Cecil Essentials of Medicine

by Cecil, Russell L.; Bennett, J. Claude, Md; Carpenter, Charles C. J., Md; Plum, Fred, Md; Cecil, Russell L.

• ISBN13: 9780721666976
• ISBN10: 0721666973
• Edition: 4th
• Format: Paperback
• Copyright: 1997-02-01
• Publisher: Elsevier Science Health Science div

Summary

For almost 20 years, Cecil Essentials of Medicine has been a trusted and respected name in Internal Medicine.

The new 5 th Edition continues this legacy by laying the groundwork for effective diagnosis and treatment by presenting the core of internal medicine in an easy-to-read format.

Concise and complete, incorporates important advances in diagnosis and therapy.

Table of Contents

SECTION I CARDIOVASCULAR DISEASE	1	(110)
Structure and Function of the Normal Heart and Blood Vessels	3	(7)
Gross Anatomy	3	(1)
Electrical Conduction System	4	(1)
Microscopic Anatomy	5	(1)
Fetal Circulation	6	(1)
Myocardial Metabolism	6	(1)
Circulatory Physiology	6	(2)
Physiology of the Coronary Circulation	8	(1)
Physiology of the Systemic Circulation	8	(1)
Physiology of the Pulmonary Circulation	9	(1)
Cardiovascular Response to Exercise	9	(1)
Cardiovascular Physiology During Pregnancy	9	(1)
Electrophysiology	9	(1)
Evaluation of the Patient with Cardiovascular Disease	10	(10)
History	10	(3)
Arterial Pressure and Pulses	13	(1)
Examination of the Neck Veins	14	(1)
Precordial Examination	15	(1)
Cardiac Auscultation	15	(1)
Abnormal Heart Sounds	15	(2)
Abnormal Murmurs	17	(2)
Prosthetic Valve Sounds	19	(1)
Special Tests and Procedures in the Patient with Cardiovascular Disease	20	(13)
Cardiac Radiography	20	(1)
Electrocardiography	20	(2)
Abnormal ECG Patterns	22	(5)
Long-Term Ambulatory ECG Recording	27	(1)
Stress Testing	27	(1)
Echocardiography	28	(1)
Nuclear Cardiology	28	(1)
Other Techniques	29	(1)
Cardiac Catheterization	29	(1)
Special Techniques	30	(3)
Congestive Heart Failure	33	(7)
Evaluation and Treatment of Patients with Heart Failure	34	(2)
Diuretics	36	(1)
Vasodilators	36	(1)
Digitalis	37	(1)
Sympathomimetic Amines	37	(1)
Cardiovascular Assist Devices	37	(1)
Acute Pulmonary Edema	38	(1)
Diastolic Heart Failure	39	(1)
Congenital Heart Disease	40	(5)
Bicuspid Aortic Valve	40	(1)
Coarctation of the Aorta	40	(2)
Pulmonic Valve Stenosis	42	(1)
Atrial Septal Defect	42	(1)
Ventricular Septal Defect	42	(1)
Patent Ductus Arteriosus	43	(1)
Tetralogy of Fallot	43	(1)
General Considerations in the Evaluation and Management of Adults with Congenital Heart Disease	44	(1)
Acquired Valvular Heart Disease	45	(8)
General Considerations	45	(1)
Aortic Stenosis	45	(1)
Aortic Regurgitation	46	(2)
Mitral Stenosis	48	(1)
Mitral Regurgitation	49	(1)
Mitral Valve Prolapse	50	(1)
Tricuspid Stenosis	50	(1)
Tricuspid Regurgitation	50	(1)
Pulmonic Stenosis and Regurgitation	51	(1)
Multivalvular Disease	51	(1)
Rheumatic Fever	51	(1)
Prosthetic Valves	51	(2)
Coronary Heart Disease	53	(16)
Atherosclerosis	53	(1)
Risk Factors	53	(1)
Nonatherosclerotic Causes of Coronary Artery Obstruction	54	(1)
Nonobstructive Causes of Ischemic Heart Disease	54	(1)
Pathophysiology of Ischemic Heart Disease	54	(1)
Angina Pectoris	55	(2)
Medical Management of Angina	57	(2)
Coronary Bypass Surgery and Coronary Angioplasty for Angina Pectoris	59	(1)
Variant Angina	60	(1)
Acute Myocardial Infarction	61	(2)
Treatment of Acute Myocardial Infarction	63	(1)
Thrombolytic Therapy and Primary Coronary Angioplasty for Acute Myocardial Infarction	63	(2)
