease, 1908
cytomegalovirus, 2132, 2132f,
2192t-2193t, 2195, 2224, 2435
in HIV infection, 2195
Toxoplasma, 2195, 2435
Retinitis pigmentosa, 196, 2440-2441, 2441f
Retinoblastoma, 2441, e366-1
Retinoids, 2511
lipid disorders and, 1352t
Retinol. See Vitamin A
Retinopathy
diabetic, 2438, 2438f, e236-13, e236-13t
hypertensive, 387-388, 387f, 2438, 2438f
melanoma-associated, 1193t
paraneoplastic, 1193t
of prematurity, 2441
sickle cell, 1071
Takayasus, 1722-1723
Retrobulbar neuritis, 2444
Retrocalcaneal bursitis, 1681
Retropharyngeal abscess, 514t
Retrosternal clear space, 265
Retroviral vectors, 208-209
Retrovirus infection, 2136-2140, 2138t.
See also Human immunodeficiency
virus (HIV) infection
adult T-cell leukemia/lymphoma and,
2137-2140, 2138f
definition of, 2136-2140
epidemiology of, 2136
injection drug abuse and, 2137
myelopathy/tropical spastic paraparesis
and, 2139-2140
pathobiology of, 2137-2140
perinatal transmission of, 2137
sexual transmission of, 2136-2137
transfusion transmission of, 2137
transmission of, 2136-2137, 2136t
Retts syndrome, 2388-2389
Reverse-transcription-polymerase chain
reaction
in enterovirus infection, 2142
in parainfluenza virus infection, 2094
in respiratory syncytial virus infection,
2092
in viral hemorrhagic fever, 2154
Reversible cerebral vasoconstriction
syndrome, 1724-1725, 1724t
Review of systems, 23, 23t
Reward circuits, 141, 141f
Rewarming therapy, 669b, 669t
Reyes syndrome, 983, 2098
Rhabdomyolysis, 700-705, 2410
acquired, 701t, 702-703
clinical manifestations of, 702-703
creatine kinase levels in, 703
definition of, 700
diagnosis of, 703-705
differential diagnosis of, 703
drug-related, 700-702, 701t
epidemiology of, 700
etiology of, 700-705
exertional, 700-702, 701t-702t
hereditary, 701t, 702
infection-related, 702
in influenza virus infection, 2098
myoglobin testing in, 703
pathobiology of, 701-703, 701f
prevention of, 703, 704t
prognosis for, 704
trauma-related, 702
treatment of, 703b-704b, 704t
Rhabdomyosarcoma, 1261-1262
Rheumatic disease, 1648-1651. See also
specific diseases
age and, 1648
anatomic aspects of, 1648, 1649t
anti-DNA antibodies in, 1654
anti-phospholipid antibodies in, 1655
antineutrophil cytoplasmic antibodies in,
1655
antinuclear antibodies in, 1653-1655,
1654t
arthrography in, 1658-1659
C-reactive protein in, 1652
classification of, 1648, 1649t, 1650-1651
complement in, 1655
computed tomography in, 1658
cryoglobulins in, 1655
cyclophosphamide in, 164-165
diagnosis of, 1648-1651, 1649t, 1650f
imaging in, 1656-1659
laboratory testing in, 1651-1656, 1652t,
1653f, 1654t
erythrocyte sedimentation rate in, 1652
etiology of, 1648, 1649f, 1649t
extra-articular manifestations of,
1649-1650
family history in, 1648
functional disability indices in, 1649
gender and, 1648
inflammation in, 1652
joint distribution in, 1648
joint fluid analysis in, 1653, 1653f
local, 1650-1651
magnetic resonance imaging in,
1656-1657, 1658f-1659f
occupation and, 1648
onset of, 1648-1649
pain in, 1648, 1650f
pathobiology of, 1648
patient history in, 1648-1651
physical examination in, 1649-1650, 1650f
radiography in, 1656, 1656f, 1657t
range of motion in, 1650
recreational activities and, 1648
regional, 1650-1651
scintigraphy in, 1659
stiffness in, 1649
systemic manifestations of, 1649
treatment of, 1651b
ultrasonography in, 1657-1658
Rheumatic fever, 453, 457, 1826
erythema marginatum of, 2533, 2533f
vs. rheumatoid arthritis, 1687t
Rheumatoid arthritis, 228t, 1681-1689
anti-CCP antibodies in, 1653
articular manifestations of, 1684-1685,
1684f
cardiac manifestations of, 1685t, 1686,
1689
classification criteria for, 1687, 1687t
clinical course of, 1686
INDEX e71
Rheumatoid arthritis (Continued)
clinical manifestations of, 1684-1689,
1684f
cutaneous manifestations of, 1685-1686,
1685f, 1685t
cyclophosphamide in, 164-165
cytokines in, 232
definition of, 1681-1682
diagnosis of, 1656, 1656f, 1686, 1687t
differential diagnosis of, 1687, 1687t
of elbow, 1685f
elderly-onset, 1730
epidemiology of, 1682-1689
etiology of, 1682-1683, 1683f
extra-articular manifestations of,
1685-1686, 1685t, 2404-2405, 2405t
of feet, 1684
Feltys syndrome in, 1686
genetics of, 1682, 1682t
of hands, 1684, 1684f-1685f
HLA associations in, 225, 225t, 1682,
1682t
immune response in, 1683
immunization in, 1689
of knee, 1684-1685, 1685f
laboratory testing in, 1687
lymphoma and, 1689
morning stiffness in, 1686
of neck, 1685, e272-1f
neurologic manifestations of, 1685t, 1686
ocular manifestations of, 1685t, 1686,
2440
pain in, 488t
pathobiology of, 1682-1684, e47-1t
pathogenesis of, 1683, 1683f
pathology of, 1683-1684
pericarditis in, 481
pleural effusion in, 610, 1686
prognosis for, 1689
pulmonary manifestations of, 564, 1685t,
1686, 1686f
rheumatoid factor in, 1652-1653, 1652t
small-vessel vasculitis in, 1685-1686, 1686f
vs. spondyloarthropathies, 1691t
subcutaneous nodules in, 1685, 1685f
synovitis in, 1683-1684, 1683f
treatment of, 1687b-1689b, 1688t
disease-modifying antirheumatic drugs
in, 1688-1689, 1688t
glucocorticoids in, 1688, 1688t
interleukin-1 inhibitors in, 166
NSAIDs in, 1688
tumor necrosis factor- inhibitors in,
165-166
of wrist, 1684, 1684f
Rheumatoid factor, 712, 1652-1653, 1652t,
1682, 1687
Rhinitis, 2455
allergic. See Allergic rhinitis
atrophic, 1625
clinical manifestations of, 2455, 2455t
definition of, 2455
diagnosis of, 2455-2458
differential diagnosis of, 2457
epidemiology of, 2455
imaging of, 2457, 2457f
laboratory testing in, 2456
pathobiology of, 2455
patient history in, 2455
physical examination in, 2456
vs. seasonal allergic rhinitis, 1624
treatment of, 2457b
vasomotor, 1624
viral, 1624, 2457
Rhinitis medicamentosa, 1624
Rhinocerebral mucormycosis, 1995
Rhinorrhea, 2089-2091, 2361
Rhinosinusitis, 1825, 2251. See also Rhinitis;
Sinusitis
Rhinoviruses
in bronchitis, 586-587
in common cold, 2089-2091, 2089t.
See also Common cold
Rhombencephalitis, listerial, 1836
Ribavirin
adverse effects of, 2087t, 2088
drug interactions with, 2087t
e72 INDEX
Ribavirin (Continued)
in hepatitis C, 977b-978b, 978f,
2086t-2087t, 2088
in influenza viral pneumonia, 2100b
in respiratory syncytial virus infection,
2092b
in viral hemorrhagic fevers, 87b, 2154
Riboflavin, e225-2t-e225-5t
Ribonucleic acid (RNA), 187-188, 188f
Ricin toxin, 84t
Rickets, 1587-1591, e225-2t-e225-5t.
See also Osteomalacia
definition of, 1587
hypophosphatemic, 755, 1341t
Rickettsia akari infection, 1960-1962
Rickettsia conorii infection, 1958-1962, 1958f
Rickettsia felis infection, 1959
Rickettsia helvetica infection, 1958-1962,
1958f
Rickettsia japonica infection, 1958-1962,
1958f
Rickettsia parkeri infection, 1958-1962, 1958f
Rickettsia prowazekii infection, 1959-1962
Rickettsia raoultii infection, 1958-1962, 1958f
Rickettsia rickettsii infection. See Rocky
Mountain spotted fever
Rickettsia slovaca infection, 1958-1962, 1958f
Rickettsia typhi infection, 1959-1962
Rickettsialpox, 1956t, 1960-1962, 1966t
Rickettsioses, 1954-1964
definition of, 1954-1964, 1955t
flea-borne, 1956t, 1959
louse-borne, 1956t, 1959-1962
mite-borne, 1956t, 1959-1962
tick-borne, 1955-1962, 1955t-1956t,
1957f-1958f, 2078. See also Rocky
Mountain spotted fever
Riedels thyroiditis, e233-10
Riegers syndrome, 1428
Rifampin, 1807t, 1809t-1811t
drug interactions with, 1765
in Haemophilus influenzae infection
prevention, 1863
in leprosy, 1953-1954
in Neisseria meningitidis infection
prevention, 1854t
resistance to, 1808t
in Staphylococcus aureus infection
prevention, 1820
Rifaximin, in irritable bowel syndrome, 871t
Rift Valley fever, 87t, 2148t-2149t, 2151t,
2155, 2158. See also Viral hemorrhagic
fevers
Right atrial pressure, e52-5t
Right ventricle. See Ventricle (cardiac), right
Right ventricular pressure, e52-5t
Rigidity, in Parkinsons disease, 2327
Rilonacept, 166
Riluzole, in amyotrophic lateral sclerosis,
2345b
Rimantadine
in bronchitis, 587b
in influenza virus infection, 2085-2086,
2085t-2086t, 2100b
in influenza virus infection prevention,
2099, 2099t
Rimonabant, in smoking cessation, 144t
Ring, esophageal, 883, 883f
Rippling muscle disease, 2412t, 2415
Risedronate, in Pagets disease, 1605t
Risk assessment
in adolescent medicine, 59-60, 60t
cardiac. See Cardiac risk assessment
in periodic health examination, 52-53
Risk difference, e8-2-e8-3
Risk ratio, vs. odds ratio, e8-3
Risperidone, 2243t
Rituximab, 167-168, 1168t-1176t
in autoimmune hemolytic anemia, 1049
in chronic lymphocytic leukemia, 1217
in hairy cell leukemia, 1214b
in refractory idiopathic thrombocytopenic
purpura, 1129t
in systemic lupus erythematosus, 1704
Rivaroxaban, 174
Rivastigmine, in Parkinsons disease,
2330t-2332t
River blindness, e366-3t, e366-5-e366-6
treatment of, 2009, e366-1t, e366-6b
RNA interference (RNAi), 210, e43-1f
Robertsonian translocation, 190
Rocio encephalitis, 2167
Rockall score, 858, 859t
Rocky Mountain spotted fever, 1955-1962,
1956t, 1966t
vs. bacterial meningitis, 2360
clinical manifestations of, 1956-1957,
2525
vs. Colorado tick fever, 2156
diagnosis of, 1957
epidemiology of, 1955-1956, 1957f
prevention of, 1957, 1957f, 2079
prognosis for, 1957-1958
treatment of, 1957b
vs. viral hemorrhagic fever, 2153t
Rocuronium, hypersensitivity reactions to,
2484
Rodents, in viral hemorrhagic fever
transmission, 2150
Romaas sign, 2081
Ropinirole
in Parkinsons disease, 2330t-2332t
in restless legs syndrome, 2341b
Rosacea, 2531, 2531f
Rosai-Dorfman disease, 1228
Roseola (exanthem subitum), 2106t,
2523
Rosiglitazone
in diabetes mellitus type 2, e237-7t
in nonalcoholic fatty liver disease,
999b
Ross River fever virus, 2160
Ross syndrome, 2394
Rotator cuff tendinitis, 1678-1679, 1678f
Rotavirus infection, 2144-2147
clinical manifestations of, 2146
definition of, 2144-2147
diagnosis of, 2147
epidemiology of, 2145f, 2145t, 2146
pathobiology of, 2146
prevention of, 2147
treatment of, 2147b
Roths spots, 250, 2438, 2439f
Rotigotine, in Parkinsons disease,
2330t-2332t
Rotors syndrome, 960, 960t
Roundworms. See also specific roundworm
infections
intestinal, 2064-2068
treatment of, 2009, 2065t
tissue, e366-1-e366-8
treatment of, 2009, e366-1t
Roussel-Uclaf causality assessment method,
983t, 984
Rove beetle dermatitis, 2080
RPR (rapid plasma reagin) test,
e327-4-e327-5, e327-5t
RPS14 gene, 1200
Rubella (German measles), 2107-2109
clinical manifestations of, 2108, 2108f,
2523
congenital, 2108
diagnosis of, 2108-2109
epidemiology of, 2107
pathobiology of, 2108
definition of, 2107-2109
diagnosis of, 2108-2109
differential diagnosis of, 2106t, 2108
epidemiology of, 2107
immunization against, 65f-66f, 67t-70t,
73-74
panencephalitis with, 2112
pathobiology of, 2107-2108
in pregnancy, 2108
prevention of, 2109
prognosis for, 2109
treatment of, 2109b
vs. viral hemorrhagic fever, 2153t
Rumination syndrome, 864
Running
diarrhea with, 898
hemoglobinuria with, 1051t
RUNX1 gene, 1200
Ryanodine receptor, e52-2
S Sarcoidosis (Continued)
S-protein (vitronectin), 243
Saccades, 2446, 2447t
Sachs disease, 1344-1345
Safety, 43-44. See also Error(s)
drug. See Drug interactions
food, 1382t
improvement of, 43-44
Sagittal sinus thrombosis, 2375
St. Louis encephalitis, 2162t, 2166-2168
Salicylates. See also Aspirin
central nervous system effects of, 672t
toxic ingestion of, 674t-677t, 684t
acid-base disorders with, 746t, 747-752
Salicylic acid, in pruritus, 2502t
Saline, nebulized, in bronchiectasis, 550
Saliva, cortisol in, 1465
Salivary glands
autoimmune disease of. See Sjgrens
syndrome
cancer of, 1258, 1261, 1263-1264, 1272
enlargement of, 2453t
asymptomatic, 2454
primary, 2453
secondary, 2453-2454
primary diseases of, 2453, 2453t
secondary diseases of, 2453-2454
secretory disorders of, 2453-2454, 2454t
Salmeterol
in asthma, 535
in COPD, 542t
in high-altitude syndromes, 575-576
in pregnancy, 1562b-1563b
Salmonella infection, 1884-1888
animal contact and, 1885
animal product contamination and, 1884
animal-to-human transmission of, 1885
antimicrobial resistance in, 1884
bloodstream, 1885-1887
carrier state in, 1885, 1887
clinical manifestations of, 1885-1888
definition of, 1884-1888
diagnosis of, 1886
enterocolitic, 1885-1887
epidemiology of, 1884
etiology of, 1884-1885
food contamination and, 1885
pathobiology of, 1885
person-to-person transmission of, 1885
prevention of, 1887
prognosis for, 1887-1888
serotypes in, 1884
treatment of, 1886b-1887b
water contamination and, 1885
Salmonella paratyphi infection. See Typhoid
fever
Salmonella typhi infection. See Typhoid fever
Salpingitis, 1799
IUD-related, 1555
Salt-wasting syndromes, 376
Sample/sampling, e8-1
description of, e8-1-e8-4
population values from, e8-4-e8-5
Samters triad, 1625
Sand flea bite, 2507, 2507f
Sandfly bite, 2025. See also Leishmaniasis
Sandfly fever, 2158
Sanfilippos syndrome, 1360, 1662-1667,
1662t
Sapovirus gastroenteritis, 2145-2146
Sappinia infection, 2047, 2047t
Sarcocystis spp. infection, e361-5t
Sarcoglycans, 320t
Sarcoidosis, 582-586
bronchoalveolar lavage in, e85-6t
calcium metabolism in, 584
cardiac, 288, 288f, 327, 330, 584-585, 585t
clinical manifestations of, 582-586
CNS, 1428, 2369-2370
computed tomography in, 583, 583f
cutaneous, 583, 583f, 585t, 2540, 2540f
definition of, 582
diagnosis of, 584-585
early-onset, 1668t
environmental exposures in, 582
epidemiology of, 582
familial, 582
gastrointestinal, 925
heart failure in, 302
hepatic, 584-585, 585t, 995, 995t
HIV infection and, 2208, 2225
with interferon therapy, 585
joint, 584, 585t, 1751
neurologic, 584-585, 584t-585t
ocular, 584-585, 585t, 2440
osseous, 584, 585t
pathobiology of, 582
prognosis for, 586
pulmonary, 582f-583f, 583-586, 585t
radiography in, 582-583, 582f, 583t
renal, 584, 585t
vs. rheumatoid arthritis, 1687t
splenic, 584
treatment of, 585b, 585t
Sarcoma, 1327-1329
biopsy in, 1328
clinical manifestations of, 1328
definition of, 1327
diagnosis of, 1328
endometrial, 1318
epidemiology of, 1327
Ewings, 1326
head and neck, 1261-1262
Kaposis. See Kaposis sarcoma
large intestine, 1281
pathobiology of, 1327-1328
prognosis for, 1329
pulmonary, 1272
risk factors for, 1327
treatment of, 1328b-1329b
Sarcomere, e52-1-e52-2, e52-3f
Sarcopenia, 107
Sargramostim, 1168t-1176t
Satiety, 1411
early, 300-301
Savages syndrome, e244-8-e244-9
Saxagliptin, in diabetes mellitus type 2,
e237-7t
Saxitoxins, 698t, 700, 898
Scabies, 1797t, 2077-2078
clinical manifestations of, 2077-2078,
2078f, 2546-2547, 2546f
definition of, 2077, 2078f
diagnosis of, 2078, 2078f
HIV infection and, 2210
oil mount for, 2508-2509, 2509f
pathobiology of, 2077
treatment of, 2078b, 2512, 2547
Scalp eschar, neck lymphadenopathy after
tick bite (SENLAT), 1908,
1908t-1909t, 1956t, 1958
Scar, 2504t
Scarlet fever, 1825, 2106t, 2522
Scarring, 2543
Scavenger receptor B1, 1347t, 1348
Schambergs disease, 2524
Schatzkis ring, 883, 883f
Scheie syndrome, 1360, 1662-1667, 1662t
Schiavo case, 6
Schilling test, 903t
Schirmer test, 1714
Schistocyte, 1025f, 1028t, 1048f
Schistosome dermatitis, 2059
Schistosomiasis, 2058-2060
acute, 2058-2059
cerebral, 2059
chronic, 2058-2059
clinical manifestations of, 2059
definition of, 2058-2060
diagnosis of, 2059-2060, 2059t
epidemiology of, 2058
hepatosplenic, 990t-992t, 994-996, 2059
pathobiology of, 2058-2059, 2058f
treatment of, 2010, 2060b
urinary tract, 2059
Schizencephaly, 2387
Schizoaffective disorder, 2243t, 2244
Schizoid personality disorders, 2245t
Schizophrenia, 2242-2245, 2243t
Schizotypal personality disorder, 2245t
Schnitzlers syndrome, 1668t
Schobers test, 1693
Schwann cells, M. leprae invasion of, 1951

Schwannoma, 2538, 2538f
Schwartz-Jampel syndrome, 2412t
Sciatica, 2264
Scimitar syndrome, 408
Scintigraphy
in hepatic adenoma, 1299
in hepatic cavernous hemangioma, 1299
in hepatic focal nodular hyperplasia, 1299
in rheumatic disease, 1658f-1659f
Sclera, 2426, 2427f
icterus of, 953-954, 953f
Scleritis, 2440
in rheumatoid arthritis, 1686
Scleroderma, 1705-1713
animal models of, 1707
antibodies in, 1654t, 1655, 1708, 1708t,
1711
bronchoalveolar lavage in, e85-6t
cardiac manifestations of, 1707, 1710
classification of, 1705-1708, 1705t
clinical manifestations of, 1708-1712,
1709f
definition of, 1705-1712
diagnosis of, 1711
differential diagnosis of, 1705t
diffuse cutaneous, 1705, 1705t, 1708
epidemiology of, 1705-1706
esophageal involvement in, 883-884
etiology of, 1706
fibrosis in, 1708
gastrointestinal manifestations of, 1709,
1711
gastroparesis in, 1709
genetic factors in, 1706
immune system in, 1707-1708, 1708t
interstitial lung disease in, 564, 1710
laboratory testing in, 1711
limited cutaneous, 1705, 1705t, 1708,
2508
localized, 1705
mortality rates in, 1712
musculoskeletal manifestations of,
1710-1711
natural history of, 1712
occupation and, 1706
pathobiology of, 1706-1707, 1706f
pathology of, 1707
pregnancy and, 1711
prognosis for, 1712
pulmonary arterial hypertension in, 1710,
1712
pulmonary function tests in, e85-4t
pulmonary manifestations of, 1707,
1709-1710
Raynauds phenomenon in, 1707,
1709-1712
renal crisis in, 1710, 1712
renal manifestations of, 788, 1707, 1710
skin care in, 1712
skin thickening in, 1708-1709
small bowel motility in, 1709
toxin exposure and, 1706
treatment of, 1711b-1712b
vasculopathy in, 1707
Scleromalacia perforans, 2440
Sclerosing cholangitis
primary, 1013, 1014f
secondary, 1013, 1014t
Sclerostenosis, 1607-1610
Scoliosis, 2262t
Scombroid poisoning, 700
vs. anaphylaxis, 1636
Scopolamine patch, 843t-844t
Scorpion bite, 2077t, 2079
Scorpionfish envenomation, 697
Scratch test, in liver disease, 955
Screening, 53-55. See also Preventive health
care
abdominal aortic aneurysm, 53, 54t
blood pressure, 53
breast cancer, 54, 1315-1316, 1316t
cervical cancer, 54, 1317-1320, 1317f,
2124
cholesterol, 53
colorectal cancer, 53, 1286-1287, 1286t
depression, 53
diabetes mellitus, 54, 54t
INDEX e73
Screening (Continued) Seizure(s) (Continued) Severe acute respiratory syndrome (SARS),
diabetes mellitus type 2, e237-3-e237-4, prognosis for, 2293 589-590, 2102
e237-4t provoked, 2283, 2284t, 2291 clinical manifestations of, 2103, 2104t
dilated cardiomyopathy, 326 psychogenic, 2289 diagnosis of, 2104
effectiveness of, 53, 53t reflex, 2291 epidemiology of, 2103
genetic, 184. See also Genetic testing risk factors for, 2283, 2284t pathobiology of, 2103
gestational diabetes, e237-4 in shigellosis, 1889 Severe combined immunodeficiency (SCID)
hearing, 55 single, 2289, 2291, 2293 syndrome
hemochromatosis, 1376 somatosenosry, 2286t enterovirus infection in, 2144
high-risk population, 54t after subarachnoid hemorrhage, gene therapy in, 209
HIV infection, 54t, 55 2321 Sex assignment, 1518
HPV infection, 2124 symptomatic, acute, 2283, 2284t, 2289, Sex hormonebinding globulin, 1520
hypertrophic cardiomyopathy, 322 2291 Sexual abuse, obesity and, 1413
inborn errors of metabolism, 1345 vs. syncope, 339, 341, 2289t Sexual activity
intimate partner violence, 1572-1573 syncope and, 337-338 abstinence from, 2182
lipid, 1351f tonic, 2286t, 2288, 2291 by adolescents, 61
lung cancer, 1271 tonic-clonic, 2286t, 2291 in heart failure, 313-314
multiple endocrine neoplasia type 1, vs. transient ischemic attack, 2315 safe, 2182, 2182t
1506-1507 treatment of, 2291b-2293b Sexual development, 1511-1517, 1512f
multiple endocrine neoplasia type 2B, unprovoked, 2289, 2293 disorders of, 1512t, 1513-1517
1507 vertiginous, 2286t androgen insensitivity and, 1515-1516
osteoporosis, 54 in viral hemorrhagic fevers, 2154 biochemical evaluation in, 1517-1518
prostate cancer, 54 visual, 2286t biopsy in, 1518
sexually transmitted disease, 54t, 55 in women of reproductive potential, chromosomal abnormalities and,
skin cancer, 1332 1550t 1516-1517
thyroid disease, 54 Selectins, 214, 1113 diagnosis of, 1517-1518
vision, 55 Selective antibody deficiency, 1621 drug-induced, 1515
SDHAF2 gene, 1472 Selective arterial calcium injection gender identity and, 1517
SDHB gene, 1472 stimulation test, 1504 gender role and, 1517
SDHC gene, 1472 Selective serotonin re-uptake inhibitors gestational history in, 1517
SDHD gene, 1472 central nervous system effects of, 672t in hermaphroditism, 1517
Sea anemone envenomation, 698t, 699 in depression, 2239t Leydig cell agenesis and, 1516
Sea snake envenomation, 697, 698f, 698t preoperative, 2478t management of, 1517-1518
Sea urchin envenomation, 699 SIADH with, 2495 medical, 1518
Seafood poisoning, 898 toxic ingestion of, 674t-676t psychosocial, 1519
Seal finger, 1966t Selegiline sex assignment in, 1518
Seasonal rhinitis. See Allergic rhinitis in depression, 2239t surgery in, 1518-1519
Seated straight leg raise test, 2261 in Parkinsons disease, 2328, 2330t-2332t mixed gonadal dysgenesis and, 1516
Sebaceous gland(s), 2498, 2499f, 2500 Selenium, e225-6t-e225-7t persistent mllerian ducts and, 1516
carcinoma of, 2431 deficiency of, e225-6t-e225-7t physical examination in, 1517
cysts of, 2537 poisoning with, 94-95, e225-6t-e225-7t prenatal diagnosis of, 1519
hyperplasia of, 2531, 2531f Self-efficacy, in healing, 180 sexual orientation and, 1517
tumors of, 2537 Self-help groups, for alcohol use/abuse, steroidogenesis defects and, 1512t,
Seborrheic blepharitis, 2431 151-152 1513-1516, 1514f-1515f
Seborrheic dermatitis, 2515, 2515f, 2550f Self-tolerance, 214, 221-222, 1047 vaginal atresia and, 1517
HIV infection and, 2211 Semantic dementia, 2282 in XX male syndrome, 1516-1517
Seborrheic keratoses, 2537 Semen analysis, 1526-1528, 1526f-1527f, in XY female syndrome, 1517
Secretin stimulation test, 903t, 942 1527t Sexual dysfunction
Secretin test, 1294 Seminoma, 1321-1322 female, e244-14
Sedative-hypnotic agents Semistarvation, 1385 male, 1528
abuse of, 157 Semonts maneuver, 2466f in multiple sclerosis, 2349, 2353
central nervous system effects of, 672t Sensitivity, test, 32t-33t, 33, 35, 35f Sexual function
in critical care, 624 Sensitivity analysis, 35 female, e244-13-e244-14
Sedentary activity, 1410-1411. See also Sensory nerve action potential, 2398 male, 1520-1521, 1521f
Exercise Sepsis. See also Shock, septic Sexual maturation rating, 59, 59f-60f
75
SeHCAT test, 903t disseminated intravascular coagulation Sexual orientation, 1517
Seizure(s), 2283-2294. See also Epilepsy with, 1146 Sexually transmitted diseases, 1796-1800.
