ゴールドマン・セシル内科学（第２７版・全２巻）
Goldman-Cecil Medicine 27TH
Editors: Lee Goldman, MD, Harold and Margaret Hatch Professor, Executive Vice President and Dean of the Faculties of Health Sciences and Medicine, Chief Executive, Columbia University Medical Center, Columbia University, New York, New York and Kathleen A. Cooney
2023:08 2 vols. 2,944 p. 1,840 illus. ISBN 978-0-323-93038-3 (Elsevier) -US-
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概要
1927年の初版刊行以来、95年以上にわたって成人患者への内科学の権威あるリソースとして名声を馳せてきた、「セシル」の3年ぶりの改訂第27版です。
今版では、新たな章でポピュレーションヘルス、気候変動による健康への影響、徐脈、トランスジェンダーへの療法、ウイップル病、COVID-19のウイルス学・病理学・臨床症状・診断・地域予防・治療・ワクチン接種、ポリオーマウイルスなどの数多くの新たな知見を詳述しています。
〔本書の特徴〕
- 現代医学界を代表する面々が執筆した400以上の章
- 最新のエビデンスに基づく参考文献に重点を置き、実用的な構成
- 1000以上のアルゴリズム、図、表によって、その情報に簡単にアクセス
- 100以上の補足ビデオ、心音、重要な参考文献にアクセス可能
- 『セシル内科学』を引き継いだゴールドマン博士による絶えざるアップデート
- 付属の電子書籍（個人利用のみ可能）では、本書の全文・図表・参考文献に様々なデバイスからアクセス可能、収録内容は次回改版まで継続的にアップデート
※前版: Goldman-Cecil Medicine, 26th ed. (2020) ISBN 9780323532662
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収録明細
Section I. Social and Ethical Issues in Medicine
1. Approach to Medicine, the Patient, and the Medical Profession: Medicine as a Learned and Humane Profession
Approach to the Medical Profession
2. Bioethics in the Practice of Medicine
Physician-Patient Relationship: Informed Consent
Termination of Medical Interventions
Assisted Suicide and Euthanasia
Allocation of Scarce Medical Resources
Financial Conflicts of Interest
4. Disparities in Health and Health Care
Definitions of Health Disparity and Health Equity
Demographic Changes in the U.S. Population
Racial and Ethnic Disparities in Health Outcomes
Socioeconomic Disparities in Health Outcomes
Insurance Coverage and Access to Care
Clinical Approaches to Reduce Disparities
Leading Causes of Disabilities
Leading Underlying Risk Factors
Changing Patterns of Disease
The Global Health Challenge
Section II. Principles of Evaluation and Management
6. History and Physical Examination
Summarizing the Findings for the Patient
7. Approach to the Patient with Abnormal Vital Signs
The Importance of Vital Signs
Role of Vital Signs in Management of the Patient
8. Statistical Interpretation of Data for Clinical Decision Making
Data and Their Characteristics
Statistical Approaches and Challenges
Using Data for Clinical Decisions
9. Measuring Health and Health Care
How Are Health and Health Care Measured?
Why Measure Health and Health Care?
Selecting Measures Based on Evidence
Selecting Measures: Which Measures Are Right for What Purpose?
Measuring Health and Health Care as Parts of a System
10. Quality, Safety, and Value
Quality and Safety During a Pandemic
Value: Connecting Safety and Quality to Cost
Population Health Management
Beyond Population Health Management to Population Health
Section III. Preventive and Environmental Issues
12. The Preventive Health Visit
History and Risk Assessment
Screening for Early Disease or Asymptomatic Risk Factors
Preventive Medications and Supplements
Nutrition’s Influence on Mortality and Morbidity
Translating Evidence into Dietary Change
General Characteristics of Immunizations
Individual Immunobiologics
Vaccines Intended Primarily for International Travelers
Vaccines for Possible Bioterrorism Agents
16. Principles of Occupational and Environmental Medicine
Occupational and Environmental Medicine Regulatory Environment
Occupational Safety Standards
Emergency Preparedness and Disaster Management
Role of the Individual Clinician
17. Effects of Climate Change on Health
How Climate Change Affects Health
Health Care Professionals and Climate Change
Non-Ionizing Radiation Injury
Response to a Bioterrorism Attack
20. Chronic Poisoning: Trace Metals and Others
Syndromes Specific to Other Toxic Metals
Section IV. Age-Specific and Geriatric Medicine
Normal Physical Growth and Development
Normal Psychosocial Development
Approach to the Adolescent Patient
Sexual and Reproductive Health
Image 11SUBSTANCE USE AND SUBSTANCE USE DISORDERS
Chronic Illness and Transition
22. Epidemiology of Aging
Disease and Disability in Older Adults
The Built and Social Environments
Geriatric Assessment In Practice
24. Common Clinical Sequelae of Aging
Effects of Aging on Specific Organs and Systems
Section V. Clinical Pharmacology
25. Principles of Drug Therapy
Pharmacokinetic Principles
Clinical Application of Pharmacokinetic Principles
Drug Monitoring as a Guide to Therapy
Adjustments of Drug Dose With Disease
Approach to Drug Overdose
Drug Use in Elderly Patients
Adverse Reactions to Drugs
Usefulness of Genomic Data
Risk Factors for Addiction
Reward Circuitry: The Neural Substrate of Addiction
Properties of Addictive Drugs
Drug-Induced Neural Plasticity Relevant to Addiction
28. Immunomodulatory Drugs
Purine and Pyrimidine Inhibitors
Immunophilin-Binding Agents, Including Calcineurin Inhibitors
29. Biologic Agents and Signaling Inhibitors
30. Complementary and Integrative Medicine
Use of Integrative and Complementary Treatments
31. Principles of Genetics
Genetic Architecture of Disease
High-Penetrance Monogenic or Chromosomal Disorders
Monogenic Versions of Common Disorders
Complex, Multifactorial Disorders
32. Clinical Genomics—Genome Structure and Variation
Genomic Variation in Humans
Genomics and Genetics as a Normal Part of Medicine
