Harrison manual of medicine 19e 2016 1

Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1 Harrison manual of medicine 19e 2016 1

GLOSSARY A2 ABGs ACE AF AIDS ALS ANA ARDS bid biw bp BUN CAPO CBC CF CHF CLL CML CMV CNS CPK CSF CT CVP CXR DIC DVT aortic second sound arterial blood gases angiotensin converting enzyme atrial fibrillation acquired immunodeficiency syndrome amyotrophic lateral sclerosis antinuclear antibody acute respiratory distress syndrome two times daily twice a week blood pressure blood urea nitrogen continuous ambulatory peritoneal dialysis complete blood count complement fixation congestive heart failure chronic lymphocytic leukemia chronic myeloid leukemia cytomegalovirus central nervous system creatine phosphokinase cerebrospinal fluid computed tomography central venous pressure chest x-ray disseminated intravascular coagulation deep venous thrombosis EBV ECG EEG ELISA EMG ENT EOM ESR FDA FEV, GFR GI G6PD Hb Hct HDL HIV hs HSV ICU IFN lg IL IM IP IV IVC IVP Epstein-Barr virus electrocardiogram electroencephalogram enzyme-linked immunosorbent assay electromyogram ear, nose, and throat extraocular movement erythrocyte sedimentation rate US Food and Drug Administration forced expiratory volume in first second glomerular filtration rate gastrointestinal glucose-6-phosphate dehydrogenase hemoglobin hematocrit high-density lipoprotein human immunodeficiency virus at bedtime herpes simplex virus intensive care unit interferon immunoglobulin interleukin intramuscular intraperitoneal intravenous inferior vena cava intravenous pyelogram 19th Edition ��m��(Q)[N] 0ir MANUAL OF MEDICINE EDITORS Dennis L Kasper, MD, MACHON) William Ellery Channing Professor of Medicine, Professor of Microbiology and Immunobiology, Department of Microbiology and Immunobiology, Harvard Medical School; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts Anthony S Fauci, MD, ScD(HON) Chief, Laboratory of Immunoregulation; Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland Stephen L Hauser, MD Robert A Fishman Distinguished Professor and Chairman, Department of Neurology, University of California, San Francisco, San Francisco, California Dan L Longo, MD Professor of Medicine, Harvard Medical School; Senior Physician, Brigham and Women's Hospital; Deputy Editor, New England Journal of Medicine, Boston, Massachusetts J Larry Jameson, MD, PhD Robert G Dunlop Professor of Medicine; Dean, Perelman School of Medicine at the University of Pennsylvania; Executive Vice President, University of Pennsylvania for the Health System, Philadelphia, Pennsylvania Joseph Loscalzo, MD, PhD Hersey Professor of the Theory and Practice of Medicine, Harvard Medical School; Chairman, Department of Medicine, and Physician-in-Chief, Brigham and Women's Hospital, Boston, Massachusetts L7 [NJ © &��� 19th Edition TM � MANUAL OF MEDICINE EDITORS Dennis L Kasper, MD Anthony S Fauci, MD Stephen L Hauser, MD Dan L Longo, MD J Larry Jameson, MD, PhD Joseph Loscalzo, MD, PhD New York Chicago San Francisco Athens London Madrid Mexico City Milan New Delhi Singapore Sydney Toronto Copyright© 2016 by McGraw-Hill Education Previous editions copyright© 2013, 2009, 2005, 2002, 1998, 1995, 1991, 1988 by The McGraw-Hill Companies, Inc All rights reserved Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission ofthe publisher ISBN: 978-0-07-182854-3 MHID: 0-07-182854-0 The material in this eBook also appears in the print version ofthis title: ISBN: 978-0-07-182852-9, MHID: 0-07-182852-4 eBook conversion by codeMantra Version 1.0 All trademarks are trademarks