absence, 2286t, 2288, 2290-2291, 2292t hypocalcemia and, 1599 See also specific diseases
in acute poisoning, 672t hypovolemia with, 724 in adolescents, 62
atonic, 2286t, 2288, 2291 in pneumococcal pneumonia, 1821 anorectal, 948-949
auditory, 2286t post-splenectomy, 1039 contraception and, 1800
in bacterial meningitis, 2358 thrombocytopenia with, 1128 definition of, 1796, 1797t
clonic, 2286t zoonoses-related, 1967t diagnosis of, 1797-1800
convulsive, 2286-2288 Septic arthritis. See Arthritis, septic epidemiology of, 1796
definition of, 2283 Septo-optic dysplasia, 1516 etiology of, 1796
diagnosis of, 2288 Serine proteases, e267-6, e267-6t expedited partner therapy in, 62
differential diagnosis of, 2288-2289, 2289t Serotonin, 1412t HIV infection and, 1797
drug abuse and, 157 carcinoid secretion of, 1509-1510 management of, 1800
dyscognitive, 2285, 2286t, 2287f synthesis of, 1509-1510, 1509f partner services in, 62, 1799
electroencephalography in, 2232-2233, Serotonin and norepinephrine re-uptake pathogens in, 1796-1797
2232f inhibitors, in depression, 2239t post-exposure interventions for, 1799
epidemiology of, 2283 Serotonin syndrome, 2394, 2484, 2494-2495, pre-exposure interventions for, 1799
febrile, 2290, 2293 2494t prevention of, 1799
focal, 2283, 2285-2286, 2286t, 2287f, linezolid-related, 1765 screening for, 55
2292t Sertoli-Leydig tumor, 1320 syndromic approach to, 1797
in focal cortical dysplasia with balloon Sertraline Szarys syndrome, 1216, 1226, 2513,
cells, 2387 in depression, 2239t 2539-2540
frontal lobe, 2289 in menopausal hot flushes, 1569t-1570t Shapiros syndrome, 2392
generalized, 2283, 2286-2288, 2286t, in pruritus, 2502t Sheehans syndrome, 1433, 1438
2288f, 2292t Serum sickness, 229 Shellfish poisoning, 698t, 700, 898
gustatory, 2286t vs. anaphylaxis, 1636 Shift work, 2303
vs. ischemic stroke, 2315 Sevelamer carbonate, in hyperphosphatemia, Shigellosis, 84t, 897, 1888-1891
limbic, 2286t 756b, 756t clinical manifestations of, 1889, 1889t
motor, 2286t Sevelamer hydrochloride, in definition of, 1888-1890
myoclonic, 2286t, 2288, 2291, 2292t hyperphosphatemia, 756t diagnosis of, 1889-1890
olfactory, 2286t Seventy-two-hour fast test, 1501-1503, 1501t, epidemiology of, 1888
postoperative, 2489 1502f, 1503t pathobiology of, 1888-1889
e74 INDEX
Shigellosis (Continued)
prevention of, 1890
prognosis for, 1890
treatment of, 1890b
vs. viral hemorrhagic fever, 2153t
Shingles. See Zoster
Shock, 29, 645-654
acidosis with, 646, 648
adrenal dysfunction in, 653
vs. anaphylaxis, 1636
in bacterial meningitis, 2360
burn-related, 692
cardiogenic, 648, 654-658
clinical manifestations of, 655, 655t
definition of, 654
diagnosis of, 654t, 655-658
echocardiography in, 655
epidemiology of, 654-655, 654f
pathobiology of, 655
prognosis for, 658
right heart catheterization in, 655-656
in ST segment elevation MI, 439t, 445
trauma-related, 688
treatment of, 651f-652f, 656b-657b,
656f
clinical manifestations of, 647, 647t
compensatory responses in, 646
compressive, trauma-related, 688
definition of, 645
diagnosis of, 648
dissociative, 648, 651f-652f
distributive, 648, 651f-652f
end-organ dysfunction in, 647, 647t
epidemiology of, 645
fluid therapy in, 649-650, 650f, 653t
glycolysis in, 646
heat, 666-667
hemorrhagic, 648t
trauma-related, 687-688, 688t
hypovolemic, 647, 651f-652f
lactate in, 646
multiple causation in, 648
neurogenic, trauma-related, 688
noncompensatory responses in, 646-647
obstructive, extracardiac, 648, 651f-652f
pathobiology of, 645-653, 646f
prognosis for, 653
septic, 658-666
adaptive immune response in, 658-659
cardiovascular dysfunction in, 661, 661t
clinical manifestations of, 661
coagulation response in, 659, 660f
definition of, 658
diagnosis of, 661-662, 662f
differential diagnosis of, 662-663
epidemiology of, 658
immunosuppression in, 660
innate immune response in, 658-665,
660f
late, 660-661
pathobiology of, 658-665, 659t
prevention of, 663, 663t
prognosis for, 665
tissue hypoxia in, 659-660
treatment of, 659t, 663b-665b, 664t,
665f
transfusion therapy in, 650-653
trauma-related, 687-688
treatment of, 648b-653b, 649t, 650f-652f,
653t
urine output in, 648
vasopressor therapy in, 651f-652f, 653
Shock index, 647t
Short-bowel syndrome, 907-908
treatment of, 908b
Short QT syndrome, 367
Short unilateral neuralgiform headache with
conjunctival injection and tearing, 2249,
2250t
Shoulder
examination of, 26
frozen, 1679
Milwaukee, 1742
tendinitis of, 1678-1679
Shunt, pulmonary-systemic, 631-633
Shwachman-Diamond syndrome, 1102t,
1103
Shy-Drager syndrome, 2392
Sialadenosis, 2454
Siberian tick typhus, 1956t, 1958
Sibutramine, in obesity, 1416
Sick building syndrome, 77
Sick sinus syndrome, 340t, 349
Sickle cell, 1025f, 1069f, 1072
Sickle cell disease, 1066-1075
acute anemia in, 1071
acute chest syndrome in, 1070-1071, 1073,
1073t
arthritis in, 1748-1749
bone disease in, 1071
cardiovascular complications of, 1072
clinical manifestations of, 1067t,
1068-1074, 1070t
definition of, 1066
diagnosis of, 1067t, 1069f, 1072
epidemiology of, 1066, 1067f
eye disease in, 1071
family studies in, 1072
gallstones in, 1071
hand-foot syndrome in, 1068-1069
hematocrit in, 1067t, 1068
hemoglobin composition in, 1066-1067,
1068f, 1072
hemolysis in, 1067, 1070f
infection in, 1071
leg ulcers in, 1071
liver disease in, 1071
malaria protection and, 2015
Mycoplasma pneumoniae infection with,
1915
nephropathy in, 788, 1071, 1072t, 1074
osteomyelitis in, 1071
osteonecrosis in, 1071, 1073
painful episodes in, 1068-1069, 1072-1073
pathobiology of, 1066-1068, 1068f, 1070f
peripheral blood smear in, 1025f, 1028t,
1069f, 1072
pregnancy and, 1071
priapism in, 1071, 1073
prognosis for, 1074
pulmonary hypertension in, 1071, 1073,
1073t
screening for, 185t, 1072
stroke in, 1070, 1073, 2316
surgery in, 1074
treatment of, 1072b-1074b
in acute chest syndrome, 1073, 1073t
hydroxyurea in, 1072, 1073t
iron chelation therapy in, 1074
in osteonecrosis, 1073
in painful episodes, 1072-1073
in priapism, 1073
in pulmonary hypertension, 1073,
1073t
red blood cell transfusion in, 1072,
1074
in renal disease, 1074
stem cell transplantation in, 1074
in stroke, 1073
vaso-occlusive episodes in, 1067-1069,
1072-1073
Sickle cell trait, 1066, 1067f, 1068
Sideroblastic anemia, 1043
clinical manifestations of, 1044
definition of, 1043
diagnosis of, 1041t, 1044, 1044f
drug-induced, 1043-1044
epidemiology of, 1043
genetics of, 1043, 1043f
hereditary, 1043
idiopathic, 1044
pathobiology of, 1043-1044
prognosis for, 1044
pure, 1044
treatment of, 1044b
Sigmoidoscopy, 1284
in Escherichia coli infection, 1873
screening, 53, 1286, 1286t
Signal transducers and activators of
transcription (STAT) proteins, 1424,
e159-2-e159-3
Signal transduction, in cancer development,
1185-1186, 1186f
Significance testing, e8-4-e8-5
Signs, 2
Silent myocardial ischemia, 417, 424
Silicosis, 567, 568t, 573
mortality with, e93-1f
Silodosin, in benign prostatic hyperplasia,
807, 808t
Silver poisoning, 95, 95f
Silver-Russell syndrome, 1531
Simultanagnosia, 2273-2274
Sindbis virus infection, 2161
Single-nucleotide polymorphism, 188, 189f,
195, 1340
Single-photon emission computed
tomography (SPECT)
myocardial, 285-286, 416t, 417
in neurologic disorders, 2235t
Sinoatrial exit block, 349, 349f
first-degree, 349
high-degree, 349
second-degree, 349
Sinoatrial node, 272, 272f, e52-2f
Sinus(es)
in cystic fibrosis, 544
inflammation of. See Sinusitis
mucormycosis of, 1995
transillumination of, 24
Sinus arrest, 339, 340t, 342, 349
Sinus arrhythmia, 349, e64-1f
Sinus bradycardia, 337, 339, 340t, 349-355
definition of, 349
electrocardiography in, 342, 349f
post-infarction, 444-445
Sinus headache, 2251
Sinus histiocytosis, 1228
Sinus node dysfunction, 349-355, 349t
diagnosis of, 350, 351t
treatment of, 350b
Sinus node re-entry, 352, 352t
Sinus of Valsalva, aneurysm of, 253t, 405
Sinus pause, 342
Sinus rhythm, 353f
Sinus tachycardia, 29, 352, 352f, 352t
radio frequency ablation in, 373
treatment of, 355
Sinusitis, 2455
in allergy, 1613
Aspergillus in, 1991-1993
chronic, 1625-1626, 1626t, 1627f, 2457
vs. allergic rhinitis, 1625
clinical manifestations of, 2455, 2455t
with common cold, 2090
computed tomography in, 1614
definition of, 2455
dematiaceous fungi in, 2008
diagnosis of, 2455-2458
differential diagnosis of, 2457
epidemiology of, 2455
Haemophilus influenzae in, 1862
imaging of, 2457, 2457f
laboratory testing in, 2456
in older adults, 99t
pathobiology of, 2455
patient history in, 2455
physical examination in, 2456
Streptococcus pyogenes in, 1825
treatment of, 2457b
Sirolimus, 159t, 164
adverse effects of, 162t
in kidney transplantation, 824f, 825, 825t
Sister Mary Josephs node
in colorectal cancer, 1285
in gastric cancer, 1276
Sitagliptin, in diabetes mellitus type 2,
e237-7t
Sitophobia, 935
Sitosterolemia, 1012t
Six-minute walk test, 395
Sjogrens syndrome, pathobiology of, e276-1f
Sjgrens syndrome, 1713-1716
clinical manifestations of, 1713-1716,
1713t-1714t, 2393t
definition of, 1713
diagnosis of, 1714t, 1715-1716, 1715f
differential diagnosis of, 1713, 1713t
epidemiology of, 1713
extraglandular manifestations of, 1714,
1714t, 2405, 2405t
Sjgrens syndrome (Continued)
laboratory testing in, 1714-1715
pathobiology of, 1713
pulmonary abnormalities in, 564
vs. rheumatoid arthritis, 1687t
rheumatoid factor in, 1715
salivary gland enlargement in, 2454
treatment of, 1716b
Skiers thumb, 1679
Skin, 2498-2503
aging-related changes in, 108-109, 108f,
2542
anaplastic large cell lymphoma of, 1226
anthrax of, 1837-1838, 1838f
apoptosis in, 2501
atrophy of, 2504t, 2506t, 2508, 2542,
2542f, 2542t
bacillary angiomatosis of, 1909-1910,
1909f, 1909t
barrier function of, 2498
biopsy of, 2509
in cancer, 2509
in dermatitis herpetiformis, 2527
in leishmaniasis, 2028
in leprosy, 1953
in leukocytoclastic vasculitis, 2525,
2525f
in pemphigus, 2527
in peripheral neuropathy, 2398
punch, 2509, 2509f
in urticaria, 1630
black, 2549, 2549f, 2549t
blood supply of, 2500
blue-gray pigmentation of, 95, 95f
burns of. See Burn injury
cancer of. See Skin cancer
CD30+ lymphoproliferative disorders of,
1226
diphtheria of, 1833
drug-related lesions of, 2534-2543, 2534t,
2535f-2536f, 2536t
electric current injury to, 686b, 686f
examination of, 26, 2503-2509
biopsy in, 2509, 2509f
in cardiovascular disease, 253, 255f
diagnostic tests in, 2508-2509,
2508f-2509f
feature-specific, 2503
lesion arrangement in, 2505-2506,
2506f, 2506t
lesion classification in, 2506-2508,
2506t
lesion distribution in, 2504-2505, 2505f,
2505t
lesion morphology in, 2504, 2504t
lesion number in, 2506
lighting for, 2503
in Lyme disease, 1933
in melanoma, 2504
in nutritional assessment, 1386t
patient history in, 2503-2504
physical examination in, 2503
total body, 2503
universal precautions for, 2503
functions of, 2498
glycosaminoglycan deposition in,
e233-6-e233-7
healing of, 2502-2503
HIV-related disorders of, 2209-2212,
2212t
infectious, 2209-2210, 2209f-2210f,
2209t, 2212t
inflammatory, 2211, 2211f
metabolic, 2212, 2212f
neoplastic, 2210-2211, 2211f
hyperpigmentation of, 2548-2549, 2548f
hypopigmentation of, 2547-2549, 2547t,
2548f
immune system of, 2498, 2501
infection of, 2544-2551. See also specific
infections
bacterial, 2544, 2544t
anaerobic organisms in, 1849
treatment of, 2511
Candida, 1987, 1988f, 2508-2509, 2508f
diagnosis of, 2508-2509, 2508f-2509f
fungal, 2511-2512, 2542, 2544t, 2546

Skin (Continued)
parasite, 2512, 2544t, 2546-2549
viral, 2512, 2544t, 2546
ionizing radiation injury to, 80
itching of. See Pruritus
Langerhans cells of, 2499f, 2500-2501
leishmaniasis of, 1965t, 2026f, 2028, 2029f
lesions of, 2504-2509. See also Dermatitis
and specific cutaneous disorders
annular, 2505-2506, 2506t
arrangement of, 2505-2506, 2506f,
2506t
atrophic, 2504t, 2506t, 2508, 2542,
2542f, 2542t
bullous, 2504t
categorization of, 2504-2506
clustered, 2505-2506, 2506f, 2506t
coalescing, 2505-2506, 2506t
in compromised host, 1778-1779,
1778t, 1779f
in cryptococcosis, 1984
distribution of, 2504-2505, 2505f,
2505t, 2549, 2549t-2550t, 2550f
drug-related, 2534-2543, 2534t,
2535f-2536f, 2536t
eczematous, 2506-2507, 2506t, 2514,
2514t
in endocrine disorders, 1420
erosive, 2504t
granulomatous, 2540, 2540f
grouped, 2505-2506, 2506t
herpetiform, 2505-2506, 2506f
inflammatory, 2539-2541
koebnerization of, 2505-2506
in leprosy, 1952-1953, 1952f
linear, 2505-2506, 2506f, 2506t
macular, 2504t, 2522, 2522t
maculopapular, 2506t, 2507, 2507f
melanocytic, 2538, 2539f
melanotic, 2506t, 2508, 2508f
morphology of, 2504, 2504t, 2506t
in mucormycosis, 1995-1996
in Mycoplasma pneumoniae infection,
1914-1915, 1914f
nodular, 2504t, 2506t, 2508, 2508f,
2536-2537, 2536t, 2540-2541
number of, 2506
in onchocerciasis, e366-6
papular, 2504t, 2522, 2522t,
2536-2537, 2539-2540
papulosquamous, 2506t, 2507, 2508f,
2517, 2517t
patch, 2504t
pigmentary, 2547, 2547t
plaque, 2504t
psoriatic, 2505, 2505f, 2507, 2507f,
2517-2521, 2517f
pustular, 2504t, 2506t, 2507, 2507f,
2530-2532
in sarcoidosis, 583, 583f, 585t
scale, 2504t
sclerotic, 2542-2543
secondary, 2504t
in systemic lupus erythematosus, 1699,
1699f
telangiectatic, 2506t, 2508, 2543
treatment of, 2510-2514
analgesics in, 2512
anthralin in, 2511
antibacterials in, 2511
antifungals in, 2511-2512
antimalarials in, 2511
antimicrobials in, 2511-2512
antiparasitics in, 2512
antipruritics in, 2512-2513, 2512t
antivirals in, 2512
calcipotriol in, 2511
chemical peels in, 2513
colchicine in, 2511
cosmetics in, 2514
dapsone in, 2511
dressings in, 2510
glucocorticoids in, 2510, 2510t-2511t
gold in, 2511
hormonal therapies in, 2513
immunomodulatory therapies in,
2513
Skin (Continued)
immunosuppressives in, 2513
keratolytics in, 2513
laser therapy in, 2513
moisturizing agents in, 2513
nonsteroidal anti-inflammatory
agents in, 2511
phototherapy in, 2513
principles of, 2510
retinoids in, 2511
soaks in, 2510
sunscreen in, 2513-2514
surgical, 2513
tars in, 2511
thalidomide in, 2511
topical medications in, 2510
tumorous, 2536-2537, 2536t
ulcerative, 2504t, 2508, 2543
urticarial, 2506t, 2507-2508, 2508f,
2532-2543, 2533t-2534t
vascular, 2539-2543, 2539f-2540f
vesiculobullous, 2504t, 2506t, 2507,
2507f, 2525, 2526t
wheal, 2504t
zosteriform, 2505-2506, 2506t
mastocytosis of, 1640-1642, 1641f, 1644
melanocytes of, 2499-2500
melanoma of, 26, 1330, 1331f, 1331t
biopsy of, 2509
examination for, 2504
Merkel cells of, 2500
paraneoplastic lesions of, 1195-1200,
1196t
pigmentation of. See also
Hyperpigmentation;
Hypopigmentation
blue-gray, 95, 95f
cosmetics for, 2514
disorders of, 2547, 2547t
porphyria of, 1364f, 1365t, 1367-1370,
2517, 2517f, 2528, 2529f
protective function of, 2498
purpura of, 2507, 2507f. See also Purpura
rheumatoid nodules of, 1685, 1685f
scabies of, 2077-2078, 2078f
secretory function of, 2498
sensory function of, 2498
in shock, 647t
snips of, in onchocerciasis, e366-6
structure of, 2498-2500, 2499f
in systemic sclerosis, 1708-1709, 1709f.
