Cecil Essentials of Medicine

by Andreoli, Thomas E.

• ISBN13: 9780721681795
• ISBN10: 0721681794
• Edition: 5th
• Format: Paperback
• Copyright: 2000-10-01
• Publisher: Elsevier Science Health Science div

Summary

The new edition of this book, which has been trusted for nearly 20 years, presents the core of internal medicine in an easy-to-read format. In addition to three new sections, seven have been entirely rewritten, and the remaining have been exhaustively revised.

Table of Contents

SECTION I Introduction to Molecular Medicine	1	(12)
The Molecular Basis of Human Disease	3	(10)
Joseph Loscalzo
Deoxyribonucleic Acid and the Genetic Code	3	(2)
Regulation of Gene Expression	5	(2)
Genetic Variation, Population Diversity, and Genetic Polymorphisms	7	(1)
Genes and Human Disease	8	(1)
Gene Mapping	9	(1)
Identifying Mutant Genes	10	(1)
Molecular Diagnostics	11	(1)
Genetic Therapies	12	(1)
Promising Advances	12	(1)
SECTION II Decision-Making in Medical Practice	13	(6)
Evidence-Based Medicine	15	(4)
Awny S. Farajallah
Susan S. Beland
Searching for Relevant Information	15	(1)
Critical Appraisal of the Literature	16	(1)
Evaluating Evidence About Diagnostic Tests	16	(1)
Evaluating Evidence About Outcome	17	(1)
Evaluating Evidence About Treatment	17	(1)
Including the Patient in the Decision Process	18	(1)
SECTION III Cardiovascular Disease	19	(146)
Structure and Function of the Normal Heart and Blood Vessels	21	(9)
Eric H. Awtry
Joseph Loscalzo
Microscopic Anatomy	21	(1)
Gross Anatomy	21	(1)
The Circulatory Pathway	22	(1)
The Conduction System	23	(1)
Neural Innervation	24	(1)
Physiology of Contraction	24	(1)
Circulatory Physiology and the Cardiac Cycle	24	(1)
Cardiac Performance	25	(2)
Physiology of the Coronary Circulation	27	(1)
Physiology of the Systemic Circulation	28	(1)
Physiology of the Pulmonary Circulation	28	(1)
Cardiovascular Response to Exercise	29	(1)
Evaluation of the Patient with Cardiovascular Disease	30	(13)
Eric H. Awtry
Joseph Loscalzo
History	30	(4)
Physical Examination	34	(3)
Auscultation	37	(6)
Diagnostic Tests and Procedures in the Patient with Cardiovascular Disease	43	(13)
Lisa A. Mendes
Joseph Loscalzo
Chest Radiography	43	(1)
Electrocardiography	43	(2)
Abnormal ECG Patterns	45	(2)
Long-Term Ambulatory ECG Recording	47	(1)
Stress Testing	48	(2)
Echocardiography	50	(2)
Nuclear Cardiology	52	(1)
Cardiac Catheterization	52	(1)
Right-Sided Heart Catheterization	53	(1)
Other Procedures	53	(2)
Noninvasive Vascular Testing	55	(1)
Heart Failure and Cardiomyopathy	56	(7)
Lisa A. Mendes
Joseph Loscalzo
Forms of Heart Failure	56	(1)
Adaptive Mechanisms in Heart Failure	56	(1)
Evaluation and Treatment of Patients with Heart Failure	57	(2)
Treatment	59	(1)
Refractory Heart Failure	60	(1)
Cardiovascular Assist Devices	61	(1)
Acute Pulmonary Edema	61	(1)
Diastolic Dysfunction	61	(2)
Congenital Heart Disease	63	(6)
Lisa A. Mendes
Joseph Loscalzo
General Considerations	63	(1)
Fetal and Transitional Circulations	63	(1)
Congenital Aortic Stenosis	63	(1)
Coarctation of the Aorta	64	(1)
Pulmonic Valve Stenosis	65	(1)
Tetralogy of Fallot	65	(1)
Atrial Septal Defect	66	(1)
Ventricular Septal Defect	67	(1)
Patent Ductus Arteriosus	68	(1)
Other Congenital Abnormalities	68	(1)
Acquired Valvular Heart Disease	69	(10)
Lisa A. Mendes
Joseph Loscalzo
Aortic Stenosis	69	(1)
Aortic Regurgitation	70	(2)
Mitral Stenosis	72	(2)
Mitral Regurgitation	74	(1)
Mitral Valve Prolapse	74	(1)
Tricuspid Stenosis	75	(1)
Tricuspid Regurgitation	75	(1)
Pulmonic Stenosis and Regurgitation	76	(1)
Multivalvular Disease	76	(1)
Rheumatic Heart Disease	76	(1)
Prosthetic Heart Valves	77	(1)
Endocarditis Prophylaxis	77	(2)
Coronary Heart Disease	79	(21)
Eric H. Awtry
Joseph Loscalzo
Epidemiology	79	(1)
Pathophysiology of Atherosclerosis	79	(1)
Risk Factors	80	(1)
Nonatherosclerotic Causes of Cardiac Ischemia	81	(1)
Pathophysiology and Consequences of Myocardial Ischemia	82	(1)
Angina Pectoris	82	(8)
Acute Myocardial Infarction	90	(10)
Cardiac Arrhythmias	100	(27)
Eric H. Awtry
Joseph Loscalzo
Mechanisms of Arrhythmogenesis	100	(3)
Approach to the Patient with Suspected Arrhythmias	103	(1)
Management of Cardiac Arrhythmias	104	(7)
Specific Arrhythmias	111	(9)
Heart Block	120	(2)
Clinical Syndromes	122	(3)
Principles of Cardiopulmonary Resuscitation	125	(2)
Myocardial and Pericardial Disease	127	(10)
Lisa A. Mendes
Joseph Loscalzo
Myocarditis	127	(1)
Cardiomyopathy	128	(3)
Amyloidosis	131	(1)
Pericardial Disease	132	(5)
Other Cardiac Topics	137	(8)
Lisa A. Mendes
Joseph Loscalzo
Cardiac Tumors	137	(1)
Traumatic Heart Disease	138	(1)
Cardiac Surgery	139	(1)
Noncardiac Surgery in the Cardiac Patient	140	(2)
Cardiac Disease in Pregnancy	142	(1)
Specific Cardiac Conditions	142	(3)
Vascular Diseases and Hypertension	145	(20)
Eric H. Awtry
