Conn's Current Therapy 2019

Rick D. Kellerman; David Rakel

BOOK

Conn's Current Therapy 2019

Rick D. Kellerman | David Rakel

(2018)

Additional Information

Book Details

ISBN: 978-0-323-59650-3
Edition
Language: English
Pages: 1344
Subjects: General practice

Abstract

Follows a consistent, easy-to-use format throughout, with diagnosis, therapy, drug protocols, and treatment pearls presented in quick-reference boxes and tables for point-of-care answers to common clinical questions.
Features significantly revised chapters on sepsis • bacterial pneumonia • ADHD • endometriosis • atrial fibrillation • congestive heart failure • pericarditis • diabetes mellitus • measles • myasthenia gravis • irritable bowel syndrome • Parkinson’s disease • seizures and epilepsy in adolescents and adults • acute bronchitis and other viral respiratory illnesses • urinary incontinence • neutropenia • venous thromboembolism • fungal diseases of the skin • diseases of the nails • and more.
Includes all-new chapters on fatty liver, pancreatic cancer, and more.
Includes nearly 300 images, including algorithms, anatomical illustrations, and photographs, that provide useful information for diagnosis.
Provides current drug information thoroughly reviewed by PharmDs.
Shares the knowledge and expertise of 40 new authors who provide a fresh perspective in their specialties.

Section Title	Page	Action	Price
Front Cover	Cover
Inside Front Cover	ES2
Front End Sheet	ES3
Conn's Current Therapy 2019	iii
Copyright	iv
Contributors	v
Preface	xxiii
Contents	xxv
Symptomatic Care Pending Diagnosis	1
Chest Pain	1
Current Diagnosis	1
Current Therapy	1
Epidemiology	1
Initial Assessment	1
Diagnosis and Treatment	1
Acute Coronary Syndrome	1
Pulmonary Embolism	2
Aortic Dissection	3
Esophageal Rupture	3
Tension Pneumothorax	3
Other Causes of Chest Pain	3
References	4
Constipation	5
Current Diagnosis	5
Current Therapy	5
Epidemiology	5
Risk Factors	5
Pathophysiology	5
Prevention	5
Clinical Manifestations	5
Diagnosis	5
Treatment	5
Complications	6
References	7
Cough	7
Current diagnosis	7
Current therapy	7
Acute Cough	7
Chronic Cough	8
Upper Airway Cough Syndrome	8
Cough Variant Asthma and Nonasthmatic Eosinophilic Bronchitis	8
Gastroesophageal Reflux Disease	8
Other Causes of Chronic Cough	8
Reference	9
Dizziness and Vertigo	9
Current Diagnosis	9
Current Therapy	9
Epidemiology	9
Risk Factors	9
Pathophysiology	9
Clinical Manifestations	9
Diagnosis	11
Differential Diagnosis	11
Treatment	11
Monitoring	11
Complications	11
References	11
Fatigue	12
Current Diagnosis	12
Current Therapy	12
Epidemiology	12
Risk Factors	12
Prevention	12
Clinical Manifestations	12
Diagnosis	12
Differential Diagnosis	12
Treatment	12
Monitoring	13
References	13
Fever	13
Current Diagnosis	13
Current Therapy	13
Definitions	13
Pathophysiology	14
Risks and Benefits of Fever	14
Diagnostic Evaluation of Fever	14
Differential Diagnosis	14
Treatment	14
References	15
Gaseousness, Indigestion, Nausea, and Vomiting	15
Epidemiology	15
Risk Factors	15
Pathophysiology	15
Prevention	15
Clinical Manifestations	15
Diagnosis	15
Differential Diagnosis	16
Treatment	16
Monitoring	17
Complications	17
References	19
Headache	19
Evaluation and Diagnosis	20
Tension-Type Headache	21
Migraine Headache	21
Cluster Headache	21
Chronic Daily Headache	22
Posttraumatic Headache	22
Treatment	22
TTHA Treatment	22
Migraine Treatment	23
Cluster Headache Treatment	25
Chronic Daily and Posttraumatic Headache Treatment	25
Conclusion	25
References	25
Hematuria	26
Current Diagnosis	26
Epidemiology	26
Risk Factors	26
Pathophysiology	26
Prevention	26
Clinical Manifestations	26
Diagnosis	26
Differential Diagnosis	27
Therapy, Monitoring, and Complications	27
References	28
Hiccups	28
Mechanistic Description	28
Classifications	28
Epidemiology	28
Pathophysiology	28
Evaluation of the Hiccup Patient	28
History	28
Physical Examination	28
Laboratory and Diagnostic Procedures	28
Nonpharmacologic Interventions	29
Pharmacologic Interventions	29
Sedative-Hypnotics	29
Antiemetics	29
Analeptics	29
Anticonvulsants	29
Antipsychotics	29
Antidepressants	29
Calcium Channel Blockers	29
Sodium Channel Blockers	29
GABAB Agonists	29
Antacids	29
Gastrokinetic Drugs	29
Physical Interventions	29
Phrenic Nerve Destruction	29
Hypercapnia	30
Positive End-Expiratory Pressure	30
Nasogastric Tube	30
Treatment	30
References	30
Hoarseness and Laryngitis	30
Current Diagnosis	30
Current Therapy	30
Normal Laryngeal Function	31
Evaluation of Dysphonia	31
History	31
Physical Examination	31
Laryngeal Examination	32
Other Testing	32
Types of Dysphonia	32
Acute Laryngitis	32
Chronic Laryngitis	32
Vocal Fold Paralysis	32
Phonotraumatic Lesions: Nodules, Polyps, and Cysts	33
Reinke's Edema	33
Recurrent Respiratory Papillomatosis	34
Vocal Cord Cancer	34
Neurologic Disorders and the Voice	34
Functional Voice Disorders	35
Presbylaryngis	35
Conclusion	35
References	35
Pain	35
Current Diagnosis	35
Current Therapy	36
Epidemiology	36
Risk Factors	36
Pathophysiology	36
Prevention	36
Clinical Manifestations	36
Diagnosis	36
Differential Diagnosis	37
Treatment	37
Nonpharmacologic	37
Pharmacologic	37
Nonopioid Analgesics	37
Opioids (see Table 1)	37
Adjuvant Drugs	40
Monitoring	41
Complications	42
References	42
Palliative and End-of-Life Care	42
Current diagnosis	42
Current therapy	42
Epidemiology	43
Risk Factors	44
Pathophysiology	44
Prevention	44
Clinical Manifestations	44
Diagnosis	44
Differential Diagnosis	44
Therapy	44
Pain	45
Pain of All Types	45
Bone Pain	45
Neuropathic Pain	45
Visceral Pain	45
Dyspnea	45
Nausea/Vomiting	45
Constipation	46
Anxiety	46
Delirium	47
Hiccups	47
Monitoring	47
Palliative Sedation	47
Physician-Assisted Suicide (PAS)	47
Complications	47
References	47
Palpitations	48
Current Diagnosis	48
Current Therapy	48
Epidemiology	48
Differential Diagnosis	48
Risk Factors	49
Pathophysiology	49
Clinical Assessment	49
Diagnostic Testing	49
Treatment	50
References	51
Pharyngitis	51
Current Diagnosis	51
Current Therapy	51
Epidemiology	51
Risk Factors	52
Pathophysiology	52
Prevention	52
Clinical Manifestations	52
Group A β-Hemolytic Streptococcal Pharyngitis	52
Scarlet Fever	52
Poststreptococcal Glomerulonephritis	52
Viral Pharyngitis	52
Diagnosis	52
Differential Diagnosis	52
Infectious Mononucleosis	52
Acute Retroviral Syndrome	53
Neisseria gonorrhea	53
Lemierre's Syndrome	53
Treatment	53
Treatment Regimens	53
Monitoring	53
Complications	54
References	54
Pruritus	54
Current Diagnosis	54
Current Therapy	54
Classification	54
Pathophysiology	54
Clinical Manifestations	54
Differential Diagnosis	54
Therapy	55
Complications	55
References	55
Rhinitis	55
Current Diagnosis	55
Current Therapy	55
Introduction	56
Epidemiology/Risk Factors	56
Pathophysiology	56
Allergic	56
Nonallergic Rhinitis	56
Infectious Rhinitis/Rhinosinusitis	56
Prevention	57
Clinical Manifestations	57
Diagnosis	57
History	57
Physical Examination	57
Differential Diagnosis	57
Treatment	58
Overall	58
Avoidance	58
Intranasal Corticosteroid (INS)	58
Intranasal Anticholinergic (IP)	58
Intranasal Antihistamine (INA)	58
Nasal Cromolyn	58
Nasal Saline	58
Topical Decongestants	58
Oral Antihistamines	58
Leukotriene Receptor Antagonists (LTRA)	58
Oral Decongestants	58
Systemic Corticosteroids	58
Surgery	59
Anti IgE	59
Immunotherapy	59
Monitoring	59
Complications	59
References	59
Spine Pain	59
Current Diagnosis	59
Current Therapy	59
Epidemiology	60
Risk Factors	60
Pathophysiology	60
Prevention	60
Clinical Manifestations	60
Diagnosis	60
Differential Diagnosis	61
Therapy	62
Monitoring	63
Complications	63
References	63
Tinnitus	63
Current Diagnosis	63
Current Therapy	63
Definition and Epidemiology	64
Risk Factors/Etiologies (Subjective and Objective Tinnitus)	64
Pathophysiology	64
Prevention	64
Clinical Manifestations	64
Diagnosis	65
History	65
Complete physical examination	65
Laboratory tests	65
Differential Diagnosis	65
Management	65
Monitoring	66
Complications	66
References	66
Diseases of Allergy	67
Allergic Reactions to Insect Stings	67
Current Diagnosis	67
Current Therapy	67
Diagnosis	67
Treatment	68
References	68
Anaphylaxis and Serum Sickness	68
Current Diagnosis	68
Anaphylaxis	68
Pathophysiology	69
Agents That Cause Anaphylaxis	69
Recurrent Anaphylaxis	69
Differential Diagnosis	70
Management of Anaphylaxis	70
Prevention of Anaphylaxis	71
Serum Sickness	71
Pathogenesis and Laboratory Abnormalities	71
Treatment	71
References	72
Drug Hypersensitivity Reactions	72
Current Diagnosis	72
Current Therapy	72
Epidemiology	72
Classifications	72
Pathophysiology	72
Risk Factors for Hypersensitivity Drug Reactions	73
Clinical Manifestations	73
Dermatologic Symptoms	73
Stevens-Johnson Syndrome	73
Toxic Epidermal Necrolysis	73
Drug Rash with Eosinophilia and Systemic Symptoms	74
Acute Generalized Exanthematous Pustulosis	74
Acute Interstitial Nephritis	74
Evaluation	74
Management	74
Anaphylaxis	74
Angioedema	75
Specific Drugs	75
Antibiotics	75
Penicillin	75
Penicillin and Cephalosporin Cross-Reactivity	75
Sulfonamides (Sulfa Drugs)	76
Angiotensin-Converting Enzyme Inhibitors	76
Aspirin and NSAIDs	77
Corticosteroids	77
Local Anesthetics	78
Radiocontrast Media	78
Chlorhexidine	78
Herbal Supplements	78
Conclusion	78
References	78
The Cardiovascular System	81
Acute Myocardial Infarction: Focus on ST-Elevation Myocardial Infarction	81
Diagnosis	81
Electrocardiogram	81
Serum Biomarkers	81
Imaging	81
Management of STEMI	81
Prehospital Phase	81
In-Hospital Reperfusion Strategy	82
Primary Percutaneous Coronary Intervention	82
Fibrinolysis	82
Percutaneous Intervention After Fibrinolysis	82
Facilitated Percutaneous Intervention	83
Patients with STEMI and Multivessel Coronary Artery Disease	83
Patients with STEMI Who Present Later Than 12 Hours After Symptom Onset	83
Adjunct therapy	83
