Harrison’s Principles of Internal Medicine

3984 Pages·2015·700.76 MB·English

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

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INTERNAL
MEDICINE
EDITOORFSP REVIOEUDSI TIONS
T. R. Harrison R. G. Petersdorf
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L. Bennett， Jr.
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P L E S 。 F
INTERNAL
MEDICINE
EDITORS
DenniLs.K aspeMrD， Anthonsy.F aucMiD，
William Ellery Channing Professor of Medicine， Professor of Chief， Laboratory of Immunoregulation;
Microbiology and Immunobiology， Department of Microbiology Director， National Institute of Allergy and Infectious Diseases，
and Immunobiology， Harvard Medical School; Division of Infectious N ational Institutes of Health
Diseases， Brigham and Women's Hospital Bethesda， Maryland
Boston， Massachusetts
StepheLn.H auseMrD， DanL .L ongoM，D
Robert A.F ishman Distinguished Professor and Chairman， Professor of Medicine， Har飞rardMedical School; Senior Physician，
Department of Ne urology， University of California， San Francisco Bri吨g快hamand W omer白 Ho 叩咿1让ta沁l七;De叩putyEdi让tor巳，NewEngl仰dωn
San Francisco， California Journ叼叫alofMediωcin盹Eι， Boston， Massachusetts
J.L arrJya mesoMnD，， P hD JosepLho scalMzDo，P， hD
Robert G. Dunlop Professor of Medicine; Dean， Perelman School Hersey Professor of the Theory and Practice of Medicine，
of Medicine at出eUniversity of Pennsylvania; Executive Vice Harvard Medical School; Chairman， Department of Medicine， and
President， U niversity of Pennsylvania for the Health System Physician-in-Chief， Brigham and Women's Hospital
Philadelphia， Pennsylvania Boston， Massachusetts
自盟
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VII
CONTRIBUTORS XlX 22 Back and Neck Pain 111
JohWn.E ngstRriocmhA，a .Dr edy o
PREFACE . . . . . . . XXXV11
嗡ι PART . . . . . . . . . ALTEATRIOINNBS O YDTEMPAETURRE
1 Gener叩nsid叫ionsin
23 Fever 123
Clinical Medicine
CharAl.De isn arReelulvPoeo，nr at
1 The Practice of Medicine 24 Fever and Rash 127
ThEed itors ElaTiK.na ey Kee，n neMt.Kh a ye
2 Globallssues in Medicine 7 。 25e 阳lasof Rashes Associated with Fever 135
PauFla rmJeors，Re hpaht igan KenneMt.Kh a yEel，a T.iKn ae. y. e .
3 Decision-Making in Clinical Medicine . 18 26 Fever of Unknown Origin 135
.
DαηBie.Ml a rJko，hB n.W ong ChanPtB.al le ekerJ-oRWso. v evMra.dsn e， Mr e er
4 Screening and Prevention of Disease 26
KatrAirnmas trGoanrgyM，]a .r tin NEVROUSSY ESTMD YSFNUClTON . .