See also Scleroderma
thermoregulatory function of, 2498
toxicant effects on, 673
tumors of, 2536-2537, 2536t
adnexal, 2537
benign, 2537, 2537f-2538f
hematopoietic, 2539-2540
malignant. See Skin cancer
neural crest, 2538, 2538f
ultraviolet radiation effects on, 2501-2502
undernutrition effects on, 1389
warfarin-induced necrosis of, 172, 1150,
1150f
Skin cancer, 26. See also Melanoma
basal cell, 26, 1332-1333, 1333f, 2508,
2508f
biopsy in, 2509
after liver transplantation, 1011
prevention of, 1334
screening for, 1332
squamous cell, 26, 1332-1333, 1333f
ultraviolet radiation and, 82
Skin testing
in allergic rhinitis, 1623
in allergy, 1613-1614, 1614t
after anaphylaxis, 1635
in aspergillosis, 1992
in immunodeficiency disorders, 1615
in urticaria, 1630
SLC3A1 gene, 800
SLC4A1 gene, 802
SLC7A9 gene, 800
SLC12A2 gene, 801-802
SLC12A3 gene, 801
SLE. See Systemic lupus erythematosus
(SLE)
INDEX e75
Sleep. See also Sleep disorders Small intestine (Continued)
aging-related changes in, 108 imaging of, 1279-1280
behavior disorders during, 614, 2301, pathobiology of, 1278-1287, 1279f
2303 predispositions to, 1279
deficiency of, 2301, 2301t-2302t prognosis for, 1280
hypertension during, 377 staging of, 1280
NREM, 2299, 2300t surveillance for, 1280
periodic leg movements in, 2341 treatment of, 1280b
positioning for, in obstructive sleep apnea, nutrient absorption in, 904-905
616 disorders of. See Malabsorption
REM, 2299-2300, 2300t obstruction of
stages of, 613, 2299-2300, 2300t adhesion-related, 927, 928f
Sleep apnea in Crohns disease, 919
aging-related, 108 pain in, 834t-836t
central, 528, 528t pseudo-obstruction of, 864-867, 864t,
obstructive, 613-617, 2301 865f
clinical manifestations of, 613-614 diagnosis of, 865
definition of, 613 in systemic sclerosis, 1709
diagnosis of, 614, 614f-615f treatment of, 865b-866b
epidemiology of, 613 villus atrophy of. See Celiac disease
excessive daytime somnolence in, 614 Small lymphocytic lymphoma, 1215
genetics of, 613 Smallpox, 2117-2121
insomnia in, 614 bioterrorism with, 84-88, 84t-86t
obesity and, 1414 clinical manifestations of, 2118-2119,
obstructed breathing in, 614 2118f, 2118t
parasomnia in, 614 diagnosis of, 2120
pathobiology of, 613 differential diagnosis of, 2120
pathogenesis of, 613 epidemiology of, 2117
pathophysiology of, 613 flat, 2118-2119, 2118t
polysomnography in, 614, 614f-615f hemorrhagic, 2118-2119, 2118t
prognosis for, 617 immunization against, 67t-70t, 74, 86,
treatment of, 614b-616b, 615f 2121
upper airway abnormalities in, 614 modified, 2118-2119, 2118t
Sleep diary, 2300 ordinary, 2118-2119, 2118t
Sleep disorders, 2299-2304 pathobiology of, 2118
actigraphy in, 2300-2301 prognosis for, 2121
circadian rhythm disorders and, treatment of, 2121
2302-2303 vs. viral hemorrhagic fever, 2153t
clinical manifestations of, 2300 Smell, 2460-2461
definition of, 2299 disorders of, 2460-2461
diagnosis of, 2300-2303, 2300t clinical manifestations of, 2461
in fibromyalgia, 1743, 1745 diagnosis of, 2461
in heart failure, 301 pathobiology of, 2460-2461, 2461t
in menopause, 1571 Smith-Lemli-Opitz syndrome, 1515
in multiple sclerosis, 2349 Smith-Magenis syndrome, 191
multiple sleep latency test in, 2300 SMN gene, 2346
pathobiology of, 2299-2300 Smoke inhalation, 577-581, 691-692, 691t
polysomnography in, 2300 Snake bite, 64t, 694-697, 2419t
sleep diaries in, 2300 antivenom for, 679t-683t
sleepiness scales in, 2300, 2300t clinical manifestations of, 694-697
Sleepiness, excessive, 2300-2303, 2300t coral snake, 695-696
Sleepiness scales, 2300, 2300t epidemiology of, 694
Sleeping sickness, 2018-2021, 2019f-2020f, ineffective treatments for, 695t
2021t non-native species, 697
SLGT1 (sodium-glucose cotransporter pathobiology of, 694-697
protein 1), 1341, 1342t pit viper, 694-696, 696f, 696t
SLGT2 (sodium-glucose cotransporter treatment of, 695b-697b, 696f, 696t
protein 2), 1342t Sneezing. See Allergic rhinitis
Slit-lamp examination, 2427 Snellen eye chart, 102
Slys syndrome, 1662-1667, 1662t Snoring, 613-614
SM1 gene, 2058 Soaks, 2510
Small intestinal immunoproliferative disease, Social history, 22
1226 Social justice, 3
Small intestine. See also Colon Social phobia, 2240t
aging-related changes in, 106 Social support assessment, for geriatric
bacterial overgrowth in, 904, 912t, 1077 population, 103, 104t
benign tumors of, 1279 Socioeconomic status
biopsy of, 903t cardiovascular disease and, 258
in celiac disease, 906, 906f health and, 18, e5-1f
in chronic diarrhea, 911 Sodium
in malabsorption, 911 dietary, 725
carcinoid of, 1278-1279 blood pressure and, 376
fluid and electrolyte transport in, 895, 896f guidelines for, 381, 1382t-1383t
gastrointestinal stromal tumor of, fractional excretion of, 709, 759-760, 759t
1278-1279, 1279f postoperative, 2490
intussusception of, 927 renal handling of, 716-718, 718f, 720-734
ischemia of. See Intestinal ischemia renal retention of, 725-726, 726t. See also
lymphoma of, 907, 1227, 1279, 1279f Hypervolemia
melanoma of, 1279 urinary, 709
motility of, 862-863 Sodium balance, 720-734, 720f
rapid-transit disorders of, 866-867 disorders of, 722-723, 722t. See also
slow-transit disorders of, 863, 864t, 865f Hypervolemia; Hypovolemia
neoplasms of, 1278-1287 Sodium bicarbonate
clinical manifestations of, 1279 in cardiac arrest, 348
diagnosis of, 1279-1280 in contrast-related injury prevention, 760
endoscopy in, 1280 in drug-related poisonings, 679t-683t
epidemiology of, 1278 in lactic acidosis, 746b
e76 INDEX
Sodium-channel blockers
toxic ingestion of, 679t-683t
in ventricular arrhythmias, 367
Sodium channelopathy, 2414-2415
Sodium ferric gluconate, in iron deficiency
anemia, 1042
Sodium ion channel, e52-1, e52-2f
disorders of, 2414-2415
Sodium nitrite, in acute poisoning,
679t-683t
Sodium nitroprusside, in hypertensive
emergency, 388t
Sodium phosphate, 755b
watery diarrhea with, 908
Sodium polystyrene sulfonate, in
hyperkalemia, 740-741
Sodium stibogluconate, in visceral
leishmaniasis, 2027-2028
Sodium sulfate, watery diarrhea with, 908
Sodium thiosulfate, in acute poisoning,
679t-683t
Soft drinks, diarrhea with, 908
Solar urticaria, 2516
Soles. See also Foot (feet)
keratoderma blennorrhagicum of,
1694-1695, 1695f
rash on, 1771, 1771t
Solid organ transplantation. See Organ
transplantation
Soluble CR1, 244
Solvent exposure, 77, 78t, 984
Somatization disorders, 34, 2244t
Somatoform disorders, 2236t, 2244, 2244t
Somatosensory evoked responses, 2234-2235
Somatostatin, 1426
Somatostatin receptor scintigraphy, in
gastrinoma, 1294
Somatostatinoma, 1293t, 1295-1297,
1504-1505, 1505t
Somnolence, daytime, 614
Sorafenib, 166-167
hypophosphatemia with, 755
in renal cell carcinoma, 1305-1306
Sorbitol, 838
watery diarrhea with, 908
Sore throat, 2469-2470, 2470f, 2470t
Sotalol, 356t-357t
in stable myocardial ischemia, 423t
Sotos syndrome, 191-192
South American blastomycosis, 1982-1983
South American hemorrhagic fever, 2151t.
See also Viral hemorrhagic fevers
Space sickness, 2465
Sparganosis, 2053t, 2057
Spasms
cricopharyngeus, 2471
esophageal, 882, 882f
hemifacial, 2341
in multiple sclerosis, 2353
neurogenic, 2230
Specific granule deficiency, 1115,
1116t-1117t
Specific gravity, urinary, 710
in hypovolemia, 724
Specificity, test, 32t
Spectinomycin, 1809t-1811t
Spectrin, e164-1
Speech discrimination test, 2462
Speech reception threshold test, 2462
Spells, with catecholamine-secreting tumors,
1472, 1472t
Sperm
analysis of, 1526-1528, 1526f-1527f, 1527t
ionizing radiation injury to, 80
production of, 1520
Spermicides, 1552
Spherocyte, 1025f, 1028t, e164-3f, e164-3t
Spherocytosis, hereditary, 1025f, 1341t,
e164-2-e164-5, e164-3f
Sphincter of Oddi dysfunction, 1019
Sphincterotomy, in bile duct stone removal,
855, 856f
Sphingolipidoses, 1357t
Sphingosine-1-phosphate, in anaphylaxis,
1635
Spider bite, 64t, 2077t, 2079, 2079f, 2419t
Spinal anesthesia, 2486
Spinal arteries, 2267-2268, 2268f Spleen, 220-221, 1109 Squamous cell carcinoma, 26
occlusion of, 2267-2268 Candida infection of, 989-996, 1988, conjunctival, 2426
Spinal cord. See also Spine 1988f cutaneous, 1332-1333
anatomy of, 2258, 2259f, 2265-2266, enlargement of. See Splenomegaly clinical manifestations of, 1333, 1333f
2266f, 2268f examination of, 25 diagnosis of, 1333
disorders of, 2265-2267. See also Spinal imaging of, 1110, 1110f, 1110t epidemiology of, 1333
cord injury infarction of, 467, 1110 pathobiology of, 1333
anterior cord syndrome in, 2266 metastatic adenocarcinoma of, 1110f prevention of, 1334
Brown-Squard syndrome in, 2266 palpation of, 829, 1110-1111 risk factors for, 1333
central cord syndrome in, 2266 physical examination of, 1110 treatment of, 1334
clinical manifestations of, 2266-2267 red pulp of, 1109 esophageal, 1272-1273, 1272t
conus medullaris syndrome, 2267 rupture of, Epstein-Barr virus infection eyelid, 2432
definition of, 2265 and, 2135 head and neck, 1257-1264. See also Head
diagnosis of, 2267 sarcoidosis of, 584 and neck cancer
differential diagnosis of, 2267, 2269 T-cell lymphoma of, 1227 HIV infection and, 2211
epidemiology of, 2265-2266, 2266t white pulp of, 1109 Square-wave jerks, 2448
imaging in, 2267 Splenectomy, 1110-1111 St. Louis encephalitis, 2162t, 2166-2168
inflammatory, 2268 in anemia, 1039 Standard deviation, e8-1
metabolic, 2268 in autoimmune hemolytic anemia, vs. standard error, e8-4
neoplastic, 2269 1049 Standard error of the mean, e8-4
posterior cord syndrome in, 2266 in hereditary pyropoikilocytosis, Standard tube agglutination test, in
treatment of, 2267b e164-3b-e164-4b brucellosis, 1892-1893
vascular, 2267-2268, 2268f in hereditary spherocytosis, Staphylococcal scalded skin syndrome, 1816,
malformations of, 2388-2391 e164-3b-e164-4b 1818, 1818f, 2529-2530, 2529f, 2545
tethered, 2388 in idiopathic thrombocytopenic purpura, Staphylococcal toxic shock syndrome, 1816,
Spinal cord injury, 2252-2257 1128 1818, 2522
anterior cord syndrome in, 2253 neutrophilia after, 1100 Staphylococcus, coagulase-negative, 1819
antithrombotic therapy in, 175t-176t in primary myelofibrosis, 1096-1097 Staphylococcus aureus infection, 1815-1820
autonomic nervous system disorders with, in refractory idiopathic thrombocytopenic blood stream, 1816-1817, 1817t
2392 purpura, 1129t carriers of, 1820
Brown-Squard syndrome in, 2253 Splenic artery, aneurysmal dilation of, CNS, 1818
central cord syndrome in, 2253 936-937 cutaneous, 1773, 1816, 1818, 1818f,
clinical manifestations of, 2253 Splenic lymphoma with villous lymphocytes, 2529-2530, 2529f, 2544, 2544f
diagnosis of, 2254-2255 1216t diagnosis of, 1818-1819
dysautonomia in, 2256-2257 Splenic vein thrombosis, 936 endocardial, 465, 470t, 1817, 1817f
gastrointestinal motility in, 864 Splenomegaly, 1109-1110 epidemiology of, 1815
imaging in, 2255, 2255f in chronic myelogenous leukemia, eyelid, 2431, 2431f
vs. ligamentous injury, 2255 1210 follicular, 2210, 2210f
nutrition in, 2257 evaluation of, 955, 1110-1111, 1110f, in food poisoning, 1816
prognosis for, 2257, 2257t 1110t genitourinary, 1818
spinal shock in, 2253, 2256-2257 in infection, 1109, 1771-1772 HIV infection and, 2210, 2210f
thromboembolic disease in, 2257 pathobiology of, 1109-1110, 1109t immune response to, 1816
treatment of, 2256-2257 in primary myelofibrosis, 1092 implant-related, 1818
ventilatory compromise in, 2257 Spondylitis, ankylosing. See Ankylosing joint, 1817-1818
visceral function in, 2257 spondylitis mechanisms of, 1816
Spinal cord stimulation, in pain management, Spondyloarthropathies, 1690-1697. See also meningeal, 1818, 2356, 2363
139 specific spondyloarthropathies methicillin-resistant, 1815, 1815t, e290-4f
Spinal muscular atrophy, 2345-2346 clinical manifestations of, 1690 HIV infection and, 2210
Spinal nerve(s), 2258, 2258f-2259f definition of, 1690, 1690f prevention of, 1819-1820
Spinal nerve roots, 2258, 2259f diagnosis of, 1690, 1690t osseous, 1817
disorders of, 2264-2265 genetics of, 1692-1696 pathobiology of, 1815-1816
Spinal stenosis, 488t, 2262t, 2263-2265 pathobiology of, 1690 pericardial, 1817
Spinal tumors, 1253, 1253t vs. rheumatoid arthritis, 1691t prevention of, 1819-1820
extradural, 1253-1254 treatment of, 1690b-1692b prosthetic deviceassociated, 1818
intradural, 1254-1256 undifferentiated, 1696 pulmonary, 1818
intramedullary, 1254 Spondyloepiphyseal dysplasia, in scalded skin syndrome, 1816, 1818,
metastatic, 1254 1344-1345 1818f, 2529-2530, 2529f, 2545
Spine, 2258-2269 Spondylolisthesis, 2262t soft tissue, 1816
anatomy of, 2258, 2258f Spondylosis, 2260 spinal, 1817, 1817f
disc replacement for, 1757 Sponge divers disease, 699 surgical site, 1816
epidural abscess of, 2373-2376, 2373t, Sporotrichosis, 1985-1986 in toxic shock syndrome, 1816, 1818,
2374f clinical manifestations of, 1985-1986 2522
evaluation of, 2258, 2260t definition of, 1985-1986 toxins in, 1818
osteoarthritis of, 1674f, 1675, 2262t diagnosis of, 1986 treatment of, 1819b
pain in. See Back pain; Neck pain epidemiology of, 1985 susceptibility testing in, 1819
Staphylococcus aureus infection of, 1817, lymphocutaneous, 1985, 1986f vancomycin-resistant, 1830
1817f osteoarticular, 1985-1986 virulence factors in, 1815, e296-1t
stenosis of, 488t, 2262t, 2263-2265 pathobiology of, 1985 Staphylococcus epidermidis infection, 1819
SPINK gene, 546 prognosis for, 1986 Starch embolism, 603
SPINK1 gene, 938, 941 treatment of, 1986b Starlings law, e52-5-e52-6, e52-6f
Spinobulbar muscular atrophy, 2346 visceral, 1985-1986 Startle disease, 2340
Spinocerebellar ataxia, 2341-2342 Sports injury, 1677-1678, 1678t. See also Starvation. See also Protein-energy
Spiny rat mite, 2078 Trauma; Traumatic brain injury malnutrition
Spiramycin, in toxoplasmosis, e357-7t Sprain, ankle, 1681 death from, 1389-1390
Spiritual distress, in dying patient, 10t, 11-12, Sprue metabolic response to, 1388-1389
13t collagenous, 907 STAT4 gene, 1697
Spirochete infection. See Leptospirosis; Lyme nontropical. See Celiac disease Statins
disease; Pinta; Relapsing fever; Syphilis; tropical, 907, 1078 in acute coronary syndrome, 430t, 432
Yaws Spur cells, in liver disease, 963 in cardiovascular disease, 257
Spirometra spp. infection, 2053t, 2057 Spurling maneuver, 2260-2261 in deep vein thrombosis prevention, 505
Spirometry, e85-3-e85-5. See also Pulmonary Sputum, culture/examination of, 590 in diabetes mellitus type 2,
function tests in asthma, 533 e237-13-e237-14
Spironolactone in bronchiectasis, 549 in heart failure, 306f-307f
in heart failure, 312, 312t Gram stain in, 590 in lipid disorders, 1353-1354, 1353t
in hypertension, 382t in HIV-infected patient, 2204-2205 perioperative, 2478t, 2480
in hypervolemia, 727-728, 727t in lung cancer, 1267, 1267f protease inhibitor interaction with, 1352
in ST segment elevation MI, 443 in tuberculosis, 1944-1945 in ST segment elevation MI, 444, 447t

Statins (Continued)
in stable myocardial ischemia, 419
variable response to, 131
Statistics, e8-1-e8-6. See also Measure(s);
Measurement
bivariate, e8-2-e8-4
Bonferroni correction in, e8-6
causality inference in, e8-5
clustered (hierarchical) data in,
e8-6
confounding in, e8-5
descriptive, e8-1-e8-4
inferential, e8-4-e8-5
meta-analysis for, e8-5
missing data in, e8-5-e8-6
multiple linear regression for, e8-4
multiple logistic regression for, e8-4
multiple testing in, e8-6
multivariable, e8-4
population values in, e8-4-e8-5
propensity scores in, e8-5
proportional hazards (Cox) model for,
e8-4
recursive partitioning for, e8-4
sampling for, e8-1
target population for, e8-1
univariate, e8-1-e8-2
variables in, e8-1
Status asthmaticus, 536
Status epilepticus, 2286, 2293
nonconvulsive, 2286, 2287f-2288f
Steakhouse syndrome, 875
Steatohepatitis, 996-999, 996t
alcoholic, 996-999
clinical manifestations of, 997,
997f
definition of, 996
diagnosis of, 997
epidemiology of, 996
pathobiology of, 996-997
prognosis for, 998
risk factors for, 996-997, 996t
treatment of, 997b-998b
drug-induced, 983
nonalcoholic, 998-999, 1414
clinical manifestations of, 998
definition of, 998
diagnosis of, 998-999, 998f-999f
epidemiology of, 998
HFE gene in, 1377
pathobiology of, 998
prevention of, 999
prognosis for, 999
treatment of, 999b
vitamin E intake and, e225-9
in pregnancy, 987, 987t
Steatorrhea, 901
in chronic pancreatitis, 942-943
diagnosis of, 829-832, 831t-832t
in malabsorption, 911
Steatosis. See also Steatohepatitis
parenteral nutrition and, 1397
Steeple sign, 2093f
Stellate cells, in hepatic cirrhosis, 1000
Stem cell(s), 203-204, 204f, e159-1,
e159-2f-e159-3f
adult, 204, 206f
in cancer, 1187
embryonic, 203-204, 205f
fetal-derived, 204
pluripotent, induced, 204, 206f
regulation of, e159-3f