Other Measures	65	(1)
Non-Q Wave Myocardial Infarction	65	(1)
Complications of Myocardial Infarction and Their Management	66	(3)
Arrhythmias	69	(25)
Mechanisms of Arrhthymogenesis	69	(2)
Approach to the Patient with Suspected or Confirmed Arrhythmias	71	(1)
Management of Cardiac Arrhythmias	72	(8)
Specific Arrhythmias	80	(12)
Principles of Cardiopulmonary Resuscitation	92	(2)
Myocardial and Pericardial Disease	94	(6)
Myocardial Disease	94	(2)
Pericardial Disease	96	(4)
Cardiac Tumors and Trauma	100	(2)
Cardiac Tumors	100	(1)
Nonpenetrating Trauma	100	(1)
Penetrating Trauma	101	(1)
Aortic and Peripheral Vascular Disease	102	(5)
Aortic Aneurysms	102	(1)
Aortic Dissection	102	(1)
Aortic Arteritis	102	(1)
Miscellaneous Aortic Disease	103	(1)
Peripheral Vascular Disease	103	(2)
Peripheral Aneurysms and Fistulas	105	(1)
Arterial Trauma	105	(1)
Peripheral Venous Disease	105	(1)
Deep Vein Thrombosis	106	(1)
Other Cardiac Topics	107	(4)
Transplantation	107	(1)
Surgery	107	(1)
Pregnancy	108	(3)
Section II RESPIRATORY DISEASE	111	(54)
Approach to the Patient with Respiratory Disease	113	(4)
Common Presenting Complaints	113	(1)
Physical Examination	114	(3)
Anatomic and Physiologic Considerations	117	(9)
The Airway	117	(1)
Ventilation	117	(4)
The Blood Vessels	121	(2)
Pulmonary Gas Exchange	123	(1)
Nonpulmonary Factors	124	(1)
Growth and Aging of the Normal Lung	124	(1)
Nonrespiratory Functions of the Lung	125	(1)
Diagnostic Techniques and their Indications	126	(5)
Imaging Procedures	126	(1)
Pulmonary Function Evaluation	126	(5)
Obstructive Lung Disease	131	(9)
Pathophysiology of Airway Obstruction	131	(1)
Asthma	132	(1)
Chronic Obstructive Pulmonary Disease (COPD)	133	(1)
Emphysema	134	(1)
Small Airway Disease	134	(1)
Chronic Bronchitis	134	(1)
Bronchiectasis	134	(1)
Cystic Fibrosis	135	(1)
Treatment	136	(1)
Pharmacologic Therapy	136	(1)
Oxygen	137	(1)
Antibiotics and Vaccines	137	(1)
Smoking Cessation	138	(1)
Physical Therapy and Rehabilitation	138	(1)
Volume Reduction Surgery and Lung Transplantation	138	(2)
Diffuse Infiltrative Diseases of the Lung	140	(6)
Clinical Manifestations	140	(1)
Specific Entities	140	(5)
Treatment	145	(1)
Pulmonary Vascular Disease	146	(4)
Physiologic Effects of Pulmonary Hypertension	146	(1)
Causes of Pulmonary Hypertension	146	(1)
Pulmonary Embolism	146	(3)
Primary Pulmonary Hypertension	149	(1)
Disorders of the Pleural Space, Mediastinum, and Chest Wall	150	(5)
Pleural Disease	150	(2)
Mediastinal Disease	152	(1)
Chest Wall Disease	153	(2)
Neoplastic Diseases of the Lung	155	(4)
Lung Tumor Biology	155	(1)
Pathology	155	(1)
Clinical Presentation	156	(1)
Diagnosis and Evaluation	156	(1)
Solitary Pulmonary Nodule	157	(1)
Treatment and Prognosis	158	(1)
Control of Breathing in Disease States	159	(3)
Sleep Apnea Syndrome	159	(2)
Breathing Pattern Abnormalities Associated with Neurologic Disease	161	(1)
Neuromuscular Disease	161	(1)
Inhalational and Environmental Injury	162	(3)
Drowning and Near-Drowning	162	(1)
Diseases of Altitude	162	(1)
Smoke Inhalation Injury	163	(1)
Noxious Gases and Fumes	163	(2)
Section III PULMONARY CRITICAL CARE	165	(8)
Essentials of Pulmonary Critical Care Medicine	167	(6)
Shock	167	(1)
Acute Respiratory Failure	168	(1)
Oxygen Therapy and Mechanical Ventilation	168	(2)
Multiple Organ Dysfunction Syndrome, Systemic Inflammatory Response Syndrome, Sepsis, and Adult Respiratory Distress Syndrome	170	(3)
Section IV RENAL DISEASE	173	(80)
