Approach to internal medicine phần 95

Index

450
Hypersplenism............ 130, 148, 151, 153,
278, 415, 420
Hypertension
aortic dissection...............25, 28, 30,
49, 57, 60
Conn’s......................................... 348
cushing’s syndrome...................... 57
hyperaldosteronism............ 348–349
pheochromocytoma .......34, 57, 143,
281, 348–349
post-operative ............ 392, 425–426
in pregnancy............................... 409
Hypertensive cardiomyopathy.............. 34
Hypertensive emergency................ 57–58
Hypertensive retinopathy...... 57, 338, 348
Hypertensive urgency..................... 57–58
Hyperthyroidism..... 15, 19, 39, 42, 44–45,
57, 65, 90, 111, 124, 233, 309, 318,
332, 337, 344–346, 353–355, 361, 374,
412, 414, 420
in pregnancy............................... 414
Hypertrichosis...................... 180, 357, 421
Hypertriglyceridemia ......... 61–62, 80, 227
Hypertrophic cardiomyopathy........ 40, 43,
45–48, 53, 64, 312
Hypertrophic obstructive cardiomyopathy
(HOCM) ......................... 38, 42, 45, 48
Hypertrophic osteoarthropathy.........185,

374–375
Hypertrophy criteria ....................... 63–64
Hyperventilation...................... 19, 78, 83,
94, 315
Hyperviscosity syndrome............. 178, 180
Hypnic headaches ...............................314
Hypocalcemia ........... 63, 65, 89, 101, 139,
229, 309, 332, 352–353, 414
Hypogammaglobulinemia.... 5, 8, 170, 189
Hypoglycemia........... 39, 59, 83, 100, 103,
105, 107–108, 128–129, 203, 206, 226,
240, 299, 309–310, 337, 340–342, 385,
412, 414, 425, 427
Hypokalemia............................ 18, 38–39,
63, 65, 78–79, 81–82, 86, 89, 104–105,
108, 126, 135, 332, 347–348, 396, 406
Hypokinetic movement disorders .......320
Hypomagnesemia......... 38–39, 63, 78–79,
81, 83, 89, 105, 126, 135, 227, 276,
381, 396
Hyponatremia
acute............................................. 80
chronic.......................................... 80
hyperosmolar................................ 80
hypoosmolar........................... 79–80
isoosmolar .................................... 80
pseudo.......................................... 80
Hypophosphatemia ............ 18, 83–84, 89,
103, 105, 227, 332, 352–353
Hypotension .............................. 8, 25, 27,

29–30, 32–33, 48, 52, 59, 89–90, 97,
100, 103–105, 107–109, 118–120,
122–123, 129, 135, 137, 140, 146, 149,
168, 201–202, 227, 233, 235, 237–239,
248, 257, 312–313, 315, 328, 337, 344,
348–349, 352, 365, 373, 382–383, 385

Hypothermia..... 64, 81, 91, 103, 107–108,
343, 381
Hypothyroidism ............ 10, 17, 32, 34, 39,
42, 57, 61, 79–80, 98, 107–108, 126,
135–137, 145–147, 173, 180–181,
202, 220, 227, 276, 281, 287, 328, 332,
343, 345–347, 356–357, 361, 378, 381,
390, 394, 396, 414, 420–421
in pregnancy............................... 414
Hypoventilation ....................... 15, 18, 78,
92–93, 146, 403
Hypovolemia ..... 71, 80–81, 118–119, 229
Hypoxemia ..... 4, 8, 15–18, 35, 38, 92–94,
96–97, 101, 104, 108–109, 134–135,
147, 233, 235, 237, 239
Hypoxemic respiratory failure .............. 93

I
Idiopathic hirsutism.....................357–358
Idiopathic/immune thrombocytopenic
purpura (ITP)............... 132, 151–153,
170, 415
Idiopathic pulmonary fibrosis... 16, 20–21,

374
IgA nephropathy ............... 70–73, 75, 76,
288, 361
Imaging
abdominal X-rays (AXR).............. 396
chest radiography........................... 6
CT chest .......................................... 6
neurology ........................... 297, 302
Imatinib ........149, 166, 169, 203, 227, 231
Immune reconstitution syndrome
(IRIS) .............................................262
Immunization ..... 147–148, 163, 233–234,
237, 239, 261, 269–271, 365
Immunocompromised patients ...266–267
Impetigo .............................. 247, 365–366
Incidentaloma......................................348
adrenal................................ 348–349
Incontinence........... 12, 68, 103, 210, 212,
228, 231, 244, 298, 310, 312, 323,
377–380, 383–385, 403
Incoordination ..... 135, 308, 319–320, 382
Indirect factor Xa inhibitors.........160–161
Indolent lymphomas ...........................175
Infection control ..........................269–270
Inferior vena cava obstruction.............207
Inflammatory arthritis.......... 278, 283, 286
Inflammatory back pain.......................284
Inflammatory bowel disease (IBD)......5, 8,
118, 120–123, 120–122, 125, 127, 129,
155, 156, 174, 212, 220, 223, 234, 239,