Antiplatelet Therapy	83
Aspirin	83
P2Y12 Receptor Inhibitors	83
Glycoprotein IIb/IIIa Receptor Antagonists	85
Anticoagulants	85
Guideline-Directed Medical Therapy	86
Beta-Blocker	86
Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers	86
HMG CoA Reductase Inhibitors (Statins)	86
Aldosterone Antagonists	86
Implantable Cardioverter-Defibrillator	86
Other Medical Therapy	86
Morphine	86
Nitrate	86
Complications of STEMI	87
Cardiogenic Shock	87
Electrical Complications	87
Ventricular Arrhythmia	87
Supraventricular Arrhythmia	87
Bradycardia and Heart Block	87
References	87
Angina Pectoris	88
Current Diagnosis	88
Current Therapy	88
Clinical Features	88
Diagnostic Testing	88
Risk Factor Management	89
Hypertension	89
Hyperlipidemia	89
Metabolic Syndrome	90
Smoking	90
Diet	90
Other Lifestyle Changes	90
Approach to Treatment	90
Medical Therapy	90
Nitrates	90
β-Blockers	91
Calcium Channel Blockers	91
Ranolazine (Ranexa)	91
Medication Combinations	91
Antiplatelet Therapy	92
Invasive Assessment	92
Novel Therapies	92
Transmyocardial Laser Revascularization	92
External Counterpulsation	92
Spinal Cord Stimulation	93
Acupuncture	93
Other Causes of Angina	93
Syndrome X	93
Vasospastic or Prinzmetal's Angina	93
Newer Imaging Techniques	93
Calcium Scoring	93
CT Coronary Angiography	93
Summary	93
References	93
Aortic Disease: Aneurysm and Dissection	94
Current Diagnosis	94
Current Therapy	94
Abdominal Aortic Aneurysms	94
Epidemiology	94
Risk Factors	94
Pathophysiology	94
Prevention	94
Clinical Manifestations	94
Diagnosis	95
Treatment	95
Monitoring	97
Thoracic Aortic Aneurysms	97
Thoracoabdominal Aortic Aneurysms	97
Thoracic Aortic Dissection	97
References	98
Atrial Fibrillation	98
Current Diagnosis	98
Current Therapy	98
Epidemiology	98
Risk Factors and Pathophysiology	98
Clinical Manifestations	98
Diagnosis	98
Differential Diagnosis	99
Treatment	99
Rate Control	99
Rhythm Control	99
Stroke Prophylaxis	99
Oral Anticoagulants	99
Left Atrial Appendage Closure	99
Risk Factor Management and Lifestyle Modification	100
Weight Loss	100
Intensive Blood Pressure Lowering	100
Exercise Training	100
Complications	100
Special Considerations	100
Subclinical AF	100
AF Burden	100
References	100
Cardiac Arrest: Sudden Cardiac Death	101
Definition and Causes	101
Tests to Identify Risk for Sudden Death	101
Treatment	102
Acute Management of Survivors of Cardiac Arrest	102
Primary Prevention of Ventricular Arrhythmias and Sudden Cardiac Death	102
Coronary Artery Disease	102
Idiopathic Dilated Cardiomyopathy	102
Hypertrophic Cardiomyopathy	103
Arrhythmogenic Right Ventricular Dysplasia	103
Sudden Death Associated with Abnormalities of the QT Interval	103
Brugada Syndrome	104
Catecholaminergic Ventricular Tachycardia	104
Wolff-Parkinson-White Syndrome	104
Idiopathic Ventricular Fibrillation	104
Adult Congenital Heart Disease	104
Neuromuscular Diseases	104
Bradyarrhythmia	104
References	104
Congenital Heart Disease	105
Current Diagnosis	105
Current Therapy	105
Acyanotic Conditions	105
Atrial Septal Defect	105
Ventricular Septal Defect	106
Atrioventricular Canal Defect	106
Patent Ductus Arteriosus	106
Aortic Stenosis	107
Pulmonic Stenosis	107
Aortic Coarctation	107
Cyanotic Conditions	108
Ebstein's Anomaly	108
Tetralogy of Fallot	108
Eisenmenger Syndrome	109
References	110
Congestive Heart Failure	110
Current Diagnosis	110
Current Therapy	110
Heart Failure Definition	110
Epidemiology	110
Heart Failure Classification Based on Left Ventricular Ejection Fraction (LVEF)	110
Diagnosis	110
Functional Capacity	110
Clinical Manifestions and Diagnosis	111
Laboratory and Diagnostic Tests	111
Therapy	111
Diuretics	111
Renin Angiotensin System Inhibitors	111
Angiotensin-Converting Enzyme Inhibitors (ACEI)	111
Angiotensin Receptor Blockers (ARBS)	112
Angiotensin Receptor-Neprilysin Inhibitors (ARNI)	112
Beta Blockers	112
Mineralocorticoid Receptor Antagonists (MRA)	112
Hydralazine and Isosorbide Dinitrate Combination	112
Digoxin	112
Statins	112
Omega-3 Polyunsaturated Fatty Acids (PUFA)	112
Anticoagulation	113
Devices	113
Therapy for HFpEF	113
Advanced Therapies	113
References	113
Heart Block	113
Current Diagnosis	113
Current Therapy	113
Epidemiology	114
Risk Factors	114
Pathophysiology	114
Prevention	115
Clinical Manifestations	115
Diagnosis	115
Differential Diagnosis	115
Therapy	116
Monitoring	117
Complications	117
Conclusions	118
References	118
Hypertension	118
Current Diagnosis	118
Current Therapy	118
Epidemiology	118
Risk Factors	118
Diet and Sodium Intake	118
Sedentary Lifestyle and Obesity	118
Alcohol Intake	118
Smoking	118
Sleep Apnea	118
Age	119
Gender	119
Race	119
Family History	119
Pathophysiology	119
Prevention	119
Clinical Manifestations	119
Diagnosis	119
Screening	119
Clinical Diagnosis	119
Primary (Essential) Hypertension	119
Secondary Hypertension	119
Looking for Secondary Causes	119
Differential Diagnosis	119
Treatment Approaches	120
Recommendation 1	120
Recommendation 2	120
Recommendation 3	120
Recommendation 4	121
Recommendation 5	121
Recommendation 6	121
Recommendation 7	121
Recommendation 8	121
Recommendation 9	121
ACC/AHA 2017 Hypertension Guidelines	121
Nonpharmacologic	121
Diet	121
Exercise	121
Other Lifestyle Modifications	121
Pharmacologic	122
Monitoring	124
Complications	124
References	124
Hypertrophic Cardiomyopathy	125
Current Diagnosis	125
Current Therapy	125
Definition	125
Epidemiology	125
Risk Factors	125
Clinical Manifestations	125
Pathogenesis	125
Diagnosis	125
Imaging	126
Treatment	126
Asymptomatic Disease	126
Symptomatic Disease	126
Pharmacologic Management	126
Invasive Therapies	126
Role of Implantable Devices	126
Participation in Competitive Sports	126
Monitoring	126
Future Research	127
References	127
Infective Endocarditis	127
Current Diagnosis	127
Current Therapy	127
Definition	127
Epidemiology and Risk Factors	127
Pathophysiology	127
Prevention	128
Clinical Manifestations and Diagnosis	128
Blood Cultures	129
Electrocardiography	129
Echocardiography and Diagnostic Criteria	129
Other Cardiac Imaging Modalities	130
Differential Diagnosis	130
Treatment, Complications, and Outcome	130
References	132
Mitral Valve Prolapse	133
Current Diagnosis	133
Current Therapy	133
Prevalence	133
Classification	133
Pathology	133
Clinical Presentation	133
Diagnosis	134
Use of Echocardiography	134
Medical Management	135
Surgical Management	135
Percutaneous Management	136
References	136
Pericarditis	137
Current diagnosis	137
Current therapy	137
Anatomy and Functions of the Pericardium	137
Acute Pericarditis	137
Etiology	137
Presentation	137
Diagnostic Evaluation	138
Clinical Laboratory Data	138
ECG	138
Imaging	138
Treatment	138
Recurrent Pericarditis	139
Constrictive Pericarditis	140
Etiology	140
Presentation and Physical Findings	140
Diagnostic Tests	140
Treatment	140
References	140
Peripheral Artery Disease	141
Current Diagnosis	141
Current Therapy	141
Epidemiology	141
Risk Factors	141
Pathophysiology	141
Prevention	141
Clinical Manifestations	141
Diagnosis of Peripheral Artery Disease	141
Differential Diagnosis	142
Treatment of Peripheral Artery Disease	143
Treatment of Cardiovascular Risk Factors	143
Improving Functional Capacity	143
Monitoring	145
Complications	145
Acknowledgments	145
References	145
Premature Beats	145
Current Diagnosis	145
Current Therapy	145
Premature Atrial Contractions	146
Epidemiology and Risk Factors	146
Pathophysiology	146
Prevention and Clinical Manifestations	146
Diagnosis and Differential Diagnosis	146
Treatment and Monitoring	146
Premature Ventricular Contractions	147
Epidemiology and Risk Factors	147
Pathophysiology	147
Prevention and Clinical Manifestations	147
Diagnosis and Differential Diagnosis	147
Treatment and Monitoring	147
Premature Junctional Contractions	147
References	148
Tachycardias	148
Current Diagnosis	148
Current Therapy	148
Tachycardia	148
Epidemiology	148
Supraventricular Tachycardias	148
Ventricular Tachycardias	148
Pathophysiology	148
Clinical Manifestations	149
Diagnosis	149
Differential Diagnosis	149
Narrow QRS-Complex Tachycardia	149
Wide QRS-Complex Tachycardia	149
Specific Tachycardias	149
Supraventricular Tachycardias	149
Sinus Tachyarrhythmias	149
Atrioventricular Nodal Reciprocating Tachycardia	149
Atrioventricular Reciprocating Tachycardia (Extranodal Accessory Pathways)	150
Focal and Nonparoxysmal Junctional Tachycardia	150
Focal Junctional Tachycardia	150
Nonparoxysmal Junctional Tachycardia	151
Focal Atrial Tachycardias	151
Multifocal Atrial Tachycardia	151
Macro-Reentrant Atrial Tachycardia (Atrial Flutter)	151
Ventricular Tachycardias	151
Structural Heart Disease	151
Long-QT Syndrome	151
Accelerated Idioventricular Rhythm	152
References	152
Venous Thrombosis	152
Current Diagnosis	152
Current Therapy	152
Epidemiology	152
Risk Factors	152
Pathophysiology	153
Diagnosis	153
Deep Venous Thrombosis	153
Pulmonary Embolism	153
Axillary and Subclavian Vein Thrombosis	153
Treatment	154
Standard Therapy for Venous Thromboembolism	154
Duration of Treatment	154
Complications	154
Nonpharmacologic Treatments	155
Aggressive Therapies for Venous Thromboembolism	155
Inferior Vena Cava Filters	155
References	156
Valvular Heart Disease	156
Current Diagnosis	156
Current Therapy	156
Aortic Stenosis	156
Etiology	156
Pathophysiology	157
Clinical Presentation	157
Diagnosis and Management	157
Treatment	157
Surgical Treatment	158
Mitral Regurgitation	158
Etiology	159
Clinical Manifestations	159
Diagnosis	159
Management and Treatment	160
References	161
The Digestive System	163
Acute and Chronic Pancreatitis	163
Current Diagnosis	163
Current Therapy	163
Acute Pancreatitis	163
Epidemiology	163
Risk Factors	163
Pathophysiology	163
Prevention	163
Clinical Manifestations	163
Diagnosis	164
Differential Diagnosis	164
Treatment	164
Monitoring	166
Complications	166
