User:Y-S.Ko/Wikipedia course2/Internal Medicine

medical profession
]]
 * 1 the practice of medicine
 * enduring values of the medical profession
 * the science and art of medicine
 * clinical skills
 * history-taking
 * physical examination
 * diagnostic studies
 * management of patient care
 * team-based care
 * the dichotomy of inpatient and outpatient internal medicine
 * mitigating the stress of acute illness
 * medical decision-making
 * practice guidelines
 * precision medicine
 * evaluation of outcomes
 * errors in the delivery of health care
 * electronic medical records
 * patient–physician relationship
 * informed consent
 * approach to grave prognoses and death
 * maintaining humanism and professionalism
 * expanding frontiers in medical practice
 * the era of “[[omics”]]
 * the globalization of medicine
 * medicine on the internet
 * public expectations and accountability
 * medical ethics and new technologies
 * learning medicine
 * the physician as perpetual student
 * the physician as citizen
 * research, teaching, and the practice of medicine
 * further reading
 * 2 promoting good health]]
 * goals and approaches to prevention
 * tertiary prevention; secondary prevention; primary prevention; primordial prevention
 * health promotion
 * prioritizing prevention strategies
 * prevention and health promotion across the life course
 * periodic health evaluations
 * healthy behaviors and lifestyles
 * healthy eating patterns
 * physical activity
 * sleep hygiene
 * weight management
 * tobacco cessation
 * vaccination
 * mental health and addiction
 * alcohol a7nd opioids
 * accidents and suicide
 * approach to the patient
 * further reading
 * 3 vaccine opposition and hesitancy]]
 * vaccine coverage and outbreaks
 * north america
 * outside north america
 * factors in [[vaccine hesitancy
 * social and cultural trends
 * individualized health care
 * parenting trends
 * traditional media
 * the internet and social media
 * approach to the patient
 * factors in effective vaccine recommendations
 * strength of the recommendation
 * tailored communication
 * transparency and accuracy
 * support from accessible information sources
 * revisiting and reinforcement of vaccine recommendations
 * what to say to vaccine-hesitant patients
 * other considerations during clinical encounters
 * missed opportunities
 * adverse events following vaccination
 * addressing inequities in vaccine access
 * further communication with patients who refuse vaccines
 * conclusion
 * focus: covid-19 vaccine hesitancy
 * past experience with new vaccines
 * specific concerns about covid-19 vaccines
 * social and cultural trends
 * tips for discussion of covid-19 vaccines
 * further reading
 * 4 decision-making in clinical medicine
 * brief introduction to [[clinical reasoning
 * clinical expertise
 * disease knowledge; complex fine-motor skills; clinical reasoning
 * intuitive versus analytic reasoning
 * intuition; analysis; pattern recognition; diagnostic verification; heuristics; bayes's theorem; hypothetico-deductive model of reasoning;
 * diagnostic versus therapeutic decision-making
 * nonclinical influences on clinical decision-making
 * factors related to practice style
 * practice setting factors
 * payment systems
 * interpretation of diagnostic tests
 * diagnostic testing: measures of test accuracy
 * measures of disease probability and bayes’ rule
 * applications to diagnostic testing in cad
 * statistical prediction models
 * formal decision support tools
 * decision support systems
 * decision analysis
 * diagnosis as an element of quality of care
 * evidence-based medicine
 * sources of evidence: clinical trials and registries
 * meta-analysis
 * clinical practice guidelines
 * conclusions
 * further reading
 * 5 precision medicine and clinical care]]
 * disease nosology and precision medicine
 * requirements for precision medicine
 * examples of precision medicine applications
 * the future of precision medicine
 * further reading
 * 6 screening and prevention of disease]]
 * basic principles of screening
 * methods of measuring health benefits
 * assessing the harms of screeningand prevention
 * weighing the benefits and harms
 * counseling on healthy behaviors
 * implementing disease prevention and screening
 * further reading
 * 7 global diversity of health system financing and delivery]]
 * financing individual patient careservices in developed countries
 * total health expenditures
 * tax-funded systems
 * social insurance–funded systems
 * the united states
 * delivering individual patient careservices in developed countries
 * hospital services
 * primary care services
 * access to elective specialist care
 * long-term care services
 * pharmaceuticals
 * governance and regulation
 * future challenges
 * financing and providing health services in developing countries
 * further reading
 * 8 the safety and quality of health care]]
 * safety in health care
 * safety theory and systems theory
 * factors that increase the likelihood of errors
 * the frequency of adverse events in health care
 * prevention strategies
 * the national safety picture
 * measurement of safety
 * conclusions about safety
 * quality in health care
 * quality theory
 * factors relating to quality
 * data about the current state of quality
 * strategies for improving quality and performance
 * national state of quality measurement
 * public reporting
 * pay-for-performance
 * conclusions
 * further reading
 * 9 diagnosis: reducing errors and improving quality]]
 * emergence of diagnosis error as an important patient safety issue
 * new ways to think about diagnosis and diagnostic errors
 * uncertainty in diagnosis
 * don’t miss diagnoses and red flags
 * diagnostic pitfalls
 * diagnosis safety culture
 * health information technology and the future of diagnosis
 * diagnosis of diagnosis errors and safety: practical conclusions
 * further reading
 * 10 racial and ethnic disparities in health care
 * nature and extent of disparities
 * root causes of disparities
 * race, racism, and health
 * social determinants of health
 * health system factors
 * provider-level factors
 * patient-level factors
 * key recommendations to address racial/ethnic disparities in health care
 * health system interventions
 * provider interventions
 * patient interventions
 * general recommendations
 * implications for clinical practice
 * conclusion
 * further reading
 * 11 ethical issues in clinical medicine
 * approaches to ethical problems
 * ethical principles
 * respecting patients
 * beneficence or acting in patients’ best interests
 * acting justly
 * virtue ethics
 * professional oaths and codes
 * personal values
 * ethically complex professional issues for physicians
 * claims of conscience
 * physician as gatekeeper
 * moral distress
 * occupational risks and burdens
 * use of social media and patient portals
 * conflicts of interest
 * financial incentives
 * relationships with pharmaceutical companies
 * learning clinical skills
 * response to medical errors
 * physician impairment
 * ethical issues in clinical research
 * emerging technologies
 * global considerations
 * international research
 * international clinical experiences
 * conclusion
 * further reading
 * 12 palliative and end-of-life care
 * epidemiology
 * causes of death
 * site of death
 * hospice and the palliative care framework
 * assessment and care planning
 * comprehensive assessment
 * communication
 * continuous goal assessment
 * advance care planning
 * interventions
 * physical symptoms and their management
 * pain
 * constipation
 * untitled
 * dyspnea
 * fatigue
 * palliative sedation
 * psychological symptoms and their management
 * depression
 * delirium
 * insomnia
 * social needs and their management
 * financial burdens
 * relationships
 * family caregivers
 * existential needs and their management
 * managing the last stages
 * palliative care services: how and where
 * withdrawing and withholding life-sustaining treatment
 * futile care
 * euthanasia and physician-assisted suicide
 * care during the last hours
 * [[further reading

diseases presentation
]]
 * section 1 pain]]
 * 13 [[pain: pathophysiology and management]]
 * the [[pain sensory system
 * peripheral mechanisms
 * the primary afferent nociceptor
 * sensitization
 * nociceptor-induced inflammation
 * central mechanisms
 * the spinal cord and referred pain
 * ascending pathways for pain
 * pain modulation
 * neuropathic pain
 * sympathetically maintained pain
 * treatment: acute pain
 * aspirin, acetaminophen, and nonsteroidalanti-inflammatory agents (Nsaids)
 * opioid analgesics
 * chronic pain
 * treatment: chronic pain
 * antidepressant medications
 * anticonvulsants and antiarrhythmics
 * cannabinoids
 * chronic opioid medication
 * treatment of neuropathic pain
 * further reading
 * 14 [[chest discomfort
 * epidemiology and natural history
 * causes of chest discomfort
 * myocardial ischemia/injury
 * characteristics of ischemic chest discomfort
 * mechanisms of cardiac pain
 * other cardiopulmonary causes
 * pericardial and other myocardial diseases
 * diseases of the aorta
 * pulmonary conditions
 * other pulmonary parenchymal, pleural, or vascular disease
 * noncardiopulmonary causes
 * gastrointestinal conditions
 * musculoskeletal and other causes
 * emotional and psychiatric conditions
 * approach to the patient: chest discomfort
 * history
 * physical examination
 * electrocardiography
 * chest radiography
 * cardiac biomarkers
 * integrative decision-aids
 * coronary and myocardial stress imaging
 * exercise electrocardiography
 * other noninvasive studies
 * critical pathways for acute chest discomfort
 * outpatient evaluation of chest discomfort
 * further reading
 * 15 [[abdominal pain
 * some mechanisms of pain originating in the abdomen
 * inflammation of the parietal peritoneum
 * obstruction of hollow viscera
 * vascular disturbances
 * abdominal wall
 * referred pain in abdominal disease
 * metabolic abdominal crises
 * immunocompromise
 * neurogenic causes
 * approach to the patient: abdominal pain
 * further reading
 * 16 [[headache
 * general principles
 * anatomy and physiology of headache
 * clinical evaluation of acute, new-onset headache
 * secondary headache
 * meningitis
 * intracranial hemorrhage
 * brain tumor
 * temporal arteritis
 * glaucoma
 * primary headache disorders]]
 * chronic daily or near-daily headache
 * approach to the patient: chronic daily headache
 * management of medically intractable disabling primary headache
 * medication-related and medication-overuse headache
 * new daily persistent headache
 * primary care and headachemanagement
 * back and neck pain
 * anatomy of the spine
 * approach to the patient: back pain
 * types of back pain
 * examination
 * laboratory, imaging, and emg studies
 * causes of back pain
 * lumbar disk disease
 * degenerative conditions
 * spondylosis and spondylolisthesis
 * neoplasms
 * infections/inflammation
 * trauma
 * sprains and strains
 * traumatic vertebral fractures
 * metabolic causes
 * osteoporosis and osteosclerosis
 * autoimmune inflammatory arthritis
 * congenital anomalies of the lumbar spine
 * referred pain from visceral disease
 * low thoracic or lumbar pain with abdominal disease
 * sacral pain with gynecologic and urologic disease
 * other causes of back pain
 * postural back pain
 * idiopathic
 * global considerations
 * treatment: back pain
 * acute low back pain without radiculopathy
 * chronic low back pain without radiculopathy
 * low back pain with radiculopathy
 * pain in the neck and shoulder
 * trauma to the cervical spine
 * cervical disk disease
 * cervical spondylosis
 * other causes of neck pain
 * thoracic outlet syndromes
 * brachial plexus and nerves
 * shoulder
 * global considerations
 * treatment: neck pain without radiculopathy
 * treatment: neck pain with radiculopathy
 * further reading
 * section 2 alterations in body temperature]]
 * 18 [[fever
 * fever versus [[hyperthermia
 * pathogenesis of fever
 * pyrogens
 * pyrogenic cytokines
 * elevation of the hypothalamic set point by cytokines
 * production of cytokines in the cns
 * approach to the patient: fever
 * history and physical examination
 * laboratory tests
 * fever in patients receiving anticytokine therapy
 * treatment: fever
 * the decision to treat fever
 * anticytokine therapy to reduce fever in autoimmune and autoinflammatory diseases
 * mechanisms of antipyretic agents
 * regimens for the treatment of fever
 * 19 [[fever and rash
 * approach to the patient: fever and rash
 * physical examination
 * classification of rash
 * centrally distributed maculopapulareruptions
 * peripheral eruptions
 * confluent desquamativeerythemas
 * vesiculobullous or pustular eruptions
 * urticaria-like eruptions
 * nodular eruptions
 * purpuric eruptions
 * eruptions with ulcers or eschars
 * further reading
 * 20 [[fever of unknown origin
 * definition
 * etiology and epidemiology
 * differential diagnosis
 * approach to the patient: fever of unknown origin
 * first-stage diagnostic tests
 * later-stage diagnostic tests
 * second opinion in an expert center
 * treatment: fever of unknown origin
 * antibiotics and antituberculous therapy
 * colchicine, nonsteroidal anti-inflammatorydrugs, and glucocorticoids
 * interleukin 1 inhibition
 * prognosis
 * further reading
 * section 3 nervous system dysfunction]]
 * syncope
 * epidemiology and natural history
 * pathophysiology
 * classification
 * neurally mediated syncope
 * classification of neurally mediated syncope
 * features of neurally mediated syncope
 * treatment: neurally mediated syncope
 * orthostatic hypotension
 * causes of neurogenic orthostatic hypotension
 * treatment: orthostatic hypotension
 * cardiac syncope
 * arrhythmias
 * structural disease
 * treatment: cardiac syncope
 * approach to the patient: syncope
 * differential diagnosis
 * initial evaluation
 * further reading
 * 22 [[dizziness and vertigo
 * approach to the patient: dizziness
 * history
 * examination
 * ancillary testing
 * differential diagnosis and treatment
 * acute prolonged vertigo ([[Vestibular neuritis)]]
 * benign paroxysmal positional vertigo
 * vestibular migraine
 * Ménière’s disease
 * vestibular schwannoma
 * bilateral vestibular hypofunction
 * central vestibular disorders
 * psychosomatic and functional dizziness
 * treatment: vertigo
 * further reading
 * 23 [[fatigue
 * epidemiology and global considerations
 * differential diagnosis
 * psychiatric disease
 * neurologic disease
 * sleep disorders
 * endocrine disorders
 * liver and kidney disease
 * obesity
 * physical inactivity
 * malnutrition
 * infection
 * drugs
 * cardiovascular and pulmonary disorders
 * malignancy
 * hematologic disorders
 * immune-mediated disorders
 * pregnancy
 * disorders of unclear cause
 * approach to the patient: fatigue
 * treatment: fatigue
 * prognosis
 * further reading
 * 24 neurologic causes of [[weakness and paralysis
 * pathogenesis
 * upper motor neuron weakness
 * lower motor neuron weakness
 * neuromuscular junction weakness
 * myopathic weakness
 * psychogenic weakness
 * distribution of weakness
 * hemiparesis
 * paraparesis
 * quadriparesis or generalized weakness
 * monoparesis
 * distal weakness
 * proximal weakness
 * weakness in a restricted distribution
 * further reading
 * 25 [[numbness, tingling, and sensory loss
 * positive and negative symptoms
 * terminology
 * anatomy of sensation
 * approach to the patient: clinical examination of sensation
 * primary sensation
 * cortical sensation
 * quantitative sensory testing
 * electrodiagnostic studies and nerve biopsy
 * localization of sensory abnormalities
 * nerve and root
 * spinal cord
 * brainstem
 * thalamus
 * cortex
 * focal sensory seizures
 * psychogenic symptoms
 * treatment
 * gait disorders, imbalance, and falls]]
 * prevalence, morbidity,and mortality
 * anatomy and physiology
 * disorders of gait
 * cautious gait
 * stiff-legged gait
 * parkinsonism, freezing gait, and other movement disorderss]]
 * frontal gait disorder
 * cerebellar gait ataxia
 * sensory ataxia
 * neuromuscular disease
 * toxic and metabolic disorders
 * functional gait disorder
 * approach to the patient: slowly progressive disorder of gait
 * disorders of balance
 * definition, etiology, and manifestations
 * falls
 * risk factors for falls
 * assessment of the patient with falls
 * history
 * physical examination
 * fall patterns
 * treatment: interventions to reduce the risk of falls and injury
 * further reading
 * 27 [[confusion and delirium
 * clinical features of delirium
 * risk factors
 * epidemiology
 * pathogenesis
 * approach to the patient: delirium
 * history
 * physical examination
 * etiology
 * laboratory and diagnostic evaluation
 * treatment: delirium
 * prevention
 * further reading
 * 28 [[coma
 * the anatomy and physiology of coma
 * coma due to cerebral mass lesions and herniation syndromes
 * coma due to metabolic, drug, and toxic disorders
 * epileptic coma
 * coma due to widespread structural damage to the cerebral hemispheres
 * approach to the patient: coma
 * history
 * general physical examination
 * neurologic examination
 * level of arousal
 * brainstem reflexes
 * laboratory studies and imaging
 * differential diagnosis of coma
 * brain death
 * treatment: coma
 * prognosis
 * further reading
 * 29 [[dementia
 * functional anatomy of the dementias
 * the causes of dementia
 * approach to the patient: dementias
 * history
 * physical and neurologic examination
 * cognitive and neuropsychiatric examination
 * laboratory tests
 * global considerations
 * treatment: dementia
 * 30 [[aphasia, memory loss, and other cognitive disorders]]
 * the left perisylvian network for language and aphasias
 * clinical examination
 * Wernicke’s aphasia
 * Broca's aphasia
 * conduction aphasia
 * transcortical aphasias: fluent and nonfluent]]
 * global and isolation aphasias
 * anomic aphasia
 * pure word deafness
 * pure alexia without agraphia
 * apraxia and aphemia
 * gerstmann’s syndrome
 * pragmatics and prosody
 * subcortical aphasia
 * agrammatic ppa
 * semantic ppa
 * logopenic ppa
 * the parietofrontal network for spatial orientation
 * hemispatial neglect
 * clinical examination
 * bálint’s syndrome, simultanagnosia, dressing apraxia, construction apraxia, and route-finding impairments
 * causes of spatial disorientation and the posterior cortical atrophy syndrome
 * the occipitotemporal network forface and object recognition
 * causes and relation to semantic dementia
 * limbic network for explicit memory and amnesia
 * clinical examination
 * causes, including alzheimer’s disease
 * the prefrontal network for executive function and behavior
 * clinical examination
 * causes: trauma, neoplasm, and frontotemporal dementia
 * caring for patients with deficits of higher cerebral function
 * pharmacologic and nonpharmacologic interventions
 * further reading
 * sleep disorders
 * physiology of sleep and wakefulness
 * organization of human sleep
 * wake and sleep are regulated by brain circuits
 * sleep-wake cycles are driven by homeostatic, allostatic, and circadian inputs
 * physiology of circadian rhythmicity
 * behavioral and physiologic correlates of sleep states and stages
 * disorders of sleep and wakefulness
 * approach to the patient: sleep disorders
 * evaluation of daytime sleepiness
 * insufficient sleep
 * sleep apnea syndromes
 * narcolepsy
 * diagnosis
 * treatment: narcolepsy
 * evaluation of [[insomnia
 * psychophysiological factors
 * inadequate sleep hygiene
 * psychiatric conditions
 * medications and drugs of abuse
 * medical conditions
 * neurologic disorders
 * treatment: insomnia
 * treatment of medical and psychiatric disease
 * improve sleep hygiene
 * cognitive behavioral therapy
 * medications for insomnia
 * restless legs syndrome
 * periodic limb movement disorder
 * parasomnias
 * sleepwalking (Somnambulism)
 * sleep terrors
 * sleep enuresis
 * sleep bruxism
 * rem sleep behavior disorder (Rbd)
 * circadian rhythm sleep disorders
 * delayed sleep-wake phase disorder
 * advanced sleep-wake phase disorder
 * non-24-h sleep-wake rhythm disorder
 * shift-work disorder
 * treatment: shift-work disorder
 * jet lag disorder
 * medical implications of circadianrhythmicity
 * further reading
 * section 4 disorders of eyes, ears, nose, and throat]]
 * disorders of the eye
 * the human [[visual system
 * clinical assessment of visual function
 * refractive state
 * visual acuity
 * pupils
 * eye movements and alignment]]
 * stereopsis
 * color vision
 * visual fields
 * disorders
 * red or painful eye
 * corneal abrasions
 * subconjunctival hemorrhage
 * pinguecula
 * blepharitis
 * dacryocystitis
 * conjunctivitis
 * allergic conjunctivitis
 * keratoconjunctivitis sicca
 * keratitis
 * herpes simplex keratitis
 * herpes zoster ophthalmicus
 * episcleritis
 * anterior uveitis
 * posterior uveitis
 * acute angle-closure glaucoma
 * endophthalmitis
 * transient or sudden visual loss
 * amaurosis fugax
 * anterior ischemic optic neuropathy (Aion)]]
 * posterior ischemic optic neuropathy
 * optic neuritis
 * leber’s hereditary optic neuropathy
 * toxic optic neuropathy
 * papilledema
 * optic disc drusen
 * vitreous degeneration
 * retinal detachment
 * classic migraine
 * transient ischemic attacks
 * stroke
 * factitious (Functional, nonorganic) Visual loss
 * chronic visual loss
 * cataract
 * glaucoma
 * macular degeneration
 * central serous chorioretinopathy
 * diabetic retinopathy
 * retinitis pigmentosa
 * epiretinal membrane
 * melanoma and other tumors]]
 * proptosis
 * Graves' ophthalmopathy
 * orbital pseudotumor
 * orbital cellulitis
 * tumors
 * carotid cavernous fistula
 * ptosis
 * blepharoptosis
 * mechanical ptosis
 * aponeurotic ptosis
 * myogenic ptosis
 * neurogenic ptosis
 * double vision ([[Diplopia)]]
 * myasthenia gravis
 * oculomotor nerve
 * trochlear nerve
 * abducens nerve
 * multiple ocular motor nerve palsies
 * supranuclear disorders of gaze
 * horizontal gaze
 * vertical gaze
 * nystagmus
 * opsoclonus
 * further reading
 * 33 disorders of smell and taste
 * anatomy and physiology
 * olfactory system
 * taste system
 * disorders of olfaction
 * disorders of taste
 * clinical evaluation
 * treatment and management
 * further reading
 * disorders of hearing
 * physiology of hearing
 * disorders of the sense of hearing
 * conductive hearing loss
 * sensorineural hearing loss
 * noise-induced hearing loss
 * tinnitus
 * genetic causes of hearing loss
 * approach to the patient: disorders of the sense of hearing
 * laboratory assessment of hearing
 * audiologic assessment
 * evoked responses
 * imaging studies
 * treatment: disorders of the sense of hearing
 * prevention
 * further reading
 * 35 [[upper respiratory symptoms, including earache, sinus symptoms, and sore throat
 * upper respiratory infections
 * improving ambulatory antibiotic prescribing
 * ambulatory antibiotic stewardship
 * nonspecific upper respiratory infection (“the [[common cold”)]]
 * definition and etiology
 * symptoms and signs
 * treatment: nonspecific upper respiratory infection
 * ear pain
 * otitis externa
 * etiology and clinical manifestations
 * malignant otitis externa
 * treatment: otitis externa
 * acute otitis media
 * epidemiology and etiology
 * symptoms and signs
 * treatment: acute otitis media
 * otitis media with effusion
 * definition and etiology
 * symptoms and signs
 * treatment: otitis media with effusion
 * acute mastoiditis
 * etiology
 * symptoms and signs
 * evaluation
 * evaluation
 * differential diagnosis
 * treatment: mastoiditis
 * sinus symptoms
 * acute sinusitis
 * definition and etiology
 * symptoms and signs
 * complications
 * treatment: acute sinusitis
 * chronic sinusitis
 * definition and etiology
 * symptoms and signs
 * evaluation
 * treatment: chronic sinusitis
 * sore throat and neck pain]]
 * streptococcal pharyngitis
 * evaluation
 * complications
 * treatment: streptococcal pharyngitis
 * nonstreptococcal pharyngitis
 * acute [[infectious mononucleosis
 * other bacterial pharyngitis
 * head and neck abscesses
 * epiglottitis
 * laryngitis
 * further reading
 * 36 oral manifestations of disease
 * diseases of the teeth and periodontal structures
 * dental caries, pulpal and periapical disease, and complications]]
 * periodontal disease
 * prevention of tooth decay and periodontal infection
 * developmental and systemic disease affecting the teeth and periodontium
 * diseases of the [[oral mucosa
 * infections
 * pigmented lesions
 * dermatologic diseases
 * diseases of the tongue
 * HIV disease and AIDS
 * ulcers
 * hematologic and nutritional disease
 * nondental causes of [[oral pain
 * diseases of the salivary glands
 * dental care for medically complex patients
 * halitosis
 * aging and oral health
 * further reading
 * section 5 alterations in circulatory and respiratory functions]]
 * 37 [[dyspnea
 * definition
 * epidemiology
 * mechanisms underlying dyspnea
 * assessing dyspnea
 * differential diagnosis
 * approach to the patient
 * treatment
 * 38 [[cough
 * cough mechanism
 * impaired cough
 * symptomatic cough
 * assessment of chronic cough
 * chronic cough with a normal chest radiograph
 * global considerations
 * symptom-based treatment of cough
 * further reading
 * 39 [[hemoptysis
 * anatomy and physiology of hemoptysis
 * etiology
 * infections
 * vascular
 * malignancy
 * mechanical and other causes
 * evaluation and management
 * history
 * physical examination
 * diagnostic studies
 * interventions
 * further reading
 * 40 [[hypoxia and cyanosis
 * hypoxia
 * responses to hypoxia
 * effects on the central nervous system
 * effects on the cardiovascular system
 * causes of hypoxia
 * respiratory hypoxia
 * hypoxia secondary to high altitude
 * hypoxia secondary to right-to-left extrapulmonary shunting
 * anemic hypoxia
 * carbon monoxide (Co) Intoxication
 * circulatory hypoxia
 * specific organ hypoxia
 * increased o2 requirements
 * improper oxygen utilization
 * adaptation to hypoxia
 * cyanosis
 * differential diagnosis
 * central cyanosis
 * peripheral cyanosis
 * approach to the patient
 * clubbing
 * further reading
 * 41 [[edema
 * plasma and interstitial fluid exchange
 * reduction of effective arterial volume
 * renal factors and the reninangiotensin-aldosterone system
 * arginine vasopressin
 * endothelin-1
 * natriuretic peptides
 * clinical causes of edema
 * generalized edema
 * heart failure
 * edema of renal disease
 * nephrotic syndrome and other hypoalbuminemic states
 * hepatic cirrhosis
 * drug-induced edema
 * edema of nutritional origin
 * localized edema
 * other causes of edema
 * distribution of edema
 * approach to the patient
 * further reading
 * 42 approach to the patient with a [[heart murmur
 * duration and character
 * intensity
 * location and radiation
 * systolic heart murmurs
 * early systolic murmurs
 * midsystolic murmurs
 * late systolic murmurs
 * holosystolic murmurs
 * diastolic heart murmurs
 * early diastolic murmurs
 * mid-diastolic murmurs
 * continuous murmurs
 * dynamic auscultation
 * respiration
 * alterations of systemic vascular resistance
 * changes in venous return
 * post-premature ventricular contraction
 * the clinical context
 * echocardiography
 * other cardiac testing
 * integrated approach
 * further reading
 * 43 [[palpitations
 * approach to the patient
 * further reading
 * section 6 alterations in gastrointestinal function]]
 * 44 [[dysphagia
 * physiology of swallowing
 * pathophysiology of dysphagia
 * approach to the patient
 * further reading
 * 45 [[nausea, vomiting, and indigestion
 * nausea and vomiting
 * mechanisms
 * coordination of emesis
 * activators of emesis
 * differential diagnosis
 * intraperitoneal disorders
 * extraperitoneal disorders
 * medications and metabolic disorders
 * approach to the patient: nausea and vomiting
 * treatment: nausea and vomiting
 * indigestion
 * mechanisms
 * gastroesophageal reflux
 * gastric motor dysfunction
 * visceral afferent hypersensitivity
 * immune activation
 * other factors
 * differential diagnosis
 * gastroesophageal reflux disease
 * functional dyspepsia
 * ulcer disease
 * malignancy
 * other causes
 * approach to the patient: indigestion
 * treatment: indigestion
 * lifestyle, diet, and nonmedication recommendations
 * acid-suppressing or -neutralizing medications
 * helicobacter pylori eradication
 * agents that modify gastrointestinal motor activity
 * antidepressants
 * other options
 * further reading
 * 46 [[diarrhea and constipation
 * normal physiology
 * neural control
 * intestinal fluid absorption and secretion
 * small-intestinal motility
 * ileocolonic storage and salvage
 * colonic motility and tone
 * colonic motility after meal ingestion
 * defecation
 * diarrhea
 * definition
 * acute diarrhea
 * infectious agents
 * other causes
 * approach to the patient
 * treatment
 * chronic diarrhea
 * secretory causes
 * osmotic causes
 * steatorrheal causes
 * inflammatory causes
 * dysmotility causes
 * factitial causes
 * approach to the patient
 * treatment
 * constipation
 * definition
 * causes
 * approach to the patient
 * investigation of severe constipation
 * measurement of colonic transit
 * anorectal and pelvic floor tests
 * treatment
 * further reading
 * 47 [[unintentional weight loss
 * physiology of weight regulation withaging
 * causes of unintentional weight loss
 * assessment
 * treatment
 * further reading
 * 48 [[gastrointestinal bleeding
 * sources of gastrointestinal bleeding
 * upper gastrointestinal sources of bleeding
 * small-intestinal sources of bleeding
 * colonic sources of bleeding
 * approach to the patient
 * initial assessment
 * differentiation of ugib from lgib
 * evaluation and management of ugib
 * evaluation and management of lgib
 * evaluation and management of small-intestinal or obscure gib
 * positive fecal occult blood test
 * further reading
 * 49 [[jaundice
 * production and metabolism of bilirubin
 * measurement of serum bilirubin
 * measurement of urine bilirubin
 * approach to the patient
 * isolated elevation of serum bilirubin
 * elevation of serum bilirubin with other liver test abnormalities
 * global considerations
 * further reading
 * 50 [[abdominal swelling and ascites
 * abdominal swelling
 * causes
 * approach to the patient
 * imaging and laboratory evaluation
 * ascites
 * pathogenesis in the presence of cirrhosis
 * pathogenesis in the absence of cirrhosis
 * causes
 * evaluation
 * treatment
 * complications
 * further reading
 * section 7 alterations in renal and urinary tract function]]
 * 51 [[interstitial cystitis/bladder pain syndrome]]
 * definition
 * etiology and pathogenesis
 * infection and the urinary microbiota
 * autoimmunity
 * inflammation
 * urothelial dysfunction
 * urothelial permeability and the glycosaminoglycan layer
 * antiproliferative factor
 * pelvic organ crosstalk
 * neurobiologic contributions and central sensitization
 * epidemiology
 * clinical manifestations
 * approach to the patient
 * diagnosis
 * history and physical (Including frequency/volume charts)
 * symptom scores
 * urine studies
 * imaging, cystoscopy, and urodynamics
 * intravesical anesthetic bladder challenge and hydrodistension
 * treatment: clinical phenotyping
 * conservative measures
 * medical therapies
 * surgical therapies
 * complications and prognosis
 * global considerations
 * further reading
 * 52 [[azotemia and urinary abnormalities
 * azotemia
 * assessment of gfr
 * approach to the patient
 * prerenal failure
 * postrenal azotemia
 * intrinsic renal disease
 * oliguria and anuria
 * abnormalities of the urine
 * proteinuria
 * hematuria, pyuria, and casts]]
 * abnormalities of urine volume
 * polyuria
 * 53 fluid and electrolyte disturbances
 * sodium and water
 * composition of body fluids
 * hypovolemia
 * etiology
 * diagnostic evaluation
 * treatment
 * sodium disorders
 * hyponatremia
 * hypovolemic hyponatremia
 * hypervolemic hyponatremia
 * euvolemic hyponatremia
 * low solute intake and hyponatremia
 * clinical features of hyponatremia
 * diagnostic evaluation of hyponatremia
 * treatment
 * hypernatremia
 * etiology
 * clinical features
 * diagnostic approach
 * treatment
 * potassium disorders
 * hypokalemia
 * redistribution and hypokalemia
 * nonrenal loss of potassium
 * renal loss of potassium
 * magnesium deficiency and hypokalemia
 * clinical features
 * treatment
 * hyperkalemia
 * pseudohyperkalemia
 * redistribution and hyperkalemia
 * hyperkalemia caused by excess intake or tissue necrosis
 * hypoaldosteronism and hyperkalemia
 * renal disease and hyperkalemia
 * medication-associated hyperkalemia
 * clinical features
 * diagnostic approach
 * treatment
 * 54 hypercalcemia and hypocalcemia
 * hypercalcemia
 * etiology
 * clinical manifestations
 * diagnostic approach
 * treatment
 * hypocalcemia
 * etiology
 * clinical manifestations
 * diagnostic approach
 * treatment
 * global considerations
 * further reading
 * 55 [[acidosis and alkalosis
 * normal acid-base homeostasis
 * diagnosis of general types of disturbances
 * simple acid-base disorders
 * mixed acid-base disorders
 * approach to the patient: acid-base disorders
 * metabolic acidosis
 * treatment
 * high-anion gap acidoses
 * approach to the patient
 * lactic acidosis
 * ketoacidosis
 * diabetic ketoacidosis (Dka)]]
 * alcoholic ketoacidosis (Aka)]]
 * drug- and toxin-induced acidosis
 * salicylates
 * alcohols
 * ethylene glycol
 * methanol
 * propylene glycol
 * isopropyl alcohol
 * pyroglutamic acid
 * chronic kidney disease
 * non–anion gap metabolic acidoses
 * treatment
 * metabolic alkalosis
 * etiology and pathogenesis
 * differential diagnosis
 * metabolic alkalosis associated with ecfv contraction, k+ depletion, and secondary hyperreninemic hyperaldosteronism
 * gastrointestinal origin
 * renal origin
 * diuretics
 * solute losing disorders: bartter’s syndrome and gitelman’s syndrome
 * non-reabsorbable anions and magnesium deficiency
 * potassium depletion
 * after treatment of lactic acidosis or ketoacidosis
 * posthypercapnia
 * metabolic alkalosis associated with ecfv expansion, hypertension, and mineralocorticoid excess
 * symptoms
 * treatment
 * respiratory acidosis
 * respiratory alkalosis
 * section 8 alterations in the skin]]
 * 56 approach to the patient with a [[skin disorder
 * description of primary skin lesions
 * description of secondary skin lesions
 * common dermatologic terms
 * selected common dermatologic conditions
 * approach to the patient
 * diagnostic techniques
 * skin biopsy
 * KOH preparation
 * tzanck smear
 * diascopy
 * dermoscopy
 * Wood’s light
 * patch tests
 * further reading
 * 57 [[eczema, psoriasis, cutaneous infections, acne, and other common skin disorders]]
 * eczema and dermatitis
 * atopic dermatitis
 * lichen simplex chronicus
 * contact dermatitis
 * hand eczema
 * nummular eczema
 * asteatotic eczema
 * stasis dermatitis and stasis ulceration
 * seborrheic dermatitis
 * papulosquamous disorders
 * psoriasis
 * lichen planus
 * pityriasis rosea
 * cutaneous infections
 * impetigo, ecthyma, and furunculosis
 * erysipelas and cellulitis
 * dermatophytosis
 * tinea (Pityriasis) Versicolor]]
 * candidiasis
 * warts
 * herpes simplex
 * herpes zoster
 * acne
 * acne vulgaris
 * acne rosacea
 * skin diseases and [[smallpox vaccination
 * further reading
 * 58 [[skin manifestations of internal disease
 * papulosquamous skin lesions
 * erythroderma
 * alopecia
 * figurate skin lesions
 * acne
 * pustular lesions
 * telangiectasias
 * hypopigmentation
 * hyperpigmentation
 * vesicles/bullae
 * urticaria
 * papulonodular skin lesions
 * white lesions
 * skin-colored lesions
 * pink lesions
 * yellow lesions
 * red lesions
 * red-brown lesions
 * blue lesions
 * violaceous lesions
 * purple lesions
 * brown and black lesions
 * cutaneous metastases
 * purpura
 * ulcers
 * fever and rash
 * further reading
 * 59 [[immunologically mediated skin diseases
 * autoimmune cutaneous diseases
 * pemphigus vulgaris
 * pemphigus foliaceus
 * paraneoplastic pemphigus
 * bullous pemphigoid
 * pemphigoid gestationis
 * dermatitis herpetiformis
 * linear iga disease
 * epidermolysis bullosa acquisita
 * mucous membrane pemphigoid
 * autoimmune systemic diseases with prominent cutaneous features
 * dermatomyositis
 * lupus erythematosus
 * scleroderma and morphea
 * further reading
 * 60 cutaneous drug reactions
 * use of prescription drugs in theunited states
 * incidence of cutaneous reactions
 * pathogenesis of drug reactions
 * nonimmunologic drug reactions
 * immunologic drug reactions
 * immediate reactions
 * immune complex–dependent reactions
 * delayed hypersensitivity
 * genetic factors and cutaneous drug reactions
 * global considerations
 * clinical presentation of cutaneous drug reactions
 * nonimmune cutaneous reactions
 * exacerbation or induction of dermatologic diseases
 * photosensitivity eruptions
 * pigmentation changes
 * warfarin necrosis of skin
 * drug-induced hair disorders
 * drug-induced nail disorders
 * toxic erythema of chemotherapy and other chemotherapy reactions
 * immune cutaneous reactions: common
 * maculopapular eruptions
 * pruritus
 * urticaria/angioedema/anaphylaxis
 * anaphylactoid reactions
 * irritant/allergic contact dermatitis
 * fixed drug eruptions
 * immune cutaneous reactions: rare and severe
 * drug-induced hypersensitivity syndrome
 * stevens-johnson syndrome and toxic epidermal necrolysis
 * pustular eruptions
 * overlap hypersensitivity syndromes
 * vasculitis
 * management of the patient with suspected drug eruption
 * early diagnosis of severe eruptions
 * confirmation of drug reaction
 * what drug(S) To suspect and withdraw
 * recommendation for future use of drugs
 * cross-sensitivity
 * role of testing for causality and drug rechallenge
 * reporting
 * further reading
 * 61 photosensitivity and other reactions to sunlight
 * solar radiation
 * uv radiation (Uvr) And skin structure andfunction
 * molecular targets for uvr-induced skin effects
 * cutaneous optics and chromophores
 * acute effects of sun exposure
 * chronic effects of sun exposure: nonmalignant
 * chronic effects of sun exposure: malignant
 * photoimmunology
 * photosensitivity diseases
 * polymorphous light eruption
 * phototoxicity and photoallergy
 * porphyria
 * photoprotection
 * phototherapy and photochemotherapy
 * further reading
 * section 9 hematologic alterations]]
 * 62 interpreting peripheral blood smears
 * normal peripheral blood smear
 * reticulocyte count preparation
 * hypochromic microcytic anemia of iron deficiency
 * iron deficiency anemia next to normal red blood cells
 * polychromatophilia
 * macrocytosis
 * hypersegmented neutrophils
 * spherocytosis
 * rouleaux formation
 * red cell agglutination
 * fragmented red cells
 * sickle cells
 * target cells
 * elliptocytosis
 * stomatocytosis
 * acanthocytosis
 * howell-jolly bodies
 * teardrop cells and nucleated red blood cells characteristic of myelofibrosis
 * myelofibrosis of the bone marrow
 * reticulin stain of marrow myelofibrosis
 * stippled red cell in lead poisoning
 * heinz bodies
 * giant platelets
 * normal granulocytes
 * normal monocytes
 * normal eosinophils
 * normal basophil
 * pelger-hüet anomaly
 * döhle body
 * chédiak-higashi disease
 * 63 anemia and polycythemia
 * hematopoiesis and the physiologicbasis of red cell production
 * anemia
 * clinical presentation of anemia
 * approach to the patient
 * laboratory evaluation
 * peripheral blood smear
 * reticulocyte count
 * tests of iron supply and storage
 * bone marrow examination
 * other laboratory measurements
 * definition and classification of anemia
 * initial classification of anemia
 * hypoproliferative anemias
 * maturation disorders
 * blood loss/hemolytic anemia
 * treatment
 * polycythemia
 * further reading
 * 64 disorders of granulocytes and monocytes
 * neutrophils
 * maturation
 * marrow release andcirculating compartments
 * neutrophil abnormalities
 * neutropenia
 * hereditary neutropenias
 * neutrophilia
 * abnormal neutrophil function
 * mononuclear phagocytes
 * disorders of the mononuclearphagocyte system
 * eosinophils
 * eosinophilia
 * eosinopenia
 * hyperimmunoglobulin e–recurrent infection syndrome
 * laboratory diagnosis and management
 * further reading
 * 65 bleeding and thrombosis
 * steps of normal hemostasis
 * platelet plug formation
 * fibrin clot formation
 * antithrombotic mechanisms
 * the fibrinolytic system
 * approach to the patient
 * clinical presentation
 * history of bleeding
 * prohemorrhagic effects of medications and dietary supplements
 * underlying systemic diseases that cause or exacerbate a bleeding tendency
 * history of thrombosis
 * laboratory evaluation
 * screening assays
 * mixing studies
 * specific factor assays
 * testing for antiphospholipid antibodies
 * other coagulation tests
 * laboratory testing for thrombophilia
 * measures of platelet function
 * further reading
 * 66 enlargement of lymph nodes and spleen
 * lymphadenopathy
 * splenomegaly
 * splenectomy
 * [[further reading

