Cecil Essentials of Medicine (Cecil Medicine) [10 ed.] 0323722717, 9780323722711

Table of contents :
Front Cover
IFC
CECIL ESSENTIALS OF MEDICINE
Copyright
Dedication
ABOUT THE EDITORS
CONTRIBUTORS
ACKNOWLEDGMENTS
Contents
VIDEO CONTENTS
I - Introduction to Medicine
1 - Introduction to Medicine
II - Cardiovascular Disease
2 - Structure and Function of the Normal Heart and Blood Vessels
DEFINITION
CIRCULATORY PATHWAY
CONDUCTION SYSTEM
NEURAL INNERVATION
MYOCARDIAL STRUCTURE
MUSCLE PHYSIOLOGY AND CONTRACTION
Circulatory Physiology and the Cardiac Cycle
Cardiac Performance
Physiology of the Coronary Circulation
Physiology of the Systemic Circulation
Physiology of the Pulmonary Circulation
3 - Evaluation of the Patient With Cardiovascular Disease
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
CLINICAL PRESENTATION
Chest Pain
Dyspnea
Palpitation
Syncope
Edema
Cyanosis
Other
DIAGNOSIS AND PHYSICAL EXAMINATION
General
Examination of the Jugular Venous Pulsations
Examination of Arterial Pressure and Pulse
Examination of the Precordium
Auscultation
SUGGESTED READINGS
4 - Diagnostic Tests and Procedures in the Patient With Cardiovascular Disease
ELECTROCARDIOGRAPHY
Lead Positioning
Electrocardiographic Intervals
Axis
ABNORMAL ELECTROCARDIOGRAPHIC PATTERNS
Chamber Abnormalities and Ventricular Hypertrophy
Interventricular Conduction Delays
Myocardial Ischemia and Infarction
Abnormalities of the ST Segment and T Wave
CHEST RADIOGRAPHY
ECHOCARDIOGRAPHY
NUCLEAR CARDIOLOGY
CARDIAC MAGNETIC RESONANCE IMAGING
STRESS TESTING
When to Stress Symptomatic Patients
Stress Modalities
STRESS IMAGING
Stress Electrocardiography
Stress Echocardiography
Stress Cardiac Magnetic Resonance Imaging
COMPUTED TOMOGRAPHY OF THE HEART
CARDIAC CATHETERIZATION
Left Heart Catheterization and Coronary Angiography
Right Heart Catheterization
ENDOMYOCARDIAL BIOPSY
NONINVASIVE VASCULAR TESTING
5 - Heart Failure and Cardiomyopathy
Ejection Fraction
Causes
Types of Cardiomyopathy
Functional Impairment
Hemodynamic Profiles
PATHOPHYSIOLOGY
Frank-Starling Law
Adaptive Neurohormonal Response
History
Exam Findings
Laboratory Data and Imaging
Acute Management
Guideline-Directed Medical Therapy
Device Therapy
Advanced Therapy
Palliative Care
FUTURE DIRECTIONS
6 - Congenital Heart Disease
ACYANOTIC HEART DISEASE
Atrial Septal Defects
Ventricular Septal Defects
Complete Atrioventricular Septal Defects
Coarctation of the Aorta
Patent Ductus Arteriosus
Pulmonary Valve Stenosis
Aortic Valve Stenosis
CYANOTIC HEART DISEASE
Tetralogy of Fallot
Transposition of the Great Arteries
7 - Valvular Heart Disease
INTRODUCTION
AORTIC STENOSIS
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
Treatment
MITRAL STENOSIS
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
PULMONIC STENOSIS
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
TRICUSPID STENOSIS
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
Treatment
AORTIC REGURGITATION
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
Treatment
MITRAL REGURGITATION
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
Treatment
PULMONIC REGURGITATION
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
Treatment
TRICUSPID REGURGITATION
Definition and Etiology
Pathophysiology
Natural History and Clinical Presentation
Physical Examination
Diagnosis
Treatment
8 - Coronary Heart Disease
RISK FACTORS FOR ATHEROSCLEROSIS
PATHOLOGY
Angina Pectoris and Stable Ischemic Heart Disease
Acute Coronary Syndrome: Unstable Angina and NSTEMI
Acute STEMI and Complications of Myocardial Infarction
Complications of Myocardial Infarction
PROGNOSIS
Risk Stratification After Myocardial Infarction
Electrocardiographic Monitoring
Cardiac Catheterization and Noninvasive Testing
Patient Education and Cardiac Rehabilitation
9 - Cardiac Arrhythmias
BASIC CELLULAR ELECTROPHYSIOLOGY
Classification of Arrhythmias
Electrophysiologic Mechanisms of Arrhythmias
GENERAL APPROACH TO MANAGEMENT
Diagnostic Procedures
Pharmacologic Therapy
Cardioversion and Defibrillation
Ablation
BRADYCARDIA
Normal Conduction System: Anatomy and Physiology
Normal Autonomic Regulation of Heart Rate
Sinus Node Dysfunction
Atrioventricular Conduction Disturbances
TACHYCARDIAS
Overview and Classification
Supraventricular Tachycardias
Atrial Arrhythmias
Atrial Fibrillation
SYNCOPE
Prevention of Sudden Cardiac Death
SUMMARY
SUGGESTED READINGS
10 - Pericardial and Myocardial Disease
PERICARDIAL DISEASE
Acute Pericarditis
Pericardial Effusion and Cardiac Tamponade
Constrictive Pericarditis
Effusive Constrictive Pericarditis
DISEASES OF THE MYOCARDIUM
Myocarditis
Cardiomyopathies
SUGGESTED READINGS
11 - Other Cardiac Topics
CARDIAC DISEASE IN PREGNANCY
Specific Cardiac Conditions
Heart Disease Arising During Pregnancy
CARDIAC TUMORS
Benign Primary Cardiac Tumors
Malignant Primary Cardiac Tumors
Secondary Cardiac Tumors
TRAUMATIC HEART DISEASE
Nonpenetrating Cardiac Trauma
Penetrating Cardiac Trauma
Percutaneous Left Ventricular Assist Devices
Right Ventricular Support
Extracorporeal Membrane Oxygenation
Disease-Specific Approaches
12 - Vascular Diseases and Hypertension
INTRODUCTION
SYSTEMIC VASCULAR DISEASE
Peripheral Arterial Disease
Aortic Aneurysm
Aortic Dissection
Penetrating Aortic Ulcers and Intramural Hematoma
Other Arterial Diseases
PULMONARY VASCULAR DISEASE
Pulmonary Arterial Hypertension
VENOUS THROMBOEMBOLIC DISEASE
Deep Vein Thrombosis
Pulmonary Embolism
Venous Thromboembolism Prophylaxis
ARTERIAL HYPERTENSION
Initial Evaluation for Hypertension
Renal Parenchymal Hypertension
Renovascular Hypertension
Primary Aldosteronism
Mendelian Forms of Hypertension
Pheochromocytoma and Paraganglioma
TREATMENT OF HYPERTENSION
Patients With Uncomplicated Hypertension
Hypertension in African Americans
Hypertensive Nephrosclerosis
Hypertensive Patients With Diabetes
Hypertensive Patients With Coronary Artery Disease
Isolated Systolic Hypertension in Older Adults
Hypertensive Disorders of Women
Resistant Hypertension
Acute Severe Hypertension
PROGNOSIS
PROSPECTS FOR THE FUTURE
III - Pulmonary and Critical Care Medicine
13 - Lung in Health and Disease
INTRODUCTION
LUNG DEVELOPMENT
PULMONARY DISEASE
Epidemiology
Classification
PROSPECTUS FOR THE FUTURE
14 - General Approach to Patients With Respiratory Disorders
INTRODUCTION
CLINICAL PRESENTATION
HISTORY
PHYSICAL EXAMINATION
EVALUATION
PROSPECTUS FOR THE FUTURE
SUGGESTED READINGS
15 - Evaluating Lung Structure and Function
INTRODUCTION
ANATOMY
Airway
Alveoli
Blood Vessels
PHYSIOLOGY
Ventilation
Perfusion
Gas Transfer
Abnormalities of Pulmonary Gas Exchange
EVALUATION OF LUNG FUNCTION
Bronchoprovocation Testing
Lung Diffusion Capacity
Arterial Blood Gases
6-Minute Walk Distance
EVALUATION OF LUNG DISEASE
Analysis of Exhaled Breath
Chest Radiography
Fluoroscopy
Ultrasonography
Computed Tomography
Magnetic Resonance Imaging
Pulmonary Angiography
Pulmonary Ventilation-Perfusion Scanning
Positron Emission Tomography
Bronchoscopy
PROSPECTUS FOR THE FUTURE
16 - Obstructive Lung Diseases
INTRODUCTION
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment and Prevention