273, 276–277, 282–283, 367, 374, 405,
420
extra-intestinal
manifestations ............. 121, 283
Inflammatory cardiomyopathy ............. 34
Inflammatory
myopathies... 279, 281, 292–293, 332
Influenza vaccination...... 2, 4, 7, 148, 239,
261, 264

Infusion reactions ................ 194, 228, 269
Inhaled medications ............................... 2
Inotropes ................... 28–30, 98–100, 399
Insomnia ............12, 17, 42, 106, 350, 390,
418–419, 421
Insulin ..........59, 62, 82–83, 100, 104, 201,
261, 337–342, 347, 350, 357–358, 397,
403, 407, 414, 423, 425, 427
principles of use ................. 341–342
Insulin resistance syndrome ................. 62
Intensive care
admission criteria ......................... 89
general issues ......................... 89–92
mechanical ventilation ................. 89
preventative strategies................. 89
procedures.............................. 89–90
prognosis...................................... 90
sedation........................................ 89
weakness ...................................... 89
International prognostic index

follicular lymphoma.................... 175
Hodgkin’s lymphoma ................. 173
non-Hodgkin’s lymphoma .......... 175
Internuclear ophthalmoplegia
(INO) .....................................306–308
Interstitial lung disease ............ 3, 5, 8, 12,
15–17, 20–21, 23, 33, 92, 148, 281
Intoxication.............................. 38–39, 68,
91, 103, 105, 107, 135, 299, 380
Intracerebral hemorrhage ............ 93, 106,
147, 243
Intrahepatic cholestasis of
pregnancy.............................411–412
Intubation..... 1–2, 4–5, 13, 18, 78, 89–91,
94–95, 97, 99–100, 103–104,
108–109, 243, 269, 311, 338, 373, 399
impending ...................................... 5
Iodine uptake study.............................345
Irinotecan........... 187, 196, 198–200, 226,
230–231
Iron deficiency anemia ......................144,
163, 199
Iron index ............................................420
Irritable bowel syndrome (IBS) ...........124,
126–127, 239, 287, 396
Ischemia criteria ................................... 28
Ischemic cardiomyopathy................34, 93
Ischemic colitis .... 115, 118, 120, 122, 125
Ischemic stroke................. 9, 30, 147, 299,
302–303, 313

Isolations.............. 36, 148, 235, 251, 265,
267, 269
Isometric exercises................................ 45
Itraconazole ........... 3, 237, 261, 266–268,
363, 386

J
Janeway lesions .................................... 53
Jaundice ..........46, 52, 121, 128–131, 133,
138–140, 145–146, 163, 181, 185, 190,
201, 203–207, 209, 218, 240, 283, 344,
405, 411–412


Index
Joint aspirations ..................................274
Joint pain
crystal arthropathy ..................... 286
osteoarthritis ..............273, 275–276,
285–287, 347, 353, 403
rheumatoid arthritis ...........5, 11, 13,
15–16, 18, 25, 32, 47, 71, 78, 164,
233, 273, 276–280, 282, 286,
288, 292, 318, 323, 328, 332, 355,
368, 420
septic arthritis........53, 258, 273–274
systemic lupus
erythematosus ............. 279–281
Jones criteria ........................................ 51
Jugular venous pressure (JVP)........ 15, 30,

32–36, 43–44, 46, 50, 52, 64, 68, 71,
98, 412

K
Karnofsky performance status .... 186, 208,
298, 400
Keratoconjunctivitis sicca .... 273, 278–279
Keratoderma blennorrhagica...............283
Kernig sign ..........................................242
Kidney mass...................................57, 116
Killip class classification ........................ 27
King’s College criteria.................. 103, 129
acetaminophen overdose........... 103
Knee examination................................295
Korsakoff’s amnesia .............................107
Krukenberg tumor ...............................197
Kussmaul breathing..................... 107, 395
Kwashiorkor syndrome........................126

L
Labral tear ...........................................295
b-lactamase resistance ........................253
Lactoacidosis .......................................340
Lacunar stroke .....................................299
Lambert–Eaton syndrome
(LES).............................. 318–319, 328
Latent tuberculosis ..............................251
Lee criteria...........................................423
Leg pain................................................ 56
Leg swelling ................ 8, 10, 13, 158, 207

unilateral ................................ 8, 158
Leptomeningeal meningitis.................. 176
Leptospirosis.......... 34, 173, 233, 238, 240
Leser-Trelat sign .......................... 197, 370
Lesions
acneiform ................................... 363
exanthematous................... 364–365
nodules....................................... 371
papulosquamous ........................ 362
pigmented.................................. 368
pruritic ................................ 361, 363
ulcers .......................................... 368
vesicular/bullous................. 365, 371
Letrozole.............................. 192–193, 227

