Current Medical Diagnosis and Treatment 2009, 48th Edition (Current Medical Diagnosis and Treatment) PDF
Preview Current Medical Diagnosis and Treatment 2009, 48th Edition (Current Medical Diagnosis and Treatment)
LANGE 2009 CURRENT Medical Diagnosis & Treatment FO R T Y - E I G H T H E D I T I O N Edited by Stephen J. McPhee, MD Professor of Medicine Division of General Internal Medicine Department of Medicine University of California, San Francisco Maxine A. Papadakis, MD Professor of Clinical Medicine Associate Dean for Student Affairs School of Medicine University of California, San Francisco With Associate Authors New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Actof 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 sys- tem, without the prior written permission of the publisher. 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Contents Authors ix Urinary Incontinence 66 Preface xv Weight Loss & Malnutrition 68 Pressure Ulcers 69 1. Disease Prevention & Health Promotion 1 Pharmacotherapy & Polypharmacy 70 Vision Impairment 70 Michael Pignone, MD, MPH, & René Salazar, MD Hearing Impairment 70 Prevention of Infectious Diseases 3 Elder Abuse 71 Prevention of Cardiovascular Disease 6 Prevention of Osteoporosis 11 5. Palliative Care & Pain Management 72 Prevention of Physical Inactivity 12 Michael W. Rabow, MD, & Steven Z. Pantilat, MD Prevention of Overweight & Obesity 13 Cancer Prevention 15 Definition & Scope of Palliative Care 72 Prevention of Injuries & Violence 17 Pain Management 72 Substance Abuse: Alcohol & Illicit Drugs 18 Principles of Pain Management 72 Pain at the End of Life 73 2. Common Symptoms 21 Pharmacologic Pain Management Strategies 74 Nonpharmacologic Treatments 82 Ralph Gonzales, MD, MSPH, & Paul L. Nadler, MD Palliation of Other Common Symptoms 82 Cough 21 Dyspnea 82 Dyspnea 23 Nausea & Vomiting 82 Hemoptysis 26 Constipation 83 Chest Pain 27 Delirium & Agitation 83 Palpitations 29 End-of-Life Care 83 Lower Extremity Edema 31 Fever & Hyperthermia 33 6. Dermatologic Disorders 90 Involuntary Weight Loss 35 Timothy G. Berger, MD Fatigue & Chronic Fatigue Syndrome 36 Acute Headache 38 Principles of Dermatologic Therapy 90 Dysuria 40 Common Dermatoses 95 Pigmented Lesions 95 3. Preoperative Evaluation Scaling Disorders 97 & Perioperative Management 44 Vesicular Dermatoses 109 Weeping or Crusted Lesions 114 Joshua S. Adler, MD, & Hugo Q. Cheng, MD Pustular Disorders 116 Evaluation of the Asymptomatic Patient 44 Erythemas 121 Cardiac Risk Assessment & Reduction 44 Blistering Diseases 126 Pulmonary Evaluation in Non–Lung Resection Papules 127 Surgery 48 Violaceous to Purple Papules & Nodules 130 Evaluation of the Patient with Liver Disease 49 Pruritus (Itching) 131 Preoperative Hematologic Evaluation 50 Inflammatory Nodules 136 Neurologic Evaluation 51 Epidermal Inclusion Cyst 137 Management of Endocrine Diseases 52 Photodermatitis 138 Renal Disease 54 Ulcers 139 Antibiotic Prophylaxis of Surgical Site Miscellaneous Dermatologic Disorders 140 Infections 54 Pigmentary Disorders 140 Baldness (Alopecia) 141 4. Geriatric Disorders 56 Nail Disorders 142 C. Bree Johnston, MD, MPH, G. Michael Harper, MD, Dermatitis Medicamentosa (Drug Eruption) 143 & C. Seth Landefeld, MD 7. Disorders of the Eyes & Lids 147 Assessment of the Older Adult 56 Management of Common Geriatric Problems 58 Paul Riordan-Eva, FRCS, FRCOphth Dementia 58 Refractive Errors 147 Depression 62 Disorders of the Lids & Lacrimal Apparatus 148 Delirium 63 Conjunctivitis 149 Immobility 64 Pinguecula & Pterygium 151 Falls & Gait Disorders 64 Corneal Ulcer 152 iii iv CMDT 2009 CONTENTS Acute Angle-Closure Glaucoma 153 Coronary Heart Disease (Atherosclerotic Chronic Glaucoma 154 Coronary Artery Disease, Uveitis 155 Ischemic Heart Disease) 308 Cataract 156 Disturbances of Rate & Rhythm 331 Retinal Detachment 157 Bradycardias & Conduction Disturbances 344 Vitreous Hemorrhage 158 Congestive Heart Failure 348 Age-Related Macular Degeneration 158 Myocarditis & the Cardiomyopathies 358 Central & Branch Retinal Vein Occlusions 159 Acute Rheumatic Fever & Rheumatic Central & Branch Retinal Artery Occlusions 159 Heart Disease 364 Amaurosis Fugax 160 Diseases of the Pericardium 366 Retinal Disorders Associated with Pulmonary Hypertension & Pulmonary Systemic Diseases 161 Heart Disease 370 Ischemic Optic Neuropathy 163 Neoplastic Diseases of the Heart 372 Optic Neuritis 163 Cardiac Involvement in Miscellaneous Optic Disk Swelling 164 Systemic Diseases 373 Ocular Motor Palsies 164 Traumatic Heart Disease 373 Dysthyroid Eye Disease 164 The Cardiac Patient & Pregnancy 374 Orbital Cellulitis 165 Cardiovascular Screening of Athletes 375 Ocular Trauma 165 Ultraviolet Keratitis (Actinic Keratitis) 166 11. Systemic Hypertension 376 Chemical Conjunctivitis & Keratitis 166 Michael Sutters, MD, MRCP (UK) Treatment of Ocular Disorders 167 Approach to Hypertension 377 Precautions in Management of Drug Therapy: Current Antihypertensive Agents 387 Ocular Disorders 167 Resistant Hypertension 400 Adverse Ocular Effects of Systemic Drugs 171 Hypertensive Urgencies & Emergencies 400 8. Ear, Nose, & Throat Disorders 173 12. Blood Vessel & Lymphatic Disorders 404 Lawrence R. Lustig, MD, & Joshua Schindler, MD Joseph H. Rapp, MD, Rajabrata Sarkar, MD, PhD, Diseases of the Ear 173 & Catherine K. Chang, MD Diseases of the Nose & Paranasal Sinuses 186 Atherosclerotic Peripheral Vascular Disease 404 Diseases of the Oral Cavity & Pharynx 195 Nonatherosclerotic Vascular Disease 411 Diseases of the Salivary Glands 200 Arterial Aneurysms 412 Diseases of the Larynx 201 Venous Diseases 416 Tracheostomy & Cricothyrotomy 206 Diseases of the Lymphatic Channels 421 Foreign Bodies in the Upper Aerodigestive Tract 206 Shock 422 Diseases Presenting as Neck Masses 207 13. Blood Disorders 427 9. Pulmonary Disorders 209 Charles A. Linker, MD Mark S. Chesnutt, MD, James A. Murray, DO, & Thomas J. Prendergast, MD Anemias 427 Neutropenia 444 Disorders of the Airways 209 Leukemias & Other Myeloproliferative Disorders 444 Pulmonary Infections 237 Lymphomas 457 Pulmonary Neoplasms 253 Stem Cell Transplantation 462 Interstitial Lung Disease (Diffuse Parenchymal Blood Transfusions 464 Lung Disease) 255 Disorders of the Pulmonary Circulation 260 14. Disorders of Hemostasis Environmental & Occupational Lung & Antithrombotic Therapy 467 Disorders 269 Pleural Diseases 