Chronic Pancreatitis	166
Epidemiology	166
Risk factors	166
Pathophysiology	167
Prevention	167
Clinical Manifestations	167
Diagnosis	167
Differential Diagnosis	168
Treatment	168
Monitoring	169
Complications	169
References	170
Acute Diarrhea	170
Current Diagnosis	170
Current Therapy	170
Epidemiology	171
Etiology and Treatment	171
Bacteria	171
Campylobacter	171
Clostridium difficile	172
E coli	172
Salmonella	172
Shigella	172
Vibrio	172
Yersinia	172
Viruses	172
Parasite	172
Travelers Diarrhea	173
Treatment	173
References	173
Bleeding Esophageal Varices	173
Current Diagnosis	173
Current Therapy	173
Epidemiology	173
Pathophysiology	173
Diagnosis	174
Treatment	174
Primary Prophylaxis	174
Pharmacologic Therapy	174
Endoscopic Therapy	175
Management of Acute Variceal Hemorrhage	175
Pharmacologic Therapy	176
Vasopressin and Terlipressin	176
Somatostatin, Octreotide, and Vapreotide	176
Endoscopy	176
Balloon Tamponade/SEMS	176
Transjugular Intrahepatic Portosystemic Shunt	176
Surgery	176
Secondary Prophylaxis	177
Pharmacologic Therapy	177
Endoscopy	177
Transjugular Intrahepatic Portosystemic Shunt	177
Surgery	178
Cost-Effectiveness of Available Therapies	178
Summary	178
References	178
Calculous Biliary Disease	179
Current Diagnosis	179
Current Therapy	179
Cholelithiasis	179
Epidemiology	179
Pathophysiology	179
Risk Factors	179
Clinical Manifestations	179
Diagnosis	179
Biliary Sludge	179
Treatment	179
Complications	180
Choledocholithiasis	180
Diagnosis	180
Treatment	180
Complications	181
Acute Cholecystitis	181
Diagnosis	181
Treatment	182
Acute Acalculous Cholesystitis	182
Gangrenous Cholecystitis, Emphysematous Cholecystitis, and Gallbladder Perforation	182
Gallbladder Disease in Pregnancy	182
References	182
Chronic Diarrhea	183
Current Diagnosis	183
Current Therapy	183
Epidemiology	183
Classification Based on Pathophysiology	183
Watery Diarrhea	183
Fatty/Malabsorptive Diarrhea	183
Inflammatory Diarrhea	183
Clinical Manifestations	183
History	183
Physical Examination	184
Testing for Diagnosis	184
Treatment	184
References	184
Cirrhosis	184
Epidemiology	185
Clinical findings	185
Natural history of cirrhosis and prognostic models	185
Major complications of cirrhosis	186
Portal Hypertension	186
Gastroesophageal Variceal Hemorrhage	186
Ascites	187
Spontaneous Bacterial Peritonitis	188
Hepatorenal Syndrome	189
Hepatic Encephalopathy	190
Hepatocellular Carcinoma	191
Portopulmonary Hypertension	191
Hepatopulmonary Syndrome	192
Hepatic Hydrothorax	193
Liver transplantation	193
References	194
Diverticula of the Alimentary Tract	195
Current Diagnosis	195
Current Therapy	195
Esophagus	195
Zenkers Diverticulum	195
Traction Diverticulum	196
Epiphrenic Diverticulum	196
Stomach	196
Gastric Diverticula	196
Small Intestine	196
Duodenal Diverticula	196
Jejunal and Ileal Diverticula	196
Meckels Diverticulum	197
Colon	197
Diverticulosis	197
Colonic Diverticular Bleeding	197
Diverticulitis	197
References	199
Dysphagia and Esophageal Obstruction	199
Current Diagnosis	199
Current Therapy	200
Epidemiology	200
Pathophysiology	200
Diagnosis	200
Diagnostic Testing	200
Oropharyngeal Dysphagia	200
Esophageal Dysphagia	200
Oropharyngeal Dysphagia	201
Differential Diagnosis	201
Management	202
Esophageal Dysphagia	202
Differential Diagnosis: Mechanical Obstruction (Table 2)	202
Stricture	202
Eosinophilic Esophagitis	202
Rings/Webs	203
Malignancy	203
Management for Esophageal Obstruction	203
Differential Diagnosis: Motility Disorders (Table 3)	203
Achalasia	203
Esophagogastric Junction Outflow Obstruction	204
Absent Peristalsis	204
Distal Esophageal Spasm	204
Jackhammer	204
Borderline Motor Abnormalities	204
Monitoring	204
References	204
Gastritis and Peptic Ulcer Disease	204
Current Diagnosis	204
Current Treatment	205
Epidemiology	205
Risk Factors	205
Pathophysiology	205
Prevention	205
Clinical Manifestations	205
Differential Diagnosis	205
Diagnosis	206
Noninvasive Testing	206
Treatment	206
Monitoring	207
Complications	207
References	208
Gastroesophageal Reflux Disease (GERD)	208
Pathophysiology	208
Complications	208
Erosive Esophagitis	209
Strictures	209
Barrett's Esophagus	209
Adenocarcinoma	209
Diagnosis	209
Management	210
References	210
Hemorrhoids, Anal Fissure, and Anorectal Abscess and Fistula	211
Current Diagnosis	211
Current Therapy	211
History	211
Diagnosis	211
Hemorrhoids	212
Anal Fissure	213
Anorectal Abscess and Fistula	214
References	214
Hepatitis A, B, D, and E	215
Current diagnosis	215
Current therapy	215
Hepatitis A Virus	216
Introduction	216
Natural History	216
Epidemiology	216
Diagnosis	216
Treatment	216
Prevention	217
Hepatitis E	217
Introduction	217
Natural History	217
Epidemiology	217
Diagnosis	218
Treatment	218
Prevention	218
Hepatitis B	218
Introduction	218
Natural History	218
Epidemiology	219
Diagnosis	219
Treatment	219
Prevention	220
Hepatitis D	221
Introduction	221
Natural History	221
Epidemiology	221
Diagnosis	221
Treatment	221
References	221
Hepatitis C	222
Current diagnosis	222
Current therapy	222
Virology, Pathogenesis, and Natural History	222
Epidemiology	222
Risk Factors	222
Diagnosis	223
Prevention	223
Therapy	223
Monitoring	224
References	224
Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis	224
Current Diagnosis	224
Current Therapy	225
Clinical Manifestations	225
Diagnosis	225
Treatment	226
Ulcerative Colitis	227
Crohn's Disease	227
Therapeutic Options	227
Mesalamine Preparations	227
Steroids	227
Immunomodulatory Therapy	228
Cyclosporine	228
Biologic Agents	228
Other Anti-Tumor Necrosis Factor Antibodies	228
Adalimumab	228
Certolizumab	228
Golimumab	228
Anti-α4 Therapy	229
Natalizumab	229
References	229
Intestinal Parasites	230
Current Diagnosis	230
Protozoa: Amoebae, Flagellates, Ciliates	230
Entamoeba histolytica	230
Giardiasis	231
Blastocystis hominis	234
Dientamoeba fragilis	234
Balantidium coli	234
Spore-Forming Protozoa and Microsporidia	234
Cryptosporidiosis	234
Cyclospora Species	235
Cystoisospora Species	235
Microsporidiosis	235
Helminths	236
Nematodes	236
Ascaris	236
Whipworm (Trichurasis)	236
Hookworm (Necator americanus and Ancylostoma duodenale)	238
Strongyloides	238
Enterobius vermicularis	239
Anisakiasis	239
Trematodes	239
Schistosomiasis	239
Cestodes	240
Taeniasis	240
Diphyllobothriasis	240
References	240
Irritable Bowel Syndrome	240
Current Diagnosis	240
Current Therapy	241
Introduction and Definitions	241
Epidemiology of IBS	241
Prevalence	241
Causality-a biopsychsocial conceptual model for IBS	241
Impact on Population Health	241
Direct Health Care Costs	242
Evaluation of Patients with Suspected IBS	242
Tests of Unproven Value	242
Treatment of IBS	242
Dietary Modifications	242
Pharmacologic Agents for IBS	242
Behavioral Therapy for IBS	243
References	243
Malabsorption	244
Current Diagnosis	244
Current Therapy	244
Diagnosis	244
Symptoms and Signs	244
Tests	245
Routine Laboratory Tests	245
Tests for Malabsorption	245
Fat Malabsorption	245
Protein Malabsorption	246
Carbohydrate Malabsorption	246
Vitamin B12 Malabsorption	246
Bile Acid Malabsorption	246
Small Bowel Bacterial Overgrowth	246
Pancreatic Exocrine Insufficiency	246
Evaluation of Suspected Malabsorption	246
Specific Disorders Associated With Malabsorption	247
Malabsorption of Specific Nutrients	247
Disaccharidase Deficiency	247
Transport Defects at the Brush Border	247
Generalized Malabsorption	247
Celiac Disease	247
Inflammatory Diseases	247
Infiltrative Disorders	248
Infectious Diseases	248
Small Bowel Bacterial Overgrowth	248
Tropical Sprue	248
Whipple's Disease	248
Other Infections	248
Luminal Problems Causing Malabsorption	249
Pancreatic Exocrine Insufficiency	249
Bile Acid Deficiency	249
Zollinger-Ellison Syndrome	249
Postoperative Malabsorption	249
References	249
Nonalcoholic Fatty Liver Disease	249
Current Diagnosis	249
Current Therapy	250
Nonalcoholic fatty liver disease	250
Epidemiology of NAFLD	250
Risk Factors for NAFLD	250
Pathophysiology of NAFLD	251
Clinical Manifestations of NAFLD	251
Diagnosis of NAFLD (Figure 3)	252
Role of Liver Biopsy in NAFLD	253
Noninvasive Testing in NAFLD	254
Hepatic Steatosis	254
Assessing Fibrosis	254
Therapy of NAFLD (Table 1)	254
Lifestyle Modifications in NAFLD	254
Pharmacotherapeutics in NAFLD	255
Prevention of NAFLD	255
Monitoring of NAFLD	255
References	255
Pancreatic Cancer	255
Epidemiology	255
Risk Factors	256
Screening	256
Clinical Presentation	256
Diagnosis	256
Staging	256
Treatment	256
Palliative Care	256
References	257
Tumors of the Colon and Rectum	257
Current Diagnosis	257
Current Therapy	257
Background, Epidemiology, and Etiology	257
Adenomatous Polyps	257
Familial Colorectal Cancer Syndromes	258
Inflammatory Bowel Disease	258
Evaluation	258
Screening Average-Risk Patients	258
Screening High-Risk Patients	259
Symptoms and Diagnosis	259
Management	259
Preoperative Management	259
Surgery for Colonic Tumors	260
Surgery for Rectal Tumors	260
Complicated Disease	260
Surgery for High-Risk Conditions	260
Pathologic Staging and Adjuvant Therapy	260
Metastatic Disease	261
Surveillance	261
References	261
Tumors of the Stomach	261
Current Diagnosis	261
Current Therapy	262
Gastric Adenocarcinoma	262
Classification and Epidemiology	262
Risk Factors	262
Diagnosis	262
Staging	263
Treatment	263
Gastrointestinal Stromal Tumors	263
Carcinoid Tumors	264
Gastric Lymphomas	264
References	264
Endocrine and Metabolic Disorders	265
Acromegaly	265
Current Diagnosis	265
Current Therapy	265
Physiology, Biochemistry, and Regulation of the GH/IGF-1 Axis	265
Etiopathogenesis of Growth Hormone-Secreting Tumors	265
Clinical Manifestations	266
Local Tumor Effects	266
Consequences of the GH/IGF-1 Excess	266
Skeletal Growth and Skin Changes	266
Musculoskeletal System	266
Cardiovascular System	266
Respiratory Abnormalities	267
Abnormalities in Glucose Metabolism	267