451
Leukemia
acute lymphoblastic leukemia...... 167,
169–170, 177
acute myelogenous
leukemia .............. 166–168, 181
chronic lymphocytic leukemia.. 167,
170–171, 173, 179, 181
chronic myelogenous
leukemia .................... 100, 150,
165–166, 227
definition .................................... 166
Leukemic cutis.....................................167
Leukocyte alkaline phosphatase..........165
Leukocytoclastic vasculitis ...................289

Lewy body dementia................... 321, 328
Lhermitte’s sign .... 228, 298, 308, 323, 405
LHRH agonists .................192, 211–212, 227
Libman-Sacks endocarditis ............52, 279
Lichen planus ...................... 132, 362–363
Li Fraumeni syndrome............... 190, 204,
225, 297
Ligament tear .............................. 273, 295
Light chain deposition disease ......69–70,
178, 421
Light’s criteria....................................... 11
Likelihood ratio....................................417
Linitis plastica ......................................197
Lipase ........26–27, 62, 114, 116, 125, 129,
136, 139, 196–197, 199, 204–205, 213,
259–260, 339, 404
Lithium toxicity....................................104
Livedo reticularis ........ 157, 280, 288, 291,
371–372, 421
Liver enzymes..... 103, 128, 130, 138–139,
227, 259, 262, 277, 409
Liver failure
acute................................... 128–130
chronic................................ 132–135
encephalopathy................. 128–129,
132–133, 135
fulminant ............................ 128–129
hepatitis B........................... 129–130
hepatitis C ...................129, 131, 262
jaundice ...............128, 130–131, 133

Liver metastases .......... 201, 203, 207, 391
Liver transplant............. 12, 103, 119, 129,
132–137, 139, 206
Lobular carcinoma in situ (LCIS)... 189, 191
Lofgren’s syndrome............ 276–277, 279,
282, 420
Long thoracic nerve.............................330
Lower GI bleed ....................................120
Lower GI bleed ....................................120
IBD .............................................. 120
Lower motor neuron .......... 228, 285, 303,
307, 333
Low molecular weight heparins
(LMWH)............ 9–10, 29–30, 89, 100,
152, 155–156, 159–161, 410–411,
415, 425
Lumbar puncture................................100,
167–169, 176–177, 235, 239,
242–244, 260, 264, 267, 307–308, 310,
313–314, 322, 327, 329, 380, 382

Lumbosacral radiculopathy .................285
Lung abscess ......................... 6, 8, 12, 374
Lung cancer ........ 12–13, 20–21, 185–187,
220–221, 228, 261, 318–319, 347, 350,
374, 394, 411, 418–419
Lung cavities......................................... 20
Lung metastases..................................370
Lung resection assessment..................424
Lupus.......... 8–9, 69–70, 75, 79, 154–157,

233–234, 242, 279–281, 292, 322, 362,
365, 371–372, 415, 420
in pregnancy............................... 415
Lyme disease ........ 34, 112, 173, 234–236,
239, 276–277, 282, 308
Lymphadenopathy ..... 10, 13–14, 53, 144,
146, 149, 151, 167, 169–174, 177–178,
219–220, 233, 235, 237, 239–241, 246,
250, 259, 262, 266, 277, 279–280, 345,
348, 420–422
Lymphoblastic lymphoma .......... 167, 169,
174, 176–177
Lymphocytosis............. 16, 124, 170–172,
174, 308
Lymphoma
definition .................................... 167
Hodgkin’s.... 149, 163, 167, 169–174,
181, 261, 318
non-Hodgkin’s .... 149, 167, 169–171,
173–178, 227–228, 259–260,
361, 403
small lymphocytic........167, 170, 173
Lymphoplasmacytic lymphoma..........170,
174, 178

M
Macrocytic anemia............... 105, 145–147
Macrolides....7, 63, 100, 114, 255, 257, 365
Malabsorption ...... 83, 124–126, 163, 327,
352, 354–355, 405, 407, 421–422

Malaria................ 138, 145, 152, 164–165,
236, 238–240
Malar rash............................ 279–280, 371
Malignant hypertension .......... 57, 68, 151
Malignant pleural effusion.... 186–187, 220
Malnourishment .......................... 125, 406
Mammogram............. 158, 190–191, 219,
223, 225
Management ........ 1–7, 9, 11–19, 11–121,
26, 28–30, 33, 37, 39, 41–42, 48,
50–52, 54, 56, 58, 61, 68–70, 74–76,
78–84, 93–94, 99–102, 104–106,
108–109, 111, 113–114, 117,
123–124, 126, 129, 131–132, 134,
136–139, 143–151, 153, 155–157,
159, 165–171, 173, 175–176, 180,
187–189, 191–192, 195–196,
198–200, 202–206, 208–209, 211,
214, 216–220, 230–231, 234–235,
237, 243, 245, 247, 249, 251, 260–261,
264, 274–275, 277–278, 280,
283–284, 286, 288–289, 298,
302–303, 307–312, 314, 316–317,