Elements of Renal Structure and Function	175	(8)
Elements of Renal Structure	175	(2)
Elements of Renal Physiology	177	(4)
Renal Homeostatic Functions	181	(2)
Approach to the Patient with Renal Disease	183	(5)
Clinical Assessment of the Patient with Renal Disease	183	(2)
The Major Renal Syndromes	185	(1)
Anatomic Imaging of the Urinary Tract	186	(2)
Fluid and Electrolyte Disorders	188	(17)
Volume Disorders	188	(3)
Osmolality Disorders	191	(1)
Hyponatremia	192	(2)
Hypernatremic Disorders	194	(1)
Disturbances in Potassium Balance	195	(3)
Disturbances in Acid-Base Balance	198	(7)
Glomerular Diseases	205	(12)
The Glomerulus	205	(1)
Mechanisms of Glomerular Injury	205	(1)
Clinical Manifestations of Glomerular Disease	205	(1)
Approach to the Patient with Glomerular Disease	206	(1)
Acute Nephritic Syndrome	207	(1)
Rapidly Progressive Glomerulonephritis (RPGN)	208	(1)
Nephrotic Syndrome	209	(5)
Asymptomatic Urinary Abnormalities	214	(2)
Chronic Glomerulonephritis (CGN)	216	(1)
Major Nonglomerular Disorders	217	(10)
Tubulointerstitial Nephropathy	217	(3)
Cystic Diseases of the Kidney	220	(1)
Urinary Tract Obstruction	221	(1)
Nephrolithiasis	222	(2)
Renal Tumors	224	(3)
Hypertension and Vascular Disorders of the Kidney	227	(8)
Arterial Hypertension	227	(4)
Vascular Disorders of the Kidney	231	(4)
Acute Renal Failure	235	(8)
Definition and Etiology	235	(1)
Differential Diagnosis and Diagnostic Evaluation of the Patient	235	(3)
Clinical Presentation, Complications, and Management of Acute Tubular Necrosis	238	(2)
Specific Causes of Acute Renal Failure	240	(3)
Chronic Renal Failure	243	(10)
Adaptation to Nephron Loss	243	(2)
Clinical Manifestations of Renal Failure	245	(3)
Kidney Transplantation	248	(5)
Section V GASTROINTESTINAL DISEASE	253	(66)
The Common Clinical Manifestations of Gastrointestinal Disease	255	(21)
Abdominal Pain	255	(3)
Gastrointestinal Hemorrhage	258	(4)
Malabsorption	262	(7)
Diarrhea	269	(7)
Radiographic and Endoscopic Procedures in Gastroenterology	276	(6)
Radiographic Procedures	276	(3)
Endoscopic Procedures	279	(3)
Diseases of the Esophagus	282	(6)
Normal Esophageal Physiology	282	(1)
Clinical Symptoms of Esophageal Disease	282	(1)
Gastroesophageal Reflux Disease	283	(2)
Motility Disorders of the Oropharynx and Esophagus	285	(1)
Other Esophageal Disorders	286	(2)
Diseases of the Stomach and Duodenum	288	(11)
Normal Gastric Physiology	288	(2)
Gastritis	290	(1)
Peptic Ulcer Disease of the Stomach and Duodenum	291	(5)
The Zollinger-Ellison Syndrome	296	(1)
Abnormalities of Gastric Emptying	297	(2)
Inflammatory Bowel Disease	299	(6)
Definition	299	(1)
Etiology and Pathogenesis	299	(1)
Pathology	299	(1)
Clinical Manifestations	300	(1)
Diagnosis	301	(1)
Treatment and Prognosis	301	(2)
Complications	303	(1)
Ischemic Colitis	303	(1)
Diverticulitis	304	(1)
Neoplasms of the Gastrointestinal Tract	305	(7)
Carcinoma of the Esophagus	305	(1)
Carcinoma of the Stomach	306	(1)
Carcinoma of the Colon	307	(2)
Polyps of the Gastrointestinal Tract	309	(1)
The Familial Polyposis Syndromes	310	(2)
The Pancreas	312	(7)
Normal Structure and Function	312	(1)
Acute Pancreatitis	313	(2)
Chronic Pancreatitis	315	(2)
Carcinoma of the Pancreas	317	(2)
Section VI DISEASES OF THE LIVER AND BILIARY SYSTEM	319	(34)
Laboratory Tests in Liver Disease	321	(2)
Clinical Approach to Liver Disease	321	(1)
Laboratory Tests of Liver Function and Disease	321	(1)
Tests of Hepatic Function	321	(1)
Screening Tests of Hepatobiliary Disease	321	(2)
