Current Medical Diagnosis & Treatment 2000 英文版PDF电子书下载

1.General Approach to the Patient; Health Malntenance Dlsease Prevention; Common Symptoms[Stephen J. McPhee],MD, [Steven A. Schroeder], MD 1

General Approach to the Patient 1

Health Maintenance Disease Prevention 2

Infectious Diseases 3

Cardiovascular Cerebrovascular Diseases 5

Preface 11

Physical Inactivity Sedentary Lirestyle 12

Cancer 13

Authors 15

Accidents Violence 16

Substance Abuse: Alcohol IIIicit Drugs 17

Pain 19

Common Symptoms 19

Fever Hyperthermia 29

Weight Loss 31

Fatigue 32

2. Preoperative Evaluation[Joshua S. Adler], MD, [Lee Goldman], MD,MPH 35

Physiologic Effects of Anesthesia Surgery 35

Evaluation of the Asymptomatic Patient 35

Cardiac Risk Assessment 36

Pulmonary Evaluation in Non-Lung Resection Surgery 40

Evaluation of the Patient With Liver Disease 42

Neurologic Evaluation 43

11. Systemic Hyertension[Barry M.Massie],MD 44

Management of Endocrine Diseases 44

Renal Disease 45

3. Gerlatric Medicine[Nell M. Resnick], MD 47

Greneral Principoes of Geriatric Medicine 47

Evaluation of the Elderly 50

Physical Examination 51

Mental Status Examination 53

Evaluation of Functional Capacity in the Elderly 53

Laboratory Examinations Imaging 54

The Frail Elderly the Five I s 54

Intellectual Impairment 55

Immobility(Chair-or Bed-Bound) 58

Instability(Physical Instability,Falls, Unstable Gait) 59

Urinary Incontinence 62

Iatrogenic Drug Reactions 65

Overview of Special Considerations in Treating the Elderly 66

4. Cancer[Hope S. Rugo],MD 71

Incidence Etiology 71

Prevention of Cancer 74

Primary Prevention 74

Secondary Prevention 78

Special Topics in Prevention 79

Staging of Cancer 80

Primary Cancer Treatment 80

Surgery Radiation Therapy 80

Systemic Cancer Therapy 82

Adjuvant Chemotherapy for Micrometastases 93

Toxicity Dose Modification of Chemotherapeutic Agents 94

Evaluation of Tumor Response 99

Tumor Size 99

Tumor Markers 100

General Well-Being, Performance Status, Supportive Care 101

Cancer Complications: Diagnosis Management 102

Oncologic Emergencies 102

Other Complications 105

The Paraneoplastic Syndromes 107

Novel Therapies for Cancer Treatment 108

Expectations About the End of Life 111

The End of Life 111

Diagnosis of the End of Life 111

5. Care at the End of Life[Michael W. Rabow],MD, [Robert V.Brody],MD 111

The Role of the Physician at the End of Life 112

Caring for the Family 112

The Limits of Care at the End of Life 113

The Setting Structure of Care 113

Ethical Legal Background 113

Advance Diectives 114

DNAR Orders 114

Hospice Care 115

Cultural Issues 115

The Specific Tasks of Caring 116

Symptom Management 116

Psychologic, Social, Spiritual Issues 119

Nutrition Hydration 119

Withdrawal of Support 119

Tasks After Death 121

The Pronouncement Death Certificate 121

Autopsy Organ Donation 122

Follow-Up Griving 122

6. Skin, Hair, Naiis[Timothy G. Berger],MD 124

Diagnosis of Skin Disorders 124

Principoes of Dermatologic Therapy 124

Common Dermatoses 129

Pigmented Lesions 129

Scaling Disorders 133

Vesicular Dermatoses 146

Weeping or Encrusted Lesions 151

Pustular Disorders 153

Figurate Erythemas 159

Blistering Diseases 163

Papules 165

Violaceous to Purple Papules Nodules 169