transplantation of. See Hematopoietic stem
cell transplantation
Stenotrophomonas maltophilia infection, 1881,
1883, 1883t-1884t
Sterility, male, in cystic fibrosis, 546
Sternotomy, 618
Steroid hormone receptors, 1424-1425,
1425f
Steroidogenesis, 1423
adrenal, 1512-1513, 1514f
defects of, 1512t, 1513-1518, 1514f
ovarian, 1512-1513, 1514f, e244-3f,
e244-4
placental, 1513
testicular, 1512-1513, 1514f, 1520, 1520f
Steroidogenic acute regulator, 1423
Stevens-Johnson syndrome, 1640,
2528-2532, 2528f, 2535
in Mycoplasma pneumoniae infection, 1914,
1914f
phenytoin-related, 983
Stiff-person syndrome, 1193t
Stills disease, 1668t, 1669
Stimulant abuse, 140t, 142-146, 156-157,
157b
Sting(s)
cone snail, 698-699, 698t
coral, 698t, 699
fish, 697, 698t
hymenoptera, 2077t, 2081
jellyfish, 698t, 699
Portuguese man-of-war, 698t, 699
scorpion, 2079
sea anemone, 698t, 699
sea nettle, 698t
sea urchin, 699
stingray, 697-698, 698t
Stingray envenomation, 697-698, 698t
STK11 gene, 1283
Stomach. See also at Gastric; Gastro-
adenocarcinoma of. See Gastric cancer
adenoma of, 1278
aging-related changes in, 106
alcohol effects on, 148t
benign tumors of, 1278
Dieulafoys lesion of, 861, 861f, 886, 935,
935f
diffuse large B-cell lymphoma of, 1227
gastrointestinal stromal tumor of, 1278
heterotopic mucosa of, 885
leiomyoma of, 1278
leiomyosarcoma of, 1278
lymphoma of, 1277-1278
metastatic tumors of, 1278
motility of, 862-863
rapid-transit disorders of, 866-867
slow-transit disorders of, 863, 864t,
865f
pH of, e290-5
polyps of, 1278
watermelon, 935
Stomatitis
aphthous, 2449, 2450f, 2470
herpes, 2530-2532
Stomatocyte, 1026f, 1028t, e164-3f
Stomatocytosis, hereditary, 1026f, 1028t,
e164-3f, e164-5
Stone(s)
bladder, 794
common bile duct. See Choledocholithiasis
gallbladder. See Cholelithiasis
renal. See Nephrolithiasis
Stonefish envenomation, 697
Stool
blood in, 832, 1035, 1286, 1286t
culture/examination of, 1789t
in amebiasis, 2046
in cholera, 1866t, 1867
in chronic diarrhea, 900, 900f,
911-912
in chronic pancreatitis, 942-943
in cryptosporidiosis, 2040
in gastrointestinal disease, 832
in hookworm infection, 2066
in liver disease, 963
in malabsorption, 902, 903t, 911
quantitative, 903t
in Salmonella infection, 1886
in shigellosis, 1889-1890
in strongyloidiasis, 2067-2068
Sudan stain for, 903t
in yersiniosis, 1900
DNA tests on, 1286, 1286t
fatty, 901. See also Steatorrhea
diagnosis of, 829-832, 831t-832t
in malabsorption, 911
osmotic gap of, 912
pH of, 912
Strabismus, 2428, 2447-2448, 2447f
Strachans Jamaican neuropathy, 2385
Straight back syndrome, 265
Straight leg raise test, 2261
Stratum corneum, 2499, 2499f
Straw itch mite, 2078
Strength assessment, in older adults, 102-103
Streptococcal toxic shock syndrome,
1825-1826, 2522
Streptococcus agalactiae infection, 1828
invasive, 1828
meningeal, 2362t
neonatal, 1828
Streptococcus bovis infection, 1829
Streptococcus canis infection, 1829
Streptococcus dysgalactiae subspecies
equisimilis infection, 1828-1829
Streptococcus infection, 1823-1829. See also
Streptococcus pneumoniae infection;
Streptococcus pyogenes infection
glomerulonephritis after, 713, 767, 767f
group A, 1824, 1824t, 2529, 2544
group B, 1824t, 1828
group C, 1824t, 1828-1829
group G, 1824t, 1828-1829
in impetigo, 2529, 2544
in infective endocarditis, 465, 468t, 470t
viridans group, 1828-1829
zoonotic, 1829
Streptococcus iniae infection, 1829
Streptococcus pneumoniae infection,
1820-1823
clinical manifestations of, 1821
definition of, 1820-1823
diagnosis of, 1821-1822, 1822t
epidemiology of, 1820
HIV infection and, 2191t-2192t
immunization against, 55, 65f-66f, 67t-70t,
72, 1822-1823
meningeal, 2356, 2361, 2362t
pathobiology of, 1820-1821, 1821f, 1821t
prevention of, 1822-1823, 2191t-2192t
prognosis for, 1823
treatment of, 1822b-1823b, 1823t
resistance to, 1821
Streptococcus pyogenes infection, 1824-1825,
1824f, 1824t
cutaneous, 1825
diagnosis of, 1827-1828
middle ear, 1825
nonsuppurative sequelae of, 1826-1827
prevention of, 1827
pulmonary, 1825
respiratory tract, 1824-1825, 1824f, 1824t
rhinosinus, 1825
soft tissue, 1825
treatment of, 1827b
Streptococcus suis infection, 1829, 2364
Streptokinase, 176-177
in ST segment elevation MI, 439-441,
440t-441t
Streptomycin, 1812
Streptozocin, 1168t-1176t
Stress, 179-180
autonomic response to, 2392
cardiovascular disease and, 258
in functional gastrointestinal disease, 868
hypogonadism with, 1524
neurologic effects of, 180
neutrophilia with, 1099
reduction of, 180
telomere length and, 180
Stress testing
in angina pectoris, 415-417
in aortic stenosis, 455-456
in arrhythmias, 344
in cardiovascular disease, 246, 248t-249t,
255
echocardiographic, 280, 281f
in hypertrophic cardiomyopathy, 321
in interstitial lung disease, 559
pharmacologic, 285, 2479
post-infarction, 446
preoperative, 2479, 2480t
Stress ulcers, 889
String of beads lesion, in fibromuscular
disease, 379, 379f, 498, 498f
Stroke, 2304-2310
amnesia and, 2271
aphasia and, 2272
definition of, 2304, 2304f
INDEX e77
Stroke (Continued)
dysphagia in, 2471
epidemiology of, 2304-2309
hemorrhagic, 2320-2326
cholesterol levels and, 257
edema in, 2309
fusiform aneurysm and, 2322
vs. ischemic stroke, 2310, 2315
mycotic aneurysm and, 2322
primary intracerebral hemorrhage and,
2323-2326, 2323t, 2324f-2325f,
2325t
saccular aneurysm and, 2321-2326,
2323t
subarachnoid, 2320-2326
vascular malformations and, 2322-2326
ischemic, 2310-2320
air embolism and, 2318
angiography in, 2314
anterior cerebral artery, 2311, 2312t
antiphospholipid antibodies and, 2317
arterial dissection and, 2318
atherosclerosis and, 2311
atrial fibrillation and, 2310-2311, 2319t
atrial myxoma and, 2315
basilar artery, 2312
cancer and, 2316
cardiac emboli and, 2311
cardiomyopathy and, 2311
carotid stenosis and, 2310, 2319t
cervical artery dissection and, 2318
cigarette smoking and, 2310, 2319t
clinical manifestations of, 2311, 2312t
coagulation disorders and, 2316-2319
diabetes mellitus and, 2313, 2319t
diagnosis of, 2312, 2313f, 2317f
diet and, 2310
differential diagnosis of, 2315
drug-related, 2317-2318
echocardiography in, 2313
edema in, 2309
electrocardiography in, 2313
endocarditis and, 467, 2311, 2375
epidemiology of, 2310
evolution of, 2310
in Fabrys disease, 2318
fat embolism and, 2318
focal, 2308
hematologic tests in, 2313
hemoglobinopathies and, 2316
vs. hemorrhagic stroke, 2310, 2315
homocystinuria and, 2318
hormone replacement therapy and,
2310
hyperlipidemia and, 2310, 2319t
hypertension and, 374f, 2310, 2319t
hyperviscosity syndrome and, 2316
imaging in, 2313-2314, 2313f-2314f
internal carotid artery, 2311, 2312t
leukocytes in, 2309
lumbar puncture in, 2314
in Marfan syndrome, 2318
middle cerebral artery, 2311-2312,
2312t
moyamoya disease and, 2318
in neurofibromatosis, 2318
neurologic examination in, 2313
neuronal death in, 2308-2309
no-reflow phenomenon in, 2309
obesity and, 2310
onset of, 2310
oral contraceptives and, 2310
paradoxical emboli and, 2311
pathobiology of, 2308, 2310-2316
patient history in, 2312-2313
physical examination in, 2313
posterior cerebral artery, 2312, 2312t
pregnancy and, 2316
prevention of, 175t-176t, 2319b, 2319t
antihypertensives in, 386-387
aspirin in, 170, 170t
prognosis for, 2319
risk factors for, 2304, 2310
in sickle cell disease, 1070, 1073, 2316
small vessel, 2310
superior cerebellar artery, 2312t
syphilis and, e327-3-e327-4
e78 INDEX
Stroke (Continued)
-thalassemia intermedia and,
1063-1064
vs. transient ischemic attack, 2310,
2312-2313
treatment of, 175t-176t, 2315b, 2317f
ultrasonography in, 2314
valvular heart disease and, 2311
vasculitis and, 2315-2316
venous sinus thrombosis and, 2318
vertebral artery, 2312, 2312t
vertigo with, 2467
in older adults, 99t
pathobiology of, 2304-2309
postoperative, 2483
in sickle cell disease, 1073
in syphilis, e327-3-e327-4
Stroke volume, e52-5-e52-6, e52-5t, e52-6f
in heart failure, 296-297
Stromelysins, in inflammation, 233t
Strongyloidiasis, 990t-992t, 2067-2068
clinical manifestations of, 2067
diagnosis of, 2067-2068
disseminated, 2067-2068
epidemiology of, 2067
pathology of, 2067
treatment of, 2009, 2065t, 2068b
Strontium ranelate, in osteoporosis, 1585
Strmpells disease, 2342, 2342t
Study design, 39-41
case-control, 40-41
cohort, 40-41
cross-sectional, 41
experimental, 39-40
nonexperimental, 40-41
observational, 40
Sturge-Weber syndrome, 2390-2391, 2390f
Stye, 2431, 2431f
Subacute sclerosing panencephalitis,
2112-2114
Subacute sensory neuropathy, 1193t,
2404-2405
Subarachnoid hemorrhage, 2320-2326
vs. bacterial meningitis, 2360
clinical manifestations of, 2320
CSF examination in, 2231f, 2231t
diagnosis of, 2320-2326
epidemiology of, 2320
fusiform aneurysm and, 2322
imaging of, 2320-2321
mycotic aneurysm and, 2322
pathobiology of, 2320
risk factors for, 2320
saccular aneurysm and, 2321-2326, 2322f
treatment of, 2321b
vascular malformations and, 2322-2326
Subclavian artery
right, aberrant, 886
stenosis of, syncope with, 341
Subclinical disease, aging and, 98, 100t
Subcutaneous panniculitis-like T-cell
lymphoma, 1227
Subdermal implants, contraceptive, 1555
Subdural empyema, 2374
Subependymal nodular heterotopia, 2387
Submersion (drowning) injury, 574-581
Substance abuse. See Drug abuse
Substituted judgment standard, 5-6
Succimer, 90t, 91b
in arsenic toxicity, 679t-683t
in lead toxicity, 679t-683t
in mercury toxicity, 679t-683t
Succinylcholine, 1344t, 2486
Sucrose-isomaltose deficiency, 909
Sudden death. See also Cardiac arrest;
Myocardial infarction (MI)
antipsychotic-induced, 2493
cardiac risk for, 361, 366, 366t
family history of, 361
in hypertrophic cardiomyopathy, 323
refeeding and. See Refeeding syndrome
Sugarcane worker disease, 571t
Suicide, 2245, 2245t
in adolescents, 60
assisted, 7-8, 7t
diet and, 1381t
drug abuse and, 154-155
Sulfadiazine, 1809t-1811t
Sulfadoxine-pyrimethamine, in malaria, 2017,
2017t
Sulfamethoxazole, 1809t-1811t
Sulfasalazine
folate interaction with, e225-8t
in inflammatory bowel disease, 917t, 918
in rheumatoid arthritis, 1688t, 1689
in spondyloarthropathies, 1691
Sulfonamides, 1807t-1811t, 1814t
Sulfonylureas
in diabetes mellitus type 2, e237-6-e237-8,
e237-7t
toxic ingestion of, 679t-683t
Sumatriptan, in high-altitude syndromes,
575-576
Sunburn, 82
Sunitinib, 166-167, 1168t-1176t
in renal cell carcinoma, 1305-1306
Sunlight exposure, 79f, 82, 104, 108,
1329-1330, 1333, 2501-2502
drug-related sensitivity to, 2535, 2536t
protection against, 2513-2514
Sunscreen, 2513-2514
Superantigens, in vasculitides, 1722
Superficial thrombophlebitis, 505-506, 505f
Superior sulcus sign, 611, 611f
Superior vena cava
left, persistent, 408
obstruction of, 611, 612f, 1266
Supraglottitis, 2470t, 2471
Supraventricular tachycardia, 339, 352, 352t.
See also specific supraventricular
tachycardias
alcohol-related, 149
clinical manifestations of, 355
diagnosis of, 355
palpitations with, 337
treatment of, 355b-358b, 356t-357t
vs. ventricular tachycardia, 345, 363t
Suramin, in African sleeping sickness, 2020b,
2021t
Surgery
anesthesia for. See Anesthesia
antithrombotic therapy in, 175t-176t
in basal cell carcinoma, 1333
in bladder cancer, 1307b-1308b
in breast cancer, 1311
in cancer, 1164
in carcinoid syndrome, 1511
in catecholamine-secreting tumors, 1475
in cervical cancer, 1318b
in cholangiocarcinoma, 1302b-1303b
in colorectal cancer, 1287-1288
complications of, 2488-2491
alkalosis, 2490
anemia, 2490
anorexia, 2488
azotemia, 2490-2491
blood glucose, 2491
chest pain, 2488, 2488t
delirium, 2489
diarrhea, 2488
dyspnea, 2488, 2489t
edema, 2490
fever, 2490
hyperbilirubinemia, 2491
hypertension, 2489
hypoalbuminemia, 2491
hypotension, 2489
leukocytosis, 2490
platelet count abnormalities, 2490
potassium abnormalities, 2490
pulmonary, 2481
seizures, 2489
sodium abnormalities, 2490
tachycardia, 2489-2490
vomiting, 2488
weakness, 2488-2489
in coronary heart disease. See Coronary
artery bypass grafting (CABG);
Percutaneous coronary intervention
(PCI)
in Cushings disease, 1441b
in Cushings syndrome, 1466
diabetes insipidus with, e232-6, e232-6f
in endometrial cancer, 1318b-1319b
Surgery (Continued)
in epilepsy, 2292-2293
in esophageal cancer, 1273b-1274b
evaluation after. See Postoperative
consultation
evaluation for. See Preoperative
consultation
in gastrinoma, 1294
in hepatic adenoma, 1300b
in hepatocellular carcinoma, 1301b-1302b
in idiopathic multifocal fibrosclerosis,
1753b
in inborn errors of metabolism, 1346
jaundice after, 961
in joint disease. See Arthroplasty
in lung cancer, 618, 1270b-1271b
in melanoma, 1332b
in obesity, 1416
in ovarian cancer, 1319b
in pain management, 139
in pancreatic cancer, 1291b-1292b
in Parkinsons disease, 2333
in pituitary adenoma, 1435
in prostate cancer, 1323-1324
in renal cell carcinoma, 1305, e203-1f
in sarcoma, 1328b-1329b
in sexual development disorders, 1518
in sickle cell disease, 1074
in skin disease, 2513
in squamous cell carcinoma, 1334
thrombosis after, 1153
in thyrotoxicosis, e233-8-e233-9
Surgical history, 22
Surgical site infection, 1816, e290-5-e290-6
Susceptibility testing, for antibacterial agent
selection, 1763-1764, 1804
Swallowing
difficult. See Dysphagia
syncope with, 341
Sweat glands, 2498, 2499f, 2500
apocrine, 2499f, 2500
in cystic fibrosis, 545
eccrine, 2499f, 2500
Sweat testing, for cystic fibrosis, 546
Sweating
aging-related changes in, 109
disorders of, 2394-2396, 2394t
drug-induced disturbances in, 2394,
2394t
Sweeteners, 838
Sweets syndrome, 1196t, 1771, 1779, 2535,
2540-2541, 2541f
Swimmers ear, 1879
Swimmers itch, 2059, 2547
Swollen belly syndrome, 2067
Swyer-James-McLeod syndrome, 519, 552
Swyers syndrome, 1517
Sydenhams chorea, 2336
Sympathetic nervous system, 2391. See also
Autonomic nervous system
cardiac effects of, e52-3-e52-4
in heart failure, 297-298
Sympathetic ophthalmia, 2440
Sympatholytics, in hypertension, 382t-383t,
384
Symptoms, 2
Syncope, 337-339
ambulatory monitoring in, 342-343
in aortic stenosis, 455
carotid body hypersensitivity and, 341
cerebrovascular, 341
cough-related, 341
electrocardiography in, 341-342
evaluation of, 246-249, 337-339, 338f,
338t-339t
heat, 667
muscle jerking with, 339
neurocardiogenic, 338t, 339-341, 340t
vs. anaphylaxis, 1636
tilt table testing in, 343
treatment of, 341, 344b
neuropsychiatric, 338t, 341
orthostatic hypotension and, 341
prognosis for, 344
in pulmonary hypertension, 392
vs. seizure, 339, 2289t
seizures and, 341
Syncope (Continued)
subclavian artery stenosis and, 341
treatment of, 344b
Syndesmophytes
in ankylosing spondylitis, 1693-1694,
1694f
in reactive arthritis, 1695
Syndrome, 2
Syndrome of inappropriate antidiuretic
hormone (SIADH) secretion, 730,
730t, 731f
cancer and, 1191-1192
drug-induced, 2495
Synovectomy, 1755
Synovial cyst, 1680, 1684-1685, e272-1f
Synovial fluid, e267-1f
analysis of, 1653, 1653f
in gout, 1739-1740, 1740f
in rheumatoid arthritis, 1687
in septic arthritis, 1732-1733, 1733f
Synovitis
crystal-induced, 1651. See also Calcium
pyrophosphate dihydrate (CPPD)
deposition disease; Gout
inflammatory, 1651
rheumatoid, 1683-1684, 1683f
villonodular, pigmented, 1752
Synovitis, acne pustulosis, hyperostosis, and
osteitis syndrome, 1668t
Synovium, e267-5
Syntrophin, 320t
Syphilis, 1798, e327-1-e327-7
cardiovascular, e327-3
chancre of, 2546, e327-1-e327-2, e327-2f
CNS, e327-3-e327-7, e327-3t
condylomata lata in, e327-2-e327-3,
e327-2f
congenital, e327-4, e327-6
dark-field examination in, e327-4
definition of, e327-1-e327-2
diagnosis of, e327-4-e327-7, e327-5t
differential diagnosis of, e327-5
endemic, 1929-1930
epidemics of, e327-1
epidemiology of, e327-1
false-positive tests for, e327-5
follow-up examinations in, e327-7
granulomatous reaction in, e327-2
gummas in, e327-3
hepatitis in, e327-3
HIV infection and, 2198, 2210, 2210f,
e327-4
Jarisch-Herxheimer reaction in,
e327-6-e327-7
late, e327-3-e327-4, e327-3t
latent, e327-3
meningeal, 2359t, e327-3
meningoencephalitic, e327-4
meningovascular, e327-3-e327-4
musculoskeletal manifestations of, 1735
natural course of, e327-1, e327-2f
pathobiology of, e327-1-e327-2
in pregnancy, e327-6
prevention of, e327-7
primary, e327-2
prognosis for, e327-7
rash in, e327-2, e327-2f
relapsing, e327-3
screening for, 54t
secondary, 2436, 2520, 2520f, 2546,
e327-2-e327-3
serologic tests for, e327-4-e327-5,
e327-5t
spinal, e327-4
treatment of, e327-6b-e327-7b, e327-7t
Syringohydromyelia, 2388
Systemic autoinflammatory disease,
1667-1672
definition of, 1667-1668, 1668t
Systemic inflammatory response syndrome,
586. See also Shock, septic
Systemic lupus erythematosus (SLE), 228t,
230-231, 1697-1705
antinuclear antibodies in, 1653-1655,
1654t
antiphospholipid antibody syndrome and,
1702

