哈里森内科学手册

Contributors................................................xv Preface...................................................xvii Acknowledgments..........................................xix SECTION 1 CARE OF THE HOSPITALIZED PATIENT 1 Electrolytes/Acid-Base Balance....................................................1 2 Diagnostic Imaging in Internal Medicine..................................23 3 Procedures Commonly Performed by Internists......................26 4 Principles of Critical Care Medicine...........................................31 5 Pain and Its Management...........................................................35 6 Assessment of Nutritional Status...............................................40 7 Enteral and Parenteral Nutrition...............................................43 8 Transfusion and Pheresis Therapy.............................................46 9 Palliative and End-of-Life Care...................................................48 SECTION 2 MEDICAL EMERGENCIES 10 Cardiovascular Collapse and Sudden Death.............................57 11 Shock............................................................................................61 12 Sepsis and Septic Shock..............................................................65 13 Acute Pulmonary Edema............................................................69 14 Acute Respiratory Distress Syndrome.......................................71 15 Respiratory Failure......................................................................73 16 Confusion, Stupor, and Coma....................................................76 17 Stroke...........................................................................................82 18 Subarachnoid Hemorrhage........................................................91 19 Increased Intracranial Pressure and Head Trauma..................93 20 Spinal Cord Compression...........................................................98 21 Hypoxic-Ischemic Encephalopathy..........................................100 22 Status Epilepticus......................................................................101 23 Diabetic Ketoacidosis and Hyperosmolar Coma....................104 24 Hypoglycemia............................................................................107 25 Oncologic Emergencies.............................................................109 26 Anaphylaxis...............................................................................114 27 Bites, Venoms, Stings, and Marine Poisonings.......................115 SECTION 3 COMMON PATIENT PRESENTATIONS 28 Fever, Hyperthermia, and Rash................................................127 29 Generalized Fatigue..................................................................131 30 Weight Loss................................................................................135 31 Chest Pain..................................................................................137 32 Palpitations................................................................................141 33 Dyspnea......................................................................................142 34 Cyanosis.....................................................................................145 35 Cough and Hemoptysis.............................................................146 36 Edema.........................................................................................150 37 Abdominal Pain.........................................................................154 38 Nausea, Vomiting, and Indigestion.........................................158 39 Dysphagia..................................................................................162 40 Diarrhea, Malabsorption, and Constipation...........................167 41 Gastrointestinal Bleeding.........................................................174 42 Jaundice and Evaluation of Liver Function.............................178 43 Ascites........................................................................................187 44 Lymphadenopathy and Splenomegaly...................................189 45 Anemia and Polycythemia........................................................194 46 Azotemia and Urinary Abnormalities......................................197 47 Pain and Swelling of Joints.......................................................203 48 Back and Neck Pain...................................................................207 49 Headache...................................................................................215 50 Syncope......................................................................................222 51 Dizziness and Vertigo...............................................................226 52 Acute Visual Loss and Double Vision......................................229 53 Weakness and Paralysis............................................................233 54 Tremor and Movement Disorders............................................236 55 Aphasia.......................................................................................239 56 Sleep Disorders..........................................................................241 57 Dysuria and Bladder Pain.........................................................245 SECTION 4 OTOLARYNGOLOGY 58 Sore Throat, Earache, and Upper Respiratory Symptoms.............................................................247 SECTION 5 DERMATOLOGY 59 General Examination of the Skin.............................................255 60 Common Skin Conditions.........................................................258 SECTION 6 HEMATOLOGY AND ONCOLOGY 61 Examination of Blood Smears and Bone Marrow...................265 62 Red Blood Cell Disorders..........................................................267 63 Leukocytosis and Leukopenia..................................................274 64 Bleeding and Thrombotic Disorders.......................................277 65 Myeloid Leukemias, Myelodysplasia, and Myeloproliferative Syndromes................................................283 66 Lymphoid Malignancies............................................................293 67 Skin Cancer................................................................................305 68 Head and Neck Cancer..............................................................308 69 Lung Cancer...............................................................................310 70 Breast