Pruritus(Itching) 171

Inflammatory Nodules 175

Photodermatitis 177

Ulcers 178

Miscellaneous Dermatologic Disorders 180

Pigmentary Disorders 180

Baldness(Alopecia) 182

Nail Disorders 183

Dermatitis Medicamentosa(Drug Eruption) 184

7. Eye[Paul Riordan-Eva],FRCS,FRCOphth, [Daniei G. Vaughan],MD 189

Symptoms of Ocular Disease 189

Ocular Examination 190

Ophthalmologic Referrals 192

Refractive Errors 193

Disorders of the Lids Lacrimal Apparatus 194

Conjunctivitis 195

Corneal UIcer 198

Pinguecula Pterygium 198

Acute(Angle-Closure)Glaucoma 200

Open-Angle Glaucoma 201

Uveitis 202

Cataract 204

Retinal Detachrnent 204

Vitreous Hemorrhage 205

Age-Related Macular Degeneration 205

Central Branch Retinal Vein Occlusions 206

Central Branch Retinal Artery Occlusions 207

Amaurosis Fugax 208

Retinal Disorders Associated With Systemic Diseases 208

Anterior Ischemic Optic Neuropathy 211

Optic Neuritis 211

Optic Disk Swelling 212

Ocular Motor Palsies 212

Orbhital Cellulitis 213

Dysthyroid Eye Disease 213

Ocular Trauma 214

Principles of Treatment of Ocular Infections 215

Techniques Used in the Treatment of Ocular Disorders 219

Precautions in Management of Ocular Disorders 221

Adverse Ocular Effects of Systemic Drugs 221

8. Ear, Nose, Throat[Robert K. Jackier],MD, [Michael J. Kaplan],MD 223

Diseases of the Ear 223

Diseases of the Nose Paranasal Sinuses 237

Diseases of the Oral Cavity Pharynx 246

Diseases of the Salivary Glands 252

Diseases of the Larynx 253

Tracheostomy Cricothyrotomy 256

Foreign Bodies in the Upper Aerodigestive Tract 257

Diseases Presenting as Neck Masses 258

Otolaryngologic Manifestations of HIV Infection 260

Dyspnea 264

9.Lung[Mark S.Chesnutt],MD, [Thomas J.Prendergast],MD 264

Symptoms Sings of Lung Disease 264

Cough 265

Hemoptysis 266

Physical Examination 267

Pulmonary Function Tests 268

Disorders of the Airways 271

Pulmonary Infections 292

Pulmonary Nodules, Masses, Tumors 308

Interstitial Infiltrative Lung Diseases 316

Disorders of the Pulmonary Circulation 321

Enviruonmental Occupational Lung Disorders 332

Pleural Diseases 338

Disorders of Control of Ventilation 344

Acute Respiratory Failure 346

Acute Respiratory Distress Syndrome(ARDS) 348

10. Heart[Barry M. Massie],MD, [Thomas M. Amidon],MD 351

Symptoms Signs 351

Diagnostic Testing 354

Congenital Heart Disease 355

Valvular Heart Disease 360

Coronary Heart Disease 369

Disturbances of Rate Rhythm 397

Conduction Disturbances 412

Cardiac Failure 416

Myocarditis the Cardiomyopathies 427

Acute Rheumatic Fever Rheumatic Heart Disease 431

Diseases of the Pericardium 433

Pulmonary Hypertension Heart Disease 436

Neoplastic Diseases of the Heart 438

Cardiac Involvement in Miscellaneous Systemic Diseases 438

The Cardiac Patient Surgery 439

The Cardiac Patient Pregnancy 441

Management of Hypertension 445

Hypertensive Urgencies Emergencies 463

Diseases of the Aorta 467

12. Blood Vessels Lymphatics[Lawrence M. Tiemey,Jr.],MD, [Louis M.Messina],MD 467

Atherosclerotic Occlusive Disease 472

Vasomotor Disorders 482

Venous Diseases 485

Diseases of the Lymphatic Channels 493

Hypotension Shock 495

13.Blood[Charles A.Linker],MD 499

Anemias 499

Neutropenia 517

Leukemias Other Myeloproliferative Disorders 518

Lymphomas 529