pharmacology
]]
 * 67 principles of clinical pharmacology]]
 * global considerations
 * indications for drug therapy: risk versus benefit
 * adverse effects
 * therapeutic index
 * principles of pharmacokinetics
 * absorption and bioavailability
 * drug transport
 * drug metabolism
 * plasma half-life
 * drug distribution
 * drug elimination
 * active drug metabolites
 * the concept of high-risk pharmacokinetics
 * principles of pharmacodynamics
 * principles of dose selection
 * effects of disease on drug concentration and response
 * renal disease
 * liver disease
 * heart failure and shock
 * drug use in the elderly
 * drug use in children
 * interactions between drugs
 * adverse drug reactions
 * scope of the problem
 * toxicity unrelated to a drug’s primarypharmacologic activity
 * acetaminophen
 * immunologic reactions
 * diagnosis and treatment of adverse drug reactions
 * the drug development process
 * summary
 * further reading
 * 68 pharmacogenomics]]
 * principles of genetic variation and drug response
 * types of genetic variants influencing drug response
 * candidate gene approaches
 * genome-wide association studies
 * genetic variants affecting pharmacokinetics
 * cyp3a
 * cyp2d6
 * cyp2c19
 * cyp2c9
 * dpyd
 * transferase variants
 * transporter variants
 * genetic variants affecting pharmacodynamics
 * immunologically mediated drug reactions
 * tumor and infectious agent genomes
 * incorporating pharmacogenetic information into clinical practice
 * point of care versus preemptive approaches
 * challenges
 * developing evidence that pharmacogenetic testing alters drug outcomes
 * genetics and drug development
 * finding protective alleles can identify drug targets
 * cancer
 * using multiple data types
 * summary
 * [[further reading