275 Patrick F. Fogarty, MD Disorders of Control of Ventilation 280 Platelet Disorders 467 Acute Respiratory Failure 282 Disorders of Coagulation 477 Acute Respiratory Distress Syndrome 284 Antithrombotic Therapy 482 10. Heart Disease 287 15. Gastrointestinal Disorders 487 Thomas M. Bashore, MD, Christopher B. Granger, MD, Kenneth R. McQuaid, MD Patrick Hranitzky, MD, & Manesh R. Patel, MD Symptoms & Signs of Gastrointestinal Disease 487 Congenital Heart Disease 287 Diseases of the Peritoneum 508 Valvular Heart Disease 294 Diseases of the Esophagus 513 䊲 CONTENTS CMDT 2009 v Diseases of the Stomach & Duodenum 529 Nutrition in Pregnancy 689 Diseases of the Small Intestine 542 Travel & Immunizations during Pregnancy 690 Diseases of the Colon & Rectum 554 Vomiting of Pregnancy (Morning Sickness) Anorectal Diseases 577 & Hyperemesis Gravidarum (Pernicious Vomiting of Pregnancy) 690 16. Liver, Biliary Tract, Spontaneous Abortion 690 & Pancreas Disorders 582 Recurrent (Habitual) Abortion 692 Ectopic Pregnancy 692 Lawrence S. Friedman, MD Preeclampsia-Eclampsia 693 Jaundice 582 Gestational Trophoblastic Disease Diseases of the Liver 585 (Hydatidiform Mole & Choriocarcinoma) 696 Diseases of the Biliary Tract 616 Third-Trimester Bleeding 697 Diseases of the Pancreas 623 Medical Conditions Complicating Pregnancy 697 Surgical Complications during Pregnancy 704 17. Breast Disorders 630 Prevention of Hemolytic Disease of the Armando E. Giuliano, MD Newborn (Erythroblastosis Fetalis) 705 Prevention of Preterm (Premature) Labor 705 Benign Breast Disorders 630 Lactation 706 Fibrocystic Condition 630 Puerperal Mastitis 707 Fibroadenoma of the Breast 631 Nipple Discharge 632 20. Musculoskeletal & Fat Necrosis 632 Immunologic Disorders 708 Breast Abscess 632 Disorders of the Augmented Breast 633 David B. Hellmann, MD, MACP, Carcinoma of the Female Breast 633 & John B. Imboden, Jr., MD Carcinoma of the Male Breast 653 Diagnosis & Evaluation 708 Degenerative & Crystal-Induced Arthritis 708 18. Gynecologic Disorders 655 Pain Syndromes 715 H. Trent MacKay, MD, MPH Autoimmune Diseases 726 Vasculitis Syndromes 743 Abnormal Premenopausal Bleeding 655 Seronegative Spondyloarthropathies 752 Postmenopausal Vaginal Bleeding 657 Infectious Arthritis 755 Premenstrual Syndrome (Premenstrual Tension) 657 Infections of Bones 758 Dysmenorrhea 658 Other Rheumatic Disorders 761 Vaginitis 658 Allergic Diseases 762 Cervical Polyps 660 Atopic Disease 763 Cyst & Abscess of Bartholin Duct 660 Primary Immunodeficiency Disorders 764 Effects of Exposure to Diethylstilbestrol in Utero 660 Cervical Intraepithelial Neoplasia (Dysplasia 21. Fluid & Electrolyte Disorders 766 of the Cervix) 661 Carcinoma of the Cervix 663 Kerry C. Cho, MD, Masafumi Fukagawa, MD, PhD, Leiomyoma of the Uterus (Fibroid Tumor) 664 & Kiyoshi Kurokawa, MD, MACP Carcinoma of the Endometrium 665 Disorders of Sodium Concentration 767 Carcinoma of the Vulva 666 Hyperosmolar Disorders & Osmolar Gaps 773 Endometriosis 667 Disorders of Potassium Concentration 773 Pelvic Organ Prolapse 668 Disorders of Calcium Concentration 776 Pelvic Inflammatory Disease (Salpingitis, Disorders of Phosphorus Concentration 780 Endometritis) 668 