Disorders of Hemostasis 535

Hypercoagulable States 547

Blood Transfusions 549

14. Alimentary Tract[Kenneth R.McQuaid],MD 553

Symptoms Signs of Gastrointestinal Disease 553

Diseases of the Peritoneum 573

Diseases of the Esophagus 578

Diseases of the Stomach Duodenum 595

Diseases of the Small Intestine 613

Diseases of the Colon Rectum 628

Anorectal Diseases 651

15.Liver,Biliary Tract, Pancreas[Lawrence S. Friedman], MD 656

Jaundice (Icterus) 656

Diseases of the Liver 659

Diseases of the Biliary Tract 683

Diseases of the Pancreas 691

16. Breast[Armando E.Giuliano],MD 698

Benign Breast Disorders 698

Fibrocystic Disease 698

Fibroadenoma of the Breast 699

Nipple Discharge 699

Fat Necrosis 700

Breast Abscess 700

Disorders of the Augmented Breast 701

Carcinoma of the Female Breast 701

Carcinoma of the Male Breast 721

17. Gynecology[H.Trent MacKay],MD,MPH 723

Abnormal Premenopausal Bleeding 723

Postmenopausal Vaginal Bleeding 724

Premenstrual Syndrome (Premenstrual Tension) 725

Dysmenorrthea 726

Vaginitis 726

Effects of Exposure to Diethylstilbestrol in Utero 728

Cyst Abscess of Bartholin s Duct 728

Cervical Polyps 728

Cervicitis 728

Cervical Intracpithelial Neoplasia 729

Carcinoma of the Cervix 730

Leiomyoma of the Uterus 732

Carcinoma of the Endometrium 733

Carcinoma of the Vulva 734

Endometriosis 734

Genital Prolapse 735

Pelvic Inflammatory Disease 736

Uterine Prolapse 736

Ovarian Tumors 738

Persistent Anovulation 741

Painful Intercourse 742

Infertility 743

Contraception 745

Rape 753

Menopausal Syndrome 754

18. Obstetrics[William R.Crombleholme],MD 758

Diagnosis Differential Diagnosis of Pregnancy 758

Essentials of Prenatal Care 758

Nutrition in Pregnancy 761

Travel Immunizations During Pregnancy 762

Vorniting of Pregnancy Hyperemesis Gravidarum 762

Spontaneous Abortion 762

Recurrent(Habitual)Abortion 764

Ectopic Pregnancy 764

Preeclampsia-Eclampsia 765

Gestational Trophoblastic Neoplasia 768

Third-Trimester Bleeding 769

Medical Conditions Complicating Pregnancy 770

Surgical Complications During Pregnancy 777

Prevention of Hemolytic Disease of the Newborn 779

Prevention of Preterm(Premature)Labor 779

Lactation 780

Puerperal Mastitis 780

19. Allergic Immunologic Disorders[Jeffrey L.Kishiyama],MD, [Daniel C.Adelman],MD 783

Allergic Diseases 783

Atopic Disease 784

Allergic Rhinitis 784

Anaphylaxis,Urticaria, Angioedema 788

Drug Allergy 789

Immune Complex Disease(Serum Sickness) 790

Pseudoallergic Reactions 790

Cells Involved in Immunity 791

Clinical Immunology 791

Tests for Cellular Immunity 793

Immunoglobulin Structure Function 794

Immunodeficiency Disorders 796

Common Variable Immunodeficiency 796

Selective Immunoglobulin A Deficiency 797

Diseases of Immunoglobulin Overproduction 797

Autoimmunity 798

Tests for Autoantibodies Associated With Autoimmune Disease 799

Autoimmune Diseases 799

Immunogenetics Transplantation 801

Genetic Control of the Immune Response 801

Associations Between HLA Antigens Specific Diseases 801

Clinical Transplantation 802

Mechanism of Action of Immunosuppressive Drugs 804

Immunomodulating Therapies 805

20. Arthritis Musculoskeletal Disorders[David B. Hellmann], MD, FACP, [John H. Store],MD,MPH 807

Diagnosis Evaluation 807

