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placeholder for MARKETING PAGE CMDT2015_FM_pi-xiv.indd 1 7/29/14 2:19 PM This page intentionally left blank a LANGE medical book 2015 CURRENT Medical Diagnosis & Treatment FIFT Y-FOURTH EDITION Edited by Maxine A. Papadakis, MD Professor of Medicine Associate Dean of Students School of Medicine University of California, San Francisco Stephen J. McPhee, MD Professor of Medicine, Emeritus Division of General Internal Medicine Department of Medicine University of California, San Francisco Associate Editor Michael W. Rabow, MD Professor of Medicine Division of General Internal Medicine Department of Medicine University of California, San Francisco With Associate Authors New York CMDT2015_FM_pi-xiv.indd 1 Chicago San Francisco Athens London Madrid Milan New Delhi Singapore Sydney Toronto Mexico City 7/29/14 2:19 PM Copyright © 2015 by McGraw-Hill Education. All rights reserved. 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Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. Contents Authors Preface 13. Blood Disorders v xi 1. Disease Prevention & Health Promotion Lloyd E. Damon, MD, & Charalambos Andreadis, MD 1 Michael Pignone, MD, MPH, & René Salazar, MD 2. Common Symptoms 489 14. Disorders of Hemostasis, Thrombosis, & Antithrombotic Therapy 20 Ralph Gonzales, MD, MSPH, & Paul L. Nadler, MD 536 Patrick F. Fogarty, MD, & Tracy Minichiello, MD 3. Preoperative Evaluation & Perioperative Management 44 15. Gastrointestinal Disorders 562 Kenneth R. McQuaid, MD Hugo Q. Cheng, MD 4. Geriatric Disorders 16. Liver, Biliary Tract, & Pancreas Disorders 55 G. Michael Harper, MD, C. Bree Johnston, MD, MPH, & C. Seth Landefeld, MD 5. Palliative Care & Pain Management 658 Lawrence S. Friedman, MD 17. Breast Disorders 71 716 Armando E. Giuliano, MD, & Sara A. Hurvitz, MD Michael W. Rabow, MD, & Steven Z. Pantilat, MD 6. Dermatologic Disorders 18. Gynecologic Disorders 93 Jason Woo, MD, MPH, FACOG, Alicia Y. Armstrong MD, MHSCR, & H. Trent MacKay, MD, MPH Timothy G. Berger, MD 7. Disorders of the Eyes & Lids 745 163 19. Obstetrics & Obstetric Disorders Paul Riordan-Eva, FRCOphth 779 Vanessa L. Rogers, MD, & Kevin C. Worley, MD 8. Ear, Nose, & Throat Disorders 199 20. Rheumatologic & Immunologic Disorders Lawrence R. Lustig, MD, & Joshua S. Schindler, MD 9. Pulmonary Disorders David B. Hellmann, MD, MACP, & John B. Imboden, Jr., MD 240 Mark S. Chesnutt, MD, & Thomas J. Prendergast, MD 10. Heart Disease 808 21. Electrolyte & Acid-Base Disorders 861 Kerry C. Cho, MD 320 Thomas M. Bashore, MD, Christopher B. Granger, MD, Kevin Jackson, MD, & Manesh R. Patel, MD 22. Kidney Disease 890 Suzanne Watnick, MD, & Tonja Dirkx, MD 11. Systemic Hypertension 432 23. Urologic Disorders Michael Sutters, MD, MRCP (UK) 12. Blood Vessel & Lymphatic Disorders 930 Maxwell V. Meng, MD, FACS, Thomas J. Walsh, MD, MS, & Thomas D. Chi, MD 463 24. Nervous System Disorders Christopher D. Owens, MD, MSc, Joseph H. Rapp, MD, Warren J. Gasper, MD, & Meshell D. Johnson, MD 954 Michael J. Aminoff, MD, DSc, FRCP, & Geoffrey A. Kerchner, MD, PhD iii CMDT2015_FM_pi-xiv.indd 3 7/29/14 2:19 PM iv CMDT 2015 contents 25. Psychiatric Disorders 1027 Charles DeBattista, DMH, MD, Stuart J. Eisendrath, MD, & Jonathan E. Lichtmacher, MD 26. Endocrine Disorders 1081 37. Disorders Related to Environmental Emergencies Jacqueline A. Nemer, MD, FACEP 38. Poisoning Paul A. Fitzgerald, MD 27. Diabetes Mellitus & Hypoglycemia 1549 Kent R. Olson, MD 1184 39. Cancer 1236 Robert B. Baron, MD, MS 1580 Patricia A. Cornett, MD, & Tiffany O. Dea, PharmD Umesh Masharani, MB, BS, MRCP(UK) 28. Lipid Disorders 1532 e2 Fundamentals of Human Genetics Online* Reed E. Pyeritz, MD, PhD 29. Nutritional Disorders 1245 Robert B. Baron, MD, MS 40. Clinical Genetic Disorders 1651 Reed E. Pyeritz, MD, PhD 30. Common Problems in Infectious Diseases & Antimicrobial Therapy 1263 Peter V. Chin-Hong, MD, & B. Joseph Guglielmo, PharmD e1 Anti-infective Chemotherapeutic & Antibiotic Agents Online* 41. Sports Medicine & Outpatient Orthopedics Anthony Luke, MD, MPH, & C. Benjamin Ma, MD 42. Women’s Health Issues B. Joseph Guglielmo, PharmD 31. HIV Infection & AIDS 1306 e3 Diagnostic Testing & Medical Decision Making 1410 e4 Information Technology in Patient Care Brian S. Schwartz, MD 34. Spirochetal Infections 1456 e5 Integrative Medicine Samuel A. Shelburne, MD, PhD, & Richard J. Hamill, MD * Online* Kevin Barrows, MD 1475 Appendix: Therapeutic Drug Monitoring & Laboratory Reference Intervals 1707 Philip J. Rosenthal, MD 36. Mycotic Infections Online* Russ Cucina, MD, MS Susan S. Philip, MD, MPH 35. Protozoal & Helminthic Infections Online* C. Diana Nicoll, MD, PhD, MPA, Michael Pignone, MD, MPH, & Chuanyi Mark Lu, MD, PhD 1339 Wayne X. Shandera, MD, & J. Daniel Kelly, MD 33. Bacterial & Chlamydial Infections 1695 Megan McNamara, MD, MSc, & Judith Walsh, MD, MPH Mitchell H. Katz, MD, & Andrew R. Zolopa, MD 32. Viral & Rickettsial Infections 1660 C. Diana Nicoll, MD, PhD, MPA, & Chuanyi Mark Lu, MD, PhD 1517 Index 1721 Free access to online chapters at www.accessmedicine.com/cmdt CMDT2015_FM_pi-xiv.indd 4 7/29/14 2:19 PM Authors Brook Calton, MD, MHS Michael J. Aminoff, MD, DSc, FRCP Assistant Clinical Professor, Division of Geriatrics, Department of Medicine, University of California, San Francisco References Distinguished Professor and Executive Vice Chair, Department of Neurology, University of California, San Francisco; Attending Physician, University of California Medical Center, San Francisco aminoffm@neurology.ucsf.edu Nervous System Disorders Matt Cascino, MD Chief Medical Resident, Department of Medicine, University of California, San Francisco References Charalambos Babis Andreadis, MD, MSCE Assistant Professor of Medicine, Division of Hematology/ Oncology, University of California, San Francisco candreadis@medicine.ucsf.edu Blood Disorders Hugo Q. Cheng, MD Clinical Professor of Medicine, University of California, San Francisco quinny@medicine.ucsf.edu Preoperative Evaluation & Perioperative Management Alicia Y. Armstrong, MD, MHSCR Medical Monitor, Contraceptive and Reproductive Health Branch, Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes for Health, Rockville, Maryland ayba55@aol.com Gynecologic Disorders Mark S. Chesnutt, MD Clinical Professor, Pulmonary & Critical Care Medicine, Dotter Interventional Institute, Oregon Health & Science University, Portland, Oregon; Director, Critical Care, Portland Veterans Affairs Medical Center chesnutm@ohsu.edu Pulmonary Disorders David M. Barbour, PharmD, BCPS Pharmacist, Denver, Colorado dbarbour99@gmail.com Drug References Thomas D. Chi, MD Assistant Professor, Department of Urology, University of California, San Francisco TChi@urology.ucsf.edu Urologic Disorders Robert B. Baron, MD, MS Professor of Medicine; Associate Dean for Graduate and Continuing Medical Education; Vice Chief, Division of General Internal Medicine, University of California, San Francisco baron@medicine.ucsf.edu Lipid Disorders; Nutritional Disorders Peter V. Chin-Hong, MD Associate Professor, Division of Infectious Diseases, Department of Medicine, University of California, San Francisco peter.chin-hong@ucsf.edu Common Problems in Infectious Diseases & Antimicrobial Therapy Kevin Barrows, MD Associate Clinical Professor of Family and Community Medicine, Medical Director, Osher Center for Integrative Medicine; Department of Family and Community Medicine, University of California, San Francisco barrowsk@ocim.ucsf.edu CMDT Online—Integrative Medicine Kerry C. Cho, MD Assistant Clinical Professor of Medicine, Division of Nephrology, University of California, San Francisco kerry.cho@ucsf.edu Electrolyte & Acid-Base Disorders Thomas