Index

452
319–320, 322, 327–328, 333–340,
342–343, 345–353, 355, 357–358,

361–362, 364, 366–367, 369–372,
374–375, 377–378, 380, 382–385,
389, 392, 394–398, 403–407,
409–410, 412–413, 419, 422–425, 429
principles .................................... 429
Mantle cell lymphoma ....170, 173–174, 177
Marantic endocarditis........................... 52
Marasmus syndrome ...........................126
Marginal zone
lymphoma .................... 170, 173–174
Mastectomy ......... 191–192, 219, 225, 415
Maternal Medicine...............................409
McDonald criteria multiple sclerosis....308
Mechanical back pain ..........................284
Mechanical heart valve........................157
Mechanical ventilation ....... 1–2, 4, 19, 89,
93–95, 97, 99–100, 329, 399, 425
Median nerve ................ 325, 327–328, 331
Mediastinal lymphoma ........................174
Mediastinal masses............... 21, 112, 169,
171–172, 177
Medical fitness to drive............. 426–427
Medication induced headaches..........202,
236, 287, 298, 412
Medications........ 1–2, 8, 10, 13, 15–18, 29,
31–34, 39–40, 50–53, 55, 57, 61,
67–68, 75, 81, 94–95, 97–98, 101–102,
106–108, 113–115, 118, 120, 122–126,
130–133, 135, 138–139, 143–146,
148–149, 151, 153, 173, 202, 230,

233–234, 237, 239, 252, 257, 260, 270,
273, 280, 288, 306, 311–315, 318, 320,
322, 337, 341, 343–344, 346, 349, 352,
354–355, 357, 363–364, 373, 377–378,
382–383, 385–386, 390–392, 395–397,
400, 405, 407, 409, 412–414, 421,
424–426, 429
in pregnancy....................... 412–414
Mediterranean fever........... 115, 233, 241,
276–277, 282
Medullary cystic kidney disease ..... 75–76
Medullary sponge kidney ..........75–76, 84
Medullary syndromes ..........................306
Melanoma........20, 32, 159, 170, 173, 181,
195, 204, 219, 225–227, 261, 297, 299,
348, 353, 367–371
Melena................................. 118, 120, 197
Membranoproliferative
glomerulonephritis (MPGN)..... 68, 70,
72, 75, 130, 132, 170, 421
Membranous glomerulonephritis
(MGN).............................. 68, 70–71, 280
Meniere’s disease ........................315–317
Meningitis..........79, 81, 97, 135, 147, 176,
235, 240–244, 246, 257, 260, 263, 265,
267, 280, 291, 305, 309–310, 313, 317,
378, 380–382, 422
Meningitis..........79, 81, 97, 135, 147, 176,
240–244, 246, 257, 260, 263, 267, 280,
291, 305, 309–310, 313, 315, 317, 378,

380–382, 422
LEPTOMENINGEAL ...................... 176

Meniscal tear ............................... 286, 295
Mesothelioma......... 21, 32, 188, 220, 226,
228, 374
Metabolic acidosis ............ 3, 8, 19, 33, 74,
77–78, 82, 96, 101, 103–104, 107,
394–395
diabetic ketoacidosis.... 115, 338–339
Metabolic alkalosis .................. 18, 78–79,
81, 354
Metabolic cardiomyopathy................... 34
Metabolic syndrome.......... 27, 61–62, 275
Methadone conversion........................393
Methanol overdose..............................107
Methicillin resistant Staphylococcus
aureus (MRSA) ................. 6, 8, 54, 97,
100, 237, 247, 249–250, 253–255, 262,
269, 273
Methotrexate ........ 68, 121, 146, 169–170,
176–177, 181, 193, 195, 209, 226,
230–231, 260, 277–281, 283–284,
289–291, 299, 362, 366, 371–372, 415,
420
Metronidazole ........................ 7, 113–114,
117, 121–123, 136, 238, 245–246, 248,
255, 257–258, 364, 386, 413
Micafungin................................... 266, 268
Microangiopathic hemolytic anemia

(MAHA) ........... 68, 151–152, 163, 409
Microcytic anemia ...............................144
Microscopic polyangiitis (MPA) ............72,
288–289, 291, 293
Mid-systolic click..............................44, 52
Migraines............... 59, 299, 309, 313–315
Migrainous vertigo ..............................316
Minimal change disease (MCD) .....68–72,
172
Mitral regurgitation ............ 27, 33–34, 38,
43–46, 48, 51–52
Mitral stenosis .... 3, 12, 35, 38, 42, 44–47,
49–51, 312, 411, 422, 424
Mitral valve prolapse ..... 45–47, 51–53, 76
Mixed connective tissue disease ..........32,
279–281, 292
Mixed hypertriglyceridemia.................... 62
Modified Duke’s criteria ....................... 53
Monoarthritis
gout ............................................ 273
septic arthritis..................... 273–274
Monobactam .......................................254
Monoclonal antibodies ........ 227, 278, 309
Monoclonal gammopathy .................... 170
Monoclonal gammopathy of
undetermined significance
(MGUS) ......................... 179–180, 327
Mononeuritis multiplex ...... 289, 291, 327,
329, 337
Mononeuropathy......... 291, 327, 332, 337

