VOLUME I SECTION I: SOCIAL AND ETHICAL ISSUES IN MEDICINE 1 Approach to Medicine, the Patient, and the Medical Profession: Medicine as a Learned and Humane Profession 2 Bioethics in the Practice of Medicine 3 Care of Dying Patients and Their Families 4 Cultural Context of Medicine 5 Socioeconomic Issues in Medicine 6 Global Health SECTION II: PRINCIPLES OF EVALUATION AND MANAGEMENT 7 Approach to the Patient: History and Physical Examination 8 Approach to the Patient with Abnormal Vital Signs 9 Statistical Interpretation of Data 10 Using Data for Clinical Decisions 11 Measuring Health and Health Care 12 Quality of Care and Patient Safety 13 Comprehensive Chronic Disease Management SECTION III: PREVENTIVE AND ENVIRONMENTAL ISSUES 14 Counseling for Behavior Change 15 The Periodic Health Examination 16 Physical Activity 17 Adolescent Medicine 18 Immunization 19 Principles of Occupational and Environmental Medicine 20 Radiation Injury 21 Bioterrorism 22 Chronic Poisoning: Trace Metals and Others SECTION IV: AGING AND GERIATRIC MEDICINE 23 Epidemiology of Aging: Implications of an Aging Society 24 Geriatric Assessment 25 Common Clinical Sequelae of Aging 26 Incontinence 27 Neuropsychiatric Aspects of Aging 28 Delirium or Acute Mental Status Change in the Older Patient SECTION V: CLINICAL PHARMACOLOGY 29 Principles of Drug Therapy 30 Pain 31 Biology of Addiction 32 Nicotine and Tobacco 33 Alcohol Use Disorders 34 Drugs of Abuse 35 Immunosuppressing Drugs Including Corticosteroids 36 Biologic Agents and Signaling Inhibitors 37 Prostanoids, Aspirin, and Related Compounds 38 Antithrombotic Therapy 39 Complementary and Alternative Medicine SECTION VI: GENETICS 40 Principles of Genetics 41 Gene, Genomic, and Chromosomal Disorders 42 The Inherited Basis of Common Diseases 43 Application of Molecular Technologies to Clinical Medicine 44 Regenerative Medicine, Cell, and Gene Therapies SECTION VII: PRINCIPLES OF IMMUNOLOGY AND INFLAMMATION 45 The Innate Immune System 46 The Adaptive Immune System 47 Mechanisms of Immune-Mediated Tissue Injury 48 Mechanisms of Inflammation and Tissue Repair 49 Transplantation Immunology 50 Complement System in Disease SECTION VIII: CARDIOVASCULAR DISEASE 51 Approach to the Patient with Possible Cardiovascular Disease 52 Epidemiology of Cardiovascular Disease 53 Cardiac Function and Circulatory Control 54 Electrocardiography 55 Echocardiography 56 Noninvasive Cardiac Imaging 57 Catheterization and Angiography 58 Heart Failure: Pathophysiology and Diagnosis 59 Heart Failure: Management and Prognosis 60 Diseases of the Myocardium and Endocardium 61 Principles of Electrophysiology 62 Approach to the Patient with Suspected Arrhythmia 63 Approach to Cardiac Arrest and Life-Threatening Arrhythmias 64 Cardiac Arrhythmias with Supraventricular Origin 65 Ventricular Arrhythmias 66 Electrophysiologic Interventional Procedures and Surgery 67 Arterial Hypertension 68 Pulmonary Hypertension 69 Congenital Heart Disease in Adults 70 Atherosclerosis, Thrombosis, and Vascular Biology 71 Angina Pectoris and Stable Ischemic Heart Disease 72 Acute Coronary Syndrome: Unstable Angina and Non-ST Elevation Myocardial Infarction 73 ST Segment Elevation Acute Myocardial Infarction and Complications of Myocardial Infarction 74 Interventional and Surgical Treatment of Coronary Artery Disease 75 Valvular Heart Disease 76 Infective Endocarditis 77 Pericardial Diseases 78 Diseases of the Aorta 79 Atherosclerotic Peripheral Arterial Disease 80 Other Peripheral Arterial Diseases 81 Peripheral Venous Disease 82 Cardiac Transplantation SECTION IX: RESPIRATORY DISEASES 83 Approach to the Patient with Respiratory Disease 84 Imaging in Pulmonary Disease 85 Respiratory Function: Mechanisms and Testing 86 Disorders of Ventilatory Control 87 Asthma 88 Chronic Obstructive Pulmonary Disease 89 Cystic Fibrosis 90 Bronchiectasis, Atelectasis, Cysts, and Localized Lung Disorders 91 Alveolar Filling Disorders 92 Interstitial Lung Disease 93 Occupational Lung Disease 94 Physical and Chemical Injuries of the Lung 95 Sarcoidosis 96 Acute Bronchitis and Tracheitis 97 Overview of Pneumonia 98 Pulmonary Embolism 99 Diseases of the Diaphragm, Chest Wall, Pleura, and Mediastinum 100 Obstructive Sleep Apnea 101 Interventional and Surgical Approaches to Lung Disease SECTION X: CRITICAL CARE MEDICINE 102 Approach to the Patient in a Critical Care Setting 103 Respiratory Monitoring in Critical Care 104 Acute Respiratory Failure 105 Mechanical Ventilation 106 Approach to the Patient with Shock 107 Cardiogenic Shock 108 Shock Syndromes Related to Sepsis 109 Disorders Due to Heat and Cold 110 Acute Poisoning 111 Medical Aspects of Injuries and Burns 112 Envenomation 113 Rhabdomyolysis SECTION XI: RENAL AND GENITOURINARY DISEASES 114 Approach to the Patient with Renal Disease 115 Structure and Function of the Kidneys 116 Disorders of Sodium and Water Homeostasis 117 Potassium Disorders 118 Acid-Base Disorders 119 Disorders of Magnesium and Phosphorus 120 Acute Kidney Injury 121 Glomerular Disorders and Nephrotic Syndromes 122 Tubulointerstitial Nephritis 123 Obstructive Uropathy 124 Diabetes and the Kidney 125 Vascular Disorders of the Kidney 126 Nephrolithiasis 127 Cystic Kidney Diseases 128 Hereditary Nephropathies and Developmental Abnormalities of the Urinary Tract 129 Benign Prostatic Hyperplasia and Prostatitis 130 Chronic Kidney Disease 131 Treatment of Irreversible Renal Failure SECTION XII: GASTROINTESTINAL DISEASES 132 Approach to the Patient with Gastrointestinal Disease 133 Diagnostic Imaging Procedures in Gastroenterology 134 Gastrointestinal Endoscopy 135 Gastrointestinal Hemorrhage 136 Disorders of Gastrointestinal Motility 137 Functional Gastrointestinal Disorders: Irritable Bowel Syndrome, Dyspepsia, Chest Pain of Presumed Esophageal Origin, and Heartburn 138 Diseases of the Esophagus 139 Acid Peptic Disease 140 Approach to the Patient with Diarrhea and Malabsorption 141 Inflammatory Bowel Disease 142 Inflammatory and Anatomic Diseases of the Intestine, Peritoneum, Mesentery, and Omentum 143 Vascular Diseases of the Gastrointestinal Tract 144 Pancreatitis 145 Diseases of the Rectum and Anus SECTION XIII: DISEASES OF THE LIVER, GALLBLADDER, AND BILE DUCTS 146 Approach to the Patient with Liver Disease 147 Approach to the Patient with Jaundice or Abnormal Liver Tests 148 Acute Viral Hepatitis 149 Chronic Viral and Autoimmune Hepatitis 150 Toxin- and Drug-Induced Liver Disease 151 Bacterial, Parasitic, Fungal, and Granulomatous Liver Diseases 152 Alcoholic and Nonalcoholic Steatohepatitis 153 Cirrhosis and Its Sequelae 154 Hepatic Failure and Liver Transplantation 155 Diseases of the Gallbladder and Bile Ducts SECTION XIV: HEMATOLOGIC DISEASES 156 Hematopoiesis and Hematopoietic Growth Factors 157 The Peripheral Blood Smear 158 Approach to the Anemias 159 Microcytic and Hypochromic Anemias 160 Autoimmune and Intravascular Hemolytic Anemias 161 Hemolytic Anemias: Red Blood Cell Membrane and Metabolic Defects 162 The Thalassemias 163 Sickle Cell Disease and Other Hemoglobinopathies 164 Megaloblastic Anemias 165 Aplastic Anemia and Related Bone Marrow Failure States 166 Polycythemia Vera, Essential Thrombocythemia, and Primary Myelofi brosis 167 Leukocytosis and Leukopenia 168 Approach to the Patient with Lymphadenopathy and Splenomegaly 169 Disorders of Phagocyte Function 170 Eosinophilic Syndromes 171 Approach to the Patient with Bleeding and