Degenerative Crystal-Induced Arthritis 808

Pain Syndromes 815

Autoimmune Diseases 826

Vasculitis Syndromes 841

Seronegative Spondyloarthropathies 846

Infections Arthritis 850

Infections of Bones 853

Tumors Tumor-Like Lesions of Bone 856

Other Rheumatic Disorders 857

Some Orthopedic Procedures for Arthritic Joints 858

21. Fluid Electrolyte Disorders[Toshihiro Okuda],MD,PhD,[Kiyoshi Kurokawa],MD,MACP, [Maxine A.Papadakis],MD 860

Diagnosis of Fluid Electrolyte Disorders 860

Treatment of Specific Fluid,Electrolyte, Acid-Base Disorders 861

Disorders of Sodium Concentration 861

Disorders of Calcium Concentration 870

Disorders of Phosphorus Concentration 872

Disorders of Magnesium Concentration 874

Hyperosmolar Disorders Osmolar Gaps 875

Acid-Base Disorders 875

Fluid Management 884

Disorders of Potassium Concentration 886

22. Kidney[Suzanne Watnick],MD, [Gail Morrison],MD 886

Approach to Renal Disease 886

Acute Renal Failure 890

Chronic Renal Disease 895

Glomerulonephropathies 902

Tubulointerstitial Diseases 911

Cystic Diseases of the Kidney 913

Medullary Sponge Kidney 915

Multisystem Diseases With Variable Kidney Involvement 915

23. Urolgy[Joseph C.Presti,Jr.], MD, [Marshall L. Stoller],MD, [Peter R. Carroll],MD,FACS 917

Urologic Evaluation 917

Evaluation of Hematuria 921

Genitourinary Tract Infections 922

Acute Cystitis 923

Acute Pyelonephritis 924

Chronic Bacterial Prostatitis 926

Acute Bacterial Prostatitis 926

Nonbacterial Prostatitis 927

Prostatodynia 928

Acute Epididymitis 928

Urinary Stone Disease 929

Urinary Incontinence 933

Male Erectile Dysfunction Sexual Dysfunction 936

Benign Prostatic Hyperplasia 939

Malignant Genitourinary Tract Disorders 946

Prostate Cancer 946

Bladder Cancer 951

Cancers of the Ureter Renal Pelvis 954

Primary Tumors of the Kidney 954

Secondary Tumors of the Kidney 955

Primary Tumors of the Testis 955

Secondary Tumors of the Testis 957

Headache 959

24. Nervous System[Michael J.Aminoff],MD,FRCP] 959

Facial Pain 962

Epilepsy 965

Neurologic Causes of Syncope 969

Sensory Disturbances 970

Weakness Paralysis 970

Transient Ischemic Attacks 970

Stroke 973

Intracranial Spinal Space-Occupying Lesions 980

Nonmetastatic Neurologic Complications of Malignant Disease 985

Pseudotumor Cerebri 985

Selected Neurocutaneous Diseases 986

Movement Disorders 987

Dementia 994

Multiple Sclerosis 994

Vitamin E Deficiency 995

Spasticity 995

Subacute Combined Degeneration of the Spinal Cord 996

Wernicke s Encephalopathy 996

Myelopathy of Human T Cell Leukemia Virus 996

Myelopathies in AIDS 996

Stupor Coma 997

Head Injury 999

Spinal Trauma 1000

Syringomyelia 1001

Motor Neuron Diseases 1001

Peripheral Neuropathies 1002

Discogenic Neck Back Pain 1009

Brachial Lumbar Plexus Lesions 1013

Disorders of Neuromuscular Transmission 1013

Myopathic Disorders 1015

Periodic Paralysis Syndrome 1017

25. Psychiatric Disorders[Stuart J.Eisendrath],MD, [Jonathan E. Lichtmacher],MD 1019

Psychiatric Assessment 1020

Treatment Approaches 1021

Common Psychiatric Disorders 1022

Substance Use Disorders 1062

Delirium, Dementia, Other Cognitive Disorders 1071

Geriatric Psychiatric Disorders 1074

Psychiatric Problems Associated With Hospitalization Medical Surgical Disorders 1075

