CONN’S Current Therapy 2011 CONN’S Current Therapy 2011 Edward T Bope, MD Chief of Medicine, Columbus VA Clinical Professor, Department of Family Medicine The Ohio State University College of Medicine Columbus, Ohio Rick Kellerman, MD Professor and Chair, Department of Family and Community Medicine University of Kansas School of Medicine–Wichita Wichita, Kansas Robert E Rakel, MD Professor, Department of Family and Community Medicine Baylor College of Medicine Houston, Texas LATEST APPROVED METHODS OF TREATMENT FOR THE PRACTICING PHYSICIAN 1600 John F Kennedy Blvd Ste 1800 Philadelphia, PA 19103–2899 CONN’S CURRENT THERAPY 2011 Copyright # 2011, 2010, 2009, 2008 by Saunders, an imprint of Elsevier Inc ISBN: 978-1-4377-0986-5 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the Publisher Details on how 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Editor: Joan Ryan Publishing Services Manager: Anne Altepeter Senior Project Manager: Cheryl A Abbott Design Direction: Steven Stave Printed in the United States of America Last digit is the print number: Contributors Charles S Abrams, MD Deverick J Anderson, MD Associate Chief, Division of Hematology-Oncology, University of Pennsylvania School of Medicine; Staff Physician, Division of Hematology-Oncology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania Clinical Associate, Duke University Medical Center, Durham, North Carolina Rickettsial and Ehrlichial Infections (Rocky Mountain Spotted Fever and Typhus) Platelet-Mediated Bleeding Disorders Kelley P Anderson, MD Mark J Abzug, MD Professor of Pediatrics (Infectious Diseases), University of Colorado– Denver School of Medicine; Medical Director, The Children’s Hospital Clinical Trials Organization, The Children’s Hospital, Aurora, Colorado Viral Meningitis and Encephalitis ´ Horacio E Adrogue, MD Medical Director, Pancreas Transplant Program; Medical Director, Methodist Transplant Network, The Methodist Hospital Transplant Center, Houston, Texas Hypertension Tod C Aeby, MD Residency Program Director, Department of Obstetrics, Gynecology, and Women’s Health, University of Hawaii John A Burns School of Medicine, Honolulu, Hawaii Uterine Leiomyomas Lee Akst, MD Assistant Professor, Department of Otolaryngology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois Hoarseness and Laryngitis Mahboob Alam, MD Section of Cardiology, Baylor College of Medicine, Houston, Texas Hypertrophic Cardiomyopathy Clinical Associate Professor of Medicine, University of Wisconsin School of Medicine and Public Health–Marschfield Clinic Campus, Marshfield, Wisconsin Heart Block ` Emmanuel Andres, MD, PhD ´ ` ´ Service de Medecine Interne, Diabete et Maladies Metaboliques, ´ ˆ ˆ Clinique Medicale B, Hopital Civil–Hopitaux Universitaires de Strasbourg, Strasbourg, France Pernicious Anemia and Other Megaloblastic Anemias Gregory M Anstead, MD Associate Professor of Medicine, University of Texas Health Science Center at San Antonio School of Medicine; Director, Immunosuppression and Infectious Diseases Clinics, South Texas Veterans Healthcare System, San Antonio, Texas Coccidioidomycosis Aydin Arici, MD Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut Abnormal Uterine Bleeding Ann M Aring, MD Assistant Clinical Professor, Department of Family Medicine, The Ohio State University College of Medicine; Assistant Program Director, Family Medicine Residency, Riverside Methodist Hospital, Columbus, Ohio Fever Brian K Albertson, MD University Physicians Group, Harrisburg, Pennsylvania Osteomyelitis Madson Q Almeida, MD Section on Endocrinology and Genetics, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland Cushing’s Syndrome Isao Arita, MD Chairman, Agency for Cooperation in International Health– Kumamoto, Kumamoto City, Japan Smallpox Cecilio Azar, MD Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon Bleeding Esophageal Varices Girish Anand, MD Masoud Azodi, MD Fellow in Gastroenterology, Albert Einstein Medical Center, Philadelphia, Pennsylvania Associate Professor, Division of Gynecology Oncology, Yale University School of Medicine, New Haven, Connecticut Dysphagia and Esophageal Obstruction Cancer of the Endometrium v Adrianne Williams Bagley, MD Diana Bolotin, MD, PhD Pediatrician, Lincoln Community Health Center, Inc., Durham, North Carolina Section of Dermatology, The University of Chicago, Chicago, Illinois Pelvic Inflammatory Disease ´ Federico Balague, MD Privat Docent, Rheumatology, Medical School, Geneva University, Geneva, Switzerland; Adjunct Associated Professor, ´ Orthopedics, New York University, New York, New York; Medecin ˆ Chef Adj Service de Rhumatologie, HFR-Hopital, Cantonal Fribourg, Switzerland Spine Pain Ashok Balasubramanyam, MD Professor of Medicine, Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas Diabetes Insipidus Arna Banerjee, MD Assistant Professor of Anesthesiology and Surgery, Department of Anesthesiology and Critical Care and Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Contributors Delirium Nurcan Baykam, MD vi Cancer of the Skin Mary Ann Bonilla, MD Assistant Clinical Professor, Columbia University College of Physicians and Surgeons, New York, New York; Attending Physician, St Joseph’s Regional Medical Center, Paterson, New Jersey Neutropenia Zuleika L Bonilla-Martinez, MD Wound Healing Fellow, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida Venous Ulcers David Borenstein, MD Clinical Professor of Medicine, The George Washington University Medical Center, Washington, DC Spine Pain Patrick Borgen, MD Chief, Breast Service, Department of Surgery, Memorial SloanKettering Cancer Center, New York, New York Diseases of the Breast Sheryl Beard, MD Associate Professor of Infectious Diseases, University of Ankara Faculty of Medicine; Staff, Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey Brucellosis Krystene I Boyle, MD Clinical Instructor, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine; Clinical Fellow, Department of Obstetrics/Gynecology, Division of Reproductive Endocrinology, University of Cincinnati Medical Center, Cincinnati, Ohio Menopause Assistant Clinical Professor, Department of Family and Community Medicine, University of Kansas School of Medicine; Associate Director, Via Christi Regional Medical Center, Wichita, Kansas Mark E Brecher, MD Meg Begany, RD, CSP, LDN Adjunct Professor, Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina; Chief Medical Officer/Senior Vice President, Laboratory Corporation of America, Burlington, North Carolina Neonatal Nutritionist; Nutrition Support Service Coordinator, Newborn/Infant Intensive Care Unit, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Sylvia L Brice, MD Otitis Externa Normal Infant Feeding David I Bernstein, MD Professor of Medicine and Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio Hypersensitivity Pneumonitis John P Bilezikian, MD Professor, Department of Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, New YorkPresbyterian Hospital, New York, New York Primary Hyperparathyroidism and Hypoparathyroidism Federico Bilotta, MD, PhD University of Rome La Sapienza, Rome, Italy Therapeutic Use of Blood Components Associate Professor of Dermatology, University of Colorado, Denver, Colorado Viral Diseases of the Skin Patricia D Brown, MD Associate Professor of Medicine, Division of Infectious Diseases, Wayne State University School of Medicine; Chief of Medicine, Detroit Receiving Hospital, Detroit, Michigan Pyelonephritis Patrick Brown, MD Assistant Professor of Oncology and Pediatrics, The Johns Hopkins University School of Medicine; Director, Pediatric Leukemia Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland Acute Leukemia in Children Hiccups Richard B Brown, MD Natalie C Blevins, PhD Assistant Professor of Clinical Psychology in Clinical Psychiatry, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana Professor of Medicine, Tufts University School of Medicine, Boston; Senior Clinician, Baystate Medical Center, Springfield, Massachusetts Toxic Shock Syndrome Anxiety Disorders Peter Buckley, MD Roberta C Bogaev, MD Texas Heart Institute, Houston, Texas Hypertrophic Cardiomyopathy Interim Dean, School of Medicine, Medical College of Georgia, Augusta, Georgia Schizophrenia Irina Burd, MD, PhD Emery Chen, MD Instructor, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine; Staff, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania Endocrine Surgeon, Woodland Clinic, Woodland, California Menopause Diego Cadavid, MD Consultant in Immunology and Inflammatory Diseases, Massachusetts General Hospital, Charlestown, Massachusetts Relapsing Fever Grant R Caddy, MD Consultant Physician and Gastroenterologist, Ulster Hospital, Belfast, Northern Ireland Cholelithiasis and Cholecystitis Thomas R Caraccio, PharmD Associate Professor of Emergency Medicine, Stony Brook University Medical Center School of Medicine, Stony Brook, New York; Assistant Professor of Pharmacology and Toxicology, New York College of Osteopathic Medicine, Old Westbury, New York Medical Toxicology: Ingestions, Inhalations, and Dermal and Ocular Absorptions Thyroid Cancer Venkata Sri Cherukumilli, BS Medical Student, University of California–San Diego, School of Medicine, La Jolla, California Rheumatoid Arthritis Meera Chitlur, MD Assistant Professor of Pediatrics, Wayne State University School of Medicine; Staff Physician, Carman and Ann Adams Department of Pediatrics, Division of Hematology/Oncology, Children’s Hospital of Michigan, Detroit, Michigan Hemophilia and Related Bleeding Disorders Saima Chohan, MD Assistant Professor of Medicine, Section of Rheumatology, University of Chicago, Chicago, Illinois Hyperuricemia and Gout Peter E Clark, MD Associate Professor of Urologic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee Enrique V Carbajal, MD Associate Clinical Professor of Medicine, University of California– San Francisco School of Medicine, San Francisco, California; Department of Medicine, Veterans Affairs Central California Health Care System, Fresno, California Premature Beats Steve Carpenter, MD Associate Professor, Baylor College of Medicine, St Luke’s Episcopal Hospital, Houston, Texas Hodgkin’s Disease: Radiation Therapy Petros E Carvounis, MD, FRCSC Assistant Professor, Cullen Eye Institute, Baylor College of Medicine; Chief of Ophthalmology (interim), Ben Taub General Hospital, Harris County Hospital District, Houston, Texas Uveitis Donald O Castell, MD Professor of Medicine, Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina Claus-Frenz Claussen, MD Julius-Maximilians-Universitat Wurzburg, Wurzburg; Head, 4-G Research Institute, Neurootologisches Forschungsinstitut, Bad Kissingen, Germany Tinnitus Keith K Colburn, MD Professor of Medicine and Chief of Rheumatology, Loma Linda University, Loma Linda, California Bursitis, Tendinitis, Myofascial Pain, and Fibromyalgia Gary C Coleman, DDS, MS Associate Professor, Department of Diagnostic Sciences, Baylor College of Dentistry, Dallas, Texas Diseases of the Mouth Patricia A Cornett, MD Associate Chair for Education, Medicine, University of California– San Francisco; Chief, Hematology/Oncology, Veterans Affairs Medical Center–San Francisco, San Francisco, California Nonimmune Hemolytic Anemia Gastroesophageal Reflux Disease Fiona Costello, MD Alvaro Cervera, MD University of Barcelona, Barcelona, Spain; National Stroke Research Institute, Heidelberg Heights, Victoria, Australia Ischemic Cerebrovascular Disease Lawrence Chan, MD Professor of Medicine, Rutherford Chair, and Division Chief, Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine; Chief, Diabetes, Endocrinology, and Metabolism, St Luke’s Episcopal Hospital, Houston, Texas Dyslipoproteinemias; Primary Aldosteronism Miriam M Chan, BSc Pharm, PharmD Director of Pharmacy Education, Riverside Methodist Hospital Family Medicine Residency; Clinical Assistant Professor of Family Medicine and Pharmacy, The Ohio State University, Columbus, Ohio; Adjunct Professor of Pharmacy, Ohio Northern University, Lima, Ohio New Drugs in 2009 and Agents Pending FDA Approval; Popular Herbs and Nutritional Supplements Clinical Associate Professor, Departments of Clinical Neurosciences and Surgery, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada Optic Neuritis John F Coyle II, MD Clinical Professor, Department of Medicine, University of Oklahoma College of Medicine–Tulsa, Tulsa, Oklahoma Disturbances Caused by Heat Lester M Crawford, PhD Formerly Research Professor, Georgetown University School of Medicine, Washington, DC, and Head, Department of Physiology, University of Georgia College of Medicine, Athens, Georgia Foodborne Illness Burke A Cunha, MD Professor of Medicine, Stony Brook University Medical Center School of Medicine, Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital, Mineola, New York Urinary Tract Infections in Women; Viral and Mycoplasmal Pneumonias Contributors Malignant Tumors of the Urogenital Tract vii F William Danby, MD, FRCPC Stephen R Deputy, MD Assistant Professor of Surgery (Dermatology), Dartmouth Medical School, Hanover, New Hampshire; Associate Staff, Elliot Hospital Consulting Staff, Catholic Medical Center, Manchester, New Hampshire Assistant Professor of Neurology, Louisiana State University School of Medicine; Staff Neurologist, Children’s Hospital, New Orleans, Louisiana Traumatic Brain Injury in Children Anogenital Pruritus Ralph C Daniel, MD Department of Dermatology, St Dominic-Jackson Memorial Hospital, Jackson, Mississippi Diseases of the Nails Athena Daniolos, MD Associate Professor, Department of Dermatology, University of Wisconsin School of Medicine and Public Health; Attending Physician, University Health Services, University of Wisconsin, Madison, Wisconsin Condyloma Accuminata (Genital Warts) Daniel Derksen, MD Professor and Vice Chair of Service, Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico Nausea and Vomiting Richard D deShazo, MD Professor of Medicine and Pediatrics and Billy S Guyton Distinguished Professor, University of Mississippi College of Medicine; Chair, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi Pneumoconiosis Stella Dantas, MD Physician, Department of Obstetrics and Gynecology, Beaverton Medical Office, Northwest Permanente PC Physicians and Surgeons, Beaverton, Oregon Clio Dessinioti, MD, MSc Attending Dermatologist, Andreas Sygros Hospital, Athens, Greece Parasitic Diseases of the Skin Contributors Uterine Leiomyomas Andre Dascal, MD, FRCPC Associate Professor, Departments of Medicine, Microbiology, and Immunology, McGill University Faculty of Medicine; Senior Infectious Disease Physician, Sir Mortimer B Davis-Jewish General Hospital, Montreal, Quebec, Canada Adjunct Clinical Professor, The Ohio State University College of Medicine; Fellowship Director, Riverside Sports Medicine, Riverside Methodist Hospital, Columbus, Ohio Common Sports Injuries Acute Infectious Diarrhea Sunil Dogra, MD, DNB, MNAMS Susan Davids, MD, MPH