Siegenthaler, Differential Diagnosis in Internal Medicine (ISBN9783131421418), © 2007 Georg Thieme Verlag Index

Index

Notes: Please note that entries in bold and italics represent tables and figures respectively

A parapharyngeal space, 479 acromegaly, 81, 82, 743−744 acute renal failure (ARF), 852−857 spleen, 151 hands, 90 angiography, 854 Abciximab, thrombocytopenia, teeth, 212 hypertension, 738 causes, 853 459 tuberculous paravertebral, skin changes, 66 classification, 852 abdomen 597−599 ACTH-dependent Cushing definition, 852 acute see acute abdomen absolute pupillary areflexia, 97 syndrome, 742 diagnostic procedure, 855−857 angina, mesenteric infarction, Abt−Letterer−Siwe disease, 445 ACTH-independent Cushing blood analysis, 856 266 Acanthamoeba infection, syndrome, 742−743 glomerular filtration rate, 855 blood vessels, polyarteritis meningitis, 135 Actinomyces infection see main laboratory nodosa, 179 acanthocytes actinomycosis investigations, 856 pain see abdominal pain liver cirrhosis, 398 Actinomyces israelii, 131 physical examination, physical examination, 30−31 urinary sediment analysis, 847, actinomycosis, 71, 526 855−856 pleural effusion, 248 848 neck swelling, 131 radiologic examinations, 857 ultrasound, secondary acanthocytosis, 417 activated partial thromboplastin renal biopsy, 857 hypertension, 733 acanthosis nigricans, 55, 55 time (aPTT), 452, 1052−1053 urinalysis, 856 abdominal organs, nervous accelerated junctional rhythms, acute abdomen, 257−259 differential diagnosis, 855, system, 256 719 causes, 257, 257−258 855−857 abdominal pain acetaminophen chronic renal failure, 861 acute tubular necrosis vs., acute, 257−273 analgesic nephropathy, 880 clinical features, 257 856 cholelithiasis, 766 coma, 1007 complications, 258 chronic vs., 864 unclear etiology see acute acetoacetic acid, normochloremic definition, 257 history and clinical abdomen metabolic acidosis, 920 differential diagnosis, 259 examination, 855 bile ducts and liver, 286−289 acetylsalicylic acid, coma, 1007 extraabdominal pain vs., 258, acute respiratory distress causes, 265 achalasia, 804−806 265 syndrome (ARDS), 152, 536 chronic recurring, 275 achlorhydria, chronic atrophic ketoacidotic coma, 1002 aspiration of acidic gastric colic see colic gastritis, 403 acute confusional states, 990, 991 content, 529, 530 colon, 284−285 achondroplasia, 83, 84 causes, 994 respiratory acidosis, 926 differential diagnosis, 256, 259 acid−base balance, 1017−1019 pathophysiology, 989−990 acute tubular necrosis (ATN), 854 acute abdomen, 258 disturbances see acid−base acute coronary syndrome (ACS), acute renal failure vs., 856 right hypogastric and disturbances 234−240 ischemia, 854 midabdominal region, 289 indication, 1017 biochemical markers, 238−239 prerenal kidney failure, 852 diffuse, 259 influencing factors, 1017 classification, 234, 234 toxins, 854 emergency surgery indications, normal, 915 enzymes involved, 238−239 urinary sediment patterns, 851 258 regulation, levels of, 915−916 spectrum, 234, 234 acute tubulointerstitial nephritis epigastric renal compensation, 916 ST segment elevation (STEMI), and uveitis syndrome, 880 differential diagnosis, 259 respiratory compensation, 916 235−237, 237 adamantinoma, 361 diurnal rhythm, 274 acid−base disturbances, 862, clinical features, 236 Adams−Stokes syncope, 717 ketoacidotic coma, 1002 915−928 ECG, 236−237 ADAMTS-13 deficiency, 416 localization and radiation, analysis, 927, 927 pain radiation, 236 Addison disease 274 parameters, 919 without ST segment elevation anemia, 410 long-term, 274 clinical features, 919 (non-STEMI), 234−235, 235 causes, 752 nutrition dependence, 274 compensatory responses, 915, see also myocardial infarction common symptoms, 752 periodic occurrence, 274 917 (MI); myocardial ischemia crisis, 193, 752 position and movement complex disorders, 917−919, acute lymphocytic leukemia differential diagnosis, 752 dependence, 274 918 (ALL), 423, 424 hypotension, 751−752, 753 fever, 149−151 evaluation nomogram, 918 classification, 423, 424 skin pigmentation, 54, 66, 752 intoxication, 268−273 physiologic principles, 915−917 incidence, 423 Addisonian crisis, 193, 752 left hypochondriac, 259 simple disorders, 917 acute myelogenous leukemia adenocarcinoma positive predictive value, 11 symptoms and signs, 919 (AML), 423−428, 425, 427 colon, 469 postprandial systematic analysis, 927 chromosomal aberration, 425 cystadenocarcinoma, 296 chronic pancreatitis, 293 types, 927 classification, 424−425 esophagus, 802 ischemic colitis, 815 see also acidosis; alkalosis; FAB classification, 426 gastric, 802 stomach and small intestine, specific diseases/disorders World Health Organization small bowel, 817 274−284 acid−base metabolism, 915 classifications, 425, 429 thrombosis, 469 systemic diseases, 268−273 acidosis, 917−928 clinical symptoms, 423 adenoid cystic cancer, 592 umbilical, 259 definition, 915−922, 917 diagnosis, 424 adenomas vascular causes, 266−267 lactic see lactic acidosis incidence, 423 adenoma sebaceum, 69, 70 visceral vs. somatic pain, 256 metabolic see metabolic as secondary neoplasia, colorectal see colorectal polyps abdominal situs solitus, central acidosis 426−428 cystadenoma, 296 cyanosis, 684 opportunistic fungal infections, alkylating agent related, 428 liver, 795 abdominal vessels, polyarteritis 168 radiotherapy related, 428 pancreatic b-cells, 1001 nodosa, 179 acoustic neuroma, 98 topoisomerase-II parathyroid gland, 375 abducens nerve (VI), paresis, 960 acral enlargement, 743 inhibitor-related, 428 parotid gland, 481 abscesses acral ulceration, diabetic sweet syndrome, 67 pulmonary, 561 brain, 137, 208, 999 microangiopathy, 326 acute myelomonocytic leukemia, salivary gland, 481 epidural, 138, 302 acrocyanosis, 326, 708 426, 427 toxic thyroid, 486, 487 intra-abdominal, 150 acrodermatitis chronica acute myocardial infarction (AMI) adenoma sebaceum, 70 kidney, 883, 883 atrophicans, 57, 386 bradyarrhythmias, 719 tuberous sclerosis, 69 liver, 146, 151, 796 inflammatory edema, 389 coronary angiography, 234 adenomatous polyposis colic lung see pulmonary acrodermatitis papulosa eruptiva, differential diagnosis, 239 (APC) gene, colorectal diseases/disorders 767 enzyme release pattern, 238 carcinoma, 819 pancreatic, 151 non-STEMI, 234 adenomatous sigmoid polyp, 819 1069

adenosine diphosphate (ADP), hypoglycemia, 1002 Alport syndrome, 866 anaerobic threshold, platelet inhibition, 450 lactic acidosis, 921, 1004 clinical manifestations, 877 spiroergometry, 627 adenovirus infection liver diseases, 778−779 hematuria, 876−877 analgesics common cold, 140 cirrhosis see liver cirrhosis Alström disease, 86 abuse syndrome, 880, 880, 881 pneumonia, 536 hepatitis see hepatitis alternating pulse, 610 coma, 1007 adhesive capsulitis, skin color, 53, 91 aluminum hydroxide, iron nephropathy, 880−881 periarthropathia alcoholic fatty liver, 778 malabsorption, 402 see also specific drugs/drug types humeroscapularis, 353 aldosterone, 908 aluminum intoxication Anaplasma phagocytophilium, 158 Adie syndrome, 97 laboratory parameters, chronic renal failure, 861 anasarca, 611 adiposogenital dystrophy, 86 1020−1021 microcytic anemia, 404 ANCAs see antineutrophilic adrenal gland tumors steroid biosynthesis, 908 alveolar-arterial PO2, respiratory cytoplasmic autoantibodies cortical tumors, virilization, 73 aldosteronism failure, 497 (ANCAs) hereditary forms, 743 familial type I, 739 alveolar cell carcinoma, 561, 562 anemia incidentaloma, Cushing primary, 738−739 alveolar echinococcosis, 151, 796 acquired hypothyroidism, 489 syndrome, 742 volume expansion, 900 alveolar edema, cardiac dyspnea, acute leukemia, 422 adrenal insufficiency secondary, mineralocorticoid 500 alcohol-induced hepatitis, 779 coma due to, 1004 hypertension, 738 alveolar hemorrhage, analgesic nephropathy, 881 diarrhea, 825 alertness, 988, 989 Goodpasture syndrome, 874 aplastic, 410−411 hypotension, 751−752 aleukemic leukemias, 199 alveolar hyperventilation, cardiac dyspnea, 618 primary see Addison disease algodystrophy syndromes, bronchial asthma, 507 classification, 397 adrenocortical crisis, 752 305−306 alveolar hypoventilation, 496 colonic carcinoma, 818 adrenocortical hormones, 751 differential diagnosis, 306 respiratory acidosis, 926 Crohn disease, 816 see also specific hormones algorithms, diagnosis and, 4 alveolar hypoxia, respiratory definition, 396 adrenocorticotropic hormone pulmonary hypertension, 639 failure, 497 dyspnea, 501 (ACTH) Quick prothrombin time, 452 alveolar pulmonary edema, 622, hemolytic see hemolytic Addison disease, 752 aliphatic hydrocarbons, coma, 630 anemia Cushing syndrome, 740 1008 AMA see antimitochondrial high output heart failure, 655 fasting hypoglycemia, 1001 alkaline phosphatase (AP) antibodies (AMA) hyporegenerative hypoglycemia, 1002 bone metabolism, 356 Amanita phalloides, diarrhea, 812 normochromic normocytic, hypotension, 753−755 cholestasis, 768 Amblyomma americanum, 158 409−412 pituitary insufficiency, 1004 extrahepatic cholestasis, 793 amebiasis iron deficiency see adult still disease, 339 Paget disease, 367 abscesses iron deficiency anemia adult T-cell leukemia, 441 alkaline reflux gastropathy, 284 hepatic, 146, 151 laboratory techniques, 396 adult T-cell lymphoma, 441 alkali tablets, metabolic alkalosis, pulmonary, 574 macrocytic normochromic see adventitious sounds, 29, 30, 582 924 diarrheal disease, 811 macrocytic normochromic adynamiamyalgia, 1010 alkalosis, 917−919, 917−928 amenorrhea, 37−38 anemia adynamia, primary adrenocortical definition, 917, 922−928 anorexia nervosa, 755 malassimilation, 821 insufficiency, 751 metabolic see metabolic causes, 38 megaloblastic, skin changes, 68 adynamic bone disease, 861 alkalosis definition, 37 microcytic hypochromic see chronic renal failure, 860 posthypercapnic, 924 Graves disease, 485 microcytic hypochromic aerolysin, paroxysmal nocturnal alkaptonuria, 347 American Rheumatism anemia hemoglobinuria, 415 skin presentation, 65 Association (ARA), systemic multiple myeloma, 443 African tick-bite fever, 121 alkylating agents, acute lupus erythematosus, 182 normochromic normocytic African trypanosomosis, 175 myelogenous leukemia, 428 amino acid metabolism, skin diagnostic strategy, 412 afterload mismatch, 635 Allen test, peripheral artery changes, 65 renal insufficiency, 859 agammaglobulinemia, 189, 190 disease, 317 aminoglycosides, acute renal pernicious see pernicious electrophoresis, 189 allergic alveolitis, 145 failure, 855 anemia agastric syndrome, 284 allergic asthma, differential d-aminolevulinic acid (ALA), posthemorrhagic, 409 age distribution, 12, 12 diagnosis, 507 acute intermittent porphyria, renal insufficiency, 859 aggression, ischemic stroke, 997 allergic bronchopulmonary 270 sideroachrestic, 405 agranulocytosis, 198, 199 aspergillosis (ABPA), 516, 537, aminorex, pulmonary sideroblastic, 400 Ahlbäck disease, 366 538, 539, 540, 546−547 hypertension, 638−639 skin color, 53, 54 AIDS, 163−166 bronchocentric granulomatosis, aminotransferases, laboratory tuberculosis, 144 herpes genitalis, 166 571 parameters, 1022−1023 Waldenström disease, 444 Kaposi sarcoma, 166 allergic bronchopulmonary amiodarone see also specific causes see also HIV infection mycetoma, 539 pneumotoxicity, ‘amiodarone aneurysmal bone cyst, 362−363 air pollutants, bronchitis, 510 allergic edema, 389 lung,’ 550 aneurysms airway obstruction, pulmonary allergic gastritis, acute gastritis toxic multinodular goiter, 487 aorta see aortic aneurysm cyanosis, 707 vs., 275 ammonia, laboratory parameters, arteriovenous, 572, 572 airway resistance, 497 allergic granulomatosis, 180, 547 1023−1024 false (pseudoaneurysms), 240, akinetic-astatic seizure, 983 allergic leukopenia, 198 ammoniogensis, 916−917 323 akinetic mutism, 990 allergies/allergic disease, 22 ammonium production, chronic mycotic, 156 alanine aminotransferase (ALT), abdominal pain, 272 renal failure, 862 peripheral artery, 322−324 1022−1023 fever, 195 amnesia, transient global, 991 saccular, 322−323, 323 acute coronary syndrome, 239 skin manifestations, 195 amnestic aphasia, 101 angiitis, 547, 548 hepatocellular damage, 768 skin tests, 508 clinical features, 101 iatrogenic arterial disease, 320 Albers−Schönberg disease, 363 see also specific amnestic episode, 991 angina coerulea, 224 Albright osteodystrophy, 932 allergies/diseases amorphous urates, urinary angina pectoris, 221−240 Albright syndrome, 55 allergy tests, bronchial asthma, sediment, 850 aortic stenosis, 640 albumin 508 amphetamines, hypertension, 746 clinical characteristics, 222−223 glomerular proteinuria, 844 alloimmune hemolytic anemia, amylase concentric hypertrophy, 634 hypoproteinemic edema, 383 414 acute pancreatitis, 292 definitions, 221−222 laboratory parameters, 1019 alopecia, 72−73 chronic pancreatitis, 296 differential diagnosis, 220, proteinuria, 843, 845, 868 systemic lupus erythematosus, laboratory parameters, 1024 222−223 albuminuria, 843 181 pancreatic disease, 290 exercise, 230−231 classification, 845 alopecia areata, 72, 72 amyloidosis, 444 left ventricular hypertrophy, nephrotic syndrome, 868 alopecia areolaris luetica, 73, 73 primary, 347, 666 secondary to, 223−224 alcohol abuse, 12 alopecia neoplastica, 72 restrictive cardiomyopathy, 666 myocardial ischemia, 224−240

atherosclerosis risk, 226 a1-antitrypsin deficiency, 514, 789 secondary, 666 percutaneous coronary coma, 1007−1008 pulmonary emphysema, 513, amyloid, vessel wall infiltration, interventions, following, 224 dilated cardiomyopathy, 513 465 post-myocardial infarction, 669−670 a-fetoprotein (AFP) ANA see antinuclear antibodies 239−240 folic acid deficiency, 408 laboratory parameters, 1022 (ANA) 1070 hypertension, 746 liver tumors, 769

pulmonary hypertension, 636 anticholinergics, coma, 1007 anterior spinal artery apnea, 4 radiation of pain, 222, 222 antidepressants, coma, 1007 syndrome, 302 assessment, 505

renal insufficiency, 859 antidiuretic hormone (ADH), 40 differential diagnosis, 220 apoA-IMILANO,227 restrictive cardiomyopathy, 666 euvolemic hyponatremia, 903 differential diagnosis, acute apolipoproteins special forms, 223−224 anti-endomysial antibodies, celiac myocardial infarction, 239 metabolism, 230 stable, 222, 225−234 disease, 822 pain, 222, 267 structure and function, 227 coronary angiography, 234 antiepileptic drugs, folic acid post-myocardial infarction, 239 appendicitis, acute, 263 stress echocardiography, 231 deficiency, 408 transesophageal appetite problems, 37 typical, 221 anti-GBM antibodies echocardiography, 626 Addison disease, 752 angiodysplasia Goodpasture syndrome, 875 aortic ectasia, 649 see also anorexia colon, aortic stenosis, 640 renal abnormalities, 839 aortic ejection click, tetralogy of arbovirus infections, 163 congenital, 324, 324, 386, 389 anti-heparin-PF4 antibodies, 469 Fallot, 685 encephalitis, as cause of, 136, hand, 80 anti-hepatitis A virus antibodies, aortic insufficiency 136−137 angioedema, 63, 191, 389−390 773 acute, 644−646 fever, 163 angiofollicular lymph node anti-HEV antibodies, 777 causes, 645−646 arcus lipoides, 96 hyperplasia, 129−130 anti-histone antibodies, systemic chronic vs., 646 dyslipoproteinemia, 227 angiography, 317−318 lupus erythematosus, 183 clinical features, 645 hypercholesterolemia, 228 coronary, 627 antihypertensives, orthostatic pathophysiology, 644 Argyll Robertson pupils, 96, 97 left ventricular isolated hypotension, 757 special studies, 645 arms noncompaction, 670 antimitochondrial antibodies symptoms and signs, 645 arm vein thrombosis, 330−331 myocardial ischemia, 233, (AMA) cardiogenic shock, 633 Paget−Schrötter syndrome, 234 liver disease, 770 chest radiograph, 648 330 stenosis, 231 primary biliary cirrhosis, 792 chronic, 646−649 phlebography, 330 unstable angina pectoris, 234 antineutrophilic cytoplasmic acute vs., 646 bilateral neurogenic pain, liver, 771 autoantibodies (ANCAs), 176 causes and differential 310−311 portal system, 785, 786 Goodpasture syndrome, 875 diagnosis, 649 Lyme borreliosis, 311 phonoangiogram, 316 laboratory parameters, chest radiograph, 620 neurogenic pain, 306−308 Raynaud phenomenon, 325, 1025−1026 clinical features, 646 polyneuropathy, 311 325 polyarteritis nodosa, 179 occurrence, 646 radicular arm pain, 304 renal, 736, 737 antinuclear antibodies (ANA) signs, 646−647, 647 restless arms syndrome, 311 acute renal failure, 854 laboratory parameters, 1026 special studies, 647−649 unilateral pain, 306 see also specific techniques liver disease, 770, 778 volume overload, 644 Horner syndrome, 307 angioimmunoblastic systemic lupus erythematosus, Doppler echocardiography, 648 neurogenic, 306−308 lymphadenopathy, 441 183 schematic representation, 647 Phalen test, 308 angiokeratoma corporis diffusum, antinuclear factors, renal thrill, 612 plexus lesions, 306−307 65 abnormalities, 839 aortic root changes, aortic radicular syndromes, 306 angiokeratomas anti-phospholipid antibodies, 327 dissection, 244 sensory neuropathies, 308 restrictive cardiomyopathy, 667 anti-phospholipid antibody aortic sclerosis arm vein thrombosis, 330−331 vessel wall, 465 syndrome (APS), 468, 564 murmur, 616 arrhythmias, 45 angioneurotic edema, 390 systemic lupus erythematosus, systolic hypertension, 745 acute coronary syndrome with angiopathy, obliterative, 815 183 aortic stenosis, 640−642 ST elevation, 236 angioplastic sarcoma, secondary antiplatelet antibodies, idiopathic chest radiograph, 620 chest pain, 243 lymphedema, 388 thrombocytopenic purpura, 459 clinical features, 640−642 differential diagnosis, 220, Angiostrongylus cantonensis, 135 antipyretics, coma, 1007 differential diagnosis, 220 714−715 angiotensin II, volume regulation, anti-smooth muscle antibodies etiology and pathogenesis, 640 clinical examination, 714−715 898 (SMA), liver disease, 770 murmur, 616 diagnosis tools, 715 animal bites/scratches, 161 anti-thyroglobulin antibodies operative treatment, indications ECG, 715 animal excretion, contact with, (Tg-Ab), 484 for, 642 medical history, 714 161 anti-thyroid autoantibodies, 484 schematic representation, 641 focal, carotid sinus massage, anion gap, laboratory parameters, Graves disease, 485 special studies, 642, 643 715 1025 secondary hypothyroidism, 489 syncope, 978 Lyme disease, 157 anismus, 832, 832 toxic multinodular goiter, 488 thrill, 612 origin, 714 anisocoria, 96 anti-thyroid peroxidase aortic valve see also specific types anisocytosis, pernicious anemia, antibodies (TPO-Ab), 484 bicuspid, 649 arrhythmogenic right ventricular 407 anti-thyroid stimulating hormone closure delay, 613 cardiomyopathy (ARVC), 670, ankylosing spondylitis, 341, 342 receptor blocking antibodies defects, 642 671 chronic aortic insufficiency, 649 (TSB-Ab), 484 aortography, 649 arsenic intoxication, diarrhea, 812 spinal deformities, 341 anti-tumor necrosis factor aorto-iliac steal syndrome, 266, arterial blood gases ankylosis therapy, 168 815 acid−base disorders, 917 Bekhterev disease, 341 anuria, 842 aortopulmonary connections, bronchial asthma, 507 rheumatoid arthritis, 338−339 anxiety, chest pain, 220, 222 698−699 arterial bruits, Takayasu arteritis, Ann Arbor classification, Hodgkin aorta congenital vs. acquired, 698 320 disease, 437, 438 auscultation, peripheral artery aortopulmonary shunts arterial disorders, 314−326 anorectum disease, 315 surgical, 698 aneurysms of peripheral function disorders, 832 claudication, 314 tetralogy of Fallot, 685 arteries, 322−324 chronic constipation, 830 coarctation of, 745, 745 apex beat, 612 arterial occlusive disease, venereal diseases of, 814 murmur, 616 aortic stenosis, 640−642 314−322 anorexia, 89, 89, 755 configuration, 621 aphasia, 100−102 claudication, elderly patients, causes, 37 regurgitation, hypertension, 745 causes, 101 315 venous congestion, 609 see also entries beginning clinical features, 101 emboli, 322, 322, 980 see also weight loss aorto-/aortic global, 101−102, 102 functional vascular disease, anorexia nervosa, 89, 89, 755 aortic aneurysm, 243, 266−267, clinical features, 101 324−326 anterior spinal artery syndrome, 267 aphonia, 102 hypertension see hypertension 302 palpation, 267 aphthae, oral cavity, 77 hypertonia, 213 anteroseptal myocardial Takayasu arteritis, 320 aphthous lesions, acute HIV hypotension, Raynaud infarction, ECG changes, 238 aortic arch infection, 163 phenomenon, 325 anthrax, 120, 143 central cyanosis, 684 apical vessel distension, lymphatic vessel disorders, 333 anthrax pneumonia, 528 common arterial trunk, 686 pulmonary congestion, microthrombosis, antiarrhythmic therapy, atrial Takayasu arteritis, 320 621−622 myeloproliferative diseases, flutter, 722 tetralogy of Fallot, 686 aplasia, thrombocytopenia, 460 468 antibiotic-associated diarrhea, 811 aortic arch syndrome, 980 aplastic anemia, 410−411 microvascular disease, 326−328 antibodies against cytoplasmic aortic dissection, 244−245 aplastic bone disease, chronic narrowing, iatrogenic arterial elements of granulocytes acute aortic endocarditis, 645 renal failure, 860 disease, 320 (ANCA), 839 1071

occlusive, 314−322 ascending aorta dissection, 244, aortic dissection, 245 atrioventricular concordance and definition and classification, 244 cardiac dyspnea, 610 ventriculoarterial discordance 314 ascending reticular activating chronic process, 225 (complete TGA), 690, 692, 693 diagnosis, 315−318 system (ARAS), 988 renal artery stenosis, 736, 736 atrioventricular conduction epidemiology, 314 consciousness, disturbances of, risk factors, 225, 225 atrial flutter, 722 functional tests, 316−317 951 see also myocardial infarction transposition of great arteries, iatrogenic arterial disease, dysfunction, 989 (MI); myocardial ischemia corrected, 694 320 transient dysfunction, 998 atopic dermatitis, eczema atrioventricular fistulas, 655 physical examination, vigilance, 988 herpeticum, 58 atrioventricular nodal reentrant 315−316 ascites, 783−784 atransferrinemia, 404 tachycardia, 724−725 popliteal entrapment analysis, 784 atrial congestion, 655 ECG presentation, 724 syndrome, 321 Budd−Chiari syndrome, 784, atrial fibrillation, 723−724 medical history, 714 symptoms, 314−315 790 aortic stenosis, 640 syncope, 978 see also emboli/embolism; cardiac dyspnea, 611 atrioventricular blocks, 717 atrioventricular reentrant thrombosis causes, 783 cardiac dyspnea, 610 tachycardia with antegrade punctures, iatrogenic arterial differential diagnosis, 784 causes, 724 conduction disease, 320 jaundice, 766 chronic mitral insufficiency, accessory pathway, 726 restless legs, 334 malignant, 784 650 atrioventricular nodal, 725, 725 stenosis pancreatic cysts, 295 classification, 724 differential diagnosis, 726 arterial occlusive disease, 315 portal hypertension, 787 clinical examination, 714 atrioventricular septal defect phonoangiogram, 316 aseptic meningitis, encephalitis, ECG presentation, 724 (AVSD), 694−695, 695 thoracic outlet syndrome, 136 embolism, 322 Down syndrome, 696 333 aspartate aminotransferase (AST) syncope, 978 Atropa belladonna, coma, 1007 Sudeck disease, 334 acute coronary syndrome, 239 tachycardia-induced atrophic gastritis, chronic, 403 thoracic outlet syndrome, hepatocellular damage, 768 cardiomyopathy, 674 atrophic papulosis, malignant, 333−334 laboratory parameters, atrial flutter, 722−723 272 see also specific 1022−1023 atrioventricular blocks, 717 atrophie blanche, 333 diseases/disorders aspergilloma, 574 atrioventricular conduction, atrophy of the tongue, 78 arterial stimulation and venous aspergillosis, 169, 537, 538, 539, 722 attention, examination of, 992 sampling (ASVS), fasting 540, 546−547 ECG presentation, 723 atypical angina, definition, 221 hypoglycemia, 1001 aspergilloma, 574 atrial myxoma, 543, 658−659, 659 atypical aortic dissection, 244 arteries disseminated, 169 embolism, 322 atypical pneumonia, 141−142 angiography, 317−318 Aspergillus flavus, 169 murmur, 618 aura, focal seizures, 983 baroreceptors, 896 Aspergillus fumigatus, 169 atrial natriuretic peptide (ANP) auricolotemporal neuralgia, 217 see also entries beginning asphyxia, hemoptysis, 495 cardiac dyspnea, 607 auricular tophus, 345, 346 arterio-/arterial; specific aspiration paroxysmal supraventricular auscultation, 27, 29−30, 30 arteries pericardial effusion, 242 tachycardia, 714 acute abdomen, 257 arterio-arterial embolism, 322 pulmonary abscess, 573−574 volume regulation, 898 acute aortic insufficiency, 645 arterio-arterial microemboli, 980 aspiration pneumonia, 141, atrial septal defect (ASD), acute coronary syndrome with arteriosclerosis, 16 528−529, 573 702−704 ST elevation, 236 obliterating, 319 aspirin, acquired central cyanosis, 683 arterial hypertension, 635 arteriosclerotic plaque rupture thrombocytopathies, 457 Ebstein anomaly, 706, 707 arterial occlusive disease, 315 angina pectoris, 225 asthma heart sounds, 614 atrial septal defect, 704 obliterating arteriosclerosis, 319 bronchial, 506−509 pathophysiology and bronchiectasis, 514 arteriovenous aneurysms, 572, allergic forms, 506 investigations, 704 Ebstein anomaly, 706 572 allergy tests, 508 pulmonary arterial Eisenmenger syndrome, 702 arteriovenous fistula, 323 chest radiograph, 508 hypertension, 703, 705 hypertrophic cardiomyopathy, arteriovenous shunts definition, 506 secundum, 702 664 Osler−Weber−Rendu disease, diagnosis and clinical tricuspid atresia, 689 idiopathic pulmonary fibrosis, 464 findings, 507−508 atrial tachycardias, 722 551 pulmonary cyanosis, 707 differential diagnosis, 507 ECG presentation, 723 mechanical ileus, 260 arteritis temporalis Horton, 178, dyspnea, 506−509 medical history, 714 pneumococcal pneumonia, 525 178, 211 epidemiology, 507 see also specific types pulmonary congestion, 583 arthralgia, 126 forms, 506 atrial tumors, syncope, 978 pulmonary edema, 630−631 inflammatory disorders and, obstructive ventilatory atrioventricular and pulmonary hypertension, 636 465 defects, 498 ventriculoarterial discordance pulmonary interstitial edema, arthritis, 125−126 pathogenesis, 506 (double discordance), 690 543 bacterial, 125−126 special forms, 508−509 atrioventricular (AV) block, tetralogy of Fallot, 685 pathogens, age-related spirometry, 507 716−718 transposition of great arteries, spectrum, 126 sputum, 508 complete 692, 694 juvenile, 340 cardiac, 501, 605, 609 bradycardia-induced ventricular septal defect, 701 neoplasm associated, 348 paroxysmal nocturnal cardiomyopathy, 674 Austin−Flint murmur, chronic osteoarthritis see osteoarthritis dyspnea, 609 hypertension, 745 aortic insufficiency, 646 rheumatoid see rheumatoid rales, expiratory wheeze, 611 first degree, 716 autoantibodies arthritis eosinophilic infiltrates, 547 atrioventricular septal defect, chronic gastritis, 276 arthritis-dermatitis syndrome, occupational, 509 695 giant cell arteritis, 320 120 psychological aspects, 509 high grade, 717 heparin-induced pustules, 118, 119 severe, Churg−Strauss organic thrombocytopenia, 469 arthritis urica, 345 syndrome, 180 differential diagnosis, 717, liver disease, 770 arthropathies asymmetrical abdomen, 718 spondylarthropathies, 341 cartilage disorders, 348 mechanical ileus, 260 ECG presentation, 718 Takayasu arteritis, 320 endocrine disorders, 348 asymmetrical septal hypertrophy, second degree, 716−717 vasculitis and connective tissue enterocolitis associated, 634 differentiation, 717 disease, 177 343−344 asymmetric diabetic proximal type 1 (Wenckebach), 716, see also autoimmune diseases; metabolic disease associated, neuropathy, 273 717 specific antibodies 345−346 asymptomatic bacteriuria, 151 type 2 (Mobitz), 717 autoantigens, 175−176 neurologic disorders, 348 asymptomatic peritonitis, 264 third degree, 717, 718 autoimmune diseases, 17, 17 see also specific disorders ataxia telangiectasia, 190 vagotonic classification, 176 arthrosis, 16 atelectasis, 574−575, 575, 576, 577 differential diagnosis, 717, fever, 175−187 artifacts, urinary crystals, 850 atherogenic hyperlipidemia, 718 generalized, 176 asbestosis, 560 screening, 34 ECG presentation, 718 localized or organ specific, Ascaris lumbricoides, 794 atherosclerosis organic vs., 717, 718 176 aortic aneurysm, 243 1072