Morphine ...........29, 33, 37, 79–80, 84, 89,
117, 139, 147, 153, 231, 392–393
Motor Cortex ............................... 310, 332
MR angiography ............................56, 333
MRI head .........10, 80, 143, 176, 298, 302,
307–308, 310, 314–316, 322, 333
MR venography ...................................333

Mucosa associated lymphoid tissue
(MALT) .................. 173–174, 176–177
Mucositis..... 112, 181–182, 199, 226–227,
230–231, 397–398
treatment.............181, 230–231, 398
Multiple endocrine neoplasia (MEN)
syndromes ............ 201, 245, 345, 349
Multiple myeloma ...... 69, 73–74, 78, 145,
170, 178–181, 227–228, 233, 261, 284,
288, 353, 403
Multiple sclerosis ........ 107, 111–112, 126,
243, 287, 306–309, 315, 317, 320, 328,
332–333, 378, 396
Multi-system disorders ........................420
Murmurs
diastolic murmurs....... 25, 46–47, 49
innocent ....................................... 47
maneuvers.................. 35, 45–46, 48
systolic murmurs ........ 45–47, 51–52
Muscle strength grading .....................332
Myasthenia gravis (MG)............ 18, 21, 89,
112, 189, 306–308, 318–319, 332, 333,

343, 410
thymoma ...............21, 189, 318–319
Mycobacterium avium complex
(MAC)............ 123, 164–165, 259–262
Mycosis fungoides ....... 174, 177, 361–362
Myelodysplastic syndrome ........ 146, 165,
168, 181, 233
Myelofibrosis (MF) ....... 143, 150, 163–167
Myelopathy.....89, 278, 298, 308, 323, 422
Myeloproliferative disorders
chronic myelogenous
leukemia .......100, 150, 165–166
essential thrombocytosis ........ 165–166
polycythemia rubra vera ....143, 150,
156, 165–166
Myocardial infarction
peri-operative ................59, 147, 424
posterior infarction ....................... 30
right ventricular infarction ..... 29–30
territory......................................... 64
Myoclonus ... 102, 309, 320, 322, 392–393
Myopathy ............18, 61, 83, 89, 105, 126,
128, 281, 287, 332–333, 343–344, 350
Myotomes............................ 324–325, 333

N
Narcolepsy ...............................17–18, 309
Narrow complex tachycardia...........40, 63
Nausea and vomiting
adrenal insufficiency........... 111, 349

chemotherapy-induced ...... 229–230
palliative setting................. 395–396
Neck stiffness....... 233–234, 237, 239, 242
Necrotizing enterocolitis .....................238
Necrotizing fasciitis....... 97, 158, 247–248,
253, 258
Necrotizing pancreatitis.......................139
Needle stick injury ............... 261, 269–270
Negative predictive value....................417
Negligence .................................. 426, 428


Index
Nephritic syndrome............ 70–71, 74–75,
132, 137, 280
Nephrotic syndrome..... 10, 61, 69–72, 74,
79, 132, 156, 280, 343, 352
Nerve roots.......................... 285, 303, 323,
325–327, 332
Neurocardiogenic syncope .......... 312, 382
Neuroendocrine tumors ..... 124, 201–202,
219, 225
Neurogenic claudication..............284–285
Neurogenic syncope............ 310, 312, 382
Neuroimaging.............. 301, 313, 333–334
Neuroleptic malignant syndrome
(NMS)............ 101–102, 241, 332, 426
Neuropathy......18, 27, 42, 54, 73, 89, 105,
124, 126, 132, 145–146, 172, 178, 180,
185, 193, 215, 227, 235, 247–248, 252,

261, 278–280, 288–291, 313, 319, 323,
327–333, 337–338, 340, 367, 384,
396–397, 405, 420–421, 427
Neutropenia........................ 132, 148, 168,
170, 180–181, 193, 228–230,
236–238, 266, 268–269, 278–279
febrile ......... 148, 168, 170, 180–182,
193, 228–230, 236–238, 269
Neutropenic fever....... 148, 233, 237–238,
266, 406
New York heart association (NYHA)
classification .......... 27, 35, 37–38, 90,
275, 411, 422, 426
Niacin deficiency .................................201
Nicotine addiction ...............................418
Nikolsky’s sign .....................................366
Non-alcoholic steatohepatitis
(NASH) .................... 42, 128, 130, 132
Non-Hodgkin’s Lymphoma......... 149, 167,
169–171, 173–178, 182, 227–228,
259–260, 361, 403
Non-invasive positive pressure ventilation
(NIPPV).............................. 94, 96, 395
Non-ketotic hyperosmolar hyperglycemia
(NKH) ............................................339
Non-nucleoside reverse transcriptase
inhibitors (NNRTI) ................. 252, 261
Non-seminoma ............................212–214
Non-small cell lung cancer ..........186–187
Non-ulcer dyspepsia ....................113–114