viii Douglas DiOrio, MD Associate Professor of Medicine, Medical College of Wisconsin; Associate Program Director, Internal Medicine Residency, Clement J Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin Assistant Professor, Department of Dermatology, Venereology, and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India Leprosy Acute Bronchitis Susan A Davidson, MD Associate Professor, University of Colorado–Denver School of Medicine; Chief, Gynecologic Oncology, University of Colorado Hospital, Aurora, Colorado Neoplasms of the Vulva Melinda V Davis-Malesevich, MD Resident, Bobby R Alford Department of Otolaryngology – Head & Neck Surgery, Baylor College of Medicine, Houston, Texas Obstructive Sleep Apnea Basak Dokuzoguz, MD Chief, Infectious Diseases and Clinical Microbiology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey Brucellosis Joseph Domachowske, MD Professor of Pediatrics, Microbiology, and Immunology, State University of New York Upstate Medical University, Syracuse, New York Infectious Mononucleosis Francisco J.A de Paula, MD, PhD Assistant Professor, Department of Internal Medicine, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto, Brazil Osteoporosis Prakash C Deedwania, MD Professor of Medicine, University of California–San Francisco School of Medicine, San Francisco, California; Chief, Cardiology Section, Veterans Affairs Central California Health Care System, Fresno, California Premature Beats Phyllis A Dennery, MD Professor of Pediatrics, University of Pennsylvania School of Medicine; Werner and Gertrude Henle Chair and Chief, Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Hemolytic Disease of the Fetus and Newborn Geoffrey A Donnan, MD Department of Neurology, University of Melbourne Faculty of Medicine, Dentistry, and Health Sciences; Florey Neuroscience Institutes, Carlton South, Victoria, Australia Ischemic Cerebrovascular Disease Craig L Donnelly, MD Dartmouth Medical School, Hanover, New Hampshire; Chief, Child and Adolescent Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire Attention-Deficit-Hyperactivity Disorder John Dorsch, MD Associate Professor, Family and Community Medicine, University of Kansas School of Medicine – Wichita, Wichita, Kansas The Red Eye Douglas A Drevets, MD, DTM&H Walid A Farhat, MD Professor and Interim Chief, Section of Infectious Diseases, University of Oklahoma Health Sciences Center School of Medicine; Staff Physician, Veterans Affairs Medical Center, Oklahoma City, Oklahoma Associate Professor, Department of Surgery, Pediatric Urologist, The Hospital for Sick Children, Toronto, Ontario, Canada Jean Dudler, MD Associate Professor of Medicine, Division of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland Rat-Bite Fever Peter R Duggan, MD Assistant Clinical Professor, University of Calgary, Calgary, Alberta, Canada Polycythemia Vera Kim Eagle, MD Albion Walter Hewlett Professor of Internal Medicine, Chief of Clinical Cardiology, and Director, Cardiovascular Center, University of Michigan Health System, Ann Arbor, Michigan Angina Pectoris Genevieve L Egnatios, MD Department of Dermatology, Mayo Clinic Scottsdale, Scottsdale, Arizona Contact Dermatitis Julian Elliott, MB, BS, FACP Conjoint Senior Lecturer, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney; Infectious Diseases Physician, Alfred Hospital, Melbourne; HIV Clinical Advisor, International Health Research Group, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, New South Wales, Australia Psittacosis Sean P Elliott, MD Assistant Professor, University of Minnesota Medical School, Minneapolis, Minnesota Trauma to the Genitourinary Tract Dorianne Feldman, MD, MSPT Instructor of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland Rehabilitation of the Stroke Patient Gregory Feldman, MD Surgical Resident, Stanford Hospitals and Clinics, Stanford, California Peripheral Arterial Disease Steven R Feldman, MD, PhD Professor of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina Acne Vulgaris and Rosacea Barri J Fessler, MD, MSPH Associate Professor of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama Polymyalgia Rheumatica and Giant Cell Arteritis Terry D Fife, MD Associate Professor of Clinical Neurology, University of Arizona; Director, Arizona Balance Center, Barrow Neurological Institute, Phoenix, Arizona ´nie Me `re’s Disease David Finley, MD Surgeon, Thoracic Service, Memorial Sloan-Kettering, New York, New York Pleural Effusions and Empyema Thoracis Robert S Fisher, MD Lorber Professor of Medicine and Chief, Gastroenterology Section and Digestive Disease Center, Temple University School of Medicine, Philadelphia, Pennsylvania Irritable Bowel Syndrome William E Fisher, MD Dirk M Elston, MD Director, Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania Diseases of the Hair John Embil, MD Associate Professor of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Blastomycosis Tobias Engel, MD Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland Pheochromocytoma Scott K Epstein, MD Dean for Educational Affairs and Professor of Medicine, Tufts University School of Medicine, Boston, Massachusetts Acute Respiratory Failure Andrew M Evens, DO, MSc Associate Professor of Medicine and Director, Translational Therapeutics, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine/The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois Non-Hodgkin’s Lymphoma Contributors Plague Childhood Incontinence Professor of Surgery, Baylor College of Medicine, Houston, Texas Acute and Chronic Pancreatitis Alan B Fleischer, Jr., MD Professor and Chair, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina Acne Vulgaris and Rosacea Raja Flores, MD Surgeon, Thoracic Service, Memorial Sloan-Kettering, New York, New York Pleural Effusions and Empyema Thoracis Brian J Flynn, MD Associate Professor of Urology, University of Colorado–Denver School of Medicine, Aurora, Colorado Urethral Strictures Nathan B Fountain, MD Professor of Neurology and Director, Dreifuss Comprehensive Epilepsy Program, University of Virginia Seizures and Epilepsy in Adolescents and Adults Jennifer Frank, MD Department of Family Medicine; University of Wisconsin, Appleton, Wisconsin Syphilis ix Ellen W Freeman, PhD ´ ´ Marlıs Gonzalez-Fernandez, MD, PhD ´ Research Professor, Departments of Obstetrics/Gynecology and Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Assistant Professor of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine; Medical Director, Outpatient Physical Medicine and Rehabilitation Clinics, The Johns Hopkins Hospital, Baltimore, Maryland Premenstrual Syndrome Rehabilitation of the Stroke Patient Theodore M Freeman, MD San Antonio Asthma and Allergy Clinic, San Antonio, Texas Allergic Reaction to Stinging Insects Aaron Friedman, MD Ruben Bentson Professor and Chair, Pediatrics, University of Minnesota, Minneapolis, Minnesota Parenteral Fluid Therapy in Children R Michael Gallagher, DO Director, Headache Center of Central Florida, Melbourne, Florida Headache E Ann Gormley, MD Professor of Surgery (Urology), Dartmouth Medical School, Hanover, New Hampshire; Staff Urologist, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire Urinary Incontinence Eduardo Gotuzzo, MD Principal Professor of Medicine, Universidad, Peruana Cayetano Heredia; Chief, Department of Infectious, Tropical, and Dermatologic Diseases, Hospital National Cayetano Heredia, Lima, Peru Cholera John Garber, MD Instructor in Medicine, Harvard Medical School; Fellow in Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts Contributors Acute and Chronic Viral Hepatitis x Luigi Gradoni, PhD Research Director, Vector-Borne Diseases and International Health, ` Istituto Superiore di Sanita, Rome, Italy Leishmaniasis Khalil G Ghanem, MD, PhD Jane M Grant-Kels, MD Assistant Professor of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland Donald L Gilbert, MD, MS Professor and Chair, Department of Dermatology; Dermatology Residency Director; and Assistant Dean of Clinical Affairs, University of Connecticut School of Medicine; Director of Dermatopathology and Director, Cutaneous Oncology and Melanoma Center, University of Connecticut Health Center, Farmington, Connecticut Professor of Medicine, University of Cincinnati College of Medicine; Associate Professor, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio William Greene, MD Gonorrhea Gilles de la Tourette Syndrome Robert Giusti, MD Assistant Professor of Pediatrics, Division of Pediatric Pulmonology, New York University School of Medicine; New York University Langone Medical Center, New York, New York Cystic Fibrosis Mark T Gladwin, MD Professor of Medicine, University of Pittsburgh School of Medicine; Chief; Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania Melanocytic Nevi Assistant Professor, Psychiatry, University of Florida, Gainesville, Florida Drug Abuse Joseph Greensher, MD Professor of Pediatrics, Stony Brook University Medical Center School of Medicine, Stony Brook, New York; Medical Director and Associate Chair, Department of Pediatrics, Long Island Regional Poison and Drug Information Center, Winthrop-University Hospital, Mineola, New York Medical Toxicology: Ingestions, Inhalations, and Dermal and Ocular Absorptions Sickle Cell Disease David Gregory, MD Andrew W Goddard, MD Professor of Psychiatry, Indiana University Hospital, Indianapolis, Indiana Anxiety Disorders Mark S Gold, MD Distinguished Professor and Chairman, Psychiatry, Neuroscience, Anesthesiology and Community Health and Family Medicine, University of Florida College of Medicine, Gainesville, Florida Assistant Clinical Professor of Family Medicine, University of Virginia School of Medicine, Charlottesville, Virginia; Assistant Clinical Professor of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia; Director of Didactic Curriculum, Lynchburg Family Medicine Residency; Staff Physician in Family Medicine and Obstetrics, Lynchburg General Hospital and Virginia Baptist Hospital, Lynchburg, Virginia Resuscitation of the Newborn Drug Abuse Priya Grewal, MD Robert Goldstein, MD Director of Cardiac Device Clinic, Assistant Professor of Medicine, Division of Cardiology, Case Medical Center, Cleveland, Ohio Assistant Professor, Division of Liver Diseases, Mount Sinai School of Medicine, New York, New York Cirrhosis Tachycardias Charles Grose, MD Robert C Goldstein, MD Fellow, Infectious Diseases, Beth Israel Medical Center, New York, New York Toxoplasmosis Professor of Pediatrics, University of Iowa Carver College of Medicine; Director of Infectious Diseases Division, Children’s Hospital of Iowa, Iowa City, Iowa Varicella (Chickenpox) Pyelonephritis (Continued ) epidemiology, 719 factors associated with, 719b imaging, 721 microbial etiology, 720–721 in pregnancy, 1034b treatment, 721, 721b Pyrazinamide, for tuberculosis, 297–298, 298t, 299t Pyrethrins with piperidyl butoxide (RID), for pediculosis, 867b, 868 Pyridostigmine (Mestinon), for myasthenia gravis, 966, 966b Pyridoxine (vitamin B6) for nausea and vomiting, 12t for poisoning, 1180t Pyrimethamine (Daraprim), for toxoplasmosis, 167t, 168, 864, 867b Q Q fever, 130 as biological weapon agent, 1239t clinical features, 130 diagnosis, 130–131 prevention, 131 treatment, 131, 131t Q-switched Nd:YAG laser, for solar lentigines, 897 Q-switched ruby laser, for vitiligo, 898–899, 898b QT interval abnormalities, 315–316 Brugada syndrome, 316 catecholaminergic ventricular tachycardia, 316 drugs known to cause, 315t Wolff-Parkinson-White syndrome, 316 Quadrigeminy, 324 Quetiapine (Seroquel) for Alzheimer’s disease, 903–904, 904t for bipolar disorder, 1136, 1137t for delirium, 1130t, 1131b for schizophrenia, 1140t Quinacrine (Atabrine), 69t for Giardia, 558, 579t Quinapril (Accupril), for hypertension, 364t Quinidine for atrial fibrillation, 320b reference intervals for, 1232t Quinidine gluconate, for malaria, 107, 109t, 110t Quinine sulfate (Qualaquin), for malaria, 107, 109t, 110t Quinolones for bacterial prostatitis, 727 for cystic fibrosis, 247 3-quinuclidinyl benzilate, 1236t R RAAS See Renin-angiotensin-aldosterone system Rabeprazole (Aciphex), for Helicobacter pylori, 545t Rabies, 131 clinical features, 131–132 diagnosis, 132, 132b epidemiology, 132 management of human, 133 pathogenesis, 131 prevention, 132–133 treatment, 132b viral meningitis and encephalitis, 956t Radial scars, breast, 1063 Radiation therapy for acromegaly, 650 for basal cell carcinoma, 815 for Cushing’ syndrome, 658 for cutaneous T-cell lymphomas, 821 for endometrial cancer, 1099–1100 for Hodgkin’s lymphoma (Hodgkin’s disease) acute effects, 456–457 late effects, 457 for keloids, 839 for lung cancer, 252–253 for multiple myeloma, 482 for non-Hodgkin’s lymphoma and, 479 for skin cancer, 815t Radicular pain, 43, 45b Radiofrequency ablation, for atrial fibrillation, 323 Radiographic contrast media, allergic reactions to, 797 Radiography in ankylosing spondylitis, 1006–1007 chest radiograph stages of sarcoidosis, 288t Radiography (Continued ) in osteomyelitis, 1022–1023 in pericardial disease, 378 in pregnancy, 1034 in pulmonary embolism, 284 in silicosis, 293 in toxicology, 1187–1188 Radionucleotide imaging, in osteomyelitis, 1022 Raloxifene (Evista) calcium-lowering by, 664 for menopause, 1088 for osteoporosis, 630, 630b, 631, 631t Raltegravir (Isentress), 50t Ramelteon (Rozerem), for insomnia, 910t Ramipril (Altace), for hypertension, 364t, 368 Ranitidine (Zantac), for gastric and peptic ulcer disease, 545t Ranolazine, for angina pectoris, 311 Ranson’s criteria, in acute pancreatitis, 561b Rasagiline, for parkinsonism, 977 Rasburicase (Elitek), for tumor lysis syndrome (TLS), 465 Rat-bite fever, 133 clinical presentation, 133 diagnosis, 134, 134b differential diagnosis, 134 epidemiology, 133 treatment, 134, 134b Rate control, for atrial fibrillation, 320b, 321–322 Raynaud’s phenomenon, 830 Rectum, tumors of, 572 Recurrent respiratory papillomatosis, 227, 227f Red blood cells alloimmunization, 414 membrane structure of, 403f therapeutic use, 490–492 frozen RBCs, 491 indications for RBC transfusion, 491–492 irradiated RBCs, 491 leukoreduced RBCs, 491 washed RBCs, 491 Red clover flower, 1243t Reentry atrioventricular node reentry tachycardia, 333–334, 333f, 334f diagram, 332f Reference intervals, 1227 for clinical chemistry (blood, serum, and plasma), 1230t for clinical chemistry (urine), 1233t for gastrointestinal function tests, 1235t for immunologic function tests, 1235t International System of Units, 1227–1228, 1227t, 1228t for lymphocyte subsets, 1235t normal values, 1227 for semen analysis, 1235t standard prefixes, 1228t for therapeutic drug monitoring, 1232t for toxic substances, 1234t Reflex sympathetic dystrophy, 1014 Refractive errors current therapy, 190b diagnosis, 189, 189b surgical correction, 189–192 types, 187–188, 188f Rehabilitation of stroke patient, 923 bladder dysfunction, 925 cognitive dysfunction, 924 depression and neuropharmacology, 924 dysphagia, 