Systemic lupus erythematosus (SLE)
(Continued)
autoantibodies in, 1698, 1698f, 1703,
1703t
C-reactive protein in, 1652
cardiovascular manifestations of, 1701
clinical manifestations of, 1699-1702,
1699t
complement in, 1698, 1703
constitutional symptoms in, 1699
criteria for, 1702-1703, 1702t
cutaneous manifestations of, 1699, 1699f
definition of, 1697
diagnosis of, 1702-1704, 1702t-1703t
endocarditis in, 2311
environmental triggers in, 1697-1698
epidemiology of, 1697
esophageal manifestations of, 884
gastrointestinal manifestations of, 925,
1701
genetics of, 1697-1698, 1697t
hematologic manifestations of, 1702
HLA associations in, 225t
immune complexes in, 1698
immunologic triggers in, 1698
interferon- in, 1698, e274-1f
laboratory testing in, 1703
lipid disorders and, 1352t
lymphadenopathy in, 1701-1702
malar rash in, 1699, 1699f
meningitis in, 2370
musculoskeletal manifestations of, 1699
neonatal, 1702
neuropsychiatric manifestations of, 1701,
1701t
ocular manifestations of, 2440
panniculitis in, 1699, 2541
pathobiology of, 1697-1704, e274-1f
pericarditis in, 481
pleural effusion in, 610
pregnancy and, 1702
prognosis for, 1704
pulmonary manifestations of, 564, 1701
Raynauds phenomenon in, 1701
renal manifestations of, 714, 714f,
769-770, 769f, 769t, 1699-1701,
1700f, 1700t
vs. rheumatoid arthritis, 1687t
sensorimotor neuropathy in, 2405t
treatment of, 1703b-1704b
Systemic sclerosis. See Scleroderma
Systemic vascular resistance, 645-646
Systole, in heart failure, 296, 296t, 299, 299t,
316
T Tarsal tunnel syndrome, 2408
T cell. See Lymphocyte(s), T
T-cell leukemia, 1216. See also Adult T-cell
leukemia/lymphoma
T-cell lymphoma, 1226
angioimmunoblastic, 1227
enteropathy-type, 1227
extranodal, 1227
hepatosplenic, 1227
subcutaneous panniculitis-like, 1227
unspecified, 1226
T-cell receptors, 217-218
Tabes dorsalis, e327-4, e327-6
Tachy-brady syndrome, 349, 349f
Tachycardia, 29
in acute poisoning, 671
circus movement re-entry in, 336-337
diagnosis of, 339, 340t
electrocardiography in, 341-342, 342f
fever and, 28
in gastrointestinal bleeding, 858
hypotension and, 29
mechanisms of, 336-337, 336f, e61-2f
narrow-QRS complex, 341, 342f
palpitations with, 337
phase 2 re-entry in, 336-337
postoperative, 2489-2490
re-entry in, 336-337, 336f, e61-2f
reflection re-entry in, 336-337
supraventricular. See Supraventricular
tachycardia
INDEX e79
Tachycardia (Continued) Telbivudine Testis (testes)
ventricular. See Ventricular tachycardia adverse effects of, 2087t, 2088 cancer of. See Testicular cancer
wide-QRS complex, 341, 343f, 344-345 in hepatitis B, 975b-976b, 976t, development of, 1511, 1512f. See also
Tachykinins, carcinoid secretion of, 1509 2086t-2087t, 2088 Sexual development
Tachypnea, 29 Telethonin, 320t intra-abdominal, 1518-1519
pulmonary embolism and, 29 Telithromycin, 1809t-1811t ionizing radiation injury to, 80
Tacrolimus, 159t, 164 Telmisartan, in hypertension, 382t lymphoma of, 1227
adverse effects of, 162t Telogen effluvium, 2500, 2551-2553 physiology of, 1519-1528, 1519f
in kidney transplantation, 824f, 825, acute, 2551 spermatogenesis in, 1520
825t chronic, 2551 steroidogenesis in, 1512-1513, 1514f,
in minimal change disease, 763b Telomerase, in cancer, 1186 1520, 1520f
in pruritus, 2502t Telomeres, stress and, 180 testosterone synthesis in, 1512-1513,
topical, 2513 Telomeric crisis, 1300 1514f
Taenia asiatica infection, 2053t, 2054 Telvibudine, in hepatitis B, 976t Testosterone
Taenia crassiceps infection, 2057 Temazepam, 2242t aging-related changes in, 107
Taenia multiceps infection, 2053t Temosirolimus, 1168t-1176t in amenorrhea, e244-8
Taenia saginata infection, 2009-2010, 2053, Temozolomide, 1168t-1176t deficiency of, 1522, 1522f
2053t Temperature obesity and, 1414
Taenia solium infection, 2009-2010, 2053t, abnormal, 27t in erythropoiesis, 1037
2054-2056 decrease in, 29 functions of, 1520, 1520f
Tai chi, 179 elevation in, 28, 1768-1774. See also Fever replacement of, 1434t, 1522, 1525b, 1525t
Takayasus arteritis, 486, 1721, 1721t-1722t measurement of, 27 in obesity, 1414
clinical manifestations of, 1722-1723, normal, 1768 serum, 1523-1525
e278-1f for physical examination, 24 in sexual function, 1521
gastrointestinal, 934 regulation of, 666, 666f, 1768 synthesis of, 1520, 1520f
ischemic stroke and, 2316 Temperature-pulse dissociation, 1769 TET2 gene, 1091t
Takotsubo cardiomyopathy, 331, 657 Temporal (giant cell) arteritis, 486, 1721, Tetanospasmin, e304-5
Talc, in drug adulteration, 154 1721t, 1728-1731 Tetanus, 2394, e304-5
Talc embolism, 603 clinical manifestations of, 1728-1729, cephalic, e304-5
Tamm-Horsfall protein, 711-712 2439 clinical manifestations of, e304-5
Tamoxifen, 1168t-1176t definition of, 1728 definition of, e304-5
in breast cancer, 202t, 1312 diagnosis of, 1729-1730, 1729f diagnosis of, e304-5-e304-6
in breast cancer prevention, 1315 differential diagnosis of, 1730 epidemiology of, e304-5
endometrial cancer with, 1181-1182 epidemiology of, 1728 generalized, e304-5
in osteoporosis, 1584 headache in, 2251 immunization against, 64t, 65f-66f,
prophylactic, 55 ischemic stroke and, 2316 67t-70t, 73, e304-6, e304-6t
steatohepatitis with, 983 pathobiology of, 1728 local, e304-5
Tamsulosin, in benign prostatic hyperplasia, treatment of, 1730b neonatal, e304-5
807, 808t Temporal artery pathobiology of, 2230, e304-5
Tanapox virus infection, 2118 assessment of, 1729-1730 prevention of, e304-6, e304-6t
clinical manifestations of, 2120 biopsy of, 1729-1730, 1729f prognosis for, e304-6
diagnosis of, 2121 inflammation of. See Temporal (giant cell) treatment of, e304-6b
Tandem repeats, 189 arteritis Tetany, 1599, 2230
Tanner staging, 59, 59f-60f, e244-6, Temporal bone, transverse fracture of, Tethered spinal cord, 2388
e244-6t 2466 Tetrabenazine, in Tourettes syndrome, 2338b
Tapentadol, 137-138 Tender points, in fibromyalgia, 1744 Tetrachlorodibenzo-p-dioxin, porphyria
Tapeworms, 2052-2057. See also specific Tendinitis, 1676-1681, 1676t-1677t cutanea tarda with, 1367
tapeworms Achilles, 1681 Tetracycline(s), 1807t, 1809t-1811t,
definition of, 2052-2057 bicipital, 1679 1812-1813
treatment of, 2009-2010 patellar, 1680 adverse effects of, 1814t
Tarantula, 2077t, 2079 rotator cuff, 1678-1679, 1678f hepatotoxicity of, 981t
Tardive akathisia, 2340 tibial, 1681 resistance to, 1808t
Tardive dyskinesia, 2340-2342 treatment of, 1677b Tetracycline test, in osteomalacia, 1588-1589
Tardive stereotypies, 2340 Tendinopathy, 1676-1677 Tetrahydrocannabinol. See Marijuana
Target cells, 963, 1024f-1025f, 1028t Tendinosis, 1676-1677 Tetralogy of Fallot, 406, 406f
Tars, 2511 Tendon(s), e267-5 epidemiology of, 398
aging-related changes in, 107 exercise and, 409t
Taruis disease, 1356t rupture of, 1676-1677, 1676t, 1680-1681 ventricular tachycardia in, 365
Taste, 2460-2461, 2460f Tendon insufficiency, 1676-1677 Tetrathiomolybdate, in Wilsons disease,
disorders of, 2460-2461 Tenecteplase, 176-177 1372b
clinical manifestations of, 2461 in ST segment elevation MI, 439-441, Tetrodotoxin, 698t, 699, 898
diagnosis of, 2461 440t-441t TGFBR1 gene, 1664
pathobiology of, 2460-2461, 2461t Tenofovir, in hepatitis B, 975b-976b, 976t, TGFBR2 gene, 1664
Tau protein, 2282 2088 Thalassemia, 1060-1066
Tay-Sachs disease, 185t, 1360 Tenosynovitis, flexor, 1679 clinical manifestations of, 1061,
Taylor Cyanide Antidote Package, 578b Tension-type headache, 2247t, 2248-2252 1062f-1063f
Tazarotene, 2511 Teratogenicity, 1550t, 1556, 1556f definition of, 1060
Tdap (tetanus, diphtheria, acellular pertussis) of azathioprine, 162 diagnosis of, 1064
vaccine, 55, 65f-66f of cyclophosphamide, 165 epidemiology of, 1060
Team care, 3, 46 of cyclosporine, 164 genetics of, 1060-1061, 1060t
Tears, 2426 of hyperglycemia, 1563, 1563f-1564f molecular defects in, 1061
artificial, 2432, 2439 Teratoma, mediastinal, 522f pathobiology of, 1060-1066
excessive, 2429 Terazosin screening for, 185t
Technetium pertechnetate thyroid uptake, in benign prostatic hyperplasia, 807, 808t treatment of, 1064b-1066b, 1065f
e233-2 in hypertension, 382t Thalidomide, 1168t-1176t
Teflon fever, 574t Terbinafine, in dematiaceous fungal infection, in primary myelofibrosis, 1096-1097
Tegaserod, in irritable bowel syndrome, 2008b in skin diseases, 2511
871t Terminal illness. See Dying patient; Palliative Thallium, toxic ingestion of, 677t
Tegenaria spp. spiders, 2079 care Thatchers lung, 570-571
Teicoplanin, 1807t Ternidens diminutus infection, 2068 Thelarche, premature, 1531
Telangiectasia, 2543 Terrorism. See Bioterrorism Theophylline
in carcinoid syndrome, 1510 Testicular cancer, 1321-1322 in asthma, 535
cerebral, 2322 clinical manifestations of, 1321 in COPD, 541, 542t
colonic, 935 diagnosis of, 1321, 1321f in high-altitude syndromes, 576b
hemorrhagic, hereditary, 1136, 1136f epidemiology of, 1321 in kidney failure, 128t
Telangiectasia macularis eruptiva, 1642 pathobiology of, 1321 pharmacokinetics of, 126t
Telavancin, 1807t treatment of, 1321b-1322b, 1322t toxic ingestion of, 677t, 684t
e80 INDEX
Thermal injury. See Burn injury
Thermogenesis, 1412
Thermoregulation disorders. See
Hyperthermia; Hypothermia
Thiamine (vitamin B1), e225-2t-e225-5t
deficiency, 2382, 2383t, e225-2t-e225-5t
amnesia and, 2271
dilated cardiomyopathy with, 327
toxicity of, e225-2t-e225-5t
Thiazolidinediones
in diabetes mellitus type 2, e237-7t,
e237-8
heart failure and, 313
Thienopyridines, 174-176
Thiolase deficiency, 1343t
Thioridazine, 2243t
ocular effects of, 2442
Thiothixene, 2243t
Thirst, 721
regulation of, e232-1-e232-2, e232-2f
Thomsens disease, 2412t, 2414
Thoracentesis, in HIV-infected patient, 2207
Thoracic cyst, 551
Thoracoscopy, 618
Thoracotomy, 618
Thorax
Actinomyces infection of, 1968-1969, 1968f
congenital cyst diseases of, 551-552
examination of, in asthma, 532-533
Thrills, 250-251
Throat, 2469, 2469f. See also Oropharynx;
Pharynx
disorders of, 2469-2472
sore, 2469-2470, 2470f, 2470t
Thrombasthenia, Glanzmann, 1135
Thrombin inhibitors, direct, 173-174
Thromboangiitis obliterans, 494-498
clinical manifestations of, 494, 495f
definition of, 494
diagnosis of, 494-495
epidemiology of, 494
gastrointestinal involvement in, 934
pathobiology of, 494
treatment of, 495b
Thrombocythemia, essential, 1090-1098
clinical manifestations of, 1092, 1092f
definition of, 1090-1091
diagnosis of, 1092, 1093f-1094f, 1093t
epidemiology of, 1091
pathobiology of, 1091-1097, 1091t
prognosis for, 1097
treatment of, 1095b-1097b, 1096t
Thrombocytopenia, 1124-1131, 1125t
alcohol-related, 149
alloimmune, 1131
congenital, 1131
decreased platelet production and, 1125
definition of, 1124
dilutional, 1131
drug-induced, 1126-1127, 1126t
gestational, 1130
heparin-induced, 173, 504, 1127, 1127f,
1127t
immune-mediated, 1125-1127, 1125t.
See also Thrombocytopenic purpura,
idiopathic
HIV infection and, 2214
neonatal, 1131
treatment of, e159-4
in liver disease, 963
in myelodysplastic syndrome, 1201
peripheral blood smear in, 1029
platelet destruction and, 1125
platelet sequestration and, 1125
postoperative, 2490
during pregnancy, 1130-1131
in sepsis, 1128
in shock, 647
transfusion-refractory, 1126
treatment of, 1125-1131, 1155-1156,
1156f
vasculitis and, 1131
Thrombocytopenic purpura, 715
autoimmune, 228t
idiopathic, 64t, 1128-1131, 1128t
in systemic lupus erythematosus, 1702
vs. viral hemorrhagic fever, 2153t
Thrombocytopenic purpura (Continued)
thrombotic, 787-788, 1129-1131, 1129f,
1129t
hemolysis with, 1051t
HIV infection and, 2214
vs. viral hemorrhagic fever, 2153t
Thrombocytosis, 1094-1095, 1095f, 1095t
paraneoplastic, 1198
peripheral blood smear in, 1029
postoperative, 2490
Thromboembolism. See also Deep vein
thrombosis (DVT); Pulmonary
embolism; Thrombosis
atrial fibrillation and, 355, 358, 358t
post-infarction, 446
postoperative, 1758
in pregnancy, 1560, 1561t
treatment of, 171-177, 175t-176t. See also
Antithrombotic therapy
Thrombolytic therapy. See also
Antithrombotic therapy
in deep vein thrombosis, 504
hemorrhage with, 2324
in ischemic stroke, 2315, 2316t, 2317f
Thrombophilia
acquired, 1151-1153
hereditary, 1149-1153, 1150f,
1150t-1151t
in pregnancy, 1560
X-linked, 1149
Thrombophlebitis
deep. See Deep vein thrombosis (DVT)
superficial, 505-506, 505f
Thrombopoietin, e159-1
clinical application of, e159-4
Thrombopoietin receptor agonists, in
refractory idiopathic thrombocytopenic
purpura, 1129t
Thrombosis
arterial, 411, 411f, 1121-1122
in antiphospholipid antibody syndrome,
e177-9
cerebral artery. See Stroke
coronary artery. See Myocardial
infarction (MI)
hepatic artery, 936
malignancy-associated, 1198-1200
mesenteric artery, 931
oral contraceptives and, 1553
renal artery, 785-786, 786f, 786t
purpura with, 2524
venous. See also Deep vein thrombosis
(DVT); Pulmonary embolism
in antiphospholipid antibody syndrome,
1153, e177-9
in cancer, 1152
hormone replacement therapy and,
1153
in hypercoagulable states, 1124, 1124t,
1149-1150, 1150t
malignancy-associated, 1198-1200,
1199f
mesenteric vein, 932, 932t
in myeloproliferative disorders, 1152
oral contraceptives and, 1153, 1553
portal vein, 936
postoperative, 1153
in pregnancy, 1153, 1560, 1561t
renal vein, 788-789, 788t
splenic vein, 936
venous sinus, 2318, 2374
cavernous sinus, 2374-2376
lateral sinus, 2375, 2375f
sagittal sinus, 2375
Thrombotic endocarditis, nonbacterial,
332-333
Thrush, 1987, 1987f, 1989, 2470
Thumb, skiers (gamekeepers), 1679
Thumb sign, 2094f
Thymoma
immunodeficiency with, 1620
myasthenia gravis and, 2420-2421
Thymus gland
age-related changes in, 107
in myasthenia gravis, 2419
T-cell development in, 218-219, 218f, 226
Thyroglobulin, e233-1
Thyroid cancer, e233-12
anaplastic, e233-12f, e233-13
follicular, e233-12
Hrthle cell, e233-12-e233-13
medullary, 1506-1507, 1601-1603,
e233-12f, e233-13-e233-14
papillary, e233-12, e233-12f
Thyroid gland, e233-1-e233-14
anaplastic carcinoma of, e233-12f, e233-13
anatomy of, e233-1-e233-2
autoantibodies to, e233-2, e233-6-e233-7
C-cell hyperplasia of, 1601
C cell of, e233-1
disease of. See also Hyperthyroidism;
Hypothyroidism; Thyroiditis;
Thyrotoxicosis
neoplastic, e233-12
nodular, e233-11, e233-12f
in pregnancy, 1557t
preoperative assessment of, 2482
screening for, 54
ectopic, e233-5
embryology of, e233-1
evaluation of, 24, e233-1-e233-3, e233-2t
fine-needle aspiration biopsy of,
e233-11-e233-12, e233-12f
follicular carcinoma of, e233-12
function of, e233-1
functional imaging of, e233-2
histology of, e233-1
Hrthle cell carcinoma of, e233-
12-e233-13
imaging of, 1422, e233-2-e233-3, e233-7,
e233-8t
infection of, e233-10
lymphoma of, e233-12f, e233-14
medullary carcinoma of, 1506-1507,
1601-1603, e233-12f,
e233-13-e233-14
nodules of, e233-11, e233-12f
in nonthyroidal illness, e233-5
papillary carcinoma of, e233-12, e233-12f
physical examination of, e233-1-e233-2,
e233-10-e233-11
physiology of, e233-1-e233-14
radioactive iodine uptake by, e233-2
technetium pertechnetate uptake by,
e233-2
Thyroid scan, e233-2, e233-7, e233-8t,
e233-10-e233-11
Thyroid-stimulating hormone (TSH), 1423,
1423f, 1443
in amenorrhea, e244-3f, e244-7
deficiency of, 1430, 1443
measurement of, 1434t, e233-2-e233-4,
e233-4f, e233-7, e233-7f, e233-11
stimulation of, e233-1
tumor production of, 1435t, 1444, e233-7
Thyroid storm, e233-9
Thyroidectomy, in medullary carcinoma,
1602b
Thyroiditis, e233-9
acute (suppurative), e233-10
autoimmune, e233-10
drug-induced, e233-10
Hashimotos, e233-3
lymphocytic (postpartum, painless, silent),
e233-9-e233-10
postpartum, 1564
Riedels, e233-10
subacute, e233-9
Thyrotoxic crisis, e233-9
Thyrotoxicosis, e233-5
clinical manifestations of, e233-6-e233-7
definition of, e233-5
diagnosis of, e233-7-e233-9, e233-7f,
e233-8t
differential diagnosis of, e233-7
epidemiology of, e233-5
heart failure and, 314-315
pathobiology of, e233-5, e233-5t
transient, e233-5
treatment of, e233-7b-e233-9b
Thyrotropin-releasing hormone (TRH),
1412t, 1425, e233-1
Thyrotropin-releasing hormone (TRH) test,
1437t
Thyroxine, 1423, 1423f, e233-1
action of, e233-1
aging-related changes in, 107
measurement of, e233-2-e233-4, e233-2t,
e233-4f, e233-7, e233-7f
metabolism of, e233-1
replacement of, 1434t, e233-4b-e233-5b,
e233-4t
transport of, e233-1
undernutrition effects on, 1389
Thyroxine-binding globulin, e233-1
Thyroxine-binding prealbumin, e233-1
Tibial muscular dystrophy, 2414
Tibial tendinitis, 1681
Tibial tendon
inflammation of, 1681
rupture of, 1681
Tibolone, for menopausal hot flushes,
1569t-1570t
Tic(s), 2338-2342, 2338t
Ticagrelor, 176
Ticarcillin/clavulanate, 1809t-1811t
Tick bite, 2076t, 2078-2079
in babesiosis, e361-1-e361-2
in cat-scratch disease, 1908
in Colorado tick fever, 2156