hemolytic anemia, 417 barbiturates choledocholithiasis, 146 blood gases idiopathic thrombocytopenic acute intermittent porphyria, obstruction, 765, 795, 823 cardiac dyspnea, 607 purpura, 459 270 pancreatic carcinoma, 296 pulmonary edema, 631 lymphoid interstitial coma, 1006 strictures, 794 blood glucose pneumonia association, 554 respiratory depression, 1007 see also specific acute pancreatitis, 292 MALT lymphoma, 440 baritosis, 559 diseases/disorders hypoglycemic coma, 999 pure red-cell aplasia, 411 barosinusitis, head/facial pain, bilharzia see schistosomiasis laboratory parameters, 1041 see also autoantibodies; specific 207, 212 biliary cirrhosis meningitis, 131 diseases/disorders Barraquer−Simons syndrome, 87 secondary, 794 screening, 38−39 autoimmune polyendocrinopathy barrel chest, 27 skin discoloration, 53 blood pressure syndrome, 176 Barrett esophagus, 803, 804 biliary colic, abdominal ulcers, measurement, 34 hypotension, 751 Bartonella henselae, 128 277 pituitary insufficiency, 753 automatisms, 999 bartonellosis biliary malaria, 172 see also hypertension; autonomous disturbances, limb exogenous hemolytic anemia, bilirubin hypotension pain, 300 413 albumin binding, displacement blood sedimentation rate, autonomous neuropathy, renal skin infection, 71 from, 763 eosinophilic fasciitis, 186 insufficiency, 860 Bartter syndrome, 755 extrahepatic cholestasis, 793 blood vessel permeability, 452 autosomal dominant inheritance, hypokalemia, 911 impaired glucuronidation, 765 blood volume, body composition, 21−22 metabolic alkalosis, 924 impaired secretion, 765 895 autosomal dominant polycystic basal ganglionic dysarthria, laboratory parameters, ‘blue bloaters,’ 512 kidney disease (ADPKD), 888, Parkinson disease, 102 1027−1028 blue sclerae, 94 888 basilar migraine see migraine metabolism, 763, 764 B lymphocytes, 189 CT scan, 889 Bazin disease, 61 production, elevated, 763 chronic lymphocytic leukemia, autosomal recessive inheritance, B cells see B lymphocytes reduced hepatic storage, 765 430 22 BCR-ABL gene, 430 reduced hepatic uptake, 763 deficiencies, 187, 189 autosomal recessive polycystic Beau−Reil lines, 74 unconjugated, 763 B-mode ultrasound, deep vein kidney disease (ARPKD), 888 Beckwith−Wiedemann syndrome, urine, identification in, thrombosis, 329 avascular necrosis, childhood, 365 79−80 845−846 Bochdalek hernia, 578 avian influenza, 140 Behçet disease, 210, 344 Bing−Horton headache, 215 body fat distribution, 88 axial hyperostosis Bekhterev disease, 85, 341, 342 biopsy body mass index (BMI), 34, 88 diffuse idiopathic skeletal spinal deformities, 341 fine-needle aspiration, 482 pituitary insufficiency, 753 hyperostosis, 346 Bell palsy, 217 kidney body temperature, 17 osteoarthritis, 351 Bence Jones protein, 845 acute renal failure, 857 body weight classification, 86 axillary artery auscultation, multiple myeloma, 441 poststreptococcal Boeck disease see sarcoidosis peripheral artery disease, 315 benign paroxysmal positional glomerulonephritis, 868 bone(s) axillary vein occlusion, 330 vertigo (BPPV), 969 liver, 771 cysts, juvenile, 362 azoospermia, 43 benign proteinuria, 844 pleura, 247 demineralization, rheumatoid azotemia, 901 benign tumors see tumor(s) temporal artery, 178 arthritis, 338 benzodiazepines, 1007 thyroid, 482 generalized changes, 368−376 B Berardinelli−Seip syndrome, 87 Biot respiration, 28 hyperparathyroidism, Berger disease, 876 biventricular heart failure 375−376 Babesia divergens, 158 Bernard−Soulier syndrome (BSS), dilated cardiomyopathy, 669 osteomalacia, 371−374 Babesia microti, 158 457, 458 edema, 382 osteoporosis, 368−371 babesiosis, 158−159 berylliosis, 560 Björk−Shiley valves, heart sounds, Graves disease, 486 Babinski reflex, 994 beta-adrenergic drugs, bronchial 615 infarction, 362 bacillary angiomatosis, 71, 129 asthma, 506 black urine, 842 lesions, tumors vs., 361−363 skin lesions, 119 b-cells see pancreas bladder, palpation, 31 localized changes, 356−367 bacillary dysentery, 148 b-hemolytic streptococci, Blalock−Taussig shunts, tetralogy bone tumors, 356−363 Bacillus anthracis, 120, 528 erythema nodosum, 61 of Fallot, 685 Gaucher disease, 363 Bacillus cereus, 149 bicarbonate blast cells, acute leukemia, 422 hyperostosis, 363−364 bacteremia, 153 as buffer system, 916 bleeding mastocytosis, 363 causative pathogens, 153 chronic renal failure, 862 chronic, anemia, 402 osteonecrosis, 364−366 bacterial infections infusion, metabolic alkalosis, colonic carcinoma, 818 Paget disease, 367 arthritis, 125−126, 126 924 differential diagnosis, mass cellular immune deficiencies, bicycle ergometry, cardiac nonglomerular, 876 maximal, 368 190 dyspnea, 627 hypovolemic hypotension, 757 osteoporosis, 368 endocarditis, 322 Biedl−Bardet syndrome, 83 nonhypertensive, 998 pain see bone pain erythrocyte sedimentation rate, Bielschowski sign, 960 renal insufficiency, 859 remodeling, 367 196 biferious pulse, 610 subarachnoid see subarachnoid hyperparathyroidism, 376 hepatic abscesses, 151 bigeminus, 719 hemorrhage increased, 935 meningitis see meningitis bilateral diaphragmatic paralysis, see also entries beginning tumors see bone tumors multiple myeloma, 442 502 hemorrhage/hemorrhagic see also entries beginning osteo- myocarditis, 672 bilateral exophthalmos, 93 bleeding diathesis bone marrow opportunistic, 168 bilateral hydronephrosis, 884 clinical approach, 453−456 acute leukemia, 422 pericarditis, 243 bilateral neurogenic arm pain, clinical examination, 456 aplastic anemia, 411 pneumonia see pneumonia 310−311 family history, 453 hairy cell leukemia, 431 skin changes due to, 71−72, bilateral neurogenic leg pain, personal history, 454 idiopathic thrombocytopenic 119−120 310−311 clinical examination, 456 purpura, 459 tonsillitis, 138 bilateral ptosis, 993 types, 454 infiltration, anemia, 411 see also specific bilateral pulse palpation, 745 vascular, 463−465 myelodysplastic syndrome, infections/organisms bilateral radicular lesions, 311 see also coagulation disorders 432 bacterioides, sepsis, 154 bilateral radicular syndromes, 311 bleeding heart, 240 polycythemia rubra vera, 434 bad breath, 99, 99−100 bilateral renal disease, 735 blind loop syndrome, 284 thrombocytopenia, 460 Balamuthia mandrillaris, 135 bilateral strokes, 997 blood analysis bone metastases, 356 balanitis erosiva circinata, 68 bilateral vestibulopathy, 971 characteristic findings, 397−399 osteolytic, 357 Balkan nephritis, 882 bile acid malabsorption, 825 renal function, 839 radiculopathy, 304 balloon dilation, stent steatorrhea, 824−825 blood count bone pain implantation, 232 bile acid reflux gastropathy, 284 fever, 198−200 characteristics, 356 balloon enteroscopy, melena, 282 bile duct, 146 normal values, 396 diagnostic assessment, 356 Bamberger−Marie syndrome, 75 carcinoma, skin discoloration, blood cultures, bacteremia, 153 imaging studies, 356 Bannwarth syndrome, 311 53 blood disease see hematologic laboratory tests, 356 cholangitis, 146 disease renal insufficiency, 859

1073

bone tumors, 356−363 bronchiolitis obliterans CA 125 (carbohydrate antigen carbohydrate metabolism, skin cartilage derived, 356−358 organizing pneumonia (BOOP), 125), 35 changes, 65 lesions vs., 361−363 511, 541, 551−553 laboratory parameters, carbonic acid, acid-base malignant, 356 bronchitis, 141, 509−510 1029−1030 metabolism, 915 metastases, 356 acute, 509 cachexia, pituitary insufficiency, carbon monoxide, coma, 1008 osteolytic, 357 chronic, 509−510 753 g-carboxylase, oral radiculopathy, 304 Wegener disease, 873 café-au-lait spots, 54, 69 anticoagulation, 462 nomenclature, 358 clinical findings, 510 fibrous dysplasia, 363 carcinoembryonic antigen (CEA) unknown etiology, 360−361 etiology, 510 calcitonin, thyroid carcinoma, 484 laboratory parameters, 1031 see also specific types pathogenesis, 510 calcium liver tumors, 769−770 Bordetella parapertussis, 141 bronchoalveolar cell carcinoma, excretion, osteomalacia, 373 thyroid carcinoma, 484 Bordetella pertussis, 141 561 homeostasis carcinoid, 592 Bornholm disease, 139−140 bronchoalveolar lavage (BAL) disorders see calcium carcinoid restrictive Borrelia burgdorferi infection see Pneumocystis carinii infection, homeostasis disorders cardiomyopathy, 667 Lyme disease 169 regulation, 929−930 carcinoid syndrome, 826 Borrelia radiculitis, 304 sarcoidosis, 589 laboratory parameters, flushes, 55, 67 Bouchard nodes, osteoarthritis, bronchocentric granulomatosis, 1030−1031 scleroderma, 183 349 571 properties, 928 tricuspid stenosis, 659 Bourneville−Pringle disease, 69 bronchophony, 29 sequestration in bone and carcinoma nose, appearance of, 99 bronchopneumonia, 544 tissue, 933−934 gastric stump, 284 brachialgia paresthetica nocturna, histoplasmosis, 170 calcium-containing stones, 287 leukocytes, 198 308 influenza, 140 nephrolithiasis, 849, 886 nonpapillary, pain, 296 brachialgias, cyanosis, 708 bronchoscopy, 591 calcium homeostasis disorders, ulcerated, 280 bradyarrhythmias, 716−719 hemoptysis, 495 928−937 of unknown primary (CUP acute myocardial infarction, brown urine, 841 causes, 930 syndrome), 480 with, 719 Brucella abortus, 161 clinical features, 930 see also specific types/locations cardiomyopathy induction, 674 Brucella melitensis, 161 definition, 930 cardiac asthma see asthma causes, 716 Brucella suis, 161 diagnosis, 930 cardiac catheterization, 627 origin, 714 brucellosis, 161, 162 fundamental pathogenesis, 931 aortic stenosis, 642 syncope, 976 lymphocytes, 200 physiologic principles, 928−930 chronic aortic insufficiency, 649 see also specific types pneumonia, 527 signs and symptoms, 931 chronic mitral insufficiency, bradycardias see Brugada syndrome, 977 see also hypercalcemia; 652 bradyarrhythmias ECG presentation, 977 hypocalcemia dilated cardiomyopathy, 669 brady-tachycardia syndrome, 716 Brugia malayi, 174 calcium nephrolithiasis, 849, 886 mitral stenosis, 658 brain Brugia timori, 174 calcium oxalate stones, 849, 886 pulmonary edema, 631 abscesses, 208, 999 bubonic plague, 128 calcium phosphate pulmonic stenosis, 644 cerebellum, 137, 999 Budd−Chiari syndrome, 785, 790 chronic renal failure, 862 cardiac chest pain, 221−243 embolism, coma, 995 ascites, 784 homeostasis, 929 cardiac cirrhosis, venous injury, 998 liver swelling, 288 calcium phosphate stones, 886 congestion, 609, 611 see also entries beginning Buerger disease, 13, 319−320 calcium pyrophosphate, joint cardiac cyanosis, 684−706 cerbro-/cerebral; specific bulbar speech, 102 inflammation, 345 aortopulmonary connections, regions bullous diabeticorum, 60 calcium-sensing receptor (CSR), 698−699 brain natriuretic peptide (BNP) bullous emphysema, localized, hypocalcemia, 932 atrial septal defect, 702−704 cardiac dyspnea, 607 513 calciuria, 24-hour urine, 841 atrioventricular septal defect, laboratory parameters, 1028 bullous pemphigoid, 59, 59 calf vein thrombosis, 330 694−695 brainstem, arterial blood supply, bullous skin disease, 59−60 callus formation, osteomalacia, common arterial trunk, 686 957 Burkholderia pseudomallei, 175 374 congenital heart defect: Ebstein branchial cysts, 476 Burkitt lymphoma, 440 caloric testing, 965 anomaly, 704−706 Branhamella catarrhalis burning feet syndrome, 860 Campylobacter infections conotruncal anomalies, 684 pneumonia, 527 burning mouth syndrome, 78 diarrhea, 148 double inlet ventricle, 695−698 Braunwald classification, unstable Buruli ulcers, 120 food poisoning, 811 peripheral, 708 angina pectoris, 225 Buschke syndrome, 184 Canadian Cardivascular Society, pulmonary atresia, 686−687 breast cancer busulfan, pulmonary fibrosis, 550 angina classification, 224−225, tetralogy of Fallot, 684−686 radiation therapy, 541 225 transposition of great arteries, screening, 35 C canalolithiasis, 969 690−694 thoracic pain, 252 cancer tricuspid atresia, 687−690

breathing C1-esterase inhibitor deficiency, bilateral hilar enlargement, ventricular septal defect, difficulty see dyspnea 390 589−590 699−702 disorder assessment, 505 C1 inhibitor deficiency, 191 fever, 115 cardiac death, sudden, 728 see also respiration; specific C3 complement protein mortality rates, 18 arrhythmias responsible, 728 disorders laboratory parameters, pulmonary embolism, 469 hypertrophic cardiomyopathy, breath sounds, 29, 30 1033−1034 thrombophilia, 469 664 brittle bone disease, 371 poststreptococcal venous thromboembolism, 469 cardiac decompensation, causes, Broca aphasia, 101 glomerulonephritis, 867 see also neoplasms; tumor(s); 629 clinical features, 101 Wegener disease, 873 specific cancers cardiac dyspnea, 500−501 bronchial asthma see asthma C3 nephritic factor, 191 candidiasis, 168−169, 537 acute, 605 bronchial carcinoma, 567 C4 complement protein chronic mucocutaneous, 190 auscultation, 501 atelectasis, 575, 575, 576, 577 laboratory parameters, endophthalmitis, 97 chronic, 605 etiology, lifestyle factors, 13 1033−1034 sepsis, 154−155 clinical examination, 605, fever, 194 Wegener disease, 873 stomatitis, HIV infection, 164, 610−618 bronchiectasis, 513−516, 515, 578 C5 radicular syndrome, 306 164, 168 ascites, 611 definition, 513 C6 radicular syndrome, 308 urinary tract infections, 846 heart murmurs, 618 diagnosis, 514 C6 syndrome, 306 cannabinoids, coma, 1006 hepatojugular reflux, 611 etiology and pathogenesis, 514 C7 syndrome, 306 cannon waves, 611 hepatomegaly, 611 hemoptysis, 495 C7 transverse process, 307, 307 capillary rarefication, chronic inspection and palpation, 612 pneumonia associated, 545 C8 syndrome, 306 venous insufficiency, 333 perfusion states, 611 bronchiogenic cysts, 573 CA 15−3 (carbohydrate antigen Caplan syndrome, 558 pitting edema, 611 bronchiole diseases, 510−511 15−3), 1028−1029 Capnocytophaga canimorsus pleural effusion, 611 bronchiolitis CA 19−9 (carbohydrate antigen infection, 163 pulse, 610 acute, 510 19−9), 35−36 petechiae and purpura, 116 rales, expiratory wheeze, influenza, 140 laboratory parameters, 1029 capsule endoscopy, melena, 282 611−612 pneumonia, 511, 541, 551−553 liver tumors, 770 Captopril test, 737 systematic auscultation, 612−613 1074 volume status, 610−611

diagnosis, 501 cauda equina cervical carcinoma chronic aortic insufficiency, 647 differential diagnosis, 501, intermittent claudication, 314 etiology, lifestyle factors, 13 chronic mitral insufficiency, 651 605−608 radiculitis, 311 screening, 35 common arterial trunk, 686 chest radiograph, 605−607 cauliflower nose, 99 cervical lymphadenitis, 477 constrictive pericarditis, 661 ECG, 605 cavernous hemangioma, 796 cervical lymphadenopathy, 138 diagnostic features, 620 history and symptoms, 605 cavernous lung diseases, 573−574 cervical lymph nodes dilated cardiomyopathy, 621, heart failure as cause, 607 see also specific diseases enlargement, 127 622, 669 laboratory tests, 607, 618 cavernous sinus fistula, 212 tuberculosis, 127, 129 double inlet ventricle, 698 pathophysiology, 605 cavernous sinus thrombosis, 212 cervical mass, differential Ebstein anomaly, 706 special studies, 618−627 cavernous transformation, portal diagnosis, 476 Eisenmenger syndrome, 702 cardiac catheterization, 627 hypertension, 785 cervical spine hypersensitivity pneumonitis, chest radiograph, 619−622 CD3, 190 osteoarthritis, 350, 350 556 computed tomography, 626 CD4 lymphocyte count, HIV radiculopathy, 303, 304 idiopathic pulmonary fibrosis, ECG, 618−619 infection, 166 see also neck 551, 552 echocardiography, 622−626 celiac disease, 821−823 cervical tuberculosis, 478, 478 mitral stenosis, 657 magnetic resonance imaging, clinical features, 822 cervicocephalic syndrome, 212 nonspecific interstitial 626 diagnosis, 822−823 cervicogenic headache, 212 pneumonia, 551, 553 stress testing, 627 differential diagnosis, 822 Chagas disease, 175 pulmonary hypertension, 637, cardiac hypotension, 750 folic acid deficiency, 409 achalasia, 804 637 cardiac malaria, 172 histology, 823 dilated cardiomyopathy, 669 pulmonic stenosis, 644 cardiac output, hypertension, 745 pathogenesis, 821−822 Charcot−Leyden crystals, restrictive cardiomyopathy, 666 cardiac syncope, 975, 976−977 vitamin B12 deficiency, 407 bronchial asthma, 508 tetralogy of Fallot, 686 cardiac X syndrome, 224 cellular immunodeficiency, 168, Charcot triad, cholangitis, 794 transposition of great arteries, cardinal symptoms, 6 187, 190 Chatterje phenomenon, 243 694 cardiogenic shock, 632−633 cellulitis, 388 checkup, asymptomatic patients, tricuspid insufficiency, 653 acute heart failure, 628 central cyanosis, 680, 682−707 33, 33−37 ventricular septal defect, ischemic colitis, 815 causes, 682 Chediak−Higashi syndrome, 457, 701−702 cardiomyopathy clinical examination, 682−683 458 volume homeostasis disorders, definition and classification, definition, 678 cheilosis, iron deficiency, 404 899 661−662, 662 diagnostic studies, 683−684 cheiralgia paresthetica, 308 chest wall pain, angina pectoris, hereditary hemochromatosis, Eisenmenger syndrome, 702 chemical irritants, asthma, 509 223 788 etiologies, 682 chemical pneumonitis, 540−541 Cheyne−Stokes respiration, 28, schematic representation, 662 palpation and auscultation, 683 chemical urine analysis, 843, 503, 992, 993 cardiopericardial silhouette, 242 tetralogy of Fallot, 685 843−847 cardiac dyspnea, 501, 609 cardiophrenic angle opacities, 578 central facial pain, 217 chemotaxis dysfunction, 191 polysomnography, 504 cardiothoracic ratio, 619, 619 central limb pain, characteristics, chemotherapy, hemolytic anemia, chickenpox, 58, 122 cardiovascular disease 300 416 Chilaiditi syndrome, 289, 289 dyspnea, 496 central nervous system (CNS) chest diseases, abdominal pain, childhood cough, 494 lipid profile, 1048−1050 diffuse coma, 995−996 272 Child−Pugh classification, liver risk assessment, 734 diffuse lesions, 995−996 chest pain cirrhosis, 783 cardiovascular failure, acute focal lesions, 997−999 arrhythmias, 243 chills, 196 abdomen, 258 multifocal lesions, 995−996 cardiac causes, 221−243 Chlamydia infection cardiovascular hypertension, 745 sarcoidosis, 587 differential diagnosis, 220, anorectum, 814 cardiovascular system, physical systemic lupus erythematosus, 220−221 oral, 77 examination, 27 182 ECG, importance, 220 peritonitis, 264 Carney complex syndrome, 743 see also brain; specific functional pneumonia, 141−142, 526, 527 carotenemia, skin discoloration, components angina pectoris vs., 222−223 reactive arthritis, 343 53 central pain syndromes, 301−302 differential diagnosis, 221 urinary tract infections, 882 carotid artery central postural vertigo, heart, originating from, Chlamydia psittaci, 142, 527, 528 auscultation, 315 peripheral positioning vertigo 221−243 Chlamydia trachomatis, 161, 527 dissection, 208, 244 vs., 970 large vessels, originating from, chloride pulse, Takayasu arteritis, 320 central pulse, arrhythmias, 243−245 laboratory parameters, carotid body tumor, 479 714−715 medical history, importance of, 1031−1032 carotid glomus tumors, 980 central sleep apnea syndrome, 220 metabolic alkalosis, 923 carotid sinus massage, 715 503 noncardiac, diffuse esophageal chloride-resistant metabolic junctional rhythms, 719 central vestibular vertigo, dysmotility, 806 alkaloses, 924 procedure, 715 972−973 non-STEMI, 235 chloride-sensitive metabolic wide-complex tachycardias, 725 cerebellar disorder, vertigo, 954 pleura, originating from, alkaloses, 923−924 carotid sinus syndrome, 979 cerebellar dysarthria, 102 245−250 cholangiocarcinoma (CC), 796 carotidynia, 214, 217 cerebellum positive predictive value, 11 cholangitis, 794 carotis artery bifurcation, neck abscess, 137, 999 post-myocardial infarction, bile duct diseases, 146 masses, 479 arterial blood supply, 957 239−240 cholecystectomy, complaints carpal tunnel syndrome, 91, concussion, 998 pulmonary, 220 following, 288 307−308 gigantism, 79 chest, physical examination, cholecystitis, 288 cartilage disorders, arthropathies, cerebral ischemia, 27−30 pancreatitis vs., 146 348 myeloproliferative disease, 468 chest radiographs cholecystolithiasis, 287 case finding, 36 cerebral malaria, 172 acute mitral insufficiency, 649 choledocholithiasis, 793 case report, 6 cerebral seizures, 980−984 aortic insufficiency, 648 bile duct diseases, 146 Castleman disease, 129−130, 590 pathogenesis, 980−981 aortic stenosis, 642 endoscopic papillotomy, 288 chronic lymphadenitis, 479 syncope, 952 aortopulmonary connections, choledochus stones, 287 casts, urinary sediment, 849 see also epilepsy; specific types 699 post cholecystectomy, 288 cataplexy, narcolepsy, 984, 1009 cerebral syncope, 980−985 arterial hypertension, 635 cholelithiasis, 286−287 cataracts, 96 differential diagnosis, 983−984 atrial septal defect, 704 acute abdominal pain, 766 catatonic stupor, 990, 999 cerebral toxoplasmosis, 137 atrioventricular septal defect, associated liver diseases, 288 catecholamines cerebral venous thrombosis, 210 695 chronic pancreatitis, 293 deficiency, hypotension, 755 cerebrospinal fluid (CSF) bronchial asthma, 508 cholera, 149 pheochromocytoma, 739 fever, headache and neck bronchiectasis, 514 cholestasis, 768−769 potassium shifts, 907 stiffness, 131−133 bronchitis, 510 differential diagnosis, 791 sinus tachycardia, 721 leak, head pain, 211 cardiac chamber enlargement, laboratory findings, 768 cation distribution, adult body, cerebrovascular system specific, 619−621 nonobstructive 895 hypertension, 734 cardiac dyspnea, 501, 619−622 conjugated cat-scratch disease, 127, 128 infarction, 970 cardiac size, 619 hyperbilirubinemia, 766 specific lymphadenitis, 478 central cyanosis, 684 differential diagnosis, 791 1075

obstructive chylous lymphedema, 387 acute intermittent porphyria, community acquired pneumonia, conjugated cigarette smoking see tobacco 270 141 hyperbilirubinemia, 766 smoking biliary, abdominal ulcers, 277 community acquired differential diagnosis, 791 ciliary dyskinesia, primary, gastrointestinal staphylococcal infection, 153 cholestatic jaundice, 790−797 515−516 diseases/disorders, 260 compensated cirrhosis, 780 cholesterol circadian rhythms, 14 mechanical ileus, 260 complement proteins dyslipoproteinemia, 226 circulatory shock see shock porphyria, 268 defects, 188, 191 embolism, 322 circulus vitiosus, 935 posture, 85 nephrotic syndrome, 869 rapidly progressive circumscribed scleroderma, 184 renal, 885, 885 poststreptococcal glomerulonephritis, 875 cirrhosis see liver cirrhosis colitis ulcerosa, arthropathy, 343 glomerulonephritis, 867 nephrotic syndrome, 869 Claviceps purpurea, 325 collagen diseases renal abnormalities, 839 serum levels clavicular-costosternal swelling, abdominal pain, 272 see also specific proteins cholestasis, 769 SAPHO syndrome, 344, 344 vasculature see collagen complete atrioventricular block screening, 34 clinical examination, insufficient, vascular diseases see atrioventricular (AV) block stone formation, 286 10 collagen IV complete atrioventricular septal cholesterol stones, 286 clinical interview see medical Alport syndrome, 876 defect (AVSD), 694 cholinesterase (ChE), laboratory history Goodpasture syndrome, 874 complex optomotor deficit parameters, 1032−1033 clinical judgment, 6 collagenosis, 17, 67 syndromes, 962 chondocalcinosis, hypotension, Clonorchis sinensis, 794 collagenous sprue, T-cell complex regional pain syndrome 755 clopidogrel, acquired lymphoma, 822 (CRPS), 305 chondroblastoma, 357 thrombocytopathies, 457 collagen vascular diseases, 320, compression syndromes chondrocalcinosis, 345−346, 346 Clostridium difficile infection 464 peripheral artery aneurysms, axial involvement, 346 antibiotic-associated diarrhea, constrictive bronchiolitis, 510 323 bacterial arthritis, 125 811 interstitial pneumonia radicular, 303 chondrodystrophy, 84 diarrhea, 149 associated with, 554−555, computed tomographic chondromas, 356−357, 569, 595 food poisoning, 811 555 angiography (CTA), 737 chondromyxoid fibroma, 357 Clostridium perfringens infection, pleural effusion, 248 computed tomography (CT), 6 chondrosarcoma, 358 149 colon cardiac uses, 626 chordoma, 360 exogenous hemolytic anemia, angiodysplasia, aortic stenosis, central cyanosis, 684 chorioretinitis, 97 413 640 consciousness, disturbances of, chromonychia, 75 clubbing, 28, 592 carcinoma see colorectal 992 chromosome anomalies, 21 cyanosis, 680, 681, 682 carcinoma infectious diseases, 114 chronic ambulant peritoneal desquamative interstitial polyps, 818−819, 819 jaundice, 771 dialysis (CAPD), 150 pneumonia, 554 juvenile, 283, 818 pleural effusion, 246 chronic fatigue syndrome, 21, 44, nails, 74 stenosis, 260 pulmonary opacities, 521 193−194, 755, 1010 cluster headache, 207, 215 transit time assessment, 830, sarcoidosis diagnosis, 588−589 criteria, 21 coagulase-negative staphylococci, 831 concentric hypertrophy, 634, 634 chronic lymphocytic leukemia 154 colonoscopy, 35 conductive hearing loss, 98 (CLL), 430−431 urinary tract infections, 847 color-coded Doppler sonography congenital angiodysplasia, 324, incidence, 423 coagulation, 453 Duplex ultrasound, 329 324, 386, 389 staging, 431, 431 activation markers, 451 echocardiography, 624 congenital aortopulmonary chronic myeloid leukemia (CML), anti-phospholipid antibody colorectal carcinoma, 13, 817−818, connections, 698 428−430, 429 syndrome, 468 818 congenital atrioventricular accelerated and blastic phase in disease processes, 450−452 acute constipation, 830 fistulas, high output heart findings, 430 coagulation disorders hereditary, 819, 819 failure, 655 clinical symptoms, 428−429 acquired, 450 mechanical ileus, 261 congenital dyserythropoietic diagnosis, 429 bleeding types, 454 screening, 35 anemia type I, 409, 409 differential diagnosis, 430 Budd−Chiari syndrome, 790 Streptococcus bovis sepsis, 155 congenital erythropoietic incidence, 423 laboratory diagnosis principles, thrombosis, 469 porphyria, 271 Philadelphia chromosome, 450−451 ulcerative colitis, 814 congenital heart defects, skin 429−430 laboratory methods, 451 colorectal polyps, 818−819, 819 changes, 69 prognosis, 429 see also specific conditions familial adenomatous polyposis congenital hemolytic anemia, 413 chronic obstructive pulmonary coagulation time, (FAP), 819 congenital liver fibrosis, 786 disease (COPD), 509−510 anti-phospholipid antibody juvenile, 283, 818 congenital megacolon, 832 bronchitis, 141 syndrome, 468 coma, 990, 994, 996 congenital syphilis, 161 flow-volume curve, 512 coarctation of aorta, 745, 745 cerebral causes, 995−999 congenital thrombocytopathies, obstructive ventilatory defects, murmur, 616 negative neuroimaging, 457, 458 497 cobalamin, laboratory parameters, 995−996 congenital thrombocytopenias, severity degree, 509 1066 positive neuroimaging, 995 458 chronic renal failure (CRF), cocaine conditions misinterpreted as, congenital thrombophilia, 450 857−865 coma, 1007 990−991 congenital valvular aplasia, 333 anemia, 404 dilated cardiomyopathy, 670 differential diagnosis, 994 congested liver, 789 causes, 857 hypertension, 746 drug-induced, 1007 congestion, pulmonary see identification of, 858 Coccidioides immitis, 170 infections, 995 pulmonary congestion consequences, 857 coccidioidomycosis, 170 intoxication-induced, congestive gastritis, acute gastritis definition, 857 coccygodynia, 273 1005−1008, 1006 vs., 275 differentiation, acute, 864 cochlea, anatomy, 957, 957 ischemic stroke, 997 congestive heart failure endocrine kidney functions, codfish vertebrae, osteomalacia, metabolic disorders, 999−1005 pulmonary infiltrates, 541−543 857 374 see also specific causes secondary pulmonary glomerular filtration rate, 857 cognitive functions, examination combined humoral and cellular hemosiderosis, 561 potentially reversible causes, of, 992 immune deficiencies, 188, conjugate deviation, supranuclear 865 cold acting IgM antibodies, 190−191 gaze paresis, 962 metabolic acidosis, 921 hemolytic anemia, 414 combined hyperlipidemia, 229 conjugated hyperbilirubinemia, organ involvement, 859 cold agglutination disease common arterial trunk, 686, 687, 766, 772 staging, 857, 857 ears, 98 688 biliary obstruction, 765 tubular function, 857 necrotic spots, 414 common cold, 139−140 conjunctival vessel dilation, 680, Churg−Strauss syndrome, 180, cold agglutinins common iliac artery stenosis, 266 680 547, 873 hemolytic anemia, 414 common variable conjunctivitis, 97 differential diagnosis, 181 peripheral cyanosis, 708 immunodeficiency syndrome chronic, 161 chylomicrons, lipoprotein cold nodules (CVID), 516 in chronic renal insufficiency, metabolism, 230 nontoxic goiter, 483 community acquired diarrhea, 863 chylothorax, 247, 248−249 toxic multinodular goiter, 488 147 connective tissue chylous ascites, 784 colic diseases/disorders, 115 1076