924 falls, 925–926 hemiparesis, 923–924 hemiplegic shoulder pain, 924 mobility and use of adaptive equipment, 925 spasticity, 924 visual impairment, 926 Rehydration, for acute infectious diarrhea, 21–22, 21b Reinke’s edema, 226–227, 227f Relapsing fever, 135 clinical diagnosis, 135–136, 135b epidemiology, 135, 135t Jarisch-Herxheimer reaction, 137, 137b laboratory diagnosis, 136 outcome, 137 prevention, 137 treatment, 136–137, 136t, 137b REM sleep behavior disorder, 915, 915t Renal calculi, 758 classification of, 759t Index Psychiatric disorders (Continued ) substance-induced, 1136 suicide, 1132 treatment, 1133b panic disorder, 1142 course and prognosis, 1146 diagnosis, 1142–1143, 1143b differential diagnosis, 1143–1144, 1144t symptoms of panic attack, 1143b treatment, 1144–1145 algorithm for acute, 1144f current therapy, 1145b pharmacotherapy, 1145, 1145t psychotherapy, 1145 schizophrenia, 1139 comorbidity, 1141 diagnosis, 1139–1140, 1139b epidemiology and risk factors, 1139 treatment, 1140–1141, 1140t, 1141b Psychocutaneous medicine, 801 ´ acne excoriee and neurotic excoriations, 802b, 803–805, 803b classification, 801 cutaneous sensory disorders, 802b, 803b, 806–807 delusions of parasitosis, 801–802, 802b, 803b dermatitis artefacta (factitious dermatitis), 802–803, 802b, 803b diagnosis, 802b lichen simplex chronicus, 802b, 803b, 806 medications, 803b, 804t, 807 monitoring of patients on atypical antipsychotics, 802t prurigo nodularis, 802b, 803b, 805–806 trichotillomania, 802b, 803b, 806 Psychopharmacologic drugs, reference intervals for, 1232t Psychosis, postpartum, 1044 Psychosocial therapy, for attention-deficit/hyperactivity disorder, 947 Psychotherapy, for tinnitus, 40b, 41 Psyllium (Metamucil), for constipation, 25, 25t PT (prothrombin time), in disseminated intravascular coagulation, 438 PTP See Post-transfusion purpura Puffer fish, 1171 Pulmonary agents, as chemical weapons, 1236t Pulmonary angiography, in pulmonary embolism (PE), 285 Pulmonary edema cardiogenic, 238 high-altitude, 1153b, 1154–1155, 1154b Pulmonary embolism diagnosis, 283–285, 385 chest radiograph, 284 clinical features, 283–284 compression ultrasonography, 285 computed tomographic pulmonary angiography, 284–285 d-dimer blood testing, 285 electrocardiography, 284 pulmonary angiography, 285 test results that confirm or exclude, 284b ventilation/perfusion lung scanning, 284 Wells model, 284t epidemiology, 281 natural history, 282b risk stratification, 281t Pulmonary histoplasmosis acute, 257, 259t chronic, 257, 259t Pulmonary hypertension, in sickle cell disease, 415, 420–421 Pulmonary hypoplasia, 1056–1057 clinical manifestation, 1056 diagnosis, 1056 differential diagnosis, 1056 epidemiology, 1056 pathophysiology, 1056 risk factors, 1056 treatment, 1056–1057 Pulmonary rehabilitation, for chronic obstructive pulmonary disease (COPD), 241 Pulmonary sarcoidosis, 288–289 Pulmonic stenosis, 339–340 Pulsed-dye laser therapy, for warts, 841, 842 PUVA See Psoralen-ultraviolet A (PUVA) photochemotherapy Pyelonephritis, 719 See also Urinary tract infections clinical presentation, 720 diagnosis, 720, 720b 1301 Index 1302 Renal calculi (Continued ) diagnosis, 759 epidemiology, 758 laboratory and radiographic studies, 759 pathophysiology, 758–759 cystinuria, 759 hypercalciuria, 758–759 hyperuricosuria, 759 infection stones, 759 treatment, 759–760 medical care, 759–760, 760t surgical care, 760 Renal cell carcinoma, 748–749 Renal disease hepatorenal syndrome, 514 insufficiency, in multiple myeloma, 482 in sickle cell disease, 414–415 in thrombotic thrombocytopenic purpura, 440 Renal failure acute, 737 classification/causes, 737–740, 738b acute tubular necrosis, 738b, 739–740, 740t glomerular disease, 739 interstitial disease, 740 obstructive disease, 740 prerenal azotemia, 737–740, 738b, 740b, 740t definitions, 737 emerging issues, 740–741 epidemiology, 737 parenteral nutrition in, 640 treatment, 740, 741b chronic blood urea nitrogen, 746 causes of, 741 clinical abnormalities in, 742–743, 742t abnormal divalent in metabolism, 743, 746 anemia, 743, 745 hyperkalemia, 743, 746 hypernatremia, 743 hypertension, 743, 745 hyponatremia, 743 metabolic acidosis, 743, 745–746 volume overload, 743, 746 diagnosis of, 741–742, 742b management of, 743–745 parenteral nutrition in, 640 progression of, factors influencing, 744–745 protein restriction, 745 pruritus in, 35b, 37b staging of, 743–744 symptoms and signs of, 743 treatment to correct laboratory abnormalities, 745–746, 746b general approach, 744 to reduce rate of progression, 745 Renal sarcoidosis, 289 Renin-angiotensin-aldosterone system (RAAS), 667, 667f Renovascular hypertension, 363, 363b Repaglinide (Prandin), for diabetes mellitus, 594t Reperfusion therapy, for acute myocardial infarction, 371, 371f Reserpine, for hypertension, 364t Respiratory failure, acute, 233 definitions and pathophysiology, 233–234 acute hypercapnic respiratory failure, 234, 234b acute hypoxic respiratory failure, 233, 234t diagnosis, 237b screening criteria to assess readiness to undergo a trial of spontaneous breathing, 239b specific causes, 236–238 acute exacerbation of chronic obstructive pulmonary disease, 236–237 acute lung injury and acute respiratory distress syndrome, 237–238 cardiogenic pulmonary edema, 238 therapy, 237b treatment, 234–236 acute hypercapnic respiratory failure, 235b acute hypoxemic respiratory failure, 234b mechanical ventilation, 235–236 invasive ventilation, 236 noninvasive ventilation, 235–236, 236t oxygen therapy, 234–235, 235t Respiratory stimulants, reference intervals for, 1232t Respiratory syncytial virus (RSV), 274–275 Respiratory system in acromegaly, 649 Respiratory system (Continued ) acute bronchitis, 268 acute respiratory failure, 233 atelectasis, 238 bacterial pneumonia, 269 blastomycosis, 260 chronic obstructive pulmonary disease, 239 coccidioidomycosis, 255 cystic fibrosis, 244 hepatopulmonary syndrome, 515 histoplasmosis, 256 hypersensitivity pneumonitis, 294 legionellosis, 279 in obesity, 624 obstructive sleep apnea, 247 pleural effusions and empyema thoracis, 264 pneumoconiosis, 291 pneumonias, viral and mycoplasmal, 275 portopulmonary hypertension, 514–515 primary lung abscess, 266 primary lung cancer, 250 pulmonary hypoplasia, 1056–1057 sarcoidosis, 288 in sickle cell disease, 415 transfusion-related acute lung injury, 497–498 tuberculosis and other mycobacterial diseases, 295 venous thromboembolism, 280 viral respiratory infections, 273 bronchiolitis, 274–275 common colds, 273–274 croup, 274 diagnosis, 274b influenza-like illness, 274 influenza pneumonia, 275–276, 276t, 277b treatment, 274b Resting energy expenditure, 636 Restless legs syndrome, 916 clinical manifestations and diagnosis, 916 pharmacologic treatment, 916t treatment for pain, Resuscitation See Newborn resuscitation Reteplase (Retavase), for acute myocardial infarction, 372t Reticulocytosis, in autoimmune hemolytic anemia, 396b Retinal abnormalities, in sickle cell disease, 414 Retinoids for acne vulgaris, 808 for actinic keratoses or cheilitis, 852 for cutaneous T-cell lymphomas, 821 for genital warts, 844t for lichen planopilaris, 813 Retinopathy, diabetic, 603 Retrograde urethrogram, for urethral stricture, 757f Rewarming strategies, 1156–1158 active core warming, 1157–1158 active external warming, 1157 passive external warming, 1157 RF See Rheumatoid factor Rh-immunoglobulin (RhoGAM), 424–425, 426 Rheumatoid arthritis, 997 diagnosis, 997, 997b treatment, 997–1000 analgesics, 998 B-cell directed therapy, 999–1000 biological response modifiers, 999–1000 current therapy, 1000b disease-modifying antirheumatic drugs (DMARDs), 998–999 glucocorticoids, 998 interleukin-1 receptor antagonist, 999 nonsteroidal antiinflammatory drugs, 998 T-cell directed therapy, 1000 tumor necrosis factor-a inhibitors, 999 Rheumatoid factor (RF) in juvenile idiopathic arthritis, 1001, 1002b reference intervals for, 1235t Rhinitis algorithm, 794f allergic, cough and, 28b, 31b allergic caused by inhalant factors, 792 diagnosis, 793–794, 793b differential diagnosis, 793, 793b management overview, 795–796 pathophysiology and morbidity, 792 treatment, 794–795, 794b, 795b allergic rhinitis caused by inhalant factors, 792 differential diagnosis, 793b nonallergic perennial, 219 Rhinitis (Continued ) atrophic rhinitis, 220 classification, 219, 220f diagnosis, 221, 221b differential diagnosis, 221b drug-induced, 220 hormonal rhinitis, 220 nonallergic rhinitis with eosinophilia syndrome (NARES), 220 pathophysiology, 220–221 reflexive and idiopathic rhinitides, 220 surgical intervention, 223 treatment, 221–223, 221b, 222t Rhinovirus, 273 Rho(D) immune globulin (RhoGAM), 1031 Rhythm control, for atrial fibrillation, 320b, 322–323 Ribavirin (Rebetol, Virazole), 60t for respiratory syncytial virus, 274–275 Ricin toxin, as biological weapon agent, 1239t Rickettsial infections, 176–177 Rickettsia parkeri, 177 Rocky Mountain spotted fever, 176–177 Riedel’s thyroiditis, 697 Rifabutin (Mycobutin), for tuberculosis, 297, 298t Rifampin (Rifadin, Rimactane) for anthrax meningitis, 126t for bacterial meningitis prophylaxis, 116 for brucellosis, 76b, 77t for cholestasis-associated pruritus, 37b for infective endocarditis, 358t for legionellosis, 279, 279t for leprosy, 100b, 300 for Mycobacterium avium complex infection, 300 for Q fever, 131 for tuberculosis, 297–298, 298t, 299t Rifapentine (Priftin), for tuberculosis, 299t Rifaximin (Xifaxan) for irritable bowel syndrome, 537t for portosystemic (hepatic) encephalopathy, 513 for traveler’s diarrhea, 156 Right ventricular infarction, 374–375 Rimantadine (Flumadine) for influenza, 277b in acute bronchitis, 269, 269b for influenza-like illness, 274 Ringworm (tinea corporis), 869, 870t Riot control agents, as chemical weapons, 1236t RIPA (ristocetin-induced platelet aggregation) assay, 432 Risedronate (Actonel) for osteoporosis, 630, 630b, 631t for Paget’s disease of bone, 633, 633b Risperidone (Risperdal) for Alzheimer’s disease, 903–904, 904t for bipolar disorder, 1136, 1137t for delirium, 1130t, 1131b for psychocutaneous disorders, 804t for schizophrenia, 1140t for Tourette syndrome, 949t Ristocetin cofactor assay, for von Willebrand’s disease, 432 Ristocetin-induced platelet aggregation (RIPA) assay, 432 Ritonavir (Norvir), 50t, 60t Rituximab (Rituxan) for autoimmune hemolytic anemia, 396, 397 for bullous diseases, 888 for chronic lymphocytic leukemia, 471b, 472 for diffuse large B-cell lymphoma, 477b, 478 for paraneoplastic pemphigus, 890 for rheumatoid arthritis, 999, 1000b Rivastigmine (Exelon), for Alzheimer’s disease, 902, 903t, 904b River blindness See Onchocerciasis Rizatriptan (Maxalt), for migraine headaches, 953t, 954 Rocky Mountain spotted fever (RMSF), 176 clinical features and diagnosis, 176–177, 177b epidemiology, 176 pathogenesis, 176 prevention, 177 ticks as vectors, 176 treatment, 177 Romidepsin (Istodax), 1252t Ropinirole (Requip) for parkinsonism, 975–976, 976t for restless legs syndrome, 916, 916t Rosacea, 809–810 classification, 809 diagnosis, 809, 809b differential diagnosis, 809 S S-adenosyl-L-methionine (SAMe), 1243t Sal/lactic acid (Occlusal, Duofilm), for molluscum contagiosum, 863t Salicylic acid toxicology of, 1220–1222, 1221t for warts, 841 Salicylate, reference intervals for, 1232t Saline, hypertonic for cystic fibrosis, 246 Salmeterol (Serevent) for asthma, 784t, 790t for chronic obstructive pulmonary disease, 242b, 243 Salmeterol-fluticasone (Advair) for asthma, 784t for chronic obstructive pulmonary disease, 242–243, 242b Salmonella acute infectious diarrhea, 18, 21 antibiotic resistance, 171 osteomyelitis, 1023t Salmonella enterica, 170–171 Salmonellosis, 170 bacteremia and focal infection, 173 carrier state, 173–174 clinical presentation, 171–172, 171t diagnosis, 172b enteric fever, 173 epidemiology, 171 gastroenteritis, 171–172 microbiology of, 170–171 pathogenesis, 171 predisposing factors for, 171t prevention, 174 surgery, for focal infection, 173 treatment, for bacteremia and focal infection, 173 treatment, for enteric fever, 173 treatment, for gastroenteritis, 172, 172b antibiotics, 172 antimotility and antinausea agents, 172 fluid and electrolyte replacement, 172 Salsalate, for osteoarthritis, 1017 Salt wasting, cerebral, 611, 614 SAMe (S-adenosyl-L-methionine), 1243t Saquinavir (Invirase), 50t, 54t, 60t Sarcoidosis, 288 chest radiograph stages of, 288t clinical features and course, 288–289 extrapulmonary sarcoidosis, 289 pulmonary sarcoidosis, 288–289 Sarcoidosis (Continued ) diagnosis, 289–290, 290b epidemiology, 288 immunopathogenesis, 288 prognosis, 290b treatment, 290–291, 290b Sarcomas angiosarcoma, 816 Kaposi’s, 816 vulva neoplasms, 1107 Sarin, as chemical weapon, 1236t Saw palmetto berry, 1243t Saxagliptin, 1252t Scabies, 867–868 current therapy, 867b diagnosis, 865b pruritus with, 33b Scaphoid fractures, 1025–1026 Schilling test, 556 Schistosomiasis, 586, 866 current therapy, 867b diagnosis, 865b treatment, 585t Schizophrenia, 1139 comorbidity, 1141 diagnosis, 1139–1140, 1139b epidemiology and risk factors, 1139 treatment, 1140–1141, 1140t, 1141b Schwachman-Diamond syndrome, 391t neutropenia in, 423t, 424 Scleritis, 197 Scleroderma, 829–831 clinical features, 829–830 diagnosis, 829b pruritus in, 35b treatment, 830–831 current therapy, 830b of gastrointestinal manifestations, 830 of limited scleroderma, 830 of pulmonary manifestations, 830–831 of renal manifestations, 830–831 of systemic sclerosis (Raynaud’s phenomenon), 830 Scoliosis, low back pain from, 44t Scombroid poisoning, 1170–1171 Scopolamine, for nausea and vomiting, 12t Scorpion stings, 1162b, 1163 Scrotum, trauma to, 724–725 Sea and fresh water bacterial infections, 857–858 Sea bather’s itch, 1172 Sea urchins, 1172 Sea snakes, 1172 Sebaceous carcinoma, 815–816 Seborrheic blepharitis, 196, 196t, 197f Secnidazole (Noameba-DS, Secnil), 69t Secretagogues, for diabetes mellitus, 593–594 Secretin test for pancreatic exocrine insufficiency, 556 reference values for, 1235t Seizures absence, 928 atonic, 928 defined, 927 epilepsy and seizures in adolescents and adults, 927 classification, 927–928 diagnosis, 928–929, 928b differential diagnosis, 929 epidemiology, 927 refractory epilepsy, 934 special patient populations, 933–934 treatment, 929–933, 929b, 930t epilepsy in infants and children, 935 assessment, 938–939 classification, 935–936, 935b epilepsy syndromes, 936–938, 936b treatment, 939–943, 940t, 941t febrile, 27, 938 generalized, 928, 935–936 in heat stroke, 1161 neonatal, 937–938 psychogenic nonepileptic, 929 recurrent, 929 simple partial, 928 syncopal, 929 tonic-clonic, 928, 935–936 Selective estrogen receptor modulator (SERM) for endometrial cancer, 1100 for menopause, 1087b, 1088 for osteoporosis, 630, 631 Selective serotonin reuptake inhibitors (SSRIs) for Alzheimer’s disease, 904, 904t for fibromyalgia, 1015 for irritable bowel syndrome, 537t for major depression, 1134, 1134t for menopause, 1087t for panic disorder, 1145, 