33. Applications of Molecular Technologies to Clinical Medicine
Molecular Technologies Along the Continuum from Health to Disease
Genomes, Disease, and Treatment
Implementing Precision Medicine in Clinical Practice
34. Regenerative Medicine, Cell Therapy, and Gene Therapy
Section VII. Principles of Immunology and Inflammation
35. The Innate and Adaptive Immune Systems
The Immune System in Host Defense
Cellular Elements of the Innate Immune System
Principles of Innate Immune System Activation: Recognition of Immune Stimuli and Generation of Effector Function
Cellular Elements of the Adaptive Immune System
Principles of Adaptive Immune System Activation: Recognition of Antigen and Generation of Effector Function
Contribution of the Innate and Adaptive Immune Responses to Pathogenesis of Disease
36. Tissue Injury and Repair
The Inflammatory Response: Innate Immune Mechanisms
The Inflammatory Response: Adaptive Immune Mechanisms
Tissue Repair and Resolution of Inflammation
37. Complement System in Disease
38. Transplantation Immunology
Antigens in Transplantation
Mechanisms of Rejection and Graft-versus-Host Disease
Strategies to Prevent Graft-versus-Host Disease
Strategies to Prevent Allograft Rejection
Section VIII. Heart Diseases
39. Approach to the Patient with Possible Cardiovascular Disease
Using the History to Detect Cardiovascular Symptoms
Physical Examination for Detection of Signs of Cardiovascular Disease
40. Epidemiology of Cardiovascular Disease
Burden in the United States
Risk Factors for Cardiovascular Disease
41. Cardiac and Circulatory Function
Physiology of the Heart and Circulatory Control
Cardiovascular Responses to Stressors
Impaired Circulatory Function: Atherosclerosis
Normal Function and Electrocardiogram
Approach to Interpreting the Electrocardiogram
Echocardiographic Imaging
Echocardiographic Approaches
Cardiac Function Measurements
The Echocardiographic Examination
Integrating the Echocardiographic and Clinical Findings
44. Noninvasive Cardiac Imaging
Cardiac Computed Tomography
Cardiovascular Magnetic Resonance Imaging
45. Heart Failure: Epidemiology, Pathobiology, and Diagnosis
Consequences of Misdiagnosis
46. Heart Failure: Treatment and Prognosis
Evaluation and Management of Heart Failure
47. Diseases of the Myocardium and Endocardium
Diseases of the Endocardium
48. Principles of Electrophysiology
Ionic Basis of Cardiac Electrophysiology
Molecular Basis of Cardiac Electrophysiology
Mechanisms of Arrhythmogenesis
49. Approach to the Patient with Suspected Arrhythmia
50. Cardiac Arrest and Life-Threatening Arrhythmias
51. Bradycardias and Conduction System Delays
Specific Bradyarrhythmias
52. Supraventricular Ectopy and Tachyarrhythmias
Supraventricular Arrhythmias with a Normal Rate
Supraventricular Tachyarrhythmias
53. Ventricular Arrhythmias
54. Electrophysiologic Procedures and Surgery
Transthoracic Cardioversion and Defibrillation
Cardiac Implantable Electronic Devices
Closure of the Left Atrial Appendage
55. Congenital Heart Disease in Adults
56. Angina Pectoris and Chronic Ischemic Heart Disease
57. Acute Coronary Syndrome: Unstable Angina and Non–ST Elevation Myocardial Infarction
58. ST-Elevation Acute Myocardial Infarction and Complications of Myocardial Infarction
59. Interventional Diagnosis and Treatment of Coronary Artery Disease
Coronary Arteriography To Assess Coronary Stenosis
Percutaneous Coronary Intervention
Coronary Angioplasty Versus Medical Therapy
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting
60. Valvular Heart Disease
Approach To The Patient With Valvular Heart Disease
Primary (Organic) Mitral Regurgitation
Secondary (Functional) Mitral Regurgitation
Choices among Prosthetic Valves
Postoperative Care of Patients with Substitute Heart Valves
61. Infective Endocarditis
Pericardial Effusion and Tamponade
Specific Forms of Pericardial Disease
Section IX. Vascular Medicine
63. Diseases of the Aorta
64. Arterial Hypertension
Goal 1: Accurate Measurement of Blood Pressure
Goal 2: Cardiovascular Risk Stratification
Goal 3: Identification and Treatment of Secondary (Identifiable) Causes of Hypertension
Clinical Manifestations and Diagnosis
Incidental Blood Pressure Elevations in the Emergency Department AND IN INPATIENTS
65. Atherosclerotic Peripheral Arterial Disease
66. Other Peripheral Arterial Diseases
Popliteal Artery Entrapment Syndrome
Cystic Adventitial Disease of the Lower Extremity Arteries
Endofibrosis of the Iliac Artery
Thromboangiitis Obliterans (Buerger Disease)
Livedo Reticularis and Livedo Racemosa
Atheromatous Embolization
67. Thrombotic Disorders: Hypercoagulable States
Primary Hypercoagulable States
Secondary Hypercoagulable States
68. Venous Thrombosis and Embolism
Long-Term Complications of VTE
Venous Thrombosis of the Upper Extremities
Superficial Vein Thrombosis
Nonthrombotic Pulmonary Embolism
69. Pulmonary Hypertension
70. Antithrombotic and Antiplatelet Therapy
FIBRINOLYTIC AND ANTITHROMBIN AGENTS
Section X. Respiratory Diseases
71. Approach to the Patient with Respiratory Disease
Approach to the Patient with Cough
Approach to the Patient with Wheezing
Approach to the Patient with Dyspnea
Approach to the Patient with Hemoptysis
72. Imaging in Pulmonary Disease