Thrombosis 172 Thrombocytopenia 173 Von Willebrand Disease and Hemorrhagic Abnormalities of Platelet and Vascular Function 174 Hemorrhagic Disorders: Coagulation Factor Defi ciencies 175 Hemorrhagic Disorders: Disseminated Intravascular Coagulation, Liver Failure, and Vitamin K Defi ciency 176 Thrombotic Disorders: Hypercoagulable States 177 Transfusion Medicine 178 Hematopoietic Stem Cell Transplantation SECTION XV: ONCOLOGY 179 Approach to the Patient with Cancer 180 Epidemiology of Cancer 181 Cancer Biology and Genetics 182 Myelodysplastic Syndromes 183 The Acute Leukemias 184 The Chronic Leukemias 185 Non-Hodgkin Lymphomas 186 Hodgkin Lymphoma 187 Plasma Cell Disorders 188 Amyloidosis 189 Tumors of the Central Nervous System 190 Head and Neck Cancer 191 Lung Cancer and Other Pulmonary Neoplasms 192 Neoplasms of the Esophagus and Stomach 193 Neoplasms of the Small and Large Intestine 194 Pancreatic Cancer 195 Pancreatic Neuroendocrine Tumors 196 Liver and Biliary Tract Cancers 197 Tumors of the Kidney, Bladder, Ureters, and Renal Pelvis 198 Breast Cancer and Benign Breast Disorders 199 Gynecologic Cancers 200 Testicular Cancer 201 Prostate Cancer 202 Malignant Tumors of Bone, Sarcomas, and Other Soft Tissue Neoplasms 203 Melanoma and Nonmelanoma Skin Cancers 204 Cancer of Unknown Primary Origin VOLUME II SECTION XVI: METABOLIC DISEASES 205 Approach to Inborn Errors of Metabolism 206 Disorders of Lipid Metabolism 207 Glycogen Storage Diseases 208 Lysosomal Storage Diseases 209 Homocystinuria and Hyperhomocysteinemia 210 The Porphyrias 211 Wilson Disease 212 Iron Overload (Hemochromatosis) SECTION XVII: NUTRITIONAL DISEASES 213 Nutrition's Interface with Health and Disease 214 Nutritional Assessment 215 Protein-Energy Malnutrition 216 Enteral Nutrition 217 Malnutrition, Nutritional Assessment, and Nutritional Support in Adult Hospitalized Patients 218 Vitamins, Trace Minerals, and Other Micronutrients 219 Eating Disorders 220 Obesity SECTION XVIII: ENDOCRINE DISEASES 221 Approach to the Patient with Endocrine Disease 222 Principles of Endocrinology 223 Neuroendocrinology and the Neuroendocrine System 224 Anterior Pituitary 225 Posterior Pituitary 226 Thyroid 227 Adrenal Cortex 228 Adrenal Medulla, Catecholamines, and Pheochromocytoma 229 Diabetes Mellitus 230 Hypoglycemia and Pancreatic Islet Cell Disorders 231 Polyglandular Disorders 232 Neuroendocrine Tumors and the Carcinoid Syndrome 233 Disorders of Sexual Development 234 The Testis and Male Hypogonadism, Infertility, and Sexual Dysfunction 235 Ovaries and Pubertal Development 236 Reproductive Endocrinology and Infertility SECTION XIX: WOMEN'S HEALTH 237 Approach to Women's Health 238 Contraception 239 Common Medical Problems in Pregnancy 240 Menopause 241 Intimate Partner Violence SECTION XX: DISEASES OF BONE AND MINERAL METABOLISM 242 Approach to the Patient with Metabolic Bone Disease 243 Osteoporosis 244 Osteomalacia and Rickets 245 The Parathyroid Glands, Hypercalcemia and Hypocalcemia 246 Medullary Thyroid Carcinoma 247 Paget Disease of Bone 248 Osteonecrosis, Osteosclerosis/Hyperostosis, and Other Disorders of Bone SECTION XXI: DISEASES OF ALLERGY AND CLINICAL IMMUNOLOGY 249 Approach to the Patient with Allergic or Immunologic Disease 250 Primary Immunodeficiency Diseases 251 Allergic Rhinitis and Chronic Sinusitis 252 Urticaria and Angioedema 253 Systemic Anaphylaxis, Food Allergy, and Insect Sting Allergy 254 Drug Allergy 255 Mastocytosis SECTION XXII: RHEUMATIC DISEASES 256 Approach to the Patient with Rheumatic Disease 257 Laboratory Testing in the Rheumatic Diseases 258 Imaging Studies in the Rheumatic Diseases 259 Connective Tissue Structure and Function 260 Inherited Diseases of Connective Tissue 