Disorders of Magnesium Concentration 782 Ovarian Cancer & Ovarian Tumors 670 Acid–Base Disorders 784 Polycystic Ovary Syndrome 671 Fluid Management 793 Female Sexual Dysfunction 672 Infertility 673 22. Kidney Disease 794 Contraception 675 Suzanne Watnick, MD, & Gail Morrison, MD Rape 682 Menopausal Syndrome 683 Assessment of Renal Disease 794 Acute Renal Failure 797 19. Obstetrics & Obstetric Disorders 686 Chronic Kidney Disease 803 Glomerulonephropathies 811 William R. Crombleholme, MD Nephrotic Disease in Primary Diagnosis of Pregnancy 686 Renal Disorders 817 Essentials of Prenatal Care 686 Nephrotic Disease from Systemic Disorders 819 䊲 vi CMDT 2009 CONTENTS Diseases Demonstrating Nephritic Discogenic Neck Pain 903 & Nephrotic Components 820 Brachial & Lumbar Plexus Lesions 906 Tubulointerstitial Diseases 821 Disorders of Neuromuscular Transmission 906 Cystic Diseases of the Kidney 823 Myopathic Disorders 909 Multisystem Diseases with Variable Kidney Periodic Paralysis Syndrome 911 Involvement 825 25. Psychiatric Disorders 912 23. Urologic Disorders 827 Stuart J. Eisendrath, MD, & Marshall L. Stoller, MD, Christopher J. Kane, MD, FACS, Jonathan E. Lichtmacher, MD & Maxwell V. Meng, MD, FACS Common Psychiatric Disorders 912 Hematuria 827 Substance Use Disorders (Drug Dependency, Genitourinary Tract Infections 828 Drug Abuse) 951 Acute Cystitis 828 Delirium, Dementia, & Other Cognitive Acute Pyelonephritis 829 Disorders (Formerly: Organic Acute Bacterial Prostatitis 830 Brain Syndrome) 959 Chronic Bacterial Prostatitis 831 Psychiatric Problems Associated with Nonbacterial Prostatitis 831 Hospitalization & Illness 962 Prostatodynia 832 Acute Epididymitis 832 26. Endocrine Disorders 965 Urinary Stone Disease 833 Paul A. Fitzgerald, MD Interstitial Cystitis 837 Male Erectile Dysfunction & Diseases of the Hypothalamus & Pituitary Gland 965 Sexual Dysfunction 838 Diseases of the Thyroid Gland 976 Male Infertility 840 The Parathyroids 1004 Benign Prostatic Hyperplasia 842 Metabolic Bone Disease 1012 Diseases of the Adrenal Cortex 1020 24. Nervous System Disorders 848 Pheochromocytoma & Paraganglioma 1031 Pancreatic & Duodenal Michael J. Aminoff, MD, DSc, FRCP Neuroendocrine Tumors 1034 Headache 848 Diseases of the Testes & Male Breast 1035 Facial Pain 852 Amenorrhea & Menopause 1040 Epilepsy 854 Multiple Endocrine Neoplasia 1048 Dysautonomia 860 Clinical Use of Corticosteroids 1050 Sensory Disturbances 861 Weakness & Paralysis 862 27. Diabetes Mellitus & Hypoglycemia 1052 Transient Ischemic Attacks 862 Umesh Masharani, MB, BS, MRCP(UK) Stroke 864 Intracranial & Spinal Tumors 873 Diabetes Mellitus 1052 Nonmetastatic Neurologic Complications Diabetic Coma 1083 of Malignant Disease 878 The Hypoglycemic States 1089 Pseudotumor Cerebri (Benign Intracranial 28. Lipid Disorders 1095 Hypertension) 878 Selected Neurocutaneous Diseases 879 Robert B. Baron, MD, MS Movement Disorders 880 Lipoproteins & Atherogenesis 1095 Dementia 887 Lipid Fractions & the Risk of Coronary Multiple Sclerosis 887 Heart Disease 1096 Vitamin E Deficiency 889 Therapeutic Effects of Lowering Cholesterol 1096 Spasticity 889 Secondary Conditions That Affect Myelopathies in AIDS 890 Lipid