Harrison's Manual of Medicine

Dennis L. Kasper, MD, MA (Hon) William Ellery Channing Professor of Medicine Professor of Microbiology and Molecular Genetics Executive Dean for Academic Programs Harvard Medical School Director, Channing Laboratory Department of Medicine Brigham and Women's Hospital Eugene Brauwald, AB, MD, MA (Hon), MD (Hon), ScD (Hon) Distinguished Hersey Professor of Medicine Faculty Dean for Academic Programs at Brigham and Women's Hospital and Massachusetts General Hospital Harvard Medical School Vice-President for Academic Programs Partners HealthCare System Anthony S. Fauci, MD Chief, Laboratory of Immunoregulation Director, National Institute of Allergy and Infectious Diseases National Institutes of Health Stephen L. Hauser, MD Chairman and Betty Anker Fife Professor Department of Neurology University of California, San Francisco Dan L. Longo, MD Scientific Director National Institute of on Aging National Institutes of Health J. Larry Jameson, MD, PhD Irving S. Cutter Professor and Chairman Department of Medicine Northwestern University Medical School Physician-in-Chief, Northwestern Memorial Hospital

Contributors Preface Acknowledgments SECTION 1: CARE OF THE HOSPITALIZED PATIENT 1. Initial Evaluation and Admission Orders for the General Medicine Patient 2. Electrolytes/Acid-Base Balance 3. Diagnostic Imaging in Internal Medicine 4. Procedures Commonly Performed by Internists 5. Principles of Critical Care Medicine 6. Pain and its Management 7. Assessment of Nutritional Status 8. Enteral and Parenteral Nutrition 9. Transfusion and Pheresis Therapy 10. Palliative and End-of-Life Care SECTION 2: MEDICAL EMERGENCIES 11. Cardiovascular Collapse and Sudden Death 12. Shock 13. Sepsis and Septic Shock 14. Acute Pulmonary Edema 15. Acute Respiratory Distress Syndrome 16. Respiratory Failure 17. Confusion, Stupor, and Coma 18. Stroke 19. Subarachnoid Hemorrhage 20. Increased Intracranial Pressure and Head Trauma 21. Spinal Cord Compression 22. Hypoxic-Ischemic Encephalopathy 23. Status Epilepticus 24. Diabetic Ketoacidosis and Hyperosmolar Coma 25. Hypoglycemia 26. Infectious Disease Emergencies 27. Oncologic Emergencies 28. Anaphylaxis 29. Bites, Venoms, Stings, and Marine Poisonings 30. Hypothermia and Frostbite 31. Poisoning and Drug Overdose 32. Bioterrorism SECTION 3: COMMON PATIENT PRESENTATIONS 33. Chest Pain 34. Abdominal Pain 35. Headache 36. Back and Neck Pain 37. Fever, Hyperthermia, Chills, and Rash 38. Pain and Swelling of Joints 39. Syncope 40. Dizziness and Vertigo 41. Acute Visual Loss and Double Vision 42. Weakness and Paralysis 43. Tremor and Movement Disorders 44. Aphasias and Related Disorders 45. Sleep Disorders 46. Dyspnea 47. Cough and Hemoptysis 48. Cyanosis 49. Edema 50. Nausea, Vomiting, and Indigestion 51. Weight Loss 52. Dysphagia 53. Diarrhea, Constipation, and Malabsorption 54. Gastrointestinal Bleeding 55. Jaundice and Evaluation of Liver Function 56. Ascites 57. Azotemia and Urinary Abnormalities 58. Anemia and Polycythemia 59. Lymphadenopathy and Splenomegaly 60. Generalized Fatigue SECTION 4: OPHTHALMOLOGY AND OTOLARYNGOLOGY 61. Common Disorders of Vision and Hearing 62. Sinusitis, Pharyngitis, Otitis, and Other Upper Respiratory Infections SECTION 5: DERMATOLOGY 63. General Examination of the Skin 64. Common Skin Conditions SECTION 6: HEMATOLOGY AND ONCOLOGY 65. Examination of Blood Smears and Bone Marrow 66. Red Blood Cell Disorders 67. Leukocytosis and Leukopenia 68. Bleeding and Thrombotic Disorders 69. Cancer Chemotherapy 70. Myeloid Leukemias, Myelodysplasia, and Myeloproliferative Syndromes 71. Lymphoid Malignancies 72. Skin Cancer 73. Head and Neck Cancer 74. Lung Cancer 75. Breast Cancer 76. Tumors of the Gastrointestinal Tract 77. Genitourinary Tract Cancer 78. Gynecologic Cancer 79. Prostate Hyperplasia and Carcinoma 80. Cancer of Unknown Primary Site 81. Paraneoplastic Endocrine Syndromes 82. Neurologic Paraneoplastic Syndromes SECTION 7: INFECTIOUS DISEASES 83. Diagnosis of Infectious Diseases 84. Antibacterial Therapy 85. Health Care-Associated Infections 86. Infections in the Immunocompromised Host 87. Infective Endocarditis 88. Intraabdominal Infections 89. Infectious Diarrheas 90. Sexually Transmitted Diseases and Reproductive Tract Infections 91. Infections of the Skin, Soft Tissues, Joints, and Bones 92. Pneumococcal Infections 93. Staphylococcal Infections 94. Streptoccal/Enterococcal Infections, Diphtheria, and Other Infections Caused by Corynebacteria and Related Species 95. Meningococcal and Listerial Infections 96. Infections Caused by Haemophilus, Bordetella, Moraxella, and