Cancer.............................................................................316 71 Tumors of the Gastrointestinal Tract......................................321 72 Genitourinary Tract Cancer......................................................333 73 Gynecologic Cancer...................................................................338 74 Prostate Hyperplasia and Carcinoma......................................342 75 Cancer of Unknown Primary Site.............................................345 76 Paraneoplastic Endocrine Syndromes.....................................348 77 Neurologic Paraneoplastic Syndromes...................................352 SECTION 7 INFECTIOUS DISEASES 78 Infections Acquired in Health Care Facilities..........................357 79 Infections in the Immunocompromised Host.........................362 80 Infective Endocarditis...............................................................372 81 Intraabdominal Infections........................................................382 82 Infectious Diarrheas..................................................................386 83 Sexually Transmitted and Reproductive Tract Infections.....399 84 Infections of the Skin, Soft Tissues, Joints, and Bones..........415 85 Pneumococcal Infections..........................................................422 86 Staphylococcal Infections.........................................................425 87 Streptococcal/Enterococcal Infections, Diphtheria, and Infections Caused by Other Corynebacteria and Related Species..................................................................434 88 Meningococcal and Listerial Infections...................................443 89 Infections Caused by Haemophilus, Bordetella, Moraxella, and HACEK Group Organisms...............................448 90 Diseases Caused by Gram-Negative Enteric Bacteria and Pseudomonas.......................................................453 91 Infections Caused by Miscellaneous Gram-Negative Bacilli...............................................................462 92 Anaerobic Infections.................................................................469 93 Nocardiosis, Actinomycosis, and Whipple's Disease.............477 94 Tuberculosis and Other Mycobacterial Infections.................482 95 Lyme Disease and Other Nonsyphilitic Spirochetal Infections...............................................................494 96 Rickettsial Diseases...................................................................500 97 Mycoplasma pneumoniae, Legionella Species, and Chlamydia pneumoniae.............................................................510 98 Chlamydia trachomatis and C. psittaci.....................................514 99 Herpesvirus Infections..............................................................516 100 Cytomegalovirus and Epstein-Barr Virus Infections..............525 101 Influenza and Other Viral Respiratory Diseases.....................530 102 Rubeola, Rubella, Mumps, and Parvovirus Infections...........538 103 Enteroviral Infections................................................................543 104 Insect- and Animal-Borne Viral Infections..............................546 105 HIV Infection and AIDS.............................................................554 106 Fungal Infections.......................................................................568 107 Pneumocystis Infections............................................................583 108 Protozoal Infections..................................................................586 109 Helminthic Infections and Ectoparasite Infestations................................................................................599 SECTION 8 CARDIOLOGY 110 Physical Examination of the Heart...........................................613 111 Electrocardiography.................................................................618 112 Noninvasive Examination of the Heart...................................622 113 Congenital Heart Disease in the Adult....................................627 114 Valvular Heart Disease..............................................................632 115 Cardiomyopathies and Myocarditis........................................639 116 Pericardial Disease....................................................................644 117 Hypertension.............................................................................649 118 Metabolic Syndrome.................................................................656 119 ST-Segment Elevation Myocardial Infarction....................................................................................658 120 Unstable Angina and Non-ST-Elevation Myocardial Infarction................................................................668 121 Chronic Stable Angina..............................................................672 122 Bradyarrhythmias.....................................................................677 123 Tachyarrhythmias.....................................................................679 124 Heart Failure and CorPulmonale.............................................687 125 Diseases of the Aorta................................................................693 126 Peripheral Vascular Disease.....................................................696 127 Pulmonary Hypertension..........................................................699 SECTION 9 PULMONOLOGY 128 Respiratory Function and Pulmonary Diagnostic Procedures..............................................................705 129 Asthma.......................................................................................711 130 Environmental Lung Diseases..................................................715 131 Chronic Obstructive Pulmonary Disease.................................718 132 Pneumonia, Bronchiectasis, and Lung Abscess......................722 133 Pulmonary Thromboembolism and Deep-Vein Thrombosis................................................................................730 134 Interstitial Lung Disease...........................................................734 135 Diseases of the Pleura and Mediastinum................................740 136 Disorders of Ventilation............................................................744 137 Sleep Apnea...............................................................................745 SECTION 10 NEPHROLOGY 138 Acute Renal Failure...................................................................747 139 