Normal pressure hydrocephalus
(NPH) ........... 315, 322, 341–342, 378,
380, 382–383, 414
Normocytic anemia .......................73, 145
Nosocomial infections .........................269
Nosocomial pneumonia ................. 6–7, 100
NSAIDs-induced gastropathy...............114
NSAIDs-induced renal failure................ 69
Nucleoside reverse transcriptase
inhibitors (NRTI).................... 252, 261
Number needed to treat (NNT) ... 303, 418
Numbness
multiple sclerosis...................303, 337
stroke/TIA ........................... 304, 316
Nutrition ......8, 85, 96, 105, 121–122, 126,
129, 139, 237, 265, 354, 377, 382, 390,
398, 403–404, 406–407

453

O
Obesity ...... 1, 8, 17–18, 21, 23, 27, 30, 34,
36, 40–41, 43, 56–57, 61, 72, 94, 114,
117, 130, 133, 195, 198, 204, 207, 216,
247, 275, 286, 292, 314, 338, 340, 348,
350, 352, 357, 367, 384, 403, 406, 409,
413, 423
Obscure GI bleed.................................120
Obstetrical medicine.................... 152, 412
Obstructive lung disease ..... 134, 147, 424

Obstructive sleep apnea........... 17–18, 94,
143, 403
Obturator nerve................... 326, 331, 337
Occult GI bleed...... 12, 118–120, 144–145
Octreotide.... 119, 129, 135, 202, 231, 311,
342, 347, 396
Oculocephalic reflexes.......................... 91
Oculomotor nerve lesions ...................305
Odds ratio (OR)....................................418
Opening snap ......................44–46, 49–50
Opiate overdose .......................... 103, 105
Opioid Use........................... 127, 392, 396
Optic atrophy ...... 290, 306, 319, 344, 405
Optic neuritis ....... 185, 252, 306, 308–309
Oral airways .......................................... 95
Oropharyngeal dysphagia ...........112–113
Orthostatic proteinuria ................... 74–75
Oseltamivir ..................................264–265
Osler nodes........................................... 53
Osmolar gap .......... 77, 101–102, 104, 107
Osteitis fibrosa...................................... 73
Osteoarthritis (OA)...... 273, 275–276, 278,
285–286, 347, 353, 403
Osteomyelitis.......................... 10, 53, 147,
233, 248–249, 256, 258, 265, 273, 338
Osteoporosis........... 19, 59, 124, 139, 160,
181, 192, 212, 227, 350, 353–355, 377,
383, 392, 418
Osteoporosis risk assessment
instrument ....................................355

Ovarian ablation ..........................192–193
Overdose
acetaminophen................... 103, 128
digoxin............................ 38–39, 382
opioids........................................ 392
Overflow incontinence ........................384
Overlap syndrome ....................... 279, 332
Oxaliplatin ........... 196, 198–200, 226, 230
Oxazolidinones ....................................255
Oximetry................ 58, 91–92, 99, 104, 143
Oxygen saturation gap ........................104

P
Paclitaxel .........29, 31, 187, 193–194, 216,
218–220, 226, 230–231
Pain control .......28, 84, 96, 117, 147, 205,
231, 284–285, 287, 314, 356, 391–393,
395–397, 411, 415, 424

Palindromic rheumatism ... 273, 276–278,
282
Palliative
dyspnea ........ 53, 188–189, 199, 202,
209, 389, 394–395, 400
medication route ........................ 391
nausea and vomiting........ 111, 127,
395–396
pain control .........205, 391, 395–396
sedation.............................. 395, 428
Palliative care ........ 91, 219, 389–401, 429

Palliative performance scale
(PPS) ..................................... 390, 401
Palliative prognostic index (PPI)..........400
Palliative prognostic score (PaP) .........400
Palmer xanthoma ........................... 61–62
Palpable purpura........ 233, 280, 288–289,
291, 373
Palpitations
atrial fibrillation ..........39–41, 49, 52,
108, 344
pheochromocytoma ..... 39, 348–349
P-ANCA ........13, 69, 71–72, 121, 289, 291,
293, 398
Pancoast tumor .................................... 14
Pancolitis .....................................121–122
Pancreatic cancer........ 128, 138–139, 205,
220–221
Pancytopenia .......147, 153, 167, 169, 181,
187, 189, 227, 266, 405
multiple myeloma .......178, 181, 227
Papilledema................................. 57, 297,
306, 314
Pappenheimer bodies .........................163
Papulosquamous lesions .....................362
Paranasal sinus lymphoma ..................177
Parapneumonic effusion....................6, 11
Parasomnia ........................................... 17
Parkinson’s disease ............. 102, 107, 315,
320–322, 328, 379, 385
Paroxysmal hemicrania........................314