1145b, 1145t for premenstrual syndrome, 1083–1084, 1084b for psychocutaneous disorders, 803b, 804t in stroke rehabilitation, 925t for tension-type headaches, 952 toxicology of, 1222–1223 Selegiline (Eldepryl) for Alzheimer’s disease, 903 for parkinsonism, 977 Selenium sulfide (Selsun Blue) for seborrheic dermatitis, 812–813 for tinea versicolor, 870t Self-inflating bags, for newborn resuscitation, 1047, 1047f Semen analysis, reference intervals for, 1235t Sepsis, 70 catheter, 641–642 definitions, 70–71 diagnosis, 71, 71b epidemiology, 70 pathophysiology, 71 prognosis, 74 treatment, 71–74 antibiotics, 73–74, 73t early resuscitation, 71–72, 72b source control, 72 subsequent interventions, 72–73, 72b Septic shock, 70–71, 71b, 72 SERM See Selective estrogen receptor modulator Serology testing for myasthenia gravis, 965 for syphilis, 768, 769b Serotonin antagonists, for nausea and vomiting, 12t Serotonin-norepinephrine reuptake inhibitors (SNRIs) for major depression, 1134, 1135t for psychocutaneous disorders, 803b, 804t Serratia marcescens, in osteomyelitis, 1023t Sertraline (Zoloft) for Alzheimer’s disease, 904, 904t for fibromyalgia, 1012b, 1015 for major depression, 1134t for panic disorder, 1145t for premenstrual syndrome, 1084b for psychocutaneous disorders, 804t in stroke rehabilitation, 925t for tension-type headaches, 952 Serum sickness, 777–778, 778t Sestamibi, 664 Sexually transmitted diseases, 761–774 contraception, 770 genital ulcer disease, 761 chancroid, 761–762, 762f, 762t granuloma inguinale (donovanosis), 762–763, 762t, 763f lymphogranuloma venereum, 762t, 763, 763f gonorrhea, 764 nongonococcal urethritis, 766 syphilis, 768 ´ Sezary prep, 818 ´ Sezary syndrome, 818 clinical features, 819 diagnosis, 818 histopathologic and cytologic features, 819 immunophenotyping, 819 lymphoproliferative disorders associated with, 822 molecular biology, 819 TNMB staging, 819–820, 820t treatment, 820–822 Shaking-impact syndrome, 989–990 Sharks, 1173 Shift work sleep disorder, 914 Shigella, in acute infectious diarrhea, 18 Shingles, 860 Short Michigan Alcoholism Screening Test-Geriatric (SMAST-G), 1112, 1114b Shoulder bursitis and tendinitis, 1012–1013 hemiplegic shoulder pain and stroke, 924 Shoulder-hand syndrome, 1014 Sialologs, for xerostomia, 873 Sibutramine (Meridia), for weight loss, 626, 626t Sick sinus syndrome, atrial fibrillation in, 318 Index Rosacea (Continued ) treatment, 809–810 current therapy, 809b isotretinoin, 810 oral antibiotics, 809–810 physical modalities, 810 topical antibiotics, 809 Rosiglitazone (Avandia) for Cushing’ syndrome, 658 for diabetes mellitus, 594t, 595 Rosuvastatin (Crestor), for dyslipoproteinemia, 620, 621t Rotator cuff tendinitis, 1012 Rotavirus acute infectious diarrhea, 19 vaccine, 21, 150t, 152t Rotigotine, for parkinsonism, 975–976 Roundworms See Nematodes Roux-en-Y gastric bypass, 626 Rowasa, for inflammatory bowel disease, 533t RSV (respiratory syncytial virus), 274–275 Rubella, 141 clinical manifestations, 141 complications, 141 congenital rubella syndrome, 141, 1032, 1033b diagnosis, 141–142, 142b differential diagnosis, 141–142 epidemiology, 141 during pregnancy, 141 in pregnancy, 1032 prevention, 142 treatment, 142, 142b vaccine, 142, 150t, 152t, 153t viral meningitis and encephalitis, 956t Rubeola See Measles Rufinamide (Banzel), for epilepsy, 933, 941t Rule of Nines, 1147, 1148f Runner’s knee, 1026 1303 Index 1304 Sickle cell disease, 412 blood smear, 399f clinical manifestations, 412–417 acute chest syndrome, 416f cardiology, 415–416 endocrinology, 417 gastroenterology, 415 hematology, 413–414 infectious disease, 415 leg ulcers, 415 nephrology, 414–415 neurology, 414 ophthalmology, 414 priapism, 417 pulmonology, 415 clinical trials, landmark, 413t complications, 413f diagnosis, 417, 417b late diagnoses and misdiagnoses, 417 neonatal screening, 417 epidemiology, 412 pathophysiology, 412 prevention, 412 severity, 413t treatment, 417–422, 418t bone marrow transplantation, 421 chronic pain, 419 current therapy, 418b erythropoietic stimulating agents, 419–420 experimental, 422 hematopoietic stem cell transplantation, 421, 421f hydroxyurea, 420, 420f iron chelation, 419 modulation of cellular dehydration, 422 modulation of nitric oxide and arginine, 422 nutritional considerations, 420 for pulmonary hypertension, 420–421 surgical issues, 422 transfusional therapy, 419 vaso-occlusive episodes, 417–419 Sildenafil (Revatio), for portopulmonary hypertension, 515 Sildenafil citrate (Viagra) contraindications, 734 for erectile dysfunction, 734 mechanism of action, 732f side effects, 734 Silicone gel sheeting, for keloids, 839–840 Silicoproteinosis, 293 Silicosis, 292–293 criteria for diagnosis, 293 radiographic patterns, 293 syndromes, 293 treatment, 293, 293b Silver nitrate, for gonococcal conjunctivitis of the newborn, 195 Simethicone (Mylicon), for gaseousness, 13–14, 14b Simvastatin (Zocor) for acute myocardial infarction, 373t for dyslipoproteinemia, 620, 621t Single photon-emission computed tomography (SPECT), in epilepsy, 934, 943 Sinus tachycardia, 335 Sinusitis, 217 bacterial (purulent), 217 diagnosis, 217–218, 218b, 218t differential diagnosis, 218 treatment, 218–219, 219b complications, 219 cough and, 28, 28b, 31b epidemiology of acute sinusitis, 217 pathogenesis, etiology and definitions, 217 predisposing factors, 217 recurrent, 219 viral (serous), 217 Sirolimus, reference intervals for, 1232t SIRS (systemic inflammatory response syndrome), 70 Sitagliptin (Januvia), for diabetes mellitus, 594t Skeletal growth, in acromegaly, 648 Skin cancer, 814 melanoma, 848 nonmelanoma, 814 basal cell carcinoma, 814–815 clinical images of, 814f cutaneous metastases, 817 diagnosis, 817b fibrohistiocytic malignancies, 816 atypical fibroxanthoma, 816 Skin cancer (Continued ) dermatofibrosarcoma protuberans, 816 Merkel cell carcinoma, 816–817 neoplasms of adnexal origin, 815–816 microcystic adnexal carcinoma, 816 sebaceous carcinoma, 815–816 Paget’s disease, 817 squamous cell carcinoma, 815 therapeutic modalities, overview of, 815t therapy, 817b vascular malignancies, 816 angiosarcoma, 816 Kaposi’s sarcoma, 816 Skin diseases, 801–900 acne vulgaris, 807 in acromegaly, 648 anogenital pruritus, 893 atopic dermatitis, 880 autoimmune connective tissue disease, 827–831 bacterial diseases, 854 in blastomycosis, 261b bullous diseases, 886 condyloma acuminata (genital warts), 842 contact dermatitis, 890 cutaneous T-cell lymphomas, 818 cutaneous vasculitis, 831 erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis, 884 fungal diseases, 869 hair diseases, 810 keloids, 837 melanocytic nevi, 845 melanoma, 848 mouth diseases, 871 mycosis fungoides, 818 nail diseases, 833 papulosquamous eruptions (psoriasis), 801–900 parasitic diseases, 863 pigmentary disorders, 896 premalignant cutaneous and mucosal lesions, 851 pressure ulcers, 879 psychocutaneous medicine, 801 ´ acne excoriee and neurotic excoriations, 802b, 803–805, 803b classification, 801 cutaneous sensory disorders, 802b, 803b, 806–807 delusions of parasitosis, 801–802, 802b, 803b dermatitis artefacta (factitious dermatitis), 802–803, 802b, 803b diagnosis, 802b lichen simplex chronicus, 802b, 803b, 806 medications, 803b, 804t, 807 monitoring of patients on atypical antipsychotics, 802t prurigo nodularis, 802b, 803b, 805–806 trichotillomania, 802b, 803b, 806 rosacea, 807 in sarcoidosis, 289 ´ Sezary syndrome, 818 skin cancer, 814 basal cell carcinoma, 814–815 cutaneous metastases, 817 fibrohistiocytic malignancies, 816 Merkel cell carcinoma, 816–817 neoplasms of adnexal origin, 815–816 Paget’s disease, 817 squamous cell carcinoma, 815 vascular malignancies, 816 sunburn, 899 urticaria and angioedema, 895 venous ulcers, 876 viral diseases, 858 warts (verruca), 840 Skin grafts, for venous ulcers, 878 Skin lubricants, for pruritus, 36b Sleep apnea central sleep apnea syndrome, 912 complex sleep apnea syndrome, 912 in obesity, 624 obstructive, 247, 910–911 definitions and terminology, 248b diagnosis, 248–249, 248b epidemiology, 248 monitoring, 250 in obesity, 624 pathophysiology, 248 prevention, 248 risk factors, 248 Sleep apnea (Continued ) severity, 250 treatment, 249–250, 249b, 911t oral appliances, 912 positional therapy, 911–912 positive airway pressure, 912 surgery, 912 weight loss, 912 upper airway resistance syndrome, 250 sleep-related hypoventilation, 912–913 treatment, 911–912, 911t Sleep disorders, 905 classification, 905, 906b clinical approach to patient, 905–907 diagnostic and therapeutic approach to common disorders, 908–917 circadian rhythm sleep disorders, 914 etiology and clinical manifestations, 914 treatment, 914 insomnia, 908–910, 909t, 910t narcolepsy and primary central nervous system hypersomnias, 913 parasomnias, 914–915, 915t sleep-disordered breathing, 910–913 central sleep apnea syndrome, 912 complex sleep apnea syndrome, 912 obstructive sleep apnea, 910–911 sleep-related hypoventilation, 912–913 snoring, 910 treatment, 911–912, 911t sleep-related movement disorders, 916–917 movement disorders, 917 restless legs syndrome, 916, 916t sleep-related bruxism, 917 sleep-related cramps, 916–917 diagnostic tools in sleep laboratory, 907–908, 908t actigraphy monitoring, 908, 908t home sleep monitoring, 907, 908t multiple sleep latency test (MSLT), 907–908 polysomnography, 907, 908t wakefulness testing, 908 in menopause, 1086 Sleep-related movement disorders, 916–917 movement disorders, 917 restless legs syndrome, 916, 916t sleep-related bruxism, 917 sleep-related cramps, 916–917 Sleep talking, 917 Slow brainstem syndrome, tinnitus in, 40 Small bowel bacterial overgrowth diagnosis of, 558 malabsorption, 558 test for, 556 Small intestine diverticula, 527–528 duodenal diverticula, 527, 527f jejunal and ileal diverticula, 527 Meckel’s diverticulum, 527–528 Smallpox, 179 as bioweapon, 179, 1239t clinical course, 179–182, 180f, 184f clinical features, 179 differential diagnosis and laboratory studies, 183–185, 183b, 183t eradication, 179 treatment, 185, 185b Smoke inhalation, 1151 Smoking as angina pectoris risk factor, 309 and otitis media, 207 and vocal cord cancer, 227 Smoking cessation, for chronic obstructive pulmonary disease (COPD), 241, 241t Snail fever See Schistosomiasis Snakebite, venomous, 1164 diagnosis and management overview, 1164 elapid envenomations, 1167–1168 clinical effects, 1167–1168 epidemiology and recognition, 1167 management, 1168, 1168b exotic, 1168 clinical effects, 1168 epidemiology, 1168 management, 1168 snake identification, 1164 viperid envenomations, 1164–1167 clinical effects, 1165 dispositions, 1167 duration of effects, 1165 Splenectomy for b-thalassemia major, 409 for platelet disorders, 436 in sickle cell disease, 422 Splenic sarcoidosis, 289 Spondylitis See Ankylosing spondylitis Spondylolisthesis, low back pain from, 44t Spondylolysis, low back pain from, 43 Spontaneous bacterial peritonitis, 512–513 signs and symptoms, 512, 512t treatment, 513 Sports injuries, 1024 ankle injuries, 1024–1025 lateral inversion sprain, 1024 medial eversion sprain, 1024–1025 finger injuries, 1026 hand injuries, 1025–1026 scaphoid fractures, 1025–1026 head injuries, 988 knee injuries, 1025 anterior cruciate ligament tear, 1025 medial collateral ligament sprain, 1025 overuse syndromes, 1026–1027 iliotibial band syndrome, 1026–1027 lateral epicondylitis, 1027 medial epicondylitis, 1027 patellofemoral pain syndrome, 1026 Squamous cell carcinoma, 815 clinical image of, 814f suspicion of oral, 871–872, 871t vulva neoplasms, 1105–1106 Squaric acid dibutylester (SADBE) for alopecia, 813 for warts, 841 SSRIs See Selective serotonin reuptake inhibitors St John’s wort, 1243t ST-elevation myocardial infarction (STEMI), 371–374 Stachybotrys, as biological weapon agent, 1239t Staging See specific cancers Staging of Reproductive Aging Workshop (STRAW) staging system, 1085, 1085b Staphylococcal blepharitis, 196, 196t, 197f Staphylococcus aureus acute infectious diarrhea, 19 atopic dermatitis lesions, 881, 883 as biological weapon agent, 1239t cellulitis, 855 conjunctivitis, 194 folliculitis, 854–855 foodborne illness, 85 impetigo, 854 infective endocarditis, 358b methicillin-resistant Staphylococcus aureus (MRSA), 70, 75, 86t, 88, 195, 854, 854t, 1023t, 1024 osteomyelitis, 1023t, 1024 pneumonia, 270, 271–272, 271b, 276 suggested antibiotic therapy for, 854t Staphylococcus sp., otitis externa from, 206 Statins, for dyslipoproteinemia, 620, 621t STATS mnemonic, 1176 Stavudine (Zerit), 50t STEMI (ST-elevation myocardial infarction), 371–374 Stents carotid angioplasty and stenting, 381 pancreatic duct, 565, 566f soft palate for obstructive sleep apnea, 249 venous, 387 Sterilization, for permanent birth control, 773, 773t Steroids See also Corticosteroids for inflammatory bowel disease, 533 for polyarticular juvenile idiopathic arthritis, 1003 for psoriasis, 824, 824b Stevens-Johnson syndrome causes, 885, 885b diagnosis, 884b, 885 predicted mortality, 886t treatment, 885–886, 885b Stibogluconate (Pentostam), for leishmaniasis, 864, 867b Stimulants for attention-deficit/hyperactivity disorder, 944b, 945 in stroke rehabilitation, 925t Stinging insects, allergic reactions to, 798 diagnosis, 798–799, 799b treatment, 799–800, 800b Stinging nettle root, 1243t Stingrays, 1172 Stomach diverticula, 527 Stomach tumors, 569 carcinoid tumors, 571–572 gastric adenocarcinoma, 569–571 classification and epidemiology, 569–570 diagnosis, 570, 570b risk factors, 570 staging, 571 treatment, 570b, 571 gastric lymphomas, 570b, 572 gastrointestinal stromal tumors, 571 Stomatitis, aphthous, 872b, 873–874 STRAW staging system, 1085, 1085b Streptobacillus moniliformis See Rat-bite fever Streptococcal pharyngitis clinical manifestations, 229–230 epidemiology, 229 pathophysiology, 229 prevention, 229 risk factors, 229 Streptococcus pneumoniae antibiotic resistance, 209 and conjunctivitis, 194 osteomyelitis, 1023t otitis media, 207 pneumonia, 269–270, 271–272, 271b, 273t as influenza complication, 276, 277b Streptococcus pyogenes gangrene, 855 Streptomycin for brucellosis, 77t for plaque, 124–125 for rat-bite fever, 134, 134b for tuberculosis, 297–298 Streptozocin (Zanosar), for Cushing’s syndrome, 658 Stress incontinence, 710, 711–712 Stroke See also Ischemic cerebrovascular disease in atrial fibrillation, 318, 318b, 921t management of acute ischemic, 921–922 management of acute ischemic stroke, 921–922 antithrombotic drugs, 922 thrombolysis, 922 treatment of complications, 922 management of carotid stenosis, 921 prevention, 921 antithrombotic therapy, 921 in atrial fibrillation patients, 921t rehabilitation of stroke patient, 923 bladder dysfunction, 925 cognitive dysfunction, 924 depression and neuropharmacology, 924 determination of patient needs, 923f dysphagia, 924 falls, 925–926 hemiparesis, 923–924 hemiplegic shoulder pain, 924 mobility and use of adaptive equipment, 925, 926f spasticity, 924 visual impairment, 926 in sickle cell disease, 412, 414 and vertigo presentation, 211 