anemia, 403 dilatation, Kawasaki disease, coxsackie virus infection cutaneous hemangiomas, high autoantibodies, 177 129 common cold, 139−140 output heart failure, 655 microangiopathy, 326 occlusion, post-myocardial maculopapular exanthema, 118 cutaneous hemorrhages, 69 skin changes, 65−66 infarction, 239 vesicles, 118 cutaneous leishmaniosis, 119 tumors, 359−360 polyarteritis nodosa, 179 C-peptide cutaneous tuberculosis, 71 see also specific stenosis, coronary angiography, fasting hypoglycemia, 1001 cutis laxa, 66 diseases/disorders 234 laboratory parameters, 1035 cyanides, coma, 1008 connective tissue syndrome, vasocontriction/vasospasm, cranial nerves, neurological cyanosis, 28 fever, 176 angina, 222, 223 examination, 32 cardiac see cardiac cyanosis Conn syndrome see coronary heart disease (CHD) C-reactive protein (CRP), 197 central see central cyanosis aldosteronism, primary cardiac catheterization, 627 anemia, 403 clubbing, 680, 681, 682 conotruncal anomalies, 684 chest radiograph, 621 iron deficiency, 401 definition, 678 cardiac cyanosis, 684−706 classification, 234 laboratory parameters, 1036 diagnosis, 679 central cyanosis, 684 diagnostic methods, 230−234 obliterating arteriosclerosis, 319 medical history and clinical consciousness dilated cardiomyopathy, 670 rheumatoid arthritis, 339 examination, 678 anatomic fundamentals, 988 echocardiography, 231 creatine kinase (CK) cycloserine, sideroachrestic definition, 951, 988−994 gender differences, 231 acute coronary syndrome, 238 anemia, 405 differential diagnosis, 990−991 magnetic resonance imaging, laboratory parameters, Cyclospora cayetanensis, 149 disturbances of, 951−952 232 1036−1037 cylindroma, 592 causes, 994 positron emission tomography, non-STEMI, 235 cystadenocarcinoma, 296 clinical features, 990−991 232 creatine kinase-MB (CK-MB), cystadenoma, 296 examination, signs and risk factors, 225−226 1036−1037 cystic adventitial disease, 321, 321 symptoms, 991 screening, 34−35 creatinine cystic bronchiectasis, 573 pathophysiology, 989−990 tachyarrhythmias, 976 bilateral renal disease, 735 cystic echinococcosis, 796 psychogenic, 999 therapeutic implications, 234 Cushing syndrome, 741 hepatic abscesses, 151 qualitative, 989−990, 997 see also acute coronary laboratory parameters, 1037 cysticercosis, 137 quantitative, 989, 997 syndrome (ACS) creatinine clearance, 840 cystic fibrosis, 514−515, 565, 565 see also coma coronary sinus defect, 703 24-hour urine, 841 cystic fibrosis transmembrane examination protocol, 991 coronary vessels, polyarteritis CREST syndrome, 183 conductance regulator (CFTR), eyes, 992−993 nodosa, 179 Osler−Weber−Rendu disease, 293, 514 impaired, clinical forms, 953 Coronavirus, 536 464 cystic hygromas, neck, 477 motor functions, assessment of, cor pulmonale, 565, 636 Crigler−Najjar syndrome, 766, cystic kidney diseases, 887 993−994 cortex, supranuclear gaze paresis, 771, 772 acquired, 864 neurochemical fundamentals, 962 Crohn disease, 815−816, 816 sonographic findings, 887−888 988 cortical dysarthria, 102 arthropathy, 343 cystic lung diseases, 573−574 paroxysmal losses, 984 corticosteroids disease distribution and clinical see also specific diseases physiologic fundamentals, 988 biosynthesis, 908, 908 presentation, 815 cystine stones, 887 consolidation, pulmonary drug-induced fever, 116 cystitides, 882 opacities, 521 dyslipoproteinemia, 230 pyoderma gangrenosum, 62 cystitis, 882−883 constipation, 830−833 glucocorticoid-suppressible ulcerative colitis, cysts acute, 830 aldosteronism, 739 differentiation, 814 bone, 361, 362, 362−363

mechanical retention, 260 mineralocorticoids see vitamin B12 deficiency, 407 branchial, 476 anorectal dysfunction, 832 mineralocorticoids Cronkite−Canada syndrome, 819 bronchiogenic, 573 chronic, 830−831 opportunistic fungal infections, crumbly nail dystrophy, 74 cardiophrenic angle, 578 classification and 168 crural artery obstruction, 314 cervical, 476, 477 pathophysiology, 830 pigmentation disturbances, 54 cryoglobulinemia, 465−466, 466 dermoid, 477, 569, 594, 595 diverticulosis, 820 secondary osteoporosis, 369 peripheral cyanosis, 708 neck, 477 megacolon and megarectum, skin changes, 66 poststreptococcal echinococcosis, 539 832 topical, skin atrophy, 66 glomerulonephritis, 867 gout, 345, 346 temporary, 831 vessel wall, effect on renal abnormalities, 840 kidney, 864, 883, 887, 887−888 constrictive pericarditis, 660−661 composition of, 464 cryptococcosis, 169 lung, 565, 574 chest radiograph, 661 cortisol Cryptococcus neoformans lymphoepithelium, HIV signs and symptoms, 661 Addison disease, 752 infection, 169 infection, 130 constructive bronchiolitis, Cushing syndrome, 741 meningitis, 135 mesothelium, 578 510−511 laboratory parameters, 1035 cryptogenic epilepsy, 981 ovary, 73 continuous murmurs see heart primary aldosteronism, 739 cryptogenic organizing pancreas, 295 murmurs steroid biosynthesis, 908 pneumonia, 511, 541, 551−553 pericardium, 578, 595, 598 contrast echocardiography, 626 cortisone, 908 crystals, urinary sediment, 849 thyroglossal duct, 476, 477 contrast-enhanced spiral cor triatriatum, 658 cupulolithiasis, 969 thyroid gland, 482 computed tomography, 626 Corynebacterium diphtheria e Curling ulcer, 279 see also entries beginning cystic controlled alveolar infection, tonsillopharyngitis, Curschmann spirals, 508 cytogenic aberrations, hyperventilation, 928 138 Cushing disease, 742 osteomyelofibrosis, 435 convergence, optomotor system, costoclavicular compression, 307, secondary osteoporosis, 369 cytolysis, hyperkalemia, 912 958 331 skin color, 53 cytomegalovirus infection, 157, Coombs test, 417 thoracic outlet syndrome, 334 Cushing syndrome, 740−743 168 copper cough, 43−44, 494 ACTH-dependent, 742 clinical manifestations, 123 laboratory parameters, 1034 acute, 494 ACTH-independent, 742−743 pharyngitis, 139 sideroachrestic anemia, 405 cardiac dyspnea, 609 adrenal incidentaloma, 742 cytopenia, paroxysmal nocturnal coral calculi, 887, 887 chronic, 43, 43, 494 clinical features, 740−741 hemoglobinuria, 415 cornea, 96 causes, 494 common signs and symptoms, cytostatic agents band shaped opacifications, 96 productive, 43 742 acute renal failure, 855 reflexes, consciousness, 993 clinical features and etiology, diagnosis, 741 acute tubular necrosis, 854 corona phlebectatica 44 hypertension, 738 paraplantaris, 331 cough variant asthma, 507 obesity, 87 coronary angiography, 627 coumarins paraneoplastic, 742 D left ventricular isolated bleeding during therapy, 463 screening, 741 noncompaction, 670 necrosis, 68, 68, 463, 463 secondary osteoporosis, 369 dactylitis myocardial ischemia, 233, 234 oral anticoagulation, 462 skin changes, 66 psoriatic arthritis, 342 stenosis, 231 couplet extrasystoles, 719 Cushing ulcer, 279 reactive arthritis, 343 unstable angina pectoris, 234 ECG presentation, 720 cutaneous appearance see skin danger space infections, 479 coronary artery cowpox virus, 118, 125 appearance Darier−Roussy sarcoid, 588, 588 angiography see coronary Coxiella burnetii, 142 cutaneous diphtheria, 71 Darier sign, urticaria pigmentosa, angiography 55 1077

D-dimers, laboratory parameters, hypotension, 750−751 diet/eating habits disturbed nocturnal breathing, 1038 opportunistic fungal infections, atherosclerosis risk, 226 503 deafferentation pain, 300−301 168 as factor influencing diagnosis, diuretics clinical syndromes with, 301 screening, 36 13 edema, 385 deafness, 98 secondary osteoporosis, 370 vitamin B12 deficiency, 407 hypokalemia, 911 decerebration seizures, 993 skin changes, 65 diffuse alveolar damage (DAD), hypophosphatemia, 940 decision analysis, type 1 554 hypovolemic hyponatremia, probability-based, 6−7 diabetic nephropathy, 870 diffuse esophageal spasm (DES), 902−903 decision-making see fatigue, 39 806 metabolic alkalosis, 924 diagnosis/differential diagnosis hypoglycemic coma, 1000 diffuse granulomatous pulmonary divalent ions, renal excretion, 929 decortication seizures, 993 weight loss, 39 disease see sarcoidosis diverticular bleeding, 820 decubitus angina, 224 type 2 diffuse idiopathic skeletal diverticular disease, acute deep vein thrombosis (DVT) diabetic nephropathy, 871 hyperostosis (DISH), 346−347 constipation, 830 acute iliofemoral, 330 hypotension, 750 diffusely adherent Escherichia coli diverticulitis, 820 causes, 330 diabetic coma, 1000−1001, (DAEC), 148 diverticulosis, 820 hereditary thrombophilia, 467 1002−1003 diffuse parenchymal lung disease diverticulum, 804 lower limb, 330 diabetic foot, 65 (DPLD), 548−565 dobutamin, stress palpation of calves, 329 diabetic ketoacidosis classification, 549 echocardiography, 231 pelvis and legs, 329, 329−330, hypophosphatemia, 940 extrinsic allergic alveolitis, 556 Doppler echocardiography 332 normochloremic metabolic idiopathic interstitial aortic insufficiency, 648 postthrombotic damage, 333 acidosis, 920 pneumonia, 549−554 acute, 645 venous edema, 385 diabetic microangiopathy, 326, interstitial pneumonia in aortic stenosis, 642, 643 défense musculaire, acute 327 association with collagen atrial myxoma, 659 abdomen, 257 diabetic nephropathy, 870−872, vascular disease, 554−555, atrial pressure gradients, 624, degenerative disease, 16 871 555 625 degenerative joint disorders, course, 871 pneumoconiosis, 557 atrial septal defect, 704 349−351 diagnosis, 871−872 silicatosis, 559−560 atrioventricular septal defect, osteoarthritis, 349−350 stages, 872 toxic and drug-induced 695 spinal disease, 350−351 diabetic neuropathy, 8326, 34 interstitial pneumonia, 556 cardiac dyspnea, 622−625 Déjerine−Roussy syndrome, 208, chronic renal failure, 857 see also specific diseases central cyanosis, 684 301 unilateral leg pain, 309−310 diffusion capacity, pulmonary color-coded, 624 unilateral leg pain, 308 diabetic precoma, abdominal cyanosis, 707 double inlet ventricle, 698 delirium, 991 pain, 271−272 Di George syndrome, 190 Eisenmenger syndrome, 702 delirium tremens, 787 diabetic retinopathy, 97 digitalgia paresthetica, 308, 310 erythrocytes and, 623−624 dementia, 991 diabetic rubeosis, 53 digital necroses, acute tubular hemodynamic studies, 625 prolonged vertigo, 955 diagnosis/differential diagnosis, necrosis, 854, 854 mitral insufficiency, 652 dengue fever, 123, 175 5−6 dihydroergotamine heparin, 325 mitral stenosis, 658 dengue shock syndrome, 175 disease groups and, 16−23 dihydrofolic acid reductase, folic pulmonary hypertension, 637 densitometry see also specific diseases acid deficiency, 409 pulmonic stenosis, 644 hyperparathyroidism, 375 elements, 4−10 dilated cardiomyopathy (DCM), tricuspid insufficiency, 653 osteoporosis, 370 evaluation of findings, 6−9 669−670 Doppler ultrasound deoxycorticosterone (DOC), 739 medical errors, 9, 9 chest radiograph, 621, 622 color-coded, 329, 624 depigmentation see practical procedure, 5−6 definition and classification, echocardiography see Doppler hypopigmentation factors influencing, 11−16 661 echocardiography dermatoid anthrax, 120 false, 10 myocarditis, 672 primary varicosis, 331 dermatomes individually adapted, 5 diphtheria , tonsillopharyngitis, renal artery stenosis, 737, 737 radicular arm pain, 304 process, 8 138 double inlet ventricle, 695−698 radicular leg pain, 309 rules, 9 dipsomania, 41 anatomy, 695 radiculopathy, 302 verification, 5 dipyridamole, auscultation, 696−698 dermatomyositis, 67, 67, 186, dialysis thrombocytopathies, 458 chest radiograph and 186−187 anemia, 404 direct immunofluorescence echocardiography, 698 musculoskeletal thoracic pain, iron deficiency, 402 analysis, systemic lupus clinical presentation, 695−696 251 diaphragmatic paralysis, dyspnea, erythematosus, 183 transposition of great arteries, dermoid cysts, 477, 569, 594, 595 502−503 disaccharide deficiency, 821 complete, 697 neck, 477 diaphragmatic relaxation, 503, discoid lupus, 183 doubly committed ventricular dermopathy, Graves disease, 486 578 diseases septal defect (VSD), 699 descending aorta dissection, 244 diarrhea, 810−827 checkup, asymptomatic Down syndrome, 21 11-desoxycorticosterone, steroid acute, 811−812 patients, 33, 33−37 atrioventricular septal defect, biosynthesis, 908 categorization, 810 criteria, 4 694−695, 696 desquamative interstitial chronic, 813−826 ethnic groups, 14 teeth, 76 pneumonia (DIP), 554 abnormal endoscopy, etiology, 4 tongue enlargement, 78 dexamethasone 813−820 expression, 5 Dressler syndrome, 243 ACTH-independent Cushing causes, 813 geographic distribution, 14 drowsiness, 990 syndrome, 742−743 endocrine and hormonal groups, diagnosis and, 16−23 drug fever, 116, 195 Cushing syndrome, 741 causes, 825−826 occupational, 12, 14, 15−16, 509 drug-induced diseases/disorders diabetes insipidus, 40−41, malassimilation, 821−825 pathogenesis, 4 acute interstitial nephritis, 879, 905−906 normal endoscopy, 820−821 precluding or promoting, 16 879 causes, 40 chronic pancreatitis, 294 prevalence, 11 findings, 880 thirst test, 905 definition, 810 prevention, 33, 33−34 hypertension, 746 diabetes mellitus, 38−40 fever, 147−149 screening, 33, 34−36 hypoglycemia, 1002 atherosclerosis risk, 226 functional, 813 see also specific diseases hypotension, 750 cardiac dyspnea, 618 hypokalemia, 911 disk herniation liver diseases, 779 chronic pancreatitis, 294 pathogens causing, 148−149 cervical spine, 350 cholestasis, 792 coma, 1000−1001, 1002−1003 pathophysiology, 810, 810 lumbar spine, 351 pulmonary eosinophilia, 547, complications, 40 secretory, 810 dissecting aneurysms, peripheral 550 see also specific complications sensorimotor dysfunction, 810 artery, 323 pulmonary fibrosis, 550, 556 definition, 38−39 diastolic blood pressure, 732 disseminated intravascular skin conditions, 68 dermopathy, 65 diastolic heart failure coagulation (DIC), 417, 450, 460, systemic lupus erythematosus, diarrhea, 825 cardiac dyspnea, 607 470 181 dyslipoproteinemia, 230 concentric hypertrophy, 634 dissociated nystagmus, 967 drumstick fingers, 75, 90 edema, 385 differential diagnosis, 607 distal choledocholithiasis, 287 ‘dry tap,’ hairy cell leukemia, 431 etiological classification, 38 restrictive cardiomyopathy, 666 distended intestinal loops, 260 Dubin−Johnson syndrome, 766, facial redness, 91, 91 772, 772 1078

impaired bilirubin secretion, ECG see electrocardiography nephrotic syndrome, 868 tetralogy of Fallot, 685−686 765 (ECG) acute nephritic syndrome vs., transposition of great arteries, laboratory findings, 768 echinococcosis, 573, 796 869 complete, 693 ductus arteriosus, calcification of, cysts, 539 pathophysiology, 382, 382 transposition of great arteries, 699 hepatic abscesses, 151 peripheral corrected, 694 ductus choledochus, 794 pulmonary, 539, 569, 569−570 ascites, 783 tricuspid insufficiency, 653 dumping syndrome, 284 echinococcosis granulosus, 796 chronic renal insufficiency, ventricular septal defect, 701 duodenal diverticulitis, 283 echinococcosis multilocularis, 796 862 electroencephalography (EEG) duodenal ulcer, 277, 278 Echinococcus infections see peripheral pitting, 611 epileptic absence, 981 non-Hodgkin lymphoma, 282 echinococcosis pitting, 383 seizure diagnosis, 983 perforation, peritonitis, 264 echocardiography, 6, 622−626 heart failure, 382 electrolyte balance disturbances, duplex sonography acute aortic insufficiency, 645 venous congestion, 611 862 Budd−Chiari syndrome, 790 acute mitral insufficiency, 649 pulmonary see pulmonary edema, 385 jaundice, 771 aortic stenosis, 642 edema pathogenesis, 895, 895 peripheral artery disease, 317, apical four chamber view of volume expansion, 900 electrolytes, fluid compartments, 318 heart, 624 EDTA 896 Durie−Salmon staging system, arterial hypertension, 635 pseudothrombocytopenia, 459 electrophysiologic study, 444 chronic aortic insufficiency, 647 thrombocytopenia, 459 arrhythmias, 715 dust exposure, bronchitis, 510 chronic mitral insufficiency, 651 effective circulating volume, 898 emboli/embolism dwarfism, 84 common arterial trunk, 686 Ehlers−Danlos syndrome, 65 arterial, 322, 322, 980 dysarthria, 100, 102 constrictive pericarditis, 660 ehrlichiosis, 158, 159 atrial fibrillation, 322 dyserythropoiesis-mediated coronary heart disease, 231 Eisenmenger complex, 583, 702 atrial myxoma, 322 jaundice, 766 dilated cardiomyopathy, 669 Eisenmenger syndrome, 702 brain, coma, 995 dyserythropoietic anemia type I, Doppler ultrasound see Doppler atrioventricular septal defect, cholesterol, 322 congenital, 409, 409 echocardiography 694, 695 rapidly progressive dysesthesia, 300 hypertrophic cardiomyopathy, central cyanosis, 682 glomerulonephritis, 875 dyslipoproteinemia, 226−230 663, 664 common arterial trunk, 686 chronic mitral insufficiency, atherosclerosis risk, 226 mitral stenosis, 658, 658 nonrestrictive ventricular septal 650 classification, 229 myocarditis, 673 defect, 680 microemboli, 155, 980 clinical features, 226−227 pulmonary edema, 631 ventricular septal defect, 701, mitral stenosis, 655 diagnosis, 226 pulmonary hypertension, 637, 703 myocardial infarction, 322 drug-induced, 230 638 ejection click pulmonary see pulmonary primary forms, 227 restrictive cardiomyopathy, 666 common arterial trunk, 686 emboli secondary forms, 227−230 right-to-left shunt, 626 pulmonary see pulmonary septic, 153, 155 dysmorphic erythrocytes, urinary syncope, 974 ejection click see also thrombosis sediment analysis, 847 tetralogy of Fallot, 686 ejection murmur, functional, 617 emergency evaluation, 4, 5, 8 dysontogenic masses, neck, 477 transposition of great arteries, ejection systolic murmurs see see also vital signs dyspepsia, irritable bowel 693 systolic ejection murmur emphysema, 511−513, 512

syndrome, 285 transthoracic, 6 elastin defect, vessel wall, 464 alpha1-antitrypsin deficiency, dysphagia, 47, 802−807 tricuspid insufficiency, 653 elderly patients, fever, 112 513, 513 causes, 47 two-dimensional, cardiac electrocardiography (ECG), 34 barrel chest, 27 differential diagnosis, 802 dyspnea, 623 acute aortic insufficiency, 645 clinical findings, 511−513 structural lesions, 802−804 valvular insufficiency, 624 acute coronary syndrome with definition, 511 dysphonia, functional, 102 valvular stenosis, 624 ST elevation, 236−237 diagnosis, 513 dyspnea, 608−609 echovirus infections acute mitral insufficiency, 649 types, 511 cardiac see cardiac dyspnea common cold, 140 aortic stenosis, 642, 643 empyema, 529, 529 cystic fibrosis, 515 maculopapular exanthema, 118 aortopulmonary connections, enamel defects, infections, 76 definition, 496 eclampsia, 985 699 encephalitis, 136−137, 208 degree of, 496 jaundice, 792 arrhythmias, 715 arboviral causes, 136 diseases, 506−517 pulmonary edema, 632 arrhythmogenic right focal, 999 etiology, 496 ectoblastic tumors, 597 ventricular cardiomyopathy postinfectious, 137 exertion, on, 608 eczema herpeticum, 57, 58 (ARVC), 670 Encephalitozoon intestinalis, 149 extrapulmonary, 500−505 edema arterial hypertension, 635 encephalomyelitis, disseminated, functional, 276 definition, 382 atrial septal defect, 704 302 hemoptysis, 496−516 generalized, 382−385 atrioventricular septal defect, enchondroma, 356, 357 pathophysiology, 496 diabetes mellitus, 385 695 endemic sprue see celiac disease pleural effusion, 247 drug-related, 385 cardiac dyspnea, 618−619 endocardial fibrosis, carcinoid pulmonary, 500 electrolyte imbalance, 385 central cyanosis, 683−684 syndrome, 826 differential diagnosis, 605 endocrine system related, chest pain, importance, 220 endocarditis, 155−156 resting, 609 384 chronic aortic insufficiency, 647 clinical features and symptoms, vocal cord abnormalities, 506 glomerulonephritis related, chronic mitral insufficiency, 651 155 dystrophic calcification, 64 384 common arterial trunk, 686 diagnosis, 156 dysuria, fever and pollakisuria, heart failure related, 382−383 constrictive pericarditis, 660 infectious 151−152 hypoproteinemic, 383−384 coronary heart disease, acute aortic endocarditis, 645 scleroderma, 385 230−231 acute mitral insufficiency, E localized, 382, 385−390 dilated cardiomyopathy, 669 649 congenital dysplasia, 389 Ebstein anomaly, 706 causative pathogens, 156 ear, external, 98 factitious, 390 Eisenmenger syndrome, 702 chronic aortic insufficiency, early-diastolic heart sounds, 613 high altitudes, 390 hyperkalemia, 862 649 early-diastolic murmurs, 618 inflammatory edema, hypertrophic cardiomyopathy, noninfectious, 155 early dumping syndrome, 284 388−389 664, 665 petechiae and purpura, 116 early repolarization, 237, 242 ischemic and postischemic infarction localization, 237 postoperative, 155 early systolic ejection click, 615 edema, 390 mitral stenosis, 657, 657 skin changes, 69, 71 ears, 98 lipedema, 388 myocarditis, 673 endocrine diseases/disorders, 20 Ebola virus, 123 lymphedema, 385 non-STEMI, 235 abdominal pain, 271−272 Ebstein anomaly, 704−706, 705 primary lymphedema, pericarditis, 240−242 anemia associated with, 410 atrial septal defect, 706, 707 385−387 pulmonary hypertension, 637, arthropathies, 348 clinical features, 705−706 secondary lymphedema, 638 diarrhea, 825 eccentric hypertrophy, 634, 387−388 pulmonic stenosis, 644 fever, 193 634−635 urticaria and angioedema, renal insufficiency, 859 hypercalcemia, 935 ecchymosis, Cushing syndrome, 389−390 restrictive cardiomyopathy, 666 hypotension, 750−751 741, 742 venous edema, 385 syncope, 974 short stature due to, 84−85 skin changes due to, 66 1079

tall stature due to, 80−82 fasciitis, 68, 186 erythrocyanosis, 326 euvolemic hypernatremia, see also specific fibroblastic endocarditis, 667 erythrocyanosis crurum, 708 905−906 diseases/disorders gastroenteritis, 812 erythrocyte casts, urinary causes, 905 endocrine function tests, granuloma, 360 sediment, 847, 849 differential diagnosis, 904 pancreatic disease, 291 Langerhans cell histiocytosis, erythrocyte indices, 396 euvolemic hyponatremia see endocrine ophthalmopathy, 486 445 anemia of chronic disease, 403 hyponatremia endocrine psychosyndrome, 21 parietal endocarditis, 666 thalassemia, 405 event recorder, arrhythmias, 715 endocrine system pleuritis, 248 erythrocytes evidence-based medicine, 7 edema, 384 pulmonary infiltrates, 546, agglutination, hemolytic quality rating, 8 hyperactivity, fibrous dysplasia, 546−547 anemia, 414 see also quality assurance 363 epidermolysis bullosa, 60 aplasia, 411 Ewing sarcoma, 361, 361 hypertension, 737−744 epidural abscess, 138 creatine, 396 exanthema endolymphatic tube, perilymph anterior spinal artery Doppler echocardiography, acute hepatitis, 767 fistula, 971 syndrome, 302 623−624 pharyngitis, 138 endometriosis, mechanical ileus, epiglottitis, 140 enzyme defects, 418 post-arbovirus infection, 163 262 epilepsy, 980−984 eumorphic, 848 exanthema subitum, 122−123 endomyocardial fibrosis, 668 arrhythmias, 714 urinary sediment analysis, excretions, jaundice, 767 restrictive cardiomyopathy, 666, aura, 981 847 exercise, 500 667 classification, 981−983 fragmentation, hemolysis with, angina pectoris, 222 endophlebitis, veno-occlusive clinical features, 981−983 415−417, 416 asthma and, 508−509 disease, 790 consciousness disturbances, shape variations, 417−418 ECG, coronary heart disease, endoplastitis, 153 996 urinary sediment, 847 230−231 end organ damage, risk international classification, 982 erythrocyte sedimentation rate hypotension and, 640 assessment, 734 nonconvulsive epileptic state, (ESR), 196−197 intolerance endoscopic retrograde 996 causes, 197 acute heart failure, 628 pancreaticography (ERCP), 766, pathogenesis, 980−981 multiple myeloma, 442 cardiac dyspnea, 609 771 seizures, 211, 981 rheumatoid arthritis, 339 chronic mitral insufficiency, pancreatic cysts, 295 chronic subdural hematoma, Takayasu arteritis, 320 650 endoscopy 998 vasculitis, large vessels, 178 cyanosis, 682 abdominal ulcers, 277 forms, 981−983 erythrocytosis, secondary, 679 mitral stenosis, 655 gastric carcinoma, 280 syncope, 953 erythroderma, 57 exercise-induced asthma, obscure epigastric pain, 274 vertigo, 954 erythroleukemia, 426 508−509 see also specific techniques vestibular epilepsy, 972 acute, 428 exercise-induced hypotension, endothelial damage, obliterating see also specific types erythroleukemoid hematologic 640 arteriosclerosis, 319 symptomatic, 981 picture, 435 exocrine function tests, pancreatic end-stage renal disease (ESRD) syncope, 952 erythromelalgia, 326 disease, 291 causes, 858 epilepsy-related seizure myeloproliferative disease, 468 exogenous hemolytic anemia, chronic glomerulonephritis, 878 disorders, 982 polycythemia rubra vera, 434 413−414 hyperparathyroidism, 376 epilepsy syndromes, 982 erythropoiesis exogenous psychoses, 21 osteomalacia, 372 epithelial casts, urinary sediment, megaloblastic bone marrow, exophthalmos, 93−94 enophthalmos, 94 849, 850 406 bilateral, 93 Entamoeba histolytica infection see epithelial cells, urinary sediment, myelodysplastic syndrome, 432 unilateral, 93, 94 amebiasis 847−849, 849 pernicious anemia, 407 exophytic colonic carcinoma, 818 enteric fever, 147 Epstein−Barr virus (EBV) infection erythropoietic porphyrias, 271 expectoration, 495 enteritic salmonellosis, 148 clinical manifestations, 123 congenital, 271 external appearance, 79−102 enteroaggregative (EAggEC) lymph node enlargement, 127, erythropoietic protoporphyria, anorexia, 89 Escherichia coli, 148 477 271 ears, 98 Enterobacter agglomerans, 557 oral hairy leukoplakia, 169 erythropoietin eyes, 93−98 enterococcal infections, sepsis, pharyngitis, 138−139 anemia, 404 face, 91−93 154 pharyngotonsillitis, 477 multiple myeloma, 443 gynecomastia, 88−89 enterocolitis, 815 pneumonia, 536 Escherichia coli hands, 90−91 associated arthropathies, Epworth sleepiness scale, 46, acute complicated language, speech and 343−344 1009, 1009 pyelonephritis, 152 phonation, 100−102 Enterocytozoon bieneusi, 149 questionnaire, 516 diarrheal disease, 811 nose, 99 enteroinvasive Escherichia coli erectile dysfunction, 48, 48 peritonitis, 150 obesity, 86−88 (EIEC), 148 ergometry, 34−35 pyelonephritis, 883 odor, 99−100 enteropathogenic Escherichia coli ergotamine alkaloids, sepsis, 154 stature and posture, 79−86 (EPEC), 148 nonhydrogenated, 324 strains, 148 external otitis, 140 enterotoxigenic Escherichia coli ergotamine tartrate preparations, urinary tract infections, 846 extertional headache, 215 (ETEC), 148 324 esophageal chest pain, differential extracellular buffer systems, enterovirulent Escherichia coli, ergotism, 324, 324−325 diagnosis, 221 915−916 148 gangrenous, 325 esophagitis, 806−807 extracellular hyperosmolarity, enterovirus infections, meningitis, erosive gastritis, 274 HIV infection, 168 ketoacidotic coma, 1002 134 errors, 9 esophagus extracellular volume (ECV) enzyme defects, porphyrias, 269 eruptive xanthoma, carcinoma, 802−803 concomitant increases, 900 enzyme immunoassays (EIA), hyperlipidemia, 228 diffuse dysmotility, 806 contraction and expansion, hepatitis C, 776 erysipelas, 120 dysphagia, 802 899−900, 900 enzymopathy, genetic-related, 20 secondary lymphedema, 388 membranes, 803 maintenance, 896 eosinopenia, 200 skin color, 53 motility disorders, 804−806 total body water, 895 eosinophilia, 199−200 erysipeloid diphtheria, 71 rings, 803 extrahepatic cholestasis, 765, bronchial asthma, 508 erythema, 56−57, 119 tumors, 802−803 793−794, 794 Churg−Strauss syndrome, 180 erythema exsudativium ulceration, 806 extrahepatic obstructive jaundice, inflammatory edema, 388 multiforme, 59, 59−60 essential thrombocythemia (ET), 795 pulmonary erythema induratum, 61 468 extrahepatic tumors, fasting drug-induced, 547 erythema infectiosum, 122 essential thrombocytosis, 321 hypoglycemia, 1001−1002 with parasitosis, 546 erythema migrans, 56 estrogens extrapancreatic tumor, fasting schistosomiasis, 173 Lyme disease, 157 deficiency, 368 hypoglycemia, 1001 trichinosis, 162 erythema nodosum, 60−61, 62, hypercholesterolemia, 230 extrapulmonary dyspnea, eosinophilia-myalgia syndrome, 143, 143, 588, 596 ethanol abuse see alcohol abuse 500−505 68, 186 allergic reactions, 195 ethnic groups, 14 extrapulmonary restriction, eosinophils, 199−200 erythroblast aplasia, 411 ethylene glycol, coma, 1008 502−503 absence of, 200 erythroblastic leukemia, acute, etiology see diseases extrapulmonary tuberculosis, asthma, 547 426 eunuchoid habitus, 81 143−144 1080