oncology and hematology
]] ]]
 * section 1 neoplastic disorders]]
 * 69 approach to the patient with cancer
 * the magnitude of the problem
 * patient management
 * diagnosis
 * defining the extent of disease and the prognosis
 * making a treatment plan
 * management of disease and treatmentcomplications
 * long-term follow-up/latecomplications
 * supportive care
 * pain
 * nausea
 * effusions
 * nutrition
 * psychosocial support
 * death and dying
 * end-of-life decisions
 * further reading
 * 70 prevention and early detection of cancer
 * education and healthful habits
 * smoking cessation
 * physical activity
 * diet modification
 * energy balance
 * un avoidance
 * cancer chemoprevention
 * chemoprevention of cancers of the upper aerodigestive tract
 * chemoprevention of colon cancer
 * chemoprevention of breast cancer
 * chemoprevention of prostate cancer
 * vaccines and cancer prevention
 * surgical prevention of cancer
 * cancer screening
 * the accuracy of screening
 * potential biases of screening tests
 * potential drawbacks of screening
 * assessment of screening tests
 * screening for specific cancers
 * breast cancer
 * cervical cancer
 * colorectal cancer
 * lung cancer
 * ovarian cancer
 * prostate cancer
 * skin cancer
 * further reading
 * 71 cancer genetics
 * cancer is a genetic disease
 * historical perspective
 * the clonal origin and multistep nature of cancer
 * two types of cancer genes: oncogenes and tumor-suppressor genes
 * oncogenes in human cancer
 * mechanisms of oncogene activation
 * point mutation
 * dna amplification
 * chromosomal rearrangement
 * chromosomal instability in solid tumors
 * tumor-suppressor gene inactivation in cancer
 * familial cancer syndromes
 * genetic testing for familial cancer
 * viruses in human cancer
 * cancer genomes
 * tumor heterogeneity
 * personalized cancer detection and treatment
 * the future
 * further reading
 * 72 cancer cell biology
 * cancer cell biology
 * cancer as an organ that ignores its niche
 * cell cycle checkpoints
 * cellular senescence
 * signal transduction pathways in cancer cells
 * cancer-specific genetic changes and synthetic lethality
 * epigenetic influences on cancer gene transcription
 * apoptosis and other mechanisms of cell death
 * metastasis
 * cancer stem cells
 * plasticity and resistance
 * cancer metabolism
 * tumor microenvironment, angiogenesis, and immune evasion
 * obesity and cancer
 * mechanisms of tumor vessel formation
 * antiangiogenic therapy
 * evasion of the immune system by cancers
 * summary
 * further reading
 * 73 principles of cancer treatment
 * cancer presentation
 * detection of a cancer
 * establishing a cancer diagnosis
 * cancer staging
 * cancer treatment
 * localized cancer treatments
 * surgery
 * radiation
 * other localized cancer treatments
 * systemic cancer treatments
 * systemic cancer therapy overview
 * general principles
 * strategies in systemic cancer management
 * cancer biologic therapy
 * antibody-mediated therapeutic approaches
 * nontargeted immunomodulators
 * cytokines
 * t cell–mediated therapies
 * oncolytic viruses
 * cancer cytotoxic therapy
 * dna-interactive agents
 * antitumor antibiotics and topoisomerase poisons
 * antimetabolites
 * mitotic spindle inhibitors
 * cancer molecular targeted therapy
 * hormone receptor–directed therapy
 * non-receptor-linked tyrosine kinase antagonists
 * receptor-linked tyrosine kinase antagonists
 * ras/raf/mek antagonists
 * multikinase inhibitors
 * cyclin-dependent kinase inhibitors
 * protein homeostasis modulators
 * chromatin-modifying agents
 * cancer cell metabolism modulators
 * dna repair pathway modulators
 * miscellaneous targeted therapies
 * systemic radiation therapy
 * resistance to cancer treatments
 * supportive care during cancer treatment
 * myelosuppression
 * nausea and vomiting
 * diarrhea
 * mucositis
 * alopecia
 * gonadal dysfunction and pregnancy
 * palliative and supportive care
 * further reading
 * 74 infections in patients with cancer
 * system-specific syndromes
 * skin-specific syndromes
 * catheter-related infections
 * gastrointestinal tract–specificsyndromes
 * central nervous system–specific syndromes
 * pulmonary infections
 * cardiovascular infections
 * endocrine syndromes
 * musculoskeletal infections
 * renal and ureteral infections
 * abnormalities that predispose to infection
 * the lymphoid system
 * the hematopoietic system
 * treatment
 * antibacterial therapy
 * antifungal therapy
 * antiviral therapy
 * other therapeutic modalities
 * prevention of infection in cancer patients
 * effect of the environment
 * physical measures
 * immunoglobulin replacement
 * sexual practices
 * antibiotic prophylaxis
 * vaccination of cancer patients
 * in memoriam
 * further reading
 * website
 * 75 oncologic emergencies
 * structural-obstructive oncologicemergencies
 * superior vena cava syndrome
 * pericardial effusion/tamponade
 * intestinal obstruction
 * urinary obstruction
 * malignant biliary obstruction
 * spinal cord compression
 * increased intracranial pressure
 * neoplastic meningitis
 * seizures
 * pulmonary and intracerebral leukostasis
 * hemoptysis
 * airway obstruction
 * metabolic emergencies
 * hypercalcemia
 * syndrome of inappropriate secretion of antidiuretic hormone
 * lactic acidosis
 * hypoglycemia
 * adrenal insufficiency
 * treatment-related emergencies
 * tumor lysis syndrome
 * human antibody infusion reactions
 * hemolytic-uremic syndrome
 * neutropenia and infection
 * pulmonary infiltrates
 * neutropenic enterocolitis
 * hemorrhagic cystitis
 * hypersensitivity reactions to antineoplastic drugs
 * further reading
 * 76 cancer of the skin
 * melanoma
 * risk factors and epidemiology
 * global considerations
 * genetic susceptibility to melanoma
 * prevention and early detection
 * diagnosis
 * classification and pathogenesis
 * prognostic factors
 * staging
 * treatment: melanoma
 * treatment: metastatic disease
 * nonmelanoma skin cancers
 * pathophysiology and etiology
 * clinical presentation
 * natural history
 * treatment
 * prevention
 * other nonmelanoma cutaneous malignancies
 * further reading
 * 77 head and neck cancer
 * incidence and epidemiology
 * etiology and genetics
 * histopathology, carcinogenesis, and molecular biology
 * clinical presentation and differential diagnosis
 * treatment
 * salivary gland tumors
 * further reading
 * 78 neoplasms of the lung
 * epidemiology
 * risk factors
 * pathology
 * immunohistochemistry
 * molecular pathogenesis
 * early detection and screening
 * clinical manifestations
 * diagnosing lung cancer
 * staging lung cancer
 * anatomic staging of patients with lung cancer
 * staging system for non-small-cell lung cancer
 * staging system for small-cell lung cancer
 * physiologic staging
 * treatment: non-small-cell lung cancer
 * occult and stage 0 carcinomas
 * solitary pulmonary nodule and “ground-glass” opacities
 * management of stages i and ii nsclc
 * management of stage iii nsclc
 * management of metastatic nsclc
 * treatment: small-cell lung cancer
 * surgery for limited-disease small-cell lung cancer
 * chemotherapy
 * thoracic radiation therapy
 * prophylactic cranial irradiation
 * thymic tumors
 * clinical manifestations
 * staging
 * treatment
 * covid-19 and lung cancer
 * summary
 * further reading
 * 79 breast cancer
 * introduction and background
 * epidemiology and risk factors
 * prevention of breast cancer
 * screening for breast cancer
 * evaluation of breast masses
 * palpable breast masses
 * abnormal mammogram
 * breast masses in pregnancy or lactation
 * pathologic findings of the breast
 * benign breast histopathology
 * noninvasive breast neoplasms
 * ductal carcinoma in situ
 * lobular carcinoma (Neoplasia) In situ
 * invasive breast cancers
 * staging and diagnostic considerations
 * treatment
 * general considerations
 * local (Primary) Treatments
 * adjuvant systemic therapies
 * stage iii breast cancer
 * simultaneous new primary with detectable metastases
 * breast cancer survivorship issues
 * metastatic disease
 * systemic treatments for metastatic breast cancer
 * breast cancer in pregnancy
 * male breast cancer
 * further reading
 * 80 upper gastrointestinal tract cancers
 * esophageal cancer
 * incidence and causative factors
 * screening and surveillance of higher risk groups
 * genomic alterations
 * presenting symptoms
 * staging
 * treatment
 * tumors of the stomach
 * gastric lymphomas
 * uncommon tumors of the esophagus and stomach
 * neuroendocrine tumors
 * gastrointestinal stromal tumors
 * small-bowel neoplasms
 * small-bowel gastrointestinal stromal tumors
 * carcinoid (Neuroendocrine) Tumors of the small bowel
 * benign neoplasms of the small bowel
 * further reading
 * 81 lower gastrointestinal cancers
 * colorectal cancer
 * incidence
 * polyps and molecular pathogenesis
 * etiology and risk factors
 * hereditary factors and syndromes
 * inflammatory bowel disease
 * other high-risk conditions
 * primary prevention
 * screening
 * clinical features
 * treatment
 * cancers of the anus
 * 82 tumors of the liver and biliary tree
 * hepatocellular carcinoma
 * epidemiology and risk factors
 * molecular pathogenesis
 * prevention and early detection
 * treatment
 * surgical therapies
 * locoregional therapies
 * systemic therapies
 * cholangiocarcinoma
 * epidemiology, risk factors, and molecular traits
 * intrahepatic cholangiocarcinoma
 * treatment
 * extrahepatic cholangiocarcinoma
 * gallbladder cancer
 * other malignant liver tumors
 * fibrolamellar hepatocellular carcinoma
 * hepatoblastoma
 * benign liver tumors
 * further reading
 * 83 pancreatic cancer
 * epidemiology
 * risk factors
 * pathology and molecular consideration
 * clinical features
 * diagnostic workup
 * important immediate considerations in patient care
 * clinical staging
 * treatment
 * future directions
 * further reading
 * 84 gastrointestinal neuroendocrine tumors
 * incidence and prevalence
 * histologic classification and molecular features
 * clinical presentation and management of localized pancreatic neuroendocrine tumors
 * gastrinoma
 * insulinoma
 * glucagonoma
 * somatostatinoma
 * vipoma
 * other secretory pancreatic nets
 * pancreatic nets arising in the setting ofmen 1
 * nonfunctioning pancreatic nets
 * clinical presentation and management of localized extrapancreatic gastrointestinal neuroendocrine tumors
 * gastric nets
 * nets of the small intestine
 * nets of the appendix
 * rectal nets
 * clinical presentation, diagnosis, and evaluation of patients with metastatic neuroendocrine tumors
 * management of symptoms of hormone hypersecretion and the carcinoid syndrome
 * diagnosis and treatment of the carcinoid syndrome
 * carcinoid crisis
 * carcinoid heart disease
 * hepatic-directed therapy for metastatic nets
 * systemic treatment to control tumor growth
 * somatostatin analogues
 * peptide receptor radioligand therapy
 * alkylating agents
 * small-molecule tyrosine kinase inhibitors
 * mtor inhibitors
 * other systemic treatments for controlof tumor growth
 * systemic therapy for high-gradeneuroendocrine carcinoma
 * further reading
 * 85 renal cell carcinoma
 * epidemiology
 * pathology and genetics
 * clinical presentation
 * staging and prognosis
 * treatment
 * global considerations
 * further reading
 * 86 cancer of the bladder and urinary tract
 * global considerations
 * introduction
 * clinical epidemiology and risk factors
 * clinical presentation and diagnosticworkup
 * histology
 * molecular biology
 * staging and outcomes by stage
 * treatment approaches
 * further reading
 * 87 benign and malignant diseases of the prostate
 * anatomy and pathology
 * prostate cancer
 * epidemiology
 * diagnosis and treatment by clinical state
 * treatment
 * benign disease
 * benign prostatic hyperplasia
 * further reading
 * 88 testicular cancer
 * incidence
 * global considerations
 * epidemiology
 * biology
 * pathology
 * initial presentation
 * signs and symptoms
 * physical examination
 * diagnostic testing
 * serum tumor markers
 * initial management
 * inguinal orchiectomy
 * staging
 * stage-based management
 * stage i
 * stage ii
 * stage iii
 * chemotherapy
 * postchemotherapy surgery
 * relapsed disease
 * extragonadal gcts
 * testicular non–germ cell tumors
 * survivorship and late effects
 * further reading
 * 89 gynecologic malignancies
 * ovarian cancer
 * incidence and pathology
 * ovarian cancer of epithelial origin
 * epidemiology
 * genetics and pathogenesis
 * screening
 * treatment
 * uncommon ovarian tumors
 * low malignant potential tumors (Borderline tumors)
 * stromal tumors
 * germ cell tumors of the ovary
 * fallopian tube cancer
 * cervical cancer
 * etiology and genetics
 * hpv infection and prevention
 * clinical presentations
 * uterine cancer
 * epidemiology
 * pathology
 * clinical presentation
 * treatment
 * gestational trophoblastic tumors
 * risk factors
 * presentation of invasive trophoblastic disease
 * treatment: invasive trophoblastic disease
 * 90 primary and metastatic tumors of the nervous system
 * approach to the patient
 * treatment: brain tumors
 * primary brain tumors
 * epidemiology
 * molecular pathogenesis
 * intrinsic “malignant” tumors
 * diffuse gliomas
 * astrocytomas
 * oligodendroglioma
 * ependymomas
 * other less common gliomas
 * primary central nervous system lymphoma
 * medulloblastomas
 * pineal region tumors
 * extrinsic “benign” tumors
 * meningiomas
 * schwannomas
 * pituitary tumors
 * craniopharyngiomas
 * other benign tumors
 * dysembryoplastic neuroepithelial tumors (Dnts)
 * epidermoid cysts
 * dermoid cysts
 * colloid cysts
 * neurocutaneous syndromes (Phakomatoses)
 * neurofibromatosis type 1 (Von recklinghausen’s disease)
 * neurofibromatosis type 2
 * tuberous sclerosis (Bourneville disease)
 * tumors metastatic to the brain
 * diagnosis of metastases
 * treatment
 * leptomeningeal metastases
 * clinical features
 * laboratory and imaging diagnosis
 * treatment
 * epidural metastasis
 * clinical features
 * diagnosis
 * treatment
 * neurologic toxicity of therapy
 * toxicity from radiotherapy
 * toxicity from chemotherapy
 * further reading
 * 91 soft tissue and bone sarcomas and bone metastases
 * soft tissue sarcomas
 * incidence
 * epidemiology
 * genetic considerations
 * classification
 * diagnosis
 * staging and prognosis
 * treatment
 * bone sarcomas
 * incidence and epidemiology
 * classification
 * osteosarcoma
 * chondrosarcoma
 * ewing’s sarcoma
 * tumors metastatic to bone
 * further reading
 * 92 carcinoma of unknown primary
 * cup biology
 * approach to the patient
 * role of serum tumor markers and cytogenetics
 * role of imaging studies
 * role of pathologic studies
 * light microscopy evaluation
 * role of ihc analysis
 * role of cancer classifier molecular profiling
 * role of next-generation sequencing
 * treatment
 * general considerations
 * treatment of favorable cup subsets
 * women with isolated axillary adenopathy
 * women with peritoneal carcinomatosis
 * poorly differentiated carcinoma with midline adenopathy
 * neuroendocrine cancer
 * squamous cell carcinoma presenting as neck adenopathy
 * solitary metastatic sites
 * men with blastic skeletal metastases and elevated psa
 * management of disseminated cup
 * summary
 * further reading
 * 93 paraneoplastic syndromes: endocrinologic/hematologic
 * endocrine paraneoplastic syndromes
 * hypercalcemia caused by ectopic production of pthrp
 * ectopic vasopressin: tumor-associated syndrome of inappropriate antidiuretic hormone
 * cushing’s syndrome caused by ectopic acth production
 * tumor-induced hypoglycemia caused by excess production of insulin-like growth factor type ii
 * human chorionic gonadotropin
 * oncogenic osteomalacia
 * consumptive hypothyroidism
 * hematologic syndromes
 * erythrocytosis
 * granulocytosis
 * thrombocytosis
 * eosinophilia
 * thrombophlebitis and deep venous thrombosis
 * miscellaneous remote effects ofcancer
 * further reading
 * 94 paraneoplastic neurologic syndromes and autoimmune encephalitis
 * pathogenesis
 * approach to the patient: paraneoplastic neurologic disorders
 * specific paraneoplastic neurologic syndromes
 * paraneoplastic encephalomyelitis and focal encephalitis with antibodies against intracellular neuronal proteins
 * encephalitides with antibodies to cell-surface or synaptic proteins
 * paraneoplastic cerebellar degeneration
 * paraneoplastic opsoclonus-myoclonus syndrome
 * paraneoplastic syndromes of the spinal cord
 * paraneoplastic stiff-person syndrome
 * paraneoplastic sensory neuronopathy or dorsal root ganglionopathy
 * paraneoplastic peripheral neuropathies
 * lambert-eaton myasthenic syndrome
 * myasthenia gravis
 * polymyositis-dermatomyositis
 * immune-mediated necrotizing myopathy
 * paraneoplastic visual syndromes
 * further reading
 * 95 cancer survivorship and the long-term impact of cancer and its treatment
 * cardiovascular dysfunction
 * pulmonary dysfunction
 * immune system dysfunction
 * reproductive and endocrine dysfunction
 * neurologic dysfunction
 * hepatic and gastrointestinal dysfunction
 * renal and bladder dysfunction
 * psychological dysfunction and socioeconomic impact of survivorship
 * cancer survivorship care plans
 * outlook
 * [[further reading
 * section 2 hematopoietic disorders]]
 * 96 hematopoietic stem cells
 * cardinal functions of hematopoietic stem cells
 * developmental biology of hematopoieticstem cells
 * mobility of hematopoietic stem cells
 * hematopoietic stem cell microenvironment
 * excess capacity of hematopoietic stem cells
 * hematopoietic stem cell differentiation
 * self-renewal
 * cancer is similar to an organ with self-renewing capacity
 * what else can hematopoietic stem cells do?
 * stem cells as targets of gene therapy
 * further reading
 * 97 iron deficiency and other hypoproliferative anemias
 * iron metabolism
 * the iron cycle in humans
 * nutritional iron balance
 * iron-deficiency anemia
 * stages of iron deficiency
 * causes of iron deficiency
 * clinical presentation of iron deficiency
 * laboratory iron studies
 * differential diagnosis
 * treatment
 * other hypoproliferative anemias
 * anemia of acute and chronic inflammation/infection (Ai)
 * anemia of chronic kidney disease (Ckd)
 * anemia in hypometabolic states
 * anemia in aging
 * treatment: hypoproliferative anemias
 * further reading
 * 98 disorders of hemoglobin
 * hemoglobin
 * developmental biology
 * globin gene clusters
 * hemoglobin structure
 * hemoglobin function
 * globin gene switching
 * diagnosis of hemoglobin disorders
 * sickle cell disease
 * origin, spread, and epidemiology
 * pathophysiology
 * diagnosis
 * complications
 * sickle cell trait (Carriers, or simple heterozygosity for the hbs gene)
 * treatment, screening, counseling, and antenatal diagnosis
 * thalassemia
 * β thalassemia
 * epidemiology
 * classification
 * diagnosis
 * complications
 * management, screening, counseling,and antenatal diagnosis
 * α thalassemia
 * epidemiology
 * classification
 * pathophysiology
 * diagnosis
 * complications
 * management, screening, counseling, and antenatal diagnosis
 * other hemoglobinopathies of clinical importance
 * m hemoglobins
 * unstable hemoglobins
 * hemoglobins with high oxygen affinity and low oxygen affinity
 * acquired disorders of hemoglobin
 * further reading
 * 99 megaloblastic anemias
 * cobalamin
 * dietary sources and requirements
 * absorption
 * transport
 * folate
 * dietary folate
 * absorption
 * transport
 * biochemical functions
 * biochemical basis of megaloblastic anemia
 * clinical features
 * hematologic findings
 * peripheral blood
 * bone marrow
 * chromosomes
 * ineffective hematopoiesis
 * causes of cobalamin deficiency
 * inadequate dietary intake
 * gastric causes of cobalamin malabsorption
 * juvenile pernicious anemia
 * congenital intrinsic factor deficiency or functional abnormality
 * gastrectomy
 * food cobalamin malabsorption
 * intestinal causes of cobalamin malabsorption
 * abnormalities of cobalamin metabolism
 * causes of folate deficiency
 * nutritional
 * malabsorption
 * excess utilization or loss
 * antifolate drugs
 * congenital abnormalities of folate metabolism
 * diagnosis of cobalamin and folate deficiencies
 * treatment
 * megaloblastic anemia not due to cobalamin or folate deficiency or altered metabolism
 * 100 hemolytic anemias
 * definitions
 * general clinical and laboratoryfeatures
 * general pathophysiology
 * inherited hemolytic anemias
 * hemolytic anemias due to abnormalities of the membranecytoskeleton complex
 * hereditary spherocytosis
 * hereditary elliptocytosis
 * channelopathies
 * enzyme abnormalities
 * abnormalities of the glycolytic pathway
 * pyruvate kinase deficiency
 * other glycolytic enzyme abnormalities
 * abnormalities of redox metabolism
 * glucose-6-phosphate dehydrogenase (G6pd) Deficiency
 * other abnormalities of the redox system
 * pyrimidine 5’-nucleotidase (P5n) Deficiency
 * familial (Atypical) Hemolytic-uremic syndrome (Ahus)
 * acquired hemolytic anemia
 * mechanical destruction of red cells
 * infection
 * immune hemolytic anemias
 * autoimmune hemolytic anemia, warm type (Waiha: for simplicity we will use the acronym aiha)
 * paroxysmal cold hemoglobinuria (Pch)
 * cold agglutinin disease
 * hemolytic anemia from toxic agents and drugs
 * paroxysmal nocturnal hemoglobinuria (Pnh)
 * further reading
 * 101 anemia due to acute blood loss
 * treatment
 * further reading
 * 102 bone marrow failure syndromes including aplastic anemia and myelodysplasia
 * aplastic anemia
 * definition
 * epidemiology
 * etiology
 * pathophysiology
 * clinical features
 * laboratory studies
 * diagnosis
 * prognosis
 * treatment
 * pure red cell aplasia
 * definition and differential diagnosis
 * clinical associations and etiology
 * persistent parvovirus b19 infection
 * treatment
 * myelodysplastic syndromes
 * definition
 * epidemiology
 * etiology and pathophysiology
 * clinical features
 * laboratory studies
 * differential diagnosis
 * prognosis
 * treatment
 * myelophthisic anemias
 * further reading
 * 103 polycythemia vera and other myeloproliferative neoplasms
 * polycythemia vera
 * etiology
 * clinical features
 * diagnosis
 * complications
 * treatment
 * primary myelofibrosis
 * etiology
 * clinical features
 * diagnosis
 * complications
 * treatment
 * essential thrombocytosis
 * etiology
 * clinical features
 * diagnosis
 * complications
 * treatment
 * further reading
 * 104 acute myeloid leukemia
 * incidence
 * etiology
 * classification
 * prognostic factors
 * clinical presentation
 * symptoms
 * physical findings
 * hematologic findings
 * pretreatment evaluation
 * treatment
 * induction chemotherapy
 * postremission therapy
 * supportive care
 * treatment for refractory or relapsed aml
 * treatment of acute promyelocytic leukemia
 * further reading
 * 105 chronic myeloid leukemia
 * incidence and epidemiology
 * etiology
 * pathophysiology
 * clinical presentation
 * symptoms
 * physical findings
 * hematologic and marrow findings
 * cytogenetic and molecular findings
 * findings in cml transformation
 * prognosis and cml course
 * treatment
 * global aspects of cml
 * further reading
 * 106 acute lymphoid leukemia
 * incidence and age
 * etiology
 * congenital disorders
 * infectious agents
 * diagnosis and classification
 * peripheral blood
 * bone marrow examination
 * lumbar puncture
 * morphologic subtypes in all
 * immunologic subtypes
 * cytogenetic and molecular analysis
 * minimal residual disease
 * molecular response after induction therapy and impact on outcome
 * prognostic factors, risk stratification, and mrd
 * treatment principles
 * pre-phase therapy
 * induction therapy
 * postremission consolidation
 * maintenance therapy
 * treatment of all patients according to age
 * prophylaxis and treatment of central nervous system leukemia
 * stem cell transplantation
 * pediatric-inspired therapies for adolescents and young adults
 * adult all
 * elderly all
 * targeted therapies
 * tyrosine kinase inhibitors in philadelphia-positive all
 * immunotherapeutic approaches
 * anti-cd20
 * anti-cd22
 * anti-cd19
 * car-t cells
 * toxicities of immunotherapies
 * treatment of t-all
 * conclusion and future directions
 * further reading
 * 107 chronic lymphocytic leukemia
 * epidemiology
 * biology and pathophysiology
 * cell of origin
 * b-cell receptor signaling in cll
 * cytogenetic abnormalities
 * gene mutations and mir alterations
 * immunology
 * clinical presentation and diagnosisof cll
 * monoclonal b-cell lymphocytosis
 * complications of cll
 * infections
 * secondary malignancies
 * autoimmune complications
 * richter’s transformation
 * workup of cll and approach to therapy
 * workup and staging
 * staging
 * criteria for the initiation of therapy
 * initial therapy for cll
 * btk inhibitors
 * bcl2 inhibitor
 * pi3k inhibitors
 * chemoimmunotherapy
 * therapy of relapsed cll
 * assessing response to therapy and minimal residual disease in cll
 * conclusion
 * further reading
 * 108 non-hodgkin’s lymphoma
 * epidemiology and etiology
 * immunology
 * approach to the patient
 * clinical features, treatment, and prognosis of specific nhl
 * mature b-cell neoplasms
 * burkitt’s lymphoma
 * diffuse large b-cell lymphoma
 * follicular lymphoma
 * marginal zone lymphoma
 * lymphoplasmacytic lymphoma
 * mantle cell lymphoma
 * mature (Peripheral) T cell disorders
 * mycosis fungoides
 * peripheral t-cell lymphoma, not otherwise specified
 * angioimmunoblastic t-cell lymphoma
 * anaplastic large-cell lymphoma
 * other ptcl subtypes
 * adult t-cell leukemia/lymphoma
 * extranodal nk/t-cell lymphoma, nasal type
 * further reading
 * 109 hodgkin’s lymphoma
 * epidemiology and etiology
 * approach to the patient
 * treatment
 * further reading
 * 110 less common lymphoid and myeloid malignancies
 * rare lymphoid malignancies
 * mature b-cell neoplasms
 * b-cell prolymphocytic leukemia (B-pll)
 * splenic marginal zone lymphoma (Smzl)
 * hairy cell leukemia
 * nodal marginal zone b cell lymphoma
 * mediastinal (Thymic) Large b-cell lymphoma
 * intravascular large b-cell lymphoma
 * primary effusion lymphoma
 * lymphomatoid granulomatosis
 * mature t-cell and nk cell neoplasms
 * t-cell prolymphocytic leukemia
 * t-cell large granular lymphocytic leukemia
 * aggressive nk cell leukemia
 * extranodal nk/t-cell lymphoma, nasal type
 * enteropathy-type t-cell lymphoma
 * hepatosplenic t-cell lymphoma
 * subcutaneous panniculitis-like t-cell lymphoma
 * blastic nk cell lymphoma
 * primary cutaneous cd30+ t-cell lymphoma
 * angioimmunoblastic t-cell lymphoma
 * rare myeloid malignancies
 * chronic neutrophilic leukemia
 * atypical chronic myeloid leukemia
 * chronic myelomonocytic leukemia
 * juvenile myelomonocytic leukemia
 * mds/mpn, unclassifiable (Mds/mpn-u)
 * mds/mpn with ring sideroblasts and thrombocytosis (Mds/mpn-rs-t)
 * myeloproliferative neoplasm, unclassifiable (Mpn-u)
 * myeloid neoplasms with germline predisposition
 * transient myeloproliferative disorder (Tmd)
 * primary eosinophilia
 * mastocytosis
 * dendritic and histiocytic neoplasms
 * further reading
 * 111 plasma cell disorders
 * multiple myeloma
 * definition
 * etiology
 * incidence and prevalence
 * global considerations
 * pathogenesis and clinical manifestations
 * diagnosis and staging
 * prognosis
 * treatment
 * waldenström’s macroglobulinemia
 * poems syndrome
 * heavy chain diseases
 * gamma heavy chain disease (Franklin’s disease)
 * alpha heavy chain disease (Seligmann’s disease)
 * mu heavy chain disease
 * further reading
 * 112 amyloidosis
 * general principles
 * al amyloidosis
 * etiology and incidence
 * pathology and clinical features
 * diagnosis
 * staging system and risk stratification
 * treatment
 * aa amyloidosis
 * etiology and incidence
 * pathology and clinical features
 * treatment
 * attr and af amyloidosis
 * aβ2m amyloidosis
 * therapeutic frontiers
 * summary
 * further reading
 * 113 transfusion therapy and biology
 * blood components
 * blood group antigens and antibodies
 * clinical indications and efficacy assessment of blood components
 * adverse reactions to blood components
 * immune-mediated adverse reactions
 * hemolytic transfusion adverse reactions
 * febrile nonhemolytic transfusion reaction
 * allergic reactions
 * graft-versus-host disease
 * transfusion-related acute lung injury
 * posttransfusion purpura
 * alloimmunization/platelet refractoriness
 * immunomodulation
 * nonimmunologic transfusion adversereactions
 * fluid overload
 * massive transfusion-associated reactions/electrolyte and cold toxicity reactions
 * iron overload
 * hypotensive reactions
 * adverse transfusion reactions of uncertain imputability
 * infectious adverse reactions
 * alternatives and perspectives
 * further reading
 * 114 hematopoietic cell transplantation
 * the hematopoietic stem cell
 * categories of hematopoietic celltransplantation
 * the transplant preparative regimen
 * the transplant procedure
 * engraftment and immune reconstitution
 * complications following hematopoietic cell transplantation
 * early direct chemoradiotoxicities
 * late direct chemoradiotoxicities
 * graft failure
 * graft-versus-host disease
 * infection
 * treatment
 * immunodeficiency disorders
 * aplastic anemia
 * hemoglobinopathies
 * other nonmalignant diseases
 * acute leukemia
 * chronic leukemia
 * myelodysplasia and myeloproliferativedisorders
 * lymphoma
 * myeloma
 * solid tumors
 * posttransplant relapse
 * further reading
 * section 3 disorders of hemostasis]]
 * 115 disorders of platelets and vessel wall
 * the platelet
 * the vessel wall
 * disorders of platelets
 * thrombocytopenia
 * approach to the patient
 * infection-induced thrombocytopenia
 * drug-induced thrombocytopenia
 * heparin-induced thrombocytopenia
 * immune thrombocytopenic purpura
 * inherited thrombocytopenia
 * thrombotic thrombocytopenic purpura and hemolytic-uremic syndrome
 * thrombotic thrombocytopenic purpura
 * hemolytic-uremic syndrome
 * thrombocytosis
 * qualitative disorders of platelet function
 * inherited disorders of platelet function
 * acquired disorders of platelet function
 * von willebrand disease
 * disorders of the vessel wall
 * metabolic and inflammatory disorders
 * inherited disorders of the vessel wall
 * further reading
 * 116 coagulation disorders
 * hemophilia a and b
 * factor xi deficiency
 * rare bleeding disorders
 * familial multiple coagulation deficiencies
 * disseminated intravascular coagulation
 * vitamin k deficiency
 * coagulation disorders associated with liver failure
 * further reading
 * 117 arterial and venous thrombosis
 * overview of thrombosis
 * arterial thrombosis
 * overview of arterialthrombosis
 * arterial thrombosisand vascular disease
 * the platelet
 * the role of platelets and thrombosis ininflammation
 * genetics of arterial thrombosis
 * venous thrombosis
 * overview of venous thrombosis
 * deep-venous thrombosis and pulmonary embolism
 * overview of the coagulation cascade and its role in venous thrombosis
 * risk factors for venous thrombosis
 * genetics of venous thrombosis
 * fibrinolysis and thrombosis
 * the distinction between arterial and venous thrombosis
 * further reading
 * 118 antiplatelet, anticoagulant, and fibrinolytic drugs
 * antiplatelet drugs
 * role of platelets in arterial thrombosis
 * aspirin
 * adp receptor antagonists
 * dipyridamole
 * gp iib/iiia receptor antagonists
 * vorapaxar
 * anticoagulants
 * parenteral anticoagulants
 * heparin
 * low-molecular-weight heparin
 * fondaparinux
 * parenteral direct thrombin inhibitors
 * oral anticoagulants
 * warfarin
 * direct oral anticoagulants
 * fibrinolytic drugs
 * role of fibrinolytic therapy
 * mechanism of action
 * streptokinase
 * anistreplase
 * urokinase
 * alteplase
 * tenecteplase
 * reteplase
 * conclusions and future directions
 * [[further reading