26. Endocrinology[Paul A.Fitzgerald],MD 1079

Common Presentations in Endocrinology 1079

Diseases of the Hypothalamus Pituitary Gland 1083

Diseases of the Thyroid Gland 1092

The Parathyroids 1115

Metabolic Bone Disease 1121

Diseases of the Adrenal Cortex 1126

Diseases of the Adrenal Medulla 1135

Pancreatic Neuroendocrine Tumors 1138

Diseases of the Testes 1139

Amenorrhea Menopause 1142

Multiple Endocrine Neoplasia 1148

Clinical Use of Glucocorticoids 1149

27. Diabetes Mellitus Hypoglycemia[John H.Karam],MD 1152

Diabetes Mellitus 1152

Diabetic Coma 1186

The Hypoglycemic States 1192

28.Lipid Abnormalities[Robert B. Baron],MD,MS 1198

Lipids Lipoproteins 1198

Lipoproteins Atherogenesis 1198

Lipid Fractions the Risk of Coronary Heart Disease 1200

Therapeutic Effects of Lowering Cholesterol 1200

Clinical Presentations 1202

Screening for High Blood Cholesterol 1202

Secondary Conditions That Affect Lipid Metabolism 1202

Treatment of High LDL Cholesterol 1205

High Blood Triglycerides 1209

29. Nutrition[Robert B. Baron],MD,MS 1211

Nutritional Requirements 1211

Assessment of Nutritional Status 1215

Nutritional Disorders 1220

Eating Disorders 1225

Disorders of Vitamin Metabolism 1227

Diet Therapy 1232

Nutritional Support 1234

30. General Problems In Infectious Diseases[Richard A.Jacobs],MD,PhD 1241

Fever of Unknown Origin(FUO) 1241

Infections in the Immunocompromised Patient 1243

Nosocomial Infections 1246

Infections of the Central Nervous System 1248

Animal Human Bite Wounds 1250

Sexually Transmitted Diseases 1251

Infections in Drug Users 1252

Acute Infectious Diarrhea 1253

Traveler s Diarrhea 1254

Active Immunization Against Infectious Diseases 1257

Recommended Immunization of Infants, Children, Adolescents 1257

Recommended Immunization of Adults 1257

Recommended Immunization for Travelers 1262

Hypersensitivity Tests Desensitization 1264

31. HIV Infection[Mitchell H.Katz],MD, [Harry Hollander],MD 1266

Epidemiology 1267

Pathophysiology 1269

Pathogenesis 1269

Etiology 1269

Clinical Findings 1270

Differential Diagnosis 1279

Prevention 1280

Treatment 1282

Course Prognosis 1293

32. Infectious Eiseases:Viral Rickettsial[Alain Bouckenooghe],MD, [Wayne X.Shandera],MD 1295

Viral Diseases 1295

Human Herpesviruses 1296

Major Vaccine-Preventable Viral Infections 1306

Other Neurotropic Viruses 1312

Other Systemic Viral Diseases 1317

Common Viral Respiratory Infections 1320

Adenovirus Infections 1323

Other Exanthematous Viral Infections 1323

Viruses Gastroenteritis 1324

Viruses That Produce Several Syndromes 1325

Typhus Group 1326

Rickettsial Diseases 1326

Spotted Fevers 1329

Other Rickettsial Rickettsial-Like Diseases 1331

33.Infectious Diseases:Bacterial Chlamydial[Henry F.Chambers],MD 1334

Infections Caused by Gram-Positive Bacteria 1334

Infective Endocarditis 1346

Infections Caused by Gram-Negative Bacteria 1351

Nocardiosis 1367

Actinomycosis 1367

Infections Caused by Mycobacteria 1368

Infections Caused by Chlamydiae 1373

34. Infectious Diseases:Spirochetal[Richard A.Jacobs],MD,PhD 1376

Syphilis 1376

Non-Sexually Transmitted Treponematoses 1386

Miscellaneous Spirochetal Diseases 1387

Relapsing Fever 1387

Leptospirosis 1388

Rat-Bite Fever 1388

Lyme Disease 1389

35. Infectious Diseases:Protozoal Helminthic[Robert S.Goldsmith],MD,MPH,DTM H 1396

Protozoal Infections 1396

African Trypanosomiasis(Sleeping Sickness) 1396

American Trypanosomiasis(Chagas Disease) 1398

Amebiasis 1400

Pathogenic Free-Living Amebas 1405

Babesiosis (Piroplasmosis) 1406

Balantidiasis 1407

Coccidial Microsporidial Infections: Cryptosporidiosis,Isosporiasis, Sarcocystosis 1407