Joseph Loscalzo
Systemic Vascular Disease	145	(7)
Venous Thromboembolic Disease	152	(3)
Pulmonary Vascular Disease	155	(2)
Hypertension	157	(8)
SECTION IV Pulmonary and Critical Care Medicine	165	(56)
Approach to the Patient with Respiratory Disease	167	(5)
Bonnie S. Slovis
Kenneth L. Brigham
Common Presenting Complaints	167	(2)
Physical Examination	169	(3)
Anatomic and Physiologic Consideration	172	(9)
Bonnie S. Slovis
Kenneth L. Brigham
Anatomy	172	(1)
Physiology	173	(4)
Abnormalities of Pulmonary Gas Exchange	177	(4)
Diagnostic Techniques and Their Indications	181	(4)
Bonnie S. Slovis
Kenneth L. Brigham
Imaging Procedures	181	(1)
Evaluation of Lung Function	181	(4)
Obstructive Lung Disease	185	(9)
Bonnie S. Slovis
Kenneth L. Brigham
Pathophysiology of Air Flow Obstruction	185	(1)
Asthma	186	(1)
Chronic Obstructive Pulmonary Disease	187	(2)
Bronchiectasis	189	(1)
Cystic Fibrosis	189	(1)
Treatment	190	(4)
Interstitial and Infiltrative Lung Disease	194	(7)
Bonnie S. Slovis
Kenneth L. Brigham
Pathophysiology and Clinical Manifestations	194	(7)
Disorders of the Pleural Space, Mediastinum, and Chest Wall	201	(5)
Bonnie S. Slovis
Kenneth L. Brigham
Pleural Disease	201	(2)
Mediastinal Disease	203	(1)
Chest Wall Disease	203	(3)
Neoplastic Diseases of the Lung	206	(4)
Bonnie S. Slovis
Kenneth L. Brigham
Risk Factors	206	(1)
Pathology	206	(1)
Clinical Presentation	206	(1)
Diagnosis and Evaluation	207	(1)
Solitary Pulmonary Nodule	208	(1)
Treatment and Prognosis	209	(1)
Disordered Breathing	210	(3)
Bonnie S. Slovis
Kenneth L. Brigham
Sleep Apnea Syndrome	210	(1)
Other Breathing Disorders	211	(2)
Environmental and Occupational Injury	213	(3)
Bonnie S. Slovis
Kenneth L. Brigham
Pneumoconioses	213	(1)
Air Pollution	213	(1)
Noxious Gases and Fumes	214	(1)
Smoke Inhalation	214	(1)
High-Altitude Injury	215	(1)
Drowning and Near-Drowning	215	(1)
Essentials of Pulmonary Critical Care Medicine	216	(5)
Bonnie S. Slovis
Kenneth L. Brigham
Shock	216	(1)
Acute Respiratory Failure	217	(1)
Oxygen Therapy	217	(1)
Mechanical Ventilation	218	(1)
Complications of Endotracheal Intubation and Mechanical Ventilation	219	(1)
Systemic Inflammatory Response Syndrome, Sepsis, Multiple Organ Dysfunction Syndrome, and Adult Respiratory Distress Syndrome	219	(2)
SECTION V Renal Disease	221	(80)
Elements of Renal Structure and Function	223	(9)
Dinesh K. Chatoth
Elements of Renal Structure	223	(3)
Elements of Renal Physiology	226	(6)
Approach to the Patient with Renal Disease	232	(6)
Yousri M. H. Barri
Sudhir V. Shah
Assessment of the Patient with Renal Disease	232	(2)
The Major Renal Syndromes	234	(2)
Radiologic Imaging of the Urinary Tract	236	(1)
Renal Biopsy	237	(1)
Fluid and Electrolyte Disorders	238	(15)
Thomas E. Andreoli
Sameh R. Abul-Ezz
Volume Disorders	238	(3)
Osmolality Disorders	241	(1)
Hyponatremia	242	(2)
Hypernatremia	244	(1)
Disturbances in Potassium Balance	245	(3)
Disturbances in Acid-Base Balance	248	(5)
Glomerular Diseases	253	(13)
Sudhir V. Shah
The Glomerulus	253	(1)
Mechanisms of Glomerular Injury	253	(1)
Clinical Manifestations of Glomerular Disease	253	(2)
Approach to the Patient with Glomerular Disease	255	(1)
Acute Nephritic Syndrome	255	(2)
Rapidly Progressive Glomerulonephritis	257	(1)
Nephrotic Syndrome	258	(5)
Asymptomatic Urinary Abnormalities	263	(3)
Major Nonglomerular Disorders	266	(12)
Dinesh K. Chatoth
Tubulointerstitial Nephropathy	266	(3)
Cystic Diseases of the Kidney	269	(2)
Urinary Tract Obstruction	271	(1)
Nephrolithiasis	272	(3)
Renal Neoplasia	275	(3)
Vascular Disorders of the Kidney	278	(5)
Yousri M. H. Barri
Renal Arterial Occlusion	278	(1)
Ischemic Renal Disease	278	(1)
Arterioles and Microvasculature	279	(1)
Atheroembolic Diseases of the Kidney	279	(1)
Chronic Hypertensive Nephrosclerosis	280	(1)
Malignant Nephrosclerosis	280	(1)
Scleroderma	280	(1)
Hemolytic-Uremic Syndrome and Thrombotic Thrombocytopenic Purpura	281	(1)
Antiphospholipid Syndrome and the Kidney	281	(1)
Renal Vein Thrombosis	282	(1)
Acute Renal Failure	283	(8)
Sudhir V. Shah
Definition and Etiology	283	(1)
Differential Diagnosis and Diagnostic Evaluation of the Patient	283	(4)
Clinical Presentation, Complications, and Management of Acute Tubular Necrosis	287	(1)
Specific Causes of Acute Renal Failure	288	(3)
Chronic Renal Failure	291	(10)
Mary Jo Shaver
Adaptation to Nephron Loss	291	(1)
Conservative Management	292	(1)
Clinical Manifestations	293	(3)
Treatment of End-Stage Renal Failure	296	(5)
SECTION VI Gastrointestinal Disease	301	(64)
Common Clinical Manifestations of Gastrointestinal Disease	303	(18)
Abdominal Pain	303	(3)
Edgar Achkar
Physiology	303	(1)
Causes of Abdominal Pain	303	(1)
Clinical Features	303	(2)
The Acute Abdomen	305	(1)
Chronic Abdominal Pain	305	(1)
Gastrointestinal Hemorrhage	306	(4)
Gregory Zucaro, Jr.