Imaging of the Lungs, Mediastinum, and Chest Wall
Imaging of the Mediastinum
73. Respiratory Testing and Function
Other Tests of Ventilation
Maximal Respiratory Pressures
Interpretation of Lung Function Tests
Cardiopulmonary Exercise Tests
Pulmonary Function in Obesity
74. Disorders of Ventilatory Control
Hypoventilation Syndromes
76. Chronic Obstructive Pulmonary Disease
Acute Exacerbations of COPD
78. Bronchiectasis, Atelectasis, and Cavitary or Cystic Lung Diseases
Image 25Cavitary Lung Diseases
Image 25 Congenital Cystic Diseases of the Thorax
Image 25 Acquired Cystic Lung Diseases
79. Alveolar Filling Disorders
Pulmonary Alveolar Proteinosis
Acute Interstitial Pneumonia
Diffuse Alveolar Hemorrhage
Invasive Mucinous Adenocarcinoma and Lepidic Predominant Nonmucinous Adenocarcinoma (Formerly Called Bronchioloalveolar Cell Carcinoma)
80. Interstitial Lung Disease
Specific Types of Interstitial Lung Disease
81. Occupational Lung Disease
Specific Occupational Lung Disorders
Occupational Chronic Obstructive Pulmonary Disease
Hypersensitivity Pneumonitis
Chronic Beryllium Disease
Asbestos-Related Diseases
Silicosis and Other Pneumoconioses
82. Physical and Chemical Injuries of the Lung
Submersion Incidents: Drowning
Diseases of High Altitude
Decompression Illness: Decompression Sickness, Barotrauma, and Arterial Gas Embolism
84. Acute Bronchitis and Tracheitis
85. Overview of Pneumonia
Community-Acquired Pneumonia
Hospital-Acquired Pneumonia in the Immunocompetent Host
Pneumonia in Immunocompromised Hosts
86. Diseases of the Diaphragm, Chest Wall, Pleura, and Mediastinum
87. Interventional and Surgical Approaches to Lung Disease
Section XI. Critical Care Medicine
88. Approach to the Patient in a Critical Care Setting
The Intensivist-Led Interprofessional Team
Fluid Resuscitation and Acute Kidney Injury
Oxygen, Intubation, Sedation, Analgesia
Long-Term Outcomes for Survivors
Applying Evidence to Prevent Complications of Critical Illness
Predictions, Preferences, and Palliative Care
89. Respiratory Monitoring in Critical Care
Systemic Arterial Blood Gas Analysis
Carbon Dioxide Monitoring: Capnometry and Transcutaneous Carbon Dioxide Measurement
Arterial Oxygen Content and Systemic Oxygen Delivery
Measuring Ventilation: Minute Ventilation and Alveolar Ventilation
Measuring Carbon Dioxide Production
Measuring Respiratory Compliance
Measuring Respiratory Drive
Measuring Respiratory Muscle Strength
Measuring Work of Breathing
90. Acute Respiratory Failure
Specific Acute Respiratory Failure Syndromes
91. Mechanical Ventilation
Positive-Pressure Ventilation
Complications of Mechanical Ventilation
Specific Common Treatment Scenarios
Discontinuation of Mechanical Ventilation
92. Approach to the Patient with Shock
94. Shock Syndromes Related to Sepsis
95. Disorders Due to Heat and Cold
Therapeutic Hypothermia and Hyperthermia
97. Medical Aspects of Trauma and Burns
Rehabilitation of the Injured Patient
98. Envenomation, Bites, and Stings
Specific Envenomation Syndromes
Section XII. Renal and Genitourinary Diseases
100. Approach to the Patient with Renal Disease
101. Structure and Function of the Kidneys
The Kidney Regulates Extracellular Fluid Volume by Regulating Sodium Content
The Kidney Controls Body Fluid Osmolarity by Regulating Water Content
The Kidney Regulates Plasma pH by Regulating HCO3− Content
The Kidney Regulates Plasma Potassium by Secretion and the Control of Extracellular pH
The Kidney Regulates Plasma PO4 and Ca2+ by Excretion and by Synthesizing Vitamin D3
102. Disorders of Sodium and Water
Disorders of Extracellular Fluid Volume
Disorders of Tonicity of Body Fluids: Hyponatremia and Hypernatremia
105. Disorders of Magnesium and Phosphorus
107. Glomerular Disorders and Nephrotic Syndromes
Glomerulonephritis and the Nephritic Syndrome
Rapidly Progressive Glomerulonephritis
Glomerular Diseases Associated With Genetic Defects
Other Glomerular Diseases
108. Interstitial Nephritis
Acute Interstitial Nephritis
Image 10Chronic Interstitial Nephritis
109. Diabetes and the Kidney
110. Vascular Disorders of the Kidney
Atheromatous Embolization of The Renal Arterial System
112. Cystic Kidney Diseases
Autosomal Dominant Polycystic Kidney Disease
Autosomal Recessive Polycystic Kidney Disease
Autosomal Dominant Tubulointerstitial Kidney Disease (Medullary Cystic Kidney Disease)
Other Inherited Cystic Syndromes
Acquired Cystic Kidney Disease
113. Hereditary Nephropathies and Developmental Renal/Urinary Abnormalities
Development of the Kidney and Urinary Tract
114. Benign Prostatic Hyperplasia and Prostatitis
Benign Prostatic Hyperplasia
115. Urinary Incontinence
116. Chronic Kidney Disease
117. Treatment of Irreversible Renal Failure
Section XIII. Gastrointestinal Diseases
118. Approach to the Patient with Gastrointestinal Disease
General Approach to Patients with Gastrointestinal Signs and Symptoms
Gastrointestinal Bleeding
Other Gastrointestinal Complaints
119. Diagnostic Imaging Procedures in Gastroenterology
Magnetic Resonance Imaging
Interventional Procedures
120. Gastrointestinal Endoscopy
121. Gastrointestinal Hemorrhage
Upper Gastrointestinal Bleeding
Lower Gastrointestinal Bleeding
Obscure and Occult Gastrointestinal Bleeding
122. Disorders of Gastrointestinal Motility