Metabolism 1097 Myelopathy of Human T Cell Leukemia Clinical Presentations 1098 Virus Infection 890 Screening for High Blood Cholesterol 1098 Subacute Combined Degeneration of the Treatment of High Low-Density Spinal Cord 890 Lipoprotein Cholesterol 1101 Wernicke Encephalopathy 890 High Blood Triglycerides 1104 Stupor & Coma 890 Head Injury 893 29. Nutritional Disorders 1107 Spinal Trauma 894 Syringomyelia 895 Robert B. Baron, MD, MS Degenerative Motor Neuron Diseases 895 Protein-Energy Malnutrition 1107 Peripheral Neuropathies 896 Obesity 1108 䊲 CONTENTS CMDT 2009 vii Eating Disorders 1111 Spotted Fevers 1250 Disorders of Vitamin Metabolism 1113 Other Rickettsial & Rickettsial-Like Diseases 1252 Diet Therapy 1118 Kawasaki Disease 1254 Nutritional Support 1120 33. Bacterial & Chlamydial Infections 1256 30. Common Problems in Infectious Brian S. Schwartz, MD, & Henry F. Chambers, MD Diseases & Antimicrobial Therapy 1126 Infections Caused by Gram-Positive Bacteria 1256 Richard A. Jacobs, MD, PhD, Infective Endocarditis 1270 B. Joseph Guglielmo, PharmD, Infections Caused by Gram-Negative Bacteria 1275 & Peter V. Chin-Hong, MD Actinomycosis 1290 Common Problems in Infectious Diseases 1126 Nocardiosis 1291 Fever of Unknown Origin 1126 Infections Caused by Mycobacteria 1291 Infections in the Immunocompromised Patient 1128 Infections Caused by Chlamydiae 1294 Hospital-Associated Infections 1132 Infections of the Central Nervous System 1135 34. Spirochetal Infections 1297 Animal & Human Bite Wounds 1137 Susan S. Philip, MD, MPH, & Sexually Transmitted Diseases 1139 Richard A. Jacobs, MD, PhD Infections in Drug Users 1140 Acute Infectious Diarrhea 1141 Syphilis 1297 Infectious Diseases in the Returning Traveler 1142 Non-Sexually Transmitted Treponematoses 1305 Traveler’s Diarrhea 1145 Selected Spirochetal Diseases 1306 Antimicrobial Therapy 1146 Relapsing Fever 1306 Hypersensitivity Tests & Desensitization 1154 Rat-Bite Fever 1307 Immunization Against Infectious Diseases 1158 Leptospirosis 1308 Recommended Immunization of Infants, Lyme Disease (Lyme Borreliosis) 1309 Children, & Adolescents 1158 35. Protozoal & Helminthic Infections 1315 Recommended Immunization of Adults 1158 Recommended Immunization Philip J. Rosenthal, MD for Travelers 1173 Protozoal Infections 1315 31. HIV Infection & AIDS 1176 African Trypanosomiasis (Sleeping Sickness) 1315 Mitchell H. Katz, MD, & Andrew R. Zolopa, MD American Trypanosomiasis Epidemiology 1176 (Chagas Disease) 1317 Etiology 1179 Leishmaniasis 1318 Pathogenesis 1179 Malaria 1320 Pathophysiology 1179 Babesiosis 1329 Clinical Findings 1180 Toxoplasmosis 1330 Differential Diagnosis 1189 Amebiasis 1332 Prevention 1189 Infections with Pathogenic Treatment 1193 Free-Living Amebas 1335 Course & Prognosis 1204 Coccidiosis (Cryptosporidiosis, Isosporiasis, Cyclosporiasis, Sarcocystosis) 32. Viral & Rickettsial Infections 1205 & Microsporidiosis 1336 Giardiasis 1338 Wayne X. Shandera, MD, & Other Intestinal Flagellate Infections 1339 Vicente F. Corrales-Medina, MD Trichomoniasis 1340 Viral Diseases 1205 Helminthic Infections 1340 Human Herpesviruses 1205 Trematode (Fluke) Infections 1340 Major Vaccine-Preventable Viral