Acute Gastrointestinal Hemorrhage	306	(3)
Chronic Gastrointestinal Hemorrhage	309	(1)
Malabsorption	310	(6)
Edy E. Soffer
Digestion and Absorption of Fat	310	(1)
Digestion and Absorption of Carbohydrates	310	(1)
Digestion and Absorption of Proteins	310	(1)
Mechanisms of Malabsorption	310	(1)
Multiple Mechanisms	311	(1)
Clinical Manifestations of Malabsorption	311	(1)
Tests for Malabsorption	312	(2)
Approach to the Patient with Suspected Malabsorption	314	(1)
Treatment	314	(2)
Diarrhea	316	(5)
Edy E. Soffer
Definition	316	(1)
Normal Physiology	316	(1)
Pathophysiology	317	(1)
Evaluation of Diarrhea	318	(3)
Endoscopic and Radiographic Procedures in Gastroenterology	321	(5)
John J. Vargo II
Gastrointestinal Endoscopy	321	(1)
Esophagogastroduodenoscopy and Enteroscopy	321	(1)
Endoscopic Retrograde Cholangiopancreatography	322	(1)
Endoscopic Ultrasonography	323	(1)
Sigmoidoscopy and Colonoscopy	323	(1)
Radiographic Procedures	323	(3)
Diseases of the Esophagus	326	(6)
Joel E. Richter
Normal Esophageal Physiology	326	(1)
Clinical Symptoms of Esophageal Disease	326	(1)
Gastroesophageal Reflux Disease	327	(2)
Motility Disorders of the Oropharynx and Esophagus	329	(1)
Other Esophageal Disorders	330	(2)
Diseases of the Stomach and Duodenum	332	(13)
Gary W. Falk
Gastroduodenal Anatomy	332	(1)
Gastroduodenal Mucosal Secretion and Protective Factors	332	(1)
Gastroduodenal Motor Physiology	333	(1)
Gastritis	334	(1)
Peptic Ulcer Disease	335	(6)
Zollinger-Ellison Syndrome	341	(1)
Delayed Gastric Emptying	342	(1)
Rapid Gastric Emptying	343	(2)
Inflammatory Bowel Disease	345	(6)
Aaron Brzezinski
Etiology	345	(1)
Incidence and Epidemiology	345	(1)
Ulcerative Colitis: Clinical Features	346	(1)
Crohn's Disease: Clinical Features	346	(1)
Extraintestinal Manifestations	346	(1)
Other Complications	346	(1)
Colon Cancer	347	(1)
Diagnosis	347	(1)
Differential Diagnosis	347	(1)
Treatment	347	(4)
Neoplasms of the Gastrointestinal Tract	351	(5)
Carol A. Burke
Esophageal Carcinoma	351	(1)
Gastric Carcinoma	352	(1)
Colorectal Polyps and Carcinoma	353	(1)
The Polyposis Syndromes	354	(1)
Carcinoid Tumors	355	(1)
Diseases of the Pancreas	356	(9)
Darwin L. Conwell
Anatomy and Physiology	356	(2)
Acute Pancreatitis	358	(3)
Chronic Pancreatitis	361	(1)
Carcinoma of the Pancreas	362	(3)
SECTION VII Diseases of the Liver and Biliary System	365	(38)
Laboratory Tests in Liver Disease	367	(4)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Clinical Approach to Liver Disease	367	(1)
Laboratory Tests of Liver Function and Disease	367	(3)
Liver Biopsy	370	(1)
Jaundice	371	(5)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Bilirubin Metabolism	371	(1)
Laboratory Tests for Bilirubin	371	(1)
Clinical Classification	372	(2)
Approach to Diagnosis	374	(2)
Acute and Chronic Hepatitis	376	(9)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Acute Hepatitis	376	(7)
Chronic Hepatitis	383	(2)
Fulminant Hepatic Failure	385	(2)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Diagnosis	385	(1)
Treatment	385	(1)
Hepatic Transplantation	386	(1)
Prognosis	386	(1)
Cirrhosis of the Liver and its Complications	387	(7)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Clinical and Laboratory Features	387	(1)
Specific Causes	387	(1)
Major Complications	388	(4)
Hepatic Transplantation	392	(2)
Neoplastic, Infiltrative, and Vascular Diseases of the Liver	394	(4)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Hepatic Neoplasms	394	(1)
Liver Abscess	395	(1)
Granulomatous Liver Disease	395	(1)
Diagnostic Approach to Hepatic Lesions	396	(1)
Vascular Disease of the Liver	396	(2)
Disorders of the Gallbladder and Biliary Tract	398	(5)
Michael B. Fallon
Brendan M. McGuire
Gary A. Abrams
Miguel R. Arguedas
Normal Biliary Physiology	398	(1)
Pathophysiology of Gallstone Formation (Cholelithiasis)	398	(1)
Clinical Manifestations of Gallstones	399	(4)
SECTION VIII Hematologic Disease	403	(80)
Hematopoiesis and Hematopoetic Failure	405	(5)
Eunice S. Wang
Nancy Berliner
Hematopoietic Tissues	405	(1)
Stem Cell Theory of Hematopoiesis	405	(1)
Hematopoietic Differentiation Pathway	406	(2)
Disorders of Hematopoiesis	408	(2)