Diseases of Slow Transit Through the Stomach and Small Bowel
Diseases of Rapid Transit Through Stomach and Small Bowel
Colonic Motility Disorders
123. Irritable Bowel and Functional Upper Gastrointestinal Syndromes
Functional Chest Pain of Likely Esophageal Origin
124. Diseases of the Esophagus
Normal Anatomy and Physiology
Gastroesophageal Reflux Disease
Esophageal Motor Disorders
The Esophagus in Systemic Diseases
Miscellaneous Esophageal Conditions
126. Approach to the Patient with Diarrhea and Malabsorption
Persistent Acute Diarrhea
Specific Causes of Chronic Diarrhea
Congenital Malabsorption and Diarrhea
Protein-Losing Gastroenteropathy
127. Inflammatory Bowel Disease
128. Inflammatory and Anatomic Diseases of the Intestine, Peritoneum, Mesentery, and Omentum
Congenital Structural Abnormalities
Acquired Structural Disorders
Inflammation of the Intestine and Colon
Diseases of the Mesentery and Omentum
129. Vascular Diseases of the Gastrointestinal Tract
Vascular Anomalies and Disorders
Hepatic and Splenic Vascular Disease
131. Diseases of the Rectum and Anus
Specific Anorectal Conditions
Section XIV. Diseases of the Liver and Biliary System
132. Approach to the Patient with Liver Disease
Risk Factors for Liver Disease
Assessing Duration of Liver Disease
Review of Other Organ Systems
Diagnostic Studies (Table 132-1)
Approach to New-Onset Ascites
Approach to a Hepatic Mass
Approach to the Patient With Inherited Liver Disease
133. Approach to the Patient with Jaundice or Abnormal Liver Tests
Jaundice and Hyperbilirubinemia
Approach to the Patient with Hyperbilirubinemia
Liver and Biliary Tract Disease
Approach to the Patient with Jaundice or Abnormal Liver Tests
134. Acute Viral Hepatitis
General Features of Acute Viral Hepatitis
135. Chronic Viral and Autoimmune Hepatitis
Cryptogenic Chronic Liver Disease
136. Drug-Induced Liver Injury
Direct/Intrinsic Hepatotoxicity
Idiosyncratic Hepatotoxicity
137. Bacterial, Parasitic, Fungal, and Granulomatous Liver Diseases
Granulomatous Diseases of the Liver
138. Alcoholic and Nonalcoholic Steatohepatitis
Alcohol-Associated Liver Disease
Nonalcoholic Fatty Liver Disease
139. Cirrhosis and Its Sequelae
140. Liver Failure and Transplantation
141. Diseases of the Gallbladder and Bile Ducts
Section XV. Hematologic Diseases
142. Hematopoiesis and Hematopoietic Growth Factors
Hematopoietic Stem and Progenitor Cells
Hematopoietic Cell Expansion: Hematopoietic Growth Factors
Clinical Uses of Hematopoietic Cells and Growth Factors
143. The Peripheral Blood Smear
Reasons for Performing a Blood Smear
The Blood Smear in the Differential Diagnosis of Anemia
Assessment of Thrombocytopenia, Thrombocytosis, and Platelet Morphology
Leukocytosis and Leukopenia
The Incidental Detection of Clinically Significant Abnormalities
144. Approach to the Anemias
Anemias Associated with Increased Reticulocyte Production
Anemias Associated with Inadequate Reticulocyte Response (Underproduction Anemias)
Specific Anemia Syndromes
145. Microcytic and Hypochromic Anemias
Anemia of Chronic Disease (Anemia of Inflammation)
146. Autoimmune and Intravascular Hemolytic Anemias
Paroxysmal Nocturnal Hemoglobinuria
Hemolytic Transfusion Reactions
Other Causes of Intravascular Hemolysis
147. Hemolytic Anemias: Red Blood Cell Membrane and Metabolic Defects
Unstable Hemoglobinopathies
149. Sickle Cell Disease and Other Hemoglobinopathies
150. Megaloblastic Anemias
151. Aplastic Anemia and Related Bone Marrow Failure States
Idiopathic Aplastic Anemia
Paroxysmal Nocturnal Hemoglobinuria
Large Granular Lymphocyte Leukemia
Inherited Bone Marrow Failure Syndromes
152. Polycythemia Vera, Essential Thrombocythemia, and Primary Myelofibrosis
153. Leukocytosis and Leukopenia
Normal Neutrophil Dynamics
Leukocytosis Due to Expansion of Other Cell Lines
154. Approach to the Patient with Lymphadenopathy or Splenomegaly
H Group, Including Hemophagocytic Lymphohistiocytosis
156. Eosinophilic Syndromes
157. Approach to the Patient with Bleeding or Thrombosis
Mechanisms of Hemostasis and Thrombosis
Evaluation of the Patient with a Possible Bleeding Disorder
Evaluation of the Asymptomatic Patient with Abnormal Coagulation Tests
Evaluation of the Preoperative Patient
Evaluation of the Patient with a Possible Hypercoagulable State
Specific Causes of Thrombocytopenia
159. Von Willebrand Disease and Hemorrhagic Abnormalities of Platelet and Vascular Function
Acquired von Willebrand Syndrome
Qualitative Platelet Disorders
Hereditary Vascular Hemorrhagic Disorders
Acquired Vascular Hemorrhagic Disorders
160. Coagulation Factor Deficiencies
161. Disseminated Intravascular Coagulation and BLEEDING IN LIVER FAILURE
Disseminated Intravascular Coagulation
162. Transfusion Medicine
Infectious Complications of Transfusion
Indications for Blood Transfusion (Table 162-4)
Indications for Component Modification
Specific Clinical Settings
163. Hematopoietic Cell Transplantation
Allogeneic Hematopoietic Cell Transplantation
Syngeneic Hematopoietic Cell Transplantation
Autologous Hematopoietic Cell Transplantation
Indications for Transplantation
Complications After Hematopoietic Stem Cell Transplantation
164. Approach to the Patient with Cancer
Introduction to the Cancer Patient
Endocrine Manifestations of Cancer