Infections 1217 Liver, Lung, & Intestinal Flukes 1342 Other Neurotrophic Viruses 1224 Cestode Infections 1343 Other Systemic Viral Diseases 1231 Intestinal Nematode (Roundworm) Infections 1346 Common Viral Respiratory Infections 1236 Invasive Nematode (Roundworm) Infections 1350 Adenovirus Infections 1242 Filariasis 1353 Other Exanthematous Viral Infections 1243 Viruses & Gastroenteritis 1244 36. Mycotic Infections 1357 Enteroviruses That Produce Several Syndromes 1245 Samuel A. Shelburne, MD, & Richard J. Hamill, MD Rickettsial Diseases 1247 Candidiasis 1357 Typhus Group 1247 Histoplasmosis 1358 䊲 viii CMDT 2009 CONTENTS Coccidioidomycosis 1359 Staging of Cancer 1429 Pneumocystosis (Pneumocystis jiroveci Types of Cancer 1429 Pneumonia) 1361 Lung Cancer 1429 Cryptococcosis 1363 Hepatobiliary Cancers 1436 Aspergillosis 1364 Alimentary Tract Cancers 1441 Mucormycosis 1365 Cancers of the Genitourinary Tract 1455 Blastomycosis 1366 Primary Cancer Treatment 1466 Paracoccidioidomycosis (South American Systemic Cancer Therapy 1466 Blastomycosis) 1366 Toxicity & Dose Modification of Sporotrichosis 1366 Chemotherapeutic Agents 1466 Penicillium marneffei Infections 1367 Cancer Complications: Diagnosis Chromoblastomycosis (Chromomycosis) 1367 & Management 1482 Mycetoma (Maduromycosis Other Complications 1486 & Actinomycetoma) 1367 The Paraneoplastic Syndromes 1488 Other Opportunistic Mold Infections 1367 Alternative & Complementary Therapies Antifungal Therapy 1369 for Cancer 1491 37. Disorders Due to Physical Agents 1370 40. Clinical Genetic Disorders 1493 Brent R. W. Moelleken, MD, FACS, Reed E. Pyeritz, MD, PhD & Jacqueline A. Nemer, MD, FACEP Acute Intermittent Porphyria 1493 Cold & Heat 1370 Alkaptonuria 1494 Burns 1376 Down Syndrome 1495 Electrical Shock Injury 1379 Fragile X Mental Retardation 1496 Radiation Reactions 1381 Gaucher Disease 1496 Near Drowning 1382 Disorders of Homocysteine Metabolism 1497 Disorders Due to Environmental Factors 1383 Klinefelter Syndrome 1498 Marfan Syndrome 1499 38. Poisoning 1388 Hereditary Hemorrhagic Telangiectasia 1500 Kent R. Olson, MD 41. Complementary & Initial Evaluation: Poisoning or Overdose 1388 Alternative Medicine 1501 The Symptomatic Patient 1388 Antidotes & Other Treatment 1391 Ellen F. Hughes, MD, PhD, & Kevin Barrows, MD Diagnosis of Poisoning 1394 Herbal Medicines 1502 Selected Poisonings 1396 Dietary Supplements 1508 Acupuncture 1512 39. Cancer 1417 Mind-Body Medicine 1515 Hope S. Rugo, MD Appendix: Therapeutic Drug Incidence & Etiology 1417 Monitoring & Laboratory Environmental, Infectious, & Therapeutic Reference Intervals 1524 Carcinogens 1419 Prevention of Cancer 1420 C. Diana Nicoll, MD, PhD, MPA Primary Prevention 1420 Secondary Prevention (Early Detection) 1427 Index 1535 Special Topics in Prevention 1428 䊲 Authors Joshua S. Adler, MD Todd Cassese, MD Associate Professor of Clinical Medicine, Division of Chief Medical Resident, Moffitt-Long Hospital, General Internal Medicine, University of California, Department of Medicine, University of California, San San Francisco; Medical Director, Ambulatory Care, UC Francisco San Francisco Medical Center
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