Prognosis
BRONCHIOLAR DISORDERS
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
BRONCHIECTASIS
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
CYSTIC FIBROSIS
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
ASTHMA
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
17 - Interstitial Lung Diseases
OVERVIEW
IDIOPATHIC INTERSTITIAL LUNG DISEASES
Idiopathic Interstitial Pneumonias
Other Idiopathic ILDs
EXPOSURE-RELATED ILDS
Environmental and Occupational Interstitial Lung Disease
Drug and Radiation-Induced ILD
Intentional Exposures
ILD DUE TO SYSTEMIC DISEASES
Connective Tissue Diseases
Vasculitides
Sarcoidosis
Lymphangioleiomyomatosis
SUMMARY
SUGGESTED READINGS
18 - Pulmonary Vascular Diseases
INTRODUCTION
PULMONARY HYPERTENSION
Definition and Epidemiology
Pulmonary Arterial Hypertension
OTHER TYPES OF PULMONARY HYPERTENSION
PULMONARY THROMBOEMBOLISM
Definition and Epidemiology
Pathophysiology
Clinical Presentation and Diagnosis
Risk Stratification and Treatment
Chronic Thromboembolic Pulmonary Hypertension
PROSPECTUS FOR THE FUTURE
SUGGESTED READINGS
19 - Disorders of the Pleura, Mediastinum, and Chest Wall
PLEURAL DISEASE
Pleural Effusion
Transudates
Exudates
Pneumothorax
Mesothelioma
MEDIASTINAL DISEASE
Lesion Location
Mediastinitis
CHEST WALL DISEASE
Skeletal Disease
Obesity
Diaphragm Paralysis
PROSPECTUS FOR THE FUTURE
20 - Respiratory Failure
INTRODUCTION
PATHOPHYSIOLOGY
CLASSIFICATION OF RESPIRATORY FAILURE
Type I Hypoxemic Respiratory Failure
Type II Hypercarbic Respiratory Failure
Clinical Manifestations
Principles of Management
Oxygen Delivery Systems
21 - Transitions in Care From Pediatric to Adult Providers for Individuals With Pulmonary Disease
INTRODUCTION
ASTHMA AND BRONCHOPULMONARY DYSPLASIA
IMPORTANCE OF A SUCCESSFUL TRANSITION
IV - Preoperative and Postoperative Care
22 - Preoperative and Postoperative Care
INTRODUCTION
CARDIAC DISEASE
Preoperative and Postoperative Cardiac Care
PREOPERATIVE CARDIAC RISK ASSESSMENT
PREOPERATIVE RISK MODIFICATION TO REDUCE PERIOPERATIVE CARDIAC RISK
Coronary Revascularization
β-Adrenergic Antagonists
HMG-CoA Reductase Inhibitors (Statins)
Angiotensin-Converting Enzyme Inhibitors
Oral Antithrombotic Agents
POSTOPERATIVE CARDIAC RISK ASSESSMENT
Monitoring for Myocardial Infarction
NONCARDIAC SURGERY IN PATIENTS WITH SPECIFIC CARDIOVASCULAR CONDITIONS
Valvular Heart Disease
Arrhythmias and Conduction Defects
RENAL DISEASE
Hypertension
Acute Kidney Injury
Chronic Kidney Disease (CKD)
Nephrotic Syndrome
HEPATIC DISEASE
PULMONARY DISEASE
COPD/Bronchial Asthma
Obstructive Sleep Apnea
Prevention of Venous Thromboembolism
ENDOCRINE DISEASE
Diabetes Mellitus
Thyroid Disease
Adrenal Insufficiency and Long-Term Corticosteroid Use
HEMATOLOGIC DISEASE
INFECTIOUS DISEASE
NEUROLOGIC DISEASE
Neuromuscular Diseases
Parkinson’s Disease
Stroke
RHEUMATOLOGIC DISEASE
SPECIAL NEEDS OF THE GERIATRIC PATIENT
SUMMARY
V - Renal Disease
23 - Renal Structure and Function
INTRODUCTION
RENAL STRUCTURE
Macroscopic Anatomy
Renal Circulation
Renal Nerves
Walk the Nephron
Specialized Structures
RENAL FUNCTION
Excretory Function
Metabolic Function
Metabolic and Endocrine Function
24 - Approach to the Patient With Renal Disease
INTRODUCTION
Distinction of AKI From CKD
History and Examination
Assessment of Kidney Function
Assessment of Albuminuria
Assessment of Blood Pressure
Assessment of Dietary Sodium Intake
Microscopic Urinalysis
Renal Imaging
Evaluation of Risk or Susceptibility to Renal Injury
Causes of AKI
Severity of Injury
Presence of Distant Organ Effects on Consequences
25 - Fluid and Electrolyte Disorders
NORMAL VOLUME HOMEOSTASIS
Osmolality and Tonicity
HYPONATREMIA
Treatment of Hyponatremia
HYPERNATREMIA
Evaluation of Polyuria and Polydipsia
Treatment of Hypernatremia
HYPOKALEMIA
Cellular Shift With Normal Total Body Potassium
Decreased Total Body Potassium
Extrarenal Potassium Losses
Renal Potassium Losses
Clinical Presentation
Treatment of Hypokalemia
HYPERKALEMIA
Excessive Dietary Intake
Cellular Redistribution
Decreased Renal Excretion of Potassium
Clinical Presentation
Treatment of Acute Hyperkalemia
Treatment of Chronic Hyperkalemia
METABOLIC ACIDOSIS
Anion Gap Metabolic Acidosis
METABOLIC ALKALOSIS
Clinical Consequences of Metabolic Alkalosis
Approach and Treatment of Metabolic Alkalosis
RESPIRATORY ALKALOSIS
Etiology
Clinical Manifestation of Respiratory Alkalosis
Diagnosis
Treatment
RESPIRATORY ACIDOSIS
Etiology of Respiratory Acidosis
Clinical Manifestations of Respiratory Acidosis
Diagnosis
Treatment of Respiratory Acidosis
26 - Glomerular Diseases
INTRODUCTION
CLINICAL PRESENTATION
CLINICAL SYNDROMES
Asymptomatic Microscopic Hematuria
Nephrotic Syndrome
Nephritic Syndrome
Rapidly Progressive Glomerulonephritis
Chronic Glomerulonephritis
PRIMARY PODOCYTOPATHIES
Minimal Change Disease
Focal Segmental Glomerulosclerosis
Membranous Nephropathy
IMMUNE-COMPLEX GLOMERULONEPHRITIS
Infection-Related Glomerulonephritis
Immunoglobulin A (IgA) Nephropathy
Membranoproliferative Glomerulonephritis
Lupus Nephritis
Cryoglobulinemic Glomerulonephritis
GLOMERULAR DISEASES CAUSED BY PLASMA CELL DYSCRASIAS
Amyloidosis
Light Chain Deposition Disease
GLOMERULONEPHRITIS ASSOCIATED WITH VIRAL INFECTIONS
Hepatitis B
Hepatitis C
HIV-Associated Nephropathy
THROMBOTIC MICROANGIOPATHIES
Hemolytic Uremic Syndrome
Thrombotic Thrombocytopenic Purpura
DISEASES WITH GLOMERULAR BASEMENT MEMBRANE ABNORMALITIES
Alport Syndrome
Thin Glomerular Basement Membrane Nephropathy
FABRY’S DISEASE
DIABETIC NEPHROPATHY
27 - Major Nonglomerular Disorders of the Kidney
INTRODUCTION
ACUTE INTERSTITIAL NEPHRITIS
Definition, Epidemiology, and Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment and Prognosis
CHRONIC INTERSTITIAL NEPHRITIS
Pathology
Clinical Presentation and Laboratory Findings
Diagnosis and Differential Diagnosis
Analgesic Nephropathy
Heavy Metals
Sarcoidosis
Radiation Nephritis
Sickle Cell Disease
Lithium
Mesoamerican Nephropathy
Urinary Tract Obstruction
CYSTIC KIDNEY DISEASES
Simple Cysts
Complex Cysts
Acquired Cystic Kidney Disease in CKD
Hereditary Cystic Kidney Diseases
Polycystic Kidney Disease
TUBEROUS SCLEROSIS
Definition and Epidemiology
Pathology
VON HIPPEL–LINDAU DISEASE
KIDNEY TUMORS
NEPHROLITHIASIS
Epidemiology
Pathogenesis
Clinical Presentation
Diagnosis
Treatment
Prevention of Stones
Specific Types of Stones
28 - Vascular Disorders of the Kidney
INTRODUCTION
RENAL VASCULAR ANATOMY
RENOVASCULAR DISEASE
Atherosclerotic Renovascular Disease
Fibromuscular Dysplasia
Aortic Dissection
Thromboembolic Disease
Large and Medium-Sized Vessel Vasculitis
Hypertensive Nephrosclerosis
Atheroembolic Disease
Preeclampsia
Scleroderma Renal Crisis
THROMBOTIC MICROANGIOPATHY OF THE KIDNEY
Thrombotic Thrombocytopenic Purpura
Hemolytic-Uremic Syndrome
Malignancy-Associated TMA
Pregnancy-Related TMA
ANTIPHOSPHOLIPID ANTIBODY SYNDROME
RENAL VEIN THROMBOSIS
29 - Acute Kidney Injury
DEFINITION
ETIOLOGY
EPIDEMIOLOGY
DIAGNOSTIC EVALUATION
History and Physical Examination
Basic Laboratory Tests
Urinalysis and Urine Microscopy