M. Bashore, MD Patricia A. Cornett, MD Professor of Medicine; Clinical Chief, Division of Cardiology, Duke University Medical Center, Durham, North Carolina thomas.bashore@duke.edu Heart Disease Professor of Medicine, University of California, San Francisco; Chief, Hematology/Oncology, San Francisco Veterans Affairs Medical Center, San Francisco, California patricia.cornett@va.gov Cancer Timothy G. Berger, MD Marisa L. Cruz, MD Professor of Clinical Dermatology, Department of Dermatology, University of California, San Francisco bergert@derm.ucsf.edu Dermatologic Disorders Fellow, Division of Endocrinology and Metabolism, University of California, San Francisco References v CMDT2015_FM_pi-xiv.indd 5 7/29/14 2:19 PM vi CMDT 2015 Authors Russ Cucina, MD, MS Associate Professor of Hospital Medicine; Medical Director, Information Technology, UCSF Medical Center; University of California, San Francisco rcucina@medicine.ucsf.edu CMDT Online—Information Technology in Patient Care Lloyd E. Damon, MD Professor of Clinical Medicine, Department of Medicine, Division of Hematology/Oncology; Director of Adult Hematologic Malignancies and Blood and Marrow Transplantation, University of California, San Francisco damonl@medicine.ucsf.edu Blood Disorders Tiffany O. Dea, PharmD, BCOP Oncology Pharmacist, Veterans Affairs Medical Center, San Francisco, California; Adjunct Professor, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California tiffany.dea@va.gov Cancer Charles DeBattista, DMH, MD Professor of Psychiatry and Behavioral Sciences Director: Depression Clinic and Research Program Director of Medical Student Education in Psychiatry, Stanford University School of Medicine, Stanford, California debattista@stanford.edu Psychiatric Disorders Tonja Dirkx, MD Assistant Professor of Medicine, Division of Nephrology, Department of Medicine, Oregon Health & Science University, Portland, Oregon; Renal Clinic Director, Portland Veterans Affairs Medical Center dirkxt@ohsu.edu Kidney Disease Stuart J. Eisendrath, MD Professor of Psychiatry; Director of The UCSF Depression Center, Langley Porter Psychiatric Hospital and Clinics, University of California, San Francisco stuart.eisendrath@ucsf.edu Psychiatric Disorders Paul A. Fitzgerald, MD Clinical Professor of Medicine, Department of Medicine, Division of Endocrinology, University of California, San Francisco paul.fitzgerald@ucsf.edu Endocrine Disorders Patrick F. Fogarty, MD Assistant Professor of Medicine, Department of Medicine; Director, Penn Comprehensive Hemophilia and Thrombosis Program, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania patrick.fogarty@uphs.upenn.edu Disorders of Hemostasis, Thrombosis, & Antithrombotic Therapy CMDT2015_FM_pi-xiv.indd 6 Lawrence S. Friedman, MD Professor of Medicine, Harvard Medical School; Professor of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Chair, Department of Medicine, Newton-Wellesley Hospital, Newton, Massachusetts; Assistant Chief of Medicine, Massachusetts General Hospital, Boston, Massachusetts lfriedman@partners.org Liver, Biliary Tract, & Pancreas Disorders; Hepatobiliary Cancers (in Chapter 39) Warren J. Gasper, MD Clinical Instructor of Surgery, Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco warren.gasper@ucsf.edu Blood Vessel & Lymphatic Disorders Armando E. Giuliano, MD, FACS, FRCSEd Executive Vice Chair of Surgery, Associate Director of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, California armando.giuliano@cshs.org Breast Disorders Ralph Gonzales, MD, MSPH Professor of Medicine; Professor of Epidemiology & Biostatistics, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco ralphg@medicine.ucsf.edu Common Symptoms Christopher B. Granger, MD Professor of Medicine; Director, Cardiac Care Unit, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina christopher.granger@dm.duke.edu Heart Disease Blake