Cancer of Unknown Primary Origin
Survivorship and Follow-Up
165. Epidemiology of Cancer
Molecular and Genetic Epidemiology
Cancer Control: Prevention and Treatment
166. Cancer Biology and Genetics
Cancer Is a Disease of Cumulative DNA Alterations
Cancer Genetics and Targeted Therapies
Cancer Genetics for Diagnostics
167. Myelodysplastic Syndromes
169. Chronic Lymphocytic Leukemia
Other Chronic Lymphocytic Leukemias
170. CHRONIC Myeloid Leukemia
Chronic Myelomonocytic Leukemia and Atypical Chronic Myeloproliferative Diseases
171. Non-Hodgkin Lymphomas
Specific Types of Non-Hodgkin Lymphomas
Special Clinical Situations
Diseases Sometimes Confused with Lymphoma
173. Plasma Cell Disorders
Monoclonal Gammopathy of Undetermined Significance
Variant Forms of Multiple Myeloma
Waldenström Macroglobulinemia (Primary Macroglobulinemia)
Systemic Light Chain Amyloidosis
Other Systemic Amyloidoses
175. Tumors of the Central Nervous System
176. Head and Neck Cancer
177. Lung Cancer and Other Pulmonary Neoplasms
Other Pulmonary Neoplasms
178. Neoplasms of the Esophagus and Stomach
Neoplasms of the Esophagus
179. Neoplasms of the Small and Large Intestine
Neoplasms of the Small Intestine
Neoplasms of the Large Intestine
181. Liver and Biliary Tract Tumors
182. Tumors of the Kidney, Bladder, Ureters, and Renal Pelvis
Cancers of the Renal Pelvis and Ureters
183. Breast Cancer and Benign Breast Disorders
Ovarian and Fallopian Tube Cancer
Other Gynecologic Cancers
Approach to Survivors of Gynecologic Cancers
187. Malignant Bone Tumors, Sarcomas, and Other Soft Tissue Neoplasms
Gastrointestinal Stromal Tumors
Desmoid Tumors/Aggressive Fibromatosis
188. Melanoma and Nonmelanoma Skin Cancers
Basal and Squamous Cell Skin Cancer
Section XVII. Metabolic Diseases
189. Approach to Inborn Errors of Metabolism
Selected Errors of Metabolism
Disorders of Fatty Acid Oxidation
190. Disorders of Lipid Metabolism
Clinical Disorders of Lipid Metabolism
191. Glycogen Storage Diseases
192. Lysosomal Storage Diseases
Other Lysosomal Disorders Seen in Adults
193. Homocystinuria and Hyperhomocysteinemia
196. Iron Overload (Hemochromatosis)
Section XVIII. Nutritional Diseases
198. Malnutrition: Assessment and Support
199. Vitamins, Trace Minerals, and Other Micronutrients
Micronutrients in Nutritional Science
Types and Function of Micronutrients
Conditions that Increase Required Dietary Intake
Pathophysiologic and Pharmacologic Factors
Controversies Regarding Marginal Micronutrient Deficiencies
Section XIX. Endocrine Diseases
202. Approach to the Patient with Endocrine Disease
Common Symptoms of Endocrinologic Disease
Evaluation of the Response of an Endocrine Disease to Treatment
203. Principles of Endocrinology
Regulation of Hormone Synthesis and Secretion
Hormone Transport and Metabolism
Mechanism of Hormone Action
Mechanisms of Endocrine Disease
204. Neuroendocrinology and the Neuroendocrine System
Neuroendocrine Regulation
Adrenocorticotropic Hormone (ACTH)
Gonadotropins (Follicle-Stimulating Hormone and Luteinizing Hormone)
Thyroid-Stimulating Hormone
Nonfunctioning Pituitary Adenomas
Anatomy and Hormone Synthesis
Syndrome of Inappropriate Antidiuretic Hormone Secretion
Overview of Thyroid Disease
Normal Anatomy and Function
Disorders of Adrenal Function
209. Adrenal Medulla, Catecholamines, and Pheochromocytoma
Adrenal Medulla and Catecholamines
Pheochromocytoma and Paraganglioma
Metastatic Pheochromocytoma and Paraganglioma
Pheochromocytoma in Pregnancy
Acute Issues for Individuals With Diabetes
Chronic Microvascular Complications of Diabetes
Diabetic Cardiovascular Disease
212. Polyglandular Disorders
213. Neuroendocrine Neoplasms
Specific Neuroendocrine Neoplasms
Principles for Controlling Growth of Metastatic Neuroendocrine Tumors
Differences of Sexual Development
Maternal Conditions Affecting the Fetus
Hormone Insensitivity Syndromes and Other Hormone Deficiencies
Management of Individuals with Differences of Sexual Development: Gender Role and Identity
215. Transgender Medicine
216. The Testis and Male Hypogonadism, Infertility, and Sexual Dysfunction
Male Reproductive Physiology
217. Ovaries and Pubertal Development
Aberrations in Pubertal Development
218. Reproductive Endocrinology and Infertility
The Normal Menstrual Cycle
Abnormal Uterine Bleeding
Sexual Function and Dysfunction
Section XX. Women’s Health
219. Approach to Women’s Health
Health Disparities Among Women
Common Causes of Mortality in Women
Common Causes of Morbidity in Women
Reproductive Health Issues
221. Medical Issues in Pregnancy
Medical Disorders of Pregnancy
223. Intimate Partner Violence
Section XXI. Diseases of Bone and Mineral Metabolism
224. Approach to the Patient with Metabolic Bone Disease
226. Osteomalacia and Rickets
227. The Parathyroid Glands, Hypercalcemia, and Hypocalcemia
228. Paget Disease of Bone
229. Osteonecrosis, Osteosclerosis/Hyperostosis, and Other Disorders of Bone
Osteosclerosis/Hyperostosis
Section XXII. Diseases of Allergy and Clinical Immunology
230. Approach to the Patient with Allergic or Immunologic Disease
Inborn Errors of Immunity
231. Primary Immunodeficiency Diseases
An Approach to Evaluation of the Immune System
Severe T- and B-Cell Combined Defects
Less Severe T- and B-Cell Combined Defects