Abnormalities in Lipid Metabolism	267
Bone and Calcium Metabolism	267
Neoplasia	267
Associated Endocrine Abnormalities	267
Mortality	267
Biochemical Diagnosis	267
Imaging	267
Treatment	267
Surgery	267
Pharmacologic Therapy	268
Radiation Therapy	268
References	268
Adrenocortical Insufficiency	269
Current diagnosis	269
Current therapy	269
Epidemiology	269
Risk Factors	269
Hematology	377
Acute Leukemia in Adults	377
Current diagnosis	377
Current therapy	377
Epidemiology	377
Risk Factors	377
Pathophysiology	378
Clinical Manifestations	378
Diagnosis	378
Differential Diagnosis	380
Treatment of AML	380
Treatment of ALL	381
Immune-Based Therapies in Acute Leukemia	381
Monitoring	381
Management of Complications	381
References	382
Aplastic Anemia	382
Current Diagnosis	382
Current Therapy	382
Definition	382
Differential Diagnosis	382
Supportive Care	383
Treatment	384
Immunosuppressive Therapy	384
Hematopoietic Cell Transplantation	384
Long-Term Complications of Treatment	385
Conclusions	385
Acknowledgments	385
References	385
Blood Component Therapy and Transfusion Reactions	386
Current Diagnosis	386
Current Therapy	386
Therapeutic Use of Blood Components	386
Red Blood Cells	386
Indications	386
Transfusion Triggers	386
Dosage	386
Autoimmune Hemolytic Anemia	386
Special Situation	386
Platelets	387
Indications	387
Transfusion Triggers	387
Prevention of Bleeding	387
Treatment of Bleeding	387
Dosage	387
Out of ABO Group Platelet Transfusion	387
Unresponsiveness to Platelet Transfusion	387
Diseases of the Head and Neck	475
Dry Eye Syndrome	475
Current Diagnosis	475
Current Therapy	475
Introduction	475
Epidemiology	475
Risk factors	475
Pathophysiology	475
Prevention	475
Clinical Manifestations	475
Diagnosis	475
Differential Diagnosis	475
Treatment	475
Complications	477
Monitoring	477
Conclusions	477
References	477
Glaucoma	477
Current Diagnosis	477
Current Therapy	477
Primary Open Angle Glaucoma	478
Treatment	478
Topical Glaucoma Medications	478
Prostaglandin Analogues	478
β-Blockers	479
Selective α2 Agonists	479
Carbonic Anhydrase Inhibitors	479
Combined Topical Medications	479
Oral Carbonic Anhydrase Inhibitors	479
Laser Trabeculoplasty	479
Surgery	479
Visual Impairment and Blindness	479
Acute Angle Closure Glaucoma	479
Mechanism of Acute Angle Closure: Pupillary Block	479
Diagnosis	480
Treatment	480
References	480
MÉnière's Disease	480
Current Diagnosis	480
Current Therapy	480
Epidemiology	481
Risk Factors	481
Pathophysiology	481
Prevention	481
Clinical Manifestations	481
Diagnosis	482
Differential Diagnosis	482
Treatment	482
Medical Management	482
Bilateral Ménière's Disease	482
Serviceability of Hearing	483
Injections and Surgical Treatments	483
Intratympanic Gentamicin	483
Endolymphatic Sac Surgery	483
Intratympanic Steroids	483
Vestibular Neurectomy	483
Labyrinthectomy	483
Meniett Treatment	483
Monitoring	484
Complications	484
Conclusion	484
References	484
Otitis Externa	484
Current Diagnosis	484
Current Therapy	484
Epidemiology	484
Risk Factors	484
Pathophysiology	484
Prevention	484
Clinical Manifestations	484
Diagnosis	484
Differential Diagnosis	484
Treatment	484
Monitoring	485
Complications	485
References	486
Otitis Media	486
Current Diagnosis	486
Current Therapy	486
Epidemiology	486
Risk Factors	486
Pathophysiology	486
Prevention	486
Clinical Manifestations	487
Diagnosis	487
Differential Diagnosis	487
Treatment	488
Treatment Options: Observation	488
Treatment Options: Antibiotic Therapy	488
Treatment Options: Surgery	489
Treatment Options: Analgesia	489
Conclusion	490
Red Eye	490
Current Diagnosis	490
Current Therapy	490
Physical Examination	490
Conjunctivitis	490
Viral Conjunctivitis	491
Bacterial Conjunctivitis	491
Conjunctivitis of the Newborn	491
Conjunctivitis-Otitis Media Syndrome	492
Methicillin-Resistant Staphylococcus Aureus Conjunctivitis	492
Allergic Conjunctivitis	492
Subconjunctival Hemorrhage	492
Corneal Abrasion	492
Other Causes of Red Eye	493
Blepharitis	493
Hordeolum (Stye)	493
Episcleritis	493
Scleritis	493
Acute Angle Closure Glaucoma	494
Anterior Uveitis	494
References	494
Rhinosinusitis	494
Current Diagnosis	494
Current Therapy	495
Epidemiology of Acute Rhinosinusitis and Predisposing Factors	495
Predisposing Factors	495
Pathogenesis and Etiology of Rhinosinusitis	495
Diagnosis of Acute Rhinosinusitis	495
Imaging	495
Differential Diagnosis	495
Treatment of Acute Rhinosinusitis	495
Symptomatic Treatment	495
Antibiotic Treatment	496
Complications and Referral	496
References	496
Temporomandibular Disorders	496
Epidemiology	496
Signs and Symptoms	496
Anatomy and Pathophysiology	497
Pathophysiology of Intracapsular TMJ Pain Disorders	497
Pathophysiology of Masticatory Muscle Pain Disorders	497
Etiology	497
History and Examination	498
Treatment	498
Patient Education	499
Pharmacologic Therapy	499
Physical Therapy	499
Other Therapeutic Considerations	499
References	499
Uveitis	499
Current Diagnosis	499
Current Therapy	499
Clinical Features and Diagnosis	500
The Infectious Diseases	513
Amebiasis	513
Current diagnosis (See also Box 1)	513
Current therapy (See also Box 2)	513
Epidemiology and Risk Factors for Acquisition	513
Pathophysiology and Susceptible Host Factors to Invasive Diseases	513
Clinical Manifestations and Complications of Amebiasis	513
Diagnosis	514
Therapy	514
Monitoring after Treatment and Disease Prevention	514
References	515
Anthrax	515
Current diagnosis	515
Current therapy	515
Background	516
Epidemiology	516
Pathophysiology	516
Clinical Manifestations	516
Cutaneous Anthrax	516
Inhalation Anthrax	516
Gastrointestinal Tract Anthrax	516
Injection Anthrax	516
Meningitis	516
Diagnosis	516
Specimen Collection	516
Treatment	517
Supportive Care	517
Antimicrobial Treatment for Systemic Disease with Possible Meningitis	517
Antimicrobial Treatment for Systemic Disease when Meningitis is Ruled Out	517
Treatment for Cutaneous Anthrax without Systemic Involvement	517
Antitoxins	517
Pregnancy	517
Prognosis	517
Prevention	518
References	518
Babesiosis	518
Current diagnosis	518
Current therapy	518
Epidemiology	518
Clinical Features	518
Therapy	519
References	519
Bacterial Meningitis	519
Current Diagnosis	519
Current Therapy	519
Diagnosis	520
Antibiotic Selection	520
Special Considerations for Antibiotic Therapy	520
Adjunctive Therapy	522
Chemoprophylaxis for Bacterial Meningitis	522
Vaccines for Bacterial Meningitis	522
References	523
Brucellosis	523
Current Diagnosis	523
Current Therapy	523
Epidemiology	523
Risk Factors	524
Pathophysiology	524
Diagnosis	524
Differential Diagnosis	524
Treatment	525
Monitoring	525
Complications	526
Prevention	526
References	526
Campylobacter	526
Current Diagnosis	526
Current Therapy	526
Epidemiology	527
Risk Factors	527
Pathophysiology	527
Prevention	527
Clinical Manifestations	527
Diagnosis	527
Differential Diagnosis	527
Treatment	527
Complications	528
References	528
Cat Scratch Disease	528
Current Diagnosis	528
Current Therapy	528
Epidemiology	528
Clinical Manifestations	528
Typical Cat Scratch Disease	529
Atypical Cat Scratch Disease	529
Diagnosis	529
Differential Diagnosis	529
Treatment	529
The Nervous System	671
Acute Facial Paralysis	671
Current Diagnosis	671
Current Therapy	671
Epidemiology and Risk Factors	671
Pathophysiology	671
Clinical Manifestations	671
Diagnosis and Differential Diagnosis	671
Treatment	672
Medical Therapy	672
Surgical Therapy	672
Monitoring and Complications	672
References	672
Alzheimer's Disease	673
Current Diagnosis	673
Current Therapy	673
Risk Factors	673
Prevention	673
Clinical Features	673
Differential Diagnosis	674
Screening for Cognitive Impairment	674
Diagnostic Evaluation	675
History	675
Cognitive Status Examination	675
Physical Examination	675
Laboratory Testing and Neuroimaging	675
Establishment of a Working Diagnosis	675
Treatment	676
Counseling and Caregiver Support	676
Management of Cognitive Symptoms	677
Management of Behavioral Symptoms	677
Monitoring	678
References	678
Brain Tumors	678
Current Diagnosis	678
Current Therapy	678
Metastatic Tumors	679
Meningiomas	679
Gliomas	680
High-Grade Gliomas	680
Low-Grade Gliomas	681
Primary Central Nervous System Lymphoma	681
References	682
Gilles de la Tourette Syndrome	682
Current Diagnosis	682
Clinical Course	682
Diagnosis and Differential Diagnosis	683
Treatment	683
α2-Adrenergic Agonists	683
Dopamine Receptor Blocking Agents	683
Other Tic-Suppressing Medications	684
Behavioral Therapy	684
Treatment of Comorbid Conditions	684
Summary	684
References	684
Intracerebral Hemorrhage	684
Current Diagnosis	684
Current Therapy	685
Epidemiology	685
Risk Factors	685
Pathophysiology	685
Prevention	685
Clinical Manifestations	685
Diagnosis	685
Differential Diagnosis	686
Treatment	686
Monitoring	686
Complications	686
References	687
Ischemic Cerebrovascular Disease	687
Prevention	687
Antithrombotic Therapy	688
Management of Carotid Stenosis	688
Management of Acute Ischemic Stroke	688
Thrombolysis	688
Endovascular Thrombectomy	688
Antithrombotic Drugs	689
Treatment of Stroke Complications	689
References	689
Migraine Headache	689
Current Diagnosis	689
Current Therapy	689
Definition	689
Epidemiology	690
Risk Factors	690
Pathophysiology	690
Prevention	690
Triggers	690
Prophylactic Medications	690
Nonpharmacologic Therapies	690
Clinical Manifestations	690
Aura	690
Symptoms	690
Duration and Complications	690
Diagnosis	691
Differential Diagnosis	692
Treatment	692
Chronic Migraine	693
Monitoring	693
References	693
Multiple Sclerosis	693
Current Diagnosis	693
Current Therapy	693
Risk Factors	693
Pathophysiology	693
Prevention	694
Clinical Manifestations	694
Diagnosis	694
Differential Diagnosis	694
Treatment	695
Monitoring	695
Complications	695
References	698
Myasthenia Gravis	698
Current Diagnosis	698
Current Therapy	698
Epidemiology	698
