P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 July2,2007 11:13 Internal Medicine EditedbyBruceF.Scharschmidt,MD ASSOCIATE EDITORS RobertJ.Alpern,MD MichaelJ.Aminoff,MD,DSc,FRCP EdwardJ.Benz,Jr.,MD JeffreyP.Callen,MD,FACP DevronH.Char,MD AndrewR.Hoffman,MD RichardA.Jacobs,MD,PhD JoelS.Karliner,MD EmmetB.Keeffe,MD FredricB.Kraemer,MD StephenC.Lazarus,MD BiffF.Palmer,MD SusanPhilip,MD,MPH ShaunRuddy,MD i P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 June27,2007 10:22 cambridgeuniversitypress Cambridge,NewYork,Melbourne,Madrid,CapeTown,Singapore, Sa˜oPaulo,Delhi CambridgeUniversityPress 32AvenueoftheAmericas,NewYork,NY10013-2473,USA www.cambridge.org Informationonthistitle:www.cambridge.org/9780521709408 (cid:1)C 2007,2006,2002,PocketMedicine/InternalMedicinebyPocketMedicine.com,Inc. Thispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithout thewrittenpermissionofCambridgeUniversityPress. Firstpublished2007 PrintedintheUnitedStatesofAmerica AcatalogrecordforthispublicationisavailablefromtheBritishLibrary. LibraryofCongressCataloginginPublicationData Internalmedicine/[editedby]BruceF.Scharschmidt. p.;cm. ISBN-13:978-0-521-70940-8(pbk.) ISBN-10:0-521-70940-7(pbk.) 1.Internalmedicine–Handbooks,manuals,etc. I.Scharschmidt, Bruce. II.Title. [DNLM:1.InternalMedicine–Handbooks.WB39I59852007] RC55.I475 2007 616–dc 222007016973 ISBN 978-0-521-70940-8paperback CambridgeUniversityPresshasnoresponsibilityfor thepersistenceoraccuracyofURLsforexternalor third-partyInternetWebsitesreferredtointhispublication anddoesnotguaranteethatanycontentonsuch Websitesis,orwillremain,accurateorappropriate. Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateand up-to-dateinformationthatisinaccordwithacceptedstandardsandpracticeat thetimeofpublication.Nevertheless,theauthors,editors,andpublishercanmake nowarrantiesthattheinformationcontainedhereinistotallyfreefromerror,not leastbecauseclinicalstandardsareconstantlychangingthroughresearchand regulation.Theauthors,editors,andpublisherthereforedisclaimallliabilityfor directorconsequentialdamagesresultingfromtheuseofmaterialcontainedin thisbook.Readersarestronglyadvisedtopaycarefulattentiontoinformation providedbythemanufacturerofanydrugsorequipmentthattheyplantouse. ii P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 July2,2007 11:13 AFFILIATIONS editor BruceF.Scharschmidt,MD VicePresident,ClinicalDevelopment ChironCorporation associateeditors cardiology JoelS.Karliner,MD ProfessorofMedicine SchoolofMedicine UniversityofCalifornia,SanFrancisco AssociateChiefofMedicineforResearchandStaffCardiologist VAMedicalCenter,SanFrancisco dermatology JeffreyP.Callen,MD,FACP ProfessorofMedicine(Dermatology) Chief,DivisionofDermatology UniversityofLouisvilleSchoolofMedicine Louisville,Kentucky endocrinology,metabolismandbonedisorders AndrewR.Hoffman,MD ProfessorofMedicine AssociateChairforAcademicAffairs DepartmentofMedicine StanfordUniversityandVAPaloAltoHealthCareSystem Stanford,California FredricB.Kraemer,MD AssociateChiefofStaffforResearchandDevelopment VAPaloAltoHealthCareSystem PaloAlto,California ProfessorofMedicine Chief,DivisionofEndocrinology,GerontologyandMetabolism StanfordUniversitySchoolofMedicine Stanford,California iii P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 July2,2007 11:13 iv Affiliations gastroenterology,hepatologyandnutrition EmmetB.Keeffe,MD ProfessorofMedicine ChiefofHepatology Co-Director,LiverTransplantProgram StanfordUniversityMedicalCenter Stanford,California head,eye,ear,noseandthroat DevronH.Char,MD President,TumoriFoundation ClinicalProfessor,DepartmentofOphthalmology StanfordUniversitySchoolofMedicine Stanford,California hematology EdwardJ.Benz,Jr.,MD RichardandSusanSmithProfessorofMedicine HarvardMedicalSchool Boston,Massachusetts President,Dana-FarberCancerInstitute Boston,Massachusetts infectiousdiseases RichardA.Jacobs,MD,PhD ClinicalProfessorofMedicineandInfectiousDiseases SchoolofMedicine UniversityofCalifornia,SanFrancisco SusanPhilip,MD,MPH MedicalDirector,SanFranciscoCityClinic SanFranciscoDepartmentofPublicHealth AssistantClinicalProfessorofMedicine SchoolofMedicine UniversityofCalifornia,SanFrancisco kidneyandurologicdisease RobertJ.Alpern,MD EnsignProfessorofMedicine Dean,YaleSchoolofMedicine YaleUniversity