infectious
]]
 * section 1 basic considerations in infectious diseases]]
 * 119 approach to the patient with an infectious disease
 * historical perspective
 * global considerations
 * understanding the microbiota
 * when to consider an infectious etiology
 * approach to the patient
 * perspective
 * further reading
 * 120 molecular mechanisms of microbial pathogenesis
 * entry into the human host
 * establishment of infection
 * niche
 * attachment
 * replicative niche
 * survival in the vacuole
 * type iii secretion systems
 * type iv secretion systems
 * other secretion systems
 * survival in the cytosol
 * nutrient acquisition
 * cellular trafficking
 * avoidance of innate immune responses
 * complement
 * lysosomes
 * antimicrobial peptides
 * oxidative burst
 * neutrophil extracellular traps
 * pattern recognition receptors and their evasion
 * inhibition of adaptive immune responses
 * bacterial cytotoxins
 * tissue damage and pathogen dissemination
 * competition with commensal microbes
 * summary
 * further reading
 * 121 microbial genomics and infectious disease
 * microbial diagnostics
 * historical limitations and progress through genetic approaches
 * organism identification
 * pathogen discovery
 * antibiotic resistance
 * host-based diagnostics
 * therapeutics
 * genomic diagnostics informing therapeutics
 * genomics in drug and vaccine development
 * epidemiology of infectious diseases
 * transmission networks
 * origins and dynamics of pathogen spread
 * epidemic potential
 * pathogen evolution
 * global considerations
 * genomics and the covid-19 pandemic
 * summary
 * further reading
 * 122 approach to the acutely ill infected febrile patient
 * approach to the patient
 * treatment
 * specific presentations
 * sepsis without an obvious focus of primary infection
 * septic shock
 * overwhelming infection in asplenic patients
 * babesiosis
 * other sepsis syndromes
 * sepsis with skin manifestations
 * meningococcemia
 * rocky mountain spotted fever and other rickettsial diseases
 * purpura fulminans
 * ecthyma gangrenosum
 * other infections associated with rash
 * erythroderma
 * viral hemorrhagic fevers
 * sepsis with a soft tissue/muscle primary focus
 * necrotizing fasciitis
 * clostridial myonecrosis
 * neurologic infections with or without septic shock
 * bacterial meningitis
 * suppurative intracranial infections
 * brain abscess
 * cerebral malaria
 * intracranial and spinal epidural abscesses
 * other focal syndromes with afulminant course
 * rhinocerebral mucormycosis
 * acute bacterial endocarditis
 * inhalational anthrax
 * viral respiratory tract illness
 * avian and swine influenza
 * sars, covid-19, and mers
 * hantavirus pulmonary syndrome
 * clostridioides difficile infection
 * summary
 * further reading
 * 123 immunization principles and vaccine use
 * vaccine impact
 * direct and indirect effects
 * control, elimination, and eradication of vaccine-preventable diseases
 * outbreak detection and control
 * enhancing immunization in adults
 * immunization practice standards
 * deciding whom to vaccinate
 * assessing contraindications and precautions
 * history of immediate hypersensitivity to a vaccine component
 * pregnancy
 * immunosuppression
 * vaccine information statements
 * storage and handling
 * administration of vaccines
 * maintenance of vaccine records
 * vaccine safety monitoring and adverse event reporting
 * prelicensure evaluations of vaccine safety
 * postlicensure monitoring of vaccine safety
 * consumer access to and demand for immunization
 * strategies for providers and health care facilities
 * recommendation from the provider
 * system supports
 * immunization requirements
 * vaccination of health care staff
 * vaccination in nonmedical settings
 * performance monitoring
 * future trends
 * further reading
 * 124 health recommendations for international travel
 * epidemiology of travel-related conditions
 * general approach to advising international travelers
 * immunizations for travelers
 * immunizations for travelersto most destinations
 * immunizations for certainregions or situations
 * prevention of arthropod-borne infections
 * malaria prevention
 * prevention of other arthropod-borne infections
 * gastrointestinal illness
 * prevention of other travel-related problems
 * activity-specific infection risks
 * venous thromboembolism
 * altitude illness
 * jet lag
 * injuries
 * travelers with preexisting medical conditions
 * immunocompromised travelers
 * hiv-infected travelers
 * pregnant travelers
 * travelers with severe allergies
 * other pre-travel preparations
 * travel health kits
 * traveling with prescription medications
 * health care overseas and travel health insurance
 * special travel populations
 * post-travel medical care
 * outbreaks and emerging infectious diseases
 * further reading
 * 125 climate change and infectious disease
 * overview
 * greenhouse gases
 * temperature
 * precipitation
 * hurricanes
 * sea level rise
 * el niño southern oscillation
 * population migration and conflict
 * effects of climate change on infectious disease
 * vector-borne disease
 * malaria
 * dengue
 * other arbovirus infections
 * lyme disease
 * waterborne disease
 * combined sewer systems
 * rising temperatures and vibrio species
 * climate change, population displacement, and infectious disease epidemics
 * a broader view of climate change and health
 * further reading
 * section 2 clinical syndromes: community-acquired infections]]
 * 126 pneumonia
 * definition
 * pathophysiology
 * pathology
 * community-acquired pneumonia
 * etiology
 * epidemiology
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention
 * ventilator-associated pneumonia
 * etiology
 * epidemiology
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention
 * hospital-acquired pneumonia
 * global impact
 * further reading
 * 127 lung abscess
 * etiology
 * epidemiology
 * pathogenesis
 * pathology and microbiology
 * clinical manifestations
 * differential diagnosis
 * diagnosis
 * treatment
 * complications
 * prognosis and prevention
 * approach to the patient
 * further reading
 * 128 infective endocarditis
 * etiology
 * pathogenesis
 * clinical manifestations
 * diagnosis
 * treatment
 * outcome
 * prevention
 * further reading
 * 129 infections of the skin, muscles, and soft tissues
 * anatomic relationships: clues to the diagnosis of soft tissue infections
 * infections associated with vesicles
 * infections associated with bullae
 * infections associated with crusted lesions
 * folliculitis
 * papular and nodular lesions
 * ulcers with or without eschars
 * erysipelas
 * cellulitis
 * necrotizing fasciitis
 * myositis and myonecrosis
 * diagnosis
 * treatment
 * further reading
 * 130 infectious arthritis
 * approach to the patient
 * acute bacterial arthritis
 * pathogenesis
 * microbiology
 * nongonococcal bacterial arthritis
 * gonococcal arthritis
 * spirochetal arthritis
 * lyme disease
 * syphilitic arthritis
 * mycobacterial arthritis
 * fungal arthritis
 * viral arthritis
 * untitled
 * postinfectious or reactive arthritis
 * infections in prosthetic joints
 * further reading
 * 131 osteomyelitis
 * classification
 * vertebral osteomyelitis
 * pathogenesis
 * epidemiology
 * microbiology
 * clinical manifestations
 * diagnosis
 * treatment
 * complications
 * global considerations
 * osteomyelitis in long bones
 * pathogenesis
 * epidemiology
 * microbiology
 * clinical manifestations
 * diagnosis
 * treatment
 * complications
 * global considerations
 * periprosthetic joint infection
 * pathogenesis
 * epidemiology
 * microbiology
 * classification and clinical manifestations
 * diagnosis
 * treatment
 * prevention of hematogenous infection
 * global considerations
 * sternal osteomyelitis
 * pathogenesis
 * epidemiology
 * microbiology
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * global considerations
 * foot osteomyelitis
 * pathogenesis
 * epidemiology
 * risk factors
 * microbiology
 * diagnosis
 * treatment
 * global considerations
 * further reading
 * 132 intraabdominal infections and abscesses
 * peritonitis
 * primary (Spontaneous) Bacterial peritonitis
 * secondary peritonitis
 * peritonitis in patients undergoing continuous ambulatory peritoneal dialysis
 * tuberculous peritonitis
 * intraabdominal abscesses
 * intraperitoneal abscesses
 * pathogenesis and immunity
 * clinical presentation
 * diagnosis
 * treatment
 * visceral abscesses
 * liver abscesses
 * splenic abscesses
 * perinephric and renal abscesses
 * psoas abscesses
 * pancreatic abscesses
 * further reading
 * 133 acute infectious diarrheal diseases and bacterial food poisoning
 * pathogenic mechanisms
 * inoculum size
 * adherence
 * toxin production
 * invasion
 * host defenses
 * intestinal microbiota
 * gastric acid
 * intestinal motility
 * intestinal mucin
 * immunity
 * genetic determinants
 * approach to the patient
 * epidemiology
 * travel history
 * location
 * age
 * host immune status
 * bacterial food poisoning
 * laboratory evaluation
 * treatment
 * prophylaxis
 * further reading
 * 134 clostridioides difficile infection, including pseudomembranous colitis
 * definition
 * etiology and epidemiology
 * pathology and pathogenesis
 * global considerations
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention and control
 * further reading
 * 135 urinary tract infections, pyelonephritis, and prostatitis
 * definitions
 * epidemiology and risk factors
 * etiology
 * pathogenesis
 * approach to the patient
 * diagnostic tools
 * diagnostic approach
 * treatment
 * prevention of recurrent uti in women
 * prognosis
 * further reading
 * 136 sexually transmitted infections: overview and clinical approach
 * classification and epidemiology
 * management of common sexually transmitted disease (Std) Syndromes
 * urethritis in men
 * epididymitis
 * urethritis and the urethral syndrome in women
 * vulvovaginal infections
 * abnormal vaginal discharge
 * vaginal trichomoniasis
 * bacterial vaginosis
 * vulvovaginal pruritus, burning, or irritation
 * other causes of vaginal discharge or vaginitis
 * mucopurulent cervicitis
 * cervical ectopy
 * pelvic inflammatory disease
 * etiology
 * epidemiology
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention
 * ulcerative genital or perianal lesions
 * proctitis, proctocolitis, enterocolitis, and enteritis
 * prevention and control of stis
 * sti risk assessment
 * further reading
 * 137 encephalitis
 * definition
 * clinical manifestations
 * etiology
 * laboratory diagnosis
 * csf polymerase chain reaction
 * differential diagnosis
 * treatment
 * sequelae
 * chronic encephalitis
 * progressive multifocal leukoencephalopathy
 * subacute sclerosing panencephalitis
 * progressive rubella panencephalitis
 * further reading
 * 138 acute meningitis
 * bacterial meningitis
 * viral meningitis
 * subacute meningitis
 * further reading
 * 139 chronic and recurrent meningitis
 * clinical pathophysiology
 * approach to the patient: chronic meningitis
 * the immunosuppressed patient
 * further reading
 * 140 brain abscess and empyema
 * brain abscess
 * definition
 * epidemiology
 * etiology
 * pathogenesis and histopathology
 * clinical presentation
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * nonbacterial causes of infectious focal cns lesions
 * etiology
 * clinical presentation
 * diagnosis
 * treatment
 * subdural empyema
 * epidemiology
 * etiology
 * pathophysiology
 * clinical presentation
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * cranial epidural abscess
 * etiology and pathophysiology
 * clinical presentation
 * diagnosis
 * treatment
 * prognosis
 * suppurative thrombophlebitis
 * definition
 * anatomy and pathophysiology
 * clinical manifestations
 * diagnosis
 * treatment
 * further reading
 * 141 infectious complications of bites
 * dog bites
 * cat bites
 * other animal bites
 * human bites
 * approach to the patient
 * treatment
 * further reading
 * section 3 clinical syndromes: health care–associated infections]]
 * 142 infections acquired in health care facilities
 * organization, responsibilities, and scrutiny of health care–associated infection programs
 * surveillance
 * epidemiologic basis and general measures for prevention and control
 * nosocomial and device-relatedinfections
 * urinary tract infections
 * pneumonia
 * surgical-site (Wound) Infections
 * infections related to vascular access and monitoring
 * isolation techniques
 * epidemic and emerging problems
 * viral respiratory infections: coronavirus epidemics and pandemic influenza
 * other emerging viral pathogens
 * nosocomial diarrhea
 * chickenpox
 * mycobacteria
 * group a streptococcal infections
 * fungal infections
 * legionellosis
 * antibiotic-resistant bacteria: surveillance, control, and antibiotic and diagnostic stewardship
 * bioterrorism and other surge-event preparedness
 * employee health service issues
 * further reading
 * 143 infections in transplant recipients
 * pretransplantation evaluation
 * the donor
 * the recipient
 * the recipient
 * the donor cells/organ
 * infections in hematopoietic stem cell transplant recipients
 * bacterial infections
 * fungal infections
 * parasitic infections
 * viral infections
 * global considerations
 * kidney transplantation
 * heart transplantation
 * lung transplantation
 * liver transplantation
 * pancreas transplantation
 * composite-tissue transplantation
 * miscellaneous infections in solid organ transplantation
 * vaccination of transplant recipients
 * in memoriam
 * further reading
 * section 4 therapy for bacterial diseases]]
 * 144 treatment and prophylaxis of bacterial infections
 * mechanisms of action
 * inhibition of cell wall synthesis
 * β-lactams
 * glycopeptides and lipoglycopeptides
 * bacitracin (Topical) And fosfomycin
 * inhibition of protein synthesis
 * aminoglycosides
 * tetracyclines
 * macrolides and ketolides
 * lincosamides
 * streptogramins
 * chloramphenicol
 * oxazolidinones
 * pleuromutilins
 * mupirocin
 * inhibition of bacterial metabolism
 * sulfonamides
 * trimethoprim
 * inhibition of dna and rna synthesis or activity
 * quinolones
 * rifamycins
 * nitrofurantoin
 * metronidazole
 * disruption of membrane integrity
 * polymyxins
 * daptomycin
 * pharmacokinetics and pharmacodynamics
 * pharmacokinetics
 * pharmacodynamics
 * approach to therapy
 * empirical and directed therapy
 * site of infection
 * host factors
 * duration of therapy
 * failure of therapy
 * expert guidance
 * clinical use of antibacterial agents
 * β-lactams
 * glycopeptides and lipoglycopeptides
 * lipopeptides
 * aminoglycosides
 * macrolides and ketolides
 * clindamycin
 * tetracyclines
 * trimethoprim-sulfamethoxazole
 * fluoroquinolones
 * rifamycins
 * metronidazole
 * oxazolidinones
 * pleuromutilins
 * nitrofurantoin
 * polymyxins
 * quinupristin-dalfopristin
 * fosfomycin
 * chloramphenicol
 * approach to prophylaxis of infection
 * antimicrobial stewardship
 * further reading
 * 145 bacterial resistance to antimicrobial agents
 * definition of resistance
 * mechanisms of resistance
 * β-lactams
 * glycopeptides and lipoglycopeptides
 * aminoglycosides
 * tetracyclines
 * macrolides, ketolides, lincosamides, and streptogramins
 * chloramphenicol
 * oxazolidinones
 * pleuromutilins
 * mupirocin
 * sulfonamides and trimethoprim
 * quinolones
 * rifampin and rifabutin
 * metronidazole
 * nitrofurantoin
 * polymyxins
 * daptomycin
 * epidemiology of resistance and reduction of its occurrence
 * further reading
 * section 5 diseases caused by gram-positive bacteria]]
 * 146 pneumococcal infections
 * microbiology
 * etiologic agent
 * virulence factors
 * epidemiology
 * serotype distribution
 * nasopharyngeal carriage
 * invasive disease and pneumonia
 * antibiotic resistance
 * pathogenesis
 * host defense mechanisms
 * innate immunity
 * acquired immunity
 * approach to the patient
 * clinical manifestations
 * pneumonia
 * meningitis
 * other invasive syndromes
 * noninvasive syndromes
 * treatment
 * prevention
 * capsular polysaccharide vaccines
 * polysaccharide–protein conjugate vaccines
 * other prevention strategies
 * global health
 * further reading
 * websites
 * 147 staphylococcal infections
 * microbiology and taxonomy
 * s. Aureus infections
 * epidemiology
 * pathogenesis
 * diagnosis
 * clinical syndromes
 * non–s. Aureus staphylococcal infections
 * pathogenesis
 * diagnosis
 * clinical syndromes
 * treatment
 * prevention
 * further reading
 * 148 streptococcal infections
 * group a streptococci
 * pathogenesis
 * clinical manifestations
 * pharyngitis
 * bacteriologic treatment failure and the asymptomatic carrier state
 * scarlet fever
 * skin and soft tissue infections
 * impetigo (Pyoderma)
 * cellulitis
 * deep soft-tissue infections
 * pneumonia and empyema
 * bacteremia, puerperal sepsis, and streptococcal toxic shock syndrome
 * prevention
 * streptococci of groups c and g
 * group b streptococci
 * nonenterococcal group d streptococci
 * viridans and other streptococci
 * viridans streptococci
 * abiotrophia and granulicatella species (Nutritionally variant streptococci)
 * other streptococci
 * further reading
 * 149 enterococcal infections
 * microbiology and taxonomy
 * pathogenesis
 * epidemiology
 * clinical syndromes
 * urinary tract infection and prostatitis
 * bacteremia and endocarditis
 * meningitis
 * intraabdominal, pelvic, and soft tissue infections
 * other infections
 * treatment
 * further reading
 * 150 diphtheria and other corynebacterial infections
 * diphtheria
 * etiology
 * epidemiology
 * pathogenesis and immunology
 * approach to the patient
 * clinical manifestations
 * respiratory diphtheria
 * cutaneous diphtheria
 * infections due to non-diphtheriae corynebacterium species and nontoxigenic c. Diphtheriae
 * other clinical manifestations
 * complications
 * diagnosis
 * treatment
 * diphtheria antitoxin
 * antimicrobial therapy
 * management strategies
 * prognosis
 * prevention
 * vaccination
 * prophylaxis administration to contacts
 * other corynebacterial and rhodococcus infections
 * microbiology and laboratory diagnosis
 * epidemiology
 * clincal manifestations
 * c. Ulcerans
 * c. Pseudotuberculosis
 * c. Jeikeium (Group jk)
 * c. Urealyticum (Group d2)
 * c. Minutissimum (Erythrasma)
 * other nondiphtherial corynebacteria
 * rhodococcus
 * arcanobacteria
 * further reading
 * 151 listeria monocytogenes infections
 * microbiology
 * pathogenesis
 * immune response
 * epidemiology
 * clinical manifestations
 * diagnosis
 * treatment
 * prevention
 * further reading
 * 152 tetanus
 * definition
 * etiology
 * epidemiology
 * pathogenesis
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention
 * further reading
 * websites
 * 153 botulism
 * etiology and pathogenesis
 * epidemiology
 * clinical manifestations
 * clinical diagnosis and laboratory confirmation
 * treatment
 * prevention
 * global considerations
 * further reading
 * 154 gas gangrene and other clostridial infections
 * etiologic agent
 * epidemiology and transmission
 * clinical syndromes
 * clostridial wound contamination
 * polymicrobial infections involving clostridia
 * enteric clostridial infections
 * clostridial bacteremia
 * clostridial skin and soft tissue infections
 * clostridial myonecrosis (Gas gangrene)
 * toxic shock syndrome
 * other clostridial skin and soft tissue infections
 * further reading
 * section 6 diseases caused by gram-negative bacteria]]
 * 155 meningococcal infections
 * definition
 * etiology and microbiology
 * epidemiology
 * patterns of disease
 * factors associated with disease risk and susceptibility
 * pathogenesis
 * clinical manifestations
 * rash
 * meningitis
 * septicemia
 * chronic meningococcemia
 * postmeningococcal reactive disease
 * diagnosis
 * treatment
 * complications
 * prognosis
 * prevention
 * polysaccharide vaccines
 * conjugate vaccines
 * vaccines based on subcapsular antigens
 * management of contacts
 * further reading
 * 156 gonococcal infections
 * definition
 * microbiology
 * epidemiology
 * pathogenesis, immunology, and antimicrobial resistance
 * outer-membrane proteins
 * lipooligosaccharide
 * host factors
 * gonococcal resistance to antimicrobial agents
 * clinical manifestations
 * gonococcal infections in men
 * gonococcal infections in women
 * anorectal gonorrhea
 * pharyngeal gonorrhea
 * ocular gonorrhea in adults
 * gonorrhea in pregnant women, neonates, and children
 * gonococcal arthritis
 * gonococcal infections in hiv-infected persons
 * laboratory diagnosis
 * treatment
 * prevention and control
 * further reading
 * 157 haemophilus and moraxella infections
 * haemophilus influenzae
 * microbiology
 * epidemiology and transmission
 * pathogenesis
 * immune response
 * clinical manifestations
 * hib
 * nontypable h. Influenzae
 * diagnosis
 * treatment
 * prevention
 * vaccination
 * chemoprophylaxis
 * haemophilus ducreyi
 * microbiology
 * epidemiology and prevalence
 * clinical manifestations and differential diagnosis
 * diagnosis
 * treatment
 * moraxella catarrhalis
 * microbiology
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * diagnosis
 * treatment
 * further reading
 * 158 infections due to the hacek group and miscellaneous gram-negative bacteria
 * the hacek group
 * other fastidious gram-negative bacteria
 * other gram-negative bacteria
 * miscellaneous organisms
 * 159 legionella infections
 * pathogen and pathogenicity
 * epidemiology
 * clinical presentations
 * legionella pneumonia
 * pontiac fever
 * extrapulmonary disease
 * diagnosis
 * radiologic findings
 * laboratory diagnostics
 * treatment
 * outcomes
 * prevention
 * further reading
 * 160 pertussis and other bordetella infections
 * microbiology
 * epidemiology
 * pathogenesis
 * immunity
 * clinical manifestations
 * complications
 * diagnosis
 * differential diagnosis
 * treatment
 * prevention
 * further reading
 * 161 diseases caused by gram-negative enteric bacilli
 * general features and principles
 * epidemiology
 * structure and function
 * pathogenesis
 * infectious syndromes
 * diagnosis
 * treatment
 * prevention
 * escherichia coli infections
 * commensal strains
 * extraintestinal pathogenic strains
 * intestinal pathogenic strains
 * klebsiella infections
 * infectious syndromes
 * diagnosis
 * treatment
 * proteus infections
 * infectious syndromes
 * diagnosis
 * treatment
 * enterobacter and cronobacter infections
 * infectious syndromes
 * diagnosis
 * treatment
 * serratia infections
 * infectious syndromes
 * diagnosis
 * treatment
 * citrobacter infections
 * infectious syndromes
 * diagnosis
 * treatment
 * morganella and providencia infections
 * infectious syndromes
 * diagnosis
 * treatment
 * edwardsiella infections
 * infectious syndromes
 * diagnosis
 * treatment
 * infections caused by miscellaneous genera
 * further reading
 * 162 acinetobacter infections
 * definition
 * etiology and epidemiology
 * pathogenesis
 * clinical manifestations
 * pneumonia
 * bloodstream infections
 * skin and soft tissue infections
 * urinary tract infections
 * meningitis
 * other miscellaneous infections
 * treatment
 * complications and prognosis
 * infection control and prevention
 * further reading
 * 163 helicobacter pylori infections
 * etiologic agent
 * epidemiology
 * pathology and pathogenesis
 * clinical manifestations
 * peptic ulcer disease
 * diagnosis
 * treatment
 * prevention
 * further reading
 * 164 infections due to pseudomonas, burkholderia, and stenotrophomonas species
 * pseudomonas aeruginosa
 * epidemiology
 * laboratory features
 * pathogenesis
 * clinical manifestations
 * bacteremia
 * acute pneumonia
 * chronic respiratory tract infections
 * endovascular infections
 * bone and joint infections
 * central nervous system (Cns) Infections
 * eye infections
 * ear infections
 * urinary tract infections
 * skin and soft tissue infections
 * infections in febrile neutropenic patients
 * infections in patients with aids
 * gastrointestinal infections
 * multidrug-resistant infections
 * burkholderia species
 * burkholderia cepacia complex
 * burkholderia pseudomallei
 * burkholderia mallei
 * stenotrophomonas maltophilia
 * further reading
 * 165 salmonellosis
 * etiology
 * pathogenesis
 * enteric (Typhoid) Fever
 * nontyphoidal salmonellosis
 * further reading
 * 166 shigellosis
 * etiologic agent
 * epidemiology
 * pathogenesis and pathology
 * clinical manifestations
 * laboratory diagnosis
 * treatment
 * prevention
 * further reading
 * 167 infections due to campylobacter and related organisms
 * definition
 * etiology
 * epidemiology
 * pathology and pathogenesis
 * clinical manifestations
 * complications
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * further reading
 * 168 cholera and other vibrioses
 * cholera
 * definition
 * microbiology and epidemiology
 * pathogenesis
 * clinical manifestations
 * diagnosis
 * treatment
 * prevention
 * other vibrio species
 * species associated primarily with gastrointestinal illness
 * v. Parahaemolyticus
 * non-o1/o139 (Noncholera) V. Cholerae
 * species associated primarily with soft tissue infection or bacteremia
 * v. Vulnificus
 * v. Alginolyticus
 * further reading
 * 169 brucellosis
 * definition
 * etiologic agents
 * epidemiology
 * immunity and pathogenesis
 * clinical features
 * diagnosis
 * treatment
 * prognosis and follow-up
 * prevention
 * further reading
 * 170 tularemia
 * definition
 * francisella species, subspecies, and clades
 * epidemiology
 * geographic distribution
 * reservoirs and modes of transmission
 * at-risk exposures and populations
 * natural cycles of f. Tularensis
 * pathogenesis
 * clinical manifestations
 * severe type a tularemia
 * more common presentations of tularemia
 * diagnosis
 * nonspecific biologic findings
 * radiologic findings
 * clinical samples
 * serologic diagnosis
 * culture-based diagnosis
 * molecular diagnosis
 * optimized diagnostic strategy
 * treatment
 * antibiotic therapy
 * surgical treatment
 * prognosis
 * prevention
 * lack of human-to-human transmission
 * exposure prevention
 * postexposure prophylaxis
 * vaccination
 * further reading
 * 171 plague and other yersinia infections
 * plague
 * etiology
 * epidemiology
 * global features
 * pathogenesis
 * clinical manifestations
 * laboratory diagnosis
 * treatment
 * prevention
 * yersiniosis
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * postinfective phenomena
 * laboratory diagnosis
 * treatment
 * prevention and control
 * further reading
 * 172 bartonella infections, including cat-scratch disease
 * cat-scratch disease
 * definition and etiology
 * epidemiology
 * pathogenesis
 * clinical manifestations and prognosis
 * diagnosis
 * treatment
 * prevention
 * trench fever and chronic bacteremia
 * definition and etiology
 * epidemiology
 * clinical manifestations
 * diagnosis
 * treatment
 * bartonella endocarditis
 * definition and etiology
 * epidemiology
 * clinical manifestations
 * diagnosis
 * treatment
 * bacillary angiomatosis and peliosis
 * definition and etiology
 * epidemiology
 * clinical manifestations
 * pathology
 * diagnosis
 * treatment
 * prevention
 * carrión’s disease (Oroya fever and verruga peruana)
 * definition and etiology
 * epidemiology and prevention
 * pathogenesis
 * clinical manifestations
 * diagnosis and approach to the patient
 * treatment
 * complications and prognosis
 * further reading
 * 173 donovanosis
 * etiology
 * epidemiology
 * clinical features
 * diagnosis
 * treatment
 * control and prevention
 * further reading
 * section 7 miscellaneous bacterial infections]]
 * 174 nocardiosis
 * epidemiology
 * pathology and pathogenesis
 * clinical manifestations
 * respiratory tract disease
 * extrapulmonary disease
 * disease following transcutaneous inoculation
 * eye infections
 * diagnosis
 * treatment
 * further reading
 * 175 actinomycosis
 * etiologic agents
 * epidemiology
 * pathogenesis and pathology
 * clinical manifestations
 * oral–cervicofacial disease
 * thoracic disease
 * abdominal disease
 * pelvic disease
 * central nervous system disease
 * musculoskeletal and soft tissue infection
 * disseminated disease
 * diagnosis
 * treatment
 * further reading
 * 176 whipple’s disease
 * etiologic agent
 * epidemiology
 * pathogenesis and pathology
 * clinical manifestations
 * asymptomatic colonization/carriage
 * acute infection
 * chronic infection
 * diagnosis
 * treatment
 * further reading
 * 177 infections due to mixed anaerobic organisms
 * historical perspective
 * differences between anaerobic and aerobic organisms
 * anaerobes of the human microbiota
 * anaerobes and human health
 * etiology
 * pathogenesis
 * approach to the patient
 * epidemiology
 * clinical manifestations
 * anaerobic infections of the mouth, head, and neck
 * central nervous system (Cns) Infections
 * pleuropulmonary infections
 * intraabdominal infections
 * pelvic infections
 * skin and soft tissue infections
 * bone and joint infections
 * bacteremia
 * endocarditis
 * diagnosis
 * treatment
 * antibiotic therapy and resistance
 * failure of therapy
 * further reading
 * section 8 mycobacterial diseases]]
 * 178 tuberculosis
 * etiologic agent
 * epidemiology
 * pathogenesis and immunity
 * infection and macrophage invasion
 * virulence of tubercle bacilli
 * innate resistance to infection
 * the host response, granuloma formation, and “latency”
 * macrophage-activating response
 * delayed-type hypersensitivity
 * role of macrophages and monocytes
 * role of t lymphocytes
 * mycobacterial lipids and proteins
 * skin-test reactivity
 * clinical manifestations
 * pulmonary tb
 * primary disease
 * postprimary (Adult-type) Disease
 * extrapulmonary tb
 * lymph node tb (Tuberculous lymphadenitis)
 * pleural tb
 * tb of the upper airways
 * genitourinary tb
 * skeletal tb
 * tb of the central nervous system (Cns)
 * gastrointestinal tb
 * pericardial tb (Tuberculous pericarditis)
 * miliary or disseminated tb
 * less common extrapulmonary forms
 * post-tb complications
 * hiv-associated tb
 * diagnosis
 * nucleic acid amplification technology
 * afb microscopy
 * mycobacterial culture
 * drug susceptibility testing
 * radiographic procedures
 * additional diagnostic procedures
 * serologic and other diagnostic tests for active tb
 * biomarkers
 * diagnosis of m. Tuberculosis infection
 * tuberculin skin testing
 * ifn-γ release assays
 * treatment
 * drugs
 * regimens
 * patient care and support
 * monitoring treatment response and drug toxicity
 * treatment failure and relapse
 * drug-resistant tb
 * hiv-associated tb
 * special clinical situations
 * prevention
 * bcg vaccination
 * tb preventive treatment (Tpt)
 * principles of tb control
 * further reading
 * websites
 * 179 leprosy
 * etiology
 * ultrastructural characteristics of m. Leprae
 * genome of m. Leprae
 * culture difficulties
 * immunologic properties of m. Leprae
 * mycobacterium lepromatosis
 * epidemiology
 * incidence, prevalence, and disability
 * sex, age, and geographic distribution
 * transmission
 * reservoirs of infection
 * incubation period, the role of contacts, and genetic susceptibility
 * pathogenesis
 * ridley-jopling classification of leprosy
 * who simplified clinical classification of leprosy
 * clinical manifestations
 * indeterminate leprosy (Il)
 * tuberculoid (Tt) Leprosy
 * borderline tuberculoid (Bt) Leprosy
 * mid-borderline (Bb) Leprosy
 * borderline lepromatous (Bl) Leprosy
 * lepromatous (Ll) Leprosy
 * primary neuritic leprosy
 * leprosy reactions
 * type 1 leprosy reaction (T1r)
 * type 2 leprosy reaction (T2r)
 * lucio’s phenomenon
 * nerve function impairment, neuritis, and disfigurement
 * diagnosis
 * clinical diagnosis
 * diagnostic tools
 * testing of skin sensation
 * slit-skin smear
 * skin biopsy
 * pgl-1 antibody test
 * lepromin test
 * gene amplification (Pcr) Technique
 * differential diagnosis
 * diagnostic tools for nerve function impairment
 * touch sensation testing
 * voluntary muscle testing
 * nerve conduction tests
 * ultrasound testing of nerves
 * other tests of peripheral nerve function
 * treatment
 * treatment of leprosy
 * treatment of leprosy reactions
 * treatment and prognosis of nerve function impairment
 * treatment of (Neuropathic) Pain
 * disease management during treatment
 * rehabilitation and social aspects
 * physical rehabilitation
 * mental and social support
 * prevention and control
 * interruption of transmission and novel preventive strategies
 * vaccines against leprosy
 * postexposure chemoprophylaxis
 * “zero leprosy”
 * further reading
 * 180 nontuberculous mycobacterial infections
 * epidemiology
 * pathobiology
 * clinical manifestations
 * disseminated disease
 * pulmonary disease
 * cervical lymph nodes
 * skin and soft tissue disease
 * diagnosis
 * prevention
 * treatment
 * prognosis
 * global considerations
 * further reading
 * 181 antimycobacterial agents
 * tuberculosis
 * general principles
 * first-line antituberculosis drugs
 * isoniazid
 * rifampin
 * pyrazinamide
 * ethambutol
 * other rifamycin drugs
 * rifabutin
 * rifapentine
 * second-line antituberculosis drugs
 * group a
 * fluoroquinolones
 * diarylquinolines
 * oxazolidinones
 * group b
 * clofazimine
 * cycloserine
 * group c
 * nitroimidazoles
 * amoxicillin-clavulanate and carbapenems
 * aminoglycosides
 * ethionamide
 * para-aminosalicylic acid
 * drugs in development
 * nontuberculous mycobacteria
 * therapeutic considerations forspecific ntm
 * slowly growing mycobacteria
 * rapidly growing mycobacteria
 * drugs for the treatment of ntm
 * azithromycin
 * amikacin liposome inhalation suspension (Alis)
 * imipenem
 * cefoxitin
 * newer drugs
 * conclusion
 * further reading
 * section 9 spirochetal diseases]]
 * 182 syphilis
 * definition
 * etiology
 * transmission and epidemiology
 * syphilis in the united states
 * global syphilis
 * natural course and pathogenesis ofuntreated syphilis
 * clinical manifestations
 * primary syphilis
 * secondary syphilis
 * latent syphilis
 * reinfection syphilis
 * involvement of the cns
 * other manifestations of late syphilis
 * congenital syphilis
 * laboratory examinations
 * demonstration of the organism
 * serologic tests for syphilis
 * evaluation for neurosyphilis
 * evaluation of hiv-infected patients for syphilis
 * treatment
 * treatment of acquired syphilis
 * evaluation and management of congenital syphilis
 * jarisch-herxheimer reaction
 * follow-up evaluation of responses to therapy
 * immunity to syphilis
 * further reading
 * 183 endemic treponematoses
 * epidemiology
 * microbiology
 * clinical features
 * diagnosis
 * treatment
 * control
 * further reading
 * 184 leptospirosis
 * etiologic agent
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * prevention
 * further reading
 * 185 relapsing fever and borrelia miyamotoi disease
 * etiologic agent
 * epidemiology
 * pathogenesis and immunity
 * clinical manifestations
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * prevention
 * further reading
 * 186 lyme borreliosis
 * definition
 * etiologic agent
 * epidemiology
 * pathogenesis and immunity
 * clinical manifestations
 * early infection: stage 1 (Localized infection)
 * early infection: stage 2 (Disseminated infection)
 * late infection: stage 3 (Persistent infection)
 * post-lyme syndrome (Chronic lyme disease)
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * reinfection
 * prevention
 * further reading
 * section 10 diseases caused by rickettsiae, mycoplasmas, and chlamydiae]]
 * 187 rickettsial diseases
 * tick-, mite-, louse-, and flea-borne rickettsioses
 * rocky mountain spotted fever
 * mediterranean spotted fever (Boutonneuse fever), african tick-bite fever, and other tick-borne spotted fevers
 * rickettsialpox
 * flea-borne spotted fever
 * epidemic (Louse-borne) Typhus
 * endemic murine typhus
 * scrub typhus
 * ehrlichioses and anaplasmosis
 * human monocytotropic ehrlichiosis
 * ewingii ehrlichiosis and ehrlichia muris eauclairensis infections
 * “candidatus neoehrlichia mikurensis”infection
 * human granulocytotropic anaplasmosis
 * q fever
 * further reading
 * 188 infections due to mycoplasmas
 * mycoplasma pneumoniae
 * urogenital mycoplasmas
 * 189 chlamydial infections
 * etiologic agents
 * biology, growth cycle, and pathogenesis
 * c. Trachomatis infections
 * genital infections
 * trachoma
 * psittacosis
 * c. Pneumoniae infections
 * further reading
 * section 11 viral diseases: general considerations]]
 * 190 principles of medical virology
 * virus structure
 * classification of viruses
 * viral replication in cells
 * viral effects on the host cell
 * host antiviral responses and viral antagonistic mechanisms
 * molecular epidemiology of viruses
 * detection and quantification of viruses
 * detection of virus-specific antibodies
 * immunization against viral diseases
 * antiviral therapeutics
 * summary
 * 191 antiviral chemotherapy, excluding antiretroviral drugs
 * antiviral drugs for herpesvirus infections
 * antiviral drugs for respiratory virus infections
 * antiviral drugs for human papillomavirus and poxvirus infections
 * investigational antiviral drugs for picornavirus
 * antiviral drugs for hepatitis b virus infection
 * antiviral drugs for hepatitis c infection
 * further reading
 * section 12 infections due to dna viruses]]
 * 192 herpes simplex virus infections
 * definition
 * etiologic agent
 * pathogenesis
 * immunity
 * epidemiology
 * clinical spectrum
 * diagnosis
 * treatment
 * prevention
 * further reading
 * 193 varicella-zoster virus infections
 * definition
 * etiology
 * pathogenesis and pathology
 * primary infection
 * recurrent infection
 * epidemiology and clinical manifestations
 * chickenpox
 * herpes zoster
 * differential diagnosis
 * laboratory findings
 * treatment
 * prevention
 * further reading
 * 194 epstein-barr virus infections, including infectious mononucleosis
 * definition
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * diagnosis
 * treatment
 * prevention
 * further reading
 * 195 cytomegalovirus and human herpesvirus types 6, 7, and 8
 * cytomegalovirus
 * definition
 * epidemiology
 * pathogenesis
 * pathology
 * clinical manifestations
 * diagnosis
 * prevention
 * treatment
 * human herpesvirus (Hhv) Types 6, 7, and 8
 * hhv-6 and hhv-7
 * hhv-8
 * further reading
 * 196 molluscum contagiosum, monkeypox, and other poxvirus infections
 * poxviruses
 * definition and etiology
 * epidemiology
 * pathogenesis
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * complications
 * prognosis
 * prevention
 * select poxvirus infections
 * molluscum contagiosum
 * monkeypox virus
 * other poxvirus infections of humans
 * further reading
 * 197 parvovirus infections
 * parvovirus b19
 * definition
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * erythema infectiosum
 * polyarthropathy syndrome
 * transient aplastic crisis
 * pure red cell aplasia/chronic anemia
 * hydrops fetalis
 * unusual manifestations
 * diagnosis
 * treatment
 * prevention
 * human tetraparvoviruses (Parv4/5)
 * definition
 * epidemiology
 * clinical manifestations
 * human bocaparvoviruses
 * definition
 * epidemiology
 * clinical manifestations
 * human protoparvoviruses
 * definition
 * epidemiology
 * clinical manifestations
 * further reading
 * 198 human papillomavirus infections
 * pathogenesis
 * the natural history of hpv-associated malignancy
 * the effects of hiv on hpv associated disease
 * clinical manifestations of hpv infection
 * prevention of hpv infection and disease
 * screening for hpv-associated cancer
 * treatment
 * counseling patients regarding hpv disease
 * further reading
 * section 13 infections due to dna and rna respiratory viruses]]
 * 199 common viral respiratory infections, including covid-19
 * anatomic sites in the humanrespiratory tract
 * disease syndromes
 * etiologic agents
 * respiratory viruses causing disease in immunocompetent hosts
 * respiratory viruses causing disease in immunocompromised hosts
 * specific viral causes of respiratory disease
 * orthomyxoviridae: influenza viruses
 * pneumoviridae
 * paramyxoviridae
 * picornaviridae
 * adenoviridae
 * coronaviridae
 * covid-19
 * herpesviridae
 * parvoviridae: human bocavirus
 * retroviridae: hiv
 * papovaviridae: polyomaviruses
 * epidemiology
 * age
 * season
 * risk factors for disease
 * transmission
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * complications: co-infections
 * prevention
 * vaccines
 * passive protection with immunotherapy
 * isolation procedures, personal protective equipment, and hand washing
 * global considerations
 * hendra and nipah viruses
 * bunyaviridae: hantavirus
 * summary
 * further reading
 * 200 influenza
 * definition
 * etiologic agents
 * epidemiology
 * pathogenesis and immunity
 * clinical manifestations
 * complications
 * laboratory findings and diagnosis
 * differential diagnosis
 * immunization
 * treatment
 * further reading
 * section 14 infections due to human immunodeficiency virus and other human retroviruses]]
 * 201 the human retroviruses
 * structure and life cycle
 * human t-cell lymphotropic virus
 * biology and molecular biology
 * features of htlv-1 infection
 * features of htlv-2 infection
 * human immunodeficiency virus
 * further reading
 * 202 human immunodeficiency virus disease: aids and related disorders
 * definition
 * etiologic agent
 * morphology of hiv
 * replication cycle of hiv
 * hiv genome
 * molecular heterogeneity of hiv-1
 * transmission
 * sexual transmission
 * transmission through injection drug use
 * transmission by transfused blood and blood products
 * occupational transmission of hiv: health care workers, laboratory workers, and the health care setting
 * mother-to-child transmission of hiv
 * transmission of hiv by other body fluids
 * epidemiology
 * hiv infection and aids worldwide
 * hiv infection in the united states
 * pathophysiology and pathogenesis
 * early events in hiv infection: primary infection and initial dissemination of virus
 * establishment of chronic infection
 * advanced hiv disease
 * long-term survivors, long-term nonprogressors, and elite controllers
 * lymphoid organs and hiv pathogenesis
 * the role of immune activation and inflammation in hiv pathogenesis
 * cytokines and other soluble factors in hiv pathogenesis
 * lymphocyte turnover in hiv infection
 * the role of viral receptors and co-receptors in hiv pathogenesis
 * cellular targets of hiv
 * qualitative and quantitative abnormalities of mononuclear cells
 * genetic factors in hiv-1 and aids pathogenesis
 * neuropathogenesis in hiv disease
 * pathogenesis of kaposi’s sarcoma
 * immune response to hiv
 * humoral immune response
 * cellular immune response
 * diagnosis and laboratory monitoring of hiv infection
 * diagnosis of hiv infection
 * laboratory monitoring of patients with hiv infection
 * acute hiv infection
 * the asymptomatic stage—clinical latency
 * symptomatic disease
 * diseases of the respiratory system
 * diseases of the cardiovascular system
 * diseases of the oropharynx and gastrointestinal system
 * hepatobiliary diseases
 * diseases of the kidney and genitourinary tract
 * diseases of the endocrine system and metabolic disorders
 * immunologic and rheumatologic diseases
 * immune reconstitution inflammatory syndrome (Iris)
 * diseases of the hematopoietic system
 * dermatologic diseases
 * neurologic diseases
 * ophthalmologic diseases
 * additional disseminated infections and wasting syndrome
 * neoplastic diseases
 * idiopathic cd4+ t lymphocytopenia
 * treatment
 * general principles of patient management
 * antiretroviral therapy
 * principles of therapy
 * hiv and the health care worker
 * hiv prevention
 * further reading
 * section 15 infections due to rna viruses]]
 * 203 viral gastroenteritis
 * human caliciviruses
 * rotavirus
 * other viral agents of gastroenteritis
 * 204 enterovirus, parechovirus, and reovirus infections
 * enteroviruses
 * classification and characterization
 * pathogenesis and immunity
 * epidemiology
 * clinical features
 * poliovirus infection
 * paralytic poliomyelitis
 * vaccine-associated poliomyelitis
 * postpolio syndrome
 * other enteroviruses
 * nonspecific febrile illness (Summer grippe)
 * generalized disease of the newborn
 * aseptic meningitis and encephalitis
 * acute flaccid myelitis
 * pleurodynia (Bornholm disease)
 * myocarditis and pericarditis
 * exanthems
 * hand-foot-and-mouth disease
 * herpangina
 * acute hemorrhagic conjunctivitis
 * other manifestations
 * diagnosis
 * treatment
 * prevention and eradication of poliovirus
 * parechoviruses
 * reoviruses
 * further reading
 * 205 measles (Rubeola)
 * definition
 * global considerations
 * etiology
 * epidemiology
 * pathogenesis
 * immune responses
 * approach to the patient
 * clinical manifestations
 * differential diagnosis
 * diagnosis
 * treatment
 * complications
 * prognosis
 * prevention
 * prospects for measles eradication
 * further reading
 * 206 rubella (German measles)
 * etiology
 * pathogenesis and pathology
 * epidemiology
 * clinical features
 * acquired rubella
 * congenital rubella syndrome
 * diagnosis
 * acquired rubella
 * congenital rubella syndrome
 * rubella diagnosis in pregnant women
 * treatment
 * prevention
 * further reading
 * 207 mumps
 * etiologic agent
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * differential diagnosis
 * laboratory diagnosis
 * treatment
 * prevention
 * further reading
 * 208 rabies and other rhabdovirus infections
 * rabies
 * etiologic agent
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * prodromal features
 * encephalitic rabies
 * paralytic rabies
 * laboratory investigations
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * prevention
 * other rhabdoviruses
 * other lyssaviruses
 * vesicular stomatitis virus
 * further reading
 * 209 arthropod-borne and rodent-borne virus infections
 * etiology
 * amarillovirales: flaviviridae
 * articulavirales: orthomyxoviridae
 * bunyavirales: arenaviridae
 * bunyavirales: hantaviridae, nairoviridae, peribunyaviridae, and phenuiviridae
 * martellivirales: togaviridae
 * mononegavirales: rhabdoviridae
 * reovirales: reoviridae
 * epidemiology
 * diagnosis
 * clinical disease syndromes
 * arthritis and rash
 * encephalitis
 * fever and myalgia
 * pulmonary disease
 * viral hemorrhagic fever
 * further reading
 * website
 * 210 ebolavirus and marburgvirus infections
 * etiology
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * diagnosis
 * treatment
 * complications
 * prognosis
 * control and prevention
 * further reading
 * section 16 fungal infections]]
 * 211 pathogenesis, diagnosis, and treatment of fungal infections
 * definition and etiology
 * pathogenesis
 * diagnosis
 * antifungal drugs
 * amphotericin b
 * azoles
 * echinocandins
 * flucytosine (5-fluorocytosine)
 * griseofulvin and terbinafine
 * topical antifungal agents
 * further reading
 * 212 histoplasmosis
 * etiology
 * epidemiology
 * pathogenesis and pathology
 * clinical manifestations
 * diagnosis
 * treatment
 * further reading
 * 213 coccidioidomycosis
 * definition and etiology
 * epidemiology
 * pathogenesis, pathology, and immune response
 * clinical and laboratory manifestations
 * diagnosis
 * treatment
 * prevention
 * further reading
 * 214 blastomycosis
 * definition
 * etiology
 * epidemiology
 * pathogenesis
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention
 * further reading
 * 215 cryptococcosis
 * definition and etiology
 * epidemiology
 * pathogenesis
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis and complications
 * immune reconstitution inflammatory syndrome
 * prevention
 * further reading
 * 216 candidiasis
 * epidemiology
 * pathogenesis
 * clinical manifestations
 * mucocutaneous candidiasis
 * deeply invasive candidiasis
 * diagnosis
 * treatment
 * prophylaxis
 * further reading
 * 217 aspergillosis
 * epidemiology and ecology
 * risk factors and pathogenesis
 * clinical features and approach to the patient
 * invasive pulmonary aspergillosis
 * invasive sinusitis
 * tracheobronchitis
 * aspergillus bronchitis
 * disseminated aspergillosis
 * cerebral aspergillosis
 * endocarditis
 * cutaneous aspergillosis
 * chronic pulmonary aspergillosis
 * aspergilloma
 * aspergillus nodule
 * chronic aspergillus sinusitis
 * allergic bronchopulmonary aspergillosis
 * severe asthma with fungal sensitization (Safs)
 * allergic fungal rhinosinusitis
 * superficial aspergillosis
 * diagnosis
 * acute invasive aspergillosis
 * chronic aspergillosis
 * abpa, safs, and allergic aspergillus sinusitis
 * treatment
 * prophylaxis
 * outcome
 * further reading
 * 218 mucormycosis
 * etiology
 * pathogenesis
 * epidemiology
 * clinical manifestations
 * rhino-orbital-cerebral disease
 * pulmonary disease
 * cutaneous disease
 * gastrointestinal disease
 * disseminated and miscellaneous forms of disease
 * diagnosis
 * differential diagnosis
 * treatment
 * prognosis
 * further reading
 * 219 less common systemic mycoses and superficial mycoses
 * endemic mycoses (Dimorphic fungi)
 * sporotrichosis
 * paracoccidioidomycosis
 * talaromycosis (Penicilliosis)
 * phaeohyphomycoses
 * opportunistic fungal infections
 * fusariosis
 * scedosporiosis and lomentosporiosis
 * trichosporonosis
 * superficial cutaneous infections
 * yeast infections
 * dermatophyte (Mold) Infections
 * further reading
 * 220 pneumocystis infections
 * definition and description
 * epidemiology
 * pathogenesis and pathology
 * clinical features
 * diagnosis
 * course and prognosis
 * treatment
 * prevention
 * further reading
 * section 17 protozoal and helminthic infections: general considerations]]
 * 221 introduction to parasitic infections
 * helminthic infections
 * flatworms
 * roundworms
 * protozoal infections
 * intestinal protozoa
 * free-living amoebas
 * blood and tissue protozoans
 * approach to the patient
 * further reading
 * 222 agents used to treat parasitic infections
 * section 18 protozoal infections]]
 * 223 amebiasis and infection with free-living amebae
 * amebiasis
 * definition
 * life cycle and transmission
 * epidemiology
 * pathogenesis and pathology
 * clinical syndromes
 * intestinal amebiasis
 * amebic liver abscess
 * complications of amebic liver abscess
 * involvement of other extraintestinal sites
 * diagnostic tests
 * laboratory diagnosis
 * radiographic studies
 * differential diagnosis
 * treatment
 * prevention
 * infection with free-living amebae
 * epidemiology
 * naegleria infections
 * acanthamoeba infections
 * balamuthia infections
 * further reading
 * 224 malaria
 * etiology and pathogenesis
 * pathophysiology
 * erythrocyte changes
 * host response
 * clinical features
 * severe falciparum malaria
 * malaria in pregnancy
 * malaria in children
 * transfusion malaria
 * chronic complications of malaria
 * hyperreactive malarial splenomegaly
 * quartan malarial nephropathy
 * burkitt’s lymphoma and epstein-barr virus infection
 * treatment
 * global considerations
 * malaria prevention
 * personal protection against malaria
 * chemoprophylaxis
 * further reading
 * 225 babesiosis
 * etiology, epidemiology, and modes of transmission
 * clinical manifestations
 * pathogenesis
 * treatment
 * prevention
 * further reading
 * 226 leishmaniasis
 * etiology and life cycle
 * epidemiology
 * visceral leishmaniasis
 * cutaneous leishmaniasis
 * mucosal leishmaniasis
 * prevention of leishmaniasis
 * further reading
 * 227 chagas disease and african trypanosomiasis
 * chagas disease (American trypanosomiasis)
 * definition
 * transmission
 * epidemiology
 * pathology
 * clinical manifestations
 * approach to the patient
 * diagnosis and staging
 * treatment
 * prevention
 * global considerations
 * human african trypanosomiasis (Sleeping sickness)
 * definition
 * epidemiology
 * pathology and pathogenesis
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * global considerations
 * 228 toxoplasma infections
 * definition
 * etiology
 * epidemiology
 * transmission
 * pathogenesis
 * pathology
 * host immune response
 * clinical manifestations
 * diagnosis
 * treatment
 * prevention
 * 229 protozoal intestinal infections and trichomoniasis
 * protozoal infections
 * giardiasis
 * cryptosporidiosis
 * cystoisosporiasis
 * cyclosporiasis
 * microsporidiosis
 * other intestinal protozoa
 * trichomoniasis
 * section 19 helminthic infections]]
 * 230 introduction to helminthic infections
 * nematodes
 * cestodes
 * trematodes
 * conclusion
 * 231 trichinellosis and other tissue nematode infections
 * trichinellosis
 * visceral and ocular larva migrans
 * cutaneous larva migrans
 * angiostrongyliasis
 * gnathostomiasis
 * 232 intestinal nematode infections
 * ascariasis
 * hookworm
 * strongyloidiasis
 * trichuriasis
 * enterobiasis (Pinworm)
 * trichostrongyliasis
 * anisakiasis
 * capillariasis
 * abdominal angiostrongyliasis
 * 233 filarial and related infections
 * lymphatic filariasis
 * tropical pulmonary eosinophilia
 * onchocerciasis
 * loiasis
 * streptocerciasis
 * mansonella perstans infection
 * mansonella ozzardi infection
 * zoonotic filarial infections
 * dracunculiasis (Guinea worm infection)
 * 234 schistosomiasis and other trematode infections
 * approach to the patient
 * schistosomiasis
 * etiology
 * epidemiology
 * pathogenesis
 * clinical features
 * diagnosis
 * treatment
 * prevention and control
 * food-borne trematode infections
 * liver flukes
 * intestinal flukes
 * lung flukes
 * treatment
 * control and prevention
 * 235 cestode infections
 * taeniasis saginata and taeniasis asiatica
 * taeniasis solium and cysticercosis
 * echinococcosis
 * hymenolepiasis nana
 * hymenolepiasis diminuta
 * diphyllobothriasis
 * dipylidiasis
 * sparganosis
 * [[coenurosis