of their respective owners Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark Where such designations appear in this book, they have been printed with initial caps McGraw-Hill Education books are available at special quantity discounts to use as premiums and sales promotions or for use in corporate training programs To contact a representative, please visit the Contact Us pages at www.mhprofessional.com NOTE: Dr Fauci's work as editor and author was performed outside the scope of his employment as a U.S government employee This work represents his personal and professional views and not necessarily those ofthe U.S government This book was set in Minion Pro by Cenveo® Publisher Services The editors were James F Shanahan and Kim J Davis The production supervisor was Catherine H Saggese; project management was provided by Anupriya Tyagi, Cenveo Publisher Services The designer was Alan Barnett; the cover designer was Dreamit, Inc RR Donnelly was printer and binder TERMS OF USE This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work Use ofthis work is subject to these terms Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part ofit without McGraw-Hill Education's prior consent You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited Your right to use the work may be terminated if you fail to comply with these terms THE WORK IS PROVIDED "AS IS." McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill Education and its licensors not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless ofcause, in the work or for any damages resulting therefrom McGraw-Hill Education has no responsibility for the content ofany information accessed through the work Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use ofor inability to use the work, even ifany ofthem has been advised ofthe possibility ofsuch damages This limitation ofliability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise CONTENTS Contributors xv Preface xvii Acknowledgments xix IBiiMiii CARE OF THE HOSPITALIZED PATIENT Electrolytes/Acid-Base Balance Diagnostic Imaging in Internal Medicine 23 Procedures Commonly Performed by Internists .26 Principles of Critical Care Medicine 31 Pain and Its Management 35 Assessment of Nutritional Status 40 Enteral and Parenteral Nutrition 43 Transfusion and Pheresis Therapy 46 Palliative and End-of-Life Care 48 IBiiMiD MEDICAL EMERGENCIES 10 Cardiovascular Collapse and Sudden Death 57 11 Shock 61 12 Sepsis and Septic Shock .65 13 Acute Pulmonary Edema 69 14 Acute Respiratory Distress Syndrome 71 15 Respiratory Failure .73 16 Confusion, Stupor, and Coma 76 17 Stroke 82 18 Subarachnoid Hemorrhage 91 19 Increased lntracranial Pressure and Head Trauma 93 20 Spinal Cord Compression 98 21 Hypoxic-lschemic Encephalopathy 100 22 Status Epilepticus .101 23 Diabetic Ketoacidosis and Hyperosmolar Coma 104 24 Hypoglycemia 107 25 Oncologic Emergencies 109 26 Anaphylaxis 114 27 Bites, Venoms, Stings, and Marine Poisonings 115 V vi - IHiiMiiL COMMON PATIENT PRFSF.NTATIONS 28 Fever, Hyperthermia, and Rash .127 29 Generalized Fatigue 131 30 Weight Loss .135 31 Chest Pain 137 32 Palpitations .141 33 Dyspnea .142 34 Cyanosis 145 35 Cough and Hemoptysis 146 36 Edema 150 37 Abdominal Pain 154 38 Nausea, Vomiting, and Indigestion 158 39 Dysphagia 162 40 Diarrhea, Malabsorption, and Constipation 167 41 Gastrointestinal Bleeding 174 42 Jaundice and Evaluation of Liver Fundion 178 43 Ascites .187 44 Lymphadenopathy and Splenomegaly 189 45 Anemia and Polycythemia .194 46 Azotemia and Urinary Abnormalities .197 47 Pain and