Harrison’s Manual Of Medicine

1277 Pages·2019·34.632 MB·English

by  Dennis L. Kasper, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, Joseph Loscalzo

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PIARRISON'S
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MANUALO F
MEDICINE
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EDITORS
J. Larry Jameson, MD, PhD
Robert G. Dunlop Professor of Medicine
Dean, Raymond and Ruth Perelman School of Medicine
Executive Vice President, University of Pennsylvania for the
Health System
Philadelphia, Pennsylvania
Anthony S. Fauci, MD
Chief, Laboratory of Immunoregulation
Director, National Institute of Allergy and Infectious Diseases
National Institutes of Health
Bethesda, Maryland
Dennis L. Kasper, MD
William Ellery Channing Professor of Medicine
Professor of Immunology
Department of Immunology
Harvard Medical School
Boston, Massachusetts
Stephen L. Hauser, MD
Robert A. Fishman Distinguished Professor
Department of Neurology
Director, UCSF Weill Institute for Neurosciences
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
Joseph Loscalzo, MD, PhD
Hersey Professor of the Theory and Practice of Medicine
Harvard Medical School
Chairman, Department of Medicine
Physician-in-Chief, Brigham and Women’s Hospital
Boston, Massachusetts
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EDITORS
J. Larry Jameson, MD, PhD
Anthony S. Fauci, MD
Dennis L. Kasper, MD
Stephen L. Hauser, MD
Dan L. Longo, MD
Joseph Loscalzo, MD, PhD
New York Chicago San Francisco Athens London Madrid
Mexico City Milan New Delhi Singapore Sydney Toronto
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Contents
Contributors .............................................................................................................xiii
Preface .........................................................................................................................xv
Acknowledgments ..................................................................................................xvii
SECTION 1
Care of the Hospitalized Patient
1 Electrolytes ...................................................................................1
2 Acid-Base Disorders ...................................................................16
3 Diagnostic Imaging in Internal Medicine ....................................22
4 Procedures Commonly Performed by Internists ...........................26
5 Principles of Critical Care Medicine ............................................32
6 Pain and Its Management ...........................................................35
7 Assessment of Nutritional Status.................................................40
8 Enteral and Parenteral Nutrition .................................................47
9 Transfusion and Pheresis Therapy ...............................................49
10 Palliative and End-of-Life Care ..................................................51
SECTION 2
Medical Emergencies
11 Cardiovascular Collapse and Sudden Death.................................59
12 Shock .........................................................................................62
13 Narcotic Overdose ......................................................................66
14 Sepsis and Septic Shock ..............................................................68
15 Acute Pulmonary Edema ............................................................71
16 Acute Respiratory Distress Syndrome .........................................72
17 Respiratory Failure .....................................................................75
18 Confusion, Stupor, and Coma .....................................................76
19 Stroke .........................................................................................82
20 Subarachnoid Hemorrhage .........................................................91
21 Increased Intracranial Pressure and Head Trauma ........................93
22 Spinal Cord Compression ...........................................................98
23 Hypoxic-Ischemic Encephalopathy ...........................................100
24 Status Epilepticus .....................................................................101
25 Diabetic Ketoacidosis and Hyperosmolar Coma ........................103
26 Hypoglycemia ...........................................................................106
27 Oncologic Emergencies ............................................................109
28 Anaphylaxis ..............................................................................114
29 Bites, Venoms, Stings, and Marine Poisonings ...........................115
v
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vi CONTENTS
SECTION 3
Common Patient Presentations
30 Fever, Hyperthermia, and Rash .................................................127
31 Generalized Fatigue ..................................................................131
32 Unintentional Weight Loss .......................................................135
33 Chest Pain ................................................................................137
34 Palpitations...............................................................................141
35 Dyspnea ...................................................................................141
36 Cyanosis ...................................................................................144
37 Cough and Hemoptysis .............................................................146
38 Edema ......................................................................................149
39 Abdominal Pain ........................................................................153
40 Nausea, Vomiting, and Indigestion ............................................157
41 Dysphagia ................................................................................161
42 Diarrhea, Malabsorption, and Constipation ..............................166
43 Gastrointestinal Bleeding ..........................................................174
44 Jaundice and Evaluation of Liver Function ................................178
45 Ascites ......................................................................................186
46 Lymphadenopathy and Splenomegaly .......................................189
47 Anemia and Polycythemia .........................................................194
48 Azotemia and Urinary Abnormalities ........................................197
49 Pain and Swelling of Joints ........................................................203
50 Back and Neck Pain ..................................................................207
51 Headache..................................................................................215
52 Syncope ....................................................................................223
53 Dizziness and Vertigo ...............................................................227
54 Acute Visual Loss and Double Vision ........................................230
55 Weakness and Paralysis .............................................................234
56 Tremor and Movement Disorders .............................................237
57 Aphasia ....................................................................................240
58 Sleep Disorders .........................................................................242
SECTION 4
Otolaryngology
59 Sore Throat, Earache, and Upper Respiratory Symptoms ...........247
SECTION 5
Dermatology
60 General Examination of the Skin ..............................................255
61 Common Skin Conditions ........................................................258
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CONTENTS vii
SECTION 6
Hematology and Oncology
62 Examination of Blood Smears and Bone Marrow ......................267
63 Red Blood Cell Disorders .........................................................269
64 Leukocytosis and Leukopenia ...................................................275
65 Bleeding and Thrombotic Disorders ..........................................278
66 Myeloid Leukemias, Myelodysplasia, and
Myeloproliferative Syndromes ...................................................285
67 Lymphoid Malignancies............................................................296
68 Skin Cancer ..............................................................................309