Liver Biopsy	323	(1)
Jaundice	323	(6)
Definition	324	(1)
Bilirubin Metabolism	324	(1)
Laboratory Tests for Bilirubin	324	(1)
Clinical Classification of Jaundice	324	(3)
Approach to the Diagnosis of Jaundice	327	(2)
Acute and Chronic Hepatitis	329	(8)
Definition	329	(1)
Acute Hepatitis	329	(6)
Chronic Hepatitis	335	(2)
Fulminant Hepatic Failure	337	(2)
Diagnosis	337	(1)
Treatment	337	(1)
Hepatic Transplantation	338	(1)
Prognosis	338	(1)
Cirrhosis of the Liver and its Complications	339	(6)
Definition	339	(1)
Clinical and Laboratory Features	339	(1)
Specific Causes of Cirrhosis	339	(1)
Major Complications of Cirrhosis	340	(4)
Hepatic Transplantation	344	(1)
Neoplastic, Infiltrative, and Vascular Diseases of the Liver	345	(3)
Hepatic Neoplasms	345	(1)
Liver Abscess	346	(1)
Granulomatous Liver Disease	346	(1)
Vascular Disease of the Liver	347	(1)
Disorders of the Gallbladder and Biliary Tract	348	(5)
Normal Biliary Physiology	348	(1)
Pathophysiology of Gallstone Formation (Cholelithiasis)	348	(1)
Clinical Manifestations of Gallstones	349	(4)
Section VII HEMATOLOGIC DISEASE	353	(70)
The Blood and Bone Marrow	355	(3)
The Blood	355	(1)
The Bone Marrow	355	(3)
Disorders of the Hematopoietic Stem Cell	358	(9)
The Myeloaplastic Disorders	358	(1)
The Myelodysplastic Disorders	359	(3)
Myeloproliferative Disorders	362	(2)
Acute Leukemia	364	(3)
Disorders of Lymphocytes	367	(10)
Ontology of Lymphocytes	367	(1)
Localization of Lymphocytes	368	(1)
Disorders of the Lymphatic System	369	(5)
Plasma Cell Disorders	374	(3)
Disorders of Granulocytes and Monocytes	377	(4)
Neutrophil Structure and Function	377	(1)
Monocyte Structure and Function	378	(1)
Neutropenia	378	(1)
Neutrophil Leukocytosis	379	(1)
Eosinophilia	380	(1)
Disorders of Red Cells	381	(17)
Shape and Structure of Red Cells	381	(1)
Birth and Death of Red Cells	381	(1)
Anemia	381	(17)
Transfusion and Bone Marrow Transplantation	398	(5)
Transfusion	398	(3)
Allogeneic Bone Marrow Transplantation (BMT)	401	(2)
Platelets and Primary Hemostasis	403	(8)
Primary Hemostasis	403	(1)
Quantitative Platelet Disorders	404	(3)
Thrombocytosis	407	(1)
Qualitative Platelet Disorders	408	(1)
Vascular Purpuras	408	(1)
Plasma Protein Disorders Affecting Primary Hemostasis	409	(2)
Blood Coagulation and its Disorders	411	(12)
Secondary Hemostasis and Clot Stabilization	411	(5)
Factor Inhibitors	416	(1)
Natural Anticoagulants and the Fibrinolytic Pathway	416	(1)
Primary Hypercoagulable States	417	(2)
Secondary Hypercoagulable States	419	(1)
Therapy of Thromboembolic Disease	419	(4)
Section VIII ONCOLOGIC DISEASE	423	(18)
General Considerations in Oncology	425	(7)
Etiology	425	(3)
Screening for Early Cancer Detection	428	(1)
Systemic Effects of Cancer	429	(3)
Principles of Cancer Therapy	432	(6)
Forming a Treatment Plan	432	(1)
Principles of Oncologic Surgery	432	(1)
Principles of Radiation Therapy	433	(1)
Principles of Chemotherapy	434	(2)
Hormonal Therapy	436	(1)
Biologic Response Modifiers	436	(2)
Oncologic Emergencies	438	(3)
Hypercalcemia	438	(1)
Spinal Cord Compression	438	(2)
Increased Intracranial Pressure	440	(1)
Superior Vena Cava Syndrome	440	(1)
Section IX METABOLIC DISEASE	441	(34)
Introduction to Metabolic Disease	443	(2)
Eating Disorders	445	(6)
Obesity	445	(2)
Anorexia Nervosa and Bulimia Nervosa	447	(4)
Principles of Nutritional Support in Adult Patients	451	(3)
Nutritional Assessment	451	(1)
Route of Nutritional Support	451	(1)
Water	451	(1)