Risk Factors	698
Pathophysiology	698
Prevention	699
Clinical Manifestations	699
Diagnosis	699
Differential Diagnosis	700
Therapy	700
Symptomatic Therapy	700
Corticosteroids	700
Thymectomy	700
Other Immunomodulatory Therapies	701
Treatment Considerations in Pregnancy	701
Monitoring	701
Complications	702
References	702
Optic Neuritis	702
Current Diagnosis	702
Current Therapy	702
Epidemiology	702
Risk Factors	702
Pathophysiology	702
Prevention	702
Clinical Manifestations	702
Diagnosis	703
Differential Diagnosis	703
Treatment and Monitoring	703
Complications	703
References	703
Parkinson's Disease	703
Current Diagnosis	703
Current Therapy	704
Epidemiology	704
Risk Factors	704
Pathophysiology	704
Clinical Manifestations	704
Diagnosis	704
Differential Diagnosis	705
Treatment	705
Monitoring	706
Complications and Nonmotor Symptoms	707
References	708
Rehabilitation of the Stroke Patient	708
Current Therapy	708
Hemiparesis	708
Dysphagia	709
Hemiplegic Shoulder Pain	709
Spasticity	710
Cognitive Dysfunction	710
Depression and Neuropharmacology	710
Bladder Dysfunction	710
Mobility and Use of Adaptive Equipment	711
Falls	711
Visual Impairment	711
Brain-Based Therapies: Noninvasive Brain Stimulation	712
Robotics	712
Conclusions	712
References	712
Seizures and Epilepsy in Adolescents and Adults	712
Current Diagnosis	712
Current Therapy	712
Epidemiology	713
Classification	713
Definition of Epilepsy	713
Diagnosis	714
Differential Diagnosis	715
Treatment	716
Characteristics of Specific Antiepileptic Drugs	716
Phenytoin	716
Carbamazepine	716
Phenobarbital	717
Valproic Acid	717
Ethosuximide	718
Felbamate	718
Gabapentin	718
Pregabalin	718
Lamotrigine	719
Levetiracetam	719
Brivaracetam	719
Oxcarbazepine	719
Tiagabine	719
Topiramate	719
Zonisamide	719
Vigabatrin	719
Rufinamide	720
Lacosamide	720
Clobazam	720
Perampanel	720
Eslicarbazepine	720
Cannabidiol	720
Special Populations	720
Women	720
Elderly Patient	720
Pharmacoresistant or Intractable Epilepsy	720
References	721
Sleep Disorders	721
The International Classification of Sleep Disorders	721
Clinical Approach to the Sleep Medicine Patient: The Interview and Examination	721
Diagnostic Tools in the Sleep Laboratory	723
Polysomnography	723
Home Sleep Apnea Testing	723
Multiple Sleep Latency and Maintenance of Wakefulness Testing	724
Actigraphy Monitoring	724
Diagnostic and Therapeutic Approach to Common Sleep Disorders	724
Insomnia	724
Sleep-Disordered Breathing	727
Obstructive SDB: Snoring and OSA	727
Weight loss	727
Positional therapy	727
Positive airway pressure	728
Oral appliances	729
Nasal valve appliances	729
Oral pressure therapy	729
Surgery	729
Central Sleep Apnea Syndrome	729
Treatment-Emergent Central Sleep Apnea Syndrome	729
Sleep-Related Hypoventilation	729
Narcolepsy and Central Disorders of Hypersomnolence	730
Circadian Rhythm Sleep Wake Disorders	730
Parasomnias and Other Nocturnal Events	732
Sleep-Related Movement Disorders	733
RLS and PLMS	733
Sleep-Related Leg Cramps	734
Sleep-Related Bruxism	735
Other Sleep-Related Movement Disorders	735
Isolated Symptoms and Normal Variants	735
Other Sleep Disorders	735
Sleep-Related Medical and Neurologic Disorders	735
Conclusions	735
References	736
Sports-Related Head Injuries	736
Current Diagnosis	736
Current Therapy	736
Introduction and Epidemiology	736
Risk Factors	737
Pathophysiology	737
Assessment and Diagnosis of Sports-Related Head Injury	737
Clinical Manifestations	738
Therapy (or Treatment)	738
Monitoring Concussions	739
Management of Concussion Complications	739
Prevention	740
References	740
Trigeminal Neuralgia	740
Current diagnosis	740
Current therapy	740
Epidemiology	740
Risk factors	740
Pathophysiology	740
Prevention	741
Clinical manifestations	741
Diagnosis	741
Differential Diagnosis	741
Treatment	741
Monitoring	741
Management of Complications	742
References	742
Viral Meningitis	742
Current Diagnosis	742
Current Therapy	742
Epidemiology	742
Pathophysiology	742
Prevention	742
Clinical Manifestations	742
Diagnosis	742
Differential Diagnosis	744
Treatment	744
Complications	745
References	745
Psychiatric Disorders	747
Alcohol Use Disorders	747
Current Diagnosis	747
Current Therapy	747
Epidemiology	747
Economic and Medical Sequelae	747
Screening	747
Screening Rationale	747
Brief Screening	747
Diagnosis	748
Brief Intervention	748
Intention	748
Procedure	750
Assess	750
Advise	750
Agree	751
Assist	751
Arrange	751
Treatment	751
Detoxification	751
Assessment	751
Pharmacologic Therapy	751
Psychosocial Interventions for Alcohol Use Disorder	751
Medication Management of Alcohol Dependence	753
References	753
Delirium	753
Current Diagnosis	753
Current therapy	753
Epidemiology	754
Risk Factors	754
Pathophysiology	754
Prevention	754
Clinical Manifestations	754
Diagnosis	754
Differential Diagnosis	755
Treatment	755
Monitoring	755
Complications	755
References	755
Drug Abuse	756
Current Diagnosis	756
Current Therapy	756
Epidemiology	756
Diagnosis	756
Tobacco and Nicotine	757
Cannabis	758
Cocaine, Methamphetamine, and Other Stimulants	758
Opioids	758
Sedative-Hypnotics	760
Conclusion	760
References	761
Eating Disorders	761
Bulimia Nervosa	761
Current Diagnosis	761
Current Treatment	761
Diagnosis	761
Epidemiology	761
Etiology	762
Treatment	762
Binge Eating Disorder	762
Current Diagnosis	762
Current Treatment	762
Diagnosis	762
Epidemiology	762
Etiology	763
Treatment	763
Anorexia Nervosa	763
Current Diagnosis	763
Current Treatment	763
Diagnosis	763
Epidemiology	763
Etiology	764
Treatment	764
Avoidant-Restrictive Food Intake Disorder	764
Current Diagnosis	764
Current Treatment	764
Diagnosis	764
The Respiratory System	793
Acute Respiratory Failure	793
Current Diagnosis	793
Current Therapy	793
Definitions and Pathophysiology	793
Acute Hypoxic Respiratory Failure	793
Acute Hypercapneic Respiratory Failure	794
Treatment	794
Oxygen Therapy	794
Mechanical Ventilation	795
Noninvasive Ventilation	795
Invasive Ventilation	796
Specific Causes of Acute Respiratory Failure	796
Acute Exacerbation of Chronic Obstructive Pulmonary Disease	796
Etiology and Diagnosis	797
Treatment	797
Acute Lung Injury and Acute Respiratory Distress Syndrome	797
Cardiogenic Pulmonary Edema	797
References	797
Asthma in Adolescents and Adults	798
Current Diagnosis	798
Current Therapy	798
Diagnosis	798
Assessment	798
Past Severity	798
Aggravating Factors	798
Current Status	798
Long-Term Management	799
Nonpharmacologic Therapy	799
Pharmacologic Step Therapy	800
Follow-up	801
Treatment of Exacerbations	801
Home Management	801
Emergency Department and Hospital Management	805
Summary	805
Atelectasis	805
Current Diagnosis	805
Current Therapy	805
Etiology	805
Compression Atelectasis	805
Surfactant Impairment	806
Gas Resorption	806
Pathophysiology	806
Clinical Presentation	806
Diagnosis	806
Treatment	806
References	806
Bacterial Pneumonia	806
Current Diagnosis	806
Current Therapy	806
Epidemiology	807
Etiology	807
Risk Factors	807
Community-Acquired Pneumonia (CAP) Pathogens	807
Hospital-Acquired Pneumonia	807
Diagnosis	807
Community-Acquired Pneumonia (CAP)	807
Hospital-Acquired Pneumonia	808
Treatment Setting	808
Pneumonia Severity Index (PSI)	808
CURB-65	808
SMART-COP	808
Treatment	809
Community-Acquired Pneumonia (CAP)	809
Hospital-Acquired Pneumonia	809
Prevention	810
References	810
Blastomycosis	811
Current Diagnosis	811
Current Therapy	811
Epidemiology	812
Pathophysiology	812
Clinical Manifestations	812
Blastomycosis in Special Populations	812
Diagnosis	812
Treatment	813
References	815
Bronchitis and Viral Respiratory Infections	816
Current Diagnosis	816
Current Therapy	816
Epidemiology	816
Pathophysiology	816
Clinical Manifestations	816
Diagnosis	816
Differential Diagnosis	816
Common Cold/Upper Respiratory Infections (URI)	816
Croup	816
Pertussis	817
Bronchiolitis	817
Therapy (or Treatment)	817
Decreasing Antibiotic Use	817
Recommended Cough Treatment	817
Cough Treatments that are not Recommended	817
References	817
Chronic Obstructive Pulmonary Disease	818
Current Diagnosis	818
Current Therapy	818
Epidemiology	818
Risk Factors	818
Pathophysiology	818
Diagnosis	819
Differential Diagnosis	819
Treatment of Stable COPD	819
Smoking Cessation	819
Pulmonary Rehabilitation	819
Vaccinations	819
Medications	819
Noninvasive Ventilation	821
Surgical Remedies	821
Supplemental Oxygen	822
Treatment of Exacerbations of COPD	822
References	822
Coccidioidomycosis	822
Current Diagnosis	822
Current Therapy	822
Clinical Manifestations	823
Diagnosis	823
Treatment	823
References	824
Cystic Fibrosis	824
Current Diagnosis	824
Current Therapy	824
Pathophysiology	824
Diagnosis	825
Clinical Presentation With Specific Therapy	826
Gastrointestinal	826
Pulmonary	826
Treatment	827
Gene Therapy	827
CFTR Potentiator	827
Hydration of Airway Surface Fluid	827
Physical Therapy	827
Bronchodilators	827
Antibiotics	827
Mucolytic Therapy	827
Antiinflammatory Therapy	827
Corticosteroids	828
Nonsteroidal Antiinflammatory Drugs	828
Lung Transplantation	828
References	828
Histoplasmosis	828
Current Diagnosis	828
Current Therapy	828
Mycology and Pathogenesis	828
Epidemiology	828
Clinical Manifestations	829
Acute Pulmonary Histoplasmosis	829
Chronic Pulmonary Histoplasmosis	829
Disseminated Histoplasmosis	829
Mediastinal Manifestations of Histoplasmosis	829
Central Nervous System Histoplasmosis	829
Other Manifestations of Histoplasmosis	829
Diagnosis	830
Histopathology	830
Cultures	830
Serology	830
Antigen Detection	830
Treatment	830
References	831
Hypersensitivity Pneumonitis	831
Current Diagnosis	831
Current Therapy	832
Pathophysiology	832
Clinical Presentation and Diagnosis	832
Treatment	832
References	833
Legionellosis (Legionnaires' Disease and Pontiac Fever)	833
Epidemiology	833
Clinical Features	833
Diagnosis	833
Treatment	833
Obstructive Sleep Apnea	834
