To Ella and Rupert David Hui Disclaimer Approach to Internal Medicine is meant to be a practical field guide Dosages of medications are provided for quick reference only Readers should consult other resources before applying information in this manual for direct patient care The author, editors, and publisher of Approach to Internal Medicine cannot be held responsible for any harm, direct or indirect, caused as a result of application of information tained within this manual vii Preface Practice is science touched with emotion Confessio Medici, Stephen Paget, 1909 The third edition of Approach to Internal Medicine builds upon previous efforts to create a practical, evidence based, and concise educational resource for everyday clinical use and examination preparation Approach to Internal Medicine now has an expanded repertoire of over 250 internal medicine topics, classified under 17 subspecialties With the input of a new editor and publisher, we were able to significantly expand and update the content and substantially improve the layout, while maintaining the same conciseness and practicality found in previous editions Under each topic, the sections on differential diagnoses, investigations, and treatments are designed for the rapid retrieval of high yield clinical information and can be particularly useful when one is all alone assessing a patient at o’clock in the morning Other sections contain many clinical pearls that are intended to help one to excel in patient care We also included many comparison tables aimed at highlighting the distinguishing features between various clinical entities and numerous mnemonics (marked by w) In addition to everyday practice, Approach to Internal Medicine can be effectively used as an examination study guide and teaching script For this new edition, we are very fortunate to have recruited a new associate editor, Dr Alexander Leung, who brings with him a wealth of knowledge and outstanding commitment to medical education We are most grateful to our section editors and contributors for their meticulous review of each subspecialty, providing expert input on the most up to date information We would also like to take this opportunity to thank Jean Claude Quintal as a resident reviewer and the Canadian Federation of Medical Students for its support of the previous edition Finally, we would like to thank all previous and current users of this manual for their support and feedback We are pleased that Springer has taken this title under its direction and has helped to improve its quality in preparation for international release In addition to International System (SI) units, this edition also provides US customary units [in square brackets] for quick reference We would particularly like to thank Laura Walsh, senior editor, and Stacy Lazar, editorial assistant, from Springer for their expert guidance and support throughout this mammoth project from design to production We would also like to thank Walter Pagel, director of scientific publishing at M.D Anderson Cancer Center, for believing in this work and making this collaboration possible While every effort has been made to ensure the accuracy of information in this manual, the author, editors, and publisher are not responsible for omissions, errors, or any consequences that result from application of the information contained herein Verification of the information in this manual remains the professional responsibility of the practitioner Readers are strongly urged to consult other appro priate clinical resources prior to applying information in this manual for direct patient care This is ix ... examination preparation Approach to Internal Medicine now has an expanded repertoire of over 25 0 internal medicine topics, classified under 17 subspecialties With the input of a new editor and publisher,... Preface Practice is science touched with emotion Confessio Medici, Stephen Paget, 1909 The third edition of Approach to Internal Medicine builds upon previous efforts to create a practical, evidence... In addition to everyday practice, Approach to Internal Medicine can be effectively used as an examination study guide and teaching script For this new edition, we are very fortunate to have recruited