261 The Systemic Autoinflammatory Diseases 262 Osteoarthritis 263 Bursitis, Tendinitis, and Other Periarticular Disorders and Sports Medicine 264 Rheumatoid Arthritis 265 The Spondyloarthropathies 266 Systemic Lupus Erythematosus 267 Systemic Sclerosis (Scleroderma) 268 Sjoegren Syndrome 269 Inflammatory Myopathies 270 The Systemic Vasculitides 271 Polymyalgia Rheumatica and Temporal Arteritis 272 Infections of Bursae, Joints, and Bones 273 Crystal Deposition Diseases 274 Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain 275 Systemic Diseases in Which Arthritis Is a Feature 276 Surgical Treatment of Joint Diseases SECTION XXIII: INFECTIOUS DISEASES 277 Introduction to Microbial Disease: Host-Pathogen Interactions 278 The Human Microbiome 279 Principles of Anti-Infective Therapy 280 Approach to Fever or Suspected Infection in the Normal Host 281 Approach to Fever and Suspected Infection in the Compromised Host 282 Prevention and Control of Health Care-Associated Infections 283 Approach to the Patient with Suspected Enteric Infection 284 Approach to the Patient with Urinary Tract Infection 285 Approach to the Patient with a Sexually Transmitted Infection 286 Approach to the Patient before and after Travel 287 Antibacterial Chemotherapy 288 Staphylococcal Infections 289 Streptococcus Pneumoniae Infections 290 Nonpneumococcal Streptococcal Infections and Rheumatic Fever 291 Enterococcal Infections 292 Diphtheria and Other Corynebacterium Infections 293 Listeriosis 294 Anthrax 295 Erysipelothrix Infections 296 Clostridial Infections 297 Diseases Caused by Non-Spore-Forming Anaerobic Bacteria 298 Neisseria Meningitidis Infections 299 Neisseria Gonorrhoeae Infections 300 Haemophilus and Moraxella Infections 301 Chancroid 302 Cholera and Other Vibrio Infections 303 Campylobacter Infections 304 Escherichia Coli Enteric Infections 305 Infections Due to Other Members of the Enterobacteriaceae, Including Management of Multidrug-Resistant Strains 306 Pseudomonas and Related Gram-Negative Bacillary Infections 307 Diseases Caused by Acinetobacter and Stenotrophomonas Species 308 Salmonella Infections (Including Enteric Fever) 309 Shigellosis 310 Brucellosis 311 Tularemia and Other Francisella Infections 312 Plague and Other Yersinia Infections 313 Whooping Cough and Other Bordetella Infections 314 Legionella Infections 315 Bartonella Infections 316 Granuloma Inguinale (Donovanosis) 317 Mycoplasma Infections 318 Diseases Caused by Chlamydiae 319 Syphilis 320 Nonsyphilitic Treponematoses 321 Lyme Disease 322 Relapsing Fever and Other Borrelia Infections 323 Leptospirosis 324 Tuberculosis 325 The Nontuberculous Mycobacteria 326 Leprosy (Hansen Disease) 327 Rickettsial Infections 328 Zoonoses 329 Actinomycosis 330 Nocardiosis 331 Systemic Antifungal Agents 332 Histoplasmosis 333 Coccidioidomycosis 334 Blastomycosis 335 Paracoccidioidomycosis 336 Cryptococcosis 337 Sporotrichosis 338 Candidiasis 339 Aspergillosis 340 Mucormycosis 341 Pneumocystis Pneumonia 342 Mycetoma 343 Dematiaceous Fungal Infections 344 Antiparasitic Therapy 345 Malaria 346 African Sleeping Sickness 347 Chagas Disease 348 Leishmaniasis 349 Toxoplasmosis 350 Cryptosporidiosis 351 Giardiasis 352 Amebiasis 353 Babesiosis and Other Protozoan Diseases 354 Cestodes 355 Schistosomiasis (Bilharziasis) 356 Liver, Intestinal, and Lung Fluke Infections 357 Intestinal Nematode Infections 358 Tissue Nematode Infections 359 Arthropods and Leeches 360 Antiviral Therapy (Non-HIV) 361 The Common Cold 362 Respiratory Syncytial Virus 363 Parainfluenza Viral Disease 364 Influenza 365 Adenovirus Diseases 366 Coronaviruses 367 Measles 368 Rubella (German Measles) 369 Mumps 370 Cytomegalovirus, Epstein-Barr Virus, and Slow