Clonal Disorders of the Hematopoietic Stem Cell	410	(9)
Eunice S. Wang
Nancy Berliner
Myelodysplastic Disorders	410	(2)
Myeloproliferative Disorders	412	(2)
Chronic Myelogenous Leukemia	414	(1)
Acute Leukemias	415	(4)
Disorders of Red Blood Cells	419	(12)
Nancy Berliner
Normal Red Blood Cell Structure and Function	419	(1)
Clinical Approach to Anemia	419	(1)
Evaluation of Hypoproliferative Anemia	420	(11)
Clinical Disorders of Neutrophils	431	(4)
Nancy Berliner
Normal Granulocyte Development, Structure, and Function	431	(1)
Determinants of Peripheral Neutrophil Number	432	(1)
Evaluation of Leukocytosis (Neutrophilia)	433	(1)
Evaluation of Leukopenia (Neutropenia)	433	(2)
Disorders of Lymphocytes	435	(14)
Jill Lacy
Cells of the Immune System: Lymphocyte Development, Function, and Localization	435	(2)
Neoplasia of Lymphoid Origin	437	(12)
Normal Hemostasis	449	(8)
Henry M. Rinder
Vascular Wall Physiology	449	(1)
Platelet Physiology	450	(3)
Coagulation Cascade	453	(3)
Endothelial-Associated Fibrinolysis	456	(1)
Disorders of Hemostasis: Bleeding	457	(16)
Henry M. Rinder
Clinical Evaluation of Bleeding	457	(1)
Vascular Causes of Bleeding	457	(2)
Bleeding Caused by Platelet Disorders: Thrombocytopenia	459	(6)
Bleeding Caused by Platelet Disorders: Qualitative Platelet Defects	465	(3)
Fibrinogen Disorders	468	(1)
Bleeding Caused by Coagulation Factor Disorders	469	(2)
Bleeding in Patients with a Normal Laboratory Screen	471	(2)
Disorders of Hemostasis: Thrombosis	473	(10)
Henry M. Rinder
Clinical Evaluation of Thrombosis	473	(1)
Vascular Causes of Thrombosis	473	(1)
Atherothrombosis	473	(2)
Inherited Risk Factors for Venous Thrombosis	475	(1)
Acquired Risk Factors for Venous Thrombosis	476	(1)
Hypercoagulability and Platelet Disorders	477	(1)
Laboratory Evaluation of Thrombosis	477	(1)
Therapy for Venous Thromboembolism	478	(2)
Venous Thromboembolism During Pregnancy	480	(1)
Perioperative Anticoagulation	480	(1)
Future Anticoagulant Strategies	481	(2)
SECTION IX Oncologic Disease	483	(30)
Cancer Etiology: Oncogenes and Environmental/Toxic Factors	485	(4)
Christopher E. Desch
Cancer Phenotype	485	(1)
Cancer Genetics	485	(1)
Etiology	486	(3)
Cancer Epidemiology and Cancer Prevention	489	(4)
Jennifer J. Griggs
Cancer Epidemiology	489	(1)
Cancer Prevention	489	(4)
Solid Tumors	493	(12)
Jennifer J. Griggs
Christopher E. Desch
Lung Cancer	493	(2)
Gastrointestinal Cancers	495	(3)
Breast Cancer	498	(1)
Genitourinary Cancers	499	(4)
Melanoma	503	(2)
Complications of Cancer	505	(3)
Jennifer J. Griggs
Spinal Cord Compression	505	(1)
Superior Vena Cava Syndrome	506	(1)
Hypercalcemia	506	(1)
Paraneoplastic Syndromes	507	(1)
Principles of Cancer Treatment	508	(5)
Christopher E. Desch
Radiology	508	(1)
Surgery	508	(1)
Radiation Therapy	508	(1)
Chemotherapy	509	(1)
Hormonal Therapy	510	(1)
Supportive Care	511	(1)
Biologic Therapy	511	(1)
Bone Marrow Transplantation	511	(2)
SECTION X Metabolic Disease	513	(30)
Eating Disorders	515	(7)
Peter N. Herbert
Obesity	515	(4)
Anorexia Nervosa and Bulimia Nervosa	519	(3)
Principles of Nutritional Support in Adult Patients	522	(4)
Peter N. Herbert
Nutritional Assessment	522	(1)
Route of Nutritional Support	522	(1)
Water	523	(1)
Calories and Protein	523	(1)
Vitamins and Minerals	524	(1)
Home Nutritional Support	524	(2)
Disorders of Lipid Metabolism	526	(7)
Peter N. Herbert
Plasma Lipoprotein Physiology	526	(1)
Evaluation of Serum Lipoprotein Concentrations	527	(1)
Elevated Chylomicrons, VLDL, and IDL	528	(1)
Treatment of Hypertriglyceridemia	529	(1)
Elevated LDL	530	(1)
Treatment of Hypercholesterolemia	530	(1)
Lipids and Vascular Disease	531	(2)
Disorders of Metals and Metalloproteins	533	(6)
Peter N. Herbert
Wilson's Disease	533	(1)
Treatment	534	(1)
Hemochromatosis	534	(2)
Porphyrias	536	(3)
Inherited Disorders of Connective Tissue	539	(4)
Peter N. Herbert
Collagen Disorders	539	(1)
Marfan's Syndrome	540	(1)
Pseudoxanthoma Elasticum	541	(2)
SECTION XI Endocrine Disease	543	(62)
Hypothalamic-Pituitary Axis	545	(10)
Vivien Herman-Bonert
Antomy	545	(1)
Anterior Pituitary Hormone Physiology and Testing	545	(3)