extrapyramidal system, prolonged primary adrenocortical tissue degradation, 194 focal encephalitis, 999 vertigo, 955 insufficiency, 751 travel, tropical regions, 171 focal neurological deficits, sinus extrasystoles, 719−720 fatty liver tumors, 194, 194 vein thrombosis, 995 clinical examination, 714 hepatic anemia, 410 of unknown origin, 6, 113, focal nodular hyperplasia (FNH), supraventicular, 720 pregnancy-related, 790−791 113−114, 114 795 extrinsic allergic alveolitis, febrile illness see fever vegetative dystonia, 193 focal nonconvulsive epileptic 556−557 fecal culture, reactive arthritis, without localized symptoms, state, 996 exudate ascites, 784 343 114−116 focal parameningeal infections, exudate pleural fluid, 247, 247 fecal incontinence, diarrhea vs., fibrillin defect, vessel wall, 464 133 exudative diarrhea, mechanisms, 810 fibrinogen, laboratory parameters, focal segmental 810 Felty syndrome, 339 1039 glomerulosclerosis (FSGS), 870 exudative gastroenteropathy femoral artery auscultation, 315 fibrinoid necrotizing vasculitis, focal seizures, 211, 981−983 edema, 384 femoral traction pain, 309 180 localization and symptoms, hypoproteinemic edema, ferritin fibrinolytic pathways, 453 981−983 383−384 anemia of chronic disease, fibroblast growth factor receptor migraine vs., 214 exudative pleuritis, 245 403−404 gene (FGFR3), 83 seizure course, 983 eyebrows, 94 hereditary hemochromatosis, fibroma, 569 focal tachycardias, medical eyelids, 94 788 chondromyxoid, 357 history, 714 eye muscle myositis, 212 iron deficiency anemia, 401, neurofibromatosis, 54, 54, folic acid eyes, 93−98 401 69−71 deficiency, 408−409 consciousness, 992−993 laboratory parameters, nonossifying, 359, 360 myelodysplastic syndrome, Graves disease, 485−486, 486 1038−1039 ossifying, 360 432 movements, consciousness, 993 renal anemia, 410 fibromuscular dysplasia, 321 laboratory parameters, 1040 polyarteritis nodosa, 179 fertility problems, 42−43 renal artery, 736, 736 Fontan circulation, 678 red, 97 fetal hemoglobin, 709 fibromyalgia, 352, 352 food allergy, diarrhea, 812 see also entries beginning fever fibro-osteoclasia, 934 food poisoning, 811 oculo-/ocular abdominal pain, 149−151 fibrosarcoma, 360 causative pathogens, 149 acute coronary syndrome with fibrosis, lungs see pulmonary foramina recess obstructions, 304 ST elevation, 236 fibrosis forced expiratory volume (FEV), F adult still disease, 339 fibrous dysplasia, 362, 363 497, 498 allergic reactions, 195 fibrous histiocytoma, malignant, bronchial asthma, 507 Fabry disease, 866 arbovirus infections, 163 360 forced vital capacity (FVC), 497, bilateral arm/leg pain, 311 with associated cardinal filariae, inflammatory edema, 388 498 restrictive cardiomyopathy, 667 symptoms, 116−157 filariasis, 128 fourth heart sound, 614, 615 skin presentation, 65 autoimmune disease, 175−187 fine-needle aspiration biopsy, dilated cardiomyopathy, 669 vessel wall, 465 causes, 111, 112 thyroid function, 482 fractional excretion, 895 face, 91−93 clinical findings, 111 first degree atrioventricular block sodium, 899 Cushing syndrome, 740, 741 common cold symptoms, see atrioventricular (AV) block fragmentocytes, 398 scleroderma, 185 138−141 first heart sounds, 613, 614 hemolysis with erythrocyte facial expression, 91 concomitant exanthema, 116 atrioventricular septal defect, fragmentation, 415 facial neuralgia, 216−217 cough and thoracic pain, 695 hemolytic-uremic syndrome, facial pain, atypical, 217 141−145 central cyanosis, 683 875 facial redness, 91 course, 195−196 double inlet ventricle, 696 Francisella tularensis, 128 factitious edema, 386, 390 definitions and pathogenesis, tricuspid atresia, 690 free thyroxine (fT4) false aneurysms, 240, 323 111−112 first morning urine, 841 Graves disease, 486 familial adenomatous polyposis diarrhea, 147−149 fish tapeworm, vitamin B12 hypotension, 751 (FAP), 819 differential diagnosis, 111−112, deficiency, 407 laboratory parameters, 1063 familial aldosteronism type I, 739 195−200 fistula, diabetic microangiopathy, secondary hypothyroidism, 489 familial hemiplegic migraine, 214 see also specific 326 subacute thyroiditis, 483−484 familial hypercalciuric diseases/disorders Fitz−Hugh−Curtis syndrome, 150, thyroid function tests, 482 hypocalcemia, 932 duration, 111 264 toxic adenoma, 487 familial hyperlipidemia, 271 dysuria and pollakisuria, flapping tremor toxic multinodular goiter, 488 familial hypocalciuric 151−152 hepatic encephalopathy, 787 free triiodothyronine (fT3) hypercalcemia, 944 endocrine disorders, 193 liver cirrhosis, 780 laboratory parameters, 1063 familial Mediterranean fever, 192 facial redness, 91 floaters, 97 thyroid function tests, 482 differential diagnosis, 192 facial swelling, 130−131 flow-volume curve, 498 toxic adenoma, 487 peritonitis, 265 frequent leading symptoms, 116 chronic obstructive pulmonary toxic multinodular goiter, 488 familial periodic hyperkalemic headaches, 131−135 disease, 512 Frenzel spectacle testing, 958, 965 paralysis, 912 heart defects, 155−156 goiter, 499 benign paroxysmal positional familial periodic hypokalemic hemolysis, 194 fludrocortisone, primary vertigo, 969 paralysis, 911 hospitalized patients, 116 aldosteronism, 739 frequency shift, Doppler familiar hemophagocytotic immune deficiencies, 187−192 fluid compartments, 895−896 echocardiography, 623 lymphohistiocytosis, 445 inflammation parameters, size, 895−896 Fröhlich syndrome, 86 Fanconi syndrome 196−197 fluid lung, 862 frontal lobe epilepsy, 984 osteomalacia, 373 jaundice, 145−146, 766 fluid retention, acute nephritic fructose intolerance, 1002 renal calcium loss, 934 joint or bone pain, 125−126 syndrome, 866 fT3 see free triiodothyronine (fT3) fascial gaps, 331 lymph node enlargement, fluorescence activated cell sorting fT4 see free thyroxine (fT4) Fasciola hepatica, 794 127−130 (FACS), paroxysmal nocturnal functionally vegetative posthepatic jaundice, 146 medical history, 111 hemoglobinuria, 415 complaints, 20−21 fasting multiple organ involvement, fluorescence microlymphography, functional vascular disease, hypoglycemia, 1000, 1001−1002 157−175 388 324−326 ketoacidosis, 921 neck stiffness, 131−135 lymphedema, 387 fundus hemorrhages, fasting plasma glucose (FBS), neck swelling, 130−131 [18F]-fluorodeoxyglucose subarachnoid hemorrhage, 207 38−39 neurological deficits, 136−138 (FDG)-positron emission fundus paraproteinemicus, 444 fasting spot urine samples, noninfectious causes, 115−116, tomography (PET), 114, 115 fungal infections primary aldosteronism, 738 192−195 fluoroscent treponemal antibody arthritis, 126 fatigue, 44, 46 pleural effusion, 246−247 absorption test, 159 immunocompromised patients, cardiac dyspnea, 609 sepsis, 152−155 flushing, carcinoid syndrome, 537−539 causes, 45 skin rashes, 116−124 826, 826 localized mycoses, endemic chronic mitral insufficiency, special patient groups, 111 flutter waves, 722 regions, 170 650 splenomegaly, 146−147, 147 focal arrhythmias, carotid sinus meningitis, 135 diabetes mellitus type 1, 39 thrombophlebitis, 195 massage, 715 opportunistic, 168−169 thrombosis, 195 skin, 72 1081

systemic mycoses, 114 see also specific laboratory findings, 867 bacterial arthritis, 125 see also specific infections diseases/disorders renal biopsy findings, 868 chronic tophaceous, 345, 345 fungal poisoning, diarrhea, 812 gastrointestinal stroma tumors rapidly progressive see rapidly cystic defects, 345, 346 funicular myelosis, 302 (GIST), 282 progressive ears, 98 funnel chest, chest radiograph, 620 gastrointestinal system, pain, glomerulonephritis (RPGN) primary, 345 fusiform aneurysms, 322−323 260−264 streptococcal angina, 138 secondary, 345 iliac artery, 323 see also abdominal pain systemic lupus erythematosus, skin changes, 65 Fusobacterium necrophorum, Gaucher disease, 363 181−182 gout kidney, 345 130−131 gaze-evoked nystagmus, 966, 967 glomerulopathies, 865−878, 866 GPI-anchored proteins, 415 GB virus C (GBV-C), 777 asymptomatic urinary Gradengio syndrome, 216 G gender, as factor influencing abnormalities, 875−876 graft-versus-host disease (GVH), diagnosis, 12 classification, 865 scleroderma, 183 GABA see g-aminobutyric acid general anesthesia, pulmonary clinical syndromes, 866 Graham Steel murmur gait, 85−86 edema following, 632 definition, 865 Eisenmenger syndrome, 702 neurological examination, 32 genetics, simple Mendelian, immunologic factors, 865−866 mitral stenosis, 657 gait ataxia, 86 21−22 nonimmunologic factors, 866 Gram-negative microorganisms gallbladder abnormalities, 289 genitofemoral neuralgia, 273 primary acute nephritic syndrome, 866 gallium scintigraphy, sarcoidosis, genitourinary tuberculosis, 884, chronic renal failure, 858 pneumonias, 526−529 589 884 nephrotic syndrome causes, urinary tract infections, 846 gallstones, 287 geographic tongue, 78, 78 870 see also specific microorganisms g-aminobutyric acid, 1006, 1006 geriatric complaints, 12 secondary, 865 Gram-positive microorganisms coma, 1007 German measles see rubella chronic renal failure, 858 pneumonias, 524−526, 528−529 vigilance, 988 gestational diabetes, 39 nephrotic syndrome causes, urinary tract infections, 846 gamma-glutamyl transpeptidase Ghon lesion, 531 870 see also specific microorganisms (GGTP) Gianotti−Crosti syndrome, 767 glomerulosclerosis, nodular, 871 grand mal seizures, 984 cholestasis, 768 giant cell arteritis, 178, 211, 320 glossopharyngeal neuralgia, 216 granulated casts, 849, 850 laboratory parameters, giant cell myocarditis, 673 glucagonoma, skin changes, 65 granulocytopenia, 198−199 1040−1041 giant cell tumor, 360, 361 glucocerebrosidase, Gaucher acute leukemia, 422 gangrenous ergotism, 325 giant thrombocytes, disease, 363 granulomatosis, septic, 191 Gardener syndrome, 819 osteomyelofibrosis, 435 glucocorticoids, secondary granulomatous hepatitis, fever, gas retention, acute, 260 Giemsa staining, Helicobacter osteoporosis, 369 116 gastric adenocarcinoma, 802 pylori detection, 277 glucocorticoid-suppressible Graves disease, 485−486 gastric carcinoma, 280, 280 Gilbert syndrome, 771−772, 772 aldosteronism, 739 associated ophthalamology, niches, 277 bilirubin uptake, 763 glucose see blood glucose 485−486, 486 gastric ulcers, 277−279, 278 conjugated hyperbilirubinemia, glucose oxidase, glucosuria, 843 eyes, 93 perforation, peritonitis, 264 766 glucosuria, 843 facial appearance, 91, 92 stress-induced, 279 laboratory findings, 768 glutamate dehydrogenase (GLDH), onycholysis, 487 gastric volvulus, 283 gingival hemorrhage, 77 768 pretibial myxedema, 487 gastrin, chronic gastritis, 276 gingival hyperplasia, 77 glutamic oxalacetic transaminase Gray platelet syndrome, 458 gastrinoma, 826 gingivitis, 77 (GOT), laboratory parameter, greater saphenous vein Zollinger−Ellison syndrome, 279 Gitelman syndrome, 755 1022−1023 incompetence, 331 gastritis hypokalemia, 911 glutamic pyruvate transaminase Groenblad−Strandberg syndrome, acute, 274−275 metabolic alkalosis, 924 (GPT), 1022−1023 65 chronic, 276 Glanzmann thrombasthenia, 457, glutathione, 418 ground-glass opacities, achlorhydria, 403 458 enzyme deficiencies, 418 desquamative interstitial type A, 276 Glasgow coma scale, 992, 992 gluten, celiac disease, 821−822 pneumonia, 554 type B, 276 glaucoma, acute, 97 gluten-sensitive enteropathy growth hormone (GH) gastroesophageal reflux, asthma, head/facial pain, 207, 212 folic acid deficiency, 409 acromegaly, 743 and, 509 gliadin, celiac disease, 821−822 iron malabsorption, 403 deficiency, 1002 gastroesophageal reflux disease globin synthesis disorders, 400 glycol, lactic acidosis, 921 hypoglycemia, 1002 (GERD), 803 globulins, glomerular proteinuria, glycoprotein IlbIlla-receptor resistance, 84 posterior laryngitis, 102 844 antagonists, platelet inhibition, secondary hypotension, 753 gastrointestinal globus sensation, 802 450 growth hormone releasing diseases/disorders glomerular diseases/disorders, glycosylphostidylinositol (GPI), hormone (GHRH), tall stature, anorexia associated, 37 865−878 paroxysmal nocturnal 80 bleeding acute renal failure, 856 hemoglobinuria, 415 Guanarito virus, 123 analgesic nephropathy, 881 hematuria, 876 Gnathostoma spinigerum, 135 guanethidine, quadrant anemia, 402 inflammatory diseases of, 856 goiter, 483−485 syndrome, 305 chronic renal failure, 861 proteinuria, 843, 844−845 clinical classification, 27, 27 Guillain−Barré polyradiculitis, 311 occult, 402 urine collection and processing, flow-volume curve, 499 Gumprecht shadows, chronic oral anticoagulation, 463 841 intrathoracic, 597, 598 lymphocytic leukemia, 430 colic, 260 glomerular filtration rate (GFR) nontoxic, 483 gums, 77 edema, 384 acute renal failure, 852, 855 causes, 483 gynecomastia, 88, 88−89 hyperparathyroidism, 376 chronic renal failure, 857 respiratory failure, 499 causes, 89 infections, 147−148 evaluation and measurement, gonadotropins liver disease, 767 see also specific infections 840 laboratory parameters, 1042 large bowel obstruction, colonic reduced, 852−865 secondary hypotension, 753 carcinoma, 818 glomerulonephritides gonococcal infections H large bowel stenosis, postinfectious, 866 disseminated, 125 diverticulosis, 820 urinary sediment analysis, 847 skin changes, 72 Haemophilus influenzae infection lymphangiectasia, 825 glomerulonephritis urethritis, reactive arthritis, 343 bacterial meningitis, 133 malaria, 172 acute urinary tract, 882 pneumonia, 526 mechanical ileus, 260 edema, 384 gonorrhea, peritonitis, 264 hair, 72−73 noninflammatory intestinal hypercholesterolemia, 230 Goodpasture syndrome, 561−563, loss see alopecia infections, 147 chronic, 878 866, 874−875 ‘hair on end’ skull radiograph, osteomalacia, 372, 373 edema, 384 differential diagnosis, 875 405, 405 parasites, 149 intrarenal kidney failure, 853 pulmonary infiltrates, 874 hairy cell leukemia, 199, 431, 431 polyposis, 282, 282−283 poststreptococcal, 866, 867 Gordon syndrome, 914 incidence, 423 skin changes due to, 69, 70 differential diagnosis, 867 Gorham osteolysis, 363 hairy leukoplakia, HIV infection, stenoses, 260 as example of acute nephritic Gottron papules, 67 165, 168 strictures, 830 syndrome, 867 gout, 345 halitosis, 99 tuberculosis, 816−817 histology, 867 acute, 345 hallucinations, ischemic stroke, 997 1082

hamartomas, 569, 818 causes, 633 Hedinger syndrome, 826 hemoglobinopathies, 417 hamartomatous polyps, 283 decompensated, 629, 629 Heerfordt syndrome, 480, 588 see also specific types Hamman−Rich syndrome see differential diagnosis, 629 height vertigo, 968 hemoglobinopathy M, 709 interstitial pneumonia clinical presentation, severe Heinz bodies, 399 hemoglobinuria hand-foot-and-mouth disease, advanced, 611 erythrocyte enzyme deficiency, paroxysmal cold, 414 139 ears, 98 418 paroxysmal nocturnal, 415 hands, 90−91 edema, 382 hemoglobinopathy, 417 urine analysis, 841−842 Hand−Schüller−Christian high output, 607, 654−655 methemoglobinemia, 709 hemolysis syndrome, 360 causes, 654−655 Helicobacter pylori infection acute tubular necrosis, 854 Langerhans cell histiocytosis, clinical features, 654 abdominal ulcers, 276, 278 diagnostic strategy, 419 445 pathophysiology, 654 detection, 277 erythrocyte fragmentation, hanta pulmonary syndrome, 124 left-sided, 605 lymphoma, induced by, 440 415−417, 416 Hantavirus pneumonia, 536 acute, 236 HELLP syndrome, 792 fever, 194 haptoglobin, laboratory cardiac dyspnea, 500, 605 anemia, 416 jaundice, 763 parameters, 1042−1043 chronic volume overload, 644 helminth infections oxidative stress, 413 hard metal lung, 560 pulmonary arterial meningitis, 135 hemolytic anemia, 412−419, 413 Hashimoto thyroiditis, 484 hypertension, 639 opportunistic, 169 acquired, 413 acquired hypothyroidism, 488 signs and symptoms, 608 hemangioendosarcoma, 360 alloimmune, 414 nontoxic goiter vs., 483 right-sided, 605 hemangioendothelioma, 360 autoimmune, 414, 414 headaches cardiac dyspnea, 501, 605 malignant, 796 clinical findings, 412 arteritis temporalis, 178 chronic volume overload, 644 hemangioma, 360 congenital, 413 categories, 206 mitral stenosis, 655 hemangiopericytoma, 360 definition, 412 leptospirosis, 135 signs and symptoms, 608 hemangiosarcoma, 796 diagnosis, 412 metabolic etiologies, 213 tricuspid insufficiency, 653 hematemesis, 280 exogenous, 413−414 organic origin, 213 tricuspid stenosis, 659 hematologic disease sedimentation tube, 413 symptomatic, 207, 207−213 venous congestion, 609 abdominal pain, 272 skin discoloration, 53 toxic etiologies, 213 symptoms, 608−609 arthropathies, 348 hemolytic crisis, prehepatic tumor, 211 syncope, 978 coagulopathies see coagulation jaundice, 145 see also specific area/type systolic vs. diastolic, 607 disorders hemolytic-uremia syndrome head and neck region heart murmurs hemoglobinopathies, 417 (HUS), 416, 460, 470 disorders, 476−489 arterial occlusive disease, 316 peripheral cyanosis, 708 diarrhea, 148 innervation areas, 209 continuous skin changes, 68−69 fragmentocytes, 875 see also face; neck; specific central cyanosis, 683 see also specific rapidly progressive diseases/disorders pulmonary atresia, 687 diseases/disorders glomerulonephritis, 875 head/facial pain, 206−217 systemic-to-pulmonary hematoma hemophagocytosis syndrome, 195 differential diagnosis, 206−207 shunt, 685 anterior spinal artery hemophilias onset of pain, 206 diastolic murmurs, 617−618 syndrome, 302 acquired immune-inhibitor, 461 medical history, 206 central cyanosis, 683 paroxysmal finger, 327, 327 hemophilia A, 461 neuralgia in head region, double inlet ventricle, 698 pulmonary, 566 pseudotumor, 456 215−217 schematic representation, 617 retroperitoneal, unilateral leg hemophilia B, 461 see also specific area/type tricuspid stenosis, 659 pain, 309 hemopoietic neoplasia head impulse test, 959 types, 618 subdural see subdural diagnosis, 422 health status see physical ventricular septal defect, 701 hematoma leukemia, 422−431 examination diastolic regurgitant murmur transient hyperbilirubinemia, myelodysplastic syndrome, hearing impairment/loss, 98 chronic aortic insufficiency, 763 432−433 heart 646 hematomyelia, 302 myeloproliferative syndrome, chest radiograph, 619 mitral stenosis, 657 hematuria 434−435 examination, 612, 612−613 pulmonary insufficiency, 654 congenital disease with, pathogenesis, 422 orientation, 619 midsystolic murmur, tricuspid 876−878 hemoptysis, 43, 495, 590 palpation, 27, 612, 612 atresia, 690 glomerular vs. nonglomerular, causes, 43 sarcoidosis, 588 systolic murmurs, 616−617 847 Goodpasture syndrome, 874 size, 619 atrial septal defect, 704 urinary sediment, 848 pulmonary infarction, 543 sounds see heart sounds atrioventricular septal defect, heme hemorrhage see bleeding see also entries beginning 695 metabolism disorders see hemorrhagic dengue fever, 175 cardio-/cardiac cyanosis, 683 porphyrias hemorrhagic diathesis, liver heart diseases/disorders differentiation, 616 molecule, 400 disease, 767 fever, 155−156 double inlet ventricle, synthesis, defects/disorders, hemorrhagic fever, 163 rheumatic see rheumatic heart 696−697 400 renal syndrome, with, 124 disease Ebstein anomaly, 706 porphyrias, 269 hemorrhagic telangiectasia, 655 skin changes due to, 69 schematic representation, 617 see also hemoglobin hemosiderosis, pulmonary, 561 see also specific tetralogy of Fallot, 685 hemicrania, chronic paroxysmal, hemostasis diseases/disorders types, 618 215 defects in, 456 heart failure ventricular septal defect, 701 hemicrania continua, 215 laboratory methods, 451 acute, 628−633 heart sounds, 613, 618 hemiplegic migraine, 996 primary, 452 causes, 628, 628−629 differential diagnosis, 613−614 familial, 214 disorders, 457−461 clinical manifestations, 628 mitral stenosis, 657 hemispheric strokes, 997 laboratory methods, 451 differential diagnosis, 629, second, 613, 614 hemobilia, 280 secondary 629 aortic stenosis, 640 hemochromatosis, 347−348, 788 disorders of, 461−463 symptoms, 629 arterial hypertension, 635 restrictive cardiomyopathy, 667 laboratory methods, 451 volume overload, 644 atrial septal defect, 704 hemodynamics hemosuccus pancreaticus, 281, cardiac dyspnea, 605, 607 atrioventricular septal defect, Doppler echocardiography, 625 282 causes, 634−674 695 peripheral artery disease, 317 hemosynthesis inhibition, lead cardiac arrhythmias, 674 central cyanosis, 683 hemoglobin poisoning, 271 impaired contractile function, double inlet ventricle, 697 biosynthesis, 400, 709 Henderson−Hasselbalch equation, 669−673 pulmonary atresia, 687 disorders of, 404−405 918 impaired ventricular filling, transposition of great electrophoresis, 418 Henoch−Schönlein disease, 181 655−668 arteries, complete, 692 see also heme purpura, 465, 465−466, 867 increased cardiac output vs., see also heart murmurs hemoglobin cyanosis, 678, diarrhea, 812 654 heavy-chain disease, multiple 679−708 heparin-induced pressure overload, 634−635, myeloma, 441 associated findings, 679 thrombocytopenia (HIT), 469 634−644 Heberden nodes, osteoarthritis, definition, 678 heparins, 463 volume overload, 644−655 90, 349 pathophysiology, 679 thrombocytopenia, 469 chronic, 633 1083

hepatic abscesses, 796 hereditary elliptocytosis, 417 history-taking see medical history human herpesvirus 8, 168 infections, 146, 151 hereditary hemochromatosis HIV-1 RNA determination, 166 humoral immunodeficiency, 168, hepatica obliterans, 790 (HH), 788 HIV infection, 163−166 187, 189 hepatic coma, 1004 iron indices, 788 acute, 163−164 hunger edema, 384 hepatic encephalopathy, 780, 787 hereditary hemorrhagic associated diseases, 165, 166 hungry bone disease, 933 hepatic porphyria, 270 telangiectasia (HHT), 464 tuberculosis, 144 Hunter glossitis, 78 hepatitis hereditary intrinsic factor asymptomatic, 164 pernicious anemia, 406, 407 acute, laboratory findings, 768 deficiency, 406 candidal stomatitis, 168 Hunt neuralgia, 217 alcohol-induced, 772, 778−779 hereditary lymphedemapraecox, cardiomyopathy, 669 hyaline casts, urinary sediment, abdominal pain, 272 387 clinical manifestations, 164 849, 850 liver swelling, 288 hereditary neuropathy with differential diagnosis, fever, 111 hydralazine, drug-induced lupus, autoimmune, 778 liability to pressure palsies encephalitis, 137 181 autoantibodies, 770 (HNNP), 308 hairy leukoplakia, 168 hydrocarbons, coma, 1008 chronic hereditary nonpolyposis lymphoepithelial cysts, 130 hydrocephalus definition and classification, colorectal carcinoma (HNPCC), macular exanthem, 58 acute malabsorptive, 209 772, 773 819 pulmonary hypertension, 637 acute occlusive, 209 laboratory findings, 768 hereditary telangiectasis, 572, 572 pulmonary infiltrates, 540 hydrogen cyanide, coma, 1008 skin changes due to, 69 hereditary thrombophilia, skin, 72 hydrogen ions, acid-base viral, 772−777 467−468 symptomatic, 164−166 metabolism, 915 differential diagnosis, 772 Hermansky−Pudlak syndrome, vitamin B12 deficiency, 407 hydrogen sulfide, coma, 1008 liver cirrhosis, 780 457, 458 see also AIDS hydronephrosis, 884−885 transmission, 773 hernias HLA-B27, spondylarthropathies, bilateral, 884 see also specific infections cardiophrenic angle, 578 341 unilateral, 884 hepatitis A, 773, 773−774 palpation, 31 HLA-DR3, Graves disease, 485 hydrophilic mucopolysaccharides, course, 775 herniated disk, 303 HLA-haplotype DQB1*0602, edema, 384, 385 serologic and molecular heroin overdose narcolepsy, 1009 hydrosulphides, 710 findings, 774 coma, 1007 hoarseness, 102 b-hydroxybutyric acid, hepatitis B, 773, 774−776 pulmonary edema, 632 pulmonary hypertension, 636 normochloremic metabolic clinical features, 776 herpangina, common cold, 139 Hodgkin cells, 435 acidosis, 920 course, 775 herpes genitalis, AIDS, 166 Hodgkin disease, 435−437, 437 5-hydroxyindole acetic acid extrahepatic manifestations, herpes simplex virus infection, Ann Arbor classification, 437, (5-HIAA), carcinoid syndrome, 776 122 438 826 molecular screening methods, acute encephalitis, 136 B symptoms, 436 21-hydroxylase antibodies, 776 clinical manifestations, 123 clinical symptoms, 436 Addison disease, 752 polyarteritis nodosa, 179 encephalitis, coma, 995 diagnosis, 436−437 11 b-hydroxysteroid serology, 774, 774−776 skin presentation, 57 fever, 194 dehydrogenase type 2, steroid transmission and epidemiology, herpesvirus infections, 122 hilar enlargement, 589, biosynthesis, 908 774 clinical manifestations, 123 589−590 5-hydroxytryptamine (serotonin), viral arthritis, 126 herpes zoster, 58, 58, 122 histology, 437 carcinoid syndrome, 826 hepatitis C, 773, 776−777 lymph node enlargement, 128 mediastinal lymph nodes, 436 hyperaldosteronism, course, 775 pain, 273 nodular sclerosis, 437 hypokalemia, 911 membranoproliferative radiculitis, 304 pulmonary nodules, 568 hyperamylasemia, 292 glomerulonephritides, 867 herpes zoster oticus, 122 stages, 437 hyperamylasuria, 292 serologic and molecular heterochromia, 96 holocephalic pain, 215 hyperbilirubinemia, 763 findings, 774 hexose monophosphate shunt, holodiastolic reflux, chronic aortic hereditary isolated hepatitis D, 773, 777 191 insufficiency, 647 nonhemolytic, 772 serologic and molecular enzyme deficiencies, 418 holosystolic murmur, tricuspid isolated, nonhemolytic, findings, 774 hiatus hernia, 283, 578 atresia, 690 771−772 superinfection, 775, 777 dysphagia, 803 holosystolic regurgitant murmur unconjugated, 766, 771−772 hepatitis E, 773, 777 hiatus leukemicus, 424 chronic mitral insufficiency, hypercalcemia, 934−935, 935 serologic and molecular hibernating myocardium, 673 650 chronic renal failure, 860−861 findings, 774 hiccups, 47 mitral stenosis, 657 diagnosis, 937 hepatitis G, 777 ‘hidden agenda,’ patients, 5, 33, Holter monitoring differential diagnosis, 936 hepatitis viruses, 772−773, 773 36−37 arrhythmias, 715 familial hypocalciuric, 944 serologic and molecular high-altitude edema, 390 syncope, 974 hyperparathyroidism, 375 findings, 774 high-altitude pulmonary edema, homocysteine membrane excitability, 930 see also specific 632 hereditary thrombophilia, 468 hypercalcinuria, 586 viruses/infections high-density lipoprotein (HDL) laboratory parameters, 1044 hypercalciuric hypocalcemia, hepatobiliary disease, cholesterol, 1043 homocystinuria, 79 familial, 932 clinical-chemical diagnosis, 768 high grade atrioventricular block, homogentisic acid hypercapnia hepatoblastoma, 796 717 alkaptonuria, 65 chronic hepatocellular carcinoma (HCC), high lumbar radicular pain, 310 ochronosis, 347 chronic respiratory 796, 797 hilar enlargement, 582−599 honeycomb lung, 551, 552, 565 insufficiency, 925 hepatocellular damage, laboratory bilateral, 583, 583−590 hordeolum, diabetes mellitus, 94 metabolic alkalosis, 924 parameters, 768 causes, 582 hormone-secreting tumors, respiratory alkalosis, 928 hepatojugular reflux (HJR), 27, clinical features, 582 diarrhea, 826 hyperchloremic acidosis, with 611 Kaposi sarcoma, 561 Horner syndrome, 94, 95, 567, 596 normochloremic acidosis, 920 hepatomegaly mediastinum widening see dysphagia, 803 hyperchloremic metabolic Budd−Chiari syndrome, 790 mediastinum head pain, 215 acidosis, 920 cardiac dyspnea, 611 unilateral, 590−596 unilateral arm pain, 307 with normal serum anion gap, pharyngitis, 138 Hirschsprung disease, 832 Wallenberg syndrome, 301 921−922 hepatopulmonary syndrome, hirsutism, 73 ‘hot nodules’ hypercholesterolemia, 229 639−640, 787−788 histamine nontoxic goiter, 483 screening, 34 hepatorenal syndrome, 787 chronic renal failure, 860 toxic adenoma, 486 hyperchylomicronemia, 226, 227 hepatosplenic candidiasis, 151 urticaria pigmentosa, 55 toxic multinodular goiter, 488 hypercortisolism, secondary hepatotoxic drugs, 146 histiocytic tumors, 360 hourglass nails, 28 osteoporosis, 369 hereditary angioedema, 390 histiocytosis, 445 hourglass stomach, 277, 278 hyperemesis gravidarum, hereditary colorectal carcinoma, malignant, 445 human chorionic gonadotropin jaundice, 790 819, 819 non-Langerhans cell, 445 (HCG), 1044 hyperemic conjunctiva, 680, 682 hereditary coproporphyria (HCP), histiocytosis X, 360, 445, 564 human herpesvirus 6 infection, hypereosinophilic syndrome, 547 268, 270 Histoplasma capsulatum, 170 122−123 hyperfiltration, focal segmental hereditary diseases, 21−22 histoplasmosis, 170, 539, 539 clinical manifestations, 123 glomerulosclerosis, 870 see also specific diseases 1084