Urinary Indices
Renal Imaging
Kidney Biopsy
Future Tests for AKI
CLINICAL PRESENTATION, DIFFERENTIAL DIAGNOSIS, AND MANAGEMENT OF AKI
Prerenal AKI
Intrinsic AKI
Postrenal AKI
COMPLICATIONS OF AKI
GENERAL MANAGEMENT OF AKI
OUTCOME AND PROGNOSIS OF AKI
30 - Chronic Kidney Disease
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
Clinical Presentation
General Features of Uremic Syndrome
Cardiovascular
Gastrointestinal
Neurologic
Musculoskeletal
Hematologic and Immunologic
Endocrine and Metabolic
Electrolytes
Skin
DIAGNOSIS
TREATMENT
Prevention of Progression
Care for the Patient With End-Stage Renal Disease
Renal Replacement Therapies
PROGNOSIS
VI - Gastrointestinal Disease
31 - Common Clinical Manifestations of Gastrointestinal Disease: Abdominal Pain
DEFINITION AND EPIDEMIOLOGY
PHYSIOLOGY
CAUSES OF ABDOMINAL PAIN
CLINICAL PRESENTATION
History
Physical Examination
ACUTE ABDOMEN
CHRONIC ABDOMINAL PAIN
32 - Common Clinical Manifestations of Gastrointestinal Disease: Gastrointestinal Hemorrhage
INTRODUCTION
APPROACH TO PATIENTS WITH GASTROINTESTINAL BLEEDING
Prioritize
Resuscitate
Evaluate
Treat
33 - Common Clinical Manifestations of Gastrointestinal Disease: Malabsorption
DEFINITION AND EPIDEMIOLOGY
DIGESTION AND ABSORPTION OF FAT
DIGESTION AND ABSORPTION OF PROTEINS
MECHANISMS OF MALABSORPTION
Luminal Phase
Mucosal Phase
Transport Phase
CLINICAL PRESENTATION
DIAGNOSIS
Fecal Fat Analysis
Tests of Pancreatic Exocrine Function
Small Intestinal Biopsy
Imaging Studies
Schilling Test
d-Xylose Test
Breath Tests
Summary
TREATMENT
Celiac Disease
Bacterial Overgrowth Syndrome
MALABSORPTIVE THERAPY
34 - Common Clinical Manifestations of Gastrointestinal Disease: Diarrhea
DEFINITION
PATHOPHYSIOLOGY
EVALUATION OF ACUTE DIARRHEA
Acute Infectious Diarrhea
Treatment
CHRONIC DIARRHEA
Evaluation of Chronic Diarrhea
Chronic Inflammatory Diarrhea
Chronic Watery Diarrhea
Chronic Fatty Diarrhea
35 - Endoscopic and Imaging Procedures
INTRODUCTION
GASTROINTESTINAL ENDOSCOPY
Esophagogastroduodenoscopy
Enteroscopy
Video Capsule Endoscopy
Sigmoidoscopy and Colonoscopy
Endoscopic Retrograde Cholangiopancreatography
Endoscopic Ultrasound
“Second Space” and “Third Space” Endoscopy
NONENDOSCOPIC IMAGING PROCEDURES
Plain Abdominal Radiographs
Contrast Studies
Transabdominal Ultrasound
Visceral Angiography
Radionuclide Imaging
PROSPECTUS FOR THE FUTURE
36 - Esophageal Disorders
INTRODUCTION
SYMPTOMS OF ESOPHAGEAL DISEASE
DIAGNOSTIC STUDIES OF THE ESOPHAGUS
Radiology
Endoscopy and Endoscopic Imaging
Manometry
Esophageal pH Monitoring
STRUCTURAL DISORDERS
Cricopharyngeal Bars
Diverticula
Rings and Webs
Malignancy
Hiatal Hernias
Pathophysiology and Symptoms
Diagnosis
Management
Extraesophageal Manifestations of GERD
Barrett Esophagus
MOTILITY DISORDERS
Achalasia
Diffuse Esophageal Spasm
VARIANT FORMS OF ESOPHAGITIS
Eosinophilic Esophagitis
Pill-Induced Esophagitis
ESOPHAGEAL INFECTIONS
ESOPHAGEAL TRAUMA AND EMERGENCIES
Perforation of the Esophagus
Foreign Bodies and Food Impaction
Mallory-Weiss Tear
SYSTEMIC AND OTHER ILLNESSES
Scleroderma
Dermatologic Disorders
37 - Diseases of the Stomach and Duodenum
INTRODUCTION
ANATOMY
Anatomy of the Stomach
Anatomy of the Duodenum
HISTOLOGY
Histology of the Stomach
Histology of the Duodenum
GASTRODUODENAL SECRETIONS
Parietal Cells
Chief Cells
Protective Factors
GASTRODUODENAL MOTILITY
PEPTIC ULCER DISEASE
Definition and Epidemiology
Clinical Presentation
Diagnosis
Causes of Peptic Ulcer Disease
Helicobacter pylori
NSAID-Induced PUD
Zollinger-Ellison Syndrome
Stress-Induced Ulcers
Idiopathic Ulcers
General PUD Treatment
Complications of PUD
ZOLLINGER-ELLISON SYNDROME
Definition and Epidemiology
Pathophysiology of ZES
Clinical Presentation
Diagnosis
Treatment of ZES
GASTRITIS
FUNCTIONAL (NONULCER) DYSPEPSIA
CYCLIC VOMITING SYNDROME
RAPID GASTRIC EMPTYING
GASTROPARESIS
GASTRIC VOLVULUS
38 - Inflammatory Bowel Disease
INTRODUCTION
Historical Perspective
EPIDEMIOLOGY
RISK FACTORS AND PATHOPHYSIOLOGY
CLINICAL PRESENTATION
Intestinal Manifestations
Extraintestinal Manifestations
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
5-Aminosalicylic Acid (Mesalamine)
Corticosteroids
Traditional Immunomodulators
Biologic Agents
Other Agents
Surgical Management
PROGNOSIS
39 - Diseases of the Pancreas
ACUTE PANCREATITIS
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Prognosis
Treatment
CHRONIC PANCREATITIS
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
CARCINOMA OF THE PANCREAS
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
VII - Diseases of the Liver and Biliary System
40 - Laboratory Tests in Liver Diseases
INTRODUCTION
LIVER CHEMISTRY TESTS
Patterns of Abnormalities in Liver Chemistry Tests
Hepatocellular Damage
Cholestasis
Isolated Bilirubin Elevation
LIVER SYNTHETIC FUNCTION
Albumin
Coagulation Factors and Prothrombin Time
Gamma Globulins
Specific Markers of Liver Diseases
Biomarkers of Liver Fibrosis
41 - Jaundice
INTRODUCTION
BILIRUBIN METABOLISM
LABORATORY MEASUREMENT OF BILIRUBIN
UNCONJUGATED HYPERBILIRUBINEMIA
Etiology of Hyperbilirubinemia
Prehepatic Jaundice
Hepatic or Hepatocellular Jaundice
Impaired Conjugation
NEONATAL JAUNDICE
CONJUGATED HYPERBILIRUBINEMIA
Impaired Hepatic Excretion (Intrahepatic Cholestasis)
Posthepatic Jaundice
42 - Acute and Chronic Hepatitis
INTRODUCTION
ACUTE HEPATITIS
Acute Viral Hepatitis
Alcoholic Liver Disease
Drug-Induced Liver Injury
CHRONIC HEPATITIS
Chronic Viral Hepatitis
Autoimmune Hepatitis
Nonalcoholic Fatty Liver Disease
Genetic and Metabolic Hepatitis
43 - Acute Liver Failure
DEFINITIONS
PATHOGENESIS
CLINICAL PRESENTATION
DIAGNOSIS
TREATMENT
PROGNOSIS
44 - Cirrhosis of the Liver and Its Complications
LIVER CIRRHOSIS
Definition
Etiology
Pathology
Clinical Presentation
Diagnosis
Laboratory Findings
Radiology
COMPLICATIONS OF CIRRHOSIS
Hepatocellular Dysfunction
Portal Hypertension
VARICEAL HEMORRHAGE
Definition and Pathology
Clinical Presentation
Treatment
Prognosis
ASCITES
Definition and Pathology
Diagnosis
Clinical Presentation
Treatment
Prognosis
SPONTANEOUS BACTERIAL PERITONITIS
Definition and Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
HEPATORENAL SYNDROME
Definition and Pathology
Clinical Presentation and Diagnosis
Treatment and Prognosis
HEPATIC ENCEPHALOPATHY
Definition
Pathophysiology
Clinical Presentation
Diagnosis
Classification of Hepatic Encephalopathy
Treatment
Hepatopulmonary Syndrome
Portopulmonary Hypertension
HEPATOCELLULAR CARCINOMA
Epidemiology
Etiology
Diagnosis
Staging
Treatment
Prognosis
VASCULAR DISEASE OF THE LIVER
Portal Vein Thrombosis
Budd-Chiari Syndrome
Veno-Occlusive Disease
LIVER TRANSPLANTATION
MELD Score
Prognosis
45 - Disorders of the Gallbladder and Biliary Tract
INTRODUCTION
NORMAL BILIARY ANATOMY AND PHYSIOLOGY
GALLBLADDER DISORDERS
Gallstones (Cholelithiasis)
Acalculous Cholecystitis
Gallbladder Polyps
Gallbladder Carcinoma
Gallbladder Dyskinesia
BILIARY TRACT DISORDERS
Choledocholithiasis
Acute Cholangitis
Gallstone Pancreatitis
Biliary Neoplasms
Nonmalignant Causes of Biliary Obstruction
Primary Sclerosing Cholangitis