Calories and Protein	451	(2)
Vitamins and Minerals	453	(1)
Home Nutritional Support	453	(1)
Hyperuricemia and Gout	454	(4)
Prevalence	454	(1)
Mechanisms of Hyperuricemia	454	(1)
Pathogenesis of Gout Arthritis	454	(1)
Pathogenesis of Renal Disease	454	(1)
Pathogenesis of Tophi	455	(1)
Clinical Features	455	(1)
Treatment	456	(2)
Disorders of Lipid Metabolism	458	(6)
Plasma Lipoprotein Physiology	458	(1)
Evaluation of Serum Lipoprotein Concentrations	458	(1)
Elevated Chylomicrons, VLDL, and IDL	459	(1)
Treatment of Hypertriglyceridemia	460	(2)
Elevated LDL	462	(1)
Treatment of Hypercholesterolemia	462	(1)
Lipids and Vascular Disease	463	(1)
Disorders of Metals and Metalloproteins	464	(6)
Wilson's Disease	464	(1)
Hemochromatosis	465	(1)
The Porphyrias	466	(4)
Disorders of Amino Acid Metabolism	470	(3)
Homocystinemia	470	(1)
Cystinuria	470	(3)
Inherited Disorders of Connective Tissue	473	(2)
Osteogenesis Imperfecta	473	(1)
Ehlers-Danlos Syndrome	473	(1)
Marfan's Syndrome	473	(1)
Mucopolysaccharidoses	474	(1)
Section X ENDOCRINE DISEASE	475	(78)
Hypothalamic-Pituitary Axis	477	(10)
Anatomy	477	(1)
Anterior Pituitary Hormone Physiology and Testing	477	(3)
Neuroradiologic Evaluation of the Pituitary	480	(1)
Pituitary and Hypothalamic Disorders	481	(1)
Hypothalamic Dysfunction	481	(1)
Hypopituitarism	481	(1)
Empty Sella Syndrome	482	(1)
Pituitary Tumors	483	(2)
The Posterior Pituitary Gland	485	(1)
Di	485	(1)
Siadh	486	(1)
The Thyroid Gland	487	(10)
Thyroid Hormone Physiology	487	(1)
Thyroid Evaluation	488	(1)
Hyperthyroidism	489	(1)
Graves' Disease	490	(1)
Toxic Adenoma	491	(1)
Toxic Multinodular Goiter	491	(1)
Thyroiditis	491	(1)
Thyrotoxicosis Factitia	492	(1)
Rare Causes of Thyrotoxicosis	492	(1)
Hypothyroidism	492	(2)
Goiter	494	(1)
Solitary Thyroid Nodules	494	(1)
Thyroid Carcinoma	495	(2)
Adrenal Gland	497	(12)
Physiology	497	(1)
Adrenal Insufficiency	498	(3)
Hyporeninemic Hypoaldosteronism	501	(1)
Congenital Adrenal Hyperplasia	501	(1)
Syndromes of Adrenocorticoid Hyperfunction	502	(7)
Female Reproductive Endocrinology	509	(10)
Normal Sexual Development	509	(1)
Precocious Puberty	509	(2)
Amenorrhea	511	(3)
Hirsutism	514	(3)
Infertility	517	(1)
Dysmenorrhea	517	(1)
Premenstrual Syndrome (PMS)	517	(1)
Menopause	518	(1)
Cancer of the Breast, Cervix, Uterus, and Ovary	519	(6)
Cancer of the Breast	519	(1)
Carcinoma of the Cervix	520	(1)
Cancer of the Uterus	521	(2)
Ovarian Carcinoma	523	(2)
Male Reproductive Endocrinology	525	(8)
Hypogonadism	525	(4)
Primary Gonadal Abnormalities	529	(1)
Defects in Androgen Action	529	(1)
Impotence	529	(1)
Gynecomastia	529	(1)
Testicular Tumors	530	(1)
Benign Prostatic Hyperplasia	531	(1)
Carcinoma of the Prostate	531	(2)
Diabetes Mellitus	533	(13)
Basic Classification	533	(2)
Diagnosis	535	(1)
Pathogenesis	535	(1)
Treatment of Diabetes	536	(3)
Complications	539	(7)
Hypoglycemia	546	(7)
Definition of a Low Blood Glucose Level	546	(1)
Normal Physiology	546	(1)
Causes of Hypoglycemia	547	(3)
Diagnostic Work-Up for Hypoglycemia	550	(1)
Treatment	550	(3)
Section XI DISEASES OF BONE AND BONE MINERAL METABOLISM	553	(34)
Normal Physiology of Bone and Bone Minerals	555	(9)
Bone Structure and Metabolism	555	(1)
Calcium Metabolism	555	(2)
Phosphorus Metabolism	557	(2)
Magnesium Metabolism	559	(2)
Vitamin D	561	(1)
Calcitonin	562	(2)
The Parathyroid Glands, Hypercalcemia, and Hypocalcemia	564	(9)
Normal Physiology	564	(1)
Hypercalcemia	564	(5)
Hypocalcemia	569	(4)