5 Principles of Clinical Pharmacology 31
DanM. R oden 27 Syncope 142
RoyF reeman
。 6e Women's Health 45
AndrDeuan a扩 28 Dizziness and Vertigo 148
MarFk.W alkReorb，eB r.Dt a roff
。 7e Men's Health 45
ShaleBnhdaesSrih ne，h Bzaasda ria 29 Fatigue . 151
JeffiMγ.eGy e lfaVnadn，Cj .Da o uglas
8 Medical Disorders During Pregnancy 45
RobeLrB.ta γbJioeh口T.n，R epke 30 Neurologic Causes of Weakness and Paralysis 154
MichaAemli].n off
9 Medical Evaluation of the Surgical Patient 51
WeCi.L aKui，m A .E agle 31 Numbness， Tingling， and Sensory Loss 158
Mich].a Aemli noff
10 Palliative and End-of-Life Care. . . . . . . . . . . . . . . . . . . 55
EzekiEemla].n uel 32 Gait and Balance Disorders 162
LewSiusd arsky
11 Clinical Problems of Aging 70
LuiFgeir rSutcecpih，Sa tnuidee nski 。 33e Video Library of Gait Disorders 165
GailKNainc豆h，Bo.lG aasl ifiaMniackhiDas.Ge， el s chwin
。 12e The Safety and Quality of Health Care 85
DavWi.dB ates 34 Confusion and Delirium 166
SA.n dγJeows ep如huscoLen.M，i ll盯
。 13e Primary Care in Low-and
Middle-Income Countries 85 35 Dementia 170
TiEmv aKnusm.a nRaans anathan WillWi.aS me eBlreuyLc，.Me i ller
。 14e Complement刑，AI阳native，and 36 Aphasia， Memory Loss， and Other Focal
Integrative Health Practices 86 Cerebral Disorders 176
M.-MaMresseull am
JosepPhB.ir niegg s
。 15e The Economics of Medi臼ICare 86 。 37e Primary Progressive Apha归，MemoryLo路，
JosPe.pN he whouse and Other Focal Cerebral Disorders 184
MarLiuai Gsoar nToe-mpJiennin，O份 graJro，Ke rla mer，
。 16e Racial and Ethnic Dispari阳
BruLc.Me i llGeiRrla， b inoMvaircCiiaa，r mTealrat aglia
Health Care 86
JosRe.Bp eht ancAoluerxtaR，n.G d reere n 38 Sleep Disorders 184
CharAl.Ce zse iTshloemrEa，.Ss c ammCellijflo，γ SdaBp.盯
。 17e Ethicallssues in Clinical Medicine 86
BernLaorC，dh risGtriandey
DISOSRO DFE REEYAE，RSN S，O ，SA ENTDH ROAT
PART2
39 Disorders of the Eye 195
臼ωr呻dinal川al川Mfa阳川v叽h阳阳l阳阳lani剖m圳n川li est阳刷a
JonatchH.aonr ton
$ζ
Presentation of Diseases
。 40e Use of the Hand-Held Ophthalmoscope 211
HomayoTuanba nMdoerht，Fo .Gn o ldberg
PAIN 。 41e Video Library of Neu陪Ophthalmology 211
ShirH.lW erya y
18 Pain: Pathophysiology and Management.. 87
42 Disorders of Smell and Taste ... . 211
JamPeR.sa thmHeolwla，Lr .Fd i elds
RichLa.Dr odt Syt，e Mv.eB nr omley
19 Chest Discomfort 95
43 Disorders of Hearing 217
DavAi.dM orrow
AniK.lL alwani
20 Abdominal Pain 103
44 Sore Throat， Earache， and Upper
DannOy.J acoWbisl，lS iialme n
Respiratory Symptoms 225
21 Headache 107 MichAaR.eu lb iLna，町 CF.o叫Ra怡hGonzales
PeteGro]a.d sNbeHyi.，lR askin
VIII 45 Oral Manifestations of Disease 235 68 Hirsutism 331
SamuCe.Dl u rso DavAi.Ed h rmann
。 46e Atlas of Oral Manifestations of Disease 242 69 Menstrual Disorders and Pelvic Pain 335
SamuCe.Dlu rJsao，nA e.Yt e llowitz
JanEe.Ht a ll
ALTETRIAOINNCSR I CLUATOARNYRD E SRPAITOFRUNYC OTNIS
ALTEATRIOINNTS H SEK IN
。 47e Dyspnea 243 70 Approach to the Patient with a Skin Disorder 339
RichMa.rS dc hwa;γtzstein Thomf，aLs a wlKeiym， Y Ba.n cey