Sphincter of Oddi Dysfunction
VIII - Hematologic Disease
46 - Hematopoiesis and Hematopoietic Failure
HEMATOPOIESIS
HEMATOPOIESIS
Hematopoietic Tissues
Stem Cell Theory of Hematopoiesis
Hematopoietic Differentiation Pathway
PRIMARY HEMATOPOIETIC FAILURE SYNDROMES
Growth Factors in Clinical Use
Hematopoietic Stem Cell Transplantation
Aplastic Anemia
Paroxysmal Nocturnal Hemoglobinuria
Myelodysplastic Syndrome
PROSPECTUS FOR THE FUTURE
47 - Clonal Disorders of the Hematopoietic Stem Cell
INTRODUCTION
MYELOPROLIFERATIVE NEOPLASMS
Definition and Etiology
POLYCYTHEMIA VERA
Definition and Epidemiology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment and Prognosis
ESSENTIAL THROMBOCYTHEMIA
Definition and Epidemiology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment and Prognosis
PRIMARY (IDIOPATHIC) MYELOFIBROSIS
Definition and Epidemiology
Etiology
Diagnosis and Differential Diagnosis
Clinical Presentation
Treatment and Prognosis
CHRONIC MYELOGENOUS LEUKEMIA
Definition, Epidemiology, and Pathology
Diagnosis and Differential Diagnosis
Clinical Presentation
Treatment
Prognosis
ACUTE LEUKEMIAS
Definition and Epidemiology
Pathology
Diagnosis and Differential Diagnosis
Clinical Presentation
Treatment
Prognosis
Acute Myeloid Leukemia
Acute Promyelocytic Leukemia
Acute Lymphoblastic Leukemia
PROSPECTUS FOR THE FUTURE
Myeloproliferative Disease
Acute Leukemia
48 - Disorders of Red Blood Cells
LABORATORY EVALUATION
EVALUATION OF HYPOPROLIFERATIVE ANEMIAS
Microcytic Anemias
Macrocytic Anemias
Normocytic Anemias
EVALUATION OF ANEMIA WITH RETICULOCYTOSIS
Immune Hemolytic Anemia
Hemolysis From Causes Extrinsic to the Erythrocyte
Hemolytic Anemias Caused by Disorders of the Erythrocyte Membrane
Hemolytic Anemias Caused by Disorders of Erythrocyte Enzymes
Hemoglobinopathies
PROSPECTUS FOR THE FUTURE
49 - Clinical Disorders of Granulocytes and Monocytes
INTRODUCTION
NORMAL GRANULOCYTE DEVELOPMENT, STRUCTURE, AND FUNCTION
Neutrophils
Eosinophils and Basophils
Monocytes
NEUTROPHILIA
NEUTROPENIA
Differential Diagnosis
Laboratory Evaluation
Treatment
PROSPECTUS FOR THE FUTURE
50 - Disorders of Lymphocytes
INTRODUCTION
LYMPHOCYTE DEVELOPMENT, FUNCTION, AND LOCALIZATION
B Cells
T Cells
Lymphoid System
NEOPLASIA OF LYMPHOID ORIGIN
Non-Hodgkin’s Lymphomas
Hodgkin Lymphoma
Lymphoid Leukemias
Plasma Cell Disorders
51 - Normal Hemostasis
INTRODUCTION
VASCULATURE PHYSIOLOGY
VON WILLEBRAND FACTOR
PLATELET PHYSIOLOGY
Platelet Activation
Platelet Adhesion
Platelet Secretion
COAGULATION
Coagulation Cascade Model
Cell-Based Model of Coagulation
Termination of Clotting
Fibrin Clot Architecture
Fibrinolysis
Laboratory Testing of Coagulation
52 - Disorders of Hemostasis: Bleeding
INTRODUCTION
HEMOSTASIS
CLINICAL EVALUATION OF BLEEDING
LABORATORY EVALUATION OF BLEEDING
BLEEDING CAUSED BY VASCULAR DISORDERS
BLEEDING CAUSED BY THROMBOCYTOPENIA
Decreased Marrow Production of Platelets
Platelet Sequestration
Platelet Destruction
Acquired Causes of Platelet Dysfunction
Congenital Causes of Platelet Dysfunction
Platelet Transfusion Therapy
BLEEDING CAUSED BY VON WILLEBRAND DISEASE
Type 1 von Willebrand Disease
Type 2 von Willebrand Disease
Type 3 von Willebrand Disease
Acquired von Willebrand Disease
Congenital Factor Deficiencies
Acquired Factor Inhibitors
Plasma and Coagulation Factor Transfusion Therapy
Cryoprecipitate Transfusion Therapy
PROSPECTUS FOR THE FUTURE
53 - Disorders of Hemostasis: Thrombosis
PATHOLOGY OF THROMBOSIS
Atherothrombosis
Venous Thromboembolism: Inherited Risk Factors
Venous Thrombosis: Acquired Risk Factors
Hypercoagulability and Platelet Disorders
CLINICAL EVALUATION OF THROMBOSIS
Laboratory Diagnostics
THERAPY FOR VENOUS THROMBOEMBOLISM
Therapy for VTE in Malignancy
Prophylaxis of VTE
Antithrombotic Therapy During Pregnancy
Perioperative Anticoagulation
IX - Oncologic Disease
54 - Cancer Biology
INTRODUCTION
THE GENETICS OF CANCER
THE TUMOR MICROENVIROMENT
HALLMARKS OF CANCER
54
Genomic Instability: Impairing DNA Repair Genes
Anchor 126
Oncogenes Unleash Proliferation
Anchor 128
Anchor 129
Tumor Suppressor Genes Disrupt Growth Checkpoints
Hypoxia, Angiogenesis, Invasion, and Metastases
Anchor 132
Anchor 133
Immune Escape
55 - Cancer Epidemiology
INTRODUCTION
CANCER EPIDEMIOLOGY METHODS
RISK FACTORS
Genetic
Lifestyle
CANCER PREVENTION
Lifestyle Changes
Chemoprevention
CANCER SCREENING
56 - Principles of Cancer Therapy
INTRODUCTION
DIAGNOSIS AND STAGING
PRINCIPLES OF CANCER SURGERY
PRINCIPLES OF RADIATION THERAPY
PRINCIPLES OF MEDICAL THERAPY
Mechanisms of Chemotherapy
Indications for Chemotherapy
Limitations of Chemotherapy
Targeted Therapy
Endocrine Therapy
Personalized Medicine
Immunotherapy
EVALUATION OF RESPONSE
SUPPORTIVE CARE
57 - Lung Cancer
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
Histologic Subgroups
Molecular-Genomic Subtypes
The Lung Cancer Genome
CLINICAL PRESENTATION
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
Prevention and Screening
Diagnostic and Staging Work-Up
Solitary Pulmonary Nodule
TREATMENT
Small Cell Lung Cancer
Non–Small Cell Lung Cancer
PROGNOSIS
58 - Gastrointestinal Cancers
INTRODUCTION
ESOPHAGEAL CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
GASTRIC CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
PANCREATIC CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
CHOLANGIOCARCINOMA (BILE DUCT CANCERS)
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
HEPATOCELLULAR CARCINOMA
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
COLORECTAL CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
ANAL CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
Prognosis
59 - Genitourinary Cancers
RENAL CELL CARCINOMA
Definition and Epidemiology
Pathology
Diagnosis and Differential Diagnosis
Clinical Presentation
Treatment
Prognosis
BLADDER CANCER
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
PROSTATE CANCER
Definition, Epidemiology, and Screening
Clinical Presentation
Diagnosis and Staging
Pathology, Prognosis, and Genetic Mutations
Treatment
TESTICULAR CANCER
Definition and Epidemiology
Pathology
Diagnosis and Differential Diagnosis
Clinical Presentation
Treatment
Prognosis
60 - Breast Cancer
EPIDEMIOLOGY
RISK FACTORS
Breast Cancer Genetics
CLINICAL PRESENTATION AND DIAGNOSIS
Histology
BREAST CANCER STAGING
TREATMENT
Early-Stage Breast Cancer
Therapy for HR+ Breast Cancer
Metastatic Breast Cancer
Triple-Negative Breast Cancer
Special Circumstances
Male Breast Cancer
Breast Cancer in Older Women
SCREENING
CONCLUSION AND FUTURE DIRECTIONS
61 - Gynecological Cancer
OVARIAN CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
UTERINE CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
CERVICAL CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
VULVAR CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
VAGINAL CANCER
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
GESTATIONAL TROPHOBLASTIC DISEASE AND GESTATIONAL TROPHOBLASTIC NEOPLASIA
Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment
Prognosis
62 - Other Solid Tumors (Head and Neck, Sarcomas, Melanoma, Unknown Primary)