NewHaven,Connecticut P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 July2,2007 11:13 Affiliations v BiffF.Palmer,MD ProfessorofInternalMedicine DirectorofRenalFellowshipProgram DepartmentofMedicine DivisionofNephrology UniversityofTexasSouthwesternMedicalSchool Dallas,Texas neurology MichaelJ.Aminoff,MD,DSc,FRCP ProfessorofNeurologyandExecutiveViceChair DepartmentofNeurology SchoolofMedicine,UniversityofCaliforniaSanFrancisco AttendingNeurologist UCSFMedicalCenter SanFrancisco withcontributionsbyDr.Aminoffand ChadChristine,MD AssistantClinicalProfessorofNeurology DepartmentofNeurology SchoolofMedicine UniversityofCalifornia,SanFrancisco pulmonarymedicine StephenC.Lazarus,MD ProfessorofMedicine Director,FellowshipPrograminPulmonaryandCriticalCareMedicine AssociateDirector,AdultPulmonaryLaboratory SeniorInvestigator,CardiovascularResearchInstitute SchoolofMedicine UniversityofCalifornia,SanFrancisco rheumatology,allergyandimmunology ShaunRuddy,MD ElamC.TooneProfessorEmeritus DepartmentofInternalMedicine MedicalCollegeofVirginia VCUHealthSystems Richmond,Virginia P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 June27,2007 10:22 vi P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 June27,2007 10:22 NOTICE Becauseofthedynamicnatureofmedicalpracticeanddrug selectionanddosage,usersareadvisedthatdecisionsregard- ing drug therapy must be based on the independent judg- mentoftheclinician,changinginformationaboutadrug(e.g., asreflectedintheliteratureandmanufacturer’smostcurrent productinformation),andchangingmedicalpractices. Whilegreatcarehasbeentakentoensuretheaccuracyofthe informationpresented,usersareadvisedthattheauthors,edi- tors, contributors, and publisher make no warranty, express or implied, with respect to, and are not responsible for, the currency, completeness, or accuracy of the information con- tained in this publication, nor for any errors, omissions, or theapplicationofthisinformation,norforanyconsequences arisingtherefrom.Usersareencouragedtoconfirmtheinfor- mationcontainedhereinwithothersourcesdeemedauthorita- tive.Ultimately,itistheresponsibilityofthetreatingphysician, relyingonexperienceandknowledgeofthepatient,todeter- minedosagesandthebesttreatmentforthepatient.Therefore, theauthor(s),editors,contributors,andthepublishermakeno warranty,expressorimplied,andshallhavenoliabilitytoany personorentitywithregardtoclaims,loss,ordamagecaused, orallegedtobecaused,directlyorindirectly,bytheuseofinfor- mationcontainedinthispublication. Further,theauthor(s),editors,contributors,andthepublisher arenotresponsibleformisuseofanyoftheinformationpro- videdinthispublication,fornegligencebytheuser,orforany typographicalerrors. vii P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 June27,2007 10:22 viii P1:SBT 0521779407pre CUNY1086/Karliner 0521779407 June27,2007 10:22 Contents Preface pagexxix AbdominalAorticAneurysm(AAA).........................1 AbscessesandFistulas..................................5 AcanthosisNigricans ................................... 7 Acne ............................................... 9 Acromegaly ......................................... 12 ActinicKeratosis......................................15 AcuteAcalculousCholecystitis ........................... 16 AcuteBacterialMeningitis .............................. 18 AcuteFattyLiverofPregnancy ........................... 21 AcuteHeartFailure....................................23 AcuteLymphoblasticLeukemia...........................29 AcuteMyeloblasticLeukemia............................37 AcuteMyocarditides...................................41 AcutePancreatitis.....................................45 AcutePericarditis.....................................48 AcuteRenalFailure....................................50 AcuteRespiratoryAcidosis .............................. 55 AcuteRespiratoryAlkalosis..............................56 AcuteRespiratoryFailure/Monitoring......................58 AdenocarcinomaoftheAmpullaofVater....................62 Adenovirus..........................................63 AdrenalInsufficiency .................................. 66 AdrenalTumors ...................................... 70 AdultOpticNeuropathies...............................74 AgeRelatedMaculopathy...............................80 ix