Paroxysmal nocturnal hemoglobinuria
(PNH) ........ 9, 146, 153, 156–157, 167
Parvovirus B19............ 147, 281, 288, 291,
364–365
Pelvic inflammatory disease ..............115,
221, 246
Pemphigus vulgaris .....................365–366
Penciclovir ...........................................265
Penicillin allergy .................. 114, 257, 373
Penicillins...................... 15, 32, 51, 54, 68,
114, 123, 146, 148–149, 233–234,
240, 243, 246–248, 253–254,
257–258, 270, 288, 365, 372–373, 380,
413, 426
Peptic ulcer disease (PUD)...... 25–26, 111,
113, 115, 118–120, 125, 220, 280, 353
Percutaneous coronary intervention
(PCI) ............ 26, 29, 31, 144, 423–424
Performance status..... 175, 177, 186–188,
194, 196, 198, 200, 208, 216, 237, 298,
390, 397, 400
Pericardial effusion ......... 3, 8, 32–33, 146,
168, 186, 188, 278, 343, 394


Index

454
Pericarditis .... 6, 25–28, 30–33, 40, 43–44,
51, 53, 64, 68, 134, 136–137, 164, 181,

266, 278–279, 281, 303, 422
Peri-operative assessment...........422–425
Perioral dermatitis .......................363–364
Peripartum cardiomyopathy................. 411
Peripheral blood smear ....... 143, 163, 168
Peripheral nerves........................ 297, 303,
325–327, 329–332
Peripheral neuropathy.... 54, 73, 105, 132,
145–146, 178, 215, 227, 235, 252,
279–280, 288–289, 291, 319, 323,
327–332, 338, 367, 384, 405, 420–421
Peripheral vascular disease........ 54–56, 59,
247, 337–338, 367
Peritoneal carcinomatosis............ 220, 398
Peritonitis ..... 86, 115–117, 135–137, 221,
238, 246, 258
Peroneal nerve ............ 323, 326, 331, 347
Pheochromocytoma ... 34, 39, 57, 60, 143,
201, 208, 225, 233, 281, 337, 348–349
Photophobia.................. 42, 283, 314, 316
Photosensitivity ............ 43, 226–227, 273,
279–280, 292, 364, 371–372
Pigmented lesions ...............................368
Pink puffer.............................................. 4
Pitting edema.................. 35, 55, 158, 283
Pituitary tumors........... 346, 349, 351–352
Pityriasis rosea .....................................362
Plasma cell dyscrasias..........................178
Platelet activation pathway .................154
Platinating agents ...............................226

Pleural based disease ........................... 21
Pleural effusion........... 3, 7–12, 16, 18, 21,
25–26, 31, 33, 36, 40, 64, 86, 100, 134,
186–188, 195, 215, 220, 241, 250,
278–279, 281, 343, 394–395, 422
Plummer-Vinson syndrome ......... 144, 195
Pneumocystis jirovecii pneumonia
(PJP)............. 16, 20, 92–93, 227, 255,
259–262, 413
Pneumonia............... 3, 5–8, 10–12, 15–16,
19–20, 25–26, 33, 36, 38, 42, 47, 52–53,
79, 89, 92–93, 97, 100, 105, 108, 111,
113–115, 125, 135, 139, 146–149, 187,
236, 238, 241–243, 252–253, 257–260,
262–264, 266–267, 269, 279, 300, 310,
365, 374, 380–382, 394, 406, 410, 418,
425–426
recurrent......................................... 8
Pneumonia severity of illness score
(PSI) ............................................. 6–7
Podagra ...............................................275
POEMS syndrome ........................ 178, 180
Polyarteritis nodosa (PAN)..............68–69,
130–131, 233, 288, 291, 308
Polyarthritis
fever ...... 51, 122, 277, 283, 365, 422
rheumatoid arthritis ........... 277, 279
seronegative spondyloar
thropathies .......................... 283
systemic lupus erythematosus ... 279

Polycystic kidney disease.......... 57, 73–76,
143, 207, 244

Polycystic ovarian syndrome
(PCOS)................... 356–358, 364, 413
Polycythemia rubra vera (PRV) ... 143, 150,
156, 164–167
Polymyalgia rheumatica ..... 273, 276–277,
282, 289–290, 292
Polymyositis...........89, 101, 204, 273, 277,
279–282, 292–293, 332–333, 397
Polyneuropathy ...... 42, 89, 180, 291, 327,
333, 337
Polypharmacy .............................. 377, 385
Polyuria
diabetes insipidus................. 81, 347
diabetes mellitus ........................ 338
hypercalcemia .............81, 178, 229,
347, 353
Porphyria .......79, 115, 132, 309, 357, 365,
371–372, 420–421
Porphyria cutanea tarda ...... 365, 372, 421
Portal hypertension.... 12, 14, 60, 133–135,
137, 164, 206, 278
Portal vein thrombosis ........................136
Portopulmonary hypertension ............134
Poser criteria........................................308
Poser criteria for multiple sclerosis......308
Positive predictive value .....................417
Posterior infarction ............................... 30