cardiovascular
]]
 * section 1 introduction to cardiovascular disorders]]
 * 236 approach to the patient with possible cardiovascular disease
 * the magnitude of the problem
 * natural history
 * cardiac symptoms
 * diagnosis
 * family history
 * assessment of functional impairment
 * electrocardiogram
 * assessment of the patient with a heart murmur
 * pitfalls in cardiovascular medicine
 * disease prevention and management
 * 237 basic biology of the cardiovascular system
 * developmental biology of thecardiovascular system
 * the blood vessel
 * vascular ultrastructure
 * vascular cell biology
 * arteriogenesis and angiogenesis
 * cellular basis of cardiac contraction
 * cardiac ultrastructure
 * the contractile process
 * cardiac activation
 * control of cardiac performance and output
 * the role of muscle length (Preload)
 * cardiac performance
 * ventricular afterload
 * exercise
 * assessment of cardiac function
 * diastolic function
 * cardiac metabolism
 * regenerating cardiac tissue
 * 238 epidemiology of cardiovascular disease
 * the epidemiologic transition
 * patterns in the epidemiologic transition
 * global trends in cardiovascular disease
 * risk factors
 * behavioral risk factors
 * metabolic risk factors
 * genetic risk factors
 * summary
 * section 2 diagnosis of cardiovascular disorders]]
 * 239 physical examination of the cardiovascular system
 * the general physical examination
 * skin
 * head and neck
 * chest
 * abdomen
 * extremities
 * cardiovascular examination
 * jugular venous pressure and waveform
 * assessment of blood pressure
 * arterial pulse
 * cardiac auscultation
 * heart sounds
 * systolic sounds
 * diastolic sounds
 * cardiac murmurs
 * diastolic murmurs
 * continuous murmur
 * dynamic auscultation
 * prosthetic heart valves
 * pericardial disease
 * 240 electrocardiography
 * electrophysiologic background
 * ecg waveforms and intervals
 * ecg leads
 * genesis of the normal ecg
 * major ecg abnormalities
 * cardiac enlargement and hypertrophy
 * bundle branch blocks and related patterns
 * myocardial ischemia and infarction
 * metabolic factors and drug effects
 * nonspecific st-t changes and low qrs voltage
 * electrical alternans syndromes
 * clinical interpretation of the ecg
 * computerized electrocardiography
 * 241 noninvasive cardiac imaging: echocardiography, nuclear cardiology, and magnetic resonance/computed tomography imaging
 * principles of multimodality cardiac imaging
 * echocardiography
 * radionuclide imaging
 * cardiac computed tomography
 * cardiac magnetic resonance
 * assessment of cardiac structure and function
 * assessment of left ventricular systolic function
 * assessment of left ventricular diastolic function
 * assessment of right ventricular function
 * patient safety considerations
 * radiation exposure
 * contrast agents
 * safety considerations of cmr in patients with pacemakers and defibrillators
 * patient-centered applications of cardiac imaging
 * coronary artery disease
 * valvular heart disease
 * myocardial infarction and heart failure
 * pericardial disease
 * cardiac thrombus and mass
 * role of imaging in infectious and inflammatory disease
 * evaluation of common congenital abnormalities in the adult
 * 242 diagnostic cardiac catheterization and coronary angiography
 * cardiac catheterization
 * indications, risks, and preproceduremanagement
 * technique
 * hemodynamics
 * ventriculography and aortography
 * cinefluoroscopy of prosthetic mechanical valves
 * coronary angiography
 * section 3 disorders of rhythm]]
 * 243 principles of clinical cardiac electrophysiology
 * historical perspective
 * cellular electrophysiology
 * normal cardiac impulse propagation
 * mechanisms of cardiac arrhythmias
 * care of the arrhythmia patient
 * 244 the bradyarrhythmias: disorders of the sinoatrial node
 * structure and physiology of the sa node
 * diagnosis of sa nodal disease
 * sa nodal dysfunction subtypes
 * treatment
 * 245 the bradyarrhythmias: disorders of the atrioventricular node
 * structure and physiology of the av node
 * electrocardiographic definitions of av conduction block
 * etiology of av conduction disease
 * diagnostic testing
 * treatment
 * 246 approach to supraventricular tachyarrhythmias
 * clinical presentation
 * 247 physiologic and nonphysiologic sinus tachycardia
 * physiologic sinus tachycardia
 * nonphysiologic sinus tachycardia
 * 248 focal atrial tachycardia
 * 249 paroxysmal supraventricular tachycardias
 * atrioventricular nodal reentry tachycardia
 * junctional tachycardia
 * accessory pathways and the wolff-parkinson-white syndrome
 * atrioventricular reciprocating tachycardia
 * preexcited tachycardias
 * management of patients with accessory pathways
 * treatment
 * 250 common atrial flutter and macroreentrant and multifocal atrial tachycardias
 * atrial flutter
 * multifocal atrial tachycardia
 * 251 atrial fibrillation
 * pathophysiology and epidemiology
 * clinical presentation and manifestations
 * treatment
 * risk factors for and lifestyle impact on atrial fibrillation
 * 252 approach to ventricular arrhythmias
 * types of vas
 * clinical manifestations
 * evaluation of patients with documented or suspected ventricular arrhythmias
 * arrhythmia surgery
 * 253 premature ventricular contractions, nonsustained ventricular tachycardia, and accelerated idioventricular rhythm
 * premature ventricular contractions and non-sustained vt
 * pvcs and nsvt during acute illness
 * pvcs and nsvt in patients without heart disease
 * treatment of idiopathic arrhythmias
 * pvcs and nsvt associated with acute coronary syndromes
 * pvcs and nsvt associated with depressed ventricular function and heart failure
 * pvc and nsvt associated with other cardiac diseases
 * pvc-induced ventricular dysfunction
 * accelerated idioventricular rhythms
 * future directions
 * 254 sustained ventricular tachycardia
 * diagnosis
 * treatment and prognosis
 * sustained monomorphic vt in specific diseases
 * arrhythmogenic right ventricular cardiomyopathy
 * adult congenital heart disease
 * bundle branch reentry vt
 * idiopathic monomorphic vt
 * management of idiopathic vt
 * future directions
 * 255 polymorphic ventricular tachycardia and ventricular fibrillation
 * polymorphic ventricular tachycardia
 * polymorphic vt associated with acute myocardial infarction/ischemia
 * repolarization abnormalities and genetic arrhythmia syndromes
 * acquired long qt syndrome
 * congenital long qt syndrome
 * short qt syndrome
 * brugada syndrome
 * early repolarization syndrome
 * catecholaminergic polymorphic vt
 * hypertrophic cardiomyopathy
 * genetic dilated cardiomyopathies
 * ventricular fibrillation
 * future directions
 * 256 electrical storm and incessant ventricular tachycardia
 * electrical storm
 * incessant vt
 * management of patients presenting with icd shocks
 * management of the patient with electrical storm
 * section 4 disorders of the heart, muscles, valves, and pericardium]]
 * 257 heart failure: pathophysiology and diagnosis
 * clinical definitions, epidemiology, and phenotypes
 * definitions
 * epidemiology
 * phenotypes and causes
 * pathophysiology
 * progressive disease
 * mechanisms of disease progression
 * cardiorenal and abdominal interactions
 * gut congestion, the microbiome, and inflammation
 * high-output states
 * evaluation
 * history
 * physical examination
 * diagnosis
 * comorbidities
 * diabetes
 * sleep apnea
 * obesity
 * depression
 * differential diagnosis
 * 258 heart failure: management
 * heart failure with preserved ejection fraction
 * general principles
 * clinical trials in hfpef
 * novel targets
 * clinical guiding principles
 * acute decompensated heart failure
 * general principles
 * volume management
 * vasoactive therapy
 * inotropic therapy
 * other therapies for adhf
 * clinical guiding principles
 * heart failure with reduced ejection fraction
 * neurohormonal antagonism
 * mineralocorticoid receptor antagonists
 * raas therapy and neurohormonal “escape”
 * alternative vasodilators
 * novel neurohormonal antagonists
 * heart rate modification
 * sglt-2 inhibition
 * soluble guanylyl cyclase stimulation
 * myosin activation
 * digoxin
 * oral diuretics
 * calcium channel antagonists
 * anti-inflammatory therapy
 * hmg-coa reductase inhibitors (Statins)
 * anticoagulation and antiplatele ttherapy
 * fish oil
 * micronutrients
 * enhanced external counterpulsation
 * exercise
 * management of selected comorbidity
 * neuromodulation using device therapy
 * cardiac contractility modulation
 * cardiac resynchronization therapy
 * sudden cardiac death prevention in heart failure
 * surgical therapy in heart failure
 * cellular and gene-based therapy
 * disease management and supportive care
 * global considerations
 * 259 cardiomyopathy and myocarditis
 * definition and classification
 * general presentation
 * genetic causes of cardiomyopathy
 * dilated cardiomyopathy
 * myocarditis
 * infective myocarditis
 * specific viruses implicated in myocarditis
 * therapy of viral myocarditis
 * other infectious causes
 * noninfective myocarditis
 * peripartum cardiomyopathy
 * toxic cardiomyopathy
 * metabolic causes of cardiomyopathy
 * familial dilated cardiomyopathy
 * takotsubo cardiomyopathy
 * idiopathic dcm
 * overlapping types of cardiomyopathy
 * disorders of metabolic pathways
 * restrictive cardiomyopathy
 * nfiltrative disease
 * fibrotic restrictive cardiomyopathy
 * endomyocardial disease
 * hypertrophic cardiomyopathy
 * diagnosis
 * treatment
 * prognosis
 * global perspectives
 * 260 cardiac transplantation and prolonged assisted circulation
 * cardiac transplantation
 * candidates for cardiac transplantation
 * principles of donor recovery and allocation
 * surgery for cardiac transplantation
 * cardiac allograft rejection and immunosuppression
 * late complications after cardiac transplantation
 * prolonged assisted circulation
 * left ventricular assist systems and clinical trials
 * management of lvas and their complications
 * novel devices
 * total artificial heart
 * global considerations
 * 261 aortic stenosis
 * global burden of valvular heart disease
 * etiology and pathogenesis
 * bicuspid aortic valve disease
 * other forms of obstruction to left ventricular outflow
 * pathophysiology
 * symptoms
 * physical findings
 * laboratory examination
 * treatment
 * 262 aortic regurgitation
 * etiology
 * pathophysiology
 * history
 * physical findings
 * laboratory examination
 * treatment
 * 263 mitral stenosis
 * etiology and pathology
 * pathophysiology
 * symptoms
 * physical findings
 * laboratory examination
 * differential diagnosis
 * cardiac catheterization
 * treatment
 * 264 mitral regurgitation
 * etiology
 * pathophysiology
 * symptoms
 * physical findings
 * laboratory examination
 * treatment
 * 265 mitral valve prolapse
 * clinical features
 * laboratory examination
 * treatment
 * 266 tricuspid valve disease
 * tricuspid stenosis
 * tricuspid regurgitation
 * 267 pulmonic valve disease
 * pulmonic stenosis
 * pulmonic regurgitation
 * 268 multiple and mixed valvular heart disease
 * pathophysiology
 * symptoms
 * physical findings
 * laboratory examination
 * treatment
 * 269 congenital heart disease in the adult
 * prevalence
 * the changing landscape of adult chd
 * special considerations for the achdpatient
 * congenital terminology, development, and genetics
 * specific chd lesions
 * dilated right heart
 * atrial septal defect
 * partial anomalous pulmonary venous return
 * ebstein anomaly
 * shunt lesions causing left heart dilation
 * ventricular septal defects
 * patent ductus arteriosus
 * moderate and complex chd
 * tetralogy of fallot
 * transposition of the great arteries
 * coarctation of the aorta
 * single ventricle physiology
 * unrepaired cyanotic chd
 * eisenmenger syndrome
 * the role of palliative care in achd
 * global considerations
 * 270 pericardial disease
 * normal functions of the pericardium
 * acute pericarditis
 * cardiac tamponade
 * viral or idiopathic acute pericarditis
 * chronic pericardial effusions
 * chronic constrictive pericarditis
 * 271 atrial myxoma and other cardiac tumors
 * primary tumors
 * clinical presentation
 * myxoma
 * other benign tumors
 * malignant tumors
 * tumors metastatic to the heart
 * 272 cardiac trauma
 * cardiac trauma
 * blunt cardiac injury
 * penetrating cardiac injury
 * section 5 coronary and peripheral vascular disease]]
 * 273 ischemic heart disease
 * epidemiology and global trends
 * pathophysiology
 * coronary atherosclerosis
 * stable angina pectoris
 * coronary revascularization
 * asymptomatic (Silent) Ischemia
 * 274 non-st-segment elevation acute coronary syndrome (Non-st-segment elevation myocardial infarction and unstable angina)
 * pathophysiology
 * clinical presentation
 * treatment
 * long-term management
 * prinzmetal’s variant angina
 * global considerations
 * 275 st-segment elevation myocardial infarction
 * pathophysiology: role of acute plaque rupture
 * clinical presentation
 * laboratory findings
 * electrocardiogram
 * serum cardiac biomarkers
 * cardiac imaging
 * initial management
 * management in the emergency department
 * control of discomfort
 * management strategies
 * limitation of infarct size
 * hospital phase management
 * pharmacotherapy
 * complications and their management
 * 276 percutaneous coronary interventions and other interventional procedures
 * technique
 * success and complications
 * indications
 * other interventional techniques
 * conclusion
 * 277 hypertension
 * epidemiology
 * mechanisms of hypertension
 * pathologic consequences of hypertension
 * defining hypertension
 * clinical disorders of hypertension
 * monogenic hypertension
 * approach to the patient
 * treatment
 * 278 renovascular disease
 * mechanisms of vascular injury and hypertension
 * diagnosis of renovascular disease
 * treatment
 * atheroembolic renal disease
 * thromboembolic renal disease
 * microvascular injury associated with hypertension
 * arteriolonephrosclerosis
 * 279 deep-venous thrombosis and pulmonary thromboembolism
 * epidemiology
 * pathophysiology
 * classification of pulmonary embolism and deep-venous thrombosis
 * diagnosis
 * treatment: deep-venous thrombosis
 * treatment: pulmonary embolism
 * prevention of vte
 * 280 diseases of the aorta
 * congenital anomalies of the aorta
 * aortic aneurysm
 * etiology
 * thoracic aortic aneurysms
 * abdominal aortic aneurysms
 * acute aortic syndromes
 * clinical manifestations
 * treatment
 * chronic atherosclerotic occlusive disease
 * acute aortic occlusion
 * aortitis
 * takayasu’s arteritis
 * giant cell arteritis
 * rheumatic aortitis
 * idiopathic aortitis
 * infective aortitis
 * 281 arterial diseases of the extremities
 * peripheral artery disease
 * fibromuscular dysplasia
 * thromboangiitis obliterans
 * vasculitis
 * acute limb ischemia
 * atheroembolism
 * thoracic outlet compression syndrome
 * popliteal artery entrapment
 * popliteal artery aneurysm
 * arteriovenous fistula
 * raynaud’s phenomenon
 * acrocyanosis
 * livedo reticularis
 * pernio (Chilblains)
 * erythromelalgia
 * frostbite
 * 282 chronic venous disease and lymphedema
 * chronic venous disease
 * venous anatomy
 * pathophysiology of chronic venous disease
 * clinical presentation
 * differential diagnosis
 * classification of chronic venous disease
 * diagnostic testing
 * treatment
 * lymphedema
 * lymphatic anatomy
 * etiology
 * clinical presentation
 * differential diagnosis
 * diagnostic testing
 * treatment
 * 283 pulmonary hypertension
 * pathobiology
 * pathophysiology
 * diagnosis
 * pulmonary hypertension classification
 * other disorders affecting the pulmonary vasculature
 * pharmacologic treatment of pah
 * approach to pah treatment
 * [[unmet and future research needs in pulmonary hypertension