Current Diagnosis	834
Current Therapy	834
Epidemiology	834
Risk Factors	834
Pathophysiology	835
Prevention	835
Diagnosis	835
Treatment	835
Continuous Positive Airway Pressure Therapy	835
Oral Appliances	835
Surgical Procedures	836
Monitoring	836
References	836
Pleural Effusions and Empyema Thoracis	836
Etiology	836
Diagnosis	837
Imaging	837
Thoracentesis	837
Pleural Fluid	837
Treatment	837
Infected Pleural Space and Empyema	837
References	838
Pneumoconiosis: Asbestosis and Silicosis	838
Current Diagnosis	838
Current Therapy	838
Asbestosis	838
Criteria for Diagnosis	839
Asbestos-Related Benign Pleural Disease	839
Lung Cancer and Malignant Mesothelioma	839
Treatment	839
Silicosis	840
Radiographic Patterns of Silicosis	840
Silicosis Syndromes	840
Criteria for Diagnosis	840
Treatment	840
Disclaimer	840
References	840
Primary Lung Abscess	841
Current Diagnosis	841
Current Therapy	841
Definition and Classification	841
Epidemiology and Risk Factors	841
Pathophysiology	841
Clinical Manifestations	841
Diagnosis	841
Differential Diagnosis	842
Treatment	842
Prognosis	842
References	842
Primary Lung Cancer	842
Current Diagnosis	842
Current Therapy	842
Epidemiology	843
Etiology	843
Clinical Presentation	843
Screening	844
Diagnosis and Evaluation	844
Treatment	844
Non-Small Cell Lung Cancer	844
Small Cell Lung Cancer	847
References	847
Sarcoidosis	848
Current Diagnosis	848
Current Therapy	848
Epidemiology	848
Immunopathogenesis	848
Clinical Features and Clinical Course	848
Pulmonary Sarcoidosis	848
Extrapulmonary Sarcoidosis	849
Diagnosis and Initial Workup	850
Treatment	851
References	851
Tuberculosis and Other Mycobacterial Diseases	851
Tuberculosis	852
Epidemiology	852
Natural History	852
Diagnosis of Active Tuberculosis	853
Principles of Treatment	853
Chemoprophylaxis	853
Definitive Therapy	854
Treatment of Tuberculosis in Resource-Poor Settings	856
Treatment of Tuberculosis in Special Circumstances	856
Multidrug-Resistant Tuberculosis	856
Extrapulmonary and Sputum-Negative Tuberculosis	856
Mycobacterium avium Complex Infection	856
Mycobacterium leprae	857
Mycobacteria Other Than Tuberculosis	857
References	857
Venous Thromboembolism	858
Current Diagnosis	858
Current Therapy	858
Pathophysiology/Risk Factors	858
Acquired Risk Factors	858
Genetics of Venous Thromboembolism	859
Epidemiology and Natural History	859
Long-Term Complications of VTE	859
Postthrombotic Syndrome (PTS)	859
Chronic Thromboembolic Pulmonary Hypertension (CTEPH)	859
Diagnosis of Deep Venous Thrombosis	860
Clinical Features	860
D-Dimer Screening	860
Imaging	860
Ultrasonography	860
Contrast Venography	861
Diagnosis of PE	861
Clinical Features	861
Chest X-Ray, Electrocardiography, and Troponin	861
Ventilation/Perfusion (V/Q) Scanning	861
Computed Tomography Pulmonary Angiography	861
Pulmonary Angiography	861
Magnetic Resonance Angiography	861
Diagnosis of Recurrent DVT	862
Treatment of Venous Thromboembolism	862
Anticoagulation Therapy for VTE	862
Choice of Initial Anticoagulant Therapy	862
Comparison of Warfarin Versus DOACs	863
Cancer-Associated Thrombosis	864
Special Considerations in the Acute Management of Venous Thromboembolism (VTE)	864
Massive Pulmonary Embolism (PE) With Hemodynamic Instability	864
Extensive Proximal Vein Lower Extremity Thrombosis	864
Spontaneous Proximal Upper Extremity Thrombosis	864
VTE Presenting With Paradoxical Embolism	865
Acute Venous Thromboembolism With Contraindication to Anticoagulation	865
Isolated Subsegmental Pulmonary Embolism and Incidental VTE	865
Special Circumstances for Anticoagulant Monitoring	865
Reversal Agents	865
Duration of Anticoagulation	865
Clinical Presentation	865
Thrombus Site	866
Standard Versus Indefinite Anticoagulation	866
Clinical Decision Making	866
Prevention of Venous Thromboembolism	867
General Surgery	867
Orthopedic Surgery	867
Acute Medical Illness	867
References	868
Viral and Mycoplasmal Pneumonias	868
Current Diagnosis	868
Current Therapy	869
Influenza (Human, Avian, and Swine)	869
Anti-Influenza Therapy	871
Mycoplasma pneumoniae	871
Therapy	872
References	872
Viral Respiratory Infections	873
Current Diagnosis	873
Current Therapy	873
Common Colds	873
Influenza-Like Illness	873
Croup	874
Bronchiolitis	874
References	874
Rheumatology and the Musculoskeletal System	875
Ankylosing Spondylitis	875
Current Diagnosis	875
Current Therapy	875
Epidemiology	875
Pathophysiology	875
Clinical Manifestations	875
Diagnosis	876
Differential Diagnosis	876
Treatment	876
Monitoring	876
Complications	877
References	877
Bursitis and Tendinopathy	877
Current diagnosis	877
Current therapy	877
Tendinopathy	877
Background	877
Evaluation	878
Prevention	878
Treatment	879
Bursitis	880
Background	880
Evaluation	881
Treatment	881
References	882
Common Sports Injuries	882
Current Diagnosis	882
Current Therapy	882
Ankle Injuries	882
Lateral Ankle Sprain	883
Medial Ankle Sprain	883
High Ankle Sprain	883
Osteochondral Ankle Injuries	883
Anterior Cruciate Ligament Injuries	884
PCL Injuries	885
MCL Injuries	885
Osteochondral Knee Injuries	886
Hand Injuries	886
Mallet Finger	886
Jersey Finger	886
Proximal Interphalangeal Joint Dorsal Dislocation	887
Scaphoid Fracture	887
Overuse Injuries	888
Tendinosis	888
Stress Fractures	888
Spondylolysis and Spondylolisthesis	890
References	892
Connective Tissue Disorders	893
Current Diagnosis	893
Current Therapy	893
Lupus Erythematosus	893
Clinical Features	893
Management	894
Prevention	894
Treatment of Cutaneous Lupus Erythematosus	894
Treatment of Systemic Lupus Erythematosus	894
Treatment of Musculoskeletal Manifestations	894
Treatment of Hematologic Manifestations	894
Treatment of Renal Manifestations	895
Treatment of Nervous System Manifestations	895
Dermatomyositis and Polymyositis	895
The Sexually Transmitted Diseases	923
Chlamydia Trachomatis	923
Current Diagnosis	923
Current Therapy	923
Epidemiology	923
Risk Factors	923
Pathophysiology	923
Prevention	923
Clinical Manifestations	924
Diagnosis	924
Differential Diagnosis	924
Treatment	924
Monitoring	925
Complications	925
References	925
Condylomata Acuminata	925
Current Diagnosis	925
Current Therapy	925
Epidemiology	926
Risk Factors	926
Pathophysiology	926
Prevention	926
Clinical Manifestations	926
Diagnosis	926
Differential Diagnosis	926
Treatment	926
Monitoring	926
Complications	927
References	927
Genital Ulcer Disease: Chancroid, Granuloma Inguinale, and Lymphogranuloma	928
Chancroid	928
Diseases of the Skin	939
Acne Vulgaris	939
Current Diagnosis	939
Current Therapy	939
Epidemiology	939
Prevention	939
Pathophysiology	939
Diagnosis	939
Clinical Manifestations	939
Differential Diagnosis	939
Treatment	940
References	940
Atopic Dermatitis	940
Current Diagnosis	940
Current Therapy	941
Pathophysiology	941
Diagnosis and Clinical Assessment	941
Management of Atopic Dermatitis and Associated Conditions	942
Daily Maintenance Care	942
Topical and Systemic Medications	942
Food Allergies	942
Infections	943
Inhalant Allergies and Asthma	943
Investigational Treatments for Atopic Dermatitis	943
References	944
Bacterial Diseases of the Skin	944
Current Diagnosis	944
Current Therapy	944
Common Infections	944
Impetigo	944
Folliculitis	944
Cellulitis	945
Abscess	945
Life-Threatening Infections	945
Group A β-Hemolytic Streptococcal Gangrene	945
Synergistic Necrotizing Cellulitis	945
Clostridial Myonecrosis	946
Necrotizing Fasciitis	946
Special Circumstances	947
Fournier's Gangrene	947
Ecthyma Gangrenosum	947
Sea Water and Fresh Water Infections	947
Conclusion	948
References	948
Bullous Diseases	948
Current Diagnosis	948
Current Therapy	948
Epidemiology	948
Risk Factors	948
Pathophysiology	948
Prevention	948
Clinical Manifestations	948
Complications	948
Diagnosis	948
Differential Diagnosis	948
Treatment	949
Principles	949
Pharmacologic Treatment	949
Glucocorticoids	949
Azathioprine	949
Mycophenolate Mofetil	949
Methotrexate	949
Cyclophosphamide	949
Cyclosporine	949
Dapsone	949
Tetracycline	949
Niacinamide (Nicotinamide)	949
High-Dose Intravenous Immunoglobulin	949
Rituximab	950
Plasmapheresis and Immunoapheresis	950
Treatment of Individual Disorders	950
Pemphigoid	950
Bullous Pemphigoid	950
Mucous Membrane Pemphigoid	950
Epidermolysis Bullosa Acquisita	950
Dermatitis Herpetiformis	951
Linear Immunoglobulin A Disease	951
Pemphigus	951
Pemphigus Vulgaris	951
Pemphigus Foliaceous	951
Paraneoplastic Pemphigus	951
References	951
Cancer of the Skin	952
Current Diagnosis	952
Current Therapy	952
Basal Cell Carcinoma	952
Squamous Cell Carcinoma	953
Neoplasms of Adnexal Origin	953
Sebaceous Carcinoma	954
Microcystic Adnexal Carcinoma	954
Fibrohistiocytic Malignancies	954
Dermatofibrosarcoma Protuberans	954
Atypical Fibroxanthoma	954
Vascular Malignancies	954
Kaposi's Sarcoma	954
Angiosarcoma	954
Other Nonmelanoma Skin Cancers	954
Merkel Cell Carcinoma	954
Paget's Disease	955
Cutaneous Metastases	955
References	955
Contact Dermatitis	956
Current Diagnosis	956
Current Therapy	956
Diagnosis	957
Treatment	957
References	959
Cutaneous T-Cell Lymphomas, Including Mycosis Fungoides and Sézary Syndrome	959
Current Diagnosis	959
Current Therapy	959
Cutaneous T-Cell Lymphomas	959
Classification	959
Standard Diagnosis and Staging Methods	959
Mycosis Fungoides, Sézary Syndrome, and Variants	960
Clinical Features	960
Histopathologic and Cytologic Features	960
Immunophenotyping	960
Molecular Biology	960
TNMB Staging	960
Treatment	961
Phototherapy	961
Topical Therapy	961
Radiotherapy	962
Apheresis-Based Therapy	962
Cytokine Therapy	962
Tumor-Associated Antigen-Directed Therapies	962
Systemic Chemotherapy	962
Retinoids	963
Enzyme Inhibitors	963
Miscellaneous Therapies	963
Selection of Therapy	963
Lymphoproliferative Disorders Associated with Mycosis Fungoides and Sézary Syndrome	963
Types and Clinical Features	963