hypergammaglobulinemia, 584 causes, 55 causes, 483, 485 adrenergic manifestations, 1000 eosinophilic fasciitis, 186 oral cavity, 77 diarrhea, 825 clinical features, 999−1000 polyclonal, autoimmune hyperplasia, nodular regenerative, edema, 384 differential diagnosis, 1001 hepatitis, 778 786 fever, 193 neuroglycopenic hyperglycemia, diabetes mellitus, hyperplastic nodules, nontoxic high output heart failure, 655 manifestations, 1000 40 goiter, 483 hypotension, 751 without diabetes mellitus, hyperglycemic hyperosmolar hyperprolactinemia, secondary secondary osteoporosis, 369 1001−1002 nonketotic coma, 1002−1003 osteoporosis, 370 skin changes, 66 hypogonadism, 43 hypergranular promyelocytic hyperreninemic thyrotoxic crises, 193 secondary osteoporosis, 369 leukemia, 426 hypoaldosteronism, 914 toxic multinodular goiter, 487 hypogonadotrophic hyperhomocysteinemia hypersegmented neutrophils, 407 hypertonic hyperhydration, hypogonadism, 755 hereditary thrombophilia, 468 hypersensitivity pneumonitis, edema, 385 hypokalemia obliterating arteriosclerosis, 319 556−557 hypertriglyceridemia, 229 anorexia nervosa, 755 hyperhydration hypersensitivity vasculitis, 181 hypertrophic cardiomyopathy, clinical features, 909 chronic renal insufficiency, 862 hypersomnia, 984, 1008−1010, 662−664, 663 definition, 909 prerenal kidney failure, 852 1010 clinical features, 664 diagnosis, 909, 912 hyperimmunoglobulinemia D clinical features, 1008−1009 differential diagnosis, 664 differential diagnosis, 910 syndrome (HIDS), 192−193 diagnostic confirmation, 1010 dilated, 663 ECG changes, 909, 909 differential diagnosis, 192 differential diagnosis, 1010 ECG, 665 enhanced potassium loss, 911 hyperkalemia, 862, 912−914 following coma, 989, 990 etiology and pathogenesis, familial periodic paralysis, 911 chronic renal insufficiency, 862, hypersplenism, 460 662−664 hypertension, 911 913 hypersynchronization, syncope, signs and symptoms, 664 hypotension, 755 clinical features, 909 954 hypertrophic obstructive primary aldosteronism, 738 definition, 909 hypertension cardiomyopathy (HOCM) reduced potassium intake, 910 diagnosis, 909, 914 acute cardiac decompensation, ECG, 665 signs and symptoms, 909 differential diagnosis, 913 629 murmur, 616 transcellular potassium shifts, ECG changes, 862, 909, 909 aortic dissection, 245, 267 schematic representation, 664 911 excessive potassium intake, 912 arterial, 635 syncope, 978 with normal/reduced blood familial periodic paralysis, 912 chronic stable angina tachyarrhythmias, 976 pressure, 911 mineralocorticoid deficiency, pectoris, 225 hypertrophic osteoarthropathy, hypomagnesemia, 942−943 914 screening, 34 348, 363−364 definition, 942 reduced distal sodium delivery, atherosclerosis risk, 226 nail changes, 75 diagnosis, 944 913−914 cardiac output, increased, 745 see also clubbing differential diagnosis, 943 reduced potassium excretion, chest radiograph, 620 hypertrophic subpulmonic hypokalemia, 911 913−914 classification, 732, 732 stenosis, 642 hypotension, 755 in renal failure, 862 clinical examination, 734 hypertropic cardiomyopathy, signs and symptoms, 942 renal tubular acidosis, 921, 922 definition, 732, 732 murmur, 616 hyponatremia, 901−904 signs and symptoms, 909 diagnostic management, hyperuricemia, gout, 345 Addison disease, 752 transcellular shifts, 912 732−734 hyperuricosuria, 886 cardiac dyspnea, 618 hyperkinetic heart syndrome, 655 drug-induced, 746 hyperventilation, 502, 993 diagnosis, 903 hyperlipidemia, 229 encephalopathy, coma, 995 hyperventilation tetany, 985 euvolemic, 902, 902, 903−904 alcohol-induced hepatitis, 779 endocrine disorders, associated, hyperviscosity syndrome, 444 causes, 903 familial, 271 737−744 coma, 1005 differential diagnosis, nephrotic syndrome, 868, 869 genetic forms, 744, 744 hypervolemic hypernatremia, 906 903−904 transient, abdominal pain, 271 gout, 345 differential diagnosis, 904 volume expansion, 900 hyperlipoproteinemia, 226 hemorrhages, 997 hypervolemic hyponatremia, 902, hypo-osmolar hyperhydration, hypermagnesemia, 944−945 hypokalemia, 911 902, 904 1060 differential diagnosis, 943 idiopathic, 635−636 hypnagogic hallucinations, 984 hypoparathyroidism, 932−933 signs and symptoms, 942 thrombus formation, 640 hypnic headache, 215 diarrhea, 825 hypermenorrhea, anemia, 402 laboratory testing, 734 hypnotics, coma, 1007 differential diagnosis, 932 hypernatremia, 905−906 malignant, anemia, 416 hypoalbuminemia hyperphosphatemia, 941 differential diagnosis, 904 management, 733 calcium levels, 930 nail changes, 74 hypernephroma, fever, 194 medical history, 734 nephrotic syndrome, 868 hypoparathyroidism , skin hyperosmolar coma, 1002−1003 membranous hypoaldosteronism changes, 66 differential diagnosis, vs., 1003 glomerulonephritis, 870 Addison disease, 752 hypophosphatasia, osteomalacia, hyperosmolarity, 896 monogenetic forms, 744 genetic variants, 914 373 dehydration, 1060, 1061 pregnancy, 746, 746 hypo-a-lipoproteinemia, 227 hypophosphatemia, 939−940 hyperhydration, 1061 primary, 733, 734 hypobaric hypoxia, 501 definition, 937 hyperostosis, 363−364 pulmonary see pulmonary hypocalcemia, 932−934 diagnosis, 940 hyperostosis frontalis interna, 364 hypertension acute pancreatitis, 292 differential diagnosis, 939 hyperparathyroidism, 375, pulmonary edema, 630, 631 diagnosis, 933 hemolytic anemia, 413 375−376, 934−935 recommended interventions, differential diagnosis, 932 hyperparathyroidism, 376 acute, fever, 193 732 familial hypercalciuric, 932 osteomalacia, 373 chronic renal failure, 860−861 renal insufficiency, 859 membrane excitability, 930 signs and symptoms, 938 differential diagnosis, 936 renovascular see renovascular hypocalciuria, hypotension, 755 hypophosphatemic vitamin hypocalcemia, 934, 934 hypertension hypochromia D-resistant rickets, 940 hypophosphatemia, 939 risk assessment, 732, 734, 734 anemia, 397 hypophyseal insufficiency, hypotension, 751 screening, 34 iron deficiency anemia, 401 hereditary hemochromatosis, primary, 375 secondary, 733, 735−746, 746 microcytic anemia, 373 788 secondary, 860 clinical examination, 733 renal anemia, 410 hypopigmentation, 54 differential diagnosis, 376 diagnostic studies, 733−734 thalassemia, 404−405 Addison disease, 54, 66, 752 osteomalacia, 373 endocrine forms, 733 hypogammaglobulinemia postinflammatory, 54 vitamin D deficiency, 933 evaluation, 732−734 acquired, 189 hypopituitarism vitamin D excess, 935 history, 733 celiac disease, 822 causes, 754 hyperphosphatemia, 941 laboratory tests, 733 hypogastric pain, differential hair loss, 73 chronic renal failure, 860 preliminary analysis, 733 diagnosis, 264 skin color, 53 definition, 937 toxic agent-induced, 746 hypoglycemia, 1000 hypoplastic myelodysplastic diagnosis, 941 hypertensive crisis, arterial alcohol-induced coma, 1007 syndrome, 411 differential diagnosis, 939 hypertrophy, 635 coma see below hypopnea, 505 iron malabsorption, 402 hypertensive heart, 621, 664 differential diagnosis, 1000 assessment, 505 signs and symptoms, 938 hyperthermia, 111 drug-induced, 1002 hypoproteinemic edema, 383−384 vitamin D deficiency, 933 malignant, 111 fasting, 1001−1002 clinical features, 383 hyperpigmentation, 54−56 hyperthyroidism, 485−488 hypoglycemic coma, 999−1002 diagnosis, 383 etiology, 383−384 1085

hyporegenerative normochromic idiopathic headache, 213−215 laboratory parameters, inguinal compression normocytic anemia, 409−412, idiopathic hirsutism, 73 1044−1045 neuropathies, unilateral leg 410 idiopathic hypersomnia, 1010 nephropathy, 876, 877 pain, 310 classification, 409 idiopathic hypertension, 734 immunoglobulin D (IgD), inheritance hyporegenerative situations, 409 idiopathic hypotension, 750 hyper-IgD syndrome, 192 autosomal dominant, 21−22 hyporeninemic idiopathic intestinal immunoglobulin E (IgE), autosomal recessive, 22 hypoaldosteronism, 914 pseudoobstruction, 262 laboratory parameters, inner ear, perilymph fistula, 971 hypotension idiopathic kyphoscoliosis, 502 1045−1046 insomnia, 46, 990 acute ischemic tubular necrosis, idiopathic mediastinal fibrosis, immunoglobulin G (IgG), 465 clinical features, 46 854 599 laboratory parameters, insulin cardiac, 756 idiopathic pericarditis, 242 1044−1045 autoantibodies, hypoglycemia, definition, 750 idiopathic portal hypertension, poststreptococcal 1002 endocrine, 750, 750−751 786 glomerulonephritis, 867 deficiency, ketoacidotic coma, associated disturbances, 755 idiopathic primary immunoglobulin M (IgM), 465 1002 genetic forms, 755−756, 756 glomerulopathy, 865 laboratory parameters, hyperglycemic hyperosmolar hypovolemic, 757 idiopathic pulmonary fibrosis 1044−1045 nonketotic coma, 1002 myocardial infarction, in course (IPF), 550−551, 552 impaired consciousness, 951−953 hypophosphatemia therapy, of, 240 idiopathic pulmonary clinical forms, 953 940 neurogenic, 756 hemosiderosis, 561 impotence, 48, 48 laboratory parameters, 1035 orthostatic dysregulation, 979 idiopathic thrombocytopenic ‘inborn errors of metabolism,’ 20 potassium shifts, 907 portal see portal hypertension purpura (ITP), 454, 459 incarcerated inguinal hernia, 262 see also diabetes mellitus primary, 750 Bernard−Soulier syndrome, incidentaloma insulin-like growth factor 1 renal, 756 differentiation, 457 pheochromocytoma, 740 (IGF-1), 743 secondary, 750, 750−756 idiopathic ventricular tachycardia, prevalence, 742 insulinomas, fasting toxic and drug-induced, 757 727, 727, 978 individually adapted diagnosis, 5 hypoglycemia, 1001 hypothalamic-pituitary-adrenal ileal disease, bile acid indocyanine green (ICG) clearance insulin receptor defects, 39 axis, Cushing syndrome, 741 malabsorption, 824 testing, 769 hypertension, 744 hypotheses, first working, 7 ileal resection indolent lymphoma, 438 insulin resistance, 38 hypothyroidism, 488−489, 489 bile acid malabsorption, 824 industrial toxins, hemolytic acromegaly, 743 acquired, 488−489 short bowel syndrome, 824 anemia, 413 see also metabolic syndrome anemia, 410 ileocecal resection, small bowel infarction, spleen, 267 intercoastal neuralgia, 273 causes, 488, 488 bacterial overgrowth, 824 infections intercostal pain, 251 definition, 488 ileocecal tuberculosis, 817 acute leukemia, 422 interleukin-6 (IL-6), anemia, 404 facial appearance, 91, 92 ileus, 260−263 ascites, 784 intermediate atrioventricular hypercholesterolemia, 230 bowel obstruction, 817 bacterial see bacterial infections septal defect, 694 hypotension, 751 mechanical, 260−262 chronic renal insufficiency, 863 intermittent claudication, neonatal, 488, 488 paralytic, 262−263 diarrheal disease, 811 314−315 primary, 488, 488 iliac artery fungal see fungal infections posture for optimal resolution, screening, 36 aneurysms, 323 lymphadenopathy, 446 314 secondary, 488 obstruction, 319 opportunistic see opportunistic intermittent fever, 196, 196 causes, 488 claudication, 314 infections intermittent porphyria, acute, symptoms, 489 iliofemoral vein, acute deep vein parasitic see parasitic diseases 268, 270 skin changes, 66 thrombosis, 330 postoperative International Headache Society tertiary, 488, 488 illicit drugs, coma, 1005, 1006 special patient groups, fever, criteria, migraine without aura, hypotonic hyperhydration, 385 imaging 111 213 hypotonic hyponatremia, 902 acute pancreatitis, 292 see also specific infections international normalized ratio hypotrichosis, jaundice, 767 neck masses, 476 pulmonary edema, 632 (INR), 1058 hypovolemia, 898 see also specific modalities skin changes due to, 71−72 International Prognostic Scoring hypotension, 750 Imerslund−Graesbeck syndrome, viral see viral infections System (IPSS), myelodysplastic nephrotic syndrome, 869 407 see also specific infections syndrome, 433, 433 hypovolemic hypernatremia, 905 immobilization, long-term, infectious diseases, 16 internuclear ophthalmoplegia differential diagnosis, 904 nephrolithiasis, 935 abdominal pain, 272 (INO), 962 hypovolemic hyponatremia, 901, immobilizing vertigo, 955 fever, 114 etiology, 964 902 immune complexes, 17 petechiae and purpura, 116 interphalangeal joints, causes, 902 diseases, 22 rash, presenting with, 117 rheumatoid arthritis, 338 diuretics, 902−903 immune-inhibitor hemophilia, see also specific diseases interstitial edema, acute, cardiac hypovolemic shock, 633 461 infectious lymphadenitis, 477 dyspnea, 500 hypoxia immune mediated diseases, 17 infectious mononucleosis, interstitial nephritis, urinary cardiac dyspnea, 607 autoimmune see autoimmune 138−139 findings, 879 pulmonary emphysema, 512 diseases inferior sinus venous defect, 703 interstitial pneumonia, 145 respiratory alkalosis, 928 see also specific diseases inferior vena cava, acute, 553−554 respiratory failure, 497 immune-mediated enteropathy, hypoproteinemic edema, 383 collagen vascular disease hysterical state, 985 celiac disease, 821−822 infertility, 42−43 associated, 554−555, 555 immunocompromised patients inflammation/inflammatory idiopathic, 549−554 I diarrhea, 147 disorders, 16, 465−466 lymphoid, 554 fungal infection, 537−539 concomitant arthralgias, 465 nonspecific, 551, 553 iatrogenic disorders infections, 167−169 edema, 388−389 toxic and drug-induced, 556 arterial disease, 320 non-Hodgkin lymphoma, 438 giant cell arteritis, 320 see also diffuse parenchymal atrioventricular fistulas, high pneumonia, 141 intestinal infections, 147 lung disease (DPLD) output heart failure, 655 see also AIDS; HIV infection obliterating arteriosclerosis, 319 interstitial pneumonitis, Cushing syndrome, 740 immunodeficiency pseudotumors, 130 Pneumocystis carinii, 167 hypotension, 750 cellular, 168, 187, 190 pulmonary nodules, 569−570 interstitial pulmonary edema, plexus lesion, unilateral leg classification, 187−188, 187−188 stenosis, 803 622, 630 pain, 309 humoral, 168, 187,9 18 thromboangiitis obliterans, 320 intestinal pseudo-obstruction pneumothorax, 250 immunoglobulin(s) Wegener disease, 873 syndrome, 831 secondary adrenocortical laboratory parameters, see also specific intestinal torsion, mechanical insufficiency, 753 1044−1046 diseases/disorders ileus, 261 see also drug-induced nephrotic syndrome, 869 influenza, 140 intestinal tuberculosis, 149 diseases/disorders see also specific isotypes influenza pneumonia, 536 intoxication-induced coma, idiopathic calcification, 64 immunoglobulin A (IgA) influenza vaccination, 33−34 1005−1008 idiopathic cranial hypertension, deficiency, 191 infundibular pulmonary stenosis, causes, 1006 211 selective, 189 ventricular septal defect, 701, clinical features, 1005−1006 idiopathic epilepsy, 981 701 diagnosis, 1005−1006 1086

intoxications, 23 stroke, 997 tuberculosis, 126 bilateral, 735 abdominal pain, 268 ischemic cardiomyopathy, 673, judgment, false diagnoses and, 10 calculi, 885 epilepsy, 981 673 jugular vein cancer, 888−890 odor, 99 ischemic chest pain, differential edema, heart failure, 382 diagnosis, 889 skin changes, 68 diagnosis, 221 filling, 610 pulmonary metastasis, 571 intra-abdominal abscesses, 150 ischemic colitis, 815 pulse, 610 ultrasound, 889 intra-abdominal infections, 149 ischemic edema, 390 junctional rhythms, 719 see also renal cell carcinomas intracardiac echocardiography, ischemic papillary muscle ECG presentation, 719 chronic, secondary 626 rupture, 632 Junin virus, 123 hypertension, 732 intracellular buffer systems, ischemic rest pain, 315 juvenile arthritis, 340 cysts 915−916 ischemic stroke, 997 chronic oligoarticular, 340 acquired cystic disease, 864 intracellular volume (ICV), 895 ischemic tubular necrosis, acute, juvenile bone cyst, 362 sonographic findings, intracerebral hemorrhage, 208, 854 juvenile nephronophthisis 887−888 997−998, 998 isolated noncompaction of left complex, 888 urinary tract infections, 883 intracranial hypertension, 211 ventricle, 670, 672 eclampsia, 985 intracranial hypotension, 211 isoniazid, sideroachrestic anemia, K hypertension, 735, 735−737 intrahepatic cholestasis, 765, 405 hypoperfusion, hypovolemia, 790−792, 794 isosthenuria, 843 Kaposi sarcoma, 561, 563, 817 898 classification, 791 AIDS, 166 malaria, 172 severe infectious diseases, with, J gums, 77, 77 osteodystrophy 792 human herpes virus 8, 168 chronic renal failure, 860−861 intrahepatic postsinusoidal portal Jacksonian motor seizure, Kartagener syndrome, 515 mechanisms, 861 hypertension, 786 981−982 Kasabach−Merritt syndrome, 796 prevention, 861 intrahepatic pregnancy-related Janeway lesions, endocarditis, 69 high output heart failure, 655 osteopathy, osteomalacia, 372 cholestasis, 790 Japanese encephalitis virus, 137 Katayama fever, 173 unilateral, 735 intrahepatic presinusoidal jaundice, 145−146, 763−799 Kawasaki disease, 129 see also specific diseases resistance, 785 causes, 765 Kawasaki syndrome, 57 Kiel classification, non-Hodgkin intrahepatic sinusoidal resistance, clinical classification, 765−766 Kayser−Fleischer corneal ring, lymphoma, 439 786 clinical symptoms, 766−767 788, 789 Kikuchi−Fujimoto disease, 130 intrapulmonary intra-alveolar fever, 145−146 keratitis, 97 Kimmelstiel−Wilson edema, 609 hemolytic anemia, 412 ketoacidosis, fasting, 921 glomerulosclerosis, 326, 871 intrarenal diseases, 853 pharyngitis, 138 ketoacidotic coma, 1002 Klebsiella pneumoniae, 526 intrarenal kidney failure, 853 sclerae, yellow, 95 hyperosmolar coma vs., 1003 Kleine−Levin syndrome, 984 intrathoracic goiter, 597, 598 skin color, 54 ketoacidotic decompensation, Klinefelter syndrome, 21, 80, 81 intravasal catheter infections, 111 venous congestion, 611 1002 hair loss, 73 intravenous iron substitution, 403 definition, 763 ketones, 843 Klippel−Trénaunay syndrome, 80, intrinsic asthma, 507 differential diagnosis, 763−771, ketonuria, 843 80 intrinsic factor, 406 771−797 kidney(s) knee trauma, osteonecrosis, 366 iodine imaging techniques, 771 acid excretion regulation, knowledge, false diagnoses and, deficiency, nontoxic goiter, 483 immunoglobulins, 769 916−917 10 requirements, 483 laboratory parameters, altered function Koenen tumors, 69, 70 ion transport defects, 417 768−770, 1027 diagnostic procedures, 839 Köhler disease, 365 iridocyclitis, 96 medical history, 766 laboratory findings, 839 Köhlmeier−Degos syndrome head/facial pain, 212 obstructive, 794, 795 pathological sonographic abdominal pain, 272 iris, 96 pancreatic carcinoma, 296 findings, 882−890 skin changes, 272 iritis, 96 transaminase levels, 768 serologica examinations, koilonychia, 74 head/facial pain, 212 pathophysiology, 763−766 839−840 Koplik spots, 122 iron posthepatic, 146 symptoms and signs, Kozhevnikov epilepsy, 983 daily cycle, 401 postoperative, 792 839−840 Kümmel−Verneuille disease, 365 deficiency see iron deficiency during pregnancy, 790−792, ammonium excretion Kussmaul respiration, 28 formulations, melena, 281 792 mechanisms, 916 hyperosmolar coma, 1003 laboratory parameters, 1046 quantitative liver function tests, biopsy ketoacidotic coma, 1002 metabolism, 400 769 acute renal failure, 857 Kussmaul sign, 610 disorders, 400, 404 urinary findings, 769 poststreptococcal Kveim reaction, 589 negative balance, 400 jejunum glomerulonephritis, 868 kwashiorkor, 384 reabsorption, 400 bacterial culture, 824 calcium loss, 934 kyphoscoliosis, 502, 502 requirement, 400 distension, dumping syndrome, calcium retention, 935 cyanosis, 683 iron deficiency 284 chloride loss, 923 anemia see iron deficiency peptic ulcer, 284 electrolyte excretion, 895 anemia Jo-1 antibodies, 186−187 endocrine functions, chronic L cheilosis, 404 joint inflammation renal failure, 857 dietetic, 402 anemia, 403 enlargement, autosomal L3 associated pain syndrome, renal anemia, 410 calcium pyrophosphate, 345 dominant polycystic kidney 309 symptoms, 403 rheumatic, 338−348 disease, 888 L4 syndrome, 309 iron deficiency anemia, 400−403 arthropathies associated with failure, prerenal, 852−853 L5 syndrome, 309 atrophic tongue, 403 metabolic disease, 345−346 causes, 852 laboratory techniques, 6 bleeding diathesis, 454 rheumatoid arthritis, diagnostic difficulties, 852 laboratory tests causes, 404 338−340 palpation, 31 myocarditis, 673 diagnosis, 401 spondylarthropathies, phosphate loss, 940 parameters, 1017 gastric carcinoma, 280 341−344 phosphate retention, 941 pulmonary edema, 631 nail changes, 74 joint protheses infections, polyarteritis nodosa, 179 pulmonary hypertension, skin presentations, 69 126−127 potassium excretion, 908, 909 637−638 irritable bowel syndrome (IBS), joints size determination, 864 restrictive cardiomyopathy, 666 284−285 arthritis see arthritis sodium retention, 899 see also specific tests/substances abdominal pain, 273 examination, 31−32 transplantation labyrinth clinical features, 284−285 inflammation see joint chronic renal failure, 857 arterial blood supply, 958 definition, 284 inflammation hypertension following, 735 injury, traumatic vertigo, 971 diagnosis, 285 pain see arthralgia see also entries beginning lesions, 970 differential diagnosis, 285 sarcoidosis, 588 nephro-/glomerular/renal labyrinthitis, 98 pain localization, 285 swelling, rheumatoid arthritis, kidney diseases, 840 lactase deficiency, 820−821 pain misinterpretation, 285 338 abscess, 883 acquired, 820 irritable stomach, 276 systemic lupus erythematosus, urinary tract infections, 883 secondary, short bowel ischemic brain lesions, 208−209 181 anemia, 409−410 syndrome, 824 1087

lactate inguinal compression lipase swelling, post-cholecystectomy, laboratory parameters, neuropathies, 310 chronic pancreatitis, 296 288 1046−1047 mononeuropathy, 310 laboratory parameters, 1048 toxic and drug-induced, 778−779 lactic acidosis, 921 topical neurological lipedema, 386, 388 tumors, 795−796 lactate dehydrogenase (LDH), 591 syndromes, 308−310 lipid(s) metastases, 795, 796, 818 acute coronary syndrome, 239 unilateral neurogenic leg pains, dyslipoproteinemia, 226 see also specific laboratory parameters, 1047 308−310 laboratory parameters, diseases/disorders pleural fluid, 247 leiomyoma, 803 1048−1050 liver failure, 787 lactic acidosis, 921 stomach, 282 lipid storage disease, skin liver function tests, quantitative, coma, 1003−1004 leiomyosarcoma, gastric changes, 65 769 differential diagnosis, 1003 carcinoma, 280 lipiduria, nephrotic syndrome, liver-kidney microsomes (LKM) type B, 921 Leishmania donovani, 172−173 868 antibodies, liver disease, 770 lactose intolerance, secondary, leishmaniasis, 172−173 lipodystrophies, 87 lividoid vasculitis, 327 821 Lemierre syndrome, 130−131 lipoid nephrosis, 844 Loa loa infection, 175 lactose tolerance test, 820 lens, 96 lipoid pneumonia, 541 inflammatory edema, 388 lacunar infarcts, head pain, lepromatous leprosy, 120 lipomas, 569 lobular panniculitis, 61 208−209 leprosy, 120 neck, 479 localized bullous emphysema, 513 lamina dura, Leptospira interrogans, 162 lipoproteins localized lymphadenopathy, 446 hyperparathyroidism, 375 leptospirosis, 162 categorization, 226 local psychosyndrome, 21 Landouzy sepsis, 144 meningitis, 132, 135 metabolism, 230 locked-in syndrome, 991 Langerhans cell histiocytosis, 360, lesions, space-occupying structure and function, 227 Löffler endocarditis, 666, 667 445, 564 laboratory findings, 768 liquorice, primary aldosteronism, Löfgren syndrome, 585, 588 language disturbances, 100−102 liver, 795−797 739 erythema nodosum, 61 laparoscopy, jaundice, 771 pancreatic region, 294−295 listeria meningitis, 133−134 long QT syndrome, 977 Laplace law, 634 lethargia pitutiaria, 1004 lithium, hyperparathyroidism, long sleepers, 1010 large bowel lethargic encephalitis, 995 375 loop diuretics, renal calcium loss, ileus, 261 Letterer−Siwe syndrome, 360 livedo, causes, 57 934 obstruction, colonic carcinoma, leucine crystals, urinary livedo racemosa, 327 Looser zones, 373−374 818 sediment, 850 livedo reticularis, 327, 708, 854, lordosis stenosis, diverticulosis, 820 leukemia, 422−431 854 intermittent claudication, 314 see also anorectum; colon; acute, 422−428 liver lumbar, unilateral leg pain, 309 entries beginning colorectal clinical symptoms, 422 angiography, 771, 786 low output heart failure, 607 large-vessel vasculitis, Takayasu diagnosis, 422 biopsy, 771 low oxygen affinity hemoglobins, arteritis, 320 see also specific forms failure, 787 709 Laron dwarfs, 84 chronic forms, 428−431 function tests, quantitative, 769 lucidity, 951, 988 larynx diseases, 506 see also specific forms iron index, hereditary lumbar spine Lasègue sign, 304 classification, 422 hemochromatosis, 788 hyperostosis, 351 radiculopathy, 303 distribution, 422 palpation, 30−31 osteoarthritis, 351 Lassa fever, 123 hilar enlargement, 590 see also entries beginning osteochondrosis, 350, 351 late-diastolic murmurs, 618 myeloblastic hepato-/hepatic lumbosacral plexitis, 309 late dumping syndrome, 284, with maturation, 426 liver cirrhosis, 780−788, 782 lung(s) 1001 with minimal maturation, acanthocytes, 398 auscultation, cardiac dyspnea, latent syphilis, 161 426 ascites, 780 501 lateral cervical cysts, 476, 477 without maturation, 426 Child−Pugh classification, 783 cancer see lung cancer lateral cervical fistulae, 476 leukemoid reactions, 198 classification, 780 cysts, 565, 574 lateral recess obstructions, leukocyte casts, urinary sediment, severity dependence, 783 disease see pulmonary radicular compression 848, 849 clinical features, 780−783, 781 diseases/disorders syndromes, 304 leukocytes, 198−199 decompensated, 780 hyperinflation, 512 Lawrence−Moon syndrome, 83, 86 paroxysmal nocturnal tremor, 91 physical examination, 27−30 lead anemia, 271 hemoglobinuria, 415 ultrasound pattern, 782 sequestration, 578 leading loop syndrome, 284 urinary sediment, 847, 848 definition, 780 see also entries beginning lead poisoning leukocytosis, 198 etiologies, 780 pulmonary/respiratory abdominal pain, 268 acute appendicitis, 263 fever, 116 lung cancer, 145, 567−569, erythropoietic porphyria, 271 acute pancreatitis, 292 hereditary hemochromatosis, 590−592, 594 left atrial enlargement, chest hyper-IgD syndrome, 192 788 classification, 592, 593 radiograph, 620 peritonitis, 150 laboratory findings, 768 diagnosis, 591−592, 592 left bundle branch block leukocyturia, urinary sediment, laparoscopic findings, 780 epidemiology, 590 coronary artery occlusion, 234 848 pathogenesis, 780 hemoptysis, 495 transmural ischemia, 236 leukonychia, 76 pleural effusion, 248 localizations, 591 left common iliac vein leukopenia, 198−199 pulmonary hypertension, 639 screening, 35 compression, 330 pernicious anemia, 407 skin alterations, 69, 781 staging, 593 left hypochondriac abdominal tuberculosis, 144 liver disease survival rates, 593 pain, differential diagnosis, 259 leukoplakia, 77 abdominal pain, 272 symptoms, 590, 590−591 left iliac fossa pain, differential causes, 77 abscesses, 146, 151, 796 see also pulmonary nodules diagnosis, 259 Lewis method, cyanosis acute gastritis vs., 275 lung function tests see pulmonary left-to-right shunt, double inlet differentiation, 682 acute venous congestion, 288 function tests ventricle, 696 Libman−Sacks endocarditis, 182 anemia, 410 lupus anticoagulation, left ventricle see ventricle, left Libman−Sacks syndrome, 155 chronic congestion, edema, anti-phospholipid antibody Legionella pneumonia, 527, 528 lichen ruber planus, 75, 75 382−383 syndrome, 468 Legionella pneumophila, 142 Liddle syndrome, 744 chronic, porphyria cutanea lupus erythematodes, 554 Legionnaires disease, 142, 527 lifestyle, influencing diagnosis, tarda, 270 lupus erythematosus, 67 legs 12−13 cirrhosis see liver cirrhosis lupus pernio, 588 bilateral arm/leg pain, 310−311 lifting trauma, radicular coagulation, 462 luteal hormone-releasing Déjerine−Roussy syndrome, 308 compression syndromes, 304 fibrosis, congenital, 786 hormone (LHRH) agonists, dermatomes, 309 ligament ossification, ankylosing hepatitis see hepatitis secondary osteoporosis, 369 Fabry disease, 311 spondylitis, 341, 342 hepatovenous causes, 789−790 Lyell syndrome, 59−60, 60 Lyme borreliosis, 311 limbic structures, epilepsy, 982 hypoproteinemic edema, 383 Lyme disease, 157−158, 669 polyneuropathy, 311 limbs laboratory findings, 768 abdominal pain, 273 radicular leg pain, 309 movements, consciousness macrocytic anemia, 409 bilateral arm/leg pain, 311 ulcers, causes, 63 assessment, 993 osteomyelofibrosis, 435 clinical manifestations, 158 unilateral leg pain, 308−309 neurological examination, 32 sarcoidosis, 587 dilated cardiomyopathy, 669 diabetic neuropathy, 309−310 see also arms; legs skin changes due to, 69, 781 inflammatory edema, 389 lines of Mees, 74 skin presentation, 56 1088