Virus Infections of the Central Nervous System 371 Parvovirus 372 Smallpox, Monkeypox, and Other Poxvirus Infections 373 Papillomavirus 374 Herpes Simplex Virus Infections 375 Varicella-Zoster Virus (Chickenpox, Shingles) 376 Cytomegalovirus 377 Epstein-Barr Virus Infection 378 Retroviruses Other Than Human Immunodeficiency Virus 379 Enteroviruses 380 Rotaviruses, Noroviruses, and Other Gastrointestinal Viruses 381 Viral Hemorrhagic Fevers 382 Arboviruses Causing Fever and Rash Syndromes 383 Arboviruses Aff ecting the Central Nervous System SECTION XXIV: HIV AND THE ACQUIRED IMMUNODEFICIENCY SYNDROME 384 Epidemiology and Diagnosis of Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome 385 Immunopathogenesis of Human Immunodeficiency Virus Infection 386 Biology of Human Immunodeficiency Viruses 387 Prevention of Human Immunodeficiency Virus Infection 388 Antiretroviral Therapy of HIV/AIDS 389 Infectious and Metabolic Complications of HIV and AIDS 390 Gastrointestinal Manifestations of HIV and AIDS 391 Pulmonary Manifestations of Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome 392 Skin Manifestations in Patients with Human Immunodeficiency Virus Infection 393 Hematology and Oncology in Patients with Human Immunodeficiency Virus Infection 394 Neurologic Complications of Human Immunodeficiency Virus Infection 395 Immune Reconstitution Inflammatory Syndrome in HIV/AIDS SECTION XXV: NEUROLOGY 396 Approach to the Patient with Neurologic Disease 397 Psychiatric Disorders in Medical Practice 398 Headaches and Other Head Pain 399 Traumatic Brain Injury and Spinal Cord Injury 400 Mechanical and Other Lesions of the Spine, Nerve Roots, and Spinal Cord 401 Regional Cerebral Dysfunction: Higher Mental Functions 402 Alzheimer Disease and Other Dementias 403 The Epilepsies 404 Coma, Vegetative State, and Brain Death 405 Disorders of Sleep 406 Approach to Cerebrovascular Diseases 407 Ischemic Cerebrovascular Disease 408 Hemorrhagic Cerebrovascular Disease 409 Parkinsonism 410 Other Movement Disorders 411 Multiple Sclerosis and Demyelinating Conditions of the Central Nervous System 412 Meningitis: Bacterial, Viral, and Other 413 Brain Abscess and Parameningeal Infections 414 Acute Viral Encephalitis 415 Prion Diseases 416 Nutritional and Alcohol-Related Neurologic Disorders 417 Congenital, Developmental, and Neurocutaneous Disorders 418 Autonomic Disorders and Their Management 419 Amyotrophic Lateral Sclerosis and Other Motor Neuron Diseases 420 Peripheral Neuropathies 421 Muscle Diseases 422 Disorders of Neuromuscular Transmission XXVI: EYE, EAR, NOSE, AND THROAT DISEASES 423 Diseases of the Visual System 424 Neuro-Ophthalmology 425 Diseases of the Mouth and Salivary Glands 426 Approach to the Patient with Nose, Sinus, and Ear Disorders 427 Smell and Taste 428 Hearing and Equilibrium 429 Throat Disorders SECTION XXVII: MEDICAL CONSULTATION 430 Principles of Medical Consultation 431 Preoperative Evaluation 432 Overview of Anesthesia 433 Postoperative Care and Complications 434 Medical Consultation in Psychiatry SECTION XXVIII: SKIN DISEASES 435 Structure and Function of the Skin 436 Examination of the Skin and an Approach to Diagnosing Skin Diseases 437 Principles of Therapy of Skin Diseases 438 Eczemas, Photodermatoses, Papulosquamous (Including Fungal) Diseases, and Figurate Erythemas 439 Macular, Papular, Vesiculobullous, and Pustular Diseases 440 Urticaria, Drug Hypersensitivity Rashes, Nodules and Tumors, and Atrophic Diseases 441 Infections, Hyperpigmentation and Hypopigmentation, Regional Dermatology, and Distinctive Lesions in Black Skin 442 Diseases of Hair and Nails APPENDIX-LABORATORY REFERENCE INTERVALS AND VALUES Reference Intervals and Laboratory Values