respiratory
]]
 * section 1 diagnosis of respiratory disorders]]
 * 284 approach to the patient with disease of the respiratory system
 * history
 * dyspnea and cough
 * additional symptoms
 * additional history
 * physical examination
 * diagnostic evaluation
 * pulmonary function testing
 * chest imaging
 * further studies
 * 285 disturbances of respiratory function
 * ventilation
 * volume-related mechanical properties—statics
 * flow-related mechanical properties—dynamics
 * the work of breathing
 * adequacy of ventilation
 * gas exchange
 * diffusion
 * ventilation/perfusion heterogeneity
 * pathophysiology
 * ventilatory restriction due to increased elastic recoil—example: idiopathic pulmonary fibrosis
 * ventilatory restriction due to chest wall abnormality—example: moderate obesity
 * ventilatory restriction due to reduced muscle strength—example: myasthenia gravis
 * airflow obstruction due to decreased airway diameter—example: acute asthma
 * airflow obstruction due to decreased elastic recoil—example: severe emphysema
 * functional measurements
 * measurement of ventilatory function
 * measurement of gas exchange
 * arterial blood gases
 * 286 diagnostic procedures in respiratory disease
 * bedside pleural procedures
 * thoracentesis
 * closed pleural biopsy
 * thoracic surgical procedures
 * thoracoscopy and thoracotomy
 * mediastinoscopy and mediastinotomy
 * bronchoscopy
 * bronchoalveolar lavage
 * brushing and endobronchial biopsy
 * transbronchial biopsy including cryobiopsy
 * transbronchial needle aspiration
 * endobronchial ultrasound-guided transbronchial needle aspiration
 * guided peripheral bronchoscopy
 * robotic bronchoscopy
 * medical imaging
 * chest x-ray
 * computed tomography
 * magnetic resonance imaging
 * positron emission tomography
 * artificial intelligence/deep learning
 * transthoracic needle aspiration
 * miscellaneous testing
 * sputum testing
 * exhaled breath condensate
 * sweat testing
 * allergy testing
 * section 2 diseases of the respiratory system]]
 * 287 asthma
 * manifestations
 * epidemiology
 * the pathway to the development of asthma
 * pathophysiology
 * mechanisms leading to acute and chronic airway obstruction
 * airway inflammation (Type 2 and non–type 2 inflammation)
 * mediators
 * etiologic mechanisms, risk factors, triggers, and complicating comorbidities
 * heritable predisposition
 * exposures and risk factors
 * triggers of airway narrowing
 * comorbidities
 * diagnosis and evaluation
 * approach
 * primary assessment tools for establishing a diagnosis
 * adjunctive assessment tools
 * additional evaluation in severe/poorly responsive asthma
 * treatment: asthma
 * goals of asthma therapy and assessment of control
 * medications
 * approach to the patient
 * treatment: asthma attacks
 * special considerations
 * high-risk asthma patients
 * exercise-induced symptoms
 * pregnancy
 * aspirin-exacerbated respiratory disease
 * severe asthma
 * elderly patients with asthma
 * asthma-copd overlap
 * 288 hypersensitivity pneumonitis and pulmonary infiltrates with eosinophilia
 * hypersensitivity pneumonitis
 * introduction and definition
 * offending antigens
 * pathophysiology
 * clinical presentation
 * diagnosis
 * differential diagnosis
 * treatment
 * global considerations
 * pulmonary infiltrates with eosinophilia
 * classifying pulmonary infiltrates with eosinophilia and general approach
 * pathophysiology
 * acute eosinophilic pneumonia
 * eosinophilic granulomatosis with polyangiitis (Egpa)
 * hypereosinophilic syndromes
 * allergic bronchopulmonary aspergillosis
 * infectious processes
 * drugs and toxins
 * global considerations
 * 289 occupational and environmental lung disease
 * history and exposure assessment
 * laboratory tests
 * determinants of inhalational exposure
 * occupational exposures and pulmonary disease
 * asbestos-related diseases
 * silicosis
 * coal worker’s pneumoconiosis (Cwp)
 * chronic beryllium disease
 * other metals
 * other inorganic dusts
 * organic dusts
 * toxic chemicals
 * occupational respiratory carcinogens
 * assessment of disability
 * general environmental exposures
 * outdoor air pollution
 * indoor exposures
 * 290 bronchiectasis
 * etiology
 * epidemiology
 * pathogenesis and pathology
 * clinical manifestations
 * diagnosis
 * approach to the patient
 * treatment
 * complications
 * prognosis
 * prevention
 * 291 cystic fibrosis
 * clinical features
 * pathogenesis
 * molecular genetics
 * diagnosis
 * complexity of a cf phenotype
 * cftr modulators
 * therapeutics directed toward cf sequelae
 * cf quality improvement
 * global considerations
 * 292 chronic obstructive pulmonary disease
 * pathogenesis
 * pathophysiology
 * risk factors
 * natural history
 * clinical presentation
 * treatment
 * 293 interstitial lung disease
 * diagnostic approach
 * history
 * physical examination
 * laboratory studies
 * pulmonary function tests
 * chest imaging studies
 * lung biopsy
 * individual forms of ild
 * idiopathic interstitial pneumonias
 * idiopathic pulmonary fibrosis
 * nonspecific interstitial pneumonia
 * smoking-related ild
 * cryptogenic organizing pneumonia
 * acute or subacute iips
 * acute interstitial pneumonia (Hamman-rich syndrome)
 * acute exacerbations of iips
 * ild associated with connective tissue disease
 * systemic sclerosis
 * rheumatoid arthritis
 * dermatomyositis/polymyositis
 * granulomatous ilds
 * genetics and ild
 * global considerations
 * 294 disorders of the pleura
 * pleural effusion
 * pneumothorax
 * 295 disorders of the mediastinum
 * mediastinal masses
 * acute mediastinitis
 * chronic mediastinitis
 * pneumomediastinum
 * 296 disorders of ventilation
 * definition and physiology
 * hypoventilation
 * hypoventilation syndromes
 * hyperventilation
 * 297 sleep apnea
 * obstructive sleep apnea/hypopnea syndrome
 * 298 lung transplantation
 * end-stage lung disease and indicationsfor lung transplantation
 * contraindications to lung transplantation
 * lung transplant candidate management
 * donor considerations
 * procurement operation
 * recipient operation and early posttransplant considerations
 * long-term management of lung transplant recipients
 * 299 interventional pulmonary medicine
 * diagnostic bronchoscopy
 * endobronchial ultrasound
 * peripheral bronchoscopy
 * therapeutic bronchoscopy
 * central airway obstruction
 * ablative therapies for cao
 * bronchoplasty
 * airway stenting
 * endobronchial intratumoral chemotherapy
 * ablative therapies for early-stage lung cancer
 * bronchoscopic therapies for asthma
 * bronchoscopic therapies for chronic obstructive pulmonary disease
 * bronchoscopic lung volume reduction
 * targeted lung denervation
 * pleural interventions
 * pneumothorax and persistent air leak
 * [[summary

critical care
]]
 * section 1 respiratory critical care]]
 * 300 approach to the patient with critical illness
 * assessment of illness severity
 * the sofa scoring system
 * the apache ii scoring system
 * other scoring systems
 * shock
 * initial evaluation
 * mechanical ventilatory support
 * respiratory failure
 * type i: acute hypoxemic respiratoryfailure
 * type ii respiratory failure: hypercapneic respiratory failure
 * type iii respiratory failure: lung atelectasis
 * type iv respiratory failure: metabolic demands
 * care of the mechanically ventilated patient
 * multiorgan system failure
 * monitoring in the icu
 * pulse oximetry
 * respiratory system mechanics
 * circulatory status
 * prevention of complications of critical illness
 * sepsis in the critical care unit
 * nosocomial infections in the icu
 * deep-venous thrombosis (Dvt)
 * stress ulcers
 * nutrition and glycemic control
 * icu-acquired weakness
 * anemia
 * acute kidney failure
 * neurologic dysfunction in critically ill patients
 * delirium
 * anoxic cerebral injury
 * stroke
 * subarachnoid hemorrhage
 * status epilepticus
 * brain death
 * withholding or withdrawing care
 * 301 acute respiratory distress syndrome
 * etiology
 * clinical course and pathophysiology
 * exudative phase
 * proliferative phase
 * fibrotic phase
 * treatment
 * general principles
 * management of mechanical ventilation
 * other strategies in mechanical ventilation
 * fluid management
 * neuromuscular blockade
 * glucocorticoids
 * other therapies
 * recommendations
 * prognosis
 * mortality
 * functional recovery in ards survivors
 * 302 mechanical ventilatory support
 * principles of mechanical ventilation
 * mechanical ventilation modes
 * strategies to optimize gas exchange on mechanical ventilation
 * complications of mechanical ventilation
 * liberation from mechanical ventilation
 * extracorporeal gas exchange
 * section 2 shock and cardiac arrest]]
 * 303 approach to the patient with shock
 * pathophysiology of shock
 * determinants of oxygen delivery
 * classification of shock
 * distributive shock
 * cardiogenic shock
 * hypovolemic shock
 * obstructive shock
 * mixed shock
 * undifferentiated shock
 * stages of shock
 * evaluation of the patient with shock
 * initial treatment of shock
 * oxygenation and ventilation support
 * 304 sepsis and septic shock
 * introduction and definitions
 * etiology
 * epidemiology
 * pathogenesis
 * approach to the patient
 * clinical manifestations
 * diagnosis
 * treatment
 * prognosis
 * prevention
 * 305 cardiogenic shock and pulmonary edema
 * cardiogenic shock
 * pulmonary edema
 * 306 cardiovascular collapse, cardiac arrest, and sudden cardiac death
 * overview and definitions
 * epidemiology
 * causes of sudden cardiac death
 * management of cardiac arrest
 * section 3 neurologic critical care]]
 * 307 nervous system disorders in critical care
 * pathophysiology
 * approach to the patient
 * critical care disorders of the cns
 * treatment
 * postcardiac bypass brain injury
 * metabolic encephalopathies
 * sepsis-associated encephalopathy
 * osmotic demyelination syndrome (Central pontine myelinolysis)
 * wernicke’s disease
 * hyperperfusion disorders (Posterior reversible encephalopathy syndrome)
 * post–solid organ transplant brain injury
 * cns complications of checkpoint inhibitor and chimeric antigen receptor t-cell therapy
 * [[critical care disorders of the peripheral nervous system

kidney and urinary
]]
 * 308 approach to the patient with renal disease or urinary tract disease]]
 * nephritic syndromes
 * glomerulonephritis
 * proteinuric states and nephrotic syndrome
 * hematuria and lower urinary tract syndromes
 * acute kidney injury
 * chronic kidney disease and the uremic syndrome
 * 309 cell biology and physiology of the kidney]]
 * embryologic development
 * determinants and regulation of glomerular filtration
 * mechanisms of renal tubular transport
 * loop of henle
 * distal convoluted tubule
 * collecting duct
 * hormonal regulation of sodium and water balance
 * 310 acute kidney injury]]
 * epidemiology
 * etiology and pathophysiology
 * prerenal azotemia
 * intrinsic aki
 * sepsis-associated aki
 * ischemia-associated aki
 * nephrotoxin-associated aki
 * postrenal aki
 * diagnostic evaluation
 * history and physical examination
 * urine findings
 * blood laboratory findings
 * renal failure indices
 * radiologic evaluation
 * kidney biopsy
 * novel biomarkers
 * complications of aki
 * uremia
 * hypervolemia and hypovolemia
 * hyponatremia
 * hyperkalemia
 * acidosis
 * hyperphosphatemia and hypocalcemia
 * bleeding
 * infections
 * cardiac complications
 * malnutrition
 * prevention and treatment of aki
 * supportive measures for aki
 * outcome and prognosis
 * 311 chronic kidney disease]]
 * pathophysiology of ckd
 * identification of risk factors and staging of ckd
 * etiology and epidemiology
 * pathophysiology and biochemistry of uremia
 * clinical and laboratory manifestations of ckd and uremia
 * fluid, electrolyte, and acid-base disorders
 * sodium and water homeostasis
 * potassium homeostasis
 * metabolic acidosis
 * disorders of calcium and phosphate metabolism
 * bone manifestations of ckd
 * calcium, phosphorus, and the cardiovascular system
 * other complications of abnormal mineral metabolism
 * cardiovascular abnormalities
 * vascular disease
 * heart failure
 * pericardial disease
 * hematologic abnormalities
 * anemia
 * abnormal hemostasis
 * neuromuscular abnormalities
 * gastrointestinal and nutritional abnormalities
 * ndocrine-metabolic disturbances
 * dermatologic abnormalities
 * evaluation and management ofpatients with ckd
 * initial approach
 * establishing the diagnosis and etiology of ckd
 * treatment
 * implications for global health
 * 312 dialysis in the treatment of kidney failure]]
 * treatment options for patients with eskd
 * hemodialysis
 * the dialyzer
 * dialysate
 * blood delivery system
 * dialysis access
 * goals of dialysis
 * complications during hemodialysis
 * peritoneal dialysis
 * forms of peritoneal dialysis
 * access to the peritoneal cavity
 * complications during peritoneal dialysis
 * long-term outcomes in eskd
 * global perspective
 * 313 transplantation in the treatment of renal failure]]
 * recent activity and results
 * recipient evaluation
 * tissue typing and clinical immunogenetics
 * donor evaluation
 * immunology of rejection
 * immunosuppressive treatment
 * clinical course and management of the recipient
 * malignancy
 * 314 glomerular diseases]]
 * pathogenesis of glomerular disease
 * progression of glomerular disease
 * approach to the patient
 * renal pathology
 * acute nephritic syndromes
 * poststreptococcal glomerulonephritis
 * subacute bacterial endocarditis
 * lupus nephritis
 * antiglomerular basement membrane disease
 * iga nephropathy
 * anca small-vessel vasculitis
 * granulomatosis with polyangiitis
 * microscopic polyangiitis
 * churg-strauss syndrome
 * c3 glomerulopathies
 * membranoproliferative glomerulonephritis
 * mesangioproliferative glomerulonephritis
 * nephrotic syndrome
 * minimal change disease
 * focal segmental glomerulosclerosis
 * membranous glomerulonephritis
 * diabetic nephropathy
 * glomerular deposition diseases
 * fabry’s disease
 * pulmonary-renal syndromes
 * basement membrane syndromes
 * anti-gbm disease
 * alport’s syndrome
 * thin basement membrane disease
 * nail-patella syndrome
 * glomerular-vascular syndromes
 * atherosclerotic nephropathy
 * hypertensive nephrosclerosis
 * cholesterol emboli
 * sickle cell disease
 * thrombotic microangiopathies
 * antiphospholipid antibody syndrome
 * global considerations
 * infectious disease–associated syndromes
 * 315 polycystic kidney disease and other inherited disorders of tubule growth and development]]
 * autosomal dominant polycystic kidney disease
 * autosomal recessive polycystic kidney disease
 * other diseases characterized bylarge kidney cysts
 * tuberous sclerosis
 * von hippel-lindau disease
 * other inherited diseases of tubulegrowth and development
 * nephronophthisis
 * karyomegalic tubulointerstitial nephritis
 * medullary sponge kidney
 * congenital abnormalities of the kidney and urinary tract
 * mitochondrial disease
 * diagnostic considertions
 * global considerations
 * 316 tubulointerstitial diseases of the kidney]]
 * acute interstitial nephritis
 * allergic interstitial nephritis
 * sjögren’s syndrome
 * tubulointerstitial nephritis with uveitis
 * systemic lupus erythematosus
 * granulomatous interstitial nephritis
 * igg4-related systemic disease
 * ain associated with the use of immune checkpoint inhibitors
 * idiopathic ain
 * infection-associated ain
 * crystal deposition disorders and obstructive tubulopathies
 * light chain cast nephropathy
 * lymphomatous infiltration of the kidney
 * chronic tubulointerstitial diseases
 * vesicoureteral reflux and reflux nephropathy
 * sickle cell nephropathy
 * tubulointerstitial abnormalities associated with glomerulonephritis
 * analgesic nephropathy
 * aristolochic acid nephropathy
 * karyomegalic interstitial nephritis
 * lithium-associated nephropathy
 * calcineurin inhibitor nephrotoxicity
 * heavy metal (Lead) Nephropathy
 * metabolic disorders
 * chronic uric acid nephropathy
 * hypercalcemic nephropathy
 * hypokalemic nephropathy
 * global perspective
 * 317 vascular injury to the kidney]]
 * thrombotic microangiopathy
 * hemolytic-uremic syndrome/thromboticthrombocytopenic purpura
 * hematopoietic stem cell transplantation–associated thrombotic microangiopathy
 * hiv-related thrombotic microangiopathy
 * radiation nephropathy
 * scleroderma (Progressive systemic sclerosis)
 * antiphospholipid syndrome
 * hellp syndrome
 * sickle cell nephropathy
 * renal vein thrombosis
 * 318 nephrolithiasis]]
 * epidemiology
 * associated medical conditions
 * pathogenesis
 * risk factors
 * approach to the patient
 * recommendations for specific stone types
 * long-term follow-up
 * 319 urinary tract obstruction]]
 * etiology
 * clinical features and pathophysiology
 * diagnosis
 * treatment
 * prognosis
 * postobstructive diuresis
 * 320 interventional nephrology]]
 * history
 * physiology and pathophysiology of dialysis access
 * arteriovenous grafts and fistulas
 * [[approach to the patient