lymphadenitis see also Hodgkin disease; secondary, 823 May−Turner syndrome, 330 acquired toxoplasmic, 478 non-Hodgkin lymphoma short stature due to, 83−84 McBurney point, acute acute, 478 lymphomatoid granulomatosis, malacoplakia, 883−884 appendicitis, 263 acute nonspecific, 477−478 571 malaria, 171−172 McLeod phenotype, erythrocyte acute suppurative, 479 lymphomonocytosis, 139, 139 clinical features and diagnosis, shape variations, 418 chronic, 478−479 lymphopenias, 190, 200 172 MCP joints, hemochromatosis, histoplasmosis, 170 lymphoplasmocytic lymphoma, blood smears, 174 347 infectious, 477 439 diarrhea, 149 measles, 122 specific, 478 lymphoplastic lymphoma, 444 exogenous hemolytic anemia, maculopapular exanthema, 118 toxoplasmic, 478 Lynch syndrome, 819 413 pneumonia, 536, 537 lymphadenopathy fever mechanical features, diagnosis, generalized, without M course of, 172 260 splenomegaly, 446−447 without localized symptoms, mechanical ileus, 260−262, 263 Hodgkin disease, 436 Machupo virus, 123 114 causes, 260−261, 262 localized, 446 Macleod syndrome, 510 pathogens and types, 171 clinical features, 260 reactive, 445−447 macroamylasemia, pancreatic quartan, 171, 172 complications, 260 see also lymph node disease, 290 malassimilation, 821−825 localization, 261 enlargement macroangiopathy, acromegaly, causes, 822 Meckel diverticulum, mechanical lymphangioleiomyomatosis 743 pathogenesis, 821 ileus, 262 (LAM), 564−565, 565 macrocytic normochromic maldigestion, 821−825 medial anterior infarct, 997 lymphangioma, 360 anemia, 406−409 pathogenesis, 821 medial calcinosis, 321, 321−322 neck, 477 causes, 408, 409 secondary malabsorption, 823 medial longitudinal fasciculus, lymphangiopathy, occlusive, 387 classification, 406 malignancies see cancer; 962 lymphangiosis carcinomatosa, definition, 406 tumor(s); specific malignancies rostral interstitial nucleus of 561, 563 see also specific causes malignant ascites, 784 MLF, 962 lymphangitis macrocytosis, 397 malignant atrophic papulosis, 272 mediastinal lymph nodes, 436 acute, 333 myelodysplastic syndrome, 411 malignant bone tumors, 356 non-Hodgkin lymphoma, 438 chronic obstructive, 174 macroglobulinemia, 444 malignant fibrous histiocytoma, mediastinoscopy, 589 lymphatic disorders macroglossia, 78 360 mediastinum chronic, 333 macrohematuria, urinary malignant diseases/disorders, 803 see also specific disorders sediment analysis, 847 hemangioendothelioma, 796 emphysema, 250 lymphatic drainage, edema, 384 macrovesicular steatosis, 778 malignant histiocytosis, 445 idiopathic fibrosis, 599 lymphatic filariasis, 174−175 macular degeneration, senile, 97 malignant hyperthermia, 111 inflammations, 597−599 lymphatic fistulas, secondary macular exanthem, 58 malignant melanoma, 14 phlegmon, 597−599 lymphedema, 388 maculopapular exanthema, 118 malignant tumors see cancer; tumors, 596−597, 597 lymphedema, 385 Maffucci syndrome, 357 tumor(s) widening, 596−599 primary, 385−387 magnesium Mallory−Weiss syndrome, 280 medical errors, 9 secondary, 386, 387−388 deficiency see hypomagnesemia malnutrition technical, 10 sporadic, 387 extrarenal loss, 943 chronic renal failure, 861 medical history, 5−6 lymph node(s) homeostasis disorders see fasting ketoacidosis, 921 insufficient, 10 examination, 445−446 magnesium homeostasis hypomagnesemia, 942 interview components, 26 metastases, 479−480 disorders vitamin D deficiency, 933 Mediterranean fever, 116 tonsillar carcinoma, 480 increased intake, 944 see also malabsorption; medullary cystic renal disease, physical examination, 26 laboratory parameters, 1050 malassimilation 888 toxoplasmosis, 162 properties, 928 Maltese crosses medullary sponge kidneys, 886 lymph node enlargement reduced intake, 942 nephrotic syndrome, 869 medullary thyroid carcinoma, 484 cytology and histology, 446 renal loss, 943 urinary sediment, 849, 849 mefenamic acid, coma, 1007 diagnosis, 446 renal retention, 944 MALT lymphoma, 440 megacolon, 832 examination, 445−446 transcellular shifts, 942−943, malum perforans, 326, 326 megaesophagus, 599 generalized, 127 944 mammography, 35 megakaryoblastic leukemia, 426, hilar enlargement see hilar magnesium homeostasis mandibular joint, arthropathy and 426 enlargement disorders, 928, 942−945 dysfunction, 213 megakaryopoiesis, infections, 128−129 causes, 942 manometry, normal swallow, 805 myelodysplastic syndrome, 432 localized, 127−128 clinical features, 942 mantle cell lymphoma, 440 megalocytic interstitial nephritis, occipital, 128 definition, 942 Mantoux test (tuberculin skin 883−884 unknown origin, 129−130 diagnosis, 942 test), 144 megalocytosis, 398 see also lymphadenopathy differential diagnosis, 943 hilar lymph node tuberculosis, megarectum, 832 lymphocytes, 200 physiologic principles, 928−930 596 MEGX test, 769 chronic lymphocytic leukemia, signs and symptoms, 942 Hodgkin disease, 437 Meige disease, 387 430 see also hypermagnesemia; primary tuberculosis, 531 Meig syndrome, 248 lymphocytic choriomeningitis, hypomagnesemia sarcoidosis, 589 melanin, hyperpigmentation, 54 meningitis, 134−135 magnetic resonance angiography marantic parotitis, 130 melena, 281−282 lymphoepithelial cysts, HIV (MRA) marble bone disease, 363 diagnosis, 281−282 infection, 130 peripheral artery disease, 318 Marburg virus, 123 Melkersson−Rosenthal syndrome, lymphogranuloma, 200 renovascular hypertension, 737 Marcumar, 462 53, 389 lymphogranuloma venereum, 161 magnetic resonance Marfan syndrome, 79, 79 meloidosis, 175 anorectum, 814 cholangiography (MRCP), 766, aortic dissection, 245 membranoproliferative lymphography, 387 771 hands, 90 glomerulonephritides, 867 lymphedema, 387 chronic pancreatitis, 294 skin presentation, 66 membranous glomerulonephritis, lymphoid interstitial pneumonia magnetic resonance imaging vessel wall, 464 870, 871 (LIP), 554 (MRI) Marie−Bamberger syndrome, 515 Mendelian genetics, 21−22 lymphoma cardiac uses, 626 mast cells, allergic bronchial Ménétrier disease, 276 bilateral hilar enlargement, central cyanosis, 684 asthma, 506 Ménière disease, 98, 970 589−590 coronary heart disease, 232 mastocytosis, 363 vertigo, 954 cervical lymph nodes, 480 infectious diseases, 114 carcinoid syndrome, 826 meningeal artery injury, 998 fever, 194 jaundice, 771 hyperpigmentation, 55 meningioma, radiculopathy, 304 lymphoplasmocytic, 439 myocardial ischemia, 233 maturity-onset diabetes of the meningism, subarachnoid lymphoplastic, 444 osteomyelitis, 127 young (MODY), 39 hemorrhage, 207 malignant, 435−444 osteonecrosis, 364 maximum oxygen uptake, meningitis, 208 multiple myeloma and malabsorption, 821−825 spiroergometry, 627 bacterial, 133−134, 208 Waldenström disease, hypomagnesemia, 942 May−Hegglin anomaly, 198, 458, cerebrospinal fluid findings, 441−444 pathogenesis, 821 460 132 pleural, 249 primary, 821−823 coma, 995 stomach, 282 1089

concomitant cases, 135 metabolic syndrome, 39, 88 consciousness disturbances, skin color, 53, 91, 92 fungal, 135 atherosclerosis risk, 226 996 special studies, 657−658 helminth, 135 definition, 88 consciousness disturbances, symptoms, 655, 657 migraine, 996 dyslipoproteinemia, 230 996 syncope, 978 neonatal, 134 hypertension, 737 Raynaud phenomenon, 325 mitral valvuloplasty, 627 posture, 85 metabolic-toxic encephalopathies, vertigo, 954 mixed connective tissue disease, protozoal, 135 coma, 996 vestibular, 972 176, 186 serous, 134−135 metacarpophalangeal (MP) joints without aura, 213−214 autoantibodies, 177 leptospirosis, 135 chronic polyarthritis, 90 migratory thrombophlebitis, 320, microaneurysm, 327 purulent meningitis vs., 134 rheumatoid arthritis, 338 328, 328 M-mode echocardiography, symptoms, 131 metapneumovirus infections, miliary tuberculosis see cardiac dyspnea, 623 viral, 208 common cold, 140 tuberculosis Mobitz second degree cerebrospinal fluid findings, metastases milk-alkali syndrome, 935 atrioventricular block, 717 132 bone, 304, 356 milk intolerance, 820 modified Bernoulli equation, 624 meningococcal meningitis, 133 calcification, 862, 863 mineralocorticoids molluscipoxvirus, 124 skin lesions, 133 skin, 64 Addison disease, 752 molluscum contagiosum, 124 meningococcal sepsis hemolytic anemia, 416 deficiency, hyperkalemia, 914 Mönckeberg medial sclerosis, petechial skin hemorrhage, 455 kidney, 571 excess 321−322 skin changes, 72 liver, 795, 796, 818 metabolic alkalosis, 924 Mondor disease, 252, 328 meningococcemia, petechiae and lung, 567, 568, 570, 571 volume expansion, 900 monitoring, 5, 6, 9 purpura, 116 lymph node(s), 479−480 hypertension, 738−739 monkeypox virus, 118, 124, 125 meningoencephalitis, 208 tonsillar carcinoma, 480 potassium regulation, 907 monoblastic leukemia, 426, 426 coma, 995 metatarsophalangeal joints, minimal-change monoclonal antibodies, cellular postinfectious, 133 rheumatoid arthritis, 338 glomerulonephritis, 870 immune deficiencies, 190 menopause, osteoporosis, 368 methanol, coma, 1008 mitochondrial cytopathy (MELAS), monoclonal gammopathy mental disorders, 20−21 methemoglobinemia, 708−710 214 multiple myeloma, 441 mental state examination, 32, 992 differential diagnosis, 710 mitral facies, 53, 657 of unknown significance mercury intoxication hereditary, 709 mitral valve (MGUS), 444 chronic, 193 sulfhemoglobinemia, 710 annulus, calcification of, 651 monocytes, 191, 200 diarrhea, 812 toxic, 709 defects, 651 monocytic leukemia, 426, 426 mesencephalic reticular methotrexate, folic acid insufficiency see mitral valve monoethylglycinexylidide (MEGX) formation deficiency, 409 insufficiency test, 769 supranuclear gaze paresis, 962 Meulengracht intermittent leaflet thickening, 655 monogenetic hypotension, syncope, 952 juvenile jaundice, 771−772 opening sound, 613, 615, 657 755−756 mesenteric angina, ischemic microalbuminuria, 844 premature closing, acute aortic monomorphic ventricular colitis, 815 microangiopathic hemolytic insufficiency, 644 tachycardia, 726−727 mesenteric artery hypoperfusion, anemia (MAHA), hemolysis pressure gradient, mononeuropathy, 305 266 with erythrocyte pre-valvuloplasty, 656 unilateral leg pain, 310 mesenteric infarction fragmentation, 415 prolapse, 652−653 mononucleosis abdominal angina, 266 microcirculatory disorders, 470 acute mitral insufficiency, hilar enlargement, 590 fever, 116 microcytic hypochromic anemia, 649 pneumonia, 536 mechanical ileus, 261 400−405 differential diagnosis, 220 moon face, Cushing syndrome, mesenteric vein thrombosis, 267 aluminium intoxication, 404 sclerae, 96 740, 741 mesial temporal lobe syndrome, classification, 400 regurgitation morbidity, 11 983 clinical findings, 403 atrioventricular septal defect, morbilliform exanthem, 56, 57 mesoblastic tumors, 597 diagnosis, 401−402 695 Morgagni hernia, 578 mesothelial cyst, 578 diagnostic strategy, 406 echocardiography, 651 Morgagni syndrome, 364 metaanalysis, 7, 7 etiology, 402−403 stenosis see mitral valve mortality, 11 metabolic acidosis, 920−922 nephrotic syndrome, 869 stenosis cancer-related, 18 chronic renal failure, 862, 921 microcytosis systolic prolapse of leaflet, 614 causes, 12 differential diagnosis, 921, 923 iron deficiency anemia, 401 valvuloplasty, 627 Morton neuralgia, 310 dyspnea, 501−502 thalassemia, 404−405 mitral valve insufficiency motion sickness, 968 laboratory parameters, 1017, microemboli, 980 acute, 649 motor aphasia, 101 1017−1018, 1018 septic, endocarditis, 155 acute heart failure, 628 motor deficits, grading, 32 normochloremic, 920 microhematuria cardiogenic shock, 632 motor paralysis, acute with increased serum anion asymptomatic, 875 chronic, 649−652 intermittent porphyria, 270 gap, 920−921 nephrolithiasis, 885 causes, 652, 652 mountain sickness, 390 normochloremic acidosis, with urinary sediment analysis, 847, operative treatment, mouth see oral cavity hyperchloremic acidosis, 920 851 indications for, 652 MRI see magnetic resonance pH of urine, 842 microlithiasis alveolaris, 564 pathophysiology, 649−650 imaging (MRI) uremic coma, 1004 micromegakaryocytes, chronic schematic representation, mucoepidermoid tumors, 592 metabolic alkalosis, 922−924 myeloid leukemia, 429 650 mucopurulent sputum, 495 diagnosis, 924 microscopic polyangiitis, 178, 873 special studies, 651−652 mucormycosis, 169 differential diagnosis, 922, 925 differential diagnosis, 181 symptoms and findings, 650, mucosal bleeding, von Willebrand exogenous alkali intake, 924 microsleep episodes, 1009 650−651 disease, 462 laboratory parameters, 1018 microspherocytes, hemolytic chronic volume overload, 644 mucosal disease (odynophagia), maintenance factors, 922−923, anemia, 414 dilated cardiomyopathy, 669, 806−807 924 microvascular disease, 326−328 670 mucous colitis, irritable bowel pH of urine, 842 microvesicular steatosis, 778 Doppler echocardiography, 652 syndrome, 285 urinary findings, 925 mid-diastolic murmurs, 618 eccentric hypertrophy, 635 mucous sputum, 495 metabolic coma, 1004−1005 atrioventricular septal defect, hypotension in myocardial mucoviscidosis, 514−515 metabolic diseases/disorders, 20 695 infarction, 240 multifactorial heredity, 22 abdominal pain, 271−272 middle lobe syndrome, 576−577, murmur, 617 multifocal atrial tachycardia, 722 associated arthropathy, 577 pulmonary edema, 631 multifocal central nervous system 345−346 middle stream urine, 841 thrill, 612 diseases, 995−996 coma, 996, 999−1005 midsystolicclick, 614, 616 mitral valve stenosis, 655−658 multiple endocrine neoplasia dyslipoproteinemia, 230 mitral valve prolapse, 652 abnormal first heart sounds, (MEN) odor, 99 midsystolic murmur, tricuspid 613 hypercalcemia, 934 see also specific atresia, 690 differential diagnosis, 658 hyperparathyroidism, 375 diseases/disorders migraine murmur, 617 thyroid carcinoma, 484 metabolic liver disorders, with aura, 214 pathogenesis, 655 multiple exostosis, 357 788−789 basilar, 214, 972 schematic representation, 656 multiple myeloma, 441−444, 567, signs, 657, 657 568 1090

paper electrophoresis, 443 myeloproliferative diseases, 468 discoloration, 75−76 nephrogenic diabetes insipidus, plasma cells see plasma cell myeloproliferative syndrome fold keratosis, 67 40−41 myeloma (MPS), 434−435 liver diseases, 767 nephrolithiasis, 885−887 polymorphic plasma cells, 443 Budd−Chiari syndrome, 790 psoriatic arthritis, 342 immobilization, long-term, 935 smoldering, 444 myocardial aneurysm, chest shape and structure changes, nephrologic syndromes, 839, 840 spinal radiograph, 443 radiograph, 621 74−75 differential diagnosis, 865−890 multiple sclerosis, 12 myocardial cell destruction, naloxone, coma, 1007 nephronophthisis, 888 multiple sleep latency test eccentric hypertrophy, 635 narcolepsy, 984, 1009, 1009 nephronophthisis complex, (MSLT), 1010 myocardial contractility, narcotics, pulmonary edema, 632 juvenile, 888 multiple symmetrical lipomatosis, decreased narrow-complex tachycardia, nephropathy, acute vs. chronic, 87 chronic volume overload, 644 721−725 864 multisensory vertigo, 973 eccentric hypertrophy, 635 differential diagnosis, 722 nephrosclerosis, gout, 345 mumps, 130 myocardial dysfunction, nausea, venous congestion, 609 nephrotic edema, facial meningitis, 134 peripheral cardiac cyanosis, 708 N-benzoyl-L-tyrosyl-p- appearance, 91 salivary glands, 480 myocardial hypertrophy, chronic aminobenzoic acid (NBT-PARA), nephrotic syndrome, 868−872 Münchausen syndrome, 10 volume overload, 644 291 causes, 870 muscular atrophy, liver diseases, myocardial infarction (MI) neck clinical features, 868−869 767 abdominal pain, 272 congenital abnormalities, coagulation defects, 469 muscular ventricular septal acute see acute myocardial 476−477 hypoproteinemic edema, 383 defect, 699 infarction (AMI) inflammatory disorders, membranous musculoskeletal system acute mitral insufficiency, 649 477−479 glomerulonephritis, 870 chest pain, 223 biomarkers, 239 superficial, 477 renal hypotension, 757 differential diagnosis, 221 cardiogenic shock, 632 masses, 479−480 urinary sediment patterns, 851 physical examination, 31, 31−32 differential diagnosis, 220 differential diagnosis, 476 vitamin D deficiency, 933 polyarteritis nodosa, 179 complications, 239−240 examination, 476 nephrotoxic drugs primary adrenocortical ECG changes, 235 stiffness acute renal failure, 855 insufficiency, 751 ST segment elevation causes, 131 antibiotics, acute tubular mushroom poisoning, diarrhea, (STEMI), 235−237, 237 neurological examination, necrosis, 854 812 without ST segment elevation 131 nerve palsy see specific nerves mutism, 100 (non-STEMI), 234−235, 235 swelling, 130−131 net urinary excretion (NAE), 916 myalgia, musculoskeletal thoracic embolism, 322 vascular malformations, neuralgia, 300 pain, 251 hypotension in course of, 240 476−477 clinical criteria, 300 myasthenia gravis, 595 syncope, 978 veins, cardiogenic shock, 632 head region, 215−217, 216 eyelids, 94 myocardial ischemia webbed, Turner syndrome, 82 occipital, 212, 216 ocular, 962 acute heart failure, 629 see also cervical spine shoulder amyotrophy, 306 mycobacteria other than angina pectoris see angina necrobiosis lipoidica, 61 traumatic, head/facial pain, 217 tuberculosis (MOTT), 535, 535 pectoris necrobiosis lipoidica neurasthenia, 755 Mycobacterium coronary angiography, 233, 234 diabeticorum, 65 neurinoma, 303, 304, 594, 597 avium-intracellulare, 535, 535 ECG signs, 236 necrolytic migratory erythema, 65 neuroborreliosis, 135 Mycobacterium infections magnetic resonance imaging, necrosis, ischemic limb pain, 315 Lyme disease, 157 lymph nodes, 129 233 necrotizing external otitis, 140 neurocardiogenic syncope, 978 nontuberculous, 120, 144−145 silent, 224 necrotizing fasciitis, neck, 479 tilt table testing, 715 skin, 120 transient, left ventricle necrotizing sarcoidlike neurocutaneous diseases, 69−71 Mycobacterium leprae, 120 hypertrophy, 223 granulomatosis, 571 neuroendocrine cancer, 592 Mycobacterium marinum see also myocardial infarction necrotizing vasculitis, systemic, neurofibromas, 54 infection, skin lesions, 119, 120 (MI) 307 neurofibromatosis, 54, 54, 69−71 Mycobacterium tuberculosis, 143, myocardial necrosis, ECG signs, needle biopsy, transthoracic, 247 neurogenic hypotension, 750 530 237 Neisseria meningitidis infection, neurogenic pain see also tuberculosis myocardial scarring, ECG signs, 133 abdomen, 273 Mycobacterium ulcerans, 120 237 petechiae and purpura, 116 arms, unilateral, 306−308 mycoplasma infections myocardial scintigraphy, 231−232 see also meningococcal causative factors, 301 pharyngitis, 138 myocarditis, 145, 672−673 meningitis; meningococcal characteristics, 300 pneumonia, 527 bacterial, 672 sepsis; meningoencephalitis clinical findings, 300−301 see also specific causes, 672, 672 neonatal hypothyroidism see definition, 300−301 infections/organisms Kawasaki disease, 129 hypothyroidism differential diagnosis, 301 Mycoplasma pneumoniae, 142, viral, 672, 672 neonatal meningitis, 134 legs, unilateral, 308−310 526 viral infections, 672, 672 neoplasms, 469 limb pain, 300−311 mycoses see fungal infections myoclonus, 985 associated arthritis, 348 definitions, 300−301 mycosis fungoides, 440−441 myoclonic attacks, 983 causes, 483 neurogenic pulmonary edema, mycotic aneurysms, 156 myogelosis, musculoskeletal consciousness disturbances, 632 myeloblastic leukemia see thoracic pain, 251 998−999 neurogenic shoulder-girdle leukemia myoglobin meningitis, 208 syndrome, 307 myeloblasts, myelodysplastic acute coronary syndrome, 238 pericarditis, 243 neurogenic syncope, 979 syndrome, 432 laboratory parameters, 1051 pleural effusion, 248 neuroleptics, coma, 1007 myelodysplastic syndrome (MDS), myoglobinuria, urine analysis, see also cancer; tumor(s); neurological examination, 32 411, 432−433 841−842 specific neoplasms gait, 32 FAB classification, 432 myxedema, 384, 384 nephritic syndrome history, 26 hypoplastic, 411 pleural effusion, 248 acute, 866 neurologic disorders International Prognostic Scoring myxedema coma, 1005 causes, 866, 867 arthropathies, 348 System, 433, 433 myxoma (atrial tumor) see atrial clinical features, 866 seizure disorders, 984 sideroachrestic anemia, 405 myxoma edema, nephrotic syndrome, see also specific disorders World Health Organization vs., 869 neuromuscular excitability, classification, 433 N urinary sediment patterns, 851 potassium disorders, 909 myelofibrosis, chronic idiopathic, nephritis neuromuscular respiratory failure, 435 NADH-oxidase deficiency, 191 chronic interstitial, 880−882 502−503 myelogenic tumors, 360 NADPH methemoglobin reductase hereditary neuropathic joint disorders, 348 myelogenous leukemia, deficiency, 709 clinical manifestations, 877 neuropathic pain, 48 symptoms, 422 Naegleria fowleri, 135 hematuria, 876−877 unilateral arm pain, 308 myeloma see multiple myeloma nail-patella syndrome, 75, 75, nephroblastomas, 890 neurosarcoidosis, 587 myelomonocytic leukemia, 426 877−878 nephrocalcinosis, 586, 885−887 neurosyphilis, 135, 161 myelopathies, vertigo, 973 nails, 74−76 etiology, 885−887 diagnosis, 159 myelopoiesis, myelodysplastic bed psoriasis, 74, 74 hyperparathyroidism, 375 neutropenia, 168 syndrome, 432 clubbing, 74 stone composition, 885−887 diarrhea, 147 1091

neutrophilia, polycythemia rubra coma, 1007 occupational asthma, 509 organ transplants vera, 434 edema, 389−390 occupational diseases/disorders, rejection, hereditary neutrophils, 191 eosinophilic pulmonary 12, 14, 15−16, 509 thrombophilia, 468 toxic, 198, 199 infiltrates, 547 see also specific transplant-associated nevus flammeus, 71, 71 hypertension, 746 diseases/disorders microangiopathy, 416 New York Heart Association nonsteroidal antirheumatics, ochronosis, 65, 347, 347 transplantation osteopathies, (NYHA), 608 acute gastritis, 274 ears, 98 370 Nezelof syndrome, 190 non-ST segment elevation skin discoloration, 53 organ tuberculosis, 143 nicotinamide adenine myocardial infarction ocular misalignment, 958 orgasm headache, 215 dinucleotide phosphate (non-STEMI), 234−235, 235 ocular motility, 98 Orientia tsutsugamushi, 122 (NADPH), 418 nontoxic goiter see goiter disorders, 956−967 Ormond disease, 599 Nikolski phenomenon, 59 nontuberculous mycobacteria ocular myasthenia gravis, 962 postrenal kidney failure, 853 nitrite, urinary tract infections, infection, 120, 144−145 ocular nerve paresis, 960, ornithosis, 528 846 Noonan syndrome, 83 960−961 oropharyngeal dysphagia, 802 nitroglycerin, angina pectoris, 222 normochloremic metabolic differential diagnosis, 962 orphan lung diseases, 561−565 Nocardia asteroides, 145, 526, 526 acidosis see metabolic acidosis etiology, 961 see also specific diseases Nocardia infections see normochromic normocytic ocular tilt reaction, 965−966 orthodontic head/facial pain, nocardiosis anemia development of, 966 212−213 nocardiosis, 71, 145 diagnostic strategy, 412 ocular vertigo, 955 orthomyxovirus, 140 skin lesions, 119 renal insufficiency, 859 oculo-cephalic reflexes (OCR), 993 orthopnea, 605, 608 nocturia, cardiac dyspnea, 609 normotension, upper limits, 732 oculoglandular syndrome, 128 cardiac dyspnea, 500 nocturnal calf cramps, 331 nose, 99 oculomotor nerve palsy, 212, 216, orthopoxviruses, 124 nocturnal choking attacks, nosocomial diarrhea, 147 993 orthostatic dysregulation, 979 obstructive sleep apnea nosocomial staphylococcal eyelids, 94 orthostatic hypotension, 757 syndrome, 516 infection, 153 subarachnoid hemorrhage, 207 orthostatic proteinuria, 844 nodular glomerulosclerosis, 871 NT-pro-brain natriuretic peptide oculomotor paresis, 960 Ortner syndrome, 636 nodular regenerative hyperplasia, (NT-proBNP), 1028 odor, 99−100, 99−100 oscillopsia, 971 786 nuclear imaging odynophagia, 47, 806−807 Osgood−Schlatter disease, 365 nodular sclerosis, Hodgkin pheochromocytoma, 740 definition, 802 Osler nodes, 69, 155, 155 disease, 437 primary aldosteronism, 739 oligoarticular juvenile chronic Osler−Weber−Rendu disease, nodular skin lesions, 60−61, prostate cancer, 935 arthritis, 340 463−464 118−119 nystagmus, 965−966 oligomenorrhea, Graves disease, high output heart failure, 655 nodules, pulmonary opacities, consciousness, assessment of, 485 lesions, 464 521 993 oligospermia, 43 osmolarity nonalcoholic fatty liver (NAFL), patterns, 967 oligosymptomatic peritonitis, 264 laboratory parameters, 1051 778 spontaneous, 958, 965, 967 oliguria, 842 potassium shifts, 907 nonalcoholic steatohepatitis development of, 965 Ollier disease, 357 osmoregulation, 896 (NASH), 779 peripheral vestibular vertigo, onchocercosis, 175 feedback loop, 896, 897 nonconvulsive epileptic state, 996 968 oncogenic osteomalacia, 372, 374 overview, 898, 898 nonerosive reflux disease (NERD), renal phosphate loss, 940 osmotically active substances, 803 onycholysis, 74 901, 901 non-Hodgkin lymphoma, O Graves disease, 487 osmotic diarrhea, mechanisms, 438−441, 440 ophthalmic zoster, 122 810 chromosomal aberations, 439 obesity, 13, 86−88, 87 ophthalmologic head/facial pain, osmotic gap, 896 classification, 439, 439 atherosclerosis risk, 226 212 laboratory parameters, 1051 clinical symptoms, 438 definition and epidemiology, 86 ophthalmoplegic migraine, 214 osmotic resistance, erythrocyte acquired ichthyosis, 67 primary, 86 opiates, coma, 1006 shape variations, 417 fever, 194 screening, 34 Opisthorchis viverrini, 794 ossifying fibroma, 360 hilar enlargement, 589−590 secondary, 87 opportunistic infections, 4 osteitis fibrosa cystica, 372 diagnosis, 439 obesity-hypoventilation bacterial, 168 chronic renal failure, 860, 861 gastric carcinoma, 280 syndrome, 503 fungal, 168−169 osteoarthritis, 349−350 histology, 439 obliterating arteriosclerosis, 319 protozoa and helminths, 169 cervical spine, 350, 350 immunoblastic, 441 obliterative angiopathy, ischemic viral, 168 clinical findings, 349 polymorphic centroblastic, 441 colitis, 815 see also specific diagnosis, 349 pulmonary, 568−569 obstetric complications, infections/organisms epidemiology, 349 rare, 440−441 hereditary thrombophilia, 468 opsonization dysfunction, 191 erosive form, 349 stomach, 282 obstructive cholestasis see optic neuritis, 216 hands, 90 nonhydrogenated ergotamine cholestasis optokinetic drum test, 965 hereditary hemochromatosis, alkaloids, 324 obstructive hypopnea, 505 optomotor system 788 nonhypertensive hemorrhages, assessment, 505 cortical, 964 hips, 349 998 obstructive ileus, 260−262 examination, 958 interphalangeal joints, 349 noninfectious endocarditis, 155 differential diagnosis, 260 importance of, 951 late consequences, 349−350 noninflammatory intestinal obstructive jaundice see jaundice subcortical, 963 lumbar spine, 351 infections, 147 obstructive lung diseases, synopsis of, 956 with osteophytes, 303 non-Langerhans cell histiocytosis, 497−498 oral anticoagulation (OAC), rheumatoid arthritis vs., 349 445 dyspnea, 496 462−463 secondary, 350 Nonne−Milroy disease, 387 pulmonary dyspnea, 500 oral cavity, 76−78 osteoblastoma, 359, 359 nonossifying fibroma, 359, 360 obstructive lymphangitis, chronic, scleroderma, 183 osteoblasts, secondary nonpapillary carcinomas, pain, 174 oral contraceptives osteoporosis, 369 296 obstructive sleep apnea syndrome Dubin-Johnson syndrome, 772 osteocartilaginous exostosis, 357 nonpneumotropic viruses, (OSAS), 516−517 focal nodular hyperplasia, 795 osteochondritis dissecans, 348, pneumonia, 536 assessment, 505, 505 hypertension, 746 366 non-rapid eye movement (NREM) obstructive uropathies, 882 oral glucose testing, acromegaly, osteochondroma, 357, 358 sleep, 988, 989 obturator nerve mononeuropathy, 744 osteoclast-activating factors, 935 nonrestrictive ventricular septal 310 oral glucose tolerance test (OGTT) osteoclasts, 367 defect (VSD), 699, 700 occasional seizure, syncope, 952 oral iron supplementation, 403 osteodensitometry, bone pain, nonspecific interstitial occipital lymph node oral thrush, 77 356 pneumonia (NSIP), 551, 553 enlargement, 128 oral ulcers, 77 osteogenesis imperfecta, 371 non-STEMI, 234−235, 235 occipital neuralgia, 212, 216 orchiectomy, anemia, 410 sclerae, 94, 96 non-steroidal anti-inflammatory occlusive lymphangiopathy, organic atrioventricular block see osteogenic tumors, 358−359 drugs (NSAIDs) secondary lymphedema, 387 atrioventricular (AV) block osteoid osteoma, 358−359, 359 acquired thrombocytopathies, occult gastrointestinal bleeding, organic dust toxic syndrome osteolytic foci, multiple myeloma, 457 anemia, 402 (ODTS), 557 442 1092