Neuroradiologic Evaluation of the Pituitary Gland	548	(1)
Pituitary and Hypothalamic Disorders	548	(2)
Pituitary Tumors	550	(2)
The Posterior Pituitary Gland	552	(3)
The Thyroid Gland	555	(9)
Vivien Herman-Bonert
Theodore C. Friedman
Thyroid Hormone Physiology	555	(1)
Thyroid Evaluation	556	(1)
Hyperthyroidism	557	(1)
Graves' Disease	557	(2)
Toxic Adenoma	559	(1)
Toxic Multinodular Goiter	559	(1)
Thyroiditis	559	(1)
Thyrotoxicosis Factitia	560	(1)
Rare Causes of Thyrotoxicosis	560	(1)
Hypothyroidism	560	(2)
Goiter	562	(1)
Solitary Thyroid Nodules	562	(1)
Thyroid Carcinoma	563	(1)
The Adrenal Gland	564	(11)
Theodore C. Friedman
Physiology	564	(1)
Adrenal Insufficiency	565	(3)
Hyporeninemic Hypoaldosteronism	568	(1)
Congenital Adrenal Hyperplasia	568	(1)
Syndromes of Adrenocorticoid Hyperfunction	569	(5)
Adrenal Medullary Hyperfunction	574	(1)
Male Reproductive Endocrinology	575	(8)
Glenn D. Braunstein
Hypogonadism	575	(4)
Erectile Dysfunction	579	(1)
Gynecomastia	579	(1)
Testicular Tumors	580	(1)
Benign Prostatic Hyperplasia	581	(1)
Carcinoma of the Prostate	581	(2)
Diabetes Mellitus	583	(16)
Philip Barnett
Glenn D. Braunstein
Definition	583	(1)
Diagnosis	583	(2)
Classification	585	(1)
Pathogenesis	586	(2)
Management	588	(6)
Complications	594	(5)
Hypoglycemia	599	(6)
Philip Barnett
Definition	599	(1)
Physiology of Glucose Homeostasis	599	(1)
Clinical Classification of Hypoglycemia	600	(3)
Diagnostic Work-up of Hypoglycemia	603	(1)
Treatment	603	(2)
SECTION XII Women's Health	605	(22)
Women's Health: General Concepts	607	(3)
Sally L. Hodder
Anne L. Taylor
Gender Differences in the Epidemiology of Disease by Age Group	607	(1)
Exercise Across the Feminine Life Cycle	608	(1)
Gender and the Patient-Physician Interaction	608	(2)
Hormonal Influences on Women's Health	610	(10)
Sally L. Hodder
Anne L. Taylor
Normal Physiology	610	(1)
Dysmenorrhea and Premenstrual Syndrome	610	(2)
Amenorrhea	612	(1)
Abnormal Uterine Bleeding	613	(3)
Hirsutism	616	(1)
Hormone Therapy	616	(4)
Diseases Common in Women	620	(7)
Sally L. Hodder
Anne L. Taylor
Cardiovascular Diseases	620	(1)
Osteoporosis	621	(1)
Breast Cancer and Benign Breast Disease	622	(1)
Cancer of the Cervix, Uterus, and Ovary	623	(1)
Sexually Transmitted Diseases and Pelvic Inflammatory Disease	623	(2)
Urinary Incontinence	625	(1)
Domestic Violence	625	(1)
Disorders of Cognition and Affect	626	(1)
SECTION XIII Diseases of Bone and Bone Mineral Metabolism	627	(40)
Normal Physiology of Bone and Bone Minerals	629	(10)
F. Richard Bringhurst
Bone Structure and Metabolism	629	(1)
Calcium Metabolism	630	(2)
Phosphorus Metabolism	632	(2)
Magnesium Metabolism	634	(2)
Vitamin D	636	(1)
Calcitonin	637	(2)
The Parathyroid Glands, Hypercalcemia, and Hypocalcemia	639	(10)
Joel S. Finkelstein
Normal Physiology	639	(1)
Hypercalcemia	640	(5)
Hypocalcemia	645	(4)
Osteomalacia and Rickets	649	(5)
F. Richard Bringhurst
Pathogenesis	649	(1)
Specific Causes	649	(3)
Clinical Manifestations	652	(1)
Laboratory and Radiographic Features	652	(1)
Diagnosis	652	(1)
Treatment	652	(2)
Osteoporosis	654	(8)
Joel S. Finkelstein
General Considerations	654	(1)
Etiology and Pathogenesis	654	(2)
Clinical Manifestations	656	(1)
Radiographic Findings	656	(1)
Diagnosis	656	(2)
Treatment	658	(2)
Glucocorticoid-Induced Bone Loss	660	(2)
Paget's Disease of Bone	662	(5)
Margaret P. Seton
Incidence and Prevalence	662	(1)
Etiology	662	(1)
Pathology and Pathophysiology	662	(1)
Clinical Picture	662	(1)
Associated Conditions	663	(1)
Laboratory Assessment	663	(1)
Treatment	663	(4)
SECTION XIV Musculoskeletal and Connective Tissue Disease	667	(58)
Approach to the Patient with Rheumatic Disease	669	(4)
Joseph H. Korn
Musculoskeletal History and Examination	669	(2)
Laboratory Testing	671	(1)
Radiographic Studies	672	(1)
Rheumatoid Arthritis	673	(5)
Joseph H. Korn
Epidemiology and Genetics	673	(1)
Pathology	673	(1)
Pathophysiology	673	(1)
Clinical Features	674	(1)
Diagnosis	675	(1)
Treatment	675	(2)
Prognosis	677	(1)
Spondyloarthropathies	678	(4)
Peter A. Merkel
Epidemiology	678	(1)
Pathogenesis	678	(1)
Clinical Features	679	(1)
Radiographic Features	680	(1)