in ehrlichiosis, 1961
in Lyme disease transmission, 1931,
1931f
prevention of, 1801, 1895, 1957,
2078-2079, e361-3
prophylaxis after, 2079
in relapsing fever transmission, 1936
in rickettsioses, 1955-1962, 1955t, 2078
tick removal after, 1957f
in tularemia transmission, 1894
in viral encephalitis transmission, 2162t
in viral hemorrhagic fever transmission,
2150
Tick-borne encephalitis, 2167-2168
Tick paralysis, 2078
vs. Guillain-Barr syndrome, 2402
Ticlopidine, 174-176
Tigecycline, 1809t-1811t
Tilt table testing, 343
Tiludronate, in Pagets disease, 1605t
Timolol
in hypertension, 382t
in stable myocardial ischemia, 423t
Tinea corporis, 2210, 2521
Tinea cruris, 2210
Tinea pedis, 2521
Tinea versicolor, 2521, 2521f
Tinel sign, 2408
Tinidazole, 2011
in amebiasis, 2046t
in giardiasis, 2042b
in trichomoniasis, e361-3b
Tinnitus, 2464
diagnosis of, 2464, 2464f
objective, 2464
subjective, 2464
treatment of, 2464b
Tiotropium, in COPD, 542t
Tiptoe sign, 686-687
Tirofiban, 176
in acute coronary syndrome, 430t
Tissue inhibitor of metalloproteinases, 235
Tissue-type plasminogen activator, 176-177
in ischemic stroke, 2315, 2316t, 2317f
Titin, 320t
TMPRSS6 gene, 1042
TNFAIP3 gene, 1697
TNFRSF1A gene, 1670
Toad venom, 674t-676t, 679t-683t
Tobacco use, 142-146. See also Cigarette
smoking
Tobramycin, 1809t-1811t
in kidney failure, 128t
pharmacokinetics of, 126t
Tocilizumab, 166
Toe(s)
erythrasma of, 2545
Pseudomonas infection of, 2545-2546
Toenail, ingrown, 2556
Tolazamide, in diabetes mellitus type 2,
e237-7t

Tolbutamide, in diabetes mellitus type 2,
e237-7t
Tolcapone, in Parkinsons disease,
2330t-2332t
Tolerance
alcohol, 147
central, 221
drug, 128, 140
in organ transplantation, 239
peripheral, 221
self-, 214, 221-222, 1047
Toll-like receptors, 230-231
Tongue. See also Mouth
cancer of, 1259. See also Head and neck
cancer
geographic, 2451, 2451f
hairy leukoplakia of, 2135-2136
Tongue worm, 2079
Tonicity, 720
Tonsillitis, 2470, 2470t
Tonsilloliths, 2470
Tonsils, 2470
cancer of, 1259
Tooth (teeth)
examination of, 24
infection of, 1849
procedures on, antibiotic prophylaxis for,
408, 472, 472t-473t
Tophi, 1739, 1740f
Topiramate, 2292t
in alcohol dependence treatment,
153
in pain, 136t
Topotecan, 1168t-1176t
Torres syndrome, 1194t, 2431
Torsades de pointes, 366
resistant, 347
Torsemide
in hypertension, 382t
in hypervolemia, 727, 727t
Toscana virus, 2158
Total lung volume, e85-3t
Tourettes syndrome, 2338-2342
Toxic epidermal necrolysis, 1779, 2528,
2535, 2536f
Toxic multinodular goiter, e233-7
Toxic oil syndrome, 1706
Toxic shock syndrome, 2522
influenza virus infection and, 2098
staphylococcal, 1816, 1818, 2522
streptococcal, 1825-1826, 2522
treatment of, 2522b
Toxicant, 670
Toxidromes, 670, 670t. See also Poisoning
Toxin(s). See also Hazardous exposures;
Poisoning
anaerobic bacteria, 1848t
anthrax, 1837
autonomic neuropathy with, 2394
Clostridium botulinum, e304-4
Clostridium difficile, e304-1
Clostridium perfringens, e304-3
Clostridium sordellii, e304-2
diphtheria, 1833
erythema with, 2545
Escherichia coli, 1871-1872
hepatotoxicity of, 979-984. See also Liver
disease, drug-induced
methemoglobinemia with, 1032
micronutrient interactions with,
e225-8
myopathy with, 2416, 2416t
neuropathy with, 2408, 2408t
peripheral neuropathy with, 2408,
2408t
pertussis, 1901
Pseudomonas aeruginosa, 1878, 1878t
rhabdomyolysis with, 702
Shiga, 1889
sideroblastic anemia with, 1043-1044
staphylococcal, 1816, 1818
streptococcal, 1826
Vibrio cholerae, 1866-1867
Toxocariasis, 990t-992t, e366-1-e366-8,
e366-1t
covert, e366-1
Toxoplasma gondii, e357-1-e357-2, e357-2f
Toxoplasmosis, 1966t, e357-1-e357-9
cerebral, 2195
clinical manifestations of, e357-3-e357-4,
e357-3t, e357-4f
congenital, e357-2, e357-3t, e357-
4-e357-6, e357-4f, e357-7t
definition of, e357-1-e357-8, e357-2f
diagnosis of, e357-4-e357-5, e357-5t
epidemiology of, e357-1-e357-2
hepatic, 990t-992t
in HIV-infected patient, 2191t-2192t,
2195, 2204, e357-1-e357-2, e357-6
in immunocompromised host,
2191t-2192t, e357-6, e357-8
lymphadenopathy in, e357-3, e357-5
myocardial, 325
ocular, 2435, e357-6, e357-8
pathobiology of, e357-2-e357-6
pathology of, e357-3
post-transplantation, e357-2, e357-6
in pregnancy, e357-2, e357-5-e357-8,
e357-7t
prevention of, 2191t-2193t, 2194,
e357-6-e357-8, e357-8t
prognosis for, e357-8
reactivation of, e357-1-e357-2, e357-3t,
e357-4, e357-7t
retinal, 2195, 2435
risk factors for, e357-1
severity, e357-3
treatment of, 2012, e357-6b, e357-7t
TP-PA (Treponema pallidum particle
agglutination) test, e327-5, e327-5t
Trace elements/metals, 90t, e225-1
poisoning with, 88-95, 88t, 90t. See also
specific metals
Trachea
iatrogenic injury to, 514t
obstruction of, bronchoscopy in, 617, 617f
Tracheal gas insufflation, 644
Tracheitis, 586-587, 586f
Tracheobronchitis, 1862
Tracheobronchomegaly, 548
Tracheostomy, in obstructive sleep apnea,
616
Trachoma, 2434, e326-2-e326-3
TRALI (transfusion-related acute lung
injury), 581
Tramadol, 137-138
Trandolapril
in heart failure, 308t
in hypertension, 382t
Tranexamic acid, in von Willebrands disease,
1134
Transcobalamin II deficiency, 1362t
Transcription factors, in hematopoiesis,
e159-1
Transdermal patch
contraceptive, 1554
estrogen, 1567, 1568t
nicotine, 144t, 145
Transferrin, iron complex with, 1040
Transferrin receptor, 1041, 1041t
Transforming growth factor-, 215t
Transgenic animals, 244
Transient familial neonatal
hyperbilirubinemia, 959
Transient global amnesia, 2271
Transient ischemic attack (TIA)
vs. seizure, 2315
vs. stroke, 2310, 2312-2313
Transillumination, sinus, 24
Transjugular pressure, in liver disease, 956
Transplantation. See Hematopoietic stem cell
transplantation; Organ transplantation
Transporter in antigen processing (TAP)
protein, 218, 218f
Transthoracic needle aspiration, in
HIV-infected patient, 2207
Transtubular potassium gradient (TTKG),
709-710, 738
Transurethral microwave thermotherapy, in
benign prostatic hyperplasia, 808
Transurethral prostatectomy (TURP), in
benign prostatic hyperplasia, 808
Transverse myelitis, 2354
in multiple sclerosis, 2349
INDEX e81
Transverse myelopathy, in systemic lupus Travel/traveler (Continued)
erythematosus, 1701 typhoid immunization for, 1801t, 1802
Tranylcypromine, in depression, 2239t yellow fever immunization for, 1801t,
Trapped lung, 610 1802
Trastuzumab, 167, 1168t-1176t Trazodone
in breast cancer, 201-202, 202t, 1312 in depression, 2239t
Trauma, 687-688. See also specific injuries in erectile dysfunction, 1528
alcohol use and, 149 Trematodes. See Flukes
brain. See Traumatic brain injury Tremor, 2334
burn. See Burn injury action, 2334
cardiac tamponade in, 688 in alcohol withdrawal, 148
cardiogenic shock in, 688 clinical manifestations of, 2334
chest wall, 606-607 definition of, 2334
compressive shock in, 688 diagnosis of, 2334t
diabetes insipidus with, e232-6, e232-6f dystonic, 2336
drug abuse and, 154-155 essential, 2334-2335
epidemiology of, 687 head, 2334
head. See Traumatic brain injury intention, 2334
hemorrhagic shock in, 687-688, 688t kinetic, 2334
hypogonadism with, 1524 orthostatic, 2334
hypothermia with, 669 palatal, 2339
inflammatory response to, 231 Parkinsons, 2327
mechanism of injury in, 687 physiologic, 2334, 2334t
neurogenic shock in, 688 postural, 2334
pancreatitis with, 938 resting, 2334
pathobiology of, 687-688 task-specific, 2334
pathophysiology of, 687-688 Trench fever, 1907-1908, 1907f, 1907t-1909t
penetrating, 687 treatment of, 1910
primary survey in, 688-689 Treponema carateum infection, 1929-1930
rhabdomyolysis with, 702 Treponema pallidum, e327-1. See also Syphilis;
secondary survey in, 689-691 Yaws
abdomen in, 690-691, 690f Treponema pallidum particle agglutination
back in, 690 (TP-PA) test, e327-5, e327-5t
buttocks in, 691 Treprostinil, in pulmonary hypertension,
chest in, 689, 689f-690f 395-396, 396f
extremities in, 691 Tretinoin, 2511
head and neck in, 689 TREX1 gene, 1697
myocardium in, 689-690 Triad syndrome, 805
pelvis in, 691 Triallelic inheritance, 192
perineum in, 691 Triamcinolone, 161t. See also
spinal cord. See Spinal cord injury Corticosteroid(s)
tension pneumothorax in, 688 Triamterene
treatment of, 688b-691b in hypertension, 382t
venous thrombosis with, 1153 in hypervolemia, 727t
Traumatic brain injury, 2252-2257 Triangular alopecia, 2553
brain death and, 2298, 2299t Triazolam, 2242t
clinical manifestations of, 2253 Triceps skinfold thickness, 1386, 1387t
diagnosis of, 2253-2254, 2253t-2254t Trichiasis, 2426, 2429
epidemiology of, 2252-2253 Trichinellosis, e366-1t, e366-2-e366-6,
executive cognitive dysfunction and, e366-2b
2273 Trichoepithelioma, 2537
hypothalamic injury with, 1429 Trichomoniasis, 1799, e361-3-e361-5
imaging in, 2253-2254, 2254f, 2254t clinical manifestations of, e361-3
meningitis and, 2357 diagnosis of, e361-3-e361-4, e361-4f
pathobiology of, 2253 epidemiology of, e361-3
primary phase of, 2253 pathobiology of, e361-3
prognosis for, 2257 prevention of, e361-4
secondary phase of, 2253 prognosis for, e361-4
treatment of, 2255b-2257b treatment of, 2010, e361-4b
Travel/traveler, 1800-1803 Trichostrongylus spp. infection, 2065t,
fever and, 1769-1770, 1769t 2068
health care after, 1803 Trichotillomania, 2552-2553, 2553f
health care before, 1800 Trichuriasis, 2066
heart failure in, 313-314 treatment of, 2009, 2065t, 2066b
hepatitis A immunization for, 1801, 1801t Tricuspid regurgitation, 462-463
hepatitis B immunization for, 1801-1802, definition of, 462
1801t diagnosis of, 462
HIV infection and, 2201 in heart failure, 301
immunizations for, 900, 1801-1802, 1801t murmur in, 253t
infectious diarrhea in, 897t, 898-901, treatment of, 462b
1788, 1788t, 1803 Tricuspid stenosis, 253t
treatment of, 1790b-1791b Tricuspid valve, e52-3
influenza immunization for, 1801t, 1802 atresia of, 407-408
injury prevention for, 1800-1801 Ebsteins anomaly of, 407,
Japanese encephalitis immunization for, 409t
1801t, 1802 Tricyclic antidepressants
malaria in, 2013, 2017-2018 in depression, 2239t
malaria prevention for, 1801-1803 in irritable bowel syndrome, 871t, 872
meningococcal immunization for, 1801t, in pain, 135-137, 136t
1802 Trifluoperazine, 2243t
mosquito bite prevention for, 1801 Trifluorothymidine, in herpesvirus infection,
pneumonia in, 589, 589t 2085
poliomyelitis immunization for, 1801t, Trigeminal autonomic cephalalgias,
1802 2249-2252
preventive measures before, 1800-1803 Trigeminal neuralgia, 2251-2252
rabies immunization for, 1801t, 1802 Trigger points, in myofascial pain, 1746-1747,
tsetse fly bite prevention for, 2021 1746t
e82 INDEX
Triglycerides, 1346
normal levels of, 1353
Trihexyphenidyl, in Parkinsons disease,
2330t-2332t
Triiodothyronine, 1423, 1423f, e233-1
action of, e233-1
aging-related changes in, 107
measurement of, e233-2
metabolism of, e233-1
transport of, e233-1
Trimeprazine, 2512t
Trimethobenzamide, in nausea and vomiting,
843t-844t
Trimethoprim, 1807t
resistance to, 1808t
Trimethoprim-sulfamethoxazole, 1809t-
1811t
adverse effects of, 1814t
in Pneumocystis jirovecii pneumonia,
e349-4b-e349-7b, e349-6t, e349-8,
e349-8t
Tripe palms, 1196t
Tripod sign, 626, e103-1f
Triptans, in migraine headache, 2247t, 2248b
Trisomy X, hypogonadism in, e244-8
Trochanteric bursitis, 1680, 1680f
Tropheryma whippelii infection, 468t
Tropical endomyocardial fibrosis, 332
Tropical myositis, 1816
Tropical pulmonary eosinophilia, e366-5
Tropical spastic paraparesis, 2139-2140
Tropical sprue, 907, 1078
-Tropomyosin, 320t
Troponin
in acute coronary syndrome, 427
in acute pericarditis, 475
Troponin C, 320t
Troponin I, 320t
in ST segment elevation MI, 437
Troponin T, 320t
in ST segment elevation MI, 437
Trousseaus test, 1599
Trypanosomiasis
African, 2018-2021
clinical manifestations of, 2019
definition of, 2018-2021
diagnosis of, 2020, 2020f
epidemiology of, 2018-2019, 2019f
pathobiology of, 2019
prevention of, 2020-2021
treatment of, 2012-2013, 2020b, 2021t
vs. viral hemorrhagic fever, 2153t
American, e355-1-e355-5
acute, e355-2-e355-3
cardiac, e355-2
chronic, e355-2-e355-3, e355-4f
clinical manifestations of,
e355-2-e355-3
definition of, e355-1
diagnosis of, e355-3-e355-5
epidemiology of, e355-1-e355-5
gastrointestinal, e355-2
in Latin America, e355-1
pathobiology of, e355-1-e355-2,
e355-2f
prevention of, e355-5
prognosis for, e355-5
reactivation of, e355-2-e355-3
treatment of, 2012-2013,
e355-3b-e355-5b
in United States, e355-1
Trypsinogen
in chronic pancreatitis, 942
in cystic fibrosis, 546
Tryptase
in anaphylaxis, 1635-1636
in mastocytosis, 1642-1643
TSC1 gene, 2390
TSC2 gene, 2390
Tsetse fly bite, 2019, 2021. See also African
sleeping sickness
Tube feeding. See Nutrition, enteral
Tuberculin skin test, 230, 1944
in HIV infection, 1944, 2201
Tuberculosis, 1939-1948
abdominal, 1943
active, 1944-1945
Tuberculosis (Continued)
arthritis in, 1734-1735
chest radiography in, 590, 590f
in children, 1945
clinical manifestations of, 1941-1944,
1942f-1943f
colonic, 924-925
cutaneous manifestations of, 2546
definition of, 1939-1947
diagnosis of, 1944-1947
drug-resistant, 1940, 1945b-1946b, 1947t,
e290-2
epidemiology of, 1940, 1941t
extrapulmonary, 1941, 1942f, 1943
gastrointestinal, 1943-1944
Ghon complex in, 1941, 1942f
hepatic, 995, 995t
HIV infection and, 2191t-2192t, 2194,
2201-2203, 2202f-2203f, 2208,
2222-2223, 2222t
latent, 1940
lymphatic, 1943
meningeal, 1943, 2231t, 2355-2356, 2359t,
2369
miliary, 1943, 1943f, 1945
occupational transmission of, e290-8
pathobiology of, 1940-1941
pericardial, 475t, 481, 1943
peritoneal, 926, 1943
pleural, 610, 1941, 1943
prevention of, 1947
primary, 1940-1941
prognosis for, 1947
progressive primary, 1941
Ranke complex in, 1941
reactivation (postprimary), 1941-1942
biologic response modifiers and, 1779
reinfection, 1943
renal, 1944
risk factors for, 1940-1941, 1941t
screening for, 54t
small intestine, 924-925
treatment of, 1945b-1946b, 1947t
duration of, 1813
uveal, 2436
vertebral, 1944
Tuberous sclerosis, 796t, 2390, 2390f, 2390t
ash-leaf spots of, 2548
intersitital lung disease with, 566
renal cysts in, 796t, 800
Tularemia, 1893-1895, 1965t-1966t
bioterrorist use of, 84t, 591, 1894
clinical manifestations of, 1894
definition of, 1893-1895
diagnosis of, 1895
differential diagnosis of, 1895
epidemiology of, 1894
glandular, 1894
meningeal, 2364
oculoglandular, 1894
oropharyngeal, 1895
pathobiology of, 1894
pneumonic, 1895
prevention of, 1895
prognosis for, 1895
treatment of, 1895b
typhoidal, 1894
ulceroglandular, 1894
vs. viral hemorrhagic fever, 2153t
Tumor. See Cancer and at specific cancers and
tumors
Tumor embolism, 603
Tumor growth factor inhibitors, 167
Tumor lysis syndrome, 1167-1177
Tumor necrosis factor-, 215t, 1411t
Tumor necrosis factor- inhibitors, 165-166
adverse effects of, 166
indications for, 165-166
Tumor necrosis factor-, 215t
Tumor necrosis factor receptor-associated
periodic syndrome, 1668t, 1669-1672,
1670t
Tumor suppressor genes, 1185t, 1186, 1266,
e184-1
Tuna poisoning, 700
Tungiasis, 2080
Turcots syndrome, 1282
Turf toe, 1681
Turkey worker disease, 571t
Turners syndrome, 935, 1516, e244-8
Tylosis, 1196t
Tylosis palmaris et plantaris, 1273
Typhlitis, 923, 924f, e304-3
Typhoid fever, 1886
carrier of, 1885, 1887
diagnosis of, 1886
immunization against, 67t-70t, 74, 1887
for travel, 1801t, 1802, 1887
pathobiology of, 1885
prognosis for, 1886, 1888
treatment of, 1887
vs. viral hemorrhagic fever, 2153t
Typhus
epidemic, 1956t, 1959-1962, 1966t
murine, 1956t, 1959-1962
scrub, 1956t, 1960-1962
vs. viral hemorrhagic fever, 2153t
Tyrosine kinase, in hematopoiesis,
e159-2-e159-3
Tyrosine kinase inhibitors, 167
dilated cardiomyopathy with, 326-327
Tyrosine kinase receptors, 1424, 1424f
Tyrosinemia, 801t, 1343t
Tzanck preparation, 2508-2509, 2509f
U in gastrinoma, 1294
UBE3A gene, 192
Ubiquitinylation, in cancer, 1187
UDG1 gene, 1091t
UDG2 gene, 1091t
UGT1A1 gene, 959
Ulcer(s)
aphthous, 2449, 2450f, 2470
Camerons, 886, 889
chancroidal, 1864-1865, 1864f
colonic. See Crohns disease; Ulcerative
colitis
Curlings, 889
Cushings, 889
cutaneous, 109, 109f, 2543
extremity
chancroidal, 1865
diabetes-related. See Diabetic foot
in sickle cell disease, 1071
gastroduodenal. See also Peptic ulcer
disease
differential diagnosis of, 888t, 891
drug-related, 887, 888t, 889, 891, 924
in hyperhistaminic syndrome, 889
idiopathic, 887, 888t
infectious, 889
ischemic, 888t, 889
in older adults, 99t
postgastrectomy, 889
stress, 889
in systemic inflammatory disorders,
887-888, 888t
genital, 1797t, 1798, e327-5
Moorens, 2440
oral, 2449-2454, 2449t, 2450f
pressure, 109, 109f
syphilitic, 1798, 2500, 2546,
e327-1-e327-2, e327-2f
in tularemia, 1894