osteolytic metastasis, 357 facial appearance, 91 complications, 292, 293 parasternal regurgitant murmur, osteomalacia, 371−374, 374 high output heart failure, 655 diagnosis, 292 tricuspid insufficiency, 653 causes, 372 stages, 367 medical treatment, course of, parathormone-related peptide chronic renal failure, 860, 861 Paget−Schrötter syndrome, 330 289 (PTHrP), hyperparathyroidism, clinical findings, 373 pain, 47−48 obstructive jaundice, 794 375 definition, 371 abdominal see abdominal pain cholecystitis vs., 146 parathyroidectomy laboratory investigations, 373, bone see bone pain chronic, 289−290, 293−294, 295 hypocalcemia, 934 374 central syndromes, 301−302 causes, 293 skin, effect on, 860 pathogenesis, 371−373 bilateral arm/leg pain, clinical features, 293−294 parathyroid gland radiological findings, 373−374 310−311 complications, 294 diseases, 489 osteomas, 358, 569 unilateral arm pain, 306 diagnosis, 294 adenoma, osteomyelitis, 126−127 unilateral leg pain, 308−309 differential diagnosis, hyperparathyroidism, 375 diabetic microangiopathy, 326 chest see chest pain pancreatic carcinoma, 294 carcinoma, imaging methods, 114 deafferentation, 300−301, 301 epidemiology, 293 hyperparathyroidism, 375 osteomyelofibrosis, 435, 435 gastrointestinal system, medical treatment, course of, removal, 860, 934 osteonecrosis, 364, 364−366, 365 260−264 289 parathyroid hormone (PTH) adulthood, in, 366 neurogenic see neurogenic pain natural course, 294 calcium homeostasis, 929 clinical features, 364 neuropathic, 48, 308 steatorrhea, 823 chronic renal failure, 860 definition, 364 see also specific types/locations hereditary, 293 laboratory parameters, 1052 knee joint, 366 pallor, 53 local complications, 293 phosphate homeostasis, 929 pathogenesis, 364 palmar erythema, 90 pleural effusion, 248 parathyroid osteitis fibrosa radiological findings, 364 jaundice, 767 pancreolauryl test, pancreatic cystica, 860 osteopenia, densitometric liver cirrhosis, 782 function, 291 paratyphus B, 148 classification, 370 palmar hyperkeratoses, 90 pancreozymin-secretin test, paravalvular regurgitation, valve osteopetrosis, 363 palmar xanthoma, 290−291 replacement, following, 652 osteopetrosis tarda, 363 dyslipoproteinemia, 227 pancytopenia , aplastic anemia, parenchymal lung pathology, osteoporosis, 368−371, 371 palmoplantar pustulosis, 344 411 pleural effusion, 247 clinical features, 368−369 palpation panhypopituitarism, skin changes, parenteral hyperalimentation, definition, 368 abdomen, 30−31 66 hypophosphatemia, 940 diagnostic assessment, 370 acute pancreatitis, 291 panic attacks, 502 parenteral nutrition epidemiology, 368 arterial occlusive disease, 315 panic reaction, 502 hypophosphatemia, 940 inherited diseases of bladder, 31 paniculosis, 352 phlebitis, 111 supporting tissue, 371 hernias, 31 panlobular emphysema, 511 paresthetic meralgia, 310 laboratory tests, 370 liver, 30−31, 766 panniculitis, 61, 61, 352 Parkinson disease multiple myeloma, 442 lymph nodes, 26, 28 panniculitis nodularis, 296 basal ganglionic dysarthria, 102 pathophysiology, 368 mechanical ileus, 260 Papanicolaou smears, 35 facial expression, 91 risk factors, 369 spine, 31 papillary carcinoma, 795 gait, 85−86 secondary, 369−371 thyroid gland, 27 papillary muscle rupture, posture, 85, 85 endocrinopathy, due to, vocal fremitus, 28 hypotension in myocardial Parkinson syndrome, unilateral 369−371 palpitations, 45 infarction, 240 leg pain, 308 immunogenic, 370−371 causes, 45 papillary necroses, analgesic parotid glands medication induced, 370 chronic aortic insufficiency, 646 nephropathy, 880 hypertrophy, 130 types, 369 panarteritis, 178−180 papillary stenosis hyperparathyroidism, 376 osteosarcoma, 359 diagnosis, 179−180 obstructive jaundice, 794 pleomorphic adenoma, 481 ostitis multiplex cystoides, 588 etiology and clinical features, post cholecystectomy, 288 sialadenosis, 481 otitis, 140 179 papilla vateri, obstructive swelling, 130 otitis media, acute, 140, 207 panarteritis nodosa (PAN), jaundice, 794 Sjögren syndrome, 340 otolith shedding, traumatic 873−874 papillitis stenosans, 795 parotitis, 130 vertigo, 971 abdominal angina, 266 papilloedema, chronic subdural recurrent, childhood, 480 otorhinologic head/facial pain, abdominal pain, 272 hematoma, 998 paroxysmal atrial fibrillation, 724 212 panbronchiolitis, diffuse, 511 pappataci fever, 163 paroxysmal cold hemoglobinuria, ototoxic drugs, 98, 971 Pancoast syndrome, 305−306, papular skin diseases, 60 414 ovalocytosis, 398 306−307 paracetamol see acetaminophen paroxysmal cough, bronchial erythrocyte shape variations, Pancoast tumor, 567, 568 paradoxical embolism, 322 asthma, 507 417 pancreas paradoxical pulse, 610 paroxysmal dysarthrophonia, 973 pernicious anemia, 407 amylase, 1024 pericardial tamponade, 660 paroxysmal finger hematoma, ovarian carcinoma b-cells paraendocrine syndromes, 18, 19 327, 327 screening, 35 adenoma, 1001 paraesophageal hernia, 283, 283 paroxysmal nocturnal dyspnea, virilization, 73 genetic defect, 39 paraganglioma, 479 605, 609 overflow proteinuria, 845 disease see pancreatic disease parainfluenza pneumonia, 536 paroxysmal nocturnal overlap syndrome, 186 endocrine function, 291 paralytic ileus, 262−263 hemoglobinuria (PNH), 415, 415 oxidative resistance, tests for, 418 exocrine function, 290−291 differential diagnosis, 260 paroxysmal supraventricular oxidative stress, hemolysis, 413 function tests, 291 paramedian pontine reticular tachycardias see oximetry, pulmonary edema, 631 pancreatic disease, 289−296 formation (PPRF), 960 tachyarrhythmias oxygen, 1051−1052 abscesses, 151 paramyxoviruses, 122 partial atrioventricular septal oxygen content [Cto2], 1051−1052 carcinoma, 293, 295−296 parotid swelling, 130 defect (AVSD), 694 oxygen partial pressure [Po2], fever, 194 pneumonia, 536 partially restrictive ventricular 1051−1052 screening, 35−36 paraneoplastic Cushing septal defect (VSD), 699 oxygen saturation [So2], clinical symptoms, 289 syndrome, 742 partial thromboplastin time (PTT), 1051−1052 cysts, 295 paraneoplastic syndromes, 18, 19 1052−1053 oxyhemoglobin fraction [FHbo2], diagnosis, 290−291 lung cancer, 592 parvovirus B19, 122 1051−1052 diarrhea, 825 renal cell carcinomas, 889 Pasteurella multocida, 163 oxylate crystals, urinary laboratory analysis, 291 parapharyngeal space, abscess of, pasteurellosis, 163 sediment, 849, 851 see also specific 479 patent ductus arteriosus, 698 diseases/disorders paraprotein deposits, 444 aortopulmonary connections, P pancreatic function tests, 291 paraproteinemia 698 pancreatic insufficiency, 291 coma, 1005 differential cyanosis, 699 pacemaker-mediated tachycardia, cystic fibrosis, 515 multiple myeloma, 441 murmurs, 618 728 pancreatitis, 289−290 parasitic diseases patent mesenteric vessels, pachydermoperiostosis, 364 acute, 289−290, 291−293 diarrhea, 149, 811, 812 ischemic colitis, 815 Paget disease, 93, 367 causes, 292, 292 eosinophilia, 199 pathologic urine findings, bone, 367 chronic pancreatitis vs., 293 jaundice, 146 841−851 complications, 367 clinical features, 291−292 see also specific diseases/infections 1093

patients perihepatitis, 150 petit mal state, 996 cardiovascular system, 27 asymptomatic, 33, 33−37 acute, 264, 287 Peutz−Jeghers syndrome, 819 chest and lungs, 27−30 false diagnosis, role in, 10 perilymph fistula, 971 colonic polyps, 283 lungs, 27−30 ‘hidden agendas,’ 5, 33, 36−37 perimembranous ventricular PFAPA syndrome, 193 lymph nodes, 26 medical history-taking see septal defect, 699 Pfeifer−Weber−Christian musculoskeletal system, 31, medical history perinuclear antineutrophilic syndrome, 296 31−32 ‘shared decision-making,’ 5 cytoplasmic antibodies Pfeiffer disease, 138−139 neurological, 32 peak expiratory flow (PEF), 497, (pANCA), 793 phagocytes, 187 thyroid gland, 27, 27 498 Periodic Acid Schiff (PAS), 564 defects, 188, 191−192, 192 physical pneumonitis, 540−541 pedal arteries, claudication, 314 periodic fever, 192−193 phakomatoses, 889−890 physical urine analysis, 841−843, Pel−Ebstein fever, 194, 194, 196 periodic health exams, 34−36 Phalen test, unilateral arm, 308 842 Pelger−Huet leukocyte anomaly, periodontitis, head/facial pain, pharyngitis, 138−139 physicians, false diagnoses and, 10 198, 199 212 pharyngotonsillitis, Epstein−Barr physiologic stimulus-induced pelvic floor dysfunction, periorbital edema, 94 virus, 477 vertigo, 968 constipation, 832 nephrotic syndrome, 869, 869 phenacetin, 710 Pickwick syndrome, 503 pelvic veins, deep vein periosteal chondroma, 356 analgesic nephropathy, 880 pigmentation disturbances, 54−56 thrombosis, 330 peripartum cardiomyopathy, 670 phenylketonuria, skin Addison disease, 54, 66, 752 pemphigus vulgaris, 59 peripheral artery aneurysms, presentation, 65 corticosteroids, 54 penicillin, hypokalemia, 911 322−324 pheochromocytoma, 739−740 hands, 90 peptic stenosis, 803 peripheral artery disease clinical features, 739 tuberous sclerosis, 54 peptic ulcer, 279 causes, 319 diagnosis, 740 see also hyperpigmentation; percussion, 28−29 hemodynamically significant, differential diagnosis, 739−740 hypopigmentation percutaneous coronary evaluation tests, 317−318 fever, 193 pigmented gallstones, 286 interventions (PCI) modified Fontaine stages, 315 hereditary forms, 740 ‘pink puffers,’ 511 angina pectoris, following, 224 Ratschow positioningtest, 316, hypertension, 738 pink urine, 842 stress ECG, 231 317 hypotension, 751 pinna, 98 percutaneous transhepatic Rutherford classification, 315 incidentaloma, 740 pinpoint pupils, consciousness, cholangiopancreatography stages, 315 localization, 740 examination of, 993 (PTC), 766, 771, 793 peripheral cyanosis, 708 Philadelphia chromosome, piriform muscle syndrome, 310 perforated duodenal ulcer, 258 cardiac, 708 chronic myeloid leukemia, Piringer−Kuchinka syndrome, 478 perfusion status, cardiac dyspnea, definition, 678 429−430 pitting edema see edema 611 dilated cardiomyopathy, 669 phlebedema, 386 pituitary apoplexy, 210, 998 perianal fistula, Crohn disease, peripheral edema see edema phlebitis, parenteral nutrition, 111 pituitary dwarfism, 84 816 peripheral local cyanosis, 708 phlebitis saltans, 328 voice, 102 periarteritis nodosa, 178 peripheral nervous system (PNS) phlebography, arm vein pituitary gigantism, 80, 81 periarthropathia disturbances of, renal thrombosis, 330 pituitary insufficiency humeroscapularis, 353, 353 insufficiency, 860 phlebopathy, 328 anterior (adenohypophysis) periarthropathies, 352−353 polyarteritis nodosa, 179 phlegmasia coerulea dolens, 329 causes, 754 periarticular osteopenia, peripheral pitting edema, 611 phobic swaying vertigo, 973 hypotension, 753−755 rheumatoid arthritis, 338, 339 peripheral positioning vertigo, phonation disturbances, 102 symptoms and diagnosis, 754 pericardial cysts, 578, 595, 598 central postural vertigo vs., 970 phosphate causes, 754, 755 pericardial effusion, 145, peripheral pulse, arrhythmias, binders clinical features, 753, 754 240−243, 242 714−715 chronic renal failure, 861 coma due to, 1004 chest radiograph, 242 peripheral reactive sclerosis, 359 hyperphosphatemia, 937 diagnosis, 755 chronic peripheral venous pressure homeostasis dwarfism, 84, 102 chest radiograph, 619 testing, 27 disorders see phosphate pityriasis versicolor alba, 54 echocardiography, 242 peripheral venous pulsations, 27 homeostasis disorders placental thrombosis, hereditary ECG changes, 240 peripheral vestibular deficit regulation, 929−930 thrombophilia, 468 echocardiography, 242 syndrome, 971 increased intestinal absorption, plague, 128−129 renal insufficiency, 859 peritoneal pain, 264−265 941 planimetry, aortic stenosis, 642 pericardial knock, 660 peritonitis, 150, 264 laboratory parameters, plantar xanthoma, pericardial rub, 240 primary, 150 1053−1054 hyperlipidemia, 228 renal insufficiency, 859 rare causes, 265 properties, 928 plaque-forming skin diseases, 60 pericardial tamponade, 659−660 rebound pain, 30 reduced intestinal absorption, plasma hypotension in myocardial secondary, 150 939−940 hypovolemic hypotension, 757 infarction, 240 tertiary, 150 retention volume expansion, anemia, pericardiocentesis, chest peritonsillar abscess, 479 hyperparathyroidism, 376 411−412 radiograph, 242 permanent atrial fibrillation, 724 osteomalacia, 372 plasma cell dyscrasia, 845 pericarditis, 145, 240−243, 544 permissive hypercapnia, 926 transcellular shifts, 940, 941 plasma cell myeloma, 441−444 acute pernicious anemia, 12, 406−407 phosphate diabetes, 940 classification, 443 clinical features, 240 clinical findings, 406−407 phosphate homeostasis disorders, clinical symptoms, 442 differential diagnosis, 240 diagnosis, 407 928−929, 937−941 criteria, 444 ECG presentation, 240−242, Hunter glossitis, 406, 407 causes, 937−939 diagnosis, 442−443 241 malassimilation, 821 clinical features, 937 differential diagnosis, 443 etiology, 242−243 pathogenesis, 406 definition, 937 Durie-Salmon staging system, myocardial ischemia vs., 237 presentations, 68−69 differential diagnosis, 939 444 bacterial, 243 skin color, 53 fundamental pathogenesis, 938 skull radiograph, 442 chest pain, 222 peroneal paralysis, tibialis physiologic principles, 928−930 staging, 443−444 chronic, 243 anterior syndrome, 327 signs and symptoms, 938 plasma cell neoplasia, 439 constrictive see constrictive peroxisome proliferator-activated see also hyperphosphatemia; plasmacellular response, pericarditis receptor-g (PPAR-g), hypophosphatemia lymphocytes, 200 differential diagnosis, 220, 240 hypertension, 744 phospholipid-binding agents, plasma proteins acute myocardial infarction persistent atrial fibrillation, 724 anti-phospholipid antibody hypoproteinemic edema, 383 vs., 239 persistent vegetative state (PVS), syndrome, 468 laboratory parameters, 1057 ECG changes, 240−242 991 photosensitivity meningitis, 131 etiology, 243 Perthes−Calvé−Legg− bullous skin diseases, 60 plasmatic coagulation disorder, Kawasaki disease, 129 Waldenström disease, 365 erythropoietic protoporphyria, 455 post-myocardial infarction, 239 Perthes disease, 365 271 Plasmodium falciparum, 171−172, renal insufficiency, 859 petechiae, 116−118 porphyrias, 268 174 viral, 242, 660 cyanosis, 681 pH, urine, 842 characteristics, 172 viral infections, 242, 660 infectious causes, 116 physical examination, 6, 26−32 course, 172 pericarditis constrictiva, 243 meningococcal sepsis, 455 abdomen, 30−31 life cycle in humans, 172, 173 portal hypertension, 787 noninfectious causes, 118 asymptomatic patients, 33, see also malaria 1094 thrombocytopenia, 455 33−37

Plasmodium malariae, 171 pneumococcal, 524, 524−525 polydipsia, 38−41 positron emission tomography see also malaria pulmonary abscess primary, 41 (PET) Plasmodium ovale, 171 formation, 574 differential diagnosis, SIADH, chronic pancreatitis, 294 see also malaria staphylococcal, 525, 525 904 coronary heart disease, 232 Plasmodium vivax, 171, 174 streptococcal, 525, 526 polymerase chain reaction (PCR), [18F]-fluorodeoxyglucose (FDG), see also malaria superinfection, 545 596 114, 115 platelets bronchiectasis, 545 Lyme disease, 158 postbulbar ulcers, 277 aggregation testing, 451 bronchiolitis obliterans polymorphic ventricular postcapillary venules, aggregation, thrombotic organizing pneumonia, 511, tachycardia, 727, 727 Osler−Weber−Rendu disease, thrombocytopenic purpura, 541, 551−553 polymyalgia rheumatica, 12, 115, 464 470 chronic, 545 178 postductal stenosis, hypertension, pooling, 460 community-acquired, 523 giant cell arteritis, 320 745 platypnea-orthodeoxia syndrome, prognostic factors, 523 musculoskeletal thoracic pain, posterior cervical contusion, 302 500 eosinophilic 251 posterior laryngitis, 102 platypnea, pulmonary dyspnea, acute, 547 polymyositis, 67, 186−187 posthemorrhagic anemia, 409 500 chronic, 547, 548 autoantibodies, 177 posthepatic jaundice, 146 Plaut−Vincent angina, 138 Epstein−Barr virus, 536 polyneuropathy, 305 posthypercapnic alkalosis, 924 pleocytosis, meningitis, 131 fungal, 537−539 bilateral arm/leg pain, 311 postictal state, 996 pleomorphic adenoma classification, 522 vertigo, 973 postinfectious encephalitis, 137 parotid glands, 481 hospital-acquired, 523 polyphagia, 37 postinfectious salivary glands, 481 interstitial see diffuse polyps glomerulonephritides, 866 plethysmography parenchymal lung disease colorectal see colorectal polyps postinfectious arterial occlusive disease, 317 (DPLD); interstitial gastrointestinal meningoencephalitis, 133 claudication, 315 pneumonia diseases/disorders, 282, postinflammatory deep vein thrombosis, 330 lipoid, 541 282−283 hypopigmentation, 54 pleura lymphoid interstitial, 554 hamartomatous, 283 postirradiation changes, biopsy, 247 measles, 536, 537 see also adenomas restrictive cardiomyopathy, 666 effusion see pleural effusion nonspecific interstitial, 551, 553 polyradiculitis, 311 postischemic edema, 390 empyema, 249 pulmonary infarction, 249 polyradiculopathies, vertigo, 973 postoperative adhesions, fluid analysis, 247 staphylococcal, 525, 525 polyserositis, systemic lupus mechanical ileus, 261, 262 friction rubs, 245 viral, 536, 537 erythematosus, 182 postoperative endocarditis, 155 mesothelioma, 249, 250 classification, 522 polysomnography (PSG), 505 postoperative jaundice, 792 neoplasms, 249 nonpneumotropic, 536 Cheyne−Stokes breathing, 504 postpartum headache, 210 pain paramyxoviruses, 536 hypersomnia, 1010 postprandial abdominal pain see pleuritis, 245−250 pneumonic plague, 129 polyuria, 39, 40, 842 abdominal pain pulmonary infarction, 543 pneumonitis, 540−541 differential diagnosis, 41 ‘postreceptor defect,’ 39 rub, 30 pneumothorax popliteal artery postrenal kidney failure, 853 pleural effusion, 245−247 Langerhans cell histiocytosis, aneurysm, 323 by obstruction, 853 abdominal diseases, 248 564 auscultation, 315 poststreptococcal ascites, 783 primary, 250 duplex ultrasound, 329 glomerulonephritis see cardiac dyspnea, 611 secondary, 250 embolism, 322 glomerulonephritis chest radiograph, 246 spontaneous, 250, 251 stenosis, 321 posttraumatic headaches, 212 clinical features, 245−246 differential diagnosis, acute Duplex ultrasonography, 318 posttraumatic stress disorder, 755 collagen vascular diseases, 248 myocardial infarction, 239 popliteal entrapment syndrome, posture, 79−86 differential diagnosis, 246−247 POEMS syndrome, 130 321 gait, 85−86 etiology, 245 multiple myeloma, 442 peripheral artery aneurysms, lying, 85 myxedema, 248 poikilocytosis, pernicious anemia, 323 standing, 85 pancreatic cysts, 295 407 pork tapeworm, 137 postvagotomy diarrhea, 284 pulmonary infarction, 249 poliomyelitis, meningitis, 134 porphyria cutanea tarda (PCT), potassium yellow nail syndrome, 248 polyarteritis nodosa 268, 270, 271 distribution, 907 pleuritis, 245 Churg−Strauss syndrome vs., porphyrias, 268−271 excretion, 907−908 chest pain, 245−250 179 acute intermittent, 268, 270 excretion mechanisms, 907 pleurodynia, 141 pulmonary involvement, 180 differential diagnosis, 269 external balance, 907−908 pleuropericarditis, rheumatoid vessel effects, 320 enzyme defects, 269 homeostasis disorders see arthritis, 338 polyarthritis, 14 heme synthesis defects, 269 potassium homeostasis plexus lesions, 305 chronic, 14 pathogenesis, 268−270 disorders causes, 305 hands, 90 skin changes, 65 internal balance, 907 unilateral arm pain, 306−307 post-arbovirus infection, 163 urine appearance, 270 kidney, regulation in, 907−908 unilateral leg pain, 309 polyarthritis nodosa, 178−180 porphyrin synthesis disorders, laboratory parameters, Plummer disease, 486−487 definition, 178 400 1054−1056 Plummer−Vinson syndrome, 803 differential diagnosis, 179 porphyrobilinogen (PBG), acute transcellular shifts, 907 skin presentations, 69 etiology and clinical features, intermittent porphyria, 270 potassium homeostasis disorders, pneumatosis cystoids intestinalis, 179 portacaval shunts, 766 907−914 285, 286 laboratory results, 179 portal hypertension, 30, 767, ECG changes, 909 pneumococcal vaccination, 34 polyarticular juvenile chronic 784−787 physiologic principles, 907−908 pneumococci infections arthritis, 340 diagnosis, 785 signs and symptoms, 909 meningitis, 133 polychondritis, 348 diseases with, 786 see also hyperkalemia; peritonitis, 150 ears, 98, 98 intrahepatic causes, 785−786 hypokalemia pneumonia, 524, 524−525 nose, appearance of, 99 major collaterals, 785 Potts shunt pneumoconiosis, 557−560, 559 polychromatic erythrocytes, 399 pathogenesis, 785 aortopulmonary connections, Pneumocystis carinii infections, polyclonal posthepatic causes, 787 698 169 hypergammaglobulinemia, prehepatic causes, 785 definition, 678 interstitial pneumonitis, 167 autoimmune hepatitis, 778 pulmonary hypertension, 639 tetralogy of Fallot, 685 pneumonia, 526, 537−539 polycystic kidney disease, 888 venous flow impairment, 787 poxviruses, 124 pneumonia, 4, 141−143, 521−540 anemia, 409 portal system, angiography, 786 P pulmonale, atrial septal defect, acute eosinophilic, 547 polycystic ovary disease, portal vein thrombosis, 267, 785 704 acute interstitial, 553−554 virilization, 73 acute, 267 practical procedure, diagnostic, adenovirus, 536 polycythemia portopulmonary hypertension, 5−6 aspiration, 528−529, 573 cardiac dyspnea, 618 639 Prader−Willi−Labhart syndrome, bacterial, 141, 523−529 skin color, 54 positive predictive value, 11 83, 86 classification, 522, 523−524 skin presentations, 69 positive pressure breathing, precordial impulse, 612 clinical presentation, 524, polycythemia rubra vera, 434 obstructive sleep apnea precursor B-cells, acute 524−529, 525, 526 polycythemia vera (PV), 468 syndrome, 517 lymphoblastic leukemia (B-ALL), 423 1095