Combined Defects with Syndromic Features
Defects of Immune Globulin and Antibody Production
Immune Dysregulation Syndromes
Diseases of Intrinsic and Inate Immunity
Autoinflammatory Disorders
Bone Marrow Failure Defects
232. Urticaria and Angioedema
Histamine-Induced Acute and Chronic Urticaria
Bradykinin-Mediated Hereditary Angioedema and Related Diseases
Section XXIII. Rheumatic Diseases
236. Approach to the Patient with Rheumatic Disease
237. Laboratory Testing in the Rheumatic Diseases
Laboratory Evaluation of Arthritis and Related Diseases
Laboratory Evaluation of Systemic Inflammatory Disease
238. Imaging Studies in the Rheumatic Diseases
Magnetic Resonance Imaging
239. Inherited Diseases of Connective Tissue
Osteogenesis Imperfecta Syndromes
240. The Systemic Autoinflammatory Diseases
Interleukin-1–Related Periodic Fever Syndromes
The Interferonopathies: Type I Interferon–Associated Autoinflammatory Diseases
Autoinflammatory Diseases Associated With Activation of NF-κB
Other Inherited Systemic Autoinflammatory Diseases
Somatic Mutation And Late-Onset Autoinflammatory Disease
242. Bursitis, Tendinopathy, Other Periarticular Disorders, and Sports Medicine
Disorders of the Shoulder Region
Disorders of the Elbow Region
Disorders of the Wrist and Hand
Disorders of the Hip Region
Disorders of the Knee Region
Disorders of the Ankle and Foot Region
243. Rheumatoid Arthritis
Common Features of Spondyloarthritis
Clinical Subsets of the Spondyloarthropathies
245. Systemic Lupus Erythematosus
246. Systemic Sclerosis (Scleroderma)
248. Inflammatory Myopathies
249. The Systemic Vasculitides
250. Giant Cell Arteritis and Polymyalgia Rheumatica
251. Infections of Bursae, Joints, and Bones
252. Crystal Deposition Diseases
Calcium Pyrophosphate Dihydrate Crystal Deposition Disease
Apatite (Basic Calcium Phosphate)-Associated Arthropathy
254. Systemic Diseases in Which Arthritis Is a Feature
Primary Biliary Cholangitis (Cirrhosis)
Inflammatory Bowel Disease
Gluten-Sensitive Enteropathy (Celiac Disease)
Pancreatitis-Arthritis Syndrome
Hypertrophic Osteoarthropathy
Carcinomatous Polyarthritis
Arthritis Associated With Treatments for Malignant Diseases
Palmar Fasciitis and Arthritis Syndrome
Multicentric Reticulohistiocytosis
Immunoglobulin G4–Related Disease
Alkaptonuria (Ochronosis)
Tenosynovial Giant Cell Tumor: Diffuse Type
255. Surgical Treatment of Joint Diseases
Anesthesia in the Orthopedic Patient
Perioperative Arthritis Medication
Section XXIV. Infectious Diseases
256. Introduction to Microbial Disease: Pathophysiology and Diagnostics
Genetic Susceptibility and Response to Infection
The Role of Infectious Agents in Chronic Diseases
257. The Human Microbiome
Structure and Function Relationships of the Microbiome
Establishment of the Microbiome
Alteration of the Microbiome
Therapies Targeting the Microbiome
258. Principles of Anti-Infective Therapy
Selecting Antimicrobial Therapy
Considerations of Antimicrobial Administration
Administrative Aspects of Antimicrobial Therapy
259. Approach to Fever or Suspected Infection in the Normal Host
260. Approach to Fever and Suspected Infection in the Immunocompromised Host
Fever in the Compromised Host
261. Prevention and Control of Health Care–Associated Infections
The Burden of Health Care–Associated Infections
262. Approach to the Patient with Suspected Enteric Infection
263. Approach to the Patient with Urinary Tract Infection
264. Approach to the Patient with a Sexually Transmitted Infection
Sexually Transmitted Infections
Sexually Transmitted Infection Syndromes
265. Approach to the Patient Before and After Travel
Dengue, Chikungunya, Zika
Noninfectious Travel Problems
266. Antibacterial Chemotherapy
Choice of Antibiotic, Dose, and administration Schedule
Determining the “Correct” Drug Dose
Effects of Pharmacokinetic Changes
Drug Classes and Their Properties
Failure of Antimicrobial Therapy
267. Staphylococcal Infections
Toxin-Mediated Staphylococcal Diseases
Coagulase-Negative Staphylococci
268. Streptococcus Pneumoniae Pulmonary Infections
269. Nonpneumococcal Streptococcal Infections and Rheumatic Fever
Classification and Identification of Streptococci
Streptococcus Pyogenes (Group A Streptococcus) Infections
Streptococcus Agalactiae (Group B Streptococcus)
Streptococcus dysgalactiae Subspecies Equisimilis (Group C and Group G Streptococcus)
Viridans Group Streptococci (Streptococcus anginosus Group/Streptococcus milleri Group)
270. Enterococcal Infections
271. Clostridial and Clostridioides Infections
Necrotizing Clostridial Tissue Infection
Neurotoxic Clostridial Infections
272. Gram-Positive Rod Infections
Infections Caused by Bacillus Anthracis and Other Bacillus Species
Diphtheria and Other Infections Caused by Corynebacteria
Erysipeloid and Other Erysipelothrix Infections
273. Diseases Caused by Non–Spore-Forming Anaerobic Bacteria
274. Neisseria Meningitidis Infections
275. Neisseria Gonorrhoeae Infections
Specific Clinical Syndromes
277. Haemophilus and Moraxella Infections
Other Haemophilus Species
278. Cholera and Other Vibrio Infections
279. Campylobacter Infections
Other Campylobacter Species
280. Escherichia Coli Enteric Infections
281. Enterobacterales: Non-Enteric Infections and Multidrug Resistance