venous, 506
viral, 2449
Ulcerative colitis, 913-921
arthritis in, 1696, 1696t
clinical manifestations of, 914, 914t
colonoscopic surveillance in, 920
colorectal cancer and, 1281
complications of, 920
definition of, 913
diagnosis of, 915, 916f
epidemiology of, 913
extraintestinal complications of, 915
extraintestinal manifestations of, 914-915,
915t
genetics of, 913-916
pathobiology of, 913-920
pathophysiology of, 914
proctitis in, 919
prognosis for, 920
Ulcerative colitis (Continued)
sclerosing cholangitis and, 1014t
treatment of, 916b-920b, 917f, 917t
medical, 916-919, 917f, 917t
surgical, 919
tumor necrosis factor- inhibitors in,
165-166
Ultradian rhythm, 1427
Ultrasonography
in abdominal pain, 837
in acute cholecystitis, 846, 846f
in acute pancreatitis, 939
in alcoholic liver disease, 997
in biliary tract disorders, 846, 846f
cardiac. See Echocardiography
in chronic kidney disease, 815
compression, in deep vein thrombosis,
500-502, 501f
in cystic echinococcosis, 2056, 2056f
Doppler
cardiac, 279
in neurologic disorders, 2235t
endobronchial, 618
in sarcoidosis, 584
endoscopic, in chronic pancreatitis, 942,
942f
in fatty liver, 1300
in gallstones, 1015, 1017f
of gastric mass, 1277f
in gastrointestinal disorders, 845-846
in goiter, e233-10
in hepatic adenoma, 1299
in hepatic cavernous hemangioma,
1298
in hepatic cysts, 1300
in hepatic focal nodular hyperplasia,
1299
intravascular, in percutaneous coronary
intervention, 292, 293f
in ischemic stroke, 2314
in liver disease, 846, 955-956, 964
in lymphatic filariasis, e366-5
in neurologic disorders, 2235t
in nonalcoholic fatty liver disease, 998-999
in polycystic kidney disease, 797, 797f,
799
in portal vein thrombosis, 846, 847f
in pulmonary embolism, 599
in pyogenic liver abscess, 989
renal, 713, 713f
in arterial stenosis, 784
normal, 779f
in obstructive uropathy, 779, 779f
in rheumatic disease, 1657-1658, 1659f
of spleen, 1110
of thorax, 517
of thyroid gland, e233-2
in thyroid nodules, e233-11
transrectal, in prostate cancer, 1323
in trauma, 690-691, 690f
Ultrasound exposure, 83
Ultraviolet radiation, 79f, 82, 108,
1180-1181, 2501-2502
Underweight, in older adults, 99t
UNG gene, 1619
Uniparental disomy, 192
Univentricular heart, 407-408
Universal precautions, 2183, 2183t, 2503
Upper extremity. See also Hand(s)
venous thrombosis of, 505
Uranium poisoning, 95
Urate
crystals of, 712, 712f, 1738-1739. See also
Gout
overproduction of, 1738, 1738t
serum, 1737
underexcretion of, 1737-1738, 1738t
Urea
in chronic kidney disease, 813, 813f
fractional excretion of, 709, 759
plasma, in hypovolemia, 724
Urea cycle, inborn errors of, 1343,
1345-1346
Urea nitrogen, in chronic kidney disease, 815,
815t
Ureaplasma spp. infection, 1912, 1912t
 INDEX e83
Uremia, 810, 813. See also Kidney disease; Urinary tract infection (Continued) Urine (Continued) V
Kidney failure, end-stage classification of, 1792, 1792t pH of, 710, 743 V wave, in mitral regurgitation, 292, 292f
acidosis with, 745-746 clinical manifestations of, 1793-1796, phosphate in, 755, 1577 Vaccine. See also Immunization
anemia with, 1033f, 1037, 1037f 1793t pigmented granular casts in, 711-712, DNA, 210
encephalopathy with, 2326 definition of, 1791-1792 711f nicotine, 144t, 145-146
pericarditis with, 475t, 481 diagnosis of, 1793-1796, 1795t pink, 710t Vaccine-derived polioviruses, 2141
platelet hypofunction and, 1136 differential diagnosis of, 1794 porphyrin in, 1370 Vaccinia, 2117t
Ureter Enterobacteriaceae, 1874 potassium in, 709-710, 735, 738 autoinoculation of, 2119, 2120f
cancer of, 1308-1309, 1308t enterococcal, 1831 protein in, 710, 761 clinical manifestations of, 2119-2120
duplication of, 804 epidemiology of, 1792 in diabetic nephropathy, 782, 782f generalized, 2119
ectopic, 804, 804f etiology of, 1793, 1793t spot sample for, 709 progressive, 2119
Ureterocele, 804 in female, 1792 twenty-four-hour collection for, 709 Vaccinia vaccine, 64t, 67t-70t, 74, 86, 2117
Ureterocolostomy, colorectal cancer and, follow-up for, 1795, 1795t protein-to-creatinine ratio of, 709 Vaccinia virus, 2117, 2117t
1281 health careassociated, e290-1-e290-2, red, 710t. See also Urine, blood in recombinant, 209
Ureteropelvic junction, abnormalities of, e290-2t, e290-4-e290-5 S. haematobium in, 2060 Vagina. See also Cervix
803-804 host factors in, 1792, 1792t sodium in, 709 anaerobic bacterial infection of, 1849,
Urethra, obstruction of, 777-778. See also imaging in, 1794 specific gravity of, 710 1849t
Urinary tract, obstruction of in male, 1792 in hypovolemia, 724 atresia of, 1517
Urethral valves, posterior, 804f, 805 outpatient vs. inpatient, 1770 thallium in, 677t cancer of, 1320
Urethritis, 1797-1798, 1797t pathobiology of, 1792-1793 two-glass test of, 809-810 candidiasis of, 1798-1799, 1987
gonococcal, 1797t, e307-2-e307-5, prevention of, 1795-1796 urate crystals in, 712, 712f cyclic changes in, e244-1
e307-2f, e307-5t prognosis for, 1796 uric acid in, 709, 790, 1737, 1738t discharge from, 1797t, 1798
nongonococcal, 1797t Pseudomonas aeruginosa, 1879-1881 white blood cells in, 711, 1794 dryness of, 1568-1571, 1568t, 1570b
Chlamydia trachomatis, e326-2t, e326-3, Staphylococcus aureus, 1818 D-xylose in, 903t infection of, 1797t, 1798, 1849
e326-3f Stenotrophomonas maltophilia, 1883 yellow, 710t Neisseria gonorrhoeae infection of,
in reactive arthritis, 1694-1695 treatment of, 1794b-1795b, 1795t, Urobilinogen, bilirubin conversion to, 957 e307-3-e307-5
treatment of, 1797, 1797t 1813 Urocortin, 1412t pH of, 1798
Uric acid, urinary, 709, 790, 1737, 1738t Urine. See also Urinalysis UROD gene, 1367 Vaginosis, bacterial, 1797t, 1798, 1849
Urinalysis, 710, 710t. See also at Urine 24-hour collection of, in nephrolithiasis Urokinase, 176-177 Vagus nerve, in inflammatory response, 180
in acute interstitial nephritis, 773 prevention, 793, 793t Uropathy, obstructive. See Urinary tract, Valacyclovir
in acute kidney injury, 759, 759t acid secretion in, 743 obstruction of adverse effects of, 2082
in benign prostatic hyperplasia, 807 albumin in, 709-710, 815 Uroporphyrinogen decarboxylase inhibition, drug interactions with, 2084t
in urinary tract obstruction, 779 alkalinization of 1364f, 1365t, 1367-1370 excretion of, 2083t
Urinary incontinence, 110-114, 1551 in acute poisoning, 684 Uroporphyrinogen III cosynthase deficiency, in herpesvirus infection, 2082, 2083t
aging-related, 106 in rhabdomyolysis, 700 1364f, 1365t, 1369-1370 herpesvirus resistance to, 2082
clinical manifestations of, 111 in uric acid nephrolithiasis, 793-794 UROS gene, 1369 Valganciclovir
definition of, 110 appearance of, 710, 710t Urosepsis, 1793 adverse effects of, 2084, 2084t
detrusor overactivity and, 110, 113t arsenic in, 677t clinical manifestations of, 1793, 1793t drug interactions with, 2084t
detrusor-sphincter dyssynergia and, 111 bacteria in, 711, 1791-1792. See also prognosis for, 1796 excretion of, 2083t
detrusor underactivity and, 111, 113t Urinary tract infection treatment of, 1794 in herpesvirus infection, 2083-2084,
diagnosis of, 111, 112f, 112t bilirubin in, 963 Ursodeoxycholic acid 2083t
epidemiology of, 110 black, 710t, 1046, 1046t in cholestasis, 1013b Validity, measurement, 37
functional, 111 blood in, 710-711, 711f, 761 in primary biliary cirrhosis, 1015b Valproate, 2292t
mixed, 111 abdominal pain and, 833 Urticaria, 1613, 1628, 2506t, 2507-2508, hepatotoxicity of, 679t-683t
in multiple sclerosis, 2349 in bladder cancer, 1307 2508f, 2532-2543 hyperammonemia with, 679t-683t
in older adults, 99t in glomerular disease, 761 autoimmune, 1629 Valproic acid
overflow, 111, 113t blue, 710t chronic, 1634-1635 in bipolar disorder, 2238b
pathobiology of, 110-113, 111t brown, 710t, 1046, 1046t clinical manifestations of, 1629, 1629f, hepatotoxicity of, 983
prevention of, 113 calcium in, 709, 790, 1577 2533 toxic ingestion of, 677t, 684t
prognosis for, 113 casts in, 711-712, 711f cold, 669, 1100 Valsartan
screening for, 103, 104t cells in, 710-711 definition of, 1628, 2532, 2532f in heart failure, 309t
stress, 110-111, 113t citrate in, 709, 790 diagnosis of, 1629-1633, 1632f, 2533, in hypertension, 382t
surgical treatment of, 113 color of, 710, 710t 2533f Value, of health care, 44
transient, 110-113, 111t concentration of, e232-5 differential diagnosis of, 1629-1630, Valvular heart disease. See Heart disease,
treatment of, 112b-113b, 113t copper in, 1372 1630t valvular and specific diseases
urethral obstruction and, 111, 113t cortisol in, 1464 epidemiology of, 1628, 2532, 2533t Van Buchems disease, 1607-1610
urge, 111, 113t creatinine in, 709 idiopathic, 1629 Vancomycin, 1807t-1811t, 1813
urodynamic evaluation in, 111 crystals in, 712, 712f pathobiology of, 1628-1629, 2532-2533, adverse effects of, 1814t
Urinary retention, 106 culture of, 1793-1794 2533t Enterococcus resistance to, 1830, 1832
Urinary tract. See also Bladder; Kidney(s) cystine crystals in, 712, 712f prevention of, 1631 in kidney failure, 128t
abnormalities of, 802-805, 804f excess output of, 734, 734t prognosis for, 1631 pharmacokinetics of, 126t
development of, 802, 803f flow rate of, 736 solar, 2516 Vanishing bile duct syndromes, 1015
infection of. See Urinary tract infection foamy appearance of, 710t treatment of, 1630b-1631b, 2533b-2534b, Varenicline, in smoking cessation, 144t, 145
obstruction of, 776-780 four-glass test of, 809-810 2534t Variable, e8-1
acute renal injury with, 757-759, 757f glucose in, 710, 1341t Urticaria pigmentosa, 1630 categorical, e8-1-e8-2
clinical manifestations of, 778-780, 778t granular casts in, 711-712, 711f in mastocytosis, 1641-1642, 1641f continuous, e8-1
definition of, 776 green, 710t Urticarial vasculitis, 1726 outcome, e8-2-e8-3
diagnosis of, 779, 779t heme in, 710 U.S. Preventive Services Task Force, 52 predictor, e8-2-e8-4
differential diagnosis of, 780 hemoglobin in, 1038-1039, 1046t Ustekinumab, 166 Variant angina, 424
epidemiology of, 776 hyaline casts in, 711-712, 711f in psoriasis, 2518t Varicella-zoster virus (VZV) infection,
hematuria in, 778-779 immunoelectrophoresis of, 713 Usual interstitial pneumonia, 561, 561f 2128-2131, 2530
interstitial nephritis with, 774 large volume of. See Diabetes insipidus Uterine bleeding, abnormal, clinical manifestations of, 2129-2130,
laboratory studies in, 779 leukocytes in, 710 e244-5-e244-8 2129f, 2530, 2530f
pathobiology of, 776-777, 776f, 777t magnesium ammonium phosphate crystals Uterine fibroids, 1320 complications of, 2129
pathophysiology of, 777-778 in, 712, 712f Uterus definition of, 2128-2131
physical examination in, 778 magnesium in, 754, 1577 cancer of, 1318 diagnosis of, 2130
prognosis for, 780 mercury in, 677t examination of, 26 differential diagnosis of, 2130
symptoms of, 778-780 milky appearance of, 710t fibroids of, 1320 epidemiology of, 2129
treatment of, 780b myoglobin in, 703 Utility measures, 39 HIV infection and, 2191t-2192t
ultrasonography in, 779-780, 779f net charge of, 710 Uvea, melanoma of, 2441 immunization against, 54t, 55, 64t,
schistosomiasis of, 2059 osmolality of, e232-1, e232-2f Uveitis, 2433 65f-66f, 67t-70t, 73-74, 2130
stones in. See Nephrolithiasis in hypovolemia, 724 in ankylosing spondylitis, 1693 meningoencephalitic, 2377t
Urinary tract infection, 1791-1796 osmolarity of, 718, 718f Bartonella, 1909t pathobiology of, 2129
Acinetobacter, 1882 output of in juvenile rheumatoid arthritis, 2440 postexposure prophylaxis against, 2131
aging-related, 106 large. See Diabetes insipidus sarcoid, 584, 585t prevention of, 2130-2131
bladder cancer and, 1306 in shock, 648 Uvulopalatopharyngoplasty, in obstructive prognosis for, 2131
Candida, 1988-1990 oxalate in, 709, 712, 712f, 790 sleep apnea, 616 treatment of, 2130b
e84 INDEX
Varicella-zoster virus (VZV) infection
(Continued)
acyclovir in, 2082, 2083t
famciclovir in, 2083t
ganciclovir in, 2083-2084
valacyclovir in, 2082, 2083t
valganciclovir in, 2083-2084
Varicose veins, 505-506, 505f
Variegate porphyria, 1364f, 1365t-1366t,
1369-1370
Variola. See Smallpox
Varix (varices)
cerebral, 2322
in cirrhosis, 1001-1006
esophageal, 853, 853f
bleeding from, 857, 857f
treatment of, 853, 853f, 858b-860b
Vascular cell adhesion molecule-1, 1113
Vascular dementia. See Dementia, vascular
Vascular endothelial cells, in inflammation,
231-232
Vascular endothelial growth factor (VEGF)
inhibitors, 166-167
Vascular resistance
pulmonary, e52-5t
in COPD, 538
systemic, 645, e52-5t
Vasculitic neuropathy, 2404-2405
clinical manifestation of, 2405
definition of, 2404, 2405t
diagnosis of, 2405
differential diagnosis of, 2405
epidemiology of, 2404-2405
pathobiology of, 2405
prognosis for, 2405
treatment of, 2405b
Vasculitis, 1720-1727
age and, 1721
antiendothelial cell antibodies in, 1722
antineutrophil cytoplasmic antibodies in,
1722
classification of, 1720-1726, 1721t,
e278-1t
CNS, 2315-2316
cutaneous, 2507
definition of, 1720-1727
diagnosis of, 1726-1727
differential diagnosis of, 1726-1727,
1727t
epidemiology of, 1720-1721, 1721t
gastrointestinal tract, 934
gender and, 1721
immune complexes in, 1722
ischemic stroke and, 2315-2316
large-vessel, 1721-1726, 1721t, e278-1f
leukocytoclastic, 1196t, 1722t, 1726, 2525,
2525f, 2533
drug-related, 2535
medium-vessel, 1721t, 1722-1726, 1723f,
1724t
neuropathic, 2404-2405, 2405t
nodular, 2541, 2542f
paraneoplastic, 1199, 2404
pathobiology of, 1721
pathophysiology of, 1721
in pregnancy, 1130-1131
prognosis for, 1727
pulmonary, interstitial lung disease with,
565-567
renal, 1199
small-vessel, 1721t, 1722-1726, 1725f
in rheumatoid arthritis, 1685-1686,
1686f
superantigen model of, 1722
thrombocytopenia with, 1131
treatment of, 1727b
ulcer disease in, 888
urticarial, 1726, 2525
Vasculopathy, in systemic sclerosis, 1707
Vasoactive intestinal polypeptide (VIP),
tumor secretion of, 1293t, 1295-1297
Vasodilation
in cirrhosis, 1001-1002
hypovolemia and, 724
Vasodilators
in hypertension, 382t-383t, 384
in pulmonary hypertension, 395-396, 396f
Vasopressin, e232-1-e232-2, e232-2f
ACTH secretion and, e232-2
in anaphylaxis, 1637b
in heart failure, 298
inappropriate secretion of, 730, 730t, 731f,
e232-3
cancer and, 1191-1192
drug-induced, 2495
osmolality regulation and, e232-1, e232-2f
pressure regulation and, e232-1-e232-2
in shock, 649t, 653, 665
volume regulation and, e232-1-e232-2
in water balance, 721-722, 722f
water consumption behavior and, e232-2
in water regulation, 718
Vasopressors
in cardiogenic shock, 656-657
in septic shock, 663
in shock, 648-649, 649t, 650f, 653
Vasospasm, cerebral, 2321
Vasovagal reaction. See Syncope,
neurocardiogenic
VDRL (Venereal Disease Research
Laboratory) test, e327-4-e327-5,
e327-5t
false-positive, e327-5
Vectors
adenoviral, 208
adenovirus-associated virus, 209
herpes simplex virus type 1, 209
nonviral, 208
recombinant vaccinia virus, 209
retroviral, 208-209
virus-like particle, 209
Vecuronium, hypersensitivity reactions to,
2484
Vegetarian diet, cobalamin deficiency in,
1075
Vegetative state, 2297
clinical manifestations of, 2295t, 2298
diagnosis of, 2298, 2298t
epidemiology of, 2297-2298
pathobiology of, 2297-2298
prognosis for, 2298b
treatment of, 2298b
Veillonella infection, 1847-1851, 1850t
Vena caval filter, 504, 601
Venereal Disease Research Laboratory
(VDRL) test, e327-4-e327-5, e327-5t
false-positive, e327-5
Venezuelan equine encephalitis, 2162t, 2164
Venezuelan hemorrhagic fever, 2148t-2149t
Venlafaxine
in depression, 2239t
for menopausal hot flushes, 1569t-1570t
in pain, 136t
toxic ingestion of, 679t-683t
Venography, in deep vein thrombosis, 500,
500f
Venous air embolism, 602-603, 2318
Venous hum, 253t
Venous sinus thrombosis, 2318, 2374
Venous thrombosis. See Thromboembolism;
Thrombosis, venous
Venous ulcers, 506
Ventilation. See also Respiration(s)
alveolar, 628
assessment of, 626, 628, e85-3-e85-5,
e85-3t-e85-4t. See also Respiratory
system, monitoring of
mechanical. See Mechanical ventilation
minute, 628
regulation of, 527-530
Ventilation-perfusion mismatch, 631-633
vs. pulmonary-systemic shunt, 631
Ventilation-perfusion scan
in pregnancy, 1561
in pulmonary embolism, 599, 599f
Venting enterostomy (jejunostomy), 866
Ventricle, third, colloid cyst of, 1252
Ventricle (cardiac)
contractility of, e52-6
left, e52-2f, e52-3
aging-related changes in, 105
aneurysm of, 267f-268f, 445-446
dilation of, 266, 266f-267f. See also
Cardiomyopathy, dilated
Ventricle (cardiac) (Continued)
failure of, 519, 519f
cardiogenic shock with, 654-658,
654f, 654t, 656f
in COPD, 543-544
free wall rupture of, 445-446
function of
diastolic, 281
in heart failure, 302
radionuclide imaging of, 286
systolic, 280-281, 286
hypertrophy of, 258, 275-277, 277f.