gastrointestinal
]]
 * section 1 disorders of the alimentary tract]]
 * 321 approach to the patient with gastrointestinal disease
 * anatomic considerations
 * functions of the gi tract
 * extrinsic modulation of gut function
 * overview of gi diseases
 * classification of gi diseases
 * impaired digestion and absorption
 * altered secretion
 * altered gut transit
 * immune dysregulation
 * impaired gut blood flow
 * neoplastic degeneration
 * disorders without obvious organic abnormalities
 * genetic influences
 * symptoms of gi disease
 * abdominal pain
 * heartburn
 * nausea and vomiting
 * altered bowel habits
 * gi bleeding
 * jaundice
 * other symptoms
 * evaluation of the patient with gi disease
 * history
 * physical examination
 * tools for patient evaluation
 * treatment
 * 322 gastrointestinal endoscopy
 * endoscopic procedures
 * upper endoscopy
 * colonoscopy
 * flexible sigmoidoscopy
 * small-bowel endoscopy
 * endoscopic retrograde cholangiopancreatography
 * endoscopic ultrasound
 * natural orifice transluminal endoscopic surgery
 * endoscopic resection and closure techniques
 * risks of endoscopy
 * urgent endoscopy
 * acute gastrointestinal hemorrhage
 * gastrointestinal obstruction andpseudoobstruction
 * acute biliary obstruction
 * elective endoscopy
 * dyspepsia
 * gastroesophageal reflux disease
 * peptic ulcer
 * nonulcer dyspepsia
 * dysphagia
 * endoscopic treatment of obesity
 * treatment of malignancies
 * anemia and occult blood in the stool
 * colorectal cancer screening
 * diarrhea
 * minor hematochezia
 * pancreatitis
 * cancer staging
 * open-access endoscopy
 * 323 diseases of the esophagus
 * esophageal structure and function
 * symptoms of esophageal disease
 * diagnostic studies
 * endoscopy
 * radiography
 * endoscopic ultrasound
 * esophageal manometry
 * reflux testing
 * structural disorders
 * hiatal hernia
 * rings and webs
 * diverticula
 * tumors
 * congenital anomalies
 * esophageal motility disorders
 * achalasia
 * diffuse esophageal spasm
 * nonspecific manometric findings
 * gastroesophageal reflux disease
 * pathophysiology
 * symptoms
 * differential diagnosis
 * complications
 * treatment
 * eosinophilic esophagitis
 * infectious esophagitis
 * candida esophagitis
 * herpetic esophagitis
 * cytomegalovirus
 * mechanical trauma and iatrogenic injury
 * esophageal perforation
 * mallory-weiss tear
 * radiation esophagitis
 * corrosive esophagitis
 * pill esophagitis
 * foreign bodies and food impaction
 * esophageal manifestations of systemic disease
 * scleroderma and connectivetissue disorders
 * dermatologic diseases
 * 324 peptic ulcer disease and related disorders
 * peptic ulcer disease
 * gastric physiology
 * pathophysiologic basis of pud
 * clinical features
 * treatment
 * related conditions
 * zollinger-ellison syndrome
 * stress-related mucosal injury
 * gastritis
 * ménétrier’s disease
 * 325 disorders of absorption
 * overview: nutrient digestionand absorption
 * specific nutrients
 * luminal phase of digestion
 * mucosal phase of digestion and absorption
 * intestinal mucosal disorders
 * disorders of enterocyte carbohydrate transporters and enzyme deficiencies
 * intestinal mucosal disorders that result in malabsorption of multiple nutrients
 * whipple’s disease
 * tropical sprue
 * short-bowel syndrome
 * overview
 * disorders of post-mucosal absorption
 * protein-losing enteropathy
 * approach to the patient
 * summary
 * 326 inflammatory bowel disease
 * global considerations: epidemiology
 * global considerations: ibd phenotypes
 * etiology and pathogenesis
 * genetic considerations
 * commensal microbiota and ibd
 * defective immune regulation in ibd
 * the inflammatory cascade in ibd
 * pathology
 * ulcerative colitis: macroscopic features
 * ulcerative colitis: microscopic features
 * crohn’s disease: macroscopic features
 * crohn’s disease: microscopic features
 * clinical presentation
 * ulcerative colitis
 * crohn’s disease
 * differential diagnosis of uc and cd
 * infectious diseases
 * noninfectious diseases
 * the atypical colitides
 * extraintestinal manifestations
 * dermatologic
 * rheumatologic
 * ocular
 * hepatobiliary
 * urologic
 * metabolic bone disorders
 * thromboembolic disorders
 * other disorders
 * treatment
 * 5-asa agents
 * glucocorticoids
 * antibiotics
 * azathioprine and mercaptopurine
 * methotrexate
 * cyclosporine
 * tacrolimus
 * biologic therapies
 * anti-integrins
 * small molecules
 * ozanimod
 * nutritional therapies
 * surgical therapy
 * ibd and pregnancy
 * cancer in ibd
 * ulcerative colitis
 * crohn’s disease
 * management of dysplasia and cancer
 * covid-19 and ibd
 * 327 irritable bowel syndrome
 * clinical features
 * pathophysiology
 * approach to the patient
 * treatment
 * 328 diverticular disease and common anorectal disorders
 * diverticular disease
 * common diseases of the anorectum
 * rectal prolapse (Procidentia)
 * fecal incontinence
 * hemorrhoidal disease
 * anorectal abscess
 * fistula in ano
 * anal fissure
 * 329 mesenteric vascular insufficiency
 * intestinal ischemia
 * incidence and epidemiology
 * anatomy and pathophysiology
 * presentation, evaluation, and management
 * 330 acute intestinal obstruction
 * epidemiology
 * pathophysiology
 * history and physical findings
 * laboratory and imaging studies
 * treatment
 * 331 acute appendicitis and peritonitis
 * acute appendicitis
 * incidence and epidemiology
 * pathogenesis of appendicitis and appendiceal perforation
 * clinical manifestations
 * laboratory testing
 * imaging
 * special patient populations
 * treatment
 * acute peritonitis
 * etiology
 * clinical features
 * therapy and prognosis
 * section 2 nutrition]]
 * 332 nutrient requirements and dietary assessment
 * essential nutrient requirements
 * energy
 * protein
 * fat and carbohydrate
 * water
 * other nutrients
 * dietary reference intakes and rdas
 * estimated average requirement (Ear)
 * recommended dietary allowances
 * adequate intake (Ai)
 * tolerable upper levels (Ul)
 * chronic disease risk reduction intake (Cdrr)
 * acceptable macronutrient distribution ranges (Amdrs)
 * factors altering nutrient needs
 * physiologic factors
 * dietary composition
 * route of intake
 * disease
 * dietary assessment
 * acute-care settings
 * ambulatory settings
 * nutritional status assessment
 * global considerations
 * 333 vitamin and trace mineral deficiency and excess
 * vitamins
 * thiamine (Vitamin b1)
 * riboflavin (Vitamin b2)
 * niacin (Vitamin b3)
 * pyridoxine (Vitamin b6)
 * folate (Vitamin b12)
 * vitamin c
 * biotin
 * pantothenic acid (Vitamin b5)
 * choline
 * flavonoids
 * vitamin a
 * vitamin d
 * vitamin e
 * vitamin k
 * minerals
 * calcium
 * zinc
 * copper
 * selenium
 * chromium
 * magnesium
 * fluoride, manganese, and ultratrace elements
 * 334 malnutrition and nutritional assessment
 * malnutrition syndromes
 * nutrition assessment
 * 335 enteral and parenteral nutrition
 * nutritional physiology
 * macronutrient malnutrition syndromes
 * nutritional diagnosis
 * specialized nutritional support
 * approach to the patient
 * section 3 liver and biliary tract disease]]
 * 336 approach to the patient with liver disease
 * liver structure and function
 * liver diseases
 * clinical history
 * physical examination
 * diagnosis of liver disease
 * grading and staging of liver disease
 * nonspecific issues in the management of patients with liver disease
 * 337 evaluation of liver function
 * serum bilirubin
 * serum enzymes
 * serum albumin
 * serum globulins
 * coagulation factors
 * other diagnostic tests
 * use of liver tests
 * global considerations
 * 338 the hyperbilirubinemias
 * bilirubin metabolism
 * extrahepatic aspects of bilirubin disposition
 * disorders of bilirubin metabolism leading to unconjugated hyperbilirubinemia
 * increased bilirubin production
 * decreased hepatic bilirubin clearance
 * hereditary defects in bilirubin conjugation
 * disorders of bilirubin metabolism leading to mixed or predominantly conjugated hyperbilirubinemia
 * familial defects in hepaticexcretory function
 * 339 acute viral hepatitis
 * virology and etiology
 * hepatitis a
 * hepatitis b
 * hepatitis d
 * hepatitis c
 * hepatitis e
 * pathogenesis
 * hepatitis b
 * hepatitis c
 * hepatitis a and e
 * extrahepatic manifestations
 * pathology
 * epidemiology and global features
 * hepatitis a
 * hepatitis b
 * hepatitis d
 * hepatitis c
 * hepatitis e
 * clinical and laboratory features
 * symptoms and signs
 * laboratory features
 * prognosis
 * complications and sequelae
 * differential diagnosis
 * treatment
 * prophylaxis
 * hepatitis a
 * hepatitis b
 * hepatitis d
 * hepatitis c
 * hepatitis e
 * 340 toxic and drug-induced hepatitis
 * drug metabolism
 * liver injury caused by drugs
 * treatment: toxic and drug-induced hepatic disease
 * acetaminophen hepatotoxicity (Direct toxin)
 * isoniazid hepatotoxicity (Toxic and idiosyncratic reaction)
 * sodium valproate hepatotoxicity (Toxic and idiosyncratic reaction)
 * nitrofurantoin hepatotoxicity (Idiosyncratic reaction)
 * amoxicillin-clavulanate hepatotoxicity (Idiosyncratic mixed reaction)
 * amiodarone hepatotoxicity (Toxic and idiosyncratic reaction)
 * anabolic steroids (Cholestatic reaction)
 * trimethoprim-sulfamethoxazole hepatotoxicity (Idiosyncratic reaction)
 * hmg-coa reductase inhibitors (Statins) (Idiosyncratic mixed hepatocellular and cholestatic reaction)
 * alternative and complementary medicines (Idiosyncratic hepatitis, steatosis)
 * checkpoint inhibitor and other immunotherapies for cancer
 * highly active antiretroviral therapy for hiv infection (Mitochondrial toxic, idiosyncratic, steatosis; hepatocellular,cholestatic, and mixed)
 * 341 chronic hepatitis
 * classification of chronic hepatitis
 * classification by cause
 * classification by grade
 * classification by stage
 * chronic viral hepatitis
 * chronic hepatitis b
 * chronic hepatitis c
 * autoimmune hepatitis
 * definition
 * immunopathogenesis
 * clinical features
 * diagnostic criteria
 * differential diagnosis
 * treatment
 * 342 alcohol-associated liver disease
 * epidemiology
 * pathogenesis
 * risk factors for progression of ald
 * clinical features
 * laboratory findings
 * diagnosis
 * treatment
 * 343 nonalcoholic fatty liver diseases and nonalcoholic steatohepatitis
 * incidence, prevalence, and natural history
 * pathogenesis
 * diagnosis
 * clinical features of nafld
 * treatment of nafld
 * global health considerations
 * 344 cirrhosis and its complications
 * alcohol-associated cirrhosis
 * cirrhosis due to chronic viral hepatitis b or c
 * cirrhosis from autoimmune hepatitis and nonalcoholic fatty liver disease
 * biliary cirrhosis
 * primary biliary cholangitis
 * primary sclerosing cholangitis
 * cardiac cirrhosis
 * other types of cirrhosis
 * major complications of cirrhosis
 * portal hypertension
 * portal hypertensive gastropathy
 * splenomegaly and hypersplenism
 * ascites
 * spontaneous bacterial peritonitis
 * hepatorenal syndrome
 * hepatic encephalopathy
 * liver-lung syndromes
 * malnutrition in cirrhosis
 * abnormalities in coagulation
 * bone disease in cirrhosis
 * hematologic abnormalities in cirrhosis
 * 345 liver transplantation
 * indications
 * contraindications
 * technical considerations
 * postoperative course and management
 * outcome
 * 346 diseases of the gallbladder and bile ducts
 * physiology of bile production and flow
 * bile secretion and composition
 * the bile acids
 * enterohepatic circulation
 * gallbladder and sphincteric functions
 * diseases of the gallbladder
 * congenital anomalies
 * gallstones
 * acute and chronic cholecystitis
 * the hyperplastic cholecystoses
 * diseases of the bile ducts
 * congenital anomalies
 * choledocholithiasis
 * trauma, strictures, and hemobilia
 * extrinsic compression of the bile ducts
 * hepatobiliary parasitism
 * sclerosing cholangitis
 * section 4 disorders of the pancreas]]
 * 347 approach to the patient with pancreatic disease
 * general considerations
 * tests useful in the diagnosis of pancreatic disease
 * tests of exocrine pancreatic function
 * 348 acute and chronic pancreatitis
 * biochemistry and physiology of pancreatic exocrine secretion
 * general considerations
 * regulation of pancreatic secretion
 * water and electrolyte secretion
 * enzyme secretion
 * autoprotection of the pancreas
 * enteropancreatic axis and feedback inhibition
 * acute pancreatitis
 * general considerations
 * etiology and pathogenesis
 * activation of pancreatic enzymes in the pathogenesis of acute pancreatitis
 * approach to the patient
 * laboratory data
 * diagnosis
 * clinical course, definitions, and classifications
 * acute pancreatitis management
 * recurrent acute pancreatitis
 * pancreatitis in patients with aids
 * chronic pancreatitis and exocrine pancreatic insufficiency
 * pathophysiology
 * etiologic considerations
 * autoimmune pancreatitis
 * treatment
 * hereditary pancreatitis
 * pancreatic endocrine tumors
 * other conditions
 * annular pancreas
 * pancreas divisum
 * [[macroamylasemia

immune-related and rheumatology
]] ]]
 * section 1 the immune system in health and disease]]
 * 349 introduction to the immune system
 * definitions
 * introduction
 * the innate immune system
 * pattern recognition
 * effector cells of innate immunity
 * monocytes-macrophages
 * dendritic cells
 * innate lymphoid cells
 * neutrophils, eosinophils, and basophils
 * the complement system
 * cytokines
 * the adaptive immune system
 * t cells
 * humoral mediators of adaptive immunity: immunoglobulins
 * cellular interactions in regulation of normal immune responses
 * immune tolerance and autoimmunity
 * the cellular and molecular control of programmed cell death
 * mechanisms of immune-mediated damage to microbes or host tissues
 * clinical evaluation of immune function
 * immunotherapy
 * 350 mechanisms of regulation and dysregulation of the immune system
 * definitions
 * introduction
 * mechanisms of regulation of t-cell activation
 * checkpoint inhibitiontherapy for cancer
 * chimeric antigen receptor t cells
 * mechanisms of immunedysregulation in autoimmunedisease
 * immune dysregulation in aging
 * 351 primary immune deficiency diseases
 * diagnosis of primary immunodeficiencies
 * primary immunodeficiencies of the innate immune system
 * severe congenital neutropenia
 * asplenia
 * gata2 deficiency
 * leukocyte adhesion deficiency
 * chronic granulomatous diseases
 * mendelian susceptibility to mycobacterial disease
 * toll-like receptor (Tlr) Pathway deficiencies
 * complement deficiency
 * primary immunodeficiencies of the adaptive immune system
 * t lymphocyte deficiencies
 * severe combined immunodeficiencies
 * thymic defects
 * omenn syndrome
 * functional t-cell defects
 * t-cell primary immunodeficiencies with dna repair defects
 * t-cell primary immunodeficiencies with hyper-ige
 * autosomal dominant hyper-ige syndrome
 * cartilage hair hypoplasia
 * cd40 ligand and cd40 deficiencies
 * wiskott-aldrich syndrome
 * b lymphocyte deficiencies
 * agammaglobulinemia
 * hyper-igm (Higm) Syndromes
 * common variable immunodeficiency
 * selective ig isotype deficiencies
 * selective antibody deficiency to polysaccharide antigens
 * immunoglobulin replacement
 * primary immunodeficiencies affecting regulatory pathways
 * hemophagocytic lymphohistiocytosis
 * autoimmune lymphoproliferative syndrome
 * colitis, autoimmunity, and primary immunodeficiencies
 * conclusion
 * section 2 disorders of immune-mediated injury]]
 * 352 urticaria, angioedema, and allergic rhinitis
 * introduction
 * urticaria and angioedema
 * definition
 * predisposing factors and etiology
 * clinical presentation and pathophysiology
 * treatment
 * allergic rhinitis
 * definition
 * predisposing factors and etiology
 * pathophysiology and manifestations
 * diagnosis
 * treatment
 * 353 anaphylaxis
 * background
 * clinical manifestations
 * pathophysiology
 * predisposing factors and mechanisms
 * diagnosis
 * treatment
 * prevention
 * 354 mastocytosis
 * definition and epidemiology
 * classification and pathophysiology
 * clinical manifestations
 * diagnosis and differential diagnosis
 * treatment
 * 355 autoimmunity and autoimmune diseases
 * mechanisms of autoimmunity
 * genetic considerations
 * immunopathogenic mechanisms in autoimmune diseases
 * autoimmune diseases
 * organ-specific versus systemic autoimmune diseases
 * treatment
 * 356 systemic lupus erythematosus
 * definition and prevalence
 * pathogenesis and etiology
 * interpretation of clinical manifestations
 * laboratory tests
 * conservative therapies for management of non-life-threatening disease
 * patient outcomes, prognosis, and survival
 * drug-induced lupus
 * 357 antiphospholipid syndrome
 * definitions
 * epidemiology
 * pathogenesis
 * clinical manifestations and laboratory findings
 * diagnosis and differential diagnosis
 * treatment
 * 358 rheumatoid arthritis
 * introduction
 * clinical features
 * epidemiology
 * genetic considerations
 * environmental factors
 * pathology
 * pathogenesis
 * diagnosis
 * laboratory features
 * clinical course
 * treatment
 * approach to the patient
 * global challenges
 * summary
 * 359 acute rheumatic fever
 * global considerations
 * epidemiology
 * pathogenesis
 * clinical features
 * treatment
 * prognosis
 * prevention
 * 360 systemic sclerosis (Scleroderma) And related disorders
 * definition and classification
 * incidence and prevalence
 * genetic contribution to disease pathogenesis
 * environmental and occupational exposures
 * pathogenesis
 * pathology
 * clinical features
 * organ involvement
 * management of systemic sclerosis
 * treatment
 * course
 * prognosis
 * localized scleroderma
 * mixed connective tissue disease
 * eosinophilic fasciitis (Diffuse fasciitis with eosinophilia)
 * 361 sjögren’s syndrome
 * definition, incidence, and prevalence
 * pathogenesis
 * clinical manifestations
 * diagnosis and differential diagnosis
 * treatment
 * 362 spondyloarthritis
 * ankylosing spondylitis and axial spondyloarthritis
 * reactive arthritis
 * psoriatic arthritis
 * ibd-associated arthritis
 * sapho syndrome
 * 363 the vasculitis syndromes
 * definition
 * classification
 * pathophysiology and pathogenesis
 * approach to the patient
 * granulomatosis with polyangiitis
 * microscopic polyangiitis
 * eosinophilic granulomatosis with polyangiitis (Churg-strauss)
 * polyarteritis nodosa
 * giant cell arteritis and polymyalgia rheumatica
 * takayasu arteritis
 * iga vasculitis (Henoch-schönlein)
 * cryoglobulinemic vasculitis
 * single-organ vasculitis
 * idiopathic cutaneous vasculitis
 * primary central nervous system vasculitis
 * behçet’s disease
 * cogan’s syndrome
 * kawasaki’s disease
 * polyangiitis overlap syndromes
 * secondary vasculitis
 * 364 behçet syndrome
 * diagnosis
 * pathogenesis
 * clinical presentation
 * treatment
 * 365 inflammatory myopathies
 * diagnostic approach and differential diagnosis
 * specific disorders
 * dermatomyositis
 * polymyositis
 * overlap syndromes
 * immune-mediated necrotizing myopathy
 * antisynthetase syndrome
 * inclusion body myositis
 * treatment of the im
 * general guidelines for use ofspecific immunotherapies
 * second-line therapies
 * myositis associated with checkpoint inhibitors
 * myositis associated with covid-19 infection
 * global issues
 * 366 relapsing polychondritis
 * pathology and pathophysiology
 * clinical manifestations
 * laboratory findings and diagnostic imaging
 * diagnosis
 * treatment
 * patient outcome, prognosis, and survival
 * 367 sarcoidosis
 * definition
 * etiology
 * incidence, prevalence, and global impact
 * pathophysiology and immunopathogenesis
 * clinical manifestations
 * lung
 * skin
 * eye
 * liver
 * bone marrow and spleen
 * calcium metabolism
 * renal disease
 * nervous system
 * cardiac
 * musculoskeletal system
 * other organ involvement
 * complications
 * laboratory findings
 * diagnosis
 * prognosis
 * treatment
 * 368 igg4-related disease
 * clinical features
 * serologic findings
 * epidemiology
 * pathology
 * pathophysiology
 * treatment
 * 369 familial mediterranean fever and other hereditary autoinflammatory diseases
 * background and pathophysiology
 * acute attacks
 * amyloidosis
 * diagnosis
 * treatment: familial mediterranean fever
 * other hereditary recurrent fevers
 * tnf receptor–associated periodic syndrome
 * hyperimmunoglobulinemia d with periodic fever syndrome (Also known as mevalonate kinase deficiency)
 * nlrp3-associated autoinflammatory disease (Also known as the cryopyrinopathies or cryopyrin-associated periodic syndromes)
 * periodic fever with aphthous stomatitis, pharyngitis, and cervical adenitis
 * other inherited autoinflammatory diseases
 * [[global considerations
 * section 3 disorders of the joints and adjacent tissues]]
 * 370 approach to articular and musculoskeletal disorders
 * articular versus nonarticular
 * inflammatory versus noninflammatory disorders
 * rheumatologic evaluation of the elderly
 * rheumatologic evaluation of the hospitalized patient
 * physical examination
 * approach to regional rheumatic complaints
 * telehealth musculoskeletal evaluation
 * laboratory investigations
 * diagnostic imaging in joint diseases
 * 371 osteoarthritis
 * global considerations
 * definition
 * joint protective mechanisms and their failure
 * risk factors
 * pathology
 * sources of pain
 * clinical features
 * treatment
 * 372 gout and other crystal-associated arthropathies
 * gout
 * calcium pyrophosphate deposition disease
 * calcium apatite deposition disease
 * caox deposition disease
 * 373 fibromyalgia
 * definition
 * epidemiology
 * clinical manifestations
 * differential diagnosis
 * laboratory or radiographic testing
 * approach to the patient
 * treatment
 * 374 arthritis associated with systemic disease, and other arthritides
 * arthritis associated with systemic disease
 * arthropathy of acromegaly
 * arthropathy of hemochromatosis
 * hemophilic arthropathy
 * arthropathies associated with hemoglobinopathies
 * musculoskeletal disorders associated with hyperlipidemia
 * other arthritides
 * neuropathic joint disease
 * hypertrophic osteoarthropathy and clubbing
 * complex regional pain syndrome
 * tietze syndrome and costochondritis
 * myofascial pain syndrome
 * neoplasias and arthritis
 * 375 periarticular disorders of the extremities
 * bursitis
 * rotator cuff tendinitis and impingement syndrome
 * calcific tendinitis
 * bicipital tendinitis and rupture
 * de quervain’s tenosynovitis
 * patellar tendinitis
 * drug-induced tendinopathies
 * iliotibial band syndrome
 * adhesive capsulitis
 * lateral epicondylitis
 * medial epicondylitis
 * [[plantar fasciitis

endocrinology
]]
 * section 1 endocrinology]]
 * 376 approach to the patient with endocrine disorders
 * scope of endocrinology
 * pathologic mechanisms of endocrine disease
 * causes of hormone excess
 * causes of hormone deficiency
 * hormone resistance
 * clinical evaluation of endocrine disorders
 * hormone measurements and endocrine testing
 * screening and assessment of common endocrine disorders
 * 377 mechanisms of hormone action
 * classes of hormones
 * hormone and receptor families
 * hormone synthesis and processing
 * hormone secretion, transport, and degradation
 * hormone action through receptors
 * membrane receptors
 * nuclear receptors
 * maintenance of homeostasis
 * reproduction
 * hormonal feedback regulatory systems
 * paracrine and autocrine control
 * hormonal rhythms
 * 378 physiology of anterior pituitary hormones
 * anatomy and development
 * anterior pituitary hormones
 * prolactin
 * growth hormone
 * adrenocorticotropic hormone
 * gonadotropins: fsh and lh
 * thyroid-stimulating hormone
 * 379 hypopituitarism
 * developmental causes of hypopituitarism
 * hypothalamic endocrine dysfunction
 * kallmann syndrome
 * bardet-biedl syndrome
 * leptin and leptin receptor mutations
 * prader-willi syndrome
 * acquired hypopituitarism
 * hypothalamic infiltration disorders
 * inflammatory lesions
 * cranial irradiation
 * lymphocytic hypophysitis
 * immunotherapy and hypophysitis
 * pituitary apoplexy
 * empty sella
 * presentation and diagnosis
 * laboratory investigation
 * treatment
 * disorders of growth and development
 * adult gh deficiency
 * acth deficiency
 * gonadotropin deficiency
 * diabetes insipidus
 * 380 pituitary tumor syndromes
 * hypothalamic, pituitary, and other sellar masses
 * evaluation of sellar masses
 * sellar masses
 * pituitary adenomas and hypersecretion syndromes
 * hyperprolactinemia
 * galactorrhea
 * prolactinoma
 * acromegaly
 * cushing’s disease (Acth-producing adenoma)
 * nonfunctioning and gonadotropin-producing pituitary adenomas
 * tsh-secreting adenomas
 * aggressive adenomas
 * 381 disorders of the neurohypophysis
 * vasopressin
 * thirst
 * oxytocin
 * deficiencies of avp secretion and action
 * diabetes insipidus
 * hypodipsic hypernatremia
 * inappropriate antidiuresis
 * global perspectives
 * 382 thyroid gland physiology and testing
 * anatomy and development
 * thyroid hormone synthesis, metabolism, and action
 * thyroid hormone synthesis
 * thyroid function in pregnancy
 * thyroid hormone transport and metabolism
 * thyroid hormone action
 * physical examination
 * laboratory evaluation
 * 383 hypothyroidism
 * congenital hypothyroidism
 * autoimmune hypothyroidism
 * other causes of hypothyroidism
 * treatment
 * 384 hyperthyroidism and other causes of thyrotoxicosis
 * thyrotoxicosis
 * graves’ disease
 * other causes of thyrotoxicosis
 * acute thyroiditis
 * subacute thyroiditis
 * silent thyroiditis
 * drug-induced thyroiditis
 * chronic thyroiditis
 * sick euthyroid syndrome (Nonthyroidal illness)
 * amiodarone effects on thyroid function
 * 385 thyroid nodular disease and thyroid cancer
 * goiter and thyroid nodular disease
 * diffuse nontoxic (Simple) Goiter
 * nontoxic multinodular goiter
 * toxic multinodular goiter
 * hyperfunctioning solitary nodule
 * benign lesions
 * thyroid cancer
 * classification
 * pathogenesis and genetic basis
 * well-differentiated thyroid cancer
 * anaplastic and other forms of thyroid cancer
 * medullary thyroid carcinoma
 * 386 disorders of the adrenal cortex
 * adrenal anatomy and development
 * regulatory control of steroidogenesis
 * steroid hormone synthesis, metabolism, and action
 * cushing’s syndrome
 * mineralocorticoid excess
 * approach to the patient: incidentally discovered adrenal mass
 * adrenocortical carcinoma
 * adrenal insufficiency
 * congenital adrenal hyperplasia
 * 387 pheochromocytoma
 * epidemiology
 * etiology and pathogenesis
 * clinical features
 * diagnosis
 * treatment
 * metastatic pheochromocytoma
 * pheochromocytoma in pregnancy
 * pheochromocytoma-associated syndromes
 * genetic screening of patients with pheochromocytoma or paraganglioma
 * 388 multiple endocrine neoplasia syndromes
 * multiple endocrine neoplasia type 1
 * multiple endocrine neoplasia type 2 and type 3
 * multiple endocrine neoplasia type 4
 * hyperparathyroidism-jaw tumor syndrome
 * von hippel–lindau disease
 * neurofibromatosis
 * carney complex
 * cowden’s syndrome
 * mccune-albright syndrome
 * 389 autoimmune polyendocrine syndromes
 * aps-1
 * aps-2
 * immune checkpoint inhibitor–induced endocrine autoimmunity
 * ipex
 * thymic tumors
 * anti-insulin receptor antibodies
 * insulin autoimmune syndrome (Hirata’s syndrome)
 * poems syndrome
 * other disorders
 * global considerations
 * section 2 sex- and gender-based medicine]]
 * 390 sex development
 * sex development
 * disorders of chromosomal sex
 * klinefelter syndrome (47,xxy)
 * turner syndrome (Gonadal dysgenesis; 45,x)
 * 45,x/46,xy mosaicism
 * ovotesticular dsd
 * disorders of gonadal and phenotypic sex
 * 46,xy dsd
 * other disorders affecting 46,xy males
 * 46,xx dsd
 * global considerations
 * other disorders affecting 46,xx females
 * 391 disorders of the testes and male reproductive system
 * development and structureof the testis
 * normal male pubertal development
 * regulation of testicular function
 * regulation of the hypothalamic-pituitary-testis axis in adult man
 * the leydig cell: androgen synthesis
 * the seminiferous tubules: spermatogenesis
 * clinical and laboratory evaluation of male reproductive function
 * history and physical examination
 * gonadotropin and inhibin measurements
 * testosterone assays
 * semen analysis
 * testicular biopsy
 * disorders of sexual differentiation
 * disorders of puberty
 * precocious puberty
 * delayed puberty
 * disorders of the male reproductive axis during adulthood
 * hypogonadotropic hypogonadism
 * primary testicular causes of hypogonadism
 * androgen insensitivity syndromes
 * gynecomastia
 * aging-related changes in male reproductive function
 * approach to the patient: androgen deficiency
 * treatment: androgen deficiency
 * approach to the patient: androgenic-anabolic steroids use
 * 392 disorders of the female reproductive system
 * development of the ovary and early follicular growth
 * development of a mature follicle
 * regulation of ovarian function
 * hypothalamic and pituitary secretion
 * ovarian steroids
 * ovarian peptides
 * hormonal integration of the normal menstrual cycle
 * the follicular phase
 * the luteal phase
 * clinical assessment of ovarian function
 * puberty
 * normal pubertal development in girls
 * disorders of puberty
 * precocious puberty
 * delayed puberty
 * 393 menstrual disorders and pelvic pain
 * menstrual disorders
 * definition and prevalence
 * primary amenorrhea
 * secondary amenorrhea or oligomenorrhea
 * disorders of the uterus or outflow tract
 * disorders of ovulation
 * hypogonadotropic hypogonadism
 * hypergonadotropic hypogonadism
 * polycystic ovarian syndrome
 * pelvic pain
 * acute pelvic pain
 * chronic pelvic pain
 * 394 hirsutism
 * defining hirsutism
 * hair follicle growth and differentiation
 * clinical assessment
 * hormonal evaluation
 * treatment
 * 395 menopause and postmenopausal hormone therapy
 * perimenopause
 * physiology
 * diagnostic tests
 * symptoms
 * treatment
 * menopause and postmenopausal ht
 * benefits and risks of postmenopausal ht
 * approach to the patient
 * 396 infertility and contraception
 * infertility
 * etiology
 * fertility evaluation
 * counseling and treatment
 * psychological aspects of infertility
 * contraception
 * types of contraception
 * contraception counseling
 * 397 sexual dysfunction
 * male sexual dysfunction
 * physiology of male sexual response
 * erectile dysfunction
 * treatment
 * female sexual dysfunction
 * epidemiology
 * physiology of the female sexual response
 * approach to the patient
 * treatment
 * 398 women’s health
 * disease risk: reality and perception
 * sex differences in health and disease
 * summary
 * 399 men’s health
 * aging-related changes in male reproductive function
 * approach to the patient: older men with age-related decline in testosterone
 * age-related changes in fecundity
 * sexual dysfunction
 * muscle dysmorphia syndrome in men—a form of body image disorder
 * aas abuse by athletes and recreational bodybuilders
 * luts in men
 * medical complications of prostate cancer therapy
 * medical complications of adt
 * prevention of sexually transmitted diseases
 * sex differences in covid-19 disease outcomes
 * 400 lesbian, gay, bisexual, and transgender (Lgbt) Health
 * understanding lgbt health disparities
 * creating positive health experiences for lgbt patients
 * future direction in lgbt health
 * section 3 obesity, diabetes mellitus, and metabolic syndrome]]
 * 401 pathobiology of obesity
 * definition of obesity and overweight
 * epidemiology
 * physiologic regulation of energy balance
 * the physiology of nutrient storage in adipose tissue
 * the causes of obesity: an interaction of genes and environment
 * the relative roles of excess intake and lower energy expenditure in conferring biologic predisposition
 * environmental factors predisposing to obesity
 * why doesn’t leptin prevent obesity?
 * single-gene disorders leading to obesity
 * classical syndromic disorders
 * disorders of leptin-melanocortin signaling
 * genetic subtypes of obesity associated with neurobehavioral abnormalities
 * obesity secondary to other disorders
 * adverse consequences of obesity
 * conclusion
 * 402 evaluation and management of obesity
 * evaluation
 * treatment
 * 403 diabetes mellitus: diagnosis, classification, and pathophysiology
 * classification
 * epidemiology and global considerations
 * diagnosis
 * regulation of glucose homeostasis
 * pathogenesis
 * genetically defined, monogenic forms of dm related to reduced insulin secretion
 * approach to the patient
 * 404 diabetes mellitus: management and therapies
 * overall goals
 * ongoing aspects of comprehensive diabetes care
 * lifestyle management in diabetes care
 * diabetes self-management education and support (Dsmes)
 * nutrition therapy
 * physical activity
 * psychosocial care
 * monitoring the level of glycemic control
 * self-monitoring of blood glucose
 * continuous glucose monitoring
 * assessment of long-term glycemic control
 * pharmacologic treatment of diabetes
 * establishment of target level ofglycemic control
 * type 1 diabetes mellitus
 * general aspects
 * intensive management
 * insulin preparations
 * insulin regimens
 * other agents that improve glucose control
 * type 2 diabetes mellitus
 * general aspects
 * glucose-lowering agents
 * other therapies for diabetes
 * emerging therapies
 * adverse effects of therapy for dm
 * acute disorders related to severe hyperglycemia
 * diabetic ketoacidosis
 * hyperglycemic hyperosmolar state
 * management of diabetes in a hospitalized patient
 * special considerations in dm
 * 405 diabetes mellitus: complications
 * glycemic control and complications
 * mechanisms of complications
 * ophthalmologic complications of diabetes mellitus
 * renal complications of diabetes mellitus
 * neuropathy and diabetes mellitus
 * gastrointestinal/genitourinary dysfunction
 * cardiovascular morbidity and mortality
 * lower extremity complications
 * infections
 * dermatologic manifestations
 * 406 hypoglycemia
 * systemic glucose balance and glucose counterregulation
 * hypoglycemia in diabetes
 * hypoglycemia without diabetes
 * accidental, surreptitious, or malicious hypoglycemia
 * inborn errors of metabolism causing hypoglycemia
 * approach to the patient
 * 407 disorders of lipoprotein metabolism
 * lipoprotein structureand metabolism
 * transport of intestinally derived dietary lipids by chylomicrons
 * transport of hepatically derived lipids by vldl and ldl
 * hdl metabolism and reverse cholesterol transport
 * screening
 * disorders associated with elevated apob-containing lipoproteins
 * severe hypertriglyceridemia
 * hypercholesterolemia (Elevated ldl-c)
 * mixed hyperlipidemia (Elevated tg and ldl-c)
 * secondary contributors to elevated levels of apob-containing lipoproteins
 * disorders associated with reduced apob-containing lipoproteins
 * abetalipoproteinemia
 * familial hypobetalipoproteinemia (Fhbl)
 * familial pcsk9 deficiency
 * familial combined hypolipidemia
 * disorders associated with reduced high-density lipoproteins
 * primary (Genetic) Causes of low hdl-c
 * gene deletions and missense mutations in apoa1
 * tangier disease (Abca1 deficiency)
 * familial lcat deficiency
 * primary hypoalphalipoproteinemia
 * secondary factors that reduce hdl-c levels
 * hypertriglyceridemia
 * very-low-fat diet
 * sedentary lifestyle and obesity
 * approach to the patient
 * treatment: severe hypertriglyceridemia
 * treatment: hypercholesterolemia (Elevated ldl-cwith or without elevated tg)
 * 408 the metabolic syndrome
 * global health/epidemiology
 * risk factors
 * etiology
 * clinical features
 * diagnosis
 * treatment
 * section 4 disorders of bone and mineral metabolism]]
 * 409 bone and mineral metabolism in health and disease
 * bone structure and metabolism
 * calcium metabolism
 * phosphorus metabolism
 * magnesium metabolism
 * vitamin d
 * 410 disorders of the parathyroid gland and calcium homeostasis
 * introduction
 * pth
 * pthrp
 * calcitonin
 * hypercalcemia
 * introduction
 * primary hyperparathyroidism
 * other parathyroid causes of hypercalcemia
 * genetic disorders causing hyperparathyroidism-like syndromes
 * malignancy-related hypercalcemia
 * vitamin d–related hypercalcemia
 * high-bone-turnover states
 * renal failure–associated hypercalcemia
 * other causes of hypercalcemia
 * differential diagnosis of hypercalcemia
 * treatment
 * hypocalcemia
 * pathophysiology
 * classification of hypocalcemia
 * pth absent
 * pth ineffective
 * pth overwhelmed
 * differential diagnosis
 * 411 osteoporosis
 * definition
 * epidemiology
 * pathophysiology
 * bone remodeling
 * calcium nutrition
 * vitamin d
 * estrogen status
 * physical activity
 * chronic diseases
 * medications
 * smoking
 * other potential factors
 * diagnosis
 * measurement of bone mass
 * indications for bone mass measurement
 * vertebral imaging
 * approach to the patient
 * treatment
 * management of patients with fractures
 * management of the underlying disease
 * risk factor reduction
 * nutritional recommendations
 * exercise
 * pharmacologic treatment of osteoporosis
 * antiresorptive agents
 * anabolic agents
 * other pharmacologic agents not approved in the united states
 * nonpharmacologic approaches
 * treatment monitoring
 * glucocorticoid-induced osteoporosis
 * pathophysiology
 * evaluation of the patient
 * prevention
 * treatment
 * 412 paget’s disease and other dysplasias of bone
 * paget’s disease of bone
 * epidemiology
 * etiology
 * pathophysiology
 * clinical manifestations
 * diagnosis
 * treatment
 * sclerosing bone disorders
 * osteopetrosis
 * pyknodysostosis
 * progressive diaphyseal dysplasia
 * hyperostosis corticalis generalisata
 * melorheostosis
 * osteopoikilosis
 * hepatitis c–associated osteosclerosis
 * disorders associated with defective mineralization
 * hypophosphatasia
 * axial osteomalacia
 * fibrogenesis imperfecta ossium
 * fibrous dysplasia and mccune-albright syndrome
 * other dysplasias of bone and cartilage
 * pachydermoperiostosis
 * osteochondrodysplasias
 * extraskeletal (Ectopic) Calcification and ossification
 * metastatic calcification
 * tumoral calcinosis
 * dystrophic calcification
 * ectopic ossification
 * fibrodysplasia ossificans progressiva
 * section 5 disorders of intermediary metabolism]]
 * 413 heritable disorders of connective tissue
 * classification of connective tissue disorders
 * specific disorders
 * osteogenesis imperfecta
 * hlers-danlos syndromes
 * chondrodysplasias
 * heritable thoracic aortic aneurysm disease
 * 414 hemochromatosis
 * definition
 * prevalence
 * genetic basis
 * pathophysiology and the role of hepcidin
 * clinical manifestations
 * diagnosis
 * screening for hemochromatosis
 * treatment
 * prognosis
 * role of hfe mutations in other liver diseases
 * global considerations
 * 415 wilson’s disease
 * history of wilson’s disease
 * phenotypes
 * clinical
 * biochemical
 * molecular
 * diagnosis
 * treatment
 * future outlook
 * 416 the porphyrias
 * the porphyrias: introduction
 * global considerations
 * heme biosynthesis
 * regulation of heme biosynthesis
 * classification of the porphyrias
 * diagnosis of porphyria
 * the hepatic porphyrias
 * ala-dehydratase-deficient porphyria
 * acute intermittent porphyria
 * porphyria cutanea tarda
 * hereditary coproporphyria
 * variegate porphyria
 * the erythropoietic porphyrias
 * x-linked sideroblastic anemia
 * congenital erythropoietic porphyria
 * erythropoietic protoporphyria
 * 417 disorders of purine and pyrimidine metabolism
 * uric acid metabolism
 * hyperuricemia
 * evaluation
 * complications
 * hyperuricemia and metabolic syndrome
 * hypouricemia
 * selected inborn errors of purine and pyrimidine metabolism
 * purine disorders
 * pyrimidine disorders
 * 418 lysosomal storage diseases
 * pathogenesis
 * selected disorders
 * tay-sachs disease
 * fabry disease
 * gaucher disease
 * niemann-pick diseases
 * mucopolysaccharidoses
 * pompe disease
 * lysosomal acid lipase deficiency
 * krabbe disease
 * neuronal ceroid lipofuscinosis type 2 (Ncl2 or cln2)
 * 419 glycogen storage diseases and other inherited disorders of carbohydrate metabolism
 * selected liver glycogenoses
 * disorders with hepatomegaly and hypoglycemia
 * type i gsd (Glucose-6-phosphatase or translocase deficiency, von gierke disease)
 * type iii gsd (Debrancher deficiency, limit dextrinosis)
 * type ix gsd (Liver phosphorylase kinase deficiency)
 * type iv gsd (Branching enzyme deficiency, amylopectinosis,polyglucosan disease, or andersen disease)
 * other liver glycogenoses with hepatomegaly and hypoglycemia
 * selected muscle glycogenoses
 * disorders with muscle-energyimpairment
 * type v gsd (Muscle phosphorylase deficiency, mcardle disease)
 * type ix gsd (Muscle phosphorylase kinase deficiency)
 * disorders with progressive skeletalmuscle myopathy and/or cardiomyopathy
 * pompe disease, type ii gsd (Acid α-1,4 glucosidase deficiency)
 * selected disorders of galactose metabolism
 * selected disorders of fructose metabolism
 * global considerations
 * 420 inherited disorders of amino acid metabolism in adults
 * the hyperphenylalaninemias
 * the homocystinurias (Hyperhomocysteinemias)
 * alkaptonuria
 * urea cycle defects
 * 421 inherited defects of membrane transport
 * cystinuria
 * lysinuric protein intolerance
 * citrullinemia type 2 (Citrin deficiency)
 * hartnup disease
 * [[cystinosis