precordial prominence, 27, prostate gland pneumonia, 141, 527 sarcoidosis see sarcoidosis 682−683 diseases see prostate gland skin changes, 72 special patient groups, fever, precursor T-cells, acute disease urinary tract infections, 847 111 lymphoblastic leukemia palpation, 31 pseudoparesis, 353 stenosis, murmur, 616 (T-ALL), 423 prostate gland disease pseudoperitonitis, 1002 subphrenic abscesses, pleural preeclampsia, 985 carcinoma pseudorespiratory alkalosis, 928 effusion, 248 jaundice, 792 screening, 36 pseudotumor cerebri, 211 systemic lupus erythematosus, pulmonary edema, 632 secondary osteoporosis, 369 pseudotumors, 597 182 pregnancy postrenal kidney failure, 853 hemophilia A, 456 tumors see lung cancer aortic dissection, 245 prostatitis, 152, 882−883 pseudo-Turner syndrome, 83 see also specific Dubin−Johnson syndrome, 772 prostate-specific antigen (PSA), pseudovitamin D deficiency diseases/disorders fatty liver, 790−791 17, 36 rickets, 372 pulmonary edema, 382, 630−632 folic acid deficiency, 408 laboratory parameters, 1057 pseudo-von-Willebrand disease, acute, 605 hemolytic anemia, 416 prostatitis, 152, 882−883 458 arterial hypertension, 635 hypertension, 746, 746 prosthetic heart valves, hemolysis pseudoxanthoma elasticum, 66 acute heart failure, 628 jaundice, 790−792, 792 with erythrocyte skin presentation, 65 acute mitral insufficiency, 649 preeclampsia/eclampsia, 632, fragmentation, 415 vessel wall, 464 causes, 630−632, 631 792, 985 protein electrophoresis, psittacosis, 142, 528 chronic renal insufficiency, 862 thrombocytopenia, 460 1057−1058 fever without localized clinical features, 630 prehepatic jaundice, 145 minimal-change symptoms, 114 coma, 1007 prepositus hypoglossi (PPH), 962 glomerulonephritis, 870 splenomegaly and fever, 146 diagnosis, 630−631 prepyloric ventricular ulcer, 277 proteinuria, 841 psoriasis, nail changes, 74 interstitial, 541, 542 prerenal azotemia, nephrotic asymptomatic, 875 psoriatic arthritis, 342, 342−343 auscultation, 543 syndrome, 869 bilateral renal disease, 735 differential diagnosis, 343 non cardiac, 631 prerenal diseases, 853 classification, 844 psychiatric disorders, 20−21 pathophysiology and definition, kidney failure, 852−853 by body position, 876 psychogenic disorders 630 see also specific consequences, 868 coma, 999 rales, expiratory wheeze, 611 diseases/disorders isolated, 875−876 diarrhea, 821 special forms, 632 presbycusis, 98 minimal-change hypersomnia, 1010 stages, 630 pressor-postpressor syncope, 979 glomerulonephritis, 870 hyperventilation, acute, 928 pulmonary ejection click pressure curve, aortic stenosis, nephrotic syndrome, 868 seizures, 985 central cyanosis, 683 640, 641 poststreptococcal vertigo, 973 double inlet ventricle, 696 pressure overload glomerulonephritis, 867 psychoorganic syndrome (POS), Eisenmenger syndrome, 702 acute heart failure, 628, types, 844 21 transposition of great arteries, 628−629 see also albumin psychosocial history, 26 complete, 692 eccentric hypertrophy, 635 prothrombin time (PT), laboratory psychosomatic disorders, 20, 21 pulmonary emboli, 145, 543−544, presystolic gallop, 614 parameters, 1058 see also psychogenic disorders 544, 545 presystolic rumble, chronic aortic protodiastolic gallop, 613 psychovegetative syndromes, 20 acute myocardial infarction vs., insufficiency, 646 protozoal infections signs, 11 239 pretibial myxedema, 384, 384 meningitis, 135 pterygium colli, 83 cancer patients, 469 Graves disease, 486, 487 opportunistic, 169 Turner syndrome, 82 chronic recurrent, 640 primary adrenal insufficiency see provocation tests ptosis, bilateral, 993 deep vein thrombosis, 330 Addison disease neurogenic limb pain, 300 pudendal neuralgia, 273 fever, 116 primary biliary cirrhosis (PBC), radicular irritation, 304 puerperal headache, 210 hereditary thrombophilia, 467 792−793 proximal interphalangeal (PIP) pulmonary alveolar proteinosis nephrotic syndrome, 869 autoantibodies, 770 joints, chronic polyarthritis, 90 (PAP), 564 pleural effusion, 247 scleroderma, 183 proximal renal tubular acidosis, pulmonary arteries syncope, 978 primary sclerosing cholangitis 921 banding, atrioventricular septal pulmonary fibrosis, 565 (PSC), 793 proximal tubular disorders, defect, 694 drug-induced, 550, 556 autoantibodies, 770 hypophosphatemia, 940 dilated, 583 idiopathic, 550−551, 552 primum atrial septal defect, pruritus, 766−767 pulmonary atresia, 686−687 scleroderma, 183 702−703 chronic renal failure, 860 ventricular septal defect, 689 see also diffuse parenchymal Prinzmetal angina, 223 pruritus sine materia, 55 pulmonary capillary wedge lung disease (DPLD) ECG presentation, 223 Prussian-blue staining, anemia, pressure (PCWP), 630 pulmonary function tests, 551 probability-based decision 401, 402 pulmonary edema, 631 cardiac dyspnea, 501 analysis, 6−7 pseudoaneurysm, 240, 323 pulmonary chest pain, 220 idiopathic pulmonary fibrosis, problem-oriented patient care, 6 pseudochylothorax, 247, 248−249 pulmonary congestion, 583 551 procainamide, drug-induced pseudochylous ascites, 784 auscultation, 583 pulmonary dyspnea, 500 lupus, 181 pseudo-Cushing syndrome, 741 chest radiograph, 606, 621−622 pulmonary hypertension, 637 procalcitonin, 197 pseudocyanosis, 710 mitral stenosis, 655 pulmonary hemosiderosis, 561 laboratory parameters, 1056 definition, 678 stages, 622 pulmonary hyperinflation, proctalgia fugax, irritable bowel pseudocysts supraventricular tachycardia, bronchial asthma, 507 syndrome, 285 acute pancreatitis, 292−293 606 pulmonary hypertension, 583, productive cough, pulmonary pancreatic cysts, 295, 296 pulmonary diseases/disorders 584, 635−640 edema, 630 pseudocytopenia, 459 abdominal pain, 272 associated diseases, 639−640 progressive cyanosis, right pseudodiverticulae, 806, 806 abscesses, 141, 142, 529, 529, atrial septal defect, 703, 705 ventricular outflow tract pseudofractures, 373−374 573−574 atrioventricular septal defect, obstruction, 685 pseudogout, 345−346 amebic, 146, 574 694 progressive systemic sclerosis pseudogynecomastia, 88 aspiration, 573−574 central cyanosis, 683 (PSS), 183−184 pseudohyperaldosteronism, 911 actinomycosis, 525−526 classification, 636, 638 proinflammatory cytokines, pseudohyperkalemia, 909 adenomatosis, 561 clinical features, 636−637 disseminated intravascular pseudohypoaldosteronism, 914 anthrax, 120, 143 definition, 635−636 coagulation, 470 hypotension, 755 cancer see lung cancer investigation algorithm, 639 prolactin pseudohypokalemia, 909 cyanosis, 706−707 mitral stenosis, 655 deficiency, secondary pseudohyponatremia, 901 cysts, 565, 574 primary, 584 hypotension, 753 pseudohypoparathyroidism, 932 echinococcosis, 539, 569, pulmonary emphysema, 512 laboratory parameters, 1056 pseudolymphoma, 568 569−570 pulmonary insufficiency, 654 proliferative vascular disorders, pseudomembranous colitis, 811 edema see pulmonary edema respiratory failure, 497 463−464 Pseudomonas aeruginosa emboli see pulmonary emboli risk factors, 638−639 prolonged nocturnal sleep, 1008 infection, 14, 154, 168 hemorrhage, 544 special studies, 637−638 promyelocytic leukemia, 425 cystic fibrosis, 515 metastasis, 567, 568, 570, 571 symptoms and signs, 636 Pronator Teres syndrome, 308 nail discoloration, 76 nocardiosis, 525−526, 526 syncope, 978 proprioceptive vertigo, 973 petechiae and purpura, 116 parasitosis, 540 1096

pulmonary infarction, 145, 524, bilateral palpation, 745 Quick prothrombin time, 1058 rebound nystagmus, 967 543, 543−544 cardiac dyspnea, 610 diagnostic algorithm, 452 rebound pain, 30 pleural effusion, 249 carotid artery, Takayasu liver disease, 462 rebound tenderness pneumonia, 249 arteritis, 320 Quincke edema, 389, 390 acute abdomen, 257 pulmonary infiltrates chronic aortic insufficiency, acute appendicitis, 263 congestive heart failure, 646, 648 R acute pancreatitis, 291 541−543 paradoxical, 610, 660 differential diagnosis, 259 eosinophilic, 546, 546−547 peripheral, arrhythmias, rabies, 163 peritonitis, 264 HIV infection, 540 714−715 radiation-induced plexus injuries, recombinant immunoblot assay infectious see pneumonia segmental volume recordings, 307 (RIBA), hepatitis C, 776 noninfectious, 540−545 peripheral artery disease, 317 radiation nephritis, 882 rectal bleeding Wegener disease, 873 submaximal rate, ergometry, radiation pneumonitis, 541, 541 melena, 281 pulmonary interstitial edema see 627 radicular compression syndromes, ulcerative colitis, 813 pulmonary edema pulsion diverticulum, 804 304 rectal carcinoma, 818 pulmonary nodules, 566−572 pulsus paradoxus radicular deficit syndrome, 303 rectus abdominis muscle, hematoma, 566 bronchial asthma, 507 radicular lesions, bilateral, 311 neuropathy, 273 inflammatory, 569−570 portal hypertension, 787 radicular provocation maneuvers, red blood cells see erythrocytes multiple, 570−573, 571 pulsus parvus, 610 303 red cast cells, urinary sediment, solitary, 567, 567−570 aortic stenosis, 640 radicular syndromes, 273 848 benign tumors, 569 pulsus tardus, 610 bilateral, 311 red eye, 97 malignant neoplasms, 567, pupillary areflexia, unilateral, 96 causes, 303 redundant colon, 832 567−569 pupillary motility abnormalities, unilateral arm pain, 306 red urine, 841−842, 842 vanishing, 570 96−97 unilateral leg pain, 309 Reed−Sternberg giant cells, 435, pulmonary opacities pupils, 96−97 radiculitis, 303, 304 436 cardiophrenic angle, 578 Argyll Robertson, 96, 97 radiculopathy, 302−304 reentrant tachycardia, medical radiologic morphology, 521 consciousness, 992−993 clinical findings, 302−303 history, 714 pulmonary tuberculosis, 143, pinpoint, 993 diagnostic tests, 303 refeeding syndrome 530−534, 558 reactions, 96−97 differential diagnosis, 303 hypokalemia, 911 classification, 531 consciousness, 992−993 radicular compression hypophosphatemia, 940 diagnosis, 530−531 hysterical state, 985 syndromes, 304 reflux nephropathy, 882 postprimary, 531−534 pure red-cell aplasia, 411, 411 radiculitis, 304 refractive media disorders, 955 exudative, 531, 532 pure tone audiogram (PTA), 965 radioactive iodine treatment, refractory hypertension, 734 fibroproliferative, 534, 534 purpura, 64, 64, 116−118 edema, 384 refractory sprue, T-cell tuberculoma, 534, 534, 569 Henoch−Schönlein purpura, Radio-Allergo-Sorbent Test lymphoma, 822 tuberculous cavity, 531−533, 867, 868 (RAST), 22 regurgitant systolic murmurs, 618 532 infectious causes, 116 radiography Reiter syndrome, 68, 68, 343 primary, 531 noninfectious causes, 118 chest see chest radiographs reactive arthritis, 126 pulmonary valve senile, vessel wall, 464 osteoporosis, 370 relapsing polychondritis, 348 insufficiency, 654 traumatic, 465 radionuclide imaging remitting fever, 196, 196 mitral stenosis, 657 purpura-arthralgia-nephritis thyroid function and renal artery angiography, 736, 737 murmur, 617 syndrome, 181, 181 morphology, 482 renal artery stenosis outflow tract obstruction purpuric rash, idiopathic see also positron emission angiography, 737 double inlet ventricle, 696 thrombocytopenic purpura, 454 tomography (PET) Doppler ultrasound, 737, 737 transposition of great purulent meningitis, serous radiotherapy screening methods, 736 arteries, complete, 692 meningitis vs., 134 dental hypoplasia, 76 screening tests, 736 stenosis, tricuspid atresia, 688 purulent sputum, 495 radiation-induced plexus renal cell carcinomas, 888−890, pulmonary valve, closure delay, pustular skin diseases, 61 injuries, 307 889 613 pustules, 118 radiation nephritis, 882 CT scan, 890 pulmonary vascular disease P waves, 719, 724 radiation pneumonitis, 541, 541 renal colic, 885, 885 atrioventricular septal defect, block, 717 Raeder syndrome, 217 renal cortex granulomas, 695 pyelonephritis rales, 611−612 genitourinary tuberculosis, 884 central cyanosis, 682 acute complicated, 152 Ramsay−Hunt syndrome, 970 renal diabetes insipidus, 40−41 congestive see pulmonary acute uncomplicated, 151−152 rapid eye movement (REM) sleep, renal epithelial cells, urinary venous congestion chronic, 882 988, 989 sediment, 849 see also specific disorders urinary tract infections, 883 rapidly progressive renal failure pulmonary vasculature pygmies, 84 glomerulonephritis (RPGN), acute see acute renal failure aortopulmonary connections, pylephlebitis, 146 872−878 (ARF) 699 pyloric stenosis, 279 causes, 872−873 advanced, causes, 858 disease see pulmonary vascular pyoderma gangrenosum, 62, 119 classification, 872 anemia, 409 disease pyomyositis, 119 clinical features, 872 chronic see chronic renal failure evaluation, 684 pyonephrosis, 884 differential diagnosis, 875 (CRF) transposition of great arteries, pyrazinamide, sideroachrestic extended, 873 hyperkalemia, 862 complete, 692 anemia, 405 extrarenal symptom complex, hyperparathyroidism, 376 see also specific vessels pyrazol, coma, 1007 872 thrombocytopathies, 458 pulmonary venous congestion, pyrin gene mutation, 192 indirect immunofluorescence renal insufficiency 605 staining, 874 acute acute mitral insufficiency, 649 Q RAST (Radio-Allergo-Sorbent hypermagnesemia, 944 atrioventricular septal defect, Test), 22 phosphate retention, 941 695 Q fever, 142 rat bite necrosis, 185 chronic ischemic cardiomyopathy, 673 QRS duration, wide-complex Ratschow positioningtest, 316, 317 cardiovascular pulmonic stenosis, 642−644 tachycardias, 726 Raynaud phenomenon, 325, 325, manifestations, 859 cardiac catheterization, 627 quadrant syndrome, 305 465 clinical characteristics, clinical features, 644 quality assurance, 7 pulmonary hypertension, 636 859−865 etiology and pathogenesis, 642 guidelines, 8 secondary, 325 dermatologic manifestations, special studies, 644 see also evidence-based RBC creatine, 396 860 symptoms and signs, 644 medicine reactive arthritis, 125, 126, 343 gastrointestinal symptoms, thrill, 612 quantitative liver function tests, reactive hemophagocytotic 861 pulpitis, head/facial pain, 212 769 syndrome, 445 general symptoms, 859 pulsating exophthalmos, 94 quartan malaria, 171 reactive lymphadenopathy, hematologic changes, 859 pulse course, 172 445−447 hyperkalemia, 913 abnormal propagation, atrial Quebec platelet syndrome, 457, reactive postprandial hypermagnesemia, 944 flutter, 722 458 hypoglycemia, 1001 infections, 863

1097

malignancies, 863 neuromuscular, 502−503 rheumatological disease psoriatic arthritis, 342 malnutrition, 861 types, 496 skin changes, 67−68 reactive arthritis, 343 neurologic changes, 860 respiratory infections, 14 soft tissues see soft tissue sacroiliitis phosphate retention, 941 respiratory insufficiency, acute rheumatism enterocolitis associated vitamin D deficiency, 933 intermittent porphyria, 270 see also specific diseases arthropathy, 343 water, electrolyte and respiratory rate, physical rhinophyma, 99 spondylarthropathies, 341 acid-base disturbances, 862 examination, 28 rhinosinusitis, 509 saddle nose, 93, 99 diagnosis, 859, 864 respiratory syncytial virus (RSV), rhinovirus infection, common salicylates differential diagnosis, 864 139 cold, 139 lactic acidosis, 921 renal syndrome, hemorrhagic acute bronchiolitis, 510 Rhiz osteoarthritis, 349 overdose fever, with, 124 restenosis, angina pectoris, 224 Rhodococcus equi, 168 coma, 1007 renal tubular acidosis (RTA) resting electrocardiogram, rib tip syndrome, 252 lactic acidosis, 1004 differential diagnosis, 922 coronary heart disease, 230 rickets salivary gland diseases/disorders, hyperkalemic, 921, 922 restless arms syndrome, 311 hypocalcemia, 933−934 480−481 renal tubular epithelial cells, restless legs syndrome, 311, 334 vitamin D dependent, type 1, enlargement urinary sediment, 849 renal insufficiency, 860 372−373 differential diagnosis, 480 renal tubular necrosis sleep patterns, 1010 Rickettsia africae, 121, 121 Sjögren syndrome, 340 acute see acute tubular necrosis restrictive cardiomyopathy, Rickettsia conorii, 121 neoplasms, 481 (ATN) 665−668 rickettsial diseases, 121, 121−122 tumors, 480 intrarenal kidney failure, 853 causes, 666−667 pneumonia, 527 benign, 481 renal tubulopathies clinical features and studies, Rickettsia prowazekii, 121 malignant, 481 acute necrosis see acute tubular 666 Rickettsia rickettsii, 121 Salmonella infections, 148 necrosis (ATN) etiology and pathogenesis, Rickettsia typhi, 121 food poisoning, 811 intrarenal kidney failure, 853 665−666 Riedel thyroiditis, 484 Salmonella typhi, 147 nephritis see tubulointerstitial signs and symptoms, 666 right atrial tumor (myxoma) see diarrhea, 148 nephritis (TIN) restrictive lung diseases, dyspnea, atrial myxoma salt retention osteomalacia, 373 496 right bundle branch block, atrial edema, heart failure, 382 proximal disorders, restrictive ventilatory defects, septal defect, 704 nephrotic syndrome, 868 hypophosphatemia, 940 498−500 right hypochondriac abdominal SAPHO syndrome, 252, 344 tubular proteinuria, 845 pulmonary dyspnea, 500 pain, 259 sarcoidosis, 583−589, 596 tubulointerstitial nephritides, restrictive ventricular septal right hypogastric pain, 289 acute, 585, 588 878 defect, 699 right lower quadrant pain, clinical features, 585−586 tubulointerstitial reticulocytes, 396, 399 263−264 diagnosis, 588−589 nephropathies, urinary aplastic anemia, 411 right-sided heart failure see heart differential diagnosis, 554−555 sediment analysis, 847 reticulocytosis, erythropoietic failure erythema nodosum, 61 see also renal tubular acidosis porphyria, 271 right-to-left shunt etiology, 584 (RTA) retina, 97 central cyanosis, 682 malignancies, 589−590 renal vein thrombosis, 469 retinopathy, 97 tetralogy of Fallot, 685 organ involvement, 587−588, nephrotic syndrome, 869 retroperitoneal fibrosis, 268 right ventricle see ventricle, right 588 Rendu−Osler−Weber disease, 572, retroperitoneal hematoma, ringed sideroblasts, 405, 405 pathogenesis, 584 572 unilateral leg pain, 309 risk factors, diagnosis and, 5 restrictive cardiomyopathy, renin retroperitoneal pain, 268 risus sardonicus, 91 666−667 laboratory parameters, 1058 retropharyngeal tendonitis, 212 Rochalimaea henselae, 128 salivary glands, 480 primary aldosteronism, 738 reversed Lasègue sign, 304 Rocky Mountain spotted fever, specific lymphadenitis, 478 renin−angiotensin−aldosterone rhabdomyolysis, acute tubular 121 stages, 585, 585, 586, 587 system necrosis, 854 Romberg test, pernicious anemia, SARS, 143, 536 mineralocorticoid hypertension, rhabdoviruses, 163 407 sausage finger 738 rheumatic fever, 343 Rosai−Dorfman disease, 130 psoriatic arthritis, 342 volume expansion, 900 heart disease see rheumatic chronic lymphadenitis, 479 reactive arthritis, 343 renovascular hypertension, heart disease roseola, maculopapular scaly exanthem, 57 735−737 leukocytes, 198 exanthema, 118 scarlatiniform exanthem, 56 causes, 736 skin changes, 68 roseola syphilitica, 58 scarlet fever, tonsillopharyngitis, diagnosis, 736−737 streptococcal pharyngitis, 138 rostral interstitial nucleus of MLF 138 screening tests, 736 rheumatic heart disease (riMLF), 962 Schatzki ring, 803 reperfusion therapy, cardiogenic chronic mitral insufficiency, rotational vertigo, 969 Scheuermann disease, 365, 366 shock, 632 652 rotator cuff, periarthropathia Schilling test, pernicious anemia, reset osmostat, 903 mitral stenosis, 655 humeroscapularis, 353 407 respiration tricuspid stenosis, 659 Rota virus food poisoning, 811 schistocytes, hemolysis with auxiliary muscles, 27 rheumatic nodules, rheumatoid Rotor syndrome, 765, 766, 772, erythrocyte fragmentation, 415 palpation, 28 arthritis, 338 772 Schistosoma haematobium, 173 consciousness, disturbances of, rheumatoid arthritis, 338, rubella, 122, 590 Schistosoma japonica, 173 992 338−340 embryopathy, hearing Schistosoma mansoni, 173 physical examination, 28 clinical findings, 338 impairment, 98 schistosomiasis, 173 types, 28 diagnosis, 338−339 maculopapular exanthema, 118 portal hypertension, 785 respiratory acidosis, 925−926 differential diagnosis, 339 viral arthritis, 126 schizophreniclike syndrome, differential diagnosis, 926, 926 osteoarthritis vs., 349 rubeoliform exanthem, 56 ischemic stroke, 997 laboratory parameters, 1018 epidemiology, 338 rubeosis iritis, 212 Schmorl nodes, Scheuermann respiratory alkalosis, 928 extra-articular manifestations, rugger jersey phenomenon, 374 disease, 366 laboratory parameters, 1019 338 Rumple−Leede phenomenon, 455 Schwartz−Bartter syndrome, 903 respiratory bronchiolitis, 511 hands, 90 ruptured spleen, 267 sciatic nerve lesion, 309 respiratory pericardial effusion, 243 ruptures, 578 scintigraphy bronchiolitis-associated pleural effusions, 248 Rutherford classification, bone pain, 356 interstitial lung disease rheumatic nodules, 338 peripheral artery disease, 315 osteomalacia, 374 (RB-ILD), 554 rheumatoid factor osteonecrosis, 364 respiratory dysregulation, 503 adult still disease, 339 S renovascular hypertension, 737 respiratory excursions, physical Felty syndrome, 339 thyroid function, 482, 482 examination, 28 laboratory parameters, 1059 S1 syndrome, 309 toxic adenoma, 487, 487 respiratory failure, 496−500 polymyositis, 187 Saalam convulsions, 983 scintillating scotoma, 214 causes, differentiation of, purpura−arthralgia−nephritis saccades, 958, 965 sclerae, 94 496−497 syndrome, 181 saccular aneurysms see scleral icterus, 94 clinical features, 497 rheumatoid arthritis, 339 aneurysms scleroderma, 67, 183−184 definition, 496 spondylarthropathies, 341 sacroiliac joints clinical symptoms, 184 goiter, 499 ankylosing spondylitis, 341, 342 edema, 385 1098

facial appearance, 91 severe acute respiratory Addison disease, 66, 752, 752, soft tissue rheumatism, 352−353 hands, 90 syndrome (SARS), 143, 536 753 fibromyalgia, 352 organ involvement, 184 sexual dysfunction, 48 calcification, 64, 64 periarthropathies, 352−353 rapidly progressive sexually transmitted infections, chronic renal failure, 860 solitary arteriovenous fistula, 323 glomerulonephritis, 875 159−161 clinical findings, 53−64 solitary bone cyst, 361 skin, 184 etiology, lifestyle factors, 13 color, 53−56 soluble transferrin receptor levels, scleroderma adultorum, 184 travel abroad, 175 examination method, 53 404 scleroderma lung, 554, 555 see also urinary tract infections jaundice, 767 solvents, coma, 1008 sclerosing cholangitis, secondary, (UTIs); specific infections Köhlmeier−Degos syndrome, somatic abdominal pain, 256 793 Sézary syndrome, 440−441 272 somnolence, 952, 990 sclerosis Sharp syndrome, 176, 186 lesions, ischemic rest pain, 315 sonography see ultrasonography nodular, Hodgkin disease, 437 shigellosis, 148 pigmentary changes see sopor, 952, 990 systemic food poisoning, 811 pigmentation disturbances ischemic stroke, 997 collagen vascular disease, 320 hemolytic uremic syndrome, polyarteritis nodosa, 179 sore throat, definition, 802 microaneurysm, 327 416 porphyria cutanea tarda, 270 Sotos syndrome, 79 scolices, sputum, 570 shingles, 122 psoriatic arthritis, 342 South American trypanosomosis, scoliosis, posture, 85 radiculitis, 304 reactive arthritis, 343 175 scores, diagnosis and, 4 shock sarcoidosis, 588, 588 space-occupying lesions see screening, 33, 34−36 cardiogenic see cardiogenic scleroderma, 183, 184, 185 lesions, space-occupying see also specific conditions shock seizures, 983 specific lymphadenitis, 478 scrotum pain, nephrolithiasis, 885 dengue shock syndrome, 175 systemic disease, changes due speech disturbances, 100−102 scrub typhus, 122 hypovolemic, 633 to, 65−72 speech dyspnea, 609 second degree atrioventricular septic, 152 systemic lupus erythematosus, spherocytosis, 397 block see atrioventricular (AV) differential diagnosis, 633 181, 182 spider nevi, 64 block short bowel syndrome, 824 turgor disturbances, 64 chronic liver disease, 767 second morning urine, 841 shortness of breath see dyspnea ulceration, 62 liver cirrhosis, 781 secretory diarrhea, 810 short stature, 82−86 see also entries beginning spina bifida occulta, 71 secundum atrial septal defect, causes, 82 dermato-/cutaneous spinal claudication, 314 702 congenital syndromes, due to, skin tests, bronchial asthma, 508 spinal disk calcification, sedatives, coma, 1007 82−83 sleep apnea syndrome, 211, 1009 ochronosis, 347 sedimentation tube, hemolytic Shulman syndrome, 68, 186 respiratory dysregulation, 503 spinal joints, psoriatic arthritis, anemia, 413 shunt bilirubin, 763 see also obstructive sleep apnea 342 see-saw nystagmus, 967 sialadenitis, 480 syndrome (OSAS) spinal nerves, anterior rami segmental granulomatous differential diagnosis, 480 sleep attacks, narcolepsy, 984 neuropathy, 273 ileocolitis, 815−816 sialadenosis, 481, 481 sleep history, 46 ‘spina ventosa,’ 588 segmental pulse volume differential diagnosis, 480 sleeping sickness, 175 spine recordings, peripheral artery sialogram, parotid swelling, 130 coma, 995 ankylosing spondylitis, 341, 341 disease, 317 sialolithiasis, 480 sleep paralysis, 984, 1009 degenerative disease of, seizures see cerebral seizures sicca symptoms, Sjögren sleep patterns 350−351 selective immunoglobulin A syndrome, 339 chronic insufficiency, 1010, 1010 examination, 31 deficiency, 189 sickle cell anemia, 14, 16, 398 normal, 989 inflammation, enterocolitis selenium, 1059 hemoglobinopathy, 417 sliding hernias, mechanical ileus, associated arthropathy, 343 senile macular degeneration, 97 skin presentations, 69 261 see also individual regions senile purpura, vessel wall, 464 sickling test, 417 slipping rib syndrome, 252 spiral computed tomography, sensorimotor dysfunction sick sinus syndrome, 716 smal intestinal ileus, 262 hemoptysis, 495 diarrhea, 810 sideroachrestic anemia, 405 small airway diseases, 510−511 spiroergometry, cardiac dyspnea, sensorineural hearing sideroblastic anemia, 400 small bowel bacterial overgrowth 627 impairment/loss, 98 siderosis, 559 (SBO), 824 spirogram, 498 sensorineural hearing loss, 98 sigmoid colon, diverticulosis, 820, small intestine (bowel) spirometry, 497 sensory aphasia, 101, 991 820 adenocarcinoma, 817 bronchial asthma, 507 sensory disturbances, pain, 301 sigmoidoscopy, 35 bacterial overgrowth, 824 bronchitis, 510 sensory neuropathies, unilateral silent chest, bronchial asthma, diarrhea, 810 spleen arm pain, 308 507 histology, 823 abscesses, 151 sepsis silent myocardial ischemia, 224 ileus, 263 examination, 445−446 causative pathogens, 153−155 silicatosis, 559−560 lesions, 282 infarction, 267 clinical and laboratory findings, silicosis, 557−558, 558, 596, 596 lymphoma, 817 osteomyelofibrosis, 435 152 simple Mendelian genetics, 21−22 malignant tumors, 817 pain, 267 definition, 152 simulated fever, 195 pain, 274−284 palpation, 31 fever, 152−155 simultaneous sinus tachycardia, screen, malassimilation, 821 removal, 168

sources and predisposition, 153 717 vitamin B12 deficiency, 407 size septal panniculitis, 61 singultus, 47 see also specific components enlarged see splenomegaly septic emboli, 153 Sintrom, 462 smallpox, 124 relevance, 446 septic granulomatosis, sinus histiocytosis, small vessel occlusions, collagen splenectomy, 168 NADH-oxidase deficiency, 191 lymphadenopathy, with, 130 vascular disease, 320 splenomegaly, 445−447 septic microembolisms, sinusitis, 140 smoking see tobacco smoking ascites, 783 endocarditis, 155 sinusitis sphenoidalis, 212 smoldering myeloma (SMM), 444 endocarditis, 155 septic shock, 152 sinus node dysfunction, 716 smudge cells, chronic erythrocyte shape variations, differential diagnosis, 633 sinus of Valsalva lymphocytic leukemia, 430 417 septic thrombophlebitis, 156 chronic aortic insufficiency, 649 Sneddon syndrome, 327 examination, 446 serine protease inhibitors Kazal rupture, 646 snoring, obstructive sleep apnea fever, 146, 147 type 1 (SPINK1), 293 sinus tachycardia, 721 syndrome, 516 pharyngitis, 138 serotonin, carcinoid syndrome, sinus vein thrombosis (SVT), 995 sodium, 1060−1061 polyarteritis nodosa, 179 826 sinus venous defect, 703 edema and, 383 polycythemia rubra vera, 434 serous meningitis see meningitis six-minute walking test, 627 homeostasis disorders, 862, spondylarthropathies, 341−344 serum anion gap (SAG) Sjögren syndrome, 339, 339−340, 895−906 HLA-B27 frequency, 341 definition, 920 340 physiologic principles, sacroillitis frequency, 341 pathogenesis, 920 clinical findings, 340 895−898 undifferentiated, 344 serum enzymes, pancreatic diagnosis, 340 volume disorders, 899−900 spondylitis disease, 291 parotid swelling, 130 see also hypernatremia; brucellosis, 161, 162 serum osmolarity, 896 sialadenitis, 480 hyponatremia imaging methods, 114 serum proteins, electrophoresis, skeletal dysplasia, short stature, sodium-potassium channel rheumatoid arthritis, 339 845 83 blocker, Brugada syndrome, 977 spondylodiscitis, 126−127 skin appearance, 53−78 1099

spondylogenic pains, see also gastrointestinal anterior spinal artery physical status, 974 radiculopathy, 303 diseases/disorders; specific syndrome, 302 reflex vascular causes, 978−979 spondylolisthesis, unilateral leg disorders coma, 995 syndrome of inappropriate pain, 309 pain, 274−284 differential diagnosis, 208 antidiuretic hormone secretion spondylosis deformans, 350−351 surgery subclavian artery (SIADH), 903 spontaneous bacterial peritonitis complaints following, 284 auscultation, peripheral artery syphilis, 159−161 (SBP), 783 resection, vitamin B12 disease, 315 clinical features, 160−161 spontaneous nystagmus see deficiency, 407 obstruction, Takayasu arteritis, congenital, 161 nystagmus see also entries beginning 320 evaluation, 160 spontaneous pneumothorax, 250, gastro-gastric occlusion, 980 hemagglutination assay, 159 251 stomacytosis, 398 subclavian steal syndrome, 980, laboratory diagnosis, 159 acute myocardial infarction vs., stomatocytosis, hereditary, 417 980 latent, 161 239 storage pool defects (SPD), 457 Takayasu arteritis, 320 lymph node enlargement, 128 sporadic lymphedema, 387 Streptobacillus moniliformis subclavian vein occlusion, 330, meningitis, 135 spotted fever, 121 infections, petechiae and 331 secondary spot urine, 841 purpura, 116 subdural empyema, 138 rash, 118 sputum streptococcal toxic shocklike subdural hematoma, 210, 998 skin changes, 72 bronchial asthma, 508 syndrome, 154 acute, 998 tongue, 78 bronchiectasis, 514 streptococci group A infections chronic, 998, 999 serologic test results, disease bronchitis, 510 lymph node enlargement, 127, subendocardial ischemia, ECG stage, 160 cardiac dyspnea, 501 128 changes, 232, 237 specific lymphadenitis, 478 expectorated scolices, 570 peritonitis, 150 subinfundibular stenosis, 642 tertiary, 161 pneumococcal pneumonia, 525 streptococci group B infections, submaximal exercise capacity, syringobulbia, central facial pain, production, 495 sepsis, 154 627, 627 217 squamous cell carcinoma, Streptococcus agalactiae infection, submaximal pulse rate, syringomyelia, 302 esophagus, 802 sepsis, 154 