Strongyloides, 584 treatment, 585t Stye See Hordeolum Subacromial bursitis, 1012 Subclavian vein thrombosis, 385 Subconjunctival hemorrhage, 195, 196f Subdural hematoma, 985–986, 989 Subjective global assessment, in nutritional assessment, 636, 636b Substance-induced mood disorders, 1133b Subungual hematoma, 836 clinical features and diagnosis, 836 treatment, 836 Succimer, for lead poisoning, 1180t, 1210, 1210t Sucralfate, for gastric and peptic ulcer disease, 544, 545t Sudden cardiac death, 343 See also Cardiac arrest hypertrophic cardiomyopathy, 343 markers of, 343 risk stratification for, 343 Sudeck’s atrophy, 1014 Suicide, 1132 Sulfacetamide (Klaron) for acne vulgaris, 808 for bacterial conjunctivitis, 194t for rosacea, 885 Sulfadiazine, for toxoplasmosis, 167t, 168, 864, 867b Sulfapyridine for bullous pemphigoid, 889 for dermatitis herpetiformis, 889 Index Snakebite, venomous (Continued ) epidemiology and recognition, 1164–1165 management, 1165–1167 antibiotics, 1166 antivenom, 1165, 1166b hematologic effects, 1167, 1167b initial hospital, 1165, 1166b of local tissue injury, 1166 long-term local tissue effects, 1166 maintenance doses, 1166 prehospital, 1165b severity, 1165 SNC See Synergistic necrotizing cellulitis Sniffing position, 1046, 1046f Snoring, 247, 248b, 910 SNRIs See Serotonin-norepinephrine reuptake inhibitors Sodium hypernatremia, parenteral fluid therapy in children, 645–646 hyponatremia, 608 central nervous system response to, 609 classification and differential diagnosis, 609–612, 610f clinical presentation, 608 diagnosis, 609b laboratory findings, 610f management, 612–614, 613f molecules that regulate vasopressin, 609t parenteral fluid therapy in children, 645 water balance regulation, 608–609 renal handling of, 609 Sodium bicarbonate for antidepressant toxicity, 1226 for newborn resuscitation, 1049t for poisonings, 1180t for salicylate poisoning, 1221t, 1222 Sodium hyaluronate (Euflexxa, Hyalgan, Supartz), for osteoarthritis, 1018, 1018t Sodium iodide, radioactive for hyperthyroidism, 683 Soft palate ablation, for obstructive sleep apnea, 249 Soft palate stents, for obstructive sleep apnea, 249 Solar lentigo, 897 description, 897 diagnosis, 897b treatment, 897, 898b SOM-230 (pasireotide), for Cushing’ syndrome, 658 Soman, as chemical weapon, 1236t Somatostatin analogues for acromegaly, 650, 650b for bleeding esophageal varices, 521 Somniloquy, 917 Sorafenib (Nexavar), for endometrial cancer, 1100 Sorbitol, for constipation, 25, 25t Sotalol (Betapace) for atrial fibrillation, 320b pharmacologic and toxic properties of, 1194t Soy, 1243t Spasticity, stroke and, 924 SPECT (single photon-emission computed tomography), in epilepsy, 934, 943 Spermatozoa analysis, reference intervals for, 1235t Spherocytosis, hereditary, 399f, 402–403 Spider bites, 1162–1163 black widow spider, 1163 brown recluse spider, 1162–1163 diagnosis, 1162b tarantulas, 1163 therapy, 1162b Spinal cord stimulation, for angina pectoris, 312 Spinal stenosis, low back pain from, 44t Spine pain, 42 clinical manifestations, 43 complications, 45–46 diagnosis, 43, 43b differential diagnosis, 43, 44t epidemiology, 42 monitoring, 45 pathophysiology, 42–43 prevention, 43 risk factors, 42 therapy, 44–45, 44b, 45b Spiramycin (Rovamycine), for toxoplasmosis, 167t Spironolactone (Aldactone) for heart failure, 353t for hypertension, 364t, 367 for pattern alopecia, 812b for primary aldosteronism, 673 Spitz nevi, 847 1305 Index 1306 Sulfapyridine (Continued ) for linear immunoglobulin A disease, 889 Sulfasalazine (Azulfidine) for alopecia, 813 for ankylosing spondylitis, 1007, 1007b for rheumatoid arthritis, 998, 1000b Sulfonamides, allergic reactions to, 797 Sulfonylureas, for diabetes mellitus, 594t Sulfur dioxide, as chemical weapon, 1236t Sulfur mustard, as chemical weapon, 1236t Sulfur ointment, for scabies, 867b, 868 Sulindac (Clinoril) for osteoarthritis, 1017 for pain, 4t Sumatriptan (Imitrex), for migraine headaches, 8, 953t, 954 Sunburn, 899 diagnosis, 899b prevention, 899–900 avoidance, 899 protective clothing, 900 protective tanning, 900 sunscreens, 900 pruritus with, 33b treatment, 900, 900b Sunscreens, 900 Superior vena cava syndrome, in leukemia, 466 Suramin (Germanin), for African sleeping sickness, 864, 867b Surface oblation, corneal, 190 Surfactant impairment, 238 Surgery See specific conditions; specific procedures Surgical maze procedure, for atrial fibrillation, 323 Sweat testing, for cystic fibrosis, 246 Swimmer’s itch See Cercarial dermatitis Symptomatic care pending diagnosis, 1–46 acute infectious diarrhea, 16 constipation, 23 cough, 28 fever, 26 gaseousness and dyspepsia, 13 hiccups, 15 nausea and vomiting, pain, pruritus, 32 spine pain, 42 tinnitus, 38 Syncope, 929 Syndrome of inappropriate antidiuretic hormone (SIADH), 612, 612t, 614 Syndrome X, 312 Synergistic necrotizing cellulitis, 855–856 Syphilis, 768 alopecia in, 810–811, 811f, 812 clinical manifestations, 768, 768f complications, 770 congenital, 768, 769t diagnosis, 768–769, 769b differential diagnosis, 769 epidemiology, 768 monitoring, 769–770 pathophysiology, 768, 768f prevention, 768 risk factors, 768 treatment, 769, 769b, 769t Systemic inflammatory response syndrome (SIRS), 70 Systemic lupus erythematosus, treatment of, 828 Systemic medication exposure, pruritus after, 34b T T-2 mycotoxins, as biological weapon agents, 1239t T-cell directed therapy, for rheumatoid arthritis, 1000 T-cell lymphoma See Cutaneous T-cell lymphomas T-piece resuscitator, 1047 Tabun, as chemical weapon, 1236t Tachycardias, 332 atrial fibrillation, 333 atrial flutter, 333, 333f atrial tachycardia, 335 atrioventricular node reentry tachycardia, 333–334, 333f, 334f atrioventricular reciprocating tachycardia, 334–335, 334f, 335f diagnosis, 333b mechanisms, 332, 332f multifocal atrial tachycardia, 333 narrow complex, 332 Tachycardias (Continued ) sinus tachycardia, 335 ventricular catecholaminergic, 316 in structurally normal heart disease, 336–337 ion channelopathies, 337 pacemaker-related tachycardias, 337 ventricular outflow tract tachycardia, 336–337 in structured heart disease, 336 arrhythmogenic ventricular dysplasia, 336 ischemic heart disease, 336 nonischemic heart disease, 336 wide complex tachycardia, 335–336, 335b Tacrolimus (Prograf, Protopic) for anogenital pruritus, 894, 894b for contact allergy, 891–892, 892b for glomerular diseases, 717–718 for pityriasis alba, 898, 898b for psoriasis, 825 reference intervals for, 1232t Tadalafil (Cialis) for erectile dysfunction, 735 side effects, 735 Taeniasis, 587 cysticercosis, 866 treatment, 585t Tamoxifen (Soltamox) for breast cancer, 1068 for endometrial cancer, 1100 for menopause, 1088, 1088b for Riedel’s thyroiditis, 697 Tanning, protective, 900 Tapentadol (Nucynta), for pain, 6t Tapeworms malabsorption and, 559 treatment, 585t Tar, for psoriasis, 825 Tarsal tunnel syndrome, 1014 Tazarotene (Tazorac) for acne vulgaris, 808 for actinic keratoses or cheilitis, 852 for psoriasis, 825 TB See Tuberculosis Tear gas, as chemical weapon, 1236t Tegaserod (Zelnorm) for constipation, 25, 25t for gaseousness, 13–14, 14b for irritable bowel syndrome, 537t Telavancin (Vibativ), 1252t Telbivudine (Tyzeka), 1252t Telithromycin (Ketek), for legionellosis, 279t Telmisartan/amlodipine (Twynsta), 1252t Telogen effluvium See also Alopecia clinical manifestations, 810 diagnosis, 810–811, 811b pathophysiology, 810 Temozolomide (Temodar), for brain tumors, 993t Temporal arteritis, treatment for pain, Temporomandibular disorders, 1008 anatomy and pathophysiology, 1009 intracapsular pain disorders, 1009 masticatory muscle pain disorders, 1009 epidemiology, 1008 etiology, 1009 history and examination, 1009–1010 screening examination, 1010b screening questionnaire, 1010b signs and symptoms, 1008–1009, 1008b treatment, 1010–1011 patient education, 1010–1011 pharmacologic therapy, 1011 physical therapy, 1011 TEMS (transanal endoscopic microsurgery), for colorectal tumors, 575 Tendinitis, 1011–1014 body area ankle and foot region, 1013–1014 anterior chest wall, 1013 elbow region, 1013 hand and wrist region, 1013 hip region, 1013 knee region, 1013 shoulder region, 1012–1013 diagnosis, 1011, 1012b treatment, 1011–1012, 1012b Tenecteplase (TNKase), for acute myocardial infarction, 372t Tennis elbow, 1013, 1027 Tenofovir (Viread), 50t TENS (transcutaneous electrical nerve stimulation), for pain, Tension-type headache diagnosis, 950t, 951 treatment, 952 Teratogens, 1029–1030 Terazosin (Hytrin) for hypertension, 364t for pheochromocytoma, 692 Terbinafine (Lamisil) for onychomycosis, 835, 870t for tinea capitis, 813t, 870t for tinea pedis, 870t Terbutaline, for asthma, 789b Terconazole, for vulvovaginal candidiasis, 1090b Terlipressin (Glypressin), for bleeding esophageal varices, 521 Terracyclic, 1225t TESS (Toxic Exposure Surveillance System), 1173 Testis cancer of, 750b, 752–753, 754b trauma to, 724–725, 725f Testosterone for erectile dysfunction, 736 for hypopituitarism, 676 levels in hirsutism, 812 nutritional effects, 641 Tetanus, 144 clinical manifestations, 144–145, 145f cephalic tetanus, 145, 145f generalized tetanus, 144–145 localized tetanus, 145 complications, 147 differential diagnosis, 145–146, 146t epidemiology, 144 in newborns, 144 pathophysiology, 144 prevention, 147 risk factors, 144 treatment, 146–147 airway management, 146 autonomic disturbances, control of, 146 clostridial infection, control of, 146 muscle spasms, control of, 146 toxin, neutralization of, 146 vaccination, 144, 147 vaccine, 152t, 153t Tetanus toxoid, 147 Tetrabenazine (Xenazine), for Tourette syndrome, 949 Tetracosactin (Synacthen, cortrosyn), 651 Tetracycline(s) (Achromycin, Sumycin) for Balantidium coli, 579t for bullous diseases, 888 for cholera, 82t for Dientamoeba fragilis, 579t for granuloma inguinale, 762t for Helicobacter pylori, 545t for legionellosis, 279t for linear immunoglobulin A disease, 889 for Lyme disease, 140t for lymphogranuloma venereum, 762t for malaria, 107, 109t, 110t for mucous membrane pemphigoid, 889 for mycoplasmal pneumonia, 278 for osteoarthritis, 1018 for psittacosis, 130, 130b for rat-bite fever, 134, 134b for relapsing fever, 136t for rosacea, 885 Tetralogy of Fallot, 341, 341f Tetrodotoxin poisoning, 1171 Thalassemia, 407 a-thalassemia, 411 b-thalassemia intermedia, 410–411 b-thalassemia major, 408–410 clinical features, 408–409 laboratory features, 408 management, 409–410 antioxidants, 410 gene therapy, 410 hematopoietic transplantation, 410 iron chelation therapy, 409–410 osteoporosis management, 410 pharmacologic induction of fetal hemoglobin, 410 splenectomy, 409 transfusion, 409 b-thalassemia minor, 411 Thyroiditis (Continued ) drug-induced, 697 Hashimoto’s, 678–679, 697 postpartum, 696 Riedel’s, 697 silent, 696 subacute, 695–696 Thyroxine (Synthroid, Levoxyl) for hypopituitarism, 675–676 for hypothyroidism, 680 levels in hyperthyroidism, 681–682 levels in hypopituitarism, 674, 675 levels in hypothyroidism, 679 for thyroiditis, 696, 696b TIA (transient ischemic attack), 929 Tiagabine (Gabitril), for epilepsy, 932, 941t, 942 Tic douloureux, 968 Tick-borne diseases ehrlichiosis, 177–178 Rocky Mountain spotted fever, 176–177 Tics in Gilles de la Tourette syndrome, 948, 948b, 949t treatment, 949t Tietze’s syndrome, 1013 Timolol (Timoptic, Blocadren) for glaucoma, for hypertension, 364t for migraine headaches, 953 pharmacologic and toxic properties of, 1194t Tinea barbae, 869–870, 870t Tinea capitis, 812, 813t, 870, 870t Tinea corporis, 869, 870t Tinea cruris, 869, 870t Tinea faciei, 869–870, 870t Tinea manuum, 869, 870t Tinea pedis, 869, 870t Tinea versicolor (pityriasis), 870, 870t Tinel’s sign, 1013 Tinidazole (Tindamax), 66t, 69t for acute infectious diarrhea, 22t for amebiasis, 22t, 863, 867b for Entamoeba histolytica, 579t for Giardia lamblia, 558 for Giardia lamblia, 579t for trichomoniasis, 1091b Tinnitus, 38 classification of discomfort in patients, 38t of ear noises in, 38t of irritating factors for patients, 38t of time/intensity patterns, 38t clinical types, 39–40, 39f bruits, 39 combined endogenous and exogenous, 40 endogenous tinnitus, 39–40 exogenous tinnitus, 40 slow brainstem syndrome, tinnitus in, 40 diagnosis, 38b general phenomena of, 38–39 ´ ` Meniere’s disease and, 213 treatment, 40–42, 40b adapted physiotherapy, 41–42 adapted psychotherapy, 41 basics of therapy, 41 instruments of therapy, 41 noise avoidance, 41 pharmacotherapy, 41 Tinnitus retaining therapy, 40b, 41 Tioconazole, for candidiasis, vulvovaginal, 1090b Tiotropium (Spiriva), for chronic obstructive pulmonary disease (COPD), 31b, 242, 242b Tipranavir (Aptivus), 50t, 60t TIPS See Transjugular intrahepatic portosystemic shunt Tissue plasminogen activator (tPA, Activase), for ischemic cerebrovascular disease, 922, 922b Tizanidine (Zanaflex), for fibromyalgia, 1012b, 1015 TLS (tumor lysis syndrome), 465 TMP-SMX (Septra) for acute infectious diarrhea, 22t for Q fever, 131 Tobramycin (Nebcin, Tobrex, AK-Tob) for bacterial conjunctivitis, 194t for bacterial meningitis, 115t for cystic fibrosis, 246–247 reference intervals for, 1232t Tobramycin/dexamethasone ophthalmic (TobraDex ST), 1252t Tocainide, reference intervals for, 1232t Tocilizumab (Actemra), for sudden-onset juvenile idiopathic arthritis, 1004 Tolcapone (Tasmar), for parkinsonism, 976 Tolvaptan (Samsca), 1252t Tongue-retaining devices, for obstructive sleep apnea, 249 Topical anesthetics for anogenital pruritus, 894b for erythema multiforme, 884–885 Topical therapy for cutaneous T-cell lymphomas, 820–821 for psoriasis, 824–825, 824b Topiramate (Topamax) for alcohol dependence, 1117 for cluster headaches, 954t for epilepsy, 930t, 932, 941t, 942 for migraine headaches, 953 Topotecan (Hycamtin), for lung cancer, 254 Torsemide (Demadex), for hypertension, 364t Total energy expenditure, 636 Total knee replacement, 1019 Total parenteral nutrition, 634–635 See also Parenteral nutrition in adults Tourette syndrome See Gilles de la Tourette syndrome Toxic chemical agents, reference chart for, 1236, 1236t Toxic epidermal necrolysis, 885–886 Toxic Exposure Surveillance System (TESS), 1173 Toxic shock syndrome (TSS), 88 clinical manifestations, 89 diagnosis, 88b, 89, 89t epidemiology, 89 pathogenesis, 89 prevention, 90 treatment, 88b, 90, 90t Toxicology See Poisoning Toxicology screening, 1188 Toxoplasma gondii cat as host, 163 encephalitis in HIV/AIDS, 61t, 62t life cycle, 163–164 in pregnancy, 1033 Toxoplasmosis, 163 cerebral, 63 chorioretinitis, 168 congenital, 166 cutaneous, 864 current therapy, 867b diagnosis, 865b diagnosis and testing, 164–165, 164b, 164f in HIV/AIDS, 61t, 62t, 63, 165 in immunocompetent patients, 165 in immunocompromised patients, 165, 168 ocular, 165–166, 201 pathophysiology and epidemiology, 163–164 in pregnancy, 166–168 prevention, 168 treatment, 166–168, 166b, 167t Trace elements, in parenteral nutrition, 637t, 638 Trace PBG kit, test for porphyria, 488–489 Tracheal compression, in leukemia, 466 Tracheostomy, for