282. Pseudomonas and Burkholderia Infections
283. Diseases Caused by Acinetobacter and Stenotrophomonas Species
Stenotrophomonas maltophilia
284. Salmonella Infections (Including Enteric Fever)
287. Tularemia and Other Francisella Infections
288. Plague and Other Yersinia Infections
289. Whooping Cough and Other Bordetella Infections
290. Legionella Infections
291. Bartonella Infections
Intraerythrocytic Bacteremia: Oroya Fever and Trench Fever
Bacteremia and Endocarditis
Vasculoproliferative Disease: Bacillary Angiomatosis, Peliosis Hepatis, and Verruga Peruana
292. Granuloma Inguinale (Donovanosis)
293. Mycoplasma Infections
294. Diseases Caused by Chlamydiae
295. Syphilis and Nonsyphilitic Treponematoses
Nonsyphilitic Treponematoses
297. Relapsing Fever and Other Borrelia Infections
300. The Nontuberculous Mycobacteria
301. Leprosy (Hansen Disease)
302. Rickettsial Infections
Rickettsioses (Diseases Caused by Rickettsia Species and Orientia Tsutsugamushi)
Ehrlichioses and Anaplasmoses
307. Systemic Antifungal Agents
Amphotericin Preparations
Echinocandin Antifungal Agents
313. Pneumocystis Pneumonia
314. Mycetoma and Dematiaceous Fungal Infections
315. Antiparasitic Therapy
317. African Sleeping Sickness
324. Babesiosis and Other Protozoan Diseases
Intestinal Tapeworm Infections
Tissue Cestode (Cyst) Infection
326. Trematode Infections
Liver, Intestinal, and Lung Flukes
Intestinal Nematode Infections
Tissue Nematode Infections
328. Antiviral Therapy (Non-HIV)
Antivirals for Hepatitis B Virus Infections
Antivirals for Hepatitis C Virus Infections
Antivirals for Herpesvirus Infections
Antivirals for Influenza Virus Infections
Antivirals for Coronavirus Infections
330. Respiratory Syncytial Virus and Human Metapneumovirus
Respiratory Syncytial Virus
331. Parainfluenza Viral Disease
334. Pre-2019 Coronaviruses
Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome
335. COVID-19: Virology and Pathology
SARS-CoV-2: The Virus and the Genome
SARS-CoV-2 Infection of Cells
336. COVID-19: Epidemiology, Clinical Manifestations, Diagnosis, Community Prevention, and Prognosis
337. COVID-19 Treatment and Vaccination
Treatment of Infected Persons
339. Rubella (German Measles)
Other Cutaneous Human Polyomavirus–Associated Diseases
343. Smallpox, Monkeypox, and Other Poxvirus Infections
345. Herpes Simplex Virus Infections
Herpes Simplex Virus Infections in Immunocompromised Hosts
Herpes Simplex Encephalitis
Neonatal Herpes Simplex Virus Infection
346. Varicella-Zoster Virus (Chickenpox, Shingles)
348. Epstein-Barr Virus Infection
Specific Clinical Syndromes
350. Rotaviruses, Noroviruses, and Other Gastrointestinal Viruses
351. Viral Hemorrhagic Fevers
352. Arboviruses Causing Fever, Rash, and Neurologic Syndromes
Common Features of Arboviruses
Fever and Myalgia Syndrome
Meningitis and Encephalitis Syndrome
Section XXV. Retroviruses
353. Epidemiology and Diagnosis of Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome
Global Impact and Response
Regional Epidemics and Responses
354. Pathobiology of Human Immunodeficiency Viruses
Physiology of HIV Infection
355. Acute Clinical Manifestations and Diagnosis of HIV
356. Prevention of Human Immunodeficiency Virus Infection
Modes of Transmission and Prevention
Prevention Interventions for Infected Individuals
Prevention in Development
357. Antiretroviral Treatment of Human Immunodeficiency Virus Infection
When to Start Antiretroviral Therapy
When to Change Antiretroviral Therapy
Side Effects and Toxicity
358. Microbial Complications of HIV/AIDS
Immune Reconstitution Inflammatory Syndrome (IRIS)
359. Systemic Manifestations of HIV/AIDS
Neuropsychiatric Manifestations of HIV
Cardiovascular Manifestations of HIV
Endocrine Manifestations of HIV
Gastrointestinal Manifestations of HIV
Dermatologic Manifestations of HIV
Musculoskeletal Manifestations of HIV
360. Retroviruses Other Than Human Immunodeficiency Virus
Adult T-Cell Leukemia/Lymphoma
HTLV-Associated Myelopathy/Tropical Spastic Paraparesis
Other HTLV-Associated Conditions
Section XXVI. Behavioral Medicine
361. Delirium and Changes in Mental Status
Evaluation of Change in Mental Status
362. Psychiatric Disorders in Medical Practice
Major Depressive Disorder
Other Depressive and Bipolar Disorders
Obsessive-Compulsive Disorder
Acute Stress Disorder and Post-Traumatic Stress Disorder
Schizophrenia and Related Psychotic Disorders
Somatic Symptom and Related Disorders
Suicide and Evaluation of Suicidality
When to Refer a Patient for Psychiatric Evaluation
363. Nicotine and Tobacco
364. Alcohol Use Disorders
366. Approach to the Patient with Neurologic Disease
Acute Neurologic Disorders Requiring Immediate Diagnosis and Treatment
Common Complaints of Possible Neurologic Origin
Neurologic Diagnostic Procedures
367. Headaches and Other Head Pain
Cluster Headache and Other Trigeminal Autonomic Cephalalgias
Secondary Causes of Headaches
368. Traumatic Brain Injury and Spinal Cord Injury
Acute Brain and Spinal Injury
369. Mechanical and Other Lesions of the Spine, Nerve Roots, and Spinal Cord
Cervical Spinal Stenosis and Spondylotic Myelopathy
Disorders of the Nerve Roots
Disorders of the Spinal Cord
370. Regional Cerebral Dysfunction: Higher Mental Functions
Memory Function and Amnesic Disorders