Chronic Kidney Disease and Uremia........................................752 140 Dialysis.......................................................................................754 141 Renal Transplantation..............................................................756 142 Glomerular Diseases.................................................................759 143 Renal Tubular Disease...............................................................769 144 Urinary Tract Infections and Interstitial Cystitis....................775 145 Nephrolithiasis..........................................................................779 146 Urinary Tract Obstruction.........................................................782 SECTION 11 GASTROENTEROLOGY 147 Peptic Ulcer and Related Disorders.........................................785 148 Inflammatory Bowel Diseases..................................................790 149 Colonic and Anorectal Diseases...............................................794 150 Cholelithiasis, Cholecystitis, and Cholangitis.........................799 151 Pancreatitis................................................................................804 152 Acute Hepatitis..........................................................................809 153 Chronic Hepatitis.......................................................................816 154 Cirrhosis and Alcoholic Liver Disease......................................826 155 Portal Hypertension..................................................................831 SECTION 12 ALLERGY, CLINICAL IMMUNOLOGY, AND RHEUMATOLOGY 156 Diseases of Immediate-Type Hypersensitivity.......................835 157 Primary Immune Deficiency Diseases.....................................840 158 Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Other Connective Tissue Diseases....................................843 159 Vasculitis....................................................................................850 160 Ankylosing Spondylitis.............................................................854 161 Psoriatic Arthritis.......................................................................857 162 Reactive Arthritis.......................................................................859 163 Osteoarthritis.............................................................................861 164 Gout, Pseudogout, and Related Diseases...............................863 165 Other Musculoskeletal Disorders.............................................867 166 Sarcoidosis.................................................................................870 167 Amyloidosis...............................................................................873 SECTION 13 ENDOCRINOLOGY AND METABOLISM 168 Disorders of the Anterior Pituitary and Hypothalamus.........877 169 Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone...............................................................883 170 Thyroid Gland Disorders...........................................................886 171 Adrenal Gland Disorders..........................................................895 172 Obesity.......................................................................................901 173 Diabetes Mellitus.......................................................................904 174 Disorders of the Male Reproductive System...........................912 175 Disorders of the Female Reproductive System......................917 176 Hypercalcemia and Hypocalcemia...........................................924 177 Osteoporosis and Osteomalacia..............................................931 178 Hypercholesterolemia and Hypertriglyceridemia..................936 179 Hemochromatosis, Porphyrias, and Wilson's Disease...........942 SECTION 14 NEUROLOGY 180 The Neurologic Examination....................................................947 181 Seizures and Epilepsy...............................................................956 182 Dementia....................................................................................968 183 Parkinson's Disease...................................................................976 184 Ataxic Disorders........................................................................981 185 ALS and Other Motor Neuron Diseases...................................984 186 Autonomic Nervous System Disorders....................................988 187 Trigeminal Neuralgia, Bell's Palsy, and Other Cranial Nerve Disorders.................................................995 188 Spinal Cord Diseases.............................................................. 1002 189 Tumors of the Nervous System............................................. 1008 190 Multiple Sclerosis................................................................... 1012 191 Acute Meningitis and Encephalitis....................................... 1020 192 Chronic and Recurrent Meningitis........................................ 1031 193 Peripheral Neuropathies, Including Guillain-Barré Syndrome....................................................... 1040 194 Myasthenia Gravis.................................................................. 1050 195 Muscle Diseases...................................................................... 1053 SECTION 15 PSYCHIATRY AND SUBSTANCE ABUSE 196 Psychiatric Disorders............................................................. 1063 197 Psychiatric Medications......................................................... 1071 198 Eating Disorders..................................................................... 1079 199 Alcohol Use Disorder.............................................................. 1080 200 Narcotic Abuse........................................................................ 1084 SECTION 16 DISEASE PREVENTION AND HEALTH MAINTENANCE 201 Routine Disease Screening.................................................... 1087 202 Cardiovascular Disease Prevention...................................... 1092 203 Prevention and Early Detection of Cancer........................... 1094 204 Smoking Cessation................................................................. 1102 205 Women's Health..................................................................... 1104 SECTION 17 ADVERSE DRUG REACTIONS 206 Adverse Drug Reactions........................................................ 1107 Index................................................................................................. 1109