obstructive sleep apnea, 249 Traction diverticulum, 527 TRAM (transverse rectus abdominis myocutaneous) flap, 1067 Tramadol (Ultram) for fibromyalgia, 1012b, 1014 for neuropathic pain, 984t for osteoarthritis, 1016–1017 for pain, 6t for restless legs syndrome, 916, 916t Trandolapril (Mavik), for hypertension, 364t Tranexamic acid (Cyklokapron) for disseminated intravascular coagulation, 439 for hemophilia, 430–431 Transabdominal ultrasound for cholecystitis, 507–508, 508b for choledocholithiasis, 510 Transanal endoscopic microsurgery (TEMS), for colorectal tumors, 575 Transcervical tubal occlusion, 773t, 774b Transcutaneous electrical nerve stimulation (TENS), for pain, Transfusion adverse effects of, 494 for b-thalassemia major, 409 complications infectious, 495t, 499–500 parasites, 500 prions, 500 Index Thalassemia (Continued ) diagnosis, 408b globin gene arrangements, 407, 407f hematologic and clinical features, 408t pathophysiology, 407–408 Thalidomide (Thalomid) for multiple myeloma, 481, 482 for myelodysplastic syndromes, 504 for psychocutaneous disorders, 804t Theophylline (Uniphyl, Theo-24) for asthma, 784t, 788, 790t for chronic obstructive pulmonary disease, 242b reference intervals for, 1232t toxicology of, 1223–1224, 1224t Therapeutic drug monitoring, reference intervals for, 1232t Thermic effect of feeding, 636 Thiabendazole (Mintezol), for cutaneous larval migrans, 866, 867b Thiamine for alcohol withdrawal, 1117, 1180t for ethylene glycol poisoning, 1180t, 1204 in parenteral nutrition, 638 Thiamine deficiency encephalopathy, in poisoning, 1185 neuropathy from, 983 Thiazides for diabetes insipidus, 661 for hypertension, 364t Thiazolidinediones, for diabetes mellitus, 594t, 595 Thioguanine (Tabloid), for acute myeloid leukemia, 467 Thioridazine (Mellari), 1219t Thiothixene (Navane), properties of, 1219t Thoracic aortic aneurysms, 306 Thoracic aortic dissection, 306–307, 307t Thoracoabdominal aortic aneurysms, 306 Thoracocentesis, for pleural effusion diagnosis, 265 Thrombin burst, 428 Thrombocytopenia in disseminated intravascular coagulation, 438 due to decreased production, 435 due to hypersplenism, 436 due to increased destruction, 435–436 heparin-induced, 435 immune-mediated, 435 in lupus erythematosus, 828 Thromboembolism, venous See Venous thromboembolism Thrombolysis, for ischemic cerebrovascular disease, 922, 922b Thrombolytic therapy, for venous thromboembolism, 287 Thrombotic thrombocytopenic purpura (TTP), 435, 439 classification, 439, 440b clinical presentation, 439–440 diagnostic, 440–441, 440b pathogenesis, 439 prognosis, 441 treatment, 441, 441f Thymectomy, for myasthenia gravis, 967 Thyroid cancer, 683 anaplastic, 686 causes and risk factors, 683, 684b diagnosis, 684, 684b fine needle aspirate cytology, 684, 685t follicular, 685 follow-up, 686, 686t histologic classification, treatment, and prognosis, 684686 ă Hurthle cell, 685 medullary, 685 papillary, 684–685 well-differentiated, 686 Thyroid disease See Hyperthyroidism; hyperthyroidism; Hypothyroidism Thyroid hormone replacement for hypopituitarism, 675–676 for hypothyroidism, 680 Thyroid scan, 682 Thyroid stimulating hormone (TSH) levels in hyperthyroidism, 681–682 levels in hypothyroidism, 679 levels in thyroiditis, 696 Thyroid storm, treatment of, 682t, 683 Thyroiditis, 695 acute (suppurative), 681, 695 chronic (autoimmune), 696–697 current therapy, 696b diagnosis, 695b 1307 Index 1308 Transfusion (Continued ) viral transmission, 499–500 noninfectious, 496t, 500–501 alloimmunization, 500 immunomodulation, 496t, 500 massive transfusion coagulopathy, 496t, 501 post-transfusion purpura, 501 refractoriness to platelet transfusions, 500–501 volume overload, 501 plasma, indications for, 493 platelets, indications for, 492 red blood cell, indications for, 491–492 for sickle cell disease, 419 transfusion reactions, 499–501 hemolytic, 494–497, 494t acute, 494–496, 494t bacterial contamination of blood products, 494t, 497 delayed, 494t, 496–497 nonhemolytic, 494t, 497–499 allergic reactions, 498 febrile, 498 graft-versus-host disease, 498–499, 499b transfusion-related acute lung injury, 497–498 Transfusion-associated graft-versus-host disease (TAGVHD), 498–499, 499b Transfusion-related acute lung injury, 497–498 Transient ischemic attack (TIA), 929 Transient tachypnea of the newborn, 1051 Transjugular intrahepatic portosystemic shunt (TIPS) for cirrhosis, 512 for esophageal varices, bleeding, 521, 522 for hepatic hydrothorax, 515 for hepatorenal syndrome, 514 Transmyocardial laser revascularization, for angina pectoris, 312 Transplantation bone marrow for sickle cell disease, 421 kidney in sickle cell disease, 422 liver, 516–517 contraindications for, 517, 517b indications for, 516–517, 517b lung for chronic obstructive pulmonary disease, 242 for cystic fibrosis, 247 Transsphenoidal surgery for acromegaly, 659 for Cushing’ syndrome, 657–658 for hyperprolactinemia, 678 Transudative effusion, 264, 264b, 265 Transverse rectus abdominis myocutaneous (TRAM) flap, 1067 Trastuzumab (Herceptin), for endometrial cancer, 1100 Trauma bladder, 724f, 732 to external genitalia, 724–725, 725f to genitourinary tract, 722 head, 985, 989 renal, 722–723, 722f ureteral, 723, 723f urethral, 724, 724f Traumatic brain injury, 985 in children, 989 diagnosis, 991b Glascow Coma Scale, 989, 990t management, 990, 991b types and severity, 989–990 concussions and sports-related injuries, 988 diagnosis, 986b early and delayed neurologic changes, 988 Glascow Coma Scale, 985, 985t management of severe closed head injury, 987–988 pathology, 985–986 restorative therapies, 989 treatment of elevated intracranial pressure, 986–987, 987b treatment of mild and moderate trauma, 988 Travel medicine, 158 airborne diseases, prevention of, 161 altitude sickness, 159–160 contraindications to air travel, 159 environmental illnesses, prevention of, 159–160 foodborne diseases, prevention of, 160 health questionnaire, 159b infectious diseases, prevention of, 160 precautions and recommendations, 159 Travel medicine (Continued ) sexually-transmitted diseases, 161 travel vaccines, 161–162, 163t traveler’s emergency medical kit, 159b vector-borne (arthropod) diseases, prevention of, 160–161 waterborne diseases, prevention of, 160 Traveler’s diarrhea, 160 therapy, 161b Trazodone (Desyrel) for delirium, 1130t dosage and toxicity, 1225t for erectile dysfunction, 735 for fibromyalgia, 1012b, 1015 for insomnia, 910t for major depression, 1134t for psychocutaneous disorders, 804t Trematodes, 586 Trench foot, 1158, 1159b Trench mouth, 872, 872b Treponema pallidum See Syphilis Treprostinil (Tyvaso), 1252t Tretinoin (Retin-A, Vesanoid) for acne vulgaris, 808 for actinic keratoses or cheilitis, 852 for acute promyelocytic leukemia, 459 for ephelides, 897, 898b for melasma, 898b for postinflammatory hyperpigmentation, 898b for solar lentigines, 897, 898b Tretinoin plus clindamycin (Ziana), for acne vulgaris, 808 Triamcinolone (Kenalog) for anogenital pruritus, 894, 894b for contact allergy, 891–892, 892b for erythema multiforme, 884–885 for nonallergic rhinitis, 222t for polyarticular juvenile idiopathic arthritis, 1003 for psoriasis, 824b for scleroderma, 830 Triamcinolone acetonide (Azmacort), for asthma, 785t, 790t Triamcinolone hexacetonide (Aristospan), for alopecia, 813 Triamterene (Dyrenium) for hypertension, 364t for primary aldosteronism, 673 Triazolam (Halcion), for insomnia, 910t Triazolopyridine, 1225t Trichloroacetic acid (Tri-Chlor) for actinic keratoses or cheilitis, 851 for genital warts, 843t for warts, 841 Trichoderma, as biological weapon agent, 1239t Trichodystrophy, 811b Trichomonas vaginalis, 1090–1091, 1091b in pregnancy, 1033 Trichorrhexis, 810 Trichotillomania, 802b, 803b, 806 Trichuris trichuria, 583–584 treatment, 585t Tricyclic antidepressants for attention-deficit/hyperactivity disorder, 945–947 for irritable bowel syndrome, 537t for migraine headaches, 953 for panic disorder, 1145, 1145t for psychocutaneous disorders, 804t in stroke rehabilitation, 925t for tension-type headaches, 952 toxicology of, 1224–1226, 1225t Trifluoperazine (Stelazine), properties of, 1219t Trigeminal neuralgia, 968 diagnosis, 968, 968b physical examination, 968–969 treatment, 969, 969b Trigeminy, 324 Triiodothyronine (T3, Cytomel), for hypothyroidism, 680 Trimethoprim, for bacterial prostatitis, 727 Trimethoprim-sulfamethoxazole (Bactrim) for bacterial meningitis, 115t for Bordetella pertussis, 31b for brucellosis, 76b, 77t for Cyclospora, 579t for glomerular diseases, 718 for Isospora belli, 579t for pyelonephritis, 721b for salmonellosis, 172, 173 for toxoplasmosis, 167t for urinary tract infections, 701t Trimethoprim-sulfamethoxazole (Bactrim) (Continued ) for urinary tract infections in infants and children, 706 Trimipramine (Surmontil), dosage and toxicity, 1225t Triple-phase bone scan, in osteomyelitis, 1022 Triptans, for migraine headaches, 953–954, 953t Trochanteric bursitis, 1013 Tropical sprue, 558 Troponin, as myocardial infarction marker, 371 Trousseau sign, 665 TRUE Test, 891, 891b Trypanosoma cruzi, transfusion transmission of, 500 Trypanosomiasis, 864 current therapy, 867b diagnosis, 865b TSH See Thyroid stimulating hormone TSS See Toxic shock syndrome TTN (transient tachypnea of the newborn), 1051 TTP See Thrombotic thrombocytopenic purpura Tuberculin skin test, interpretation of, 297, 297b Tuberculosis, 295–296 diagnosis of active, 296 epidemiology, 295–296 in HIV/AIDS, 61t natural history, 296 prophylaxis for, 61t reactivation of in HIV/AIDS, 63 skin test, interpretation of, 297, 297b treatment, 296–301 CDC-recommended for latent, 298t chemoprophylaxis, 297 definitive therapy, 297–298 drug regimen, 299t of extrapulmonary and sputum-negative tuberculosis, 300 multidrug-resistant tuberculosis, 299–300 Mycobacterium avium complex infection, 300 in resource-poor settings, 298 Tularemia, as biological weapon agent, 1239t Tumor(s) adrenal, in Cushing’ syndrome, 658 bladder, 749–751, 750b, 754b brain, 991 colon and rectum, 572 penile, 750b, 752, 754b prostate, 747–748, 750b, 754b renal, 748–749, 750b, 754b benign, 749, 750b, 754b metastasis, 749 renal pelvis and ureter, 749, 750b, 754b stomach, 569 testicular, 750b, 752–753, 754b urethral, 750b, 752, 754b urogenital tract, 747 diagnosis, 750b Tumor-associated antigen-directed therapy, for cutaneous T-cell lymphomas, 821 Tumor lysis syndrome (TLS), 465 Tumor necrosis factor-a inhibitors for ankylosing spondylitis, 1007 for polyarticular juvenile idiopathic arthritis, 1003 for rheumatoid arthritis, 999, 1000b Tumor-node-metastasis (TNM) staging, of non-small cell lung cancer, 252–253, 252t TWEAK questionnaire, 1112, 1113t Typhoid fever (Salmonella typhi), 174 antimicrobial susceptibility, of S typhi, 175 complications of, 174b diagnosis, 175, 175b epidemiology, 174 pathogenesis and clinical features, 174–175 prevention, 176 treatment, 175–176, 176b vaccine, 163t Typhus, 176 Tzanck smear for herpes simplex virus, 859–860 for herpes zoster, 860 U UARS See Upper airway resistance syndrome Uhthoff ’s phenomenon, 199 Ulcerative colitis, 530 clinical manifestations, 530 diagnosis, 530b, 531–532, 531f, 531t treatment, 532 adalimumab, 534 biologic agents, 533–534 Urinary tract infections (UTIs) (Continued ) diagnosis, 706 imaging, 706 prophylaxis, 706–707 treatment, 706 voiding dysfunction, 706 in men, 699 (See also prostatitis) antibiotics for, 701t complicated (surgical), 699, 700b, 701 diagnosis and localization, 700, 700b in long-term care patients, 701 natural history of, 699–700 prostatitis, 701 treatment, 700–701, 700b, 701t uncomplicated (medical), 699, 700, 1042b in women, 702 benign bacteriuria of the elderly, 702 catheter-associated bacteriuria, 702, 704–705 cystitis, 702, 704 diagnosis of, 703–704, 703b, 705 dysuria-pyuria syndrome, 702, 704 pyelonephritis acute, 702–703, 705 chronic, 703–704, 705 recurrent, 702, 705 renal abscess, 705 treatment of, 704–705, 704b Urine clinical chemistry, reference intervals for, 1233t Urogenital disease, in histoplasmosis, 258 Urogenital tract, 699–760 Ursodeoxycholic acid (Actigall), for liver disease in cystic fibrosis, 245 Ursodiol (Actigall), for cholestasis-associated pruritus, 37b Urticaria, 895 classification, 895 diagnosis, 895–896, 895b mechanisms in, 895t pruritus in, 35b treatment, 896, 896b Urticarial vasculitis, 812f Ustekinumab (Stelara), 1252t Uterine bleeding, abnormal, 1073 anovulatory, 1074 diagnosis, 1075b hemorrhage, 1075 ovulatory, 1074–1075 treatment, 1075b Uterine leiomyomas, 1096 diagnosis, 1097, 1097b epidemiology, 1096 pathophysiology, 1096 symptoms and signs, 1096–1097 treatment, 1097, 1097b, 1097t Uterine rupture, 1039, 1039b UTIs See Urinary tract infections Uveitis, 199 anterior, 197, 199–200, 201 clinical features and diagnosis, 199–200 current diagnosis, 200b intermediate, 200, 201 posterior, 200, 201 sequelae and complications of, 200 treatment, 200–201, 200b V Vaccines See also Immunization for acute infectious diarrhea, 21 rotavirus, 21 Salmonella typhi, 21 Vibrio cholerae, 21 adverse events, reporting, 157 anthrax, 128 atypical measles and, 143 delivery, 156 diphtheria, tetanus, pertussis (DTP), 150t, 152t, 153t free-of-charge, 157 hepatitis A virus (HAV), 150t, 152t, 153t, 549 hepatitis B virus (HBV), 150t, 152t, 153t herpes zoster, 153t, 862 HIB (H influenzae type b) meningitis, 116, 1252t human papillomavirus (HPV), 1102b, 1252t influenza, 91, 91b, 150t, 153t, 241, 272, 1034b, 1252t Japanese encephalitis, 163t, 1252t Lyme disease, 140–141 measles, 142, 143–144, 150t, 152t, 153t measles, mumps, rubella (MMR), 122, 123, 142, 150t, 152t, 153t Vaccines (Continued ) meningococcal meningitis, 116 mumps, 122, 123, 150t, 152t, 153t pertussis (whooping cough), 149, 149t pneumococcal (Pneumovax 23), 150t, 152t, 153t, 241, 272 rabies, 132–133 rubella, 141, 142 shortages, 157 smallpox, 179 storage, 156 tetanus, 144, 147 for travelers, 161–162, 163t typhoid fever (Salmonella typhi), 163t varicella, 150t, 152t, 153t Vibrio cholerae, 21 yellow fever, 163t Vaccines for Children (VFC), 157 Vacuum-assisted closure, 880 Vagabond’s itch See Pediculosis Vagal nerve stimulation, for epilepsy, 943 Vaginal bleeding in late pregnancy, 1037 placenta previa, 1038, 1038b placental abruption, 1038–1039, 1038b uterine rupture, 1039, 1039b vasa previa, 1039, 1039b Vaginal ring, 772 Valacyclovir (Valtrex) for acute peripheral facial paralysis (Bell’s Palsy), 972, 972b formulations, 861t for herpes simplex virus, 859t, 860b, 861t, 874 for herpes zoster, 861 for varicella-zoster virus, 860b, 860t Valerian root, 1243t Valganciclovir (Valcyte), 60t Valproate/valproic acid (Depacon, Depakote, Depakene) for alcohol withdrawal, 1117 for bipolar disorder, 1136, 1137t for epilepsy, 930t, 931, 939–942, 940t reference intervals for, 1232t Valsartan (Diovan) for heart failure, 353t for hypertension, 364t Vancomycin (Vancocin) for acute infectious diarrhea, 22t allergic reactions to, 797 for bacterial meningitis, 115t for