Treatment	681	(1)
Systemic Lupus Erythematosus	682	(5)
Peter A. Merkel
Pathogenesis	682	(1)
Clinical Manifestations	682	(1)
Clinical Subsets	683	(1)
Treatment	684	(3)
Antiphospholipid Antibody Syndrome	687	(2)
Peter A. Merkel
Etiology	687	(1)
Clinical Features	687	(1)
Diagnosis	687	(1)
Treatment	688	(1)
Systemic Sclerosis (Scleroderma)	689	(5)
Joseph H. Korn
Epidemiology and Genetics	689	(1)
Pathology and Pathophysiology	689	(1)
Clinical Features	689	(2)
Diagnosis and Differential Diagnosis	691	(1)
Treatment	691	(2)
Prognosis	693	(1)
Idiopathic Inflammatory Myopathies	694	(4)
Robert W. Simms
Pathology and Pathophysiology	694	(1)
Clinical Presentation	694	(2)
Diagnosis	696	(1)
Diffential Diagnosis	696	(1)
Treatment	696	(2)
Sjogren's Syndrome	698	(3)
Peter A. Merkel
Clinical Features	698	(1)
Diagnosis	698	(2)
Treatment	700	(1)
Vasculitides	701	(6)
Peter A. Merkel
Classification	701	(1)
Pathogenesis	701	(1)
Clinical Features	702	(1)
Specific Types of Vasculitis	702	(2)
Diagnosis	704	(1)
Autontibodies and Vasculitis	705	(1)
Treatment	705	(2)
Crystal Arthropathies	707	(5)
Joseph H. Korn
Gout	707	(4)
Calcium Pyrophosphate Deposition Disease	711	(1)
Other Crystal Disorders	711	(1)
Osteoarthritis	712	(3)
Robert W. Simms
Pathology	712	(1)
Clinical Features and Diagnosis	713	(1)
Treatment	714	(1)
Nonarticular Soft Tissue Disorders	715	(5)
Robert W. Simms
Etiology and Pathogenesis	715	(1)
Classification of Bursae	715	(1)
Diagnosis of Nonarticular Soft Tissue Disorders	716	(1)
Bursitis	716	(1)
Tendinitis	717	(1)
Fibromyalgia Syndrome	717	(3)
Rheumatic Manifestations of Systemic Disorders	720	(5)
Robert W. Simms
Rheumatic Syndromes Associated with Malignancy	720	(1)
Hematologic Disorders	721	(1)
Gastrointestinal Diseases	722	(1)
Endocrine Disorders	723	(1)
Sarcoidosis	724	(1)
SECTION XV Infectious Disease	725	(150)
Organisms That Infect Humans	727	(6)
Michael M. Lederman
Viruses	727	(1)
Chlamydiae	727	(1)
Rickettsiae	728	(1)
Mycoplasma	728	(1)
Bacteria	728	(2)
Fungi	730	(1)
Protozoans	731	(1)
Helminths	732	(1)
Host Defenses Against Infection	733	(8)
Robert A. Salata
Local Barriers to Infection	733	(1)
Components of the Immune System	734	(3)
Nonspecific Effector Mechanisms	737	(1)
Resistance to Extracellular Bacteria: Encapsulated Organisms	738	(1)
Resistance to Obligate Intracellular Parasites: Viruses	739	(1)
Resistance to Facultative Intracellular Parasites: Mycobacterium tuberculosis	740	(1)
Laboratory Diagnosis of Infectious Diseases	741	(4)
Michael M. Lederman
Diagnosis by Direct Visualization of the Organism	741	(1)
Diagnosis by Detection of Microbial Antigens	742	(1)
Diagnosis by Examination of Host Immune or Inflammatory Responses	742	(1)
Assays that Detect Microbial Nucleoside Sequences	743	(1)
Diagnosis by Isolation of the Organism in Culture	743	(1)
Viral Isolation	744	(1)
Isolation of Rickettsia, Chlamydia, and Mycoplasma	744	(1)
Bacterial Isolation	744	(1)
Isolation of Fungi and Mycobacteria	744	(1)
Antimicrobial Therapy	745	(5)
Michael M. Lederman
The Pathogen	745	(1)
Site of Infection	745	(1)
Characteristics of the Antimicrobial	746	(1)
Route of Administration	746	(1)
Duration of Therapy	746	(3)
Combinations	749	(1)
Monitoring of Antimicrobial Therapy	749	(1)
Antiviral Agents	749	(1)
Antifungal Agents	749	(1)
Antimicrobial Resistance Testing	749	(1)
Fever and Febrile Syndromes	750	(15)
Robert A. Salata
Regulation of Body Temperature	750	(1)
Fever and Hyperthermia	750	(2)
Acute Febrile Syndromes	752	(8)
Fever of Unknown Origin	760	(3)
Factitious or Self-Induced Fever	763	(2)
Bacteremia	765	(6)
Robert A. Salata
Epidemiology	765	(1)
Pathogenesis	766	(1)
Clinical Manifestations	767	(2)
Diagnosis	769	(1)
Therapy	769	(2)
Infections of the Nervous System	771	(11)
Robert A. Salata
Meningitis	772	(6)
Encephalitis	778	(1)
Rabies	779	(1)
Spectrum of Tuberculous, Fungal, and Parasitic Infections	779	(3)
Infections of the Head and Neck	782	(6)
Michael M. Lederman
Infections of the Ear	782	(1)
Infections of the Nose and Sinuses	782	(1)
Infections of the Mouth and Pharynx	783	(5)
Infections of the Lower Respiratory Tract	788	(10)
Michael M. Lederman