48 Cough and Hemoptysis 243
71 Eczema， Psoriasis， Cutaneous Infections， Acne，
PatγAiK.cr iiatC ehkr，i stHo.Fpahn盯ta
and Other Common Skin Disorders 344
49 Hypoxia and Cyanosis 247 LesPl.Li aew lCeayl，vO i.Mn c CaTlhlo，m f，aLs a wley
JosLeopshc alzo
72 Skin Manifestations of Internal Disease 353
50 Edema 250
JeaLBn.o loglnriwMai.，Bn r averman
EugeBnrea unwJaolsdLe，op shc alzo
G 5引1e叫Ap阳pro阳。a础to t阳hePati剖甜ti阳ient川tw州i忧tha Heart 73 Immunologically Mediated Skin Diseases 370
Murmur 253 KimB .Y ancTehyo，mf， aLs a wley
PatrTi.OcG' ka γJao，s Leopshc alzo
74 Cutaneous Drug Reactions 377
52 Palpitations 254 KanaSdhei nRkoabieS，rS. tt eBrrnu，U.c eW introub
JosLeopshc alzo
75 Photosensitivity and Other Reactions to Light 385
AlexaGn.Md aerγneDraovsRi，.Bd i ckers
ALTETRIAOINNGS A STIRTN. OESNTAFILUN CTION
。 76e Atlas of Skin Manifestations of
53 Dysphagia 254 Internal Disease 391
lkuHoi raPneotf，，Ke ar h γilas Thomf，aLs a wlCeayl，vO i.Mn c CaRlolb，eA r.St w eγlick
54 Nausea， Vomiting， and Indigestion 258
WillLi.Ha ams l盯 HEMTAOLIOACGLT ETRIAONS
55 Diarrhea and Constipation . 。 264
MichCaaemli lJloes悦Ae，.pM hu γγay 77 Anemia and Polycythemia 392
56 Involuntary Weight Loss 274 JohWn.A damsDoannL，. L ongo
RussGeR.lo lb erf，tLs ao付nJy，a meson
78 Bleeding and Thrombosis 400
57 Gastrointestinal Bleeding 276 BarbAaK.ro an kle
LorLeani ne
79 Enlargement of Lymph Nodes and Spleen 407
58 Jaundice 279
PatrHi.Hc ekn rDya，n LLo.n go
SavJioohD na，n iSeP.lr att
59 Abdominal Swelling and Ascites 285 80 Disorders of Granulocytes and Monocytes 413
KathlEe.Ce onr Leayw，r eSnF.cr ei edman SteMv.eH no llJaon1hd.nG， a llin
。 81e A阳ofHema时ogyand Analysis of
Peripheral Blood Smears 424
ALTETRIAOINNRS E NAANLUD R NIAYRTRAFCUNTC TION
DanL. L ongo
。 60e Dys帅，Bladd町Pain，and the Interstitial
Cystitis/Bladder Pain Syndrome. 288 难三 PART3
JohWn.W arren Genes， the Environment，
and Disease
61 Azotemia and Urinary Abnormalities . . .. .. . 289
JulLiiBenr ，a dMl.De eyn ker
82 Principles of Human Genetics 425
。 62e Atlas of Urina叭甜mentsand f，L arJraym esPoentK，eo rp p
Renal Biopsies .. .. .. .. .. .. .. . .. .. . .... 295 G 83e Chromosome Disorders 445
AgnBe.Fs o gEor，Gi c.N eilson NanBc.yS pinLnaeurK.r，Ca o nlin
63 Fluid and Electrolyte Disturbances. .. .. .. .. .. 295 84 The Practice of Genetics in Clinical Medicine 446
DavBi.Md o unt SusMa.nD omchf，仗L， arJraym esSounsM，ai ne 写作ldt
。 64e Fluid and Electrolyte Imbalances and G 85e Mito巾ndrialDNA and Heritable Traits
Acid-Base Disturbances: Case Examples. .. .. .. . .. 312 and Diseases. 451
KarSlk oγDeocγkBoieη，h aγ
DavBi.Md o unTth，o mDa.Ds u BoJsre.，
。 86e The Human Microbiome 451
65 Hypercalcemia and Hypocalcemia . .. .. .. .. .. . .. . 313
JeffiγGeoyγ1d.Ro onKb，n ight
SundKeheops la
。 87e Network Medicine: Sy阳nsBiology in
66 Acidosis and Alkalosis 315 Health and Disease 451
ThomDa.Ds u Bo1sγe.， JosLeopshc alzo
ALTETRIAOINNSS E XUFAUNLC TIAONNRD E OPDRUCTION
67 Sexual Dysfunction.. .. .. .. .. . .. .. .. .. .. .. . .. . 324
KevT.inM cV:αry