Posterior pituitary deficiency...............347
Post nasal drip ...................................1, 12
Postpartum thyroiditis................. 344, 414
Post-test probability ............................417
Post transfusion purpura (PTP)............162
Post transplant lymphoproliferative
disorders (PTLD) ................... 174, 177
Postural proteinuria.............................. 75
Power of attorney........................ 378, 390
Precordial examination......................... 44
Preeclampsia ............. 152, 409–410, 412,
414–415
Pregnancy........... 8–10, 19, 30, 34, 39, 42,
45, 51, 58, 60, 70, 102, 105, 111, 115,
128, 138, 151–152, 156–159, 187, 192,
218, 221, 244–246, 251–252, 261,
270–271, 280, 292, 311, 328, 337,
345–346, 356–357, 366–367,
409–415
Pre-operative workup..........................196
Pre-test probability..........................8, 417
Priapism...............................................147
Primary biliary cirrhosis (PBC).............128,
132–133, 138, 148, 281, 343, 354, 361
Primary CNS lymphoma .............. 174, 176
Primary sclerosing cholangitis (PSC) ... 121,
128, 132, 138–140, 223, 283
Primitive reflexes ................. 304, 378–379
Proctitis........................................121–122
Progesterone challenge test................. 357

Prognostication ..................... 211, 400–401
Prolactinoma ............... 346–347, 356–357
Prolonged QT interval .........................352
Prolymphocytic leukemia ....................170
Prophylaxis
asplenic patients................. 147–148
hepatitis B....................239, 261, 269

HIV .......................259, 261, 269–270
neisseria meningitides........ 152, 269
traveler ....................... 239–240, 270
Proprioception changes...... 246, 306, 308,
315, 320, 382, 405
Prostate cancer........... 210–211, 220, 222,
224, 228, 383, 400
Prostate specific antigen (PSA)...........158,
210–212, 219–220, 222, 353, 398
Prosthetic joint infections....................250
Protease inhibitor (PI)............ 5, 252, 261,
269, 337
Proteinuria.......... 57–59, 70–76, 179, 187,
208, 227, 240, 279–280, 337, 340, 409,
420–421
Pruritus ..........73, 132, 138–139, 143, 165,
172, 174, 203–204, 235, 239, 361, 363,
392, 411–412
Pseudo-exacerbation ...........................308
multiple sclerosis ........................ 308
Pseudogout ......................... 273–277, 282
Pseudomembranous colitis .................123

Pseudomonas ......... 5–7, 12, 97, 234, 236,
241, 247, 253, 258, 273
Pseudo-renal failure ............................. 69
Pseudotumor cerebri... 243, 313–314, 403
Psoriasis vulgaris..........................362–363
Psoriatic arthritis (PA) ......... 11, 19, 20, 32,
98, 273, 275–277, 282–284, 304,
363, 409
Ptosis ............. 14, 189, 304–306, 318–319
Pulmonary embolism (PE) .... 1, 3–4, 8–12,
15, 19, 21, 23, 25–26, 28, 33, 37–38,
40, 42–44, 53, 64, 92–93, 97, 143, 156,
157–161, 279, 300, 312, 394, 410,
425–426
Pulmonary eosinophilia.......................149
Pulmonary function test ... 2, 5, 21–23, 424
Pulmonary hypertension .......... 3–4, 8, 12,
14–17, 21, 23, 25, 33, 35, 37, 43–44,
49–52, 92, 98, 134, 147, 158, 279, 281,
312, 394, 403, 411
Pulmonary regurgitation ... 45–47, 49, 201
Pulse ............15, 25, 34, 36, 38, 40, 43–44,
46–47, 49–50, 55–56, 72, 90–91, 104,
118–120, 180, 289–290, 312, 368
irregularly irregular....................... 43
Pulseless disease..................................289
Pulse pressure ............... 36, 43, 46–47, 49
wide........................................ 43, 49
Pulsus alternans.................................... 43
Pulsus paradoxus............... 1, 3, 32–33, 43

Pyelonephritis......... 68–69, 111, 115, 178,
207, 244–245, 269, 284, 412
Pyoderma gangrenosum ....121, 276–277,
282–283, 367–368
Pyridoxine deficiency ..........................126

Q
Q fever................... 52, 233, 235, 238–239
QT prolongation ............ 42, 168, 302, 392