Pathogenesis	788	(1)
Epidemiology	789	(1)
Differential Diagnosis	789	(1)
Diagnosis	790	(1)
Specific Pathogenic Organisms	791	(4)
Treatment and Outcome	795	(1)
Prevention	796	(2)
Infections of the Heart and Vessels	798	(7)
Michael M. Lederman
Infective Endocarditis	798	(4)
Prosthetic Valve Endocarditis	802	(1)
Prophylaxis of Infective Endocarditis	803	(1)
Bacterial Endarteritis and Suppurative Phlebitis	804	(1)
Skin and Soft Tissue Infections	805	(6)
Michael M. Lederman
Superficial Infections of the Skin	805	(4)
Deeper Infections of the Skin and Soft Tissue	809	(2)
Intra-Abdominal Abscess and Peritonitis	811	(4)
Michael M. Lederman
Intra-Abdominal Abscess	811	(1)
Abscesses of Solid Organs	811	(2)
Extravisceral Abscesses	813	(1)
Peritonitis	813	(2)
Infectious Diarrhea	815	(6)
Michael M. Lederman
Pathogenesis and Pathophysiology: General Concepts	815	(1)
Types of Microbial Diarrheal Diseases	815	(3)
General Epidemiologic Considerations	818	(1)
Diagnosis	818	(1)
Management: General Principles of Electrolyte Repletion Therapy	818	(3)
Infections Involving Bones and Joints	821	(4)
Michael M. Lederman
Arthritis	821	(2)
Septic Bursitis	823	(1)
Osteomyelitis	823	(2)
Infections of the Urinary Tract	825	(3)
Michael M. Lederman
Urethritis	825	(1)
Cystitis and Pyelonephritis	825	(2)
Prostatitis	827	(1)
Nosocomial Infections	828	(4)
Michael M. Lederman
Infection Control	828	(1)
Approach to the Hospitalized Patient with Possible Nosocomial Infection	828	(1)
Nosocomial Pneumonia	829	(1)
Intravascular Catheter-Related Infections	830	(1)
Pressure Sores	831	(1)
Nosocomial Urinary Tract Infection	831	(1)
Sexually Transmitted Diseases	832	(9)
Robert A. Salata
Genital Sores	832	(4)
Urethritis, Cervicitis, and Pelvic Inflammatory Disease	836	(4)
Proctocolitis in Homosexual Men	840	(1)
HIV Infection and the Acquired Immunodeficiency Syndrome	841	(22)
Charles C. J. Carpenter
Michael M. Lederman
Epidemiology	841	(2)
Pathophysiology	843	(3)
Diagnosis and Testing for HIV Infection	846	(1)
Sequential Clinical Manifestations of HIV-1 Infection	847	(2)
Management of HIV Infection	849	(3)
Management of Specific Clinical Manifestations of Immunodeficiency: A Problem-Oriented Approach	852	(1)
Mucocutaneous Diseases	853	(2)
Nervous System Diseases	855	(3)
Pulmonary Diseases	858	(2)
Gastrointestinal Diseases	860	(1)
Unexplained Fever	860	(1)
Weight Loss and Anorexia	861	(1)
AIDS-Associated Malignancies	861	(1)
Other Complications of HIV Infection	861	(1)
Prevention of HIV Infection	862	(1)
Infections in the Immunocompromised Host	863	(5)
Robert A. Salata
Disorders of Cell-Mediated Immunity	863	(1)
Disorders of Humoral Immunity	864	(1)
Impaired Neutrophil Function	864	(1)
Neutropenia	865	(1)
Diagnostic Problems in the Compromised Host	865	(1)
Prevention and Treatment of Infections in the Patient with Neutropenia	866	(2)
Infectious Diseases of Travelers: Protozoal and Helminthic Infections	868	(7)
Robert A. Salata
Preparation of Travelers	868	(2)
The Returning Traveler	870	(1)
Protozoal and Helminthic Infections	871	(4)
SECTION XVI Neurologic Disease	875	(126)
Neurologic Evaluation of the Patient	877	(6)
Frederick J. Marshall
Taking a Neurologic History	877	(1)
The Neurologic Examination	878	(1)
Technologic Assessment	879	(4)
Disorders of Consciousness	883	(7)
Roger P. Simon
Pathophysiology	883	(1)
Diagnostic Approach	884	(3)
Prognosis in Coma	887	(1)
Coma-like States	887	(3)
Disorders of Sleep	890	(3)
Roger P. Simon
Neurobiology of Sleep	890	(1)
Insomnia	890	(1)
Abnormal Arousal	890	(1)
Sleep Apnea	891	(1)
Parasomnias	891	(1)
Narcolepsy	892	(1)
Focal Brain Disease	893	(3)
Timothy J. Counihan
Anatomy	893	(1)
Regional Syndromes	893	(3)
Dementia and Memory Disturbances	896	(5)
Frederick J. Marshall
Major Dementia Syndromes	896	(3)
Other Memory Disturbances	899	(2)
Disorders of Mood and Behavior	901	(5)
Frederick J. Marshall
Psychotic Disorders	901	(1)
Depression and Bipolar Disorders	902	(2)
Anxiety Disorders	904	(1)
Somatoform Disorders	904	(1)
Factitious Disorder	905	(1)
Dissociative Disorders	905	(1)
Personality Disorders and Substance Abuse	905	(1)
Disorders of Thermal Regulation	906	(3)