Osteomalacia and Rickets	573	(4)
Pathogenesis	573	(1)
Specific Causes	573	(2)
Clinical Manifestations	575	(1)
Laboratory and Radiographic Features	575	(1)
Diagnosis	576	(1)
Treatment	576	(1)
Osteoporosis	577	(7)
General Considerations	577	(1)
Etiology and Pathogenesis	577	(2)
Clinical Manifestations	579	(1)
Radiographic Findings	579	(1)
Diagnosis	579	(2)
Treatment	581	(1)
Glucocorticoid-Induced Bone Loss	582	(2)
Paget's Disease of Bone	584	(3)
Incidence and Prevalence	584	(1)
Etiology	584	(1)
Pathology and Pathophysiology	584	(1)
Clinical Picture	584	(1)
Associated Conditions	585	(1)
Laboratory Assessment	585	(1)
Treatment	585	(2)
Sectiion XII MUSCULOSKELETAL AND CONNECTIVE TISSUE DISEASE	587	(50)
Approach to the Patient with Musculoskeletal Disease	589	(5)
Laboratory Tests	589	(3)
Radiologic Evaluation	592	(2)
Rheumatoid Arthritis	594	(4)
Pathogenesis	594	(1)
Clinical Manifestations	594	(2)
Treatment	596	(2)
Systemic Lupus Erythematosus	598	(5)
Etiology and Pathogenesis	598	(1)
Clinical Features	599	(2)
Laboratory Evaluation	601	(1)
Treatment	601	(2)
Sjogren's Syndrome	603	(2)
Clinical Features	603	(1)
Diagnosis	603	(1)
Treatment	604	(1)
Idiopathic Inflammatory Myopathies	605	(3)
Clinical Course	605	(1)
Diagnostic and Laboratory Findings	606	(1)
Treatment	606	(2)
Scleroderma (Systemic Sclerosis)	608	(4)
Localized Scleroderma	608	(1)
Limited Systemic Sclerosis (CREST Variant)	608	(1)
Diffuse Systemic Sclerosis	608	(1)
Scleroderma Sine Scleroderma	608	(1)
Clinical Features	608	(2)
Differential Diagnosis	610	(1)
Treatment	611	(1)
Mixed Connective Tissue Disease, Overlap Syndrome, and Antiphospholipid Antibody Syndrome	612	(2)
Mixed Connective Tissue Disease and Overlap Syndrome	612	(1)
Antiphospholipid Antibody Syndrome	612	(2)
Vasculitides	614	(6)
Classification	614	(1)
Immunopathogenesis	614	(1)
Hypersensitivity Angiitis	614	(1)
Polyarteritis Nodosa	615	(1)
Allergic Vasculitis of Churg and Strauss	616	(1)
Wegener's Granulomatosis	616	(1)
Polymyalgia Rheumatica and Giant Cell Arteritis	617	(3)
The Spondyloarthropathies	620	(4)
Ankylosing Spondylitis	620	(1)
Reiter's Syndrome	621	(2)
Psoriatic Arthritis	623	(1)
Arthritis Associated with Inflammatory Bowel Disease	623	(1)
Osteoarthritis	624	(3)
Classification	624	(1)
Etiology and Pathogenesis	624	(1)
Clinical Features	624	(2)
Differential Diagnosis	626	(1)
Treatment	626	(1)
The Crystal-Induced Arthropathies	627	(2)
Chondrocalcinosis and Associated Disorders	627	(2)
Miscellaneous Forms of Arthritis	629	(5)
Musculoskeletal Syndromes Associated with Malignancy	629	(1)
Arthropathies Associated with Endocrine Diseases	630	(1)
Additional Miscellaneous Disorders	631	(3)
Nonarticular Rheumatism	634	(3)
Painful Shoulder	634	(1)
Bursitis	634	(1)
Carpal Tunnel Syndrome	634	(1)
Fibromyalgia Syndrome	635	(2)
Section XIII INFECTIOUS DISEASE	637	(144)
Organisms that Infect Humans	639	(6)
Viruses	639	(1)
Chlamydiae	639	(1)
Rickettsiae	639	(1)
Mycoplasmas	640	(1)
Bacteria	640	(2)
Fungi	642	(1)
Protozoans	643	(1)
Helminths	643	(2)
Host Defenses Against Infection	645	(8)
Local Barriers to Infection	645	(1)
Components of the Immune System	646	(3)
Nonspecific Effector Mechanisms	649	(1)
Resistance to Extracellur Bacteria	650	(1)
Resistance to Obligate Intracellular Parasites: Viruses	651	(1)
Resistance to Faculative Intracellular Parasites: Mycobacterium Tuberculosis	652	(1)
Laboratory Diagnosis of Infectious Diseases	653	(4)
Diagnosis by Direct Visualization of the Organism	653	(1)