HACEK Group Organisms 97. Diseases Caused by Gram-Negative Enteric Bacteria, Pseudomonas, and Legionella 98. Infections Caused by Miscellaneous Gram-Negative Bacilli 99. Anaerobic Infections 100. Nocardiosis and Actinomycosis 101. Tuberculosis and Other Mycobacterial Infections 102. Lyme Disease and Other Nonsyphilitic Spirochetal Infections 103. Rickettsial Diseases 104. Mycoplasma Infections 105. Chlamydial Infections 106. Herpesvirus Infections 107. Cytomegalovirus and Epstein-Barr Virus Infections 108. Influenza and Other Viral Respiratory Diseases 109. Rubeola, Rubella, Mumps, and Parvovirus Infections 110. Enteroviral Infections 111. Insect- and Animal-Borne Viral Infections 112. HIV Infection and AIDS 113. Fungal Infections 114. Pneumocystis Infections 115. Protozoal Infections 116. Helminthic Infections and Ectoparasite Infestations SECTION 8: CARDIOLOGY 117. Physical Examination of the Heart 118. Electrocardiography 119. Noninvasive Examination of the Heart 120. Congenital Heart Disease in the Adult 121. Valvular Heart Disease 122. Cardiomyopathies and Myocarditis 123. Pericardial Disease 124. Hypertension 125. Metabolic Syndrome 126. ST-Segment Elevation Myocardial Infarction (STEMI) 127. Unstable Angina and Non-ST-Elevation Myocardial Infarction 128. Chronic Stable Angina 129. Bradyarrhythmias 130. Tachyarrhythmias 131. Congestive Heart Failure and Cor Pulmonale 132. Diseases of the Aorta 133. Peripheral Vascular Disease 134. Pulmonary Hypertension SECTION 9: PULMONARY 135. Respiratory Function and Pulmonary Diagnostic Procedures 136. Asthma 137. Environmental Lung Diseases 138. Chronic Obstructive Pulmonary Disease 139. Pneumonia and Lung Abscess 140. Pulmonary Thromboembolism and Deep-Vein Thrombosis 141. Interstitial Lung Disease 142. Diseases of the Pleura and Mediastinum 143. Disorders of Ventilation 144. Sleep Apnea SECTION 10: NEPHROLOGY 145. Approach to the Patient with Renal Disease 146. Acute Renal Failure 147. Chronic Kidney Disease and Uremia 148. Dialysis 149. Renal Transplantation 150. Glomerular Diseases 151. Renal Tubular Disease 152. Urinary Tract Infections 153. Renovascular Disease 154. Nephrolithiasis 155. Urinary Tract Obstruction SECTION 11: GASTROENTEROLOGY 156. Peptic Ulcer and Related Disorders 157. Inflammatory Bowel Diseases 158. Colonic and Anorectal Diseases 159. Cholelithiasis, Cholecystitis, and Cholangitis 160. Pancreatitis 161. Acute Hepatitis 162. Chronic Hepatitis 163. Cirrhosis and Alcoholic Liver Disease 164. Portal Hypertension SECTION 12: ALLERGY, CLINICAL IMMUNOLOGY, AND RHEUMATOLOGY 165. Diseases of the Immediate Type Hypersensitivity 166. Primary Immune Deficiency Diseases 167. SLE, RA, and Other Connective Tissue Diseases 168. Vasculitis 169. Ankylosing Spondylitis 170. Psoriatic Arthritis 171. Reactive Arthritis 172. Osteoarthritis 173. Gout, Pseudogout, and Related Diseases 174. Other Musculoskeletal Disorders 175. Sarcoidosis 176. Amyloidosis SECTION 13: ENDOCRINOLOGY AND METABOLISM 177. Disorders of the Anterior Pituitary and Hypothalamus 178. Diabetes Insipidus and SIADH 179. Thyroid Gland Disorders 180. Adrenal Gland Disorders 181. Obesity 182. Diabetes Mellitus 183. Disorders of the Male Reproductive System 184. Disorders of the Female Reproductive System 185. Hypercalcemia and Hypocalcemia 186. Osteoporosis and Osteomalacia 187. Hypercholesterolemia and Hypertriglyceridemia 188. Hemochromatosis, Porphyrias, and Wilson's Disease SECTION 14: NEUROLOGY 189. The Neurologic Examination 190. Neuroimaging 191. Seizures and Epilepsy 192. Alzheimer's Disease and Other Dementias 193. Parkinson's Disease 194. Ataxic Disorders 195. ALS and Other Motor Neuron Diseases 196. Autonomic Nervous System Disorders 197. Trigeminal Neuralgia, Bell's Palsy, and Other Cranial Nerve Disorders 198. Spinal Cord Diseases 199. Tumors of the Nervous System 200. Multiple Sclerosis (MS) 201. Acute Meningitis and Encephalitis 202. Chronic Meningitis 203. Peripheral Neuropathies, Including Guillain-Barre Syndrome (GBS) 204. Myasthenia Gravis (MG) 205. Muscle Diseases SECTION 15: PSYCHIATRY AND SUBSTANCE ABUSE 206. Psychiatric Disorders 207. Psychiatric Medications 208. Eating Disorders 209. Alcoholism 210. Narcotic Abuse SECTION 16: DISEASE PREVENTION AND HEALTH MAINTENANCE 211. Routine Disease Screening 212. Immunization and Advice to Travelers 213. Cardiovascular Disease Prevention 214. Prevention and Early Detection of Cancer 215. Smoking Cessation 216. Women's Health SECTION 17: ADVERSE DRUG REACTIONS 217. Adverse Drug Reactions SECTION 18: LABORATORY VALUES 218. Laboratory Values of Clinical Importance Index