Treatment	963
References	963
Cutaneous Vasculitis	964
Current Diagnosis	964
Current Therapy	964
Leukocytoclastic Vasculitis	964
Epidemiology	964
Risk Factors	964
Pathophysiology	964
Clinical Manifestations	964
Diagnosis	964
Differential Diagnosis	964
Treatment	964
Monitoring	965
Complications	965
Cutaneous Vasculitis Associated with Systemic Vasculitis	965
References	966
Diseases of the Hair	966
Current Diagnosis	966
Current Therapy	966
Epidemiology	966
Risk Factors	966
Pathophysiology	966
Prevention	966
Clinical Manifestations	966
Diagnosis	966
Alopecia	966
Hirsutism	967
Differential Diagnosis	968
Treatment	968
Alopecia	968
Hirsutism	969
Monitoring	969
Complications	969
References	969
Diseases of the Mouth	969
Current diagnosis	969
Current therapy	970
Odontogenic Infection	970
Suspicion of Oral Cancer	971
Necrotizing Ulcerative Gingivitis	971
Oral Candidiasis	971
Xerostomia	972
Aphthous Stomatitis	972
Orofacial Herpes Simplex Infection	973
Erythema Multiforme	973
Erosive Lichen Planus and Similar Autoimmune Ulcerative Conditions of the Oral Mucosa	973
Corticosteroid Treatment of Immune-Mediated Oral Ulcers	974
Osteonecrosis of the Jaw	974
References	974
Diseases of the Nails	975
Anatomy	975
Physiology	975
Function	975
Diseases	975
Onychomycosis	975
Current Diagnosis: Onychomycosis	975
Clinical Features and Diagnosis	975
Current Therapy: Onychomycosis	976
The Urogenital Tract	1047
Acute Renal Failure	1047
Current Diagnosis	1047
Current Therapy	1047
Epidemiology and Definitions	1047
Classification	1047
Prerenal Azotemia	1048
Glomerular Disease	1049
Acute Tubular Necrosis	1049
Interstitial Disease	1050
Obstructive Disease	1050
Treatment	1050
Emerging Issues	1050
References	1051
Chronic Kidney Disease	1051
Current Diagnosis	1051
Current Therapy	1051
Prevalence of Chronic Kidney Disease	1051
Risk Factors for CKD	1051
Approach to the Diagnosis of Chronic Kidney Disease	1052
Management of Chronic Kidney Disease	1052
Staging of CKD	1052
CKD Stage 3 (moderately decreased GFR)	1052
CKD Stage 4 (Severely decreased GFR)	1052
CKD Stage 5 (Kidney failure)	1052
General Approach to Treatment of Chronic Kidney Disease	1052
Strategies to Slow Progression of CKD	1052
Blood Pressure Management	1052
Angiotensin- Converting Enzyme Inhibitors and Angiotensin Receptor Blockers	1053
Dietary Protein Restriction	1053
Avoid Nephrotoxic Medications	1054
Clinical Manifestations of Kidney Failure	1054
Measures Designed to Treat Comorbidity in Kidney Disease	1055
Anemia (Table 5)	1055
Metabolic Acidosis	1055
Divalent Ion Metabolism	1055
Hyperkalemia	1055
Volume Overload	1056
Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD)	1056
Cardiovascular Disease	1056
References	1056
Malignant Tumors of the Urogenital Tract	1057
Current Diagnosis	1057
Current Therapy	1057
Carcinoma of the Prostate	1059
Diagnosis	1059
Treatment	1060
Tumors of the Renal Parenchyma	1060
Renal Cell Carcinoma	1061
Diagnosis	1061
Treatment	1061
Benign Renal Tumors	1061
Metastatic Renal Lesions	1061
Tumors of the Renal Pelvis and Ureter	1061
Men’s Health	1085
Bacterial Infections of the Male Urinary Tract	1085
Current Diagnosis	1085
Current Therapy	1085
Distinguishing Complicated from Uncomplicated Infections	1085
Natural History	1085
Diagnosis and Localization	1086
Treatment	1086
Uncomplicated Infections	1086
Complicated Infections	1086
Prostatitis	1087
Long-Term Care Patients	1087
References	1087
Benign Prostatic Hyperplasia	1088
Epidemiology	1088
Pathophysiology	1088
Symptoms	1088
Diagnosis	1088
Treatment	1089
Active Surveillance and Watchful Waiting	1089
Complementary and Alternative Medicine	1090
Medical Therapy	1090
α-Blocker Medications	1090
5α-Reductase Inhibitors	1090
Minimally Invasive Procedures	1090
Surgical Therapy	1090
References	1091
Epididymitis and Orchitis	1091
Current Diagnosis	1091
Current Therapy	1091
Epidemiology	1091
Risk Factors	1091
Pathophysiology	1091
Clinical Manifestations	1091
Diagnosis	1092
Differential Diagnosis	1092
Therapy/Treatment	1092
Complications	1092
References	1092
Erectile Dysfunction	1092
Epidemiology	1092
Risk Factors	1092
Pathophysiology	1093
Prevention	1093
Clinical Manifestation	1093
Diagnosis	1093
Differential Diagnosis	1093
Therapy	1093
Monitoring	1094
Complications	1094
References	1094
Prostatitis	1094
Current Diagnosis	1094
Current Therapy	1094
Epidemiology	1095
Risk Factors	1095
Pathophysiology	1095
Prevention	1095
Clinical Manifestations	1095
Diagnosis	1095
Differential Diagnosis	1095
Therapy (or Treatment)	1095
Monitoring	1096
Complications	1096
References	1096
Women’s Health	1097
Abnormal Uterine Bleeding	1097
Current Diagnosis	1097
Current Therapy	1097
Epidemiology	1097
Pathophysiology	1097
Diagnosis	1097
Treatment	1097
References	1098
Amenorrhea	1098
Current Diagnosis	1098
Definition	1099
Menstrual Cycle	1099
Etiology	1099
Hypothalamic Compartment	1099
Constitutional Delay	1099
Congenital Causes	1100
Acquired Causes	1100
Pituitary Compartment	1100
Ovarian Compartment	1100
Outflow Tract Compartment	1100
Other Causes	1100
Diagnosis	1100
History	1100
Physical Examination	1100
Investigations	1101
Initial Investigations	1101
Follow-up Investigations	1101
References	1101
Bacterial Infections of the Urinary Tract in Women	1101
Current Diagnosis	1101
Current Therapy	1101
Acute Cystitis (Urinary Tract Infection)	1102
Acute Pyelonephritis	1102
Urethritis	1103
Asymptomatic Bacteruria	1103
Recurrent Cystitis	1103
Catheter Associated Urinary Tract Infection	1103
References	1103
Benign Breast Disease	1103
Current Diagnosis	1103
Current Therapy	1104
Presentation and Workup	1104
Breast Cancer Screening	1104
Palpable Breast Mass	1104
Nipple Discharge	1105
Benign Lesions	1105
Nonproliferative Lesions	1106
Proliferative Lesions Without Atypia	1106
Proliferative Lesions With Atypia	1106
Miscellaneous Benign Breast Conditions	1106
High-Risk Evaluation and Management	1106
Chemoprevention	1107
References	1107
Chapter 274Breast Cancer	1107
Current Diagnosis	1107
Current Therapy	1107
Overview	1108
Epidemiology	1108
Risk Factors	1108
Prevention	1108
Clinical Manifestations	1108
Differential Diagnosis	1108
Diagnosis	1108
Pathophysiology	1109
Treatment	1109
Monitoring and Survivorship	1110
References	1111
Cancer of the Endometrium	1111
Current Diagnosis	1111
Current Therapy	1111
Epidemiology	1111
Classification	1111
Type I tumors	1111
Type II tumors	1111
Risk Factors	1111
Pathophysiology	1112
Prevention	1112
Clinical Manifestations	1112
Diagnosis	1112
Staging	1112
Treatment	1112
Adjuvant Therapy	1113
Early-Stage Disease	1113
Metastatic Disease	1113
Recurrent Disease	1113
Combination Chemotherapy and Radiation Therapy	1113
Hormone Therapy	1113
Targeted Therapy	1113
Monitoring	1113
References	1114
Cancer of the Uterine Cervix	1114
Current Diagnosis	1114
Current Therapy	1114
Epidemiology	1114
Pathophysiology	1114
Prevention and Screening	1114
Staging	1115
Diagnosis	1115
Treatment	1115
Conclusion	1117
References	1117
Contraception	1117
Current Therapy	1117
Nonhormonal Methods	1118
Combined Hormonal Contraception	1118
Combined Oral Contraceptive Pills	1119
Contraceptive Patch	1119
Vaginal Ring	1119
Progestin-Only Contraceptives	1120
Pill	1120
Injectable	1120
Intrauterine System	1120
Implant	1120
Permanent	1120
Emergency Contraception	1120
Counseling	1120
References	1121
Dysmenorrhea	1121
Current Diagnosis	1121
Current Therapy	1121
Diagnosis	1121
Treatment	1121
Nonsteroidal Antiinflammatory Drugs	1121
COX-2 Inhibitors	1122
Oral Contraceptives	1122
Levonorgestrel Intrauterine System	1122
Nifedipine	1122
Transcutaneous Electrical Nerve Stimulation	1122
Topical Heat and Infrared Light	1122
Complementary and Alternative Medicine Approaches	1122
Herbal	1122
Acupressure and Acupuncture	1122
Yoga	1122
Spinal Manipulation	1122
Surgical Treatment	1122
Treatment of Endometriosis	1122
References	1123
Endometriosis	1123
Current Diagnosis	1123
Current Management	1123
Epidemiology	1124
Risk Factors	1124
Pathophysiology	1124
Clinical Manifestations	1124
Diagnosis/Differential Diagnosis	1124
Medical Therapy	1124
Surgical Therapy	1125
Monitoring	1125
References	1126
Female Sexual Dysfunction	1126
Current diagnosis	1126
Current Therapy	1126
Epidemiology	1126
Pathophysiology, Diagnosis, Treatment: Decreased Libido	1126
Pathophysiology, Diagnosis, Treatment: Sexual Pain	1127
A Note About Atrophy	1128
References	1128
Infertility	1128
Current Diagnosis	1128
Current Therapy	1128
Epidemiology	1128
Risk Factors	1128
Pathophysiology	1128
Prevention	1128
Clinical Manifestations	1129
Diagnosis	1129
Differential Diagnosis	1129
Male Factors	1129
Female Factors	1129
Ovulatory Dysfunction	1129
Tubal Factor	1129
Uterine Factor	1129
Combined	1129
Unexplained	1129
Prior Diagnosis	1129
Treatment	1129
Monitoring	1130
References	1130
Menopause	1130
Current Diagnosis	1130
Current Therapy	1130
Epidemiology	1130
Risk Factors	1130
Clinical Manifestations and Pathophysiology	1130
Diagnosis	1130
Differential Diagnosis	1131
Therapy	1131
Monitoring	1131
Side Effects of Systemic Hormone Therapy	1132
Safety of Hormone Therapy	1132
Extended Use/Discontinuation of Systemic Hormone Therapy	1133
Financial Disclosure	1133
References	1133
Ovarian Cancer	1133
Current Diagnosis	1133
Current Therapy	1133
Epidemiology	1134
Risk Factors	1134
Pathophysiology	1134
Prevention	1134
Clinical Manifestations	1134
Diagnosis	1135
Differential Diagnosis	1135
Therapy or Treatment	1135
Monitoring	1135
References	1135
Pelvic Inflammatory Disease	1136
Current Diagnosis	1136
Current Therapy	1136
Epidemiology	1136
Risk Factors	1136
Pathophysiology	1136
Clinical Presentation	1137
Diagnosis	1137
Differential Diagnosis	1137
Treatment	1137
Patient Monitoring and Counseling	1137
Complications	1137
References	1138
Premenstrual Syndrome	1138
Current Diagnosis	1138