Language Function and Aphasic Disorders
Cortical Disorders of Visual Function and Hemispatial Neglect
Executive Cognitive Dysfunction and the Control of Interpersonal Behavior
371. Cognitive Impairment and Dementia
The Spectrum of Mild Cognitive Impairment to Dementia
Management of Persons with Mild Cognitive Impairment or Dementia
Cognitive Impairment Due to Cerebrovascular Disease
Dementia with Lewy Bodies
Frontotemporal Lobar Degeneration
Creutzfeldt-Jakob and Other Classic Prion Diseases
Rapidly Progressive Dementia
373. Coma, Disorders of Consciousness, and Brain Death
Unresponsive Wakefulness Syndrome
Minimally conscious state
Sleep-Related Breathing Disorders
375. Approach to Cerebrovascular Diseases
376. Ischemic Cerebrovascular Disease
377. Hemorrhagic Cerebrovascular Disease
Spontaneous Subarachnoid Hemorrhage
Other Causes of Parkinsonism
379. Other Movement Disorders
380. Multiple Sclerosis and Demyelinating Conditions
Chronic Autoimmune Syndromes
381. Meningitis: Bacterial, Viral, and Other
382. Brain Abscess and Parameningeal Infections
Venous Sinus Thrombosis Secondary to Infection
Neurologic Complications of Infectious Endocarditis
Virally Mediated Cerebral Venous Thrombosis
384. Nutritional and Alcohol-Related Neurologic Disorders
Deficiency of Water-Soluble Vitamins
Deficiency of Fat-Soluble Vitamins
Deficiency of Miscellaneous Elements and Nutrients
Alcohol-Related Disorders
385. Developmental and Neurocutaneous Disorders
Systemic Autonomic Disorders
Specific Autonomic Disorders
Regional Sympathetic Dysfunction
387. Amyotrophic Lateral Sclerosis and Other Motor Neuron Diseases
Amyotrophic Lateral Sclerosis
Spinal Muscular Atrophies
Spinobulbar Muscular Atrophy/Kennedy Disease
388. Peripheral Neuropathies
Approach to Peripheral Neuropathy
Inflammatory and Immunologic Neuropathies
Neuropathies Associated with Monoclonal Gammopathies and Multiple Myeloma
Paraneoplastic Neuropathies
The Diabetic Neuropathies
Toxic and Deficiency Syndromes
Critical Illness Neuropathy
Neuralgic Amyotrophy (Idiopathic Brachial Plexitis)
Compressive Mononeuropathies
Trigeminal Neuralgia (Tic Douloureux)
Congenital Muscular Dystrophies
Inflammatory Muscle Diseases
390. Disorders of Neuromuscular Transmission
Congenital Myasthenic Syndromes
Section XXVIII. Eye, Ear, Nose, and Throat Diseases
391. Diseases of the Visual System
Common Clinical Conditions
Inflammatory Eye Disorders
Structural and Age-Related Disorders
Systemic Diseases with Ocular Symptoms During Adulthood
Vascular Abnormalities of the Eye
Idiopathic Inflammatory and Autoimmune Disorders
Genetically Determined Diseases That May Become Symptomatic During Adulthood
Common Pediatric or Adolescent Diseases That May Persist into Adulthood
Ocular Effects of Systemic Medications
393. Diseases of the Mouth and Salivary Glands
394. Approach to the Patient with Nose, Sinus, and Ear Disorders
Nasal and Sinus Complaints
396. Hearing and Equilibrium
Disorders of the Auditory System
Equilibrium–Vestibular System
Anatomy of the Upper Aerodigestive Tract
Infectious Diseases of the Upper Aerodigestive System
Noninfectious Pharyngitis
Section XXIX. Medical Consultation
398. Principles of Medical Consultation
Approach to Medical Consultation
Setting-Specific Consultative Issues
Strategies for Effective Consultation
Special Consultative Situations
Responsibilities of the Consultant
Impact of Consultations on Patient Outcome
399. Preoperative Evaluation
General Preoperative Evaluation
Approach to Managing Medications
Communicating with the Surgeon and Anesthesiologist
400. Overview of Anesthesia
Intraoperative Management
General Versus Regional Anesthesia
401. Postoperative Care and Complications
402. Medical Care of Patients with Psychiatric Diseases
Population Health for Persons with Severe Mental Illnesses
Specific Health Challenges for Patients with Severe Mental Illness
Providing Care in Different Settings
Medical Complications of Psychiatric Treatments
Approach to Common Symptoms and Findings
Ongoing Ambulatory Medical Care of the Psychiatric Patient
Section XXX. Skin Diseases
403. Approach to Skin Diseases
Structure and Function of the Skin
Approach to a Skin Problem
Life-Threatening Emergencies
404. Principles of Therapy of Skin Diseases
Principles of Topical Therapy
Antipruritic or Anesthetic Agents
Agents that Improve Surface Functions (Lubrication, Scale)
Treatment for Skin Cancers (See Chapter 188)
405. Eczemas, Photodermatoses, Papulosquamous (Including Fungal) Diseases, and Figurate Erythemas
Papulosquamous (Including Fungal) Diseases
406. Macular, Papular, Purpuric, Vesiculobullous, and Pustular Diseases
Macular and Papular Exanthems
Acute Generalized Exanthematous Pustulosis
407. Urticaria, Drug Hypersensitivity Rashes, Nodules and Tumors, and Atrophic Diseases
Benign Papules, Nodules, and Tumors
Atrophic and Sclerotic Lesions
408. Infections, Pigmentation Disorders, Regional Dermatology, and Distinctive Lesions in Black Skin
Infections, Including Cellulitis
Disorders of Hypopigmentation and Hyperpigmentation
Distinctive Lesions in Black Skin
409. Diseases of Hair and Nails
Hair Disorders in Children
Appendix. Reference Intervals and Laboratory Values
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