bacterial pneumonia, 271b, 273t for infective endocarditis, 358t for osteomyelitis, 1023t, 1024 reference intervals for, 1232t for severe sepsis, 73t for toxic shock syndrome, 90t Vapreotide (Octastatin), for bleeding esophageal varices, 521 Vardenafil (Levitra) for erectile dysfunction, 734–735 side effects, 735 Varenicline (Chantix), for smoking cessation, 241t Varicella, 78 corticosteroids and, 80 diagnosis, 78b in immunocompromised hosts, 79–80 pathogenesis, 78, 79f treatment, 79–80 vaccine, 150t, 152t, 153t administration of, 78 breakthrough disease after, 78 epidemiology of varicella after approval of, 78 Varicella-zoster immune globulin (VZIG), alternatives to, 80 Varicella-zoster virus, 860 diagnosis, 859b in pregnancy, 1032 treatment, 860b, 860t, 861t viral meningitis and encephalitis, 956t Varicose veins, in pregnancy, 1033 Variola major virus See Smallpox Vasa previa, 1039, 1039b Vascular disorders, erectile dysfunction and, 733 Vascular malignancies, 816 angiosarcoma, 816 Kaposi’s sarcoma, 816 Vasculitic neuropathy, 984 Vasculitis cutaneous, 831 associated with systemic vasculitis, 833 Index Ulcerative colitis (Continued ) certolizumab, 534 current therapy, 532b cyclosporine, 533 mesalamine preparations, 533, 533t natalizumab, 534 steroids, 533 summary of regimen, 534b Ulcers gastric and peptic ulcer disease, 541 genital ulcer disease, 761 leg ulcers in sickle cell disease, 415 oral aphthous stomatitis, 872b autoimmune ulcerative conditions, 875–876 corticosteroid treatment of immune-mediated, 876 diagnosis, 872b necrotizing ulcerative gingivitis, 872, 872b pressure, 879 venous, 876 Ulnar nerve entrapment, 1013 Ulnar neuropathy, 981 Ultrasonography in acute pancreatitis, 560–561 antepartum care, 1031 bladder scans, 925 compression in pulmonary embolism, 285 deep venous thrombosis, 282 ectopic pregnancy, 1035 in endometriosis, 1071 Ultraviolet light therapy for contact allergy, 891–892, 892b for cutaneous T-cell lymphomas, 820 for pityriasis alba, 898, 898b for postinflammatory hypopigmentation, 898b for prurigo nodularis, 17 for psoriasis, 825 for scleroderma, 830 for vitiligo, 898–899, 898b Umbilical vein cannulation, for newborn resuscitation, 1048 Unfractionated heparin for acute myocardial infarction, 372 for venous thrombosis, 385 Unna’s boot, for pruritus, 36b Upper airway resistance syndrome, 248b, 250 Upper extremity discomfort, in pregnancy, 1033–1034 Urate, in hyperuricemia, 615 Urea (Ureaphil), for traumatic brain injury, 987 Uremia, pruritus in, 37b Urethra, trauma to, 724, 725f Urethral strictures, 756 evaluation and diagnosis, 756, 756b management, 756–758, 758b open reconstruction, 756–758 stents, 756 urethrotomy and dilation, 756 Urethritis gonorrhea, 764 nongonococcal, 766 Uricosurics, for gout, 617 Urinary incontinence in children, 707 classification of, 707–709 constipation and, 709 daytime wetting conditions, 708 dysfunctional voiding, 708 enuresis, nocturnal, 707–708 giggle incontinence, 708 non-neurogenic bladder syndrome, 708 organic, causes of, 707f terminology, 708f underactive bladder, 708 vaginal voiding, 708–709 diagnosis, 711b etiology, 709–710, 709t, 710t bladder dysfunction, 709–710 urethral-related, 710 evaluation of incontinent patient, 710–711 treatment of, 711–712, 712b mixed incontinence, 712 overflow incontinence, 711 stress incontinence, 711–712, 716 urge incontinence, 711, 712b Urinary symptoms, in pregnancy, 1032 Urinary tract infections (UTIs) in infants and children, 706 1309 Index 1310 Vasculitis (Continued ) classification, 831, 831b diagnosis, 832b diseases associated with, 832t leukocytoclastic vasculitis, 831–833 treatment, 833b leukocytoclastic, 831–833 urticarial, 812f Vaso-occlusive episode hematologic indices during, 414 treatment, 417–419 Vasodilators, for hypertension, 364t Vasopressin (Pitressin) for bleeding esophageal varices, 521 molecules that regulate, 609t regulation of water balance, 608–609 Vasopressin receptor antagonists, for hyponatremia, 614 Vasospastic (Prinzmetal’s) angina, 312 Vena cava filters, inferior, 287 for venous thrombosis, 386–387 Venezuelan equine encephalitis, as biological weapon agent, 1239t Venlafaxine (Effexor) for anogenital pruritus, 894, 894b for major depression, 1135t for menopause, 1087t for panic disorder, 1145b, 1145t for premenstrual syndrome, 1084b for psychocutaneous disorders, 804t, 807 Venography, in deep venous thrombosis (DVT), 282 Venous access, for parenteral nutrition, 638–639 Venous stasis, as venous thromboembolism risk factor, 280 Venous stents, 387 Venous thrombectomy, 387 Venous thromboembolism, 280 diagnosis deep venous thrombosis, 281–283 clinical features, 281–282 computed tomography, 283 d-dimer blood testing, 282–283 magnetic resonance imaging, 283 test results that confirm or exclude, 283b venography, 282 venous ultrasonography, 282 Wells model, 282t diagnosis of pulmonary embolism, 283–285 chest radiograph, 284 clinical features, 283–284 compression ultrasonography, 285 computed tomographic pulmonary angiography, 284–285 d-dimer blood testing, 285 electrocardiography, 284 pulmonary angiography, 285 test results that confirm or exclude, 284b ventilation/perfusion lung scanning, 284 Wells model, 284t diagnosis of recurrent deep venous thrombosis, 283 epidemiology and natural history, 281, 282b in multiple myeloma, 483 pathogenesis and risk factors, 280–281, 280b combinations of risk factors and risk stratification, 280–281, 281t hypercoagulability, 280 venous stasis, 280 vessel damage, 280 prevention, 285–286 endoscopic genitourinary surgery, neurosurgery, and ocular surgery, 286 general surgery and medicine, 285 major orthopedic surgery, 285–286 treatment, 286–287 acute anticoagulant therapy, 286 duration, 287t graduated compression stockings, 287 inferior vena caval filters, 287 long-term anticoagulant therapy, 286–287 thrombolytic therapy, 287 Venous thrombosis, 384 diagnosis, 384–385, 384b axillary and subclavian vein thrombosis, 385 deep venous thrombosis, 384–385 pulmonary embolism, 385 epidemiology, 384 pathophysiology, 384 risk factors, 384 treatment, 385–386 aggressive, 386–387 alternative and future, 386 Venous thrombosis (Continued ) complications, 386 current therapy, 385b duration of, 386 heparin, 385 inferior vena cava filters, 386–387 nonpharmacologic, 386–387 warfarin, 385–386 Venous ulcers, 876 algorithm for diagnosis and treatment, 878f complications, 877 diagnosis, 815, 877 epidemiology, 876–877 evaluation, 877 pathophysiology, 876–877 treatment, 878, 878b Venous ultrasonography, in deep venous thrombosis (DVT), 282 Ventilation, mechanical See Mechanical ventilation Ventilation/perfusion lung scanning, in pulmonary embolism (PE), 284 Ventilation-perfusion (V/Q) mismatch, 233, 238 Ventilator-associated pneumonia, 272 Ventricular arrhythmias fibrillation, idiopathic, 316 primary prevention of, 314–315, 314t arrhythmogenic right ventricular dysplasia, 315 coronary artery disease, 314 hypertrophic cardiomyopathy, 315, 315t idiopathic dilated cardiomyopathy, 314, 315t tachycardia in structurally normal heart disease, 336–337 ion channelopathies, 337 pacemaker-related tachycardias, 337 ventricular outflow tract tachycardia, 336–337 tachycardia in structured heart disease, 336 arrhythmogenic ventricular dysplasia, 336 ischemic heart disease, 336 nonischemic heart disease, 336 wide complex tachycardia, 335–336, 335b Ventricular outflow tract tachycardia, 336–337 Ventricular septal defect, 338, 338f Verapamil (Calan) for angina pectoris, 310t for atrial fibrillation, 320b for cluster headaches, 954t for hypertension, 364t for migraine headaches, 953 Verruca See Warts Verrucous carcinoma, 1106 Vertigo, episodic, 210 approach to the patient, 211–213 benign paroxysmal positional vertigo, 211, 211b, 212f, 212b current therapy, 212b management, 213 ´ ` Meniere’s disease, 211, 211b, 212b vestibular neuritis, 210–211, 211b, 212b Very-low-density lipoprotein (VLDL), 618, 619 Vesicant agents, as chemical weapons, 1236t Vestibular disorders central, 211 peripheral, 210–211 benign paroxysmal positional vertigo, 211, 211b, 212f, 212b head-thrust test, 210 ´ ` Meniere’s disease, 211, 211b, 212b vestibular neuritis, 210–211, 211b, 212b Vestibular neuritis, 210–211, 211b, 212b Vestibular system, 210–211 Viagra See sildenafil citrate (Viagra) Vibrio cholerae acute infectious diarrhea, 18–19 vaccine, 21 Vibrio parahaemolyticus, 19 Vibrio vulnificus, 856–857 Vigabatrin (Sabril) dosage and indication, 1252t for epilepsy, 932–933 Vildagliptin (Galvus), for diabetes mellitus, 594t Vincristine (Oncovin, Vincasar) for acute lymphoblastic leukemia, 466–467, 467t for brain tumors, 993t for cutaneous T-cell lymphomas, 821 Vinorelbine (Navelbine), for lung cancer, 253 Viperid envenomations, 1164–1167 clinical effects, 1165 dispositions, 1167 Viperid envenomations (Continued ) duration of effects, 1165 epidemiology and recognition, 1164–1165 management, 1165–1167 antibiotics, 1166 antivenom, 1165, 1166b hematologic effects, 1167, 1167b initial hospital, 1165, 1166b of local tissue injury, 1166 long-term local tissue effects, 1166 maintenance doses, 1166 prehospital, 1165b severity, 1165 Viral disease acute infectious diarrhea, 17b, 19 as biological weapon agent, 1239t hepatitis, 548 hepatitis A virus (HAV), 549 hepatitis B virus (HBV), 550–552 hepatitis C virus (HCV), 552–553 hepatitis D virus (HDV), 552 hepatitis E virus (HEV), 549–550 meningitis and encephalitis, 955, 1239t clinical features, 955, 956t diagnosis, 955–958, 959b etiology, 955, 956t treatment, 958–960, 960b non-Hodgkin’s lymphoma and, 474 pneumonias, 275 rabies, 131 respiratory infections, 273 bronchiolitis, 274–275 common colds, 273–274 croup, 274 diagnosis, 274b influenza-like illness, 274 influenza pneumonia, 275–276, 276t, 277b treatment, 274b skin (See Viral skin diseases) transfusion transmission, 499–500 Viral hemorrhagic fevers, as biological weapon agent, 1239t Viral hepatitis, 548 hepatitis A virus (HAV), 549 diagnosis, 549 epidemiology, 549 natural history, 549 prevalence of antibody to, 550f treatment, 549 hepatitis B virus (HBV), 550–552 diagnosis, 550 epidemiology and mode of transmission, 550, 551f natural history, 550–552, 552f populations recommended for screening, 551b treatment, 552 hepatitis C virus (HCV), 552–553 diagnosis, 552–553 epidemiology, 552 natural history, 553 treatment, 553 hepatitis D virus (HDV), 552 diagnosis, 552 epidemiology, 552 natural history, 552 treatment, 552 hepatitis E virus (HEV), 549–550 diagnosis, 549 epidemiology, 549 natural history, 549 treatment, 549–550 transfusion transmission, 499 Viral skin diseases, 858 hand-foot-and-mouth disease, 862 diagnosis, 859b treatment, 860b herpes simplex virus, 858–860 diagnosis, 859–860, 859b eczema herpeticum, 859 genital infection, 858–859 herpes gladiatorum, 859 herpetic whitlow, 859 orofacial infection, 858 treatment, 859t, 860b, 861t herpes zoster, 860–862 diagnosis, 860 treatment, 860–862 molluscum contagiosum, 862 diagnosis, 859b Vocal tics, 948 Voice See Dysphonia Volcano sign, 863–864, 865b Volume depletion, signs of, 644t Volume expanders, for newborn resuscitation, 1049t Volume overload, as transfusion complication, 501 Vomiting See Nausea and vomiting Vomiting agents, as chemical weapons, 1236t Von Hippel-Lindau syndrome, pheochromocytoma and, 687, 688b Von Willebrand’s disease, 432–434 acquired, 434 clinical presentation, 432, 432t diagnosis, 432 hemophilias compared, 430t in pregnancy, 434 treatment, 432–434 Voriconazole (Vfend) for blastomycosis, 262–264 for coccidioidomycosis, 255b, 256 Vorinostat (Zolinza), for cutaneous T-cell lymphomas, 822 "Vowel" mnemonic, 1179 VSD See Ventricular septal defect VTE See Venous thromboembolism Vulva, trauma to, 725 Vulva neoplasms, 1104 benign cystic neoplasms, 1104 benign solid neoplasms condyloma acuminatum, 1104–1105 diagnosis, 1106b intraepithelial neoplasms, 1105, 1105t Paget’s disease, 1105 vulvar intraepithelial neoplasia, 1105 invasive vulvar lesions, 1105–1107, 1106b basal cell carcinoma, 1107 malignant melanoma, 1106 sarcomas, 1107 squamous cell carcinomas and adenocarcinomas, 1105–1106 verrucous carcinoma, 1106 treatment, 1106b Vulvodynia, 807 Vulvovaginitis, 1089 bacterial vaginosis, 1089, 1089b candidiasis, 1089–1090, 1090b Trichomonas vaginalis, 1090–1091, 1091b VWD See von Willebrand’s disease VX, as chemical weapon, 1236t W Wakefulness testing, 908 Warfarin for mitral valve prolapse, 349, 349t for stroke prevention, 321, 322f for venous thromboembolism acute therapy, 286 long-term therapy, 286–287 for venous thrombosis, 385–386, 385b Warts, 840 clinical features, 840 diagnosis, 840b genital (condyloma acuminata), 842 clinical presentation, 843 diagnosis, 840b, 843 epidemiology, 843 etiology, 842 pathogenesis, 843 treatment, 843–845, 844t algorithm, 844f CDC recommendations, 843t current therapy, 845b treatment, 840–842, 841b Water balance regulation, 608–609 renal handling of sodium, 609 renal handling of water, 608–609 Water exposure, pruritus after, 34b Watson-Schwartz test, 488–489 Wegener’s granulomatosis, cutaneous vasculitis in, 812f Weight gain, in pregnancy, 1032 Weight loss, pruritus in rapid, 35b West African sleeping sickness See African sleeping sickness West Nile virus, 956t Western equine encephalitis, as biological weapon agent, 1239t Whiplash, neck pain from, 44t Whipple’s disease, 558 Whipworm (trichuriasis), 583–584, 585t Whole-bowel irrigation, 1177 Whooping cough See Pertussis Wide complex tachycardia, 335b Wiskott-Aldrich syndrome, 424 Wolff-Parkinson-White syndrome, 316, 334, 334f Wuchereria bancrofti, 866 X X-linked neutropenia, 423t, 424 Xanthine oxidase inhibitors, for hyperuricemia, 617 Xerostomia, 872b, 873 Xerotic eczema, 33b Xiphodynia, 1013 Y Yellow fever vaccine, 163t Yersinia pestis, as biological weapon agent, 1239t Yersinia pestis, plague and, 124 Yoga, for pain, Index Viral skin diseases (Continued ) treatment, 860b, 863t orf, 862–863 diagnosis, 859b treatment, 860b parvovirus B19, 862 diagnosis, 859b treatment, 860b varicella-zoster virus, 860 diagnosis, 859b treatment, 860b, 860t, 861t Viscosupplementation, 1017 Vision accommodation, 187, 188f assessment of, 189 disorders of diagnosis, 189, 189b epidemiology, 189 pathophysiology, 187–188 refractive errors, 187–188, 188f in stroke, 926 Vision corrective procedures, 187 LASIK (laser in situ keratomileusis), 189–190, 189f, 190b phakic intraocular lens implant, 192, 192f photorefractive keratectomy, 190–191, 190b refractive lens exchange, 191–192 Vital signs, 1174t Vitamin(s) deficiency, neuropathy from, 983 infant feeding, 1058 in parenteral nutrition, 637t, 638 Vitamin B6 for carpal tunnel syndrome, 1013 for nausea and vomiting, 12t for poisoning, 1180t Vitamin B12 for cyanide toxicity, 567 malabsorption test, 556 Vitamin B12 deficiency anemias, 403 clinical features, 405, 406b diagnosis, 406, 406b epidemiology, 404 etiology, 404–405, 404f, 404t, 405b food-cobalamin malabsorption, 404, 405b treatment, 406, 406b, 406f Vitamin D