Roger P. Simon
Hypothermia	906	(1)
Hyperthermia	906	(3)
Headache, Neck Pain, and Other Painful Disorders	909	(9)
Timothy J. Counihan
Headache	909	(6)
Neck and Back Pain	915	(3)
Disorders of Vision and Hearing	918	(7)
Timothy J. Counihan
Disorders of Vision and Eye Movements	918	(4)
Hearing and Its Impariments	922	(3)
Dizziness	925	(4)
Roger P. Simon
Approach to the Diagnosis	925	(3)
Treatment	928	(1)
Disorders of the Motor System	929	(10)
Frederick J. Marshall
Symptoms and Signs of Motor System Disease	929	(1)
Movement Disorders and Ataxia	930	(3)
Hypokinetic Movement Disorders	933	(2)
Hyperkinetic Movement Disorders	935	(2)
Cerebellar Ataxias	937	(2)
Developmental and Neurocutaneous Disorders	939	(3)
Robert C. Griggs
Spinal Malformations	939	(1)
Chiari Malformations	939	(1)
Tethered Spinal Cord	939	(1)
Syringohydromyelia	939	(1)
Malformations of Cortical Development	940	(1)
Developmental and Neurocutaneous Disorders	940	(2)
Cerebrovascular Disease	942	(11)
Timothy J. Counihan
Epidemiology	942	(1)
Anatomy	942	(1)
Physiology	943	(1)
Ischemic Stroke	943	(2)
Major Stroke Syndromes	945	(2)
Diagnosis	947	(1)
Differential Diagnosis	947	(1)
Primary Stroke Prevention	947	(1)
Management of Acute Stroke	948	(1)
Intracerebral Hemorrhage	949	(2)
Intracranial Aneurysms	951	(1)
Vascular Malformations	952	(1)
Trauma to Head and Spine	953	(3)
Roger P. Simon
Head Injury	953	(2)
Spinal Cord Injury	955	(1)
Whiplash	955	(1)
Epilepsy	956	(9)
Robert C. Griggs
Definition	956	(1)
Incidence and Etiology	956	(1)
Classification and Clinical Manifestations	956	(4)
Diagnosis	960	(1)
Differential Diagnosis	961	(1)
Treatment	962	(2)
Prognosis	964	(1)
Discontinuing Antiepileptic Drugs	964	(1)
Central Nervous System Tumors	965	(4)
Jennifer J. Griggs
Classification	965	(1)
Clinical Manifestations	965	(1)
Evaluation of the Patient	966	(1)
Treatment	966	(1)
Specific Tumors	967	(2)
Infectious Diseases of the Nervous System	969	(4)
Robert C. Griggs
Roger P. Simon
Brain Abscess	969	(1)
Subdural Empyema	970	(1)
Malignant External Otitis	970	(1)
Spinal Epidural Abscess	970	(1)
Septic Cavernous Sinus Thrombosis	971	(1)
Lateral Sinus Thrombosis	971	(1)
Septic Sagittal Thrombosis	971	(1)
Neurologic Complications of Infectious Endocarditis	971	(1)
Prion Diseases	972	(1)
Demyelinating and Inflammatory Disorders	973	(6)
Robert C. Griggs
Multiple Sclerosis	973	(2)
Neuromyelitis Optica	975	(1)
Optic Neuritis	975	(2)
Acute Transverse Myelitis	977	(1)
Acute Disseminated Encephalomyelitis	977	(2)
Neuromuscular Diseases: Disorders of the Motor Neuron and Plexus and Peripheral Nerver Disease	979	(9)
Robert C. Griggs
Diagnostic Tests	980	(1)
Diseases of the Motor Neuron (Anterior Horn Cell)	981	(1)
Plexopathy	982	(1)
Peripheral Nerve Disease	982	(1)
Common Mononeuropathies	983	(1)
Polyneuropathies	984	(4)
Muscle Diseases	988	(10)
Robert C. Griggs
Organization and Structure of Muscle	988	(1)
Assessment	988	(2)
Muscular Dystrophies	990	(1)
Congenital Myopathies	991	(1)
Metabolic Myopathies	991	(1)
Specific Mitochondrial Disorders Affecting Muscle	992	(1)
Channelopathies (Nondystrophic Myotonias and Periodic Paralyses)	993	(1)
Inflammatory Myopathies	994	(2)
Myopathies Caused by Endocrine and Systemic Disorders	996	(1)
Toxic Myopathies	996	(1)
Myoglobinuria	997	(1)
Neuromuscular Junction Disease	998	(3)
Robert C. Griggs
Myasthenia Gravis	998	(1)
Lambert-Eaton Myasthenic Syndrome	999	(1)
Drug-Induced Myasthenic Syndromes	1000	(1)
Organophosphate Intoxication	1000	(1)
SECTION XVII The Aging Patient	1001	(10)
The Biology of Aging	1003	(8)
David A. Lipschitz
Robert J. Reis
Dennis H. Sullivan
Theories of Aging	1003	(2)
Demographics of Aging and Implications for Health Care	1005	(1)
Assessment of the Older Patient	1006	(1)
Common and Often Inadequately Assessed Medical Problems of the Elderly	1006	(5)
SECTION XVIII Substance Abuse	1011	(12)
Alchol and Substance Abuse	1013	(10)
Timothy E. Holcomb
Jeffrey L. Clothier
Screening	1014	(1)
Tobacco and Alcohol Abuse	1014	(4)
Prescription Drug Abuse	1018	(2)
Illicit Drug Abuse	1020	(3)
Appendix Commonly Measured Laboratory Values	1023	(6)
Index	1029