INTRODUCTION
HEAD AND NECK CANCER
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Staging
Treatment and Prognosis
MELANOMA
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment and Prognosis
SARCOMA
Definition and Epidemiology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment and Prognosis
CANCER OF UNKNOWN PRIMARY SITE
Definition and Epidemiology
Clinical Presentation
Diagnosis and Pathology
Treatment and Prognosis
63 - Complications of Cancer and Cancer Treatment
INTRODUCTION
CANCER-ASSOCIATED THROMBOSIS
Epidemiology
Pathology
Clinical Presentation
Treatment
SPINAL CORD COMPRESSION
Epidemiology
Pathology
Clinical Presentation
Diagnosis
Treatment
SUPERIOR VENA CAVA SYNDROME
Definition
Clinical Presentation
Diagnosis
Treatment
HYPERCALCEMIA
Epidemiology
Pathology
Clinical Presentation
Treatment
FEBRILE NEUTROPENIA
Definition
Treatment
CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING
Definition
Pathology
Treatment
DERMATOLOGIC TOXICITY
Clinical Presentation
Treatment
TUMOR LYSIS SYNDROME
Definition
Pathology
Diagnosis
Treatment
IMMUNE CHECKPOINT INHIBITOR TOXICITY
Definition
Pathophysiology
Diagnosis
Treatment
X - Endocrine Disease and Metabolic Disease
64 - Hypothalamic-Pituitary Axis
ANATOMY AND PHYSIOLOGY
PITUITARY TUMORS
DISORDERS OF ANTERIOR PITUITARY HORMONES
Prolactin
Growth Hormone
Thyroid-Stimulating Hormone
Adrenocorticotropic Hormone
Gonadotropins
DISORDERS OF POSTERIOR PITUITARY HORMONES
Diabetes Insipidus
65 - Thyroid Gland
INTRODUCTION
THYROID HORMONE PHYSIOLOGY
Thyroid Hormone Transport
Peripheral Metabolism of Thyroid Hormones
Control of Thyroid Function
Physiologic Effects of Thyroid Hormones
THYROID EVALUATION
Thyroid Hormone Synthesis
Tests of Serum Thyroid Hormone Levels
Thyroid Imaging
Thyroid Antibodies
Thyroid Biopsy
HYPERTHYROIDISM
Signs and Symptoms
Differential Diagnosis
HYPOTHYROIDISM
Clinical Presentation
Diagnosis
Treatment
Subclinical Hypothyroidism
GOITER
SOLITARY THYROID NODULES
THYROID CARCINOMA
Treatment
66 - Adrenal Gland
PHYSIOLOGY
SYNDROMES OF ADRENOCORTICAL HYPOFUNCTION
Adrenal Insufficiency
Hyporeninemic Hypoaldosteronism
Congenital Adrenal Hyperplasia
Cushing’s Syndrome
Primary Mineralocorticoid Excess
ADRENAL MEDULLARY HYPERFUNCTION
Pheochromocytoma
Incidental Adrenal Mass
Primary Adrenal Cancer
67 - Male Reproductive Endocrinology
INTRODUCTION
HYPOGONADISM
Hypothalamic-Pituitary Disorders
Primary Gonadal Abnormalities
Defects in Androgen Action
Diagnosis
Male Infertility
Therapy for Hypogonadism and Infertility
GYNECOMASTIA
68 - Diabetes Mellitus, Hypoglycemia
DIABETES MELLITUS
Definition and Diagnostic Criteria
Etiologic Classification
Type 1 Diabetes
Type 2 Diabetes
Management of Diabetes During Intercurrent Illness
Gestational Diabetes Mellitus
Management of Severe Metabolic Decompensation in Diabetes
Chronic Complications of Diabetes
HYPOGLYCEMIA
Definition
Signs and Symptoms
Pathology
Etiologic Classification
Approach to the Diagnosis
Treatment
69 - Obesity
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY OF OBESITY
Risks Associated With Obesity
DIAGNOSIS AND ASSESSMENT OF OBESITY
TREATMENT OF OBESITY
Lifestyle Modification
Behavior Modification and Patient Education
Pharmacologic Treatment of Obesity
PROGNOSIS
70 - Malnutrition, Nutritional Assessment, and Nutritional Support in Adult Patients
MALNUTRITION IN HOSPITALIZED PATIENTS
NUTRITIONAL ASSESSMENT
NUTRITIONAL SUPPORT
Oral Nutrition Support
Administration of Enteral Tube Feeding
Administration of Parenteral Nutrition
71 - Disorders of Lipid Metabolism
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
CLINICAL PRESENTATION
DIAGNOSIS
TREATMENT
Lifestyle Modification
Pharmacotherapy
LIPID DISORDERS
Familial Hypercholesterolemia
Elevated Plasma Lipoprotein(a)
Polygenic Hypercholesterolemia
Familial Combined Hyperlipoproteinemia
Familial Dysbetalipoproteinemia
Familial Chylomicronemia
Apolipoprotein C-
Familial Hypertriglyceridemia
XI - Women’s Health
72 - Women’s Health Topics
INTRODUCTION
THE MENSTRUAL CYCLE
Primary Amenorrhea
Secondary Amenorrhea
Abnormal Uterine Bleeding
CONTRACEPTION
Methods of Contraception
INFERTILITY
MENOPAUSE
Transition From Perimenopause to Menopause
Perimenopausal Symptoms
Postmenopausal Therapy
BREAST PAIN, DISCHARGE, AND MASSES
Mastalgia
Nipple Discharge
Breast Masses
Breast Cancer Screening
CERVICAL CANCER SCREENING
OSTEOPOROSIS
INTIMATE PARTNER VIOLENCE
OBESITY, METABOLIC SYNDROME, AND POLYCYSTIC OVARY SYNDROME
Obesity/Metabolic Syndrome
Polycystic Ovary Syndrome
FIBROMYALGIA
HUMAN IMMUNODEFICIENCY VIRUS INFECTION
EATING DISORDERS
CARDIOVASCULAR DISEASE
PERINATAL DEPRESSION
SEXUAL DYSFUNCTION
PELVIC PAIN
GENDER AND FEMALE SEXUAL MINORITIES
XII - Men’s Health
73 - Men’s Health Topics
INTRODUCTION
TESTOSTERONE DEFICIENCY
Definition and Epidemiology
Pathophysiology
Clinical Presentation
Diagnosis
Treatment
ERECTILE DYSFUNCTION
Mechanism of Erection
Causes of Erectile Dysfunction
PEYRONIE’S DISEASE
Pathophysiology
Differential Diagnosis
Evaluation
Treatment
BENIGN PROSTATIC HYPERPLASIA
Pathophysiology
Diagnosis
Differential Diagnosis
Medical Management
Surgical Management
Conclusion
BENIGN SCROTAL DISEASES
Varicocele
Spermatocele (Epididymal Cyst)
Acute Epididymitis
Hydrocele
Testicular Torsion
SUGGESTED READINGS
XIII - Diseases of Bone and Bone Mineral Metabolism
74 - Normal Physiology of Bone and Mineral Homeostasis
CALCIUM HOMEOSTASIS
Calcium Fluxes Into and Out of Extracellular Fluid
Regulatory Hormones
Integration of Calcium Homeostasis
PHOSPHATE HOMEOSTASIS
Intestinal Phosphate Absorption
Skeletal Phosphate Fluxes
Intracellular-Extracellular Phosphate Fluxes
Renal Phosphate Handling
Regulatory Hormones
MAGNESIUM HOMEOSTASIS
Regulatory Hormones
PROSPECTUS FOR THE FUTURE
75 - Disorders of Serum Minerals
INTRODUCTION
DISORDERS OF CALCIUM METABOLISM
Hypercalcemia
Hypocalcemia
DISORDERS OF PHOSPHATE METABOLISM
Hyperphosphatemia
Hypophosphatemia
DISORDERS OF MAGNESIUM METABOLISM
Hypermagnesemia
Hypomagnesemia
76 - Metabolic Bone Diseases
INTRODUCTION
PAGET’S DISEASE OF BONE
OSTEOMALACIA AND RICKETS
HYPERPARATHYROID BONE DISEASE
RENAL OSTEODYSTROPHY
TRANSPLANTATION OSTEOPOROSIS
GENETIC DISEASES
ISCHEMIC AND INFILTRATIVE DISEASES
77 - Osteoporosis
INTRODUCTION
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY AND RISK FACTORS
CLINICAL PRESENTATION
Radiography
PREVENTION
TREATMENT AND PROGNOSIS
Bisphosphonates
Denosumab
Estrogen Agonists-Antagonists
Hormone Therapy
Parathyroid Hormone
Parathyroid Hormone-Related Peptide
Romosozumab
Calcitonin
Duration of Treatment
Vertebroplasty and Kyphoplasty
XIV - Musculoskeletal and Conne ctive Tissue Disease
78 - Approach to the Patient With Rheumatic Disease
INTRODUCTION
MUSCULOSKELETAL HISTORY
PHYSICAL EXAMINATION
LABORATORY TESTING
IMAGING STUDIES
SUMMARY
79 - Rheumatoid Arthritis
DEFINITION
EPIDEMIOLOGY
ETIOLOGY AND GENETICS
PATHOLOGY AND PATHOGENESIS
CLINICAL PRESENTATION
Articular Manifestations
Extra-articular Manifestations
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
Pharmacologic Approach
Conventional Disease-Modifying Antirheumatic Drugs