Current Therapy	1138
Symptoms	1138
Prevalence	1138
Morbidity	1138
Etiology	1139
Diagnosis	1139
Treatment	1139
Selective Serotonin Reuptake Inhibitors	1139
Luteal Phase Dosing	1140
Insufficient Response to Selective Serotonin Reuptake Inhibitors	1140
Other Treatments	1140
Hormonal	1140
Anxiolytics	1140
Nonpharmacologic	1140
Treatment Duration	1140
Conclusions	1140
References	1141
Uterine Leiomyomas	1141
Current Diagnosis	1141
Current Therapy	1141
Epidemiology	1141
Risk Factors	1141
Pathophysiology	1141
Clinical Manifestations	1141
Diagnosis	1141
Differential Diagnosis	1142
Treatment	1142
Expectant Management	1142
Medical Treatments	1142
Surgical Treatments	1142
References	1143
Vulvar Neoplasia	1143
Current Diagnosis	1143
Current Therapy	1143
Benign Cystic Neoplasms	1143
Benign Solid Neoplasms	1143
Condyloma Acuminatum	1143
Intraepithelial Neoplasms of the Vulva	1144
Vulvar Intraepithelial Neoplasia	1144
Paget's Disease	1144
Invasive Vulvar Lesions	1144
Squamous Cell Carcinomas and Adenocarcinomas	1145
Verrucous Carcinoma	1145
Malignant Melanoma	1145
Basal Cell Carcinoma	1145
Sarcomas	1145
References	1146
Vulvovaginitis	1146
Current diagnosis	1146
Current therapy	1146
Differential Diagnosis	1146
Clinical Manifestations	1146
Diagnosis	1146
Trichomoniasis	1147
Treatment of trichomoiasis	1147
Bacterial Vaginosis (BV)	1147
Treatment of Bacterial Vaginosis	1148
Vulvovaginitis Candidiasis (VVC)	1148
Treatment of Vaginal Candidiasis	1148
References	1149
Pregnancy and Antepartum Care	1151
Children's Health	1169
Acute Leukemia in Children	1169
Classification	1169
Epidemiology	1169
Prognosis	1169
Etiology	1169
Predispositions	1169
Cellular Pathogenesis	1170
Molecular Pathogenesis	1170
Clinical Presentation	1173
Medical Emergencies in Childhood Leukemia	1173
Differential Diagnosis	1174
Risk Stratification	1175
Treatment	1175
Acute Lymphoblastic Leukemia	1176
Acute Myeloid Leukemia	1176
Relapse	1176
Late Effects	1176
References	1177
Adolescent Health	1177
Current Diagnosis	1177
Current Therapy	1177
Setting the Stage for the Adolescent Visit	1178
Consent and Confidentiality Laws-Consent Does Not Equal Confidential	1178
The HEADS Interview	1178
Home/Education/Employment/Activities/Accident Prevention	1179
Diet/Disordered Eating	1179
Drugs (Substance Use)	1179
Depression/Suicide/Self-Harm	1179
Sex	1179
Sleep/Social Media	1180
Summary	1180
References	1180
Asthma in Children	1181
Current Diagnosis	1181
Current Therapy	1181
Epidemiology	1181
Risk Factors	1181
Pathophysiology	1181
Prevention	1181
Clinical Manifestations	1182
Diagnosis	1182
Differential Diagnosis	1182
Treatment	1182
Medications	1185
Rescue Medications	1185
Controller Medications	1185
Acute Asthma Exacerbations	1186
Monitoring	1187
Complications	1188
References	1188
Attention-Deficit/Hyperactivity Disorder	1188
Current Diagnosis	1188
Current Therapy	1188
Epidemiology/Pathophysiology	1188
Risk Factors	1189
Clinical Manifestations and Diagnosis	1189
Differential Diagnosis	1189
Treatment	1189
Stimulants	1190
Nonstimulants	1192
Behavior Therapy and Educational Interventions	1192
Monitoring	1192
Management of Complications	1192
References	1192
Bronchiolitis	1192
Current diagnosis	1192
Current therapy	1192
Epidemiology and Virology	1193
Risk Factors	1193
Pathophysiology	1193
Clinical Manifestations	1193
Diagnosis	1193
Differential Diagnosis	1193
Treatment	1193
Outpatient Management	1193
Inpatient Management	1193
Prevention	1194
Immunoprophylaxis	1194
Breastfeeding	1194
Complications	1194
References	1194
Diabetes Mellitus in Children	1194
Current Diagnosis	1194
Current Treatment	1194
Type 1 Diabetes: Introduction	1195
Epidemiology	1195
Presentation	1195
Diagnosis	1195
Treatment of T1DM	1195
T1DM (without ketoacidosis or after ketoacidosis has resolved)	1195
Treatment of Diabetic Ketoacidosis (DKA)	1197
Diabetes Self-Management Education	1197
Mental Health Considerations in T1DM	1197
Goals of Therapy for Patients with T1DM	1197
Sick Day Management	1198
Risk for Additional Autoimmune Disorders	1198
Screening for Complications of T1DM	1198
Technological Changes in T1DM Care	1198
Type 2 Diabetes in Children	1199
Monogenic or Maturity Onset Diabetes of Youth (MODY)	1199
References	1200
Encopresis	1200
Current Diagnosis	1200
Current Therapy	1200
Epidemiology	1200
Diagnosis	1200
Differential Diagnosis	1201
Pathophysiology	1201
Clinical Manifestations	1201
History	1201
Physical Examination	1201
Retentive Encopresis	1201
Nonretentive Encopresis	1201
Treatment	1201
References	1202
Epilepsy in Infants and Children	1202
Current Diagnosis	1202
Current Therapy	1202
Risk Factors	1202
Pathophysiology	1202
Clinical Manifestations	1202
Diagnosis and Management	1202
History and Physical Examination	1202
Diagnostic Studies	1202
Specific Epilepsy Syndromes	1203
Neonatal Seizures	1203
Febrile Seizures	1203
Infantile Spasms	1203
Dravet Syndrome	1203
Lennox-Gastaut Syndrome	1203
Childhood and Juvenile Absence Epilepsy	1204
``Benign´´ Epilepsy With Centrotemporal Spikes and ``Benign´´ Occipital Epilepsy	1204
Juvenile Myoclonic Epilepsy	1204
Other Epilepsy Syndromes With a Poor Prognosis	1204
Tumors	1205
Cortical Dysgenesis	1205
Mesial Temporal Lobe Epilepsy With Hippocampal Sclerosis	1205
Comorbidities	1205
Differential Diagnosis	1205
Treatment	1205
1. Trials of Additional Medication	1205
2. Surgery	1205
3. Diet Therapy	1205
Monitoring	1206
Complications	1207
References	1207
Hemolytic Disease of the Fetus and Newborn	1207
Current Diagnosis	1207
Current Therapy	1207
Epidemiology	1207
Risk Factors	1208
Pathophysiology	1208
Prevention	1208
Clinical Manifestations	1209
Diagnosis	1209
Differential Diagnosis	1209
Treatment	1209
Monitoring	1210
Complications	1210
References	1210
Nocturnal Enuresis	1211
Current Diagnosis	1211
Current Therapy	1211
Epidemiology	1211
Risk Factors	1211
Pathogenesis	1211
Diagnosis	1211
History	1211
Onset and Frequency	1211
Timing, Frequency, and Volume per Episode	1212
Associated Symptoms	1212
Volume of First Morning Void	1212
Soundness of Sleep	1212
Past Health	1212
Family History	1212
Physical Examination	1212
Laboratory and Imaging Studies	1212
Treatment	1212
References	1213
Normal Infant Feeding	1213
Current Therapy	1213
Breast-feeding and Breast Milk	1213
Infant Formulas	1214
Micronutrients	1214
Defining Adequate Intake	1214
Introduction of Complementary Foods	1215
Summary	1220
References	1220
Parenteral Fluid Therapy for Infants and Children	1220
Current Diagnosis	1220
Current Therapy	1220
Maintenance Fluid Therapy	1220
Restoration Fluid Therapy	1221
Replacement Fluids	1222
Hyponatremia and Hypernatremia	1222
Approach to Hyponatremia	1222
Approach to Hypernatremia	1222
Intravenous Electrolyte Replacements	1223
References	1223
Pediatric Failure to Thrive	1223
Current diagnosis	1223
Current therapy	1223
Epidemiology	1224
Risk Factors	1224
Pathophysiology	1224
Prevention	1224
Clinical Manifestations	1224
Differential Diagnosis	1224
Therapy	1224
Monitoring	1225
Complications	1225
References	1225
Pediatric Sleep Disorders	1225
Current Diagnosis	1225
Current Therapy	1225
Introduction	1226
Developmental Aspects of Sleep	1226
Clinical Approach	1226
Taking a Sleep History	1226
Past Medical History/Family History	1227
Focused Physical Examination	1227
Diagnostic Tools	1227
Polysomnography	1227
Overnight Oximetry	1227
Sleep Logs/Actigraphy	1227
Multiple Sleep Latency Test	1227
Common Pediatric Sleep Diagnoses and Treatment	1227
Obstructive Sleep Apnea	1227
Epidemiology	1227
Pathophysiology	1228
Clinical Manifestation	1228
Physical and Chemical Injuries	1247
Burns	1247
Current diagnosis	1247
Current therapy	1247
Epidemiology	1247
Risk Factors	1247
Pathophysiology	1247
Burning Tissue	1247
Prevention	1247
Clinical Manifestations	1247
Special Situations	1248
Ocular Injuries	1248
Nonaccidental Trauma	1248
Chemical Burns	1249
Electrical Injuries	1249
Therapy (or Treatment)	1249
First Aid and Office Management	1249
Hospital Management	1250
Burn Management	1250
Burn Center Referral Criteria	1250
Monitoring	1250
Transfer	1252
Complications	1252
References	1253
Disturbances Due to Cold	1253
Current Diagnosis	1253
Preventive Health	1333
Immunization Practices	1333
Current Diagnosis	1333
Current Therapy	1333
Definitions and Background	1333
Physiology of Vaccines	1333
Immunization Recommendations	1333
Disease Prevention	1333
Immunization Responsibility	1333
General Principles for Vaccine Scheduling	1333
Route of Administration	1337
Storage	1337
Vaccine Safety	1337
Contraindications and Adverse Events	1337
Barriers	1337
Recording Vaccinations	1337
Special Populations	1338
Children	1338
Breast-feeding	1338
Pregnancy	1338
Altered Immunocompetence	1338
Health Care Personnel	1338
Travel Medicine	1338
Vaccinations	1339
Routine Vaccinations	1339
Measles-Mumps-Rubella Vaccine	1339
Poliovirus Vaccine	1339
Tetanus-Diphtheria-Pertussis Vaccine	1340
Varicella Vaccine	1340
Influenza Vaccine	1340
Pneumococcal Vaccine	1340
Routine Travel Vaccination	1340
Hepatitis A Vaccine	1340
Typhoid Vaccine	1340
Hepatitis B	1340
Geographically Targeted Vaccines	1340
Yellow Fever Vaccine	1340
Japanese Encephalitis	1341
Rabies	1341
Meningococcal Vaccine	1341
Tick-Borne Encephalitis	1341
Cholera	1341
Malaria Prophylaxis	1342
Chemoprophylaxis	1342
Personal Protection/Bite Avoidance Measures	1342
Seeking Medical Care	1342
Travelers Diarrhea	1342
Prevention	1342
Treatment	1343
Altitude Sickness	1343
Conclusion	1343
Acknowledgment	1343
References	1343
Appendices	1345
Biologic Agents Reference Chart	1345
Popular Herbs and Nutritional Supplements	1351
References	1360
Toxic Chemical Agents Reference Chart: Symptoms and Treatment	1361
Index	1367
Back End Sheet	ES4
Inside Back Cover	ES5

Conn's Current Therapy 2019

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