Diagnosis by Detection of Microbial Antigens	654	(1)
Diagnosis by Examination of Host Immune or Inflammatory Responses	655	(1)
Diagnosis by Detection of Microbial Nucleotide Sequences	655	(1)
Diagnosis by Isolation of the Organism in Culture	655	(2)
Antimicrobial Therapy	657	(6)
The Pathogen	657	(1)
Site of Infection	657	(2)
Characteristics of the Antimicrobial	659	(1)
Route of Administration	660	(1)
Monitoring of Antimicrobial Therapy	660	(1)
Antiviral Agents	660	(1)
Antifungal Agents	661	(2)
Fever and Febrile Syndromes	663	(14)
Regulation of Body Temperature	663	(1)
Fever and Hyperthermia	663	(2)
Acute Febrile Syndromes	665	(8)
Fuo	673	(4)
Bacteremia	677	(5)
Epidemiology	677	(1)
Pathogenesis	678	(1)
Clinical Manifestations	679	(1)
Diagnosis	680	(1)
Therapy	680	(2)
Infections of the Nervous System	682	(11)
Meningitis	683	(5)
Encephalitis	688	(2)
Spectrum of Tuberculous, Fungal, and Parasitic Infections	690	(3)
Infections of the Head and Neck	693	(6)
Infections of the Ear	693	(1)
Infections of the Nose and Sinuses	693	(1)
Infections of the Mouth and Pharynx	694	(5)
Infections of the Lower Respiratory Tract	699	(9)
Pathogenesis of Pneumonia	699	(1)
Epidemiology	699	(1)
Diagnostic Approach to the Patient	700	(1)
Radiographic Patterns in Patients with Pneumonia	700	(1)
Other Laboratory Findings	701	(1)
Diagnosis and Management of the Patient with Pneumonia	701	(1)
Specific Pathogenic Organisms	702	(3)
Treatment and Outcome	705	(2)
Prevention	707	(1)
Infections of the Heart and Vessels	708	(7)
Infective Endocarditis (IE)	708	(4)
Prosthetic Valve Endocarditis (PVE)	712	(1)
Prophylaxis of Infective Endocarditis	712	(1)
Bacterial Endarteritis and Suppurative Phlebitis	713	(2)
Skin and Soft Tissue Infections	715	(5)
Superficial Infections of the Skin	715	(4)
Deeper Infections of the Skin and Soft Tissue	719	(1)
Intra-Abdominal Abscess and Peritonitis	720	(4)
Intra-Abdominal Abscess	720	(1)
Abscesses of Solid Organs	720	(2)
Extravisceral Abscesses	722	(1)
Peritonitis	722	(2)
Acute Infectious Diarrhea	724	(6)
Pathogenesis and Pathophysiology: General Concepts	724	(1)
Types of Microbial Diarrheal Diseases	724	(2)
General Epidemiologic Considerations	726	(1)
Diagnosis	727	(1)
Management: General Principles of Electrolyte Repletion Therapy	727	(3)
Infections Involving Bones and Joints	730	(4)
Arthritis	730	(2)
Septic Bursitis	732	(1)
Osteomyelitis	732	(2)
Infections of the Urinary Tract	734	(3)
Urethritis	734	(1)
Cystitis and Pyelonephritis	734	(2)
Prostatitis	736	(1)
Nosocomial Infections	737	(4)
Approach to the Hospitalized Patient with Suspected Nosocomial Infection	737	(1)
Nosocomial Pneumonia	738	(1)
Intravascular Catheter-Related Infections	739	(1)
Pressure Sores	739	(1)
Nosocomial Urinary Tract Infection	739	(2)
Sexually Transmitted Diseases	741	(8)
Genital Sores	741	(4)
Urethritis, Cervicitis, and Pelvic Inflammatory Disease (PID)	745	(4)
HIV Infection and the Acquired Immunodeficiency Syndrome	749	(20)
Epidemiology	749	(2)
Pathophysiology	751	(2)
Diagnosis and Testing for HIV Infection	753	(2)
Sequential Clinical Manifestations of HIV-1 Infection	755	(1)
Management of HIV Infection	756	(3)
Management of Specific Clinical Manifestations of Immunodeficiency: A Problem-Oriented Approach	759	(1)
Mucocutaneous Diseases	759	(2)
Nervous System Diseases	761	(2)
Pulmonary Diseases	763	(1)
Gastrointestinal Diseases	764	(2)
Other Complications of HIV Infection	766	(1)