Biologic DMARDs
Symptomatic Control and Bridging Therapy
Medical Care Specialized for Rheumatoid Arthritis
CONCLUSION AND PROGNOSIS
80 - Spondyloarthritis
DEFINITION
PATHOLOGY
CLINICAL PRESENTATION
Common Clinical Features of Spondyloarthritis
Specific Clinical Features of Spondyloarthritis
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
SUMMARY
81 - Systemic Lupus Erythematosus
DEFINITION AND EPIDEMIOLOGY
Incidence and Prevalence
Mortality
PATHOLOGY
CLINICAL PRESENTATION
Constitutional Symptoms
Mucocutaneous Manifestations
Musculoskeletal Manifestations
Hematologic Manifestations
Cardiopulmonary Manifestations
Gastrointestinal and Hepatic Manifestations
Renal Manifestations
Neuropsychiatric Manifestations
Vascular Manifestations
Ocular Manifestations
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
Classification Criteria
Drug-Induced Lupus
Neonatal Lupus
Overlap Syndrome
TREATMENT
PROGNOSIS
SPECIAL CONSIDERATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS
Pregnancy
Hormone Therapy
Bone Health
Cardiovascular Health
Secondary Antiphospholipid Syndrome
Malignancy
Vaccines
Psychosocial Effects of Systemic Lupus Erythematosus
SUMMARY
SUGGESTED READINGS
82 - Systemic Sclerosis
INTRODUCTION
EPIDEMIOLOGY
PATHOLOGY
CLINICAL PRESENTATION
Classification by Cutaneous Features
Serologic Classification
Interstitial Lung Disease
Pulmonary Hypertension
Scleroderma Renal Crisis
Cardiac Manifestations
Gastrointestinal Tract Manifestations
Musculoskeletal Manifestations
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
Raynaud’s Phenomenon
Cutaneous Disease
Scleroderma Renal Crisis
Interstitial Lung Disease
Pulmonary Hypertension
Cardiac Manifestations
Gastrointestinal Manifestations
Skeletal Muscle, Joint, and Tendon Manifestations
SPECIAL CONSIDERATIONS
83 - Systemic Vasculitis
DEFINITION AND EPIDEMIOLOGY
Small Vessel Vasculitis
Medium Vessel Vasculitis
Large Vessel Vasculitis
PATHOLOGY
CLINICAL PRESENTATION AND DIAGNOSIS
Small Vessel Vasculitis
Medium Vessel Vasculitis
Large Vessel Vasculitis
TREATMENT AND PROGNOSIS
Small Vessel Vasculitis
Medium Vessel Vasculitis
Large Vessel Vasculitis
ADDITIONAL CONSIDERATIONS IN TREATMENT
Acknowledgments
84 - Crystal Arthropathies
GOUT
Epidemiology
Pathogenesis
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
APATITE-ASSOCIATED ARTHROPATHY
CALCIUM OXALATE DEPOSITION DISEASE
85 - Osteoarthritis
DEFINITION AND EPIDEMIOLOGY
PATHOLOGIC FACTORS
CLINICAL PRESENTATION
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
PROGNOSIS
86 - Nonarticular Soft Tissue Disorders
INTRODUCTION
EPIDEMIOLOGY
ETIOLOGIC FACTORS AND PATHOGENESIS
CLINICAL PRESENTATION
DIAGNOSIS AND TREATMENT
Septic Bursitis
Nonseptic Bursitis
Tendinitis
Fibromyalgia Syndrome
87 - Rheumatic Manifestations of Systemic Disorders and Sjögren’s Syndrome
INTRODUCTION
Hypertrophic Osteoarthropathy
Rheumatoid Arthritis–like Polyarthritis
Systemic Autoimmune Diseases and Malignancy
Vasculitides
Inflammatory Myopathies
Malignancies Associated With TNF Inhibitors
HEMATOLOGIC DISORDERS WITH RHEUMATIC MANIFESTATIONS
Hemophilia
Sickle Cell Disease
Endocrine Disorders
Diabetes
Thyroid Disease
Parathyroid Disease
Acromegaly
GASTROINTESTINAL DISEASES WITH RHEUMATIC MANIFESTATIONS
Whipple Disease
Hemochromatosis
MISCELLANEOUS DISORDERS
Multiple Myeloma
Amyloidosis
Human Immunodeficiency Virus Infection
Sarcoidosis
SJÖGREN’S SYNDROME
Definition and Epidemiology
Pathogenesis
Clinical Presentation
Sjögren’s Syndrome and Non-Hodgkin Lymphomas
Laboratory Findings
Diagnosis
Classification Criteria
Differential Diagnosis
Management
XV - Infectious Disease
88 - Host Defenses Against Infection
Nonimmunologic Host Defenses
Innate Immunity
Adaptive Immunity
HOST DEFENSE RESPONSE TO PATHOGENS
Humoral Response
Cell-Mediated Response
89 - Laboratory Diagnosis of Infectious Diseases
INTRODUCTION
DIAGNOSTIC STEWARDSHIP
Liquid Media and Self-Collected Specimens
Provider Responsibility for Optimizing Results
DIRECT SMEAR INTERPRETATION
Special Stains
CULTURE WITH A BOOST
Antibody and Antigen Tests From Blood and Body Fluids
MOLECULAR DIAGNOSTICS
SYNDROMIC ASSAY PANELS
POINT-OF-CARE OR NEAR-PATIENT TESTING
Point-of-Care Testing in Resource-Poor Settings
Point-of-Care Testing Quality Issues
90 - Fever and Febrile Syndromes
INTRODUCTION
PATHOGENESIS
Viral Infection
Bacterial Infections
Fever With Localized Symptoms and Signs
FEVER OF UNKNOWN ORIGIN
Classic Fever of Unknown Origin
Health Care–Associated Fever of Unknown Origin
Approach to the Patient With Fever of Unknown Origin
SPECIFIC CONDITIONS AND EXPOSURES CAUSING FEVER
Fever After Animal Exposures
Fever and Rash
Fever With Lymphadenopathy
Infections Causing Regional Lymphadenopathy
FACTITIOUS FEVER AND SELF-INDUCED ILLNESS
91 - Bacteremia and Sepsis
DEFINITION
EPIDEMIOLOGY
PATHOLOGY AND IMMUNOPATHOGENESIS
PATHOPHYSIOLOGY OF SEPTIC SHOCK
CLINICAL PRESENTATION
DIAGNOSIS
TREATMENT
PROGNOSIS
92 - Infections of the Central Nervous System
INTRODUCTION
MENINGITIS
Definition
Epidemiology and Etiology
Clinical Presentation
Diagnosis
Treatment
ENCEPHALITIS
Definition
Epidemiology and Etiology
Clinical Presentation
Diagnosis
Treatment
BRAIN ABSCESS
Definition
Pathology and Pathophysiology
Clinical Presentation
Diagnosis
Treatment
PARAMENINGEAL INFECTIONS
Subdural Empyema
SPINAL EPIDURAL ABSCESS
Definition and Epidemiology
Pathology and Pathophysiology
Clinical Presentation
Diagnosis
Treatment
SINUS THROMBOSIS
Septic Cavernous Sinus Thrombosis
Lateral Sinus Thrombosis
Septic Sagittal Sinus Thrombosis
NEUROLOGIC COMPLICATIONS OF INFECTIVE ENDOCARDITIS
Epidemiology
Pathophysiology
Clinical Manifestations
Diagnosis
Treatment
PRION DISEASES
Etiology
Sporadic Creutzfeldt-Jakob Disease
93 - Infections of the Head and Neck
COMMON COLD
Definition and Epidemiology
Pathogenesis and Microbiology
Clinical Presentation
Treatment
ACUTE BACTERIAL RHINOSINUSITIS
Definition and Epidemiology
Pathogenesis and Microbiology
Clinical Presentation
Treatment
Complications
PHARYNGITIS AND TONSILLITIS
Definition and Epidemiology
Pathogenesis and Microbiology
Clinical Presentation
Treatment
DEEP NECK SPACE INFECTIONS
Definition and Epidemiology
Submandibular Space Infection
Retropharyngeal Infection
Lateral Pharyngeal Space Infection
Bacterial Epiglottitis
Acute Bacterial Otitis Externa
Acute Bacterial Otitis Media
94 - Infections of the Lower Respiratory Tract
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
Pathophysiology
Transmission of Respiratory Pathogens
Specific Etiologic Agents
CLINICAL PRESENTATION
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
PROGNOSIS
PREVENTION
TUBERCULOSIS
Definition
Epidemiology
Microbiology
Pathobiology
Diagnosis
Clinical Manifestations
Extrapulmonary TB
Treatment and Prevention
Prognosis
95 - Infections of the Heart and Blood Vessels
INFECTIVE ENDOCARDITIS
ENDARTERITIS AND SUPPURATIVE PHLEBITIS
CENTRAL VENOUS CATHETER–RELATED BLOODSTREAM INFECTIONS
SUGGESTED READINGS
96 - Acute Bacterial Skin and Skin Structure Infections
DEFINITION
EPIDEMIOLOGY
PATHOLOGY
Infectious Mechanisms