Giardiasis 1410

Leishmaniasis 1412

Malaria 1416

Toxoplasmosis 1427

Helminthic Infections 1429

Trematode(Fluke)Infections 1429

Cestode Infections 1436

Nematode (Roundworm)Infections 1443

36. Infectious Diseases:Mycotic[Richard J.Hamill],MD 1463

Candidiasis 1463

Histoplasmosis 1464

Coccidioidomycosis 1465

Pneumocystosis 1467

Cryptococcosis 1469

Aspergillosis 1470

Blastomycosis 1471

Mucormycosis 1471

Paracoccidioidomycosis 1472

Sporotrichosis 1472

Penicillium marneffei Infections 1472

Chromomycosis 1473

Mycetoma 1473

Other Opportunistic Mold Infections 1473

Antifungal Therapy 1474

37. Anti-infective Chemotherapeutic Antibiotic Agents[Richard A.Jacobs],MD,PhD, [B.Joseph Guglielmo]PharmD 1476

Some Principles of Antimicrobial Therapy 1476

Penicillins 1484

Cephalosporins 1489

Other β-Lactam Drugs 1493

Erythromycin Group(Macrolides) 1494

Azalides 1495

Tetracycline Group 1496

Chloramphenicol 1497

Aminoglycosides 1497

Polymyxins 1500

Antituberculous Drugs 1500

Sulfonamides Antifolate Drugs 1503

Sulfones Used in the Treatment of Leprosy 1505

Specialized Drugs Used Against Bacteria 1505

Streptogramins 1507

Quinolones 1507

Pentamidine Atovaquone 1510

Urinary Antiseptics 1510

Antifungal Drugs 1511

Systemically Active Drugs in Urinary Tract Infections 1511

Antiviral Chemotherapy 1515

38. Disorders Due to Physical Agents[Richard Cohen], MD,MPH, [Brent R.W.Moelleken],MD,FACS 1520

Disorders Due to Cold 1520

Disorders Due to Heat 1525

Burns 1528

Electric Shock 1532

Ionizing Radiation Reactions 1533

Drowning 1535

Other Disorders Due to Physical Agents 1537

39.Poisoning[Kent R.Oison],MD 1541

Initial Evaluation of the Patient With Poisoning or Drug Overdose 1541

The Symptomatic Patient 1541

Antidotes Other Treatment 1546

Diagnosis of Poisoning 1548

Clinical Laboratory Tests in Management of Poisoning 1549

Treatment of Common Specific Poisonings(Alphabetical Order) 1551

40. Medical Genetics[Reed E.Pyeritz],MD,PhD 1574

Introduction to Medical Genetics 1574

Genes Chromosomes 1575

Mutation 1576

Genes in Individuals 1577

Genes in Families 1578

Disorders of Multifactorial Causation 1580

Chromosomal Aberrations 1581

The Techniques of Medical Genetics 1582

Cytogenetics 1582

Biochemical Genetics 1584

DNA Analysis 1585

Prenatal Diagnosis 1587

Neoplasia:Chromosomal DNA Analysis 1589

Selected Genetic Disorders 1591

Acute Intermittent Porphyria 1591

Alkaptonuria 1592

Down s Syndrome 1593

Gaucher s Disease 1594

Homocystinuria 1594

Klinefelter s Syndrome 1595

Homocysteine Arterial Occlusive Disease 1595

Marfan s Syndrome 1596

41. Diagnostic Testing Medical Declsion Mading[C.Diana Nicoll],MD,PhD,[Michael Pignone],MD,MPH, [William M.Detmer],MD,MSc 1598

Benefits; Costs Risks 1598

Performance of Diagnostic Tests 1599

Test Characteristics 1599

Use of Tests in Diagnosis Management 1602

Odds-Likelihood Ratios 1603

The Internet in Clinical Practice 1609

42. Informatics in Patient Care: The Internet, Telemedicine, Clinical Decision Support[Justin V.Graham],MD, [Rick G. Kulkaml],MD 1609

Information Reliability Quality Assessment 1610

Health Information Security 1611

Patient-Clinician E-Mail Communication 1612

Interactive Forums 1613

Telemedicine 1614

Clinical Decision Support Systems 1614

Appendix:Therapeutic Drug Monitoring Laboratory Reference Ranges[C.Diana Nicoll], MD,PhD 1617

Index 1627