Gregory, MD Chief Resident, Department of Medicine, University of California, San Francisco References; Illustrations B. Joseph Guglielmo, PharmD Professor and Dean, School of Pharmacy, University of California, San Francisco guglielmoj@pharmacy.ucsf.edu Common Problems in Infectious Diseases & Antimicrobial Therapy; CMDT Online—Anti-infective Chemotherapeutic & Antibiotic Agents David L. Hamel, Jr., MD Chief Medical Resident, Department of Medicine, University of California, San Francisco References 7/29/14 2:19 PM Authors CMDT 2015 Richard J. Hamill, MD Meshell D. Johnson, MD G. Michael Harper, MD C. Bree Johnston, MD, MPH David B. Hellmann, MD, MACP Mitchell H. Katz, MD Professor, Division of Infectious Diseases, Departments of Medicine and Molecular Virology & Microbiology, Baylor College of Medicine, Houston, Texas rhamill@bcm.edu Mycotic Infections Associate Professor, Department of Medicine, University of California San Francisco School of Medicine; Associate Chief of Staff for Geriatrics, Palliative and Extended Care, San Francisco Veterans Affairs Medical Center, San Francisco, California michael.harper3@med.va.gov Geriatric Disorders Aliki Perroti Professor of Medicine; Vice Dean for Johns Hopkins Bayview; Chairman, Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland hellmann@jhmi.edu Rheumatologic & Immunologic Disorders Assistant Professor, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco meshell.johnson@ucsf.edu Blood Vessel & Lymphatic Disorders Director of Palliative and Supportive Care, PeaceHealth St. Joseph Medical Center, Bellingham, Washington; Clinical Professor of Medicine, Division of Geriatrics, University of California, San Francisco bjohnston@peacehealth.org Geriatric Disorders Clinical Professor of Medicine, Epidemiology & Biostatistics, University of California, San Francisco; Director of Health Services, Los Angeles County mkatz@dhs.lacounty.gov HIV Infection & AIDS Robin K. Kelley, MD Fellow, Division of Pulmonary & Critical Care Medicine, University of California, San Francisco References Assistant Professor of Medicine, Division of Hematology/Oncology, University of California, San Francisco katie.kelley@ucsf.edu Alimentary Tract Cancers (in Chapter 39) Sara A. Hurvitz, MD J. Daniel Kelly, MD Carolyn Hendrickson, MD Assistant Professor; Director, Breast Oncology Program, Division of Hematology/Oncology, Department of Internal Medicine, University of California, Los Angeles shurvitz@mednet.ucla.edu Breast Disorders John B. Imboden, Jr., MD Alice Betts Endowed Chair for Arthritis Research; Professor of Medicine, University of California, San Francisco; Chief, Division of Rheumatology, San Francisco General Hospital John.Imboden@ucsf.edu Rheumatologic & Immunologic Disorders Kevin Jackson, MD vii Fellow, Division of Infectious Diseases, Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco Dan.Kelly@ucsf.edu Viral & Rickettsial Infections Geoffrey A. Kerchner, MD, PhD Assistant Professor of Neurology and Neurological Sciences, Stanford Center for Memory Disorders, Stanford University School of Medicine, Stanford, California kerchner@stanford.edu Nervous System Disorders C. Seth Landefeld, MD Assistant Professor of Medicine, Director of Electrophysiology, Duke Raleigh Hospital, Duke University Medical Center, Durham, North Carolina k.j@duke.edu Heart Disease Professor; Chief, Division of Geriatrics; Associate Chair for Strategic Planning and Implementation, Department of Medicine, University of California, San Francisco; Staff Physician, San Francisco Veterans Affairs Medical Center sethl@medicine.ucsf.edu Geriatric Disorders Jane Jih, MD, MPH David Lange, MD Primary Care Research Fellow, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco References CMDT2015_FM_pi-xiv.indd 7 Fellow, Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California References 7/29/14 2:19 PM