deficiency in osteoporosis, 629, 630 for hypoparathyroidism, 666 for osteoporosis, 630, 630b Vitamin E for Alzheimer’s disease, 903 in menopause, 1087t Vitamin K in parenteral nutrition, 638 for poisonings, 1180t Vitamin K antagonists, for venous thromboembolism acute therapy, 286 prevention, 285–286 Vitiligo description, 898 diagnosis, 897b treatment, 898, 898b VLDL (very-low-density lipoprotein), 618, 619 Vocal cord cancer, 227 Vocal fold cysts, 226 nodules, 226 normal, 224f paralysis, 225–226, 226f polyps, 226, 226f recurrent respiratory papillomatosis, 227, 227f Reinke’s edema, 226–227, 227f smoking and, 227 tremor, 228 Z Zafirlukast (Accolate) for asthma, 784t, 790t for urticaria, 896 Zaleplon (Sonata), for insomnia, 910t Zanamivir (Relenza) for influenza, 92t, 93b, 276, 276t for influenza in acute bronchitis, 269, 269b for influenza-like illness, 274 Zenker’s diverticulum, 523, 524, 525, 526, 527f Zidovudine (Retrovir), 50t Zileuton (Zyflo) for asthma, 784t for urticaria, 896 Zinc pyrithione, for seborrheic dermatitis, 812–813 Ziprasidone (Geodon) for bipolar disorder, 1136, 1137t for delirium, 1130t, 1131b for psychocutaneous disorders, 804t for schizophrenia, 1140t for Tourette syndrome, 949t Zoledronic acid (Reclast) for osteoporosis, 630, 630b, 631t for Paget’s disease of bone, 633, 633b Zollinger-Ellison syndrome, 542, 559 Zolmitriptan (Zomig), for migraine headaches, 953t, 954 Zolpidem (Ambien) for fibromyalgia, 1012b, 1014 for insomnia, 910t Zonisamide (Zonegran), for epilepsy, 930t, 932, 941t, 942 Zoster See Herpes zoster 1311 DISEASES/CONDITIONS AND ICD-9-CM CODES Abruptio placentae 641.2** Acne vulgaris 706.1 Acromegaly 253.0 Actinic keratosis 702.0 Acute bronchitis 466.0 Acute and chronic viral hepatitis 070.9 Acute diarrhea (NOS) 787.91 Acute leukemia (plain leukemia) 208.0** Acute myocardial infarction 410.9** Acute otitis media 382.9 Acute pancreatitis 577.0 Acute peripheral facial paralysis (Bell’s palsy) 351.0 Acute renal failure 584.9 Acute respiratory failure 518.81 Acute stress disorder 308.9 Adrenocortical insufficiency 255.4 Adverse reactions to blood transfusions 999 Alcoholism 303.9** Allergic reactions to drugs 995.2 Allergic reactions to insect stings 989.5 Allergic rhinitis 477.8 Alopecia areata 704.01 Alzheimer’s disease 331.0 Amebiasis 006.9 Amenorrhea 626.0 Anal fissure 565.0 Anaphylaxis, NOS 995.0 Angina pectoris 413.9 Angioedema 995.1 Ankle fracture 824.8 Ankylosing spondylitis 720.0 Anorectal abscess 566 Anorexia nervosa 307.1 Aortic aneurysm and dissection 441.00 Aplastic anemia 284.9 Asthma 493.9** Atelectasis 518.0 Atopic dermatitis 691.8 Atopic fibrillation 427.31 Attention deficit/hyperactivity disorder 314.01 Autoimmune hemolytic anemia 283.0 Bacterial meningitis 320 Bacterial pneumonia 482.9 Bacterial vaginitis 616.1 Benign prostatic hyperplasia 600 Blastomycosis 116.0 Bleeding esophageal varices 456.0 Brain abscess 324 Brain tumors 239.6 Breast cancer 174 Brucellosis 023 Bulimia nervosa 307.51 Bullous diseases 694 Burns .940-949 Bursitis 726-727 Cancer of the endometrium 182.0 Cancer of the skin 172-173 Cancer of the uterine cervix 180 Cardiac arrest, sudden cardiac death 427.5 Care after myocardial infarction 414.8 Cellulitis 682 Chancroid 099.3 Chlamydia trachomatis infection 079.88 Cholelithiasis and cholecystitis 574.1-574.9 Cholera 001 Chronic fatigue syndrome 780.71 Chronic leukemia 208.1** Chronic obstructive pulmonary disease 491.2** Chronic pancreatitis 577.1 Chronic renal failure 585 Chronic serous otitis media 381.1** Coccidioidomycosis 114* Colorectal cancer 153 Concussion 850 Congenital heart disease .745-747 Congenital rubella 771.0 Congestive heart failure 428.0 Conjunctivitis, acute 372.0** Connective tissue disease 710* Constipation 564.0 Contact dermatitis 692 Cough 786.2 Cushing’s syndrome 255.0 Delirium 780.0 Dementia, multi-infarct, uncomplicated 294.8 Depression psychosis 298.0 Depression with anxiety 300.4 Diabetes insipidus 253.5 Diabetes mellitus, I 250.01 Diabetes mellitus, II 250.02 Diabetic ketoacidosis 276.2** Diphtheria 032* Diseases of the mouth 528* Disseminated intravascular coagulation 286.6 Diverticulitis 562.11 Drug abuse (nondependent) 305.9** Dysfunctional uterine bleeding 626.6 Dysmenorrhea 635.5 Dysphagia and esophageal obstruction 530.3 Ectopic pregnancy 633* Elbow dislocation 832.0** Encephalitis 323* Endometriosis 617* Enuresis 786.30 Epididymitis 604** Episodic vertigo 386.11 Erythema multiforme 695.1 Fetal lung immaturity 770.4 Fever 780.6 Fibrocystic diseases of the breast 610.1 Fibromyositis 729.1 Fifth disease 057.0 Finger dislocation, closed 834.0** Finger fracture 816.0** Fistula (anal) 565.1 Fitting of diaphragm V25.02 Folliculitis 704.8 Food allergy 693.1 Food poisoning 005* Foot fracture 825.2** Frostbite 991* Gangrene 785.4 Gastritis 535** Gastroesophageal reflux disease (GERD) 530.81 Generalized anxiety disorder 300.02 Generalized epilepsy 345.1** Genital warts (condylomata acuminata) 078.11 Giant cell arteritis 446.5 Giardiasis 7.1 Gilles de la Tourette syndrome 307.23 Glaucoma 365** Gonorrhea 098.0 Gout 274.9 Granuloma inguinale (donovanosis) 099.2 Guillain-Barre syndrome 357.0 ´ Headache 784.0 Heart block 426.1** Heat exhaustion 992.3 Heat stroke 992.0 Hemochromatosis 285.0 Hemolytic disease of the fetus and newborn 773.2 Hemophilia and related conditions 286.0 Hemorrhoids 455.6 Herpes gestationis 646.8** Herpes simplex 054* Herpes zoster 053* Hiccups 786.8 High-altitude sickness 993.2 Histoplasmosis 115** HIV-associated infections 042.0 HIV infection, asymptomatic V08 HIV infection, early symptomatic 042 HIV infection, late symptomatic 042 Hyperlipoproteinemias 272* Hyperparathyroidism 252.0 Hyperprolactinemia 253.1 Hypersensitivity pneumonitis 495 Hypertension (essential) 401* Hyperthyroidism 242** Hypertrophic cardiomyopathy 425.4 Hypoparathyroidism 252.1 Hypothyroidism 244* Immunization practices V03, V04, V05, V06** Impetigo 684 Impotence 302.72 Indigestion 536.8 Infectious diarrhea 009.2 Infectious mononucleosis 075 Infective endocarditis 424.9** Influenza 487.2 Ingrowing nail 703.0 Insect and spider bite 989.5 Insertion of intrauterine device V25.1 Insomnia (NOS) 780.52 Intracerebral hemorrhage 431 Iron deficiency anemia 280.0-280.9 Irritable bowel syndrome 564.1 Jellyfish sting 989.5 *4th digit needed **5th (or 4th and 5th) digit needed 440 420 400 380 360 HEIGHT IN FEET 8Љ 6Љ 4Љ 2Љ 4Ј 10Љ 8Љ 6Љ 4Љ 2Љ 3Ј 10Љ 150 145 140 135 130 125 120 115 110 1.20 1.15 1.10 1.05 200 190 180 170 140 130 120 110 100 95 90 85 80 75 160 150 140 70 65 130 60 120 55 110 50 100 45 1.00 95 105 150 90 40 90 100 85 95 80 80 90 35 70 75 30 70 60 85 65 8Љ 25 80 60 6Љ 75 50 55 20 50 40 15 WEIGHT IN KILOGRAMS 10Љ 300 290 280 270 260 250 240 230 220 210 WEIGHT IN POUNDS 5Ј 160 155 160 320 2.10 2.00 1.95 1.90 1.85 1.80 1.75 1.70 1.65 1.60 1.55 1.50 1.45 1.40 1.35 1.30 1.25 170 340 2.30 2.20 SURFACE AREA IN SQUARE METERS 2Љ 220 215 210 205 200 195 190 185 180 175 170 165 HEIGHT IN CENTIMETERS 7Ј 10Љ 8Љ 6Љ 4Љ 2Љ 6Ј 10Љ 8Љ 6Љ 4Љ 3.00 2.90 2.80 2.70 2.60 2.50 2.40 200 190 180 DISEASES/CONDITIONS AND ICD-9-CM CODES (Continued) Juvenile rheumatoid arthritis 714.3** Keloids 701.4 Laryngitis 464.00 Lead poisoning 984* Legionnaires’ disease 482.84 Leishmaniasis 085* Leprosy 030* Lichen planus 697.0 Low back pain 724.2 Lyme disease 088.81 Lymphogranuloma venereum 099.1 Malabsorption 579* Malaria 084.6 Measles (rubeola) 055.9 Meconium aspiration 770.1 Melanoma, malignant 172* Meniere’s disease 386.0** ´ ´ Meningitis .320-322 Menopausal 627.2 Migraine headache 346** Mitral valve prolapse 424.0 Monilial vulvovaginitis 121.1 Multiple myeloma 203.0** Multiple sclerosis 340 Mumps 072.9 Myasthenia gravis 358.0** Mycoplasmal pneumonias 483.0 Mycosis fungoides 202.1** Nausea and vomiting 787.01 Neoplasm of the vulva 239.5 Neutropenia 288.0 Nevi 216* Newborn physiologic jaundice 774.6 Nongonococcal urethritis 099.4** Non-Hodgkin’s lymphomas 202.8** Non-autoimmune hemolytic anemia 283.1** Normal delivery 650 Obesity 278.0** Obsessive-compulsive disorders 300.3 Onychomycosis 110.1 Optic neuritis 377.3** Osteoarthritis 715** Osteomyelitis 730** Osteoporosis 733.00 Otitis externa 380.10 Paget’s disease of bone 731.0 Panic disorder 300.01 Pap smear V72.3 Parkinsonism 332.0 Paronychia 681.0** Partial epilepsy 345.4** Patent ductus arteriosus 747.0 Pediculosis 132* Pelvic inflammatory disease 614* Peptic ulcer disease 533* Pericarditis 432.9 Peripheral arterial disease 443.9 Peripheral neuropathies 356* Pernicious anemia 281.0 Personality disorder 301** Pheochromocytoma 227.0 Phobia 300.2** Pigmentary disorders—vitiligo 709.01 Pinworms 127.4 Pityriasis rosea 696.3 Placenta previa 641** Plague 020* Platelet-mediated bleeding disorders 287.1 Pleural effusion 511.9 Polycythemia vera 238.4 Polymyalgia rheumatica 725 Porphyria 277.1 Postpartum hemorrhage 666.1** Post-traumatic stress disorder 309.81 Pregnancy V22.2 Pregnancy-induced hypertension 642** Premature beats 427.6** Premenstrual tension syndrome (PMS) 625.4 Prescribed oral contraceptive V25.01 Pressure ulcers 707.0 Preterm labor 644.2** Primary glomerular disease 581-583 Primary lung abscess 513.0 Primary lung cancer 162.9 Prostate cancer 185 Prostatitis 601* Pruritus 698.9 Pruritus ani 698.0 Pruritus vulvae 698.1 Psittacosis (ornithosis) 073* Psoriasis 696.1 Pulmonary embolism 415.1 Pyelonephritis 590** Q fever 083.0 Rabies 071 Rat-bite fever 026* Relapsing fever 087* Renal calculi 592 Reye syndrome 331.81 Rheumatic fever 390 Rheumatoid arthritis 714.0 Rib fracture 807.0** Rocky Mountain spotted fever 082.0 Rosacea 695.3 Roseola 057.8 Rubella 056* Salmonellosis 003.0 Sarcoidosis 135 Scabies 133.0 Schizophrenia 295** Seborrheic dermatitis 690.1** Septicemia 038* Sezary’s syndrome 202.2** Shoulder dislocation 831.0** Sickle cell anemia 282.6** Silicosis 502 Sinusitis, chronic 473* Skull fracture 800, 801, 803 Sleep apnea 780.57 Sleep disorders 780.50 Snakebite 989.5 Stasis ulcers 454.0 Status epilepticus 345.3 Stomach cancer 151* Streptococcal pharyngitis 034.0 Stroke 436 Strongyloides infection 127.2 Subdural or subarachnoid hemorrhage 852** Sunburn 692.71 Syphilis 090-097 Tachycardias 785.0 Tapeworm infections 123* Telogen effluvium 704.02 Temporomandibular joint syndrome 524.6** Tendonitis 726.90 Tetanus 037 Thalassemia 282.4** Therapeutic use of blood components V59.0** Thrombotic thrombocytopenic purpura 446.6 Thyroid cancer 193 Thyroiditis 245* Tinea capitis 110.0 Tinnitus 388.3** Toe fracture 826.0 Toxic shock syndrome 040.82 Toxoplasmosis 130* Transient cerebral ischemia 435* Trauma to the genitourinary tract 958, 959 Trichinellosis 124 Trichomonal vaginitis 131.01 Trigeminal neuralgia 350.1 Tuberculosis, pulmonary 011** Tularemia 021* Typhoid fever 002.0 Typhus fevers 080, 081 Ulcerative colitis 556* Urethral stricture 598* Urinary incontinence 788.30 Urticaria 708* Uterine inertia 661.0** Uterine leiomyoma 218* Varicella 052* Venous thrombosis 453.8 Viral pneumonia 480.9 Viral respiratory infections 465.9 Vitamin deficiency 264-269 Vitamin K deficiency 269.0 Warts (verrucae) 078.10 Wegener’s granulomatosis 446.4 Whooping cough (pertussis) 033* Wrist fracture 814.0** *4th digit needed **5th (or 4th and 5th) digit needed Body Mass Index Normal BMI 19 20 21 22 Overweight 23 Obese Extreme Obesity 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 115 119 123 127 131 135 140 144 148 153 158 162 167 172 177 182 186 192 197 119 124 128 132 136 141 145 150 155 159 164 169 174 179 184 189 194 200 205 124 128 133 137 142 146 151 156 161 166 171 176 181 186 191 197 202 208 213 129 133 138 143 147 152 157 162 167 172 177 182 188 193 199 204 210 216 221 134 138 143 148 153 158 163 168 173 178 184 189 195 200 206 212 218 224 230 138 143 148 153 158 163 169 174 179 185 190 196 202 208 213 219 225 232 238 143 148 153 158 164 169 174 180 186 191 197 203 209 215 221 227 233 240 246 148 153 158 164 169 175 180 186 192 198 203 209 216 222 228 235 241 248 254 153 158 163 169 175 180 186 192 198 204 210 216 222 229 235 242 249 256 263 158 163 168 174 180 186 192 198 204 211 216 223 229 236 242 250 256 264 271 162 168 174 180 186 191 197 204 210 217 223 230 236 243 250 257 264 272 279 167 173 179 185 191 197 204 210 216 223 230 236 243 250 258 265 272 279 287 172 178 184 190 196 203 209 216 223 230 236 243 250 257 265 272 280 287 295 177 183 189 195 202 208 215 222 229 236 243 250 257 265 272 280 287 295 304 181 188 194 201 207 214 221 228 235 242 249 257 264 272 279 288 295 303 312 186 193 199 206 213 220 227 234 241 249 256 263 271 279 287 295 303 311 320 191 198 204 211 218 225 232 240 247 255 262 270 278 286 294 302 311 319 328 196 203 209 217 224 231 238 246 253 261 269 277 285 293 302 310 319 327 336 201 208 215 222 229 237 244 252 260 268 276 284 292 301 309 318 326 335 344 205 212 220 227 235 242 250 258 266 274 282 291 299 308 316 325 334 343 353 210 217 225 232 240 248 256 264 272 280 289 297 306 315 324 333 342 351 361 215 222 230 238 246 254 262 270 278 287 295 304 313 322 331 340 350 359 369 220 227 235 243 251 259 267 276 284 293 302 311 320 329 338 348 358 367 377 224 232 240 248 256 265 273 282 291 299 308 318 327 338 346 355 365 375 385 229 237 245 254 262 270 279 288 297 306 315 324 334 343 353 363 373 383 394 234 242 250 259 267 278 285 294 303 312 322 331 341 351 361 371 381 391 402 239 247 255 264 273 282 291 300 309 319 328 338 348 358 368 378 389 399 410 244 252 261 269 278 287 296 306 315 325 335 345 355 365 375 386 396 407 418 248 257 266 275 284 293 302 312 322 331 341 351 362 372 383 393 404 415 426 253 262 271 280 289 299 308 318 328 338 348 358 369 379 390 401 412 423 435 258 267 276 285 295 304 314 324 334 344 354 365 376 386 397 408 420 431 443 Height (inches) Body Weight (pounds ) 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 91 94 97 100 104 107 110 114 118 121 125 128 132 136 140 144 148 152 156 96 99 102 106 109 113 116 120 124 127 131 135 139 143 147 151 155 160 164 100 104 107 111 115 118 122 126 130 134 138 142 146 150 154 159 163 168 172 105 109 112 116 120 124 128 132 136 140 144 149 153 157 162 166 171 176 180 110 114 118 122 126 130 134 138 142 146 151 155 160 165 169 174 179 184 189 Source: Adapted from National Heart, Lung, and Blood Institute: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: the Evidence Report See http://www.nhibhi.nih.gov/guidelines/obesity/bmi_tbl.pdf ... (Stadol) 4.7 h 3-4 h 4.7 h 3-4 h 0. 5-2 mg IV q 3-4 h prn 1-4 mg IM q 3-4 h prn 1-2 sprays q 3-4 h 4-6 h 1 5-6 0 mg q 4-6 h No benefit in exceeding mg per dose IM Not to exceed sprays q 3-4 h 360 mg Agonist... mg IV 0. 8-1 .0 mg SC, IM 2.6 h mg 3-4 h mg-8 mg PO q 3-4 h 2.6 h mg PR 6-8 h mg q 6-8 h 2. 5-4 h 3-4 h 5 0-1 50 mg IM, PO, SC q 3-4 h Methadone (Dolophine) Average 23 h Long and variable half-life 50 mg... 6 0-9 0 if required 1 5-6 0 mg SC, IV 360 mg 12 tabs/day 2. 5-3 .5 h Codeine sulfate Codeine ỵ acetaminophen 2. 5-3 .5 h 15, 30, 60 mg/ 300 mg 1 5-6 0 mg PO 30 mg/300 mg 3-4 h 3-4 h 1 5-6 0 mg bid-qid3 1-2