Prevention of HIV Infection	767	(2)
Infections in the Immunocompromised Host	769	(4)
Disorders of Cell-Mediated Immunity	769	(1)
Disorders of Humoral Immunity	769	(1)
Impaired Neutrophil Function	770	(1)
Neutropenia	770	(1)
Diagnostic Problems in the Compromised Host	771	(1)
Prevention and Treatment of Infections in the Neutropenic Patient	772	(1)
Infectious Diseases of Travelers; Protozoal and Helminthic Infections	773	(8)
Preparation of Travelers	773	(2)
The Returning Traveler	775	(1)
Protozoal and Helminthic Infections	776	(5)
Section XIV NEUROLOGIC DISEASE	781	(148)
Neurologic Evaluation of the Patient	783	(6)
The Neurologic History	783	(1)
The Neurologic Examination	784	(1)
Diagnostic Tests: Scope and Limitations	785	(4)
Disorders of Consciousness and Higher Brain Function	789	(14)
Sleep and Its Disorders	789	(1)
Pathologic Alterations of Consciousness	790	(6)
Focal Disturbances of Higher Brain Function	796	(3)
Dementia	799	(4)
Disorders of Mood and Behavior	803	(12)
Psychiatric Disorders	803	(4)
Drug and Alcohol Abuse	807	(8)
Disorders of Autonomic Function	815	(3)
Hypothalamus (HT)	815	(2)
Central and Peripheral Autonomic Insufficiencies	817	(1)
Disorders of Sensory Function	818	(21)
Pain and Painful Syndromes	818	(8)
The Special Senses	826	(13)
Disorders of the Motor System	839	(19)
Mechanisms of Normal and Abnormal Motor Function	839	(6)
Movement Disorders	845	(4)
The Major Cerebellar Ataxias	849	(3)
Mechanical Lesions of the Spine and Spinal Cord	852	(6)
Cerebrovascular Disease	858	(16)
Anatomy and Pathophysiology of the Cerebral Circulation	858	(1)
Epidemiology and Risk Factors	859	(1)
Ischemic Stroke	860	(8)
Spontaneous Parenchymal Cerebral Hemorrhage	868	(3)
Intracranial Aneurysms	871	(2)
Arteriovenous Malformations (AVMs)	873	(1)
Trauma to the Head and Spine	874	(5)
Head/Brain Injury	874	(3)
Spinal Cord Injury	877	(2)
Epilepsy	879	(9)
Incidence and General Etiology	879	(1)
Pathophysiology	879	(1)
Clinical Seizure Patterns	879	(5)
Management	884	(4)
Intracranial Neoplasms, CNS Complications of Cancer, and States of Altered Intracranial Pressure	888	(10)
Intracranial Neoplasms	888	(5)
Spinal Neoplasms	893	(1)
Paraneoplastic Syndromes	893	(2)
Non-Neoplastic Alterations of Intracranial Pressure	895	(3)
Infectious and Inflammatory Disorders of the Nervous System	898	(9)
Bacterial Infections of the Brain	898	(4)
Slow Virus Infections of the Nervous System	902	(1)
Demyelinating and Other CNS Inflammatory Disorders of Probable Immune Cause	903	(4)
Motor Nerve, Nerve Root, Peripheral Nerve, and Neurocutaneous Disorders	907	(14)
Peripheral Nerve Disorders	907	(3)
Mono- and Polyneuropathies Affecting Somatic Cranial Nerve Functions	910	(3)
Neurocutaneous Syndromes	913	(1)
The Motor Neuron Dieseases	913	(2)
Focal Radiculopathy and Neuropathy	915	(4)
Polyneuropathy	919	(2)
Disorders of Myoneural Junction and Skeletal Muscle	921	(8)
Disorders of Myoneural Junction	921	(2)
Disorders of Skeletal Muscle	923	(6)
Section XV THE AGING PATIENT	929	(10)
The Biology of Aging	931	(8)
The Demographics of Aging and Implications for Health Care	931	(2)
Assessment of the Older Patient	933	(2)
Common and Often Inadequately Assessed Medical Problems of the Elderly	935	(4)
Section XVI SUBSTANCE ABUSE	939	(12)
Alcohol and Substance Abuse	941	(10)
Screening	941	(1)
Tobacco and Alcohol Abuse	941	(4)
Prescription Drug Abuse	945	(2)
Illicit Drug Abuse	947	(4)
Appendix: Commonly Measured Laboratory Values	951	(4)
Index	955