69 Head and Neck Cancer .............................................................312
70 Lung Cancer .............................................................................314
71 Breast Cancer ...........................................................................320
72 Tumors of the Gastrointestinal Tract .........................................325
73 Genitourinary Tract Cancer ......................................................337
74 Gynecologic Cancer ..................................................................343
75 Tumors of the Nervous System ..................................................347
76 Prostate Hyperplasia and Carcinoma .........................................352
77 Cancer of Unknown Primary Site ..............................................355
78 Paraneoplastic Endocrine Syndromes ........................................359
79 Neurologic Paraneoplastic Syndromes .......................................362
SECTION 7
Infectious Diseases
80 Growing Threats in Infectious Disease ......................................367
81 Infections Acquired in Health Care Facilities .............................371
82 Infections in the Immunocompromised Host ............................376
83 Infective Endocarditis ...............................................................387
84 Intraabdominal Infections .........................................................398
85 Infectious Diarrheas and Bacterial Food Poisoning ....................403
86 Sexually Transmitted and Reproductive Tract Infections ............417
87 Infections of the Skin, Soft Tissues, Joints, and Bones................433
88 Pneumococcal Infections...........................................................440
89 Staphylococcal Infections ..........................................................444
90 Streptococcal/Enterococcal Infections, Diphtheria,
and Infections Caused by Other Corynebacteria and
Related Species .........................................................................453
91 Meningococcal and Listerial Infections .....................................463
92 Infections Caused by Haemophilus, Bordetella, Moraxella,
and HACEK Group Organisms ................................................467
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viii CONTENTS
93 Diseases Caused by Gram-Negative Enteric Bacteria
and Pseudomonads ...................................................................473
94 Infections Caused by Miscellaneous Gram-Negative Bacilli .......483
95 Anaerobic Infections .................................................................490
96 Nocardiosis, Actinomycosis, and Whipple’s Disease ..................498
97 Tuberculosis and Other Mycobacterial Infections ......................503
98 Lyme Disease and Other Nonsyphilitic Spirochetal
Infections .................................................................................515
99 Rickettsial Diseases ...................................................................521
100 Mycoplasma pneumoniae, Legionella Species, and
Chlamydia pneumoniae ...................................................................531
101 Chlamydia trachomatis and Chlamydia psittaci ...............................535
102 Infections with Herpes Simplex Virus, Varicella-Zoster
Virus, Cytomegalovirus, Epstein-Barr Virus, and
Human Herpesvirus Types 6, 7, and 8 ........................................537
103 Influenza and Other Viral Respiratory Diseases ........................551
104 Rubeola, Rubella, Mumps, and Parvovirus Infections ................555
105 Enterovirus Infections ..............................................................561
106 Insect- and Animal-Borne Viral Infections ................................564
107 HIV Infection and AIDS ..........................................................572
108 Pneumocystis Pneumonia, Candidiasis, and
Other Fungal Infections ............................................................588
109 Overview of Parasitic Infections ................................................606
110 Malaria, Toxoplasmosis, Babesiosis, and
Other Protozoal Infections........................................................610
111 Helminthic Infections and Ectoparasite Infestations .................625
SECTION 8
Cardiology
112 Physical Examination of the Heart ............................................639
113 Electrocardiography ..................................................................644
114 Noninvasive Examination of the Heart ......................................648
115 Congenital Heart Disease in the Adult ......................................653
116 Valvular Heart Disease ..............................................................658
117 Cardiomyopathies and Myocarditis ...........................................666
118 Pericardial Disease ....................................................................671
119 Hypertension ............................................................................676
120 Metabolic Syndrome .................................................................682
121 ST-Segment Elevation Myocardial Infarction ...........................684
122 Unstable Angina and Non-ST-Elevation
Myocardial Infarction ...............................................................694
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CONTENTS ix
123 Chronic Stable Angina ..............................................................698
124 Bradyarrhythmias .....................................................................703
125 Tachyarrhythmias .....................................................................706
126 Heart Failure and Cor Pulmonale ..............................................715
127 Diseases of the Aorta ................................................................721
128 Peripheral Vascular Disease .......................................................724
129 Pulmonary Hypertension ..........................................................727
SECTION 9
Pulmonology
130 Diagnostic Procedures in Respiratory Disease ...........................731
131 Asthma .....................................................................................734
132 Environmental Lung Diseases ...................................................738
133 Chronic Obstructive Pulmonary Disease ...................................741
134 Pneumonia, Bronchiectasis, and Lung Abscess ..........................745
135 Pulmonary Thromboembolism and Deep-Vein Thrombosis ......754
136 Interstitial Lung Disease ...........................................................758
137 Diseases of the Pleura ...............................................................763
138 Diseases of the Mediastinum .....................................................766
139 Disorders of Ventilation ............................................................767
140 Sleep Apnea ..............................................................................768
SECTION 10
Nephrology
141 Acute Renal Failure ..................................................................771
142 Chronic Kidney Disease and Uremia .........................................776
143 Dialysis .....................................................................................778
144 Renal Transplantation ...............................................................781
145 Glomerular Diseases .................................................................784
146 Renal Tubular Disease...............................................................793
147 Dysuria, Urinary Tract Infections, Bladder Pain, and
Interstitial Cystitis ....................................................................800
148 Nephrolithiasis .........................................................................805
149 Urinary Tract Obstruction ........................................................807
SECTION 11
Gastroenterology
150 Peptic Ulcer and Related Disorders ...........................................811
151 Inflammatory Bowel Diseases ...................................................817
152 Colonic and Anorectal Diseases ................................................823
153 Cholelithiasis, Cholecystitis, and Cholangitis ............................828
154 Pancreatitis ...............................................................................835
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