Pathologic Manifestations
ETIOLOGY AND CLINICAL PRESENTATION
Causative Organisms
Other Organisms
Select Fungi and Viruses
DIAGNOSIS
Special Diagnostic Considerations
Differential Diagnosis
TREATMENT
Pharmacologic and Supportive Care
Special Treatment Considerations
PROGNOSIS
97 - Intraabdominal Infections
INTRODUCTION
SOURCE CONTROL AND TIMING OF ANTIBIOTICS
PERITONITIS
APPENDICITIS
DIVERTICULITIS
INFECTIOUS BOWEL DISEASE
Infectious Colitis
Cytomegalovirus Colitis
Clostridioides difficile Colitis
BILIARY INFECTIONS
Cholecystitis
Acalculous Cholecystitis
Cholangitis
PANCREATITIS AND PANCREATIC INFECTION
INTRAABDOMINAL ABSCESS
Solid Organ Abscesses
Intraabdominal and Intrapelvic
CONCLUSIONS
98 - Infectious Diarrhea
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
Enterotoxin-Induced Secretory Diarrhea
Cytotoxin-Induced Diarrhea
Invasive Diarrhea
Bacterial Food Poisoning
SPECIFIC PATHOGENS
Shigella
Salmonella
Campylobacter
Vibrio
Listeria
Diarrhea-Causing Escherichia coli
Clostridioides difficile
Yersinia enterocolitica
Viral Causes of Diarrhea
Protozoan Causes of Diarrhea
Traveler’s Diarrhea
CLINICAL PRESENTATION
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
Oral Fluid Therapy
Intravenous Fluid Therapy
Antimicrobial Therapy
Symptomatic Therapy
PROGNOSIS
99 - Infections Involving Bone and Joints
DEFINITION
PATHOPHYSIOLOGY
CLINICAL PRESENTATION AND DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
PROGNOSIS
100 - Urinary Tract Infections
DEFINITION AND DIAGNOSIS
LABORATORY FINDINGS
EPIDEMIOLOGY
PATHOGENESIS
TREATMENT
COMPLICATIONS
101 - Health Care–Associated Infections
INTRODUCTION
SURGICAL SITE INFECTIONS
CLOSTRIDIOIDES DIFFICILE INFECTION
MULTIDRUG-RESISTANT PATHOGENS
102 - Sexually Transmitted Infections
INTRODUCTION
URETHRITIS AND CERVICITIS
Chlamydia
Gonorrhea
Vaginitis
Other Causes of Nongonococcal Urethritis
GENITAL ULCER DISEASE
Syphilis
Herpes Simplex Virus
Chancroid
Granuloma Inguinale
Other Causes of Genital Ulcers
OTHER SEXUALLY TRANSMITTED INFECTIONS
Genital Warts
Pubic Lice
Scabies
103 - Human Immunodeficiency Virus Infection
HISTORY
EPIDEMIOLOGY
VIROLOGY
IMMUNOLOGY AND INFLAMMATION
CLINICAL DIAGNOSIS OF HIV
THE NATURAL PROGRESSION OF HIV DISEASE
Acute Retroviral Syndrome
Natural Clinical Progression of Untreated Disease
Opportunistic Infections
HIV and Malignancy
Immune Reconstitution Inflammatory Syndrome
CO-OCCURRING DISEASE AND MULTIMORBIDITY WITH HIV
Neurologic Disease in HIV
Gastrointestinal Diseases
Hepatobiliary Disease
Cardiovascular Disease
Renal Disease
Osteoporosis and Bone Disease
Endocrine Disorders
Nonalcoholic Fatty Liver Disease
Obesity
Aging and HIV
Mental Health
Substance Use Disorder
Sexually Transmitted Infections
HIV MANAGEMENT AND TREATMENT
Initial Counseling and Ambulatory Evaluation
Laboratory Monitoring
Screening for Associated Infections
Immunization
Other Health Screening
ANTIRETROVIRAL TREATMENT
Current Antiretrovirals
Treatment Guidelines
Resistance Testing
Future Directions of Antiretroviral Treatment
HIV CURE RESEARCH
HIV PREVENTION, PEP AND PREP
104 -Infections in the Immunocompromised Host
INTRODUCTION
EPIDEMIOLOGY
PATHOGENESIS
Neutropenia
Cell-Mediated and Humoral Immune Deficits
Asplenia and Complement Deficits
Hematologic Malignancies
Solid Organ Transplantation
Hematopoietic Cell Transplantation
Novel Immunomodulatory Medications
CLINICAL PRESENTATION
Central Nervous System Infection
Pneumonia
Diarrhea
Skin Manifestations
Fever of Unknown Origin
DIAGNOSIS
Host Considerations
Syndrome Considerations
Laboratory Testing
Diagnostic Imaging
TREATMENT
General Principles
Source Control
Adjusting Immunosuppression
Drug-Drug Interactions
PREVENTION
Lifestyle Precautions
Immunizations
Antimicrobial Prophylaxis
SPECIFIC PATHOGENS
HSV and VZV
CMV
Other Herpesviruses
Polyomaviruses
Candida
Cryptococcus
Aspergillus
Mucorales and Other Fungi
Nocardia
Mycobacteria
Parasites
105 - Infectious Diseases of Travelers: Protozoal and Helminthic Infections
INTRODUCTION
PREPARATION OF TRAVELERS
Immunizations
Malaria Prophylaxis
Traveler’s Diarrhea
Special Problems
The Returning Traveler
PROTOZOAL INFECTIONS
Protozoal Infections in the United States
Protozoal Infections Common in Travelers and Immigrants
HELMINTHIC INFECTIONS
Helminthic Infections Common in the United States
Helminth Infections Common in Travelers and Immigrants
FUTURE DIRECTIONS
XVI - Neurologic Disease
106 - Neurologic Evaluation of the Patient
INTRODUCTION
TAKING A NEUROLOGIC HISTORY
NEUROLOGIC EXAMINATION
TECHNOLOGIC ASSESSMENT
Lumbar Puncture
Tissue Biopsies
Electrophysiologic Studies
Imaging Studies
Genetic and Molecular Testing
PROSPECTS FOR THE FUTURE
107 - Disorders of Consciousness
INTRODUCTION
PATHOPHYSIOLOGIC FACTORS
DIAGNOSTIC APPROACH
Identification of Meningitis
PROGNOSIS IN COMA AFTER CARDIAC ARREST
COMA-LIKE STATES
108 - Disorders of Sleep
INTRODUCTION
DISORDERS OF EXCESSIVE DAYTIME SLEEPINESS
History and Examination
Sleep Studies
SLEEP-DISORDERED BREATHING
Definition and Epidemiology
Pathophysiology
Clinical Manifestation
Treatment and Prognosis
NARCOLEPSY
Pathophysiology
Diagnosis and Differential Diagnosis
Treatment
IDIOPATHIC HYPERSOMNIA
Definition and Epidemiology
Diagnosis and Differential Diagnosis
Treatment and Prognosis
KLEINE-LEVIN SYNDROME
RESTLESS LEGS SYNDROME, PERIODIC LIMB MOVEMENTS IN SLEEP, AND PERIODIC LIMB MOVEMENT DISORDER
Clinical Manifestations
Treatment and Prognosis
INSOMNIA
Definition and Epidemiology
Pathophysiology
Clinical Manifestations
Diagnosis and Differential Diagnosis
Treatment and Prognosis
PARASOMNIAS
NREM Parasomnias
Rapid Eye Movement Behavior Disorder
109 - Cortical Syndromes
FUNCTIONAL ANATOMY
CLINICAL ASSESSMENT
REGIONAL SYNDROMES
Aphasia
Agnosia and Apraxia
PROSPECTUS FOR THE FUTURE
110 - Dementia and Memory Disturbances
MAJOR DEMENTIA SYNDROMES
Alzheimer Disease
Diffuse Lewy Body Disease
Vascular Dementia
Frontotemporal Dementias
Parkinson’s Disease
Normal-Pressure Hydrocephalus
OTHER MEMORY DISTURBANCES
Structure of Memory
Isolated Disorders of Memory Function
111 - Major Disorders of Mood, Thoughts, and Behavior
CLASSIFICATION OF MENTAL DISORDERS
DEPRESSIVE AND BIPOLAR DISORDERS
PSYCHOTIC DISORDERS
PERSONALITY DISORDERS
PROSPECTUS FOR THE FUTURE
112 - Autonomic Nervous System Disorders
DEFINITION AND EPIDEMIOLOGY
PATHOLOGY
CLINICAL PRESENTATION
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
PROGNOSIS
113 - Headache, Neck and Back Pain, and Cranial Neuralgias
HEADACHE
Definition and Epidemiology
Classification of Headache
Evaluation of the Patient With Acute Headache
CRANIAL NEURALGIAS
Trigeminal Neuralgia
Glossopharyngeal Neuralgia
Postherpetic Neuralgia
Occipital Neuralgia
CERVICAL SPONDYLOSIS
ACUTE LOW BACK PAIN
114 - Disorders of Vision and Hearing
DISORDERS OF VISION AND EYE MOVEMENTS
Examination of the Visual System
Monocular Visual Loss
Binocular Visual Loss
HEARING AND ITS IMPAIRMENTS
Symptoms of Auditory Dysfunction
Examination of the Auditory System
Causes of Hearing Loss
Treatment of Hearing Loss
Prospectus for the Future
115 - Dizziness and Vertigo
DEFINITIONS AND EPIDEMIOLOGY