neurology
]]
 * section 1 diagnosis of neurologic disorders]]
 * 422 approach to the patient with neurologic disease
 * the neurologic method
 * define the anatomy
 * identify the pathophysiology
 * the neurologic history
 * the neurologic examination
 * mental status examination
 * cranial nerve examination
 * motor examination
 * reflex examination
 * sensory examination
 * coordination examination
 * gait examination
 * neurologic diagnosis
 * 423 neuroimaging in neurologic disorders
 * computed tomography
 * magnetic resonance imaging
 * magnetic resonance angiography
 * echo-planar mri
 * arterial spin labeling
 * magnetic resonance neurography
 * positron emission tomography
 * myelography
 * spine interventions
 * angiography
 * interventional neuroradiology
 * 424 pathobiology of neurologic diseases
 * neuroimmunology and neuroinflammation
 * oligodendrocytes and myelin
 * microglia and macrophages
 * astrocytes
 * lymphatics of the central nervous system
 * microbiota and neurologic disease
 * pathologic proteins, prions, and neurodegeneration
 * protein aggregation and cell death
 * prions and neurodegenerative diseases
 * neural stem cell biology
 * organoids
 * brain development and developmental disorders: microcephaly and lissencephaly
 * acquired neurodevelopmental disorders: zika
 * neurodevelopmental disorders: autism and schizophrenia
 * alzheimer’s disease
 * cell type disorders: als and huntington’s disease
 * amyotrophic lateral sclerosis
 * huntington’s disease
 * [[future perspectives

poisoning, drug
]]
 * 458 heavy metal poisoning]]
 * arsenic
 * cadmium
 * lead
 * mercury
 * 459 poisoning and drug overdose]]
 * epidemiology
 * diagnosis
 * history
 * physical examination and clinical course
 * laboratory assessment
 * treatment
 * general principles
 * supportive care
 * prevention of poison absorption
 * enhancement of poison elimination
 * administration of antidotes
 * prevention of reexposure
 * specific toxic syndromes and poisonings
 * global considerations
 * 460 disorders caused by venomous snakebites and marine animal exposures]]
 * venomous snakebite
 * epidemiology
 * snake anatomy/identification
 * venoms and clinical manifestations
 * treatment
 * morbidity and mortality
 * global considerations
 * marine envenomations
 * invertebrates
 * cnidarians
 * sea sponges
 * annelid worms
 * sea urchins
 * starfish
 * sea cucumbers
 * cone snails
 * octopuses
 * vertebrates
 * stingrays
 * stonefish
 * lionfish
 * platypuses
 * treatment
 * approach to the patient
 * sources of antivenoms and other assistance
 * marine poisonings
 * histamine (Scombroid) Fish poisoning
 * ciguatera
 * paralytic shellfish poisoning
 * amnesic shellfish poisoning
 * diarrhetic shellfish poisoning
 * 461 ectoparasite infestations and arthropod injuries]]
 * scabies
 * chiggers and other biting mites
 * tick bites and tick paralysis
 * louse infestation (Pediculiasis and pthiriasis)
 * myiasis (Fly infestation)
 * pentastomiasis
 * leech infestations
 * spider bites
 * recluse spider bites and necrotic arachnidism
 * widow spider bites
 * tarantulas and other spiders
 * scorpion stings
 * hymenoptera stings
 * bee and wasp stings
 * stinging ants
 * dipteran (Fly and mosquito) Bites
 * flea bites
 * hemipteran/heteropteran (True bug) Bites
 * centipede bites and millipede dermatitis
 * caterpillar stings and dermatitis
 * beetle vesication and dermatitis
 * [[delusional infestations

environmental disorders
]]
 * 462 altitude illness]]
 * epidemiology
 * physiology
 * genetics
 * acute mountain sickness and high-altitude cerebral edema
 * high-altitude pulmonary edema
 * other high-altitude problems
 * preexisting medical issues
 * chronic mountain sickness and high-altitude pulmonary hypertension in highlanders
 * 463 hyperbaric and diving medicine]]
 * what is hyperbaricand diving medicine?
 * mechanisms of hyperbaric oxygen
 * adverse effects of therapy
 * barotrauma
 * oxygen toxicity
 * contraindications to hyperbaric oxygen
 * indications for hyperbaric oxygen
 * late radiation tissue injury
 * selected problem wounds
 * carbon monoxide poisoning
 * current controversies in hyperbaric medicine
 * diving medicine
 * introduction
 * breathing equipment
 * suitability for diving
 * barotrauma
 * decompression sickness
 * treatment
 * 464 hypothermia and peripheral cold injuries]]
 * hypothermia
 * causes
 * thermoregulation
 * clinical presentation
 * diagnosis and stabilization
 * rewarming strategies
 * treatment
 * frostbite
 * clinical presentation
 * treatment
 * 465 heat-related illnesses]]
 * thermoregulation
 * predisposing factors and differential diagnosis
 * minor heat-emergency syndromes
 * heat cramps
 * heat exhaustion
 * heatstroke
 * cooling strategies
 * resuscitation
 * [[disposition

medical genetics
]]
 * 466 principles of human genetics]]
 * impact of genetics and genomics on medical practice
 * the human genome
 * structure of the human genome
 * replication of dna and mitosis
 * assortment and segregation of genes during meiosis
 * regulation of gene expression
 * regulation by transcription factors
 * epigenetic regulation of gene expression
 * transmission of genetic disease
 * origins and types of mutations
 * functional consequences of mutations
 * genotype and phenotype
 * chromosomal disorders
 * monogenic mendelian disorders
 * exceptions to simple mendelian inheritance patterns
 * complex genetic disorders
 * linkage and association studies
 * approach to the patient
 * 467 the practice of genetics in clinical medicine]]
 * applications of molecular genetics in clinical medicine
 * common adult-onset genetic disorders
 * inheritance patterns
 * family history
 * genetic testing for adult-onset disorders
 * methodologic approaches to genetic testing
 * direct-to-consumer genetic testing
 * informed consent
 * follow-up care after testing
 * therapeutic interventions based on genetic risk for disease
 * 468 mitochondrial dna and heritable traits and diseases]]
 * mitochondrial dna structure and function
 * maternal inheritance and lack of recombination
 * multiple copy number (Polyploidy), high mutation rate, heteroplasmy, and mitotic segregation
 * homoplasmic variants and human mtdna phylogeny
 * mitochondrial dna disease
 * overview of clinical and pathologic features of human mtdna disease
 * mtdna disease presentations
 * the investigation of suspected mtdna disease
 * impact of homoplasmic sequence variation on heritable traits and disease
 * impact of acquired somatic mtdna mutation on human health and disease
 * prospects for clinical management of mtdna disease
 * treatment of mtdna disorders
 * genetic counseling, prenatal diagnosis, and pgd in mtdna disorders
 * prevention of mitochondrial disease inheritance by assisted reproductive technologies
 * 469 telomere disease]]
 * definition
 * disease mechanism
 * genetics
 * clinical manifestations
 * telomere length measurement
 * genetic testing
 * treatment
 * 470 gene- and cell-based therapy in clinical medicine]]
 * gene transfer for genetic disease
 * immunodeficiency disorders: proof of principle for ex vivo gene transfer
 * transfusion-dependent thalassemia: extension of principle
 * neurodegenerative diseases: broadening of principle
 * long-term expression in genetic disease: in vivo gene transfer with recombinant adeno-associated viral vectors
 * first licensed product
 * retinal gene therapy
 * spinal muscular atrophy type 1
 * gene therapy for cancer
 * modifying the cancer
 * modifying the host
 * combination approaches—modification of host and tumor by virotherapy
 * other approaches
 * summary
 * 471 the human microbiome]]
 * historical perspective
 * a primer on taxonomy
 * the microbiota and human health
 * the microbiota and disease
 * mechanisms of microbiome-mediated effects
 * moving microbiome science from bench to bedside
 * [[perspective

global medicine
]]
 * 472 global issues in medicine]]
 * why global health?
 * a brief history of global health institutions
 * the economics of global health
 * mortality and the global burden of disease
 * global mortality
 * health and wealth
 * risk factors for disease burden
 * hiv infection/aids
 * tuberculosis
 * tuberculosis and aids as chronic diseases: lessons learned
 * malaria
 * ebola
 * covid-19
 * “noncommunicable” chronic diseases
 * mental and neurologic health
 * conclusion: toward a science of implementation
 * 473 emerging and reemerging infectious diseases]]
 * the concept of emerging infectious diseases
 * examples of emerging infectious diseases
 * west nile virus
 * dengue virus
 * ebola and marburg viruses
 * zika virus
 * sars-cov-2
 * poliovirus
 * measles virus
 * control of emerging infectious diseases
 * 474 primary care and global health]]
 * primary care and primary health care
 * health challenges in low- and middle-income countries
 * primary health care in the twenty-first century
 * experiences with primary care in low- and middle-income countries
 * conclusion
 * 475 health effects of climate change]]
 * effects of climate change on health
 * air pollution and synergistic effects
 * heat-related illnesses
 * natural disasters, coastal flooding, and displacement
 * food security and ocean resources
 * infections and diarrheal disease
 * potential solutions
 * [[conclusions

aging
]]
 * 476 biology of aging]]
 * aging
 * evolutionary theories of aging
 * the hallmarks of aging
 * genomic instability
 * telomere attrition
 * epigenetic alterations
 * loss of proteostasis
 * deregulated nutrient sensing
 * mitochondrial dysfunction
 * cellular senescence
 * stem cell exhaustion
 * altered intracellular communication and inflammation
 * geroscience and the relationship between aging and disease
 * strategies that increase health span and delay aging
 * caloric restriction
 * periodic fasting
 * pharmacologic interventions to delay aging and increase life span
 * exercise and physical activity
 * hormesis
 * conclusions
 * 477 caring for the geriatric patient]]
 * aging and geriatric care
 * demographics of aging and its implications for geriatric care
 * implications of the aging population for health care systems and system-based practice
 * models of geriatric care
 * interprofessional teams and co-managed care
 * age-friendly health systems
 * fundamentals of geriatric care
 * person-centered care
 * evaluation of the geriatric patient
 * prevention in older adults
 * treatment of common diseases in the geriatric population
 * hypertension
 * diabetes
 * hyperlipidemia
 * osteoarthritis
 * cancer
 * anemia
 * geriatric syndromes and conditions
 * falls
 * polypharmacy
 * cognitive impairment: delirium and dementia
 * urinary incontinence and overactive bladder
 * sleep disorders
 * frailty
 * elder abuse and neglect
 * severe acute respiratory syndrome corona virus (Sars-cov-2) Infection and covid-19 disease
 * [[end-of-life and palliative care

consultative medicine
]]
 * 478 approach to medical consultation]]
 * responsibilities of the requestingclinician
 * responsibilities of the consultant
 * responsibilities of health systems, hospitals, and medical organizations
 * special issues in medical consultation
 * curbside consults
 * advice
 * second opinions
 * consults involving advanced practice providers
 * consultation involving telemedicine
 * 479 medical disorders during pregnancy]]
 * hypertension
 * preeclampsia
 * gestational hypertension
 * treatment
 * chronic hypertension
 * renal disease
 * cardiac disease
 * valvular heart disease
 * congenital heart disease
 * aortopathy
 * cardiac complications in pregnancy
 * endocrine and metabolic disorders
 * diabetes mellitus
 * gestational diabetes
 * treatment: diabetes mellitus in pregnancy
 * treatment: gestational diabetes
 * obesity
 * thyroid disease
 * treatment: hyperthyroidism
 * treatment: hypothyroidism
 * hematologic disorders
 * deep venous thrombosis and pulmonary embolism
 * neoplasia
 * neurologic disorders
 * gastrointestinal and liver disease
 * infections
 * bacterial infections
 * viral infections
 * vaccinations
 * maternal mortality
 * summary
 * 480 medical evaluation of the surgical patient]]
 * evaluation of intermediate- and high-risk patients
 * preoperative cardiac risk assessment
 * preoperative noninvasive cardiac testing for risk stratification
 * risk modification: preventive strategies to reduce cardiac risk
 * preoperative pulmonary risk assessment
 * perioperative management and prophylaxis
 * diabetes mellitus
 * infective endocarditis
 * aortic stenosis
 * [[venous thromboembolism

frontiers
]]
 * 481 behavioral economics and health]]
 * concepts of classical economics and how they differ from behavioral economics
 * using behavioral economics to promote self-beneficial health behaviors
 * loss aversion and framing effects
 * loss aversion and overoptimism
 * peanuts effects
 * present-biased preferences
 * nonlinear probability weighting
 * regret aversion
 * defaults
 * the rational-world bias
 * applications
 * weight loss
 * medication adherence
 * the 5000 hours problem
 * reflections on sars-cov-2
 * future perspectives
 * 482 complementary and integrative therapies and practices]]
 * definitions and scope
 * patterns of use
 * categories of complementary and integrative health therapies and practices based on primary therapeutic input
 * primary dietary input
 * pain
 * anxiety
 * rheumatoid arthritis
 * irritable bowel syndrome
 * depression
 * smoking cessation
 * eye disease
 * multiple sclerosis
 * other conditions
 * general health and wellness
 * challenges
 * regulation
 * inherent toxicity
 * herb-drug interactions
 * primary psychological and physical input
 * primary psychological input
 * primary physical input
 * combined psychological and physical input
 * multimodal therapies and systems
 * naturopathy
 * chiropractic
 * osteopathic medicine
 * homeopathy
 * research challenges
 * therapeutic output—systems impacted and challenges of mechanistic research
 * patient and provider resources
 * summary
 * 483 the role of epigenetics in disease and treatment]]
 * the biochemical bases of epigenetics
 * epigenetics in development and differentiation
 * epigenetics of metabolism
 * cancer epigenetics
 * epigenetics of aging
 * epigenetics of the brain and behavior
 * epigenetic influences on infection, immunity, and inflammation
 * conclusions
 * 484 applications of stem cell biology in clinical medicine]]
 * general strategies for stem cell replacement
 * sources of stem cells for tissue repair
 * embryonic stem cells
 * induced pluripotent stem cells
 * umbilical-cord stem cells
 * organ-specific multipotent stem cells
 * disease-specific applications of stem cells
 * ischemic heart disease and cardiomyocyte regeneration
 * diabetes
 * nervous system
 * liver
 * other organ systems and the future
 * ethical issues
 * 485 the role of circadian biology in health and disease]]
 * basic evolution and structure of the circadian system
 * molecular organization of the mammalian circadian clock
 * anatomic organization of the circadian clock network
 * entrainment and measurement of the circadian system
 * primary pathologies of the circadian system
 * role of the clock system in physiology
 * 486 network medicine: systems biology in health and disease]]
 * properties of complex biologic systems
 * applications of systems biology to pathobiology
 * systems pathobiology and human disease classification: network medicine
 * 487 emerging neurotherapeutic technologies]]
 * introduction
 * technologies to harness plasticity
 * robotics
 * virtual and augmented reality
 * neurogaming
 * neuroimaging
 * neuroimaging of connectivity
 * closed-loop neuroimaging
 * noninvasive brain stimulation
 * implantable neural interfaces including brain–machine interfaces
 * implantable devices for neuromodulation
 * brain–machine interfaces for paralysis
 * 488 machine learning and augmented intelligence in clinical medicine]]
 * concepts of machine learning
 * types of machine learning
 * modern medical machine learning
 * practical concepts in training a modern machine-learning model
 * applications of modern machine learning to clinical medicine
 * computer vision
 * natural language processing
 * other applications
 * machine learning and precision medicine: deeper representations of patient state
 * conclusion
 * 489 metabolomics]]
 * approaches and sampling considerations
 * untargeted and targeted metabolomics
 * untargeted metabolomics
 * targeted metabolomics
 * sampling considerations
 * metabolomics technologies
 * nuclear magnetic resonance
 * chromatography/mass spectrometry
 * sample preparation
 * chromatography
 * mass spectrometry
 * current clinical applications
 * magnetic resonance spectroscopy
 * newborn screening programs
 * metabolite measurements in children and adults
 * emerging and experimental clinical applications
 * metabolites as biomarkers of disease
 * refining diagnosis and prediction of drug susceptibility
 * pharmacometabolomics
 * emerging technologies
 * mass spectrometry imaging
 * improving untargeted metabolomics
 * summary
 * 490 circulating nucleic acids as liquid biopsies and noninvasive disease biomarkers
 * cell-free dna in oncology
 * early cancer detection
 * noninvasive tumor genotyping
 * biologic considerations
 * pretreatment tumor burden
 * monitoring response to treatment
 * minimal residual disease
 * technical considerations
 * cell-free dna in transplantation
 * noninvasive detection of acute allograft rejection
 * monitoring microbial diversity and infection after transplantation
 * monitoring host immunity
 * cell-free dna in prenatal medicine
 * noninvasive prenatal testing for fetal aneuploidy
 * noninvasive prenatal screening versus noninvasive prenatal diagnosis versus noninvasive prenatal testing
 * dependence on fetal fraction
 * nipt in multiple gestations
 * nipt for fetal microdeletion/duplication syndromes
 * whole genome nipt and single-gene disorders
 * nipt using cell-free rna
 * nipt detecting maternal malignancy
 * beyond next-generation sequencing
 * summary
 * 491 protein folding disorders
 * protein quality control mechanisms
 * cell stress responses: sensors and regulators of protein damage
 * organismal proteostasis in aging and disease
 * properties of protein folding diseases
 * disorders that enhance misfolding and cause premature degradation (Cystic fibrosis)
 * disorders that induce toxic aggregates and loss of function (Aat deficiency)
 * interactions with pn components that change conformation, stability, or function (Cancer)
 * strongly enhanced aggregation propensity and amyloid formation (Alzheimer’s disease, parkinson’s disease, amyotrophic lateral sclerosis, huntington’s disease, type 2 diabetes mellitus)
 * secreted aggregated and amyloid species causing systemic amyloidosis
 * native proteins prone to aggregate when the cellular environment is altered by stress and aging
 * infectious diseases and imbalanced cell stress responses in aging
 * 492 novel approaches to diseases of unknown etiology
 * the undiagnosed disease state
 * the meaning and context of a diagnosis
 * undiagnosed rare diseases
 * the effect of the undiagnosed disease state on the patient
 * approach to challenging diseases of unknown etiology
 * comprehensive data collection
 * validation of subjective and objective findings
 * periodic reevaluation
 * genomics
 * exposome
 * engagement of research approaches
 * challenges
 * conclusion