See also Cardiomyopathy,
hypertrophic
imaging of, 264f, 266, 290, 290t, 294,
294f
post-infarction dysfunction of, 445
remodeling of, 298, 307
restrictive disease of, 329-333, 329t,
330f
thrombosis of, 282t-284t
right, 264f, e52-2f, e52-3
cardiomyocyte loss from, 327,
328t-329t
enlargement of, 266, 267f. See also
Cardiomyopathy, dilated
restrictive disease of, 329-333, 329t,
330f
single, 407-408
Ventricular couplets, 361, 362f
Ventricular fibrillation, 362f, 367
epidemiology of, 359
management of, 347, 347f, 371
post-infarction, 444
post-shock, 371
QRS morphology in, 361, 362f
spiral wave re-entry and, 359, 360f
treatment-resistant, 347
Ventricular flutter, 361, 362f
Ventricular outflow tract
left, obstruction of, 404
right, obstruction of, 403
Ventricular septal defect
adult, 401-402
diagnosis of, 402
exercise and, 409t
treatment of, 402b
epidemiology of, 398
murmur in, 253t
post-infarction, 445-446
Ventricular septal myectomy, in hypertrophic
cardiomyopathy, 323
Ventricular tachycardia, 339, 340t
clinical manifestations of, 359
in coronary artery disease, 373
definition of, 361
epidemiology of, 359
idiopathic, 363
implantable defibrillator and, 367, 368f
incessant, 367
management of, 344-345, 345f
monomorphic
idiopathic, 365-368
nonsustained, 361, 361f, 363t
definition of, 361
sustained, 361f, 363f-365f, 364-368
in arrhythmogenic right ventricular
cardiomyopathy, 364-365, 365f
bundle branch re-entry in, 365-368
implantable cardioverter-defibrillator
for, 367, 368f
in nonischemic dilated
cardiomyopathy, 364
in tetralogy of Fallot, 365
treatment of, 365b
pathobiology of, 359
polymorphic, 362f, 366, 366t
catecholaminergic, 366t, 367
QRS morphology in, 361, 362f
spiral wave re-entry and, 359, 360f
pulseless, 347, 347f
QRS morphology in, 361, 362f
radio frequency ablation of, 373
scar-related re-entry and, 359, 360f
vs. supraventricular tachycardia, 345, 363t
treatment of, 363b, 367
treatment-resistant, 347
Ventriculitis, cytomegalovirus, 2111
Ventriculography, 290, 290t, 294, 294f
Verapamil
in acute coronary syndrome, 430t, 431
in hypertension, 382t
in stable myocardial ischemia, 423t
Verbal fluency testing, 2274
Verner-Morrison syndrome, 1293t,
1295-1297
Verruca vulgaris. See Warts
Verruga peruana, 1906, 1908t-1909t, 1909
treatment of, 1910
Vertebral artery, 2304f, 2305
occlusion of, 2312, 2312t
Vertebrobasilar insufficiency, 2467
Vertigo, 2464-2468
in autoimmune disease, 2467
in brain stem infarction, 2467
in cerebellar infarction, 2467
in cerebellopontine angle tumors, 2467
diagnosis of, 2465-2468, 2465f-2466f
bedside, 2467-2468
caloric test in, 2467-2468
head-thrust test in, 2467
hyperventilation in, 2467
positional tests in, 2468
vestibulo-ocular reflex in, 2467
vestibulospinal function in, 2467
in epilepsy, 2467
in infection, 2467
in Menieres disease, 2466
in migraine, 2466
in multiple sclerosis, 2467
physiologic, 2465
positional, benign, 2465, 2468t
post-traumatic, 2466
in postconcussion syndrome, 2467
treatment of, 2468b, 2468t
in vertebrobasilar insufficiency, 2467
in viral infection, 2467
Vesicoureteral reflux, 804-805
Vestibular neuritis, 2465-2466, 2468t
Vestibulo-ocular reflex, 2296t, 2297, 2447,
2467
VHL gene, 1304
Vibrio infection, 1865-1868. See also Cholera
noncholera, 1868, 1868f
Vibrio parahaemolyticus infection, 897-898,
1868
Vibrio vulnificus infection, 897-898, 1868
Vidarabine, in herpesvirus infection, 2085
Video-assisted thoracoscopic biopsy, in
interstitial lung disease, 560
Video-assisted thoracoscopic surgery
(VATS), 618
Vinblastine, 1168t-1176t
Vincristine, 1168t-1176t
in hypereosinophilia, 1120-1121
Vinorelbine, 1168t-1176t
Vinyl chloride, lung cancer and, 1265
Violence, intimate partner, 1571-1574, 1572t
VIPoma, 1293t, 1295-1297, 1505t
Viral hemorrhagic fevers, 2147-2156
bat-borne, 2150
bioterrorism with, 84t-85t, 87-88, 87t
biphasic illness in, 2152
clinical manifestations of, 2151-2152,
2151t, 2152f
contact precautions for, 2154-2155
contract tracing for, 2155
definition of, 2147-2156, 2148t-2149t
diagnosis of, 2152-2154, 2152t-2153t
differential diagnosis of, 2153t
epidemiology of, 2150-2156
human to human transmission of, 2150
immunization against, 2155
laboratory tests in, 2152, 2152t, 2154
mosquito-borne, 2150
pathobiology of, 2150-2151
postexposure prophylaxis for, 2155
prevention of, 2154
prognosis for, 2155-2156
reservoir control for, 2155
rodent-borne, 2150
tick-borne, 2150
treatment of, 2154b
vector control for, 2155

Viral infection. See also specific viral infections
vs. acute leukemia, 1206
bronchial. See Bronchitis
cancer and, 1180
cutaneous, 2512, 2544t, 2546
gastrointestinal. See Norovirus infection;
Rotavirus infection
in head and neck cancer, 1258
hemorrhagic. See Viral hemorrhagic
fevers
hepatic. See Hepatitis
interstitial nephritis and, 772
joint, 1734
leukemia and, 1203
myocardial, 324, 324t
neutropenia with, 1103
pericardial, 475, 475t
pulmonary, 589-591, 593
respiratory. See Common cold; Influenza
virus infection; Pneumonia, viral;
Rhinitis
sexually transmitted. See Human
immunodeficiency virus (HIV)
infection; Human papillomavirus
(HPV) infection; Sexually
transmitted diseases
transfusion-transmitted, 1157, 1158f,
1158t
Virchows node
in colorectal cancer, 1285
in gastric cancer, 1276
Viridans group streptococcal infection,
1828-1829
Virilization, 1512t
in amenorrhea, e244-6
in aromatase deficiency, 1515
in congenital adrenal hyperplasia, 1512t,
1513-1515, 1514f-1515f, 1534
in cytochrome P-450 oxidoreductase
deficiency, 1515
diagnosis of, 1517-1518
drug-induced, 1515
luteoma and, 1515
in mixed gonadal dysgenesis, 1534
in polycystic ovary syndrome, 1533-1534
Virotherapy, 209
Virulence factors
in Bacillus anthracis, 1837
in Escherichia coli, 1871-1872, 1875
in non-spore-forming anaerobic bacteria,
1848, 1848t
in Pseudomonas aeruginosa, 1878, 1878t
Staphylococcus aureus, e296-1t
in Staphylococcus aureus, 1815
Virus-like particle vector, 209
Visceral angioedema, 924
Visceral artery aneurysm, 935
Visceral pain, 133, 133t, 832-833
enhanced perception of, 868
Visfatin, 1413
Visible light, 79f, 82
Vision, 2443-2445
aging-related changes in, 99t, 102, 104t,
108
color, 108, 2428
distorted, 2429
double, 2428
evaluation of, 24, 2427-2445, 2427f,
2427t, 2443f, 2444t
in older adults, 102, 104t
screening, 55
loss/impairment of. See also specific visual
disorders
acute, 2428-2442, 2428t-2429t
aging-related, 99t, 108
bilateral, 2428, 2428t, 2444
chronic, 2427-2442, 2427f
evaluation of, 2443-2445, 2443f, 2444t
localization of, 2443, 2443f
in multiple sclerosis, 2349
occipital cortex disease and, 2444-2445
optic chiasm lesions and, 2444
optic nerve lesions and, 2444, 2444t
optic tract lesions and, 2444
sudden, 2428t
in temporal arteritis, 1728
trachoma and, e326-2-e326-3
Vision (Continued)
unilateral, 2428, 2428t, 2444
vascular disease and, 2444-2445
Visual acuity, 2427-2442, 2427f, 2427t
Visual evoked responses, pattern reversal,
2234, 2234f
Visual fields testing, 2427, 2443, 2443f
in pituitary adenoma, 1433
Visuospatial disorders, 2273-2274, 2278
Vital capacity, in respiratory diseases, 514f
Vital signs. See also Blood pressure; Pulse;
Respiration(s); Temperature
abnormal, 27-30, 27t-28t
multiple, 28
in patient who appears ill, 28
in patient with systemic illness, 28
in patient without systemic complaints,
28
single, 28
in acute poisoning, 670t, 671
in asthma, 532
in heart failure, 301
in kidney disease, 708
measurement of, 27
normal, 27t
for physical examination, 23-24
predictive value of, 27
as symptoms, 27
Vitamin(s), e225-1
absorption of, 905
blood tests for, 911
diarrhea with, 908
in inborn errors of metabolism, 1345-1346
malabsorption of, 895, 911t
supplementation for, 55
Vitamin A, e225-2t-e225-5t, e225-9t
antioxidant effects of, e225-9
deficiency of, 2383t, 2385,
e225-2t-e225-5t
in malabsorption, 908t
in measles, 2106b
osteoporosis and, 1381
toxicity of, e225-2t-e225-5t
Vitamin B1 (thiamine), e225-2t-e225-5t
deficiency, 2382, 2383t, e225-2t-e225-5t
amnesia and, 2271
dilated cardiomyopathy with, 327
toxicity of, e225-2t-e225-5t
Vitamin B2 (riboflavin), e225-2t-e225-5t
Vitamin B3 (niacin), e225-2t-e225-5t, e225-9t
deficiency of, 2383t, e225-2t-e225-5t
toxicity of, 981t, e225-2t-e225-5t
Vitamin B6 (pyridoxine), e225-2t-e225-5t,
e225-9t
deficiency of, 2383t, 2384,
e225-2t-e225-5t
in ethylene glycol toxicity, 679t-683t
in homocystinuria, 1362b-1363b
in isoniazid toxicity, 679t-683t
in monomethylhydrazine mushroom
poisoning, 679t-683t
toxicity of, 2385, e225-2t-e225-5t
Vitamin B12 (cobalamin), 1075,
e225-2t-e225-5t
absorption of, 1075, 1077f
cellular processing of, 1075
defects in, 1362b-1363b, 1362t
deficiency of, 829-832, 905, 2383t, 2384,
e225-2t-e225-5t, e225-9
acid secretion deficiency and, 1076
acquired, 1077
bacterial overgrowth and, 1077
classification of, 1076t
clinical manifestations of, 1079
diagnosis of, 1079-1083, 1079f, 1081t
etiology of, 1082
inadequate protein dissociation and,
1075-1076
intrinsic factor efficiency and, 1076
intrinsic factor receptor disorders and,
1077
laboratory tests in, 1080-1082, 1081t
nutritional, 1075
pancreatic insufficiency and, 1077
pathogenesis of, 1075-1077
patient history in, 1080
physical examination in, 1080
Vitamin B12 (cobalamin) (Continued)
prognosis for, 1082-1083
treatment of, 1082b, 1083t
liver stores of, 1075
malabsorption of, 1341t
physiology of, 1075
prophylactic, 1082
recommended daily allowance for, 1075
serum, 1080-1081, 1081t
supplemental, 908t, 1082
transport of, 1075
Vitamin C, e225-2t-e225-5t
antioxidant effects of, e225-9
deficiency of, e225-2t-e225-5t
toxicity of, e225-2t-e225-5t
Vitamin D, 1592-1593, e225-2t-e225-5t,
e225-9t
deficiency of, 2383t, 2385,
e225-2t-e225-5t
hypocalcemia and, 1599
osteomalacia with, 1587
in sickle cell disease, 1073
in malabsorption, 908t, 2385
in multiple sclerosis, 2353
in osteomalacia, 1590, 1590t
in osteoporosis, 1583-1584
in renal osteodystrophy, 813
serum, 1588
Vitamin E, antioxidant effects of, e225-9
Vitamin E (tocopherol), e225-2t-e225-5t
in Alzheimers disease, 2279
coronary heart disease and, 1380
deficiency of, 2383t, 2385,
e225-2t-e225-5t
in malabsorption, 908t
in nonalcoholic fatty liver disease, 999b
Vitamin K, e225-2t-e225-5t
in anticoagulant toxicity, 679t-683t
deficiency of, 1148, 2383t, 2385,
e225-2t-e225-5t
in malabsorption, 908t
supplemental, 1148
toxicity of, e225-2t-e225-5t
Vitamin K antagonists, 171-172, 172f, 172t
Vitiligo, 2547, 2548f, 2550f
Vitreous, 2426, 2427f
VKORC1 gene, 200-201
Vocal cords
cancer of, 1259
dysfunction of, 514t
vs. anaphylaxis, 1636
paralysis of, 2471
Vogt-Koyanagi-Harada syndrome, 2370
Voiding, 776, 776f
Volar flexor tenosynovitis, 1679
Volvulus, colonic, 927
Vomiting, 831t-832t, 841-842
abdominal pain and, 833
chemotherapy-related, 1167-1177
diagnosis of, 842, 842f
in enteric infection, 1788t, 1789
metabolic alkalosis with, 751
motor events of, 863
postoperative, 2486-2488
treatment of, 842b, 843t-844t
Von Gierkes disease, 847f, 1356t
Von Hippel-Lindau disease, 185t, 1304, 2391
pheochromocytoma in, 1471
renal cysts in, 796t, 800
Von Willebrand factor, 1131
excess of, 1149
multimers of, 1132-1133
replacement of, 1134, 1134t
Von Willebrand disease, 1131-1136, e177-4t,
e177-7
classification of, 1132t
clinical manifestations of, 1132
definition of, 1131
diagnosis of, 1132-1136
epidemiology of, 1131
vs. hemophilia, e177-2
laboratory evaluation of, 1132-1133, 1133t
pathobiology of, 1131-1132
treatment of, 1134b, 1134t
type 1, 1132, 1132t-1133t, e177-4t
type 2, 1132, 1132t-1133t, e177-4t
type 3, 1132, 1132t-1133t, e177-4t
INDEX e85
Von Willebrand syndrome, 1134-1135,
1135t
Voriconazole, 1975
adverse effects of, 1975
in aspergillosis, 1975, 1993b-1994b, 1993t
drug interactions with, 1975
formulations of, 1975
Vulva
cancer of, 1320, 1320f
Candida infection of, 1798-1799, 1987
VWF gene, 1131-1132
W
Waist circumference, 1409
Wakefulness, 2294
Waldenstrms macroglobulinemia, 1216t,
1241
bleeding with, 1136
clinical manifestations of, 1241, 1242f
definition of, 1236t, 1241
diagnosis of, 1241-1242
laboratory evaluation of, 1241
treatment of, 1242b
Wallenbergs syndrome, 2312
Wandering atrial pacemaker, 351, 351f
Warburg effect, 1186-1187
Warfarin, 171-172, 172f, 172t
adverse effects of, 172
bleeding with, 172, 172t, 504
in deep vein thrombosis, 503-504
dosing for, 172
indications for, 171-172
metabolism of, genetic factors in, 187t
reversal of, 172
skin necrosis with, 172, 1150, 1150f
in ST segment elevation MI, 438-439, 447f
in stable myocardial ischemia, 419
in thromboembolism prevention, 200-201
variable response to, 131
Warming therapy, 669b
Warts, 2121-2125
genital, 949, 949f, 1798, 2121-2125
cervical cancer and, 1317, 2121,
2123-2125, 2125f
clinical manifestations of, 2123
diagnosis of, 2123, 2123f
differential diagnosis of, 2123
epidemiology of, 2121-2122
HIV infection and, 2198, 2209
imiquimod for, 2089
pathobiology of, 2122
prognosis for, 2124-2125, 2125f
screening for, 2124
treatment of, 2124b, 2124t
nongenital, 2121-2125, 2523-2524, 2537
clinical manifestations of, 2122, 2524f
diagnosis of, 2123, 2123f
differential diagnosis of, 2123
epidemiology of, 2122
pathobiology of, 2122
treatment of, 2124b
Wasp sting, 2081
Wasting
in HIV infection, 2194-2195, 2197t,
2199
in peripheral neuropathy, 2397
Water. See also Water balance
body
compartments of, 720, 720f
extracellular, 720-721, 720f
intracellular, 720-721, 720f
loss of, in burn injury, 692
renal regulation of, 716-718, 718f,
720-734, 721t
total, in nutritional support, 1387
undernutrition effects on, 1389
vasopressin effects on, e232-1, e232-2f
contamination of, 897-898, 897t
Campylobacter, 1869
Escherichia coli, 1872-1873
Salmonella, 1885
Vibrio cholerae, 1865-1866
daily ingestion of, 107
excess ingestion of, e232-4
treatment of, in cholera prevention,
1867-1868
e86 INDEX
Water balance, 721-722, 722f
disorders of, 728. See also Diabetes
mellitus; Hypernatremia;
Hyponatremia; Polyuria
in older adults, e232-2
vasopressin regulation of, e232-1, e232-2f
Water-borne illness, 897-898, 897t
Water deprivation test, e232-4-e232-5,
e232-5f
Waterhouse-Friderichsen syndrome, 1854b,
2358
Watermelon stomach, 935
WDHA syndrome, 1293t, 1295-1297,
1504-1505, 1505t
Weakness, 2229, 2230t
in amyotrophic lateral sclerosis, 2344
in cardiovascular disease, 249-250
diaphragmatic, 604, 604t-605t
electromyography in, 2233
episodic, 2230
in Guillain-Barr syndrome, 2401
intermittent, 2230
in multifocal motor neuropathy, 2403
in multiple sclerosis, 2349
in myasthenia gravis, 2420, 2420f
in myopathy, 2409
in neurologic disorders, 2229, 2230t
in peripheral neuropathy, 2396-2397
postoperative, 2488-2489
Web, esophageal, 883, 883f
Weeverfish envenomation, 697, 698t
Wegeners granulomatosis, 1721t-1722t,
1725
gastrointestinal involvement in, 934
interstitial lung disease with, 565
meningitis in, 2369-2370
purpura in, 1725, 1725f
treatment of, 1725
vasculitic neuropathy in, 2404-2405,
2405t
Weight
assessment of
in nutritional evaluation, 1385,
1386t
in older adults, 103
in endocrine disorders, 1420
excess. See Obesity
loss of
disease associations with, 839,
840t-841t
in HIV infection, 2194-2195, 2197t,
2199
hypogonadism with, 1524
infection and, 840t-841t
involuntary, 828, 831t-832t, 839,
840t-841t, 841f
lethal, 1389
in obstructive sleep apnea, 616
in older adults, 839
management of, 57
obstructive sleep apnea and, 613
pubertal, 59
regulation of, 1411
unintended loss of, 1385
Weils disease, 1937-1938, 1938f
Weinberg reaction, 994
Welanders myopathy, 2414
Welch Allyn AudioScope, 102
Wells prediction rule, 598t
Werdnig-Hoffman disease, 2345-2346
Werners syndrome, 1344
Wernickes aphasia, 2272, 2272t
Wernickes encephalopathy, 2383-2384
West Nile virus infection, 1965t, 2157
encephalitic, 2162t, 2165, 2166f,
2377t
Western equine virus encephalitis, 2162t,
2163-2168
Wests syndrome, 2290
Wet mount, in trichomoniasis, 1799,
e361-3-e361-4
Wheezing, 25, 512, 514t
in asthma, 532-533
in interstitial lung disease, 556-557
in lung cancer, 1266
Whiplash injury, 2260, 2262t
Whipples disease
arthritis in, 1747-1748
malabsorption in, 907
Whipworm, 2009, 2065t, 2066, 2066b
Whisper voice test, 102
White blood cell(s). See also specific cells
blood depletion of, 1155
bursal fluid, 1731
casts of, 711-712
corticosteroid effects on, 160
CSF, 2231t, 2359, 2359t
deficiency of. See Leukopenia;
Neutropenia
excess of. See Leukocytosis; Neutrophilia
homing of, 214
in ischemic stroke, 2309
in lysosomal storage disorders, 1358t
migration of, 214
normal count of, 1098
postoperative count of, 2490
production of, e159-1, e159-2f
pure aplasia of, 1104
in septic arthritis, 1733
synovial fluid, 1653, 1653f
urinary, 711, 1794
White coat blood pressure, 376-377
Whole bowel irrigation, in acute poisoning,
679
Whooping cough. See Pertussis (whooping
cough)
Wickhams striae, 2519, 2519f
Widow spider bite, 679t-683t, 2077t,
2079
Williams-Beuren syndrome, 191-192
Wilsons disease, 801t, 986, 1344t,
1371-1373
clinical manifestations of, 986, 1371-1372,
1372f, 2385
definition of, 1371
diagnosis of, 986, 1372
dystonia in, 2337
epidemiology of, 1371
gene therapy for, 1373
pathobiology of, 986, 1371
prognosis for, 1372-1373
treatment of, 986b, 1372b
Winter equation, 626
Wiskott-Aldrich syndrome, 1029, 1102
Withdrawal syndromes
alcohol, 148, 148t, 151
benzodiazepine, 157b
marijuana, 158
opioid, 155-156
Wohlfart-Kugelberg-Welander disease,
2345-2346
Wolbachia spp.
infection with, 1962
nematode symbiosis of, e366-3-e366-4,
e366-6, e366-6b
Wolff-Parkinson-White syndrome, 335, 340t,
353-354, 354f
surgery in, 373
Womens health, 1548-1552. See also Breast
cancer; Contraception; Intimate partner
violence; Menopause; Pregnancy
anxiety and, 1551
cancer and, 1549. See also Breast cancer
cardiovascular disease and, 1548
cigarette smoking and, 1551
depression and, 1550-1551
disparities in, 1548
HIV infection and, 1551
morbidity in, 1549-1551
mortality in, 1548-1549
obesity and, 1549-1550
osteoarthritis and, 1551
Womens health (Continued)
osteoporosis and, 1549
reproductive, 1550t, 1551
stage of life and, 1548, 1549t
type 2 diabetes and, 1548-1549
urinary incontinence and, 1551
Work. See Occupation
Work of breathing, 628-629, 629f
Wound
healing of, 2502-2503, 2510
aging-related changes in, 108
surgical, infection of, e290-5-e290-6
Wrist
De Quervains tenosynovitis of, 1679,
1679f
ganglion of, 1679
replacement of, 1757
rheumatoid arthritis of, 1684, 1684f
Wuchereria bancrofti infection, e366-3-e366-4,
e366-3t, e366-5f
treatment of, 2009, e366-1t, e366-5b
X poisoning with, 95
X-linked agammaglobulinemia, 1618-1621
enterovirus infection in, 2144
infection and, 1618
X-linked chronic granulomatous disease, gene
therapy in, 209
X-linked lymphoproliferative disorder
Epstein-Barr virus infection in, 2135
lymphoma and, 1218-1219
X-linked protoporphyria, 1365t, 1368
X-linked thrombophilia, 1149
Xanthelasma, 953-954
Xanthoma, 253, 255f
Xenotransplantation, 244
Xerocytosis, e164-5
Xeroderma pigmentosum, 1344, 2508, 2508f,
e184-1
Xerophthalmia, 2429, 2432, 2432f, 2434t
differential diagnosis of, 1713, 1713t
drug-related, 2439
Xerostomia, 2454, 2454t
differential diagnosis of, 1713, 1713t
Ximelagatran, in deep vein thrombosis,
504
Xpert MTB-RIF test, in tuberculosis, 1945
XX male syndrome, 1516-1517
XY female syndromes, 1517
D-Xylose test
breath, 903t
urinary, 903t
Y definition of, 1964
Yaba monkey tumor virus, 2117t, 2118
Yatapoxvirus infection, 2117t, 2118
clinical manifestations of, 2120
diagnosis of, 2121
Yaws, 1929-1930
Yellow fever, 87t, 2147-2156, 2148t-2149t,
2151t. See also Viral hemorrhagic
fevers
immunization against, 67t-70t, 74, 2155
for travel, 1801t, 1802
transmission of, 2150
Yellow nail syndrome, 2555, 2555f
Yellow phosphorus, hepatotoxicity of, 984
Yersinia enterocolitica infection, 1898
Yersinia pestis. See Plague
Yersinia pseudotuberculosis infection, 1898
Yersiniosis, 1898
clinical manifestations of, 1900
definition of, 1898
diagnosis of, 1900
epidemiology of, 1898-1899
pathobiology of, 1899-1900
prevention of, 1900
prognosis for, 1900
treatment of, 1900b
Yoga, 179
Yohimbine, in erectile dysfunction, 1528
Z
Zafirlukast, in allergic rhinitis, 1626
Zaleplon, 2242t
Zanamivir
in influenza virus infection, 2085t-2086t,
2086, 2100b
in influenza virus infection prevention,
2099, 2099t
Zellwegers spectrum, 1344t
Zenkers diverticulum, 882
Zieves syndrome, 963
Zika virus, 2158
Zileuton, in allergic rhinitis, 1626
Zinc, e225-6t-e225-7t
in acute diarrhea, 899
in common cold, 2091
deficiency of, e225-6t-e225-7t
in enteral nutrition, 1392
in malabsorption, 908t
toxicity of, e225-6t-e225-7t
Zinc acetate, in Wilsons disease, 986b,
1372b
Ziprasidone, 2243t
Zoledronate
in cancer therapy, 1167-1177
in hypercalcemia of malignancy,
1189b
in Pagets disease, 1605t
Zollinger-Ellison syndrome, 751, 1292-1297,
1293t, 1504-1505, 1505t
clinical manifestations of, 1293
definition of, 1292-1293
diagnosis of, 891, 1293-1294
differential diagnosis of, 1294
epidemiology of, 1292-1293
imaging in, 1294
in MEN 1, 1293, 1506
pathobiology of, 1293
peptic ulcers in, 888-889, 888t,
1293-1294
prognosis for, 1294
treatment of, 1294b
Zolpidem, 2242t
in insomnia, 2302b
Zonisamide, 2292t
Zoonoses, 1964-1967. See also specific
zoonoses
central nervous system, 1966t
clinical manifestations of, 1964
cutaneous, 1966t
diagnosis of, 1964-1966
emerging, 1964, 1965t
epidemiology of, 1964
highly fatal, 1967t
organ involvement in, 1967t
respiratory tract, 1965t
streptococcal, 1829
Zoster, 2128, 2530-2532
clinical manifestations of, 2129-2130,
2129f, 2407, 2530, 2530f
complications of, 2130-2131, 2407
diagnosis of, 2130
epidemiology of, 2129
HIV infection and, 2209
immunization against, 67t-70t, 73-74,
2131
ophthalmic, 2435
pain in, 247t, 834t-836t
prevention of, 2131
prognosis for, 2131
treatment of, 2085, 2130, 2522b
Zubrod performance scale, 1165t
Zydis selegiline, in Parkinsons disease,
2330t-2332t
Zygomycosis, 1994. See also Mucormycosis