DIFFERENTIATING CENTRAL FROM PERIPHERAL
CLINICAL PRESENTATION PATTERNS
DIFFERENTIAL DIAGNOSIS
TARGETED TREATMENT
116 - Disorders of the Motor System
INTRODUCTION
INTRODUCTION TO MOVEMENT DISORDERS
Parkinsonism
Tremor
Chorea
Wilson’s Disease
Drug-Induced Movement Disorders
Dystonia
Tics and Tourette Syndrome
Paroxysmal Dyskinesias
Restless Leg Syndrome
Cerebellar Ataxias
Functional Movement Disorders
117 - Congenital, Developmental, and Neurocutaneous Disorders
INTRODUCTION
CONGENITAL MALFORMATIONS
Disorders of Dorsal Induction
Disorders of Ventral Induction
Malformations of Cortical Development
DEVELOPMENTAL DISORDERS
Autism Spectrum Disorder
Attention-Deficit/Hyperactivity Disorder
Rett Syndrome
Fragile X Syndrome
NEUROCUTANEOUS DISORDERS
Neurofibromatosis 1
Neurofibromatosis 2
Tuberous Sclerosis Complex
Sturge-Weber Syndrome
118 - Cerebrovascular Disease
INTRODUCTION
DEFINITIONS AND EPIDEMIOLOGY
MODIFIABLE RISK FACTORS
PATHOLOGY
Clinical Implications of Vascular Anatomy
Vascular Pathogenesis
Injury to Brain Tissue
CLINICAL PRESENTATION
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
TREATMENT
Primary Prevention of Stroke
Acute Treatment of Ischemic Stroke
Treatment of Intracerebral Hemorrhage
Rehabilitation and Recovery
Secondary Stroke Prevention
PROGNOSIS
119 - Traumatic Brain Injury and Spinal Cord Injury
INTRODUCTION
TYPES OF INJURY
MANAGEMENT
Traumatic Brain Injury
Traumatic Spinal Cord Injury
Spinal Cord Syndromes
Spinal Shock
Acute and Subacute Management
PROGNOSIS
Traumatic Brain Injury
Traumatic Spinal Cord Injury
FUTURE
120 - Epilepsy
DEFINITIONS AND EPIDEMIOLOGY
PATHOLOGY
CLASSIFICATION AND CLINICAL MANIFESTATIONS
Seizures
Focal Seizures
Generalized Seizures
Tonic Seizures, Atonic Seizures, and Epileptic Spasms
EPILEPSIES
Focal Epilepsy
Idiopathic or Genetic Generalized Epilepsy
Combined Generalized and Focal Epilepsy
Other Seizure Conditions
DIAGNOSIS
History and Examination
Laboratory Tests—EEG
Laboratory Tests—Neuroimaging
Other Tests
DIFFERENTIAL DIAGNOSIS
TREATMENT
Medication Therapy
Epilepsy Surgery
Dietary Therapy
Neurostimulators
Status Epilepticus
GENETIC COUNSELING AND PREGNANCY
Heredity
Teratogenicity
Management During and After Pregnancy
PSYCHOSOCIAL CONCERNS
PROGNOSIS
DISCONTINUING ANTIEPILEPTIC DRUGS
121 - Central Nervous System Tumors
DEFINITION/EPIDEMIOLOGY
PATHOLOGY
CLINICAL PRESENTATION
DIAGNOSIS/DIFFERENTIAL
TREATMENT
PROGNOSIS
122 - Demyelinating and Inflammatory Disorders
INTRODUCTION
MULTIPLE SCLEROSIS
Definition/Epidemiology
Pathology
Clinical Presentation
Diagnosis
Differential Diagnosis
Prognosis of Multiple Sclerosis
Treatment
NEUROMYELITIS OPTICA SPECTRUM DISORDER (DEVIC DISEASE)
Definition/Epidemiology
Clinical Presentation
Diagnosis/Differential
Pathology
Treatment
Prognosis
ACUTE DISSEMINATED ENCEPHALOMYELITIS
ACUTE TRANSVERSE MYELITIS
IDIOPATHIC ACUTE OPTIC NEURITIS
123 - Neuromuscular Diseases: Disorders of the Motor Neuron and Plexus and Peripheral Nerve Disease
INTRODUCTION
Electromyography and Nerve Conduction Studies
DISEASES OF THE MOTOR NEURON (ANTERIOR HORN CELL)
Amyotrophic Lateral Sclerosis
Other Acquired Motor Neuron Diseases
Spinal Muscular Atrophy
Brachial Plexopathy
Acute Autoimmune Brachial Neuritis
Lumbosacral Plexopathy
DISORDERS OF THE PERIPHERAL NERVES
Definition and Epidemiology
Pathology
Clinical Presentation
Diagnosis/Differential
Treatment
Prognosis
COMMON MONONEUROPATHIES
Carpal Tunnel Syndrome
Ulnar Palsy
Peroneal Neuropathy
SPECIFIC ACQUIRED POLYNEUROPATHIES
Guillain-Barré Syndrome: Acute Inflammatory Demyelinating Polyneuropathy
Chronic Inflammatory Demyelinating Polyneuropathy
Diabetic Neuropathy
Toxic-Induced Neuropathies
Critical Illness Polyneuropathy
SPECIFIC HEREDITARY POLYNEUROPATHIES
Charcot-Marie-Tooth Disease
FAMILIAL AMYLOID NEUROPATHIES
124 - Muscle Diseases
INTRODUCTION
SYMPTOMS OF MUSCLE DISEASE
EXAMINATION
DIAGNOSTIC TESTING
INHERITED MYOPATHIES
Muscular Dystrophies
Dystrophinopathies
Myotonic Dystrophy
Facioscapulohumeral Muscular Dystrophy
CONGENITAL MYOPATHIES
METABOLIC MYOPATHIES
Glucose and Glycogen Metabolism Disorders
DISORDERS OF FATTY ACID METABOLISM
MITOCHONDRIAL MYOPATHIES
Definition and Epidemiology
Genetics and Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
MUSCLE CHANNELOPATHIES
Nondystrophic Myotonias
Periodic Paralyses
ACQUIRED MYOPATHIES
Inflammatory Myopathies
Myopathy With HMGCR Antibodies
Infectious Myositis
Toxic Myopathies
125 - Neuromuscular Junction Disease
MYASTHENIA GRAVIS
Definition/Epidemiology/Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
LAMBERT-EATON MYASTHENIC SYNDROME
Definition/Epidemiology/Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
BOTULISM
Definition/Epidemiology/Pathology
Clinical Presentation
Diagnosis and Differential Diagnosis
Treatment
Prognosis
ORGANOPHOSPHATE POISONING
XVII - Geriatrics
126 -The Aging Patient
INTRODUCTION
EPIDEMIOLOGY OF AGING
THE BIOLOGY OF AGING
THEORIES OF AGING
ASSESSMENT OF FRAILTY
CLINICAL CARE OF OLDER ADULTS
PRESENTATION OF DISEASE IN THE OLDER ADULT
MEDICATIONS
COGNITION
Dementia
Delirium
MENTAL HEALTH
SLEEP
MOBILITY
VISION AND HEARING
CONTINENCE
NUTRITION
SOCIAL AND LEGAL ISSUES
Caregiving
Mistreatment
Finances
Advance Care Planning
CONTEXTS OF CARE: SPECIAL CONSIDERATIONS
The Hospitalized Patient
Care Transitions
SYSTEMS OF CARE
Ambulatory and Home Care
Long-Term Care
Program of All-Inclusive Care for the Elderly
Geriatric Care
Emergence of Geroscience Guided Therapies
XVIII - Palliative Care
127 - Palliative Care
INTRODUCTION
Trajectory 1: Short Period of Evident Decline Before Death
Trajectory 3: Prolonged Dwindling
Trajectory 4: Severe Acute Brain Injury
SUFFERING AND SYMPTOM MANAGEMENT
Physical Symptoms
Psychological Distress
COMMUNICATION AND CARE COORDINATION
Negotiating Goals of Care
Estimating and Communicating Prognosis
END-OF-LIFE CARE
The Role of Diagnostic Tests and Invasive Procedures
Role of Hospice
Last Hours and Days of Living
COMMON ETHICAL CHALLENGES IN PALLIATIVE CARE
Patient Capacity and Surrogate Decision Making
When Patients and Families Want Near Futile Treatment
Feeding Tube Questions
Proportionate Palliative Sedation
Request for Hastened Death
PROSPECTUS FOR THE FUTURE
XIX - Alcohol and Substance Use
128 - Alcohol and Substance Use
ALCOHOL USE
ALCOHOL USE
DEFINITION AND EPIDEMIOLOGY
PHARMACOLOGIC AND METABOLIC FACTORS
CLINICAL PRESENTATION
Acute Alcohol Intoxication
Withdrawal Syndrome (Convulsions)
Delirium Tremens
TREATMENT
Screening and Intervention Strategies
Low-Risk Drinking
Nonpharmacologic Therapies
Considerations for Drug Interventions
Fetal Alcohol Spectrum Disorders
PRESCRIPTION DRUG ABUSE
Sedatives and Hypnotics
Opioids
Amphetamines
ILLICIT DRUG ABUSE
Cocaine
Cannabis
Hallucinogens and Dissociative Drugs
Inhalants
Designer Drugs
PROSPECTUS FOR THE FUTURE
CORONAVIRUS DISEASE 2019 (COVID-19)
VIROLOGY
PATHOLOGY
HOST DEFENSES
TRANSMISSION
DIAGNOSIS
CLINICAL ASPECTS
EXTRAPULMONARY MANIFESTATIONS
TREATMENT
VACCINES
PREGNANCY AND CHILDREN
PREVENTION
SUGGESTED READINGS
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