Swelling of Joints 203 48 Back and Neck Pain 207 49 Headache 215 50 Syncope .222 51 Dizziness and Vertigo 226 52 Acute Visual Loss and Double Vision 229 53 Weakness and Paralysis 233 54 Tremor and Movement Disorders 236 55 Aphasia 239 56 Sleep Disorders 241 57 Dysuria and Bladder Pain 245 IUiiMii• 58 OTOLARYNGOLOGY Sore Throat, Earache, and Upper Respiratory Symptoms 247 IBiiMii• DERMATOLOGY - vii 59 General Examination of the Skin 255 60 Common Skin Conditions 258 MUiiMil HEMATOLOGY AND ONCOLOGY 61 Examination of Blood Smears and Bone Marrow 265 62 Red Blood Cell Disorders 267 63 Leukocytosis and Leukopenia 274 64 Bleeding and Thrombotic Disorders .277 65 Myeloid Leukemias, Myelodysplasia, and Myeloproliferative Syndromes .283 66 Lymphoid Malignancies •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••293 67 Skin Cancer .305 68 Head and Neck Cancer .308 69 Lung Cancer 310 70 Breast Cancer 316 71 Tumors of the Gastrointestinal Tract 321 72 Genitourinary Tract Cancer 333 73 Gynecologic Cancer 338 74 Prostate Hyperplasia and Carcinoma .342 75 Cancer of Unknown Primary Site 345 76 Paraneoplastic Endocrine Syndromes ••••••••••••••••••••••••••••••••••••348 77 Neurologic Para neoplastic Syndromes 352 IUiiMiQ_ 1NFECTIOUS DISEAS�S 78 Infections Acquired in Health Care Facilities 357 79 Infections in the lmmunocompromised Host 362 80 Infective Endocarditis 372 81 lntraabdominal lnfedions •••••••••••••••••••••••••••••••••••••••••••••••••••••••382 82 Infectious Diarrheas 386 83 Sexually Transmitted and Reproductive Trad Infections 399 84 Infections of the Skin, Soft Tissues, Joints, and Bones 415 85 Pneumococcal lnfections •••••••••••••••••••••••••••••••••••••••••••••••••••••••••422 86 Staphylococcal lnfedions 425 87 - 88 Meningococcal and Listeria! lnfections 443 viii 89 Streptococcal/Enterococcal Infections, Diphtheria, and Infections Caused by Other Corynebacteria and Related Species 434 Infections Caused by Haemophilus, Bordetella, Moraxella, and HACEK Group Organisms .448 90 Diseases Caused by Gram-Negative Enteric Bacteria and Pseudomonas 453 91 Infections Caused by Miscellaneous Gram-Negative Bacilli 462 92 Anaerobic Infections 469 93 Nocardiosis, Actinomycosis, and Whipple's Disease 477 94 Tuberculosis and Other Mycobacterial lnfections .482 95 Lyme Disease and Other Nonsyphilitic Spirochetal Infections 494 96 97 Rickettsial Diseases 500 Mycoplasma pneumoniae, Legionella Species, and Chlamydia pneumoniae 51 O 98 Chlamydia trachomatis and C psittaci 514 99 Herpesvirus lnfections .516 100 Cytomegalovirus and Epstein-Barr Virus Infections .525 101 Influenza and Other Viral Respiratory Diseases 530 102 Rubeola, Rubella, Mumps, and Parvovirus Infections 538 103 Enteroviral lnfections .543 104 Insect- and Animal-Borne Viral Infections .546 105 HIV Infection and AIDS 554 106 Fungal lnfections 568 107 Pneumocystis lnfections 583 108 Protozoa! Infections 586 109 Helminthic Infections and Ectoparasite Infestations .599 IBiiM/i:• CARDIOLOGY 110 Physical Examination of the Heart 613 111 Electrocardiography 618 112 Noninvasive Examination of the Heart 622 113 Congenital Heart Disease in the Adult 627 � itMIIHU ANTI RETROVIRAL DRUGS USED IN THE TREATMENT OF HIV INFECTION (CONTINUED) Drug Entry Inhibitors Enfuvirtide (Fuzeon) Indication Licensed In combination with other agents in treatment-experi­ enced patients with evidence of HIV-1 replication despite ongoing anti-retrovi­ ral therapy In combination with other antiretroviral agents in adults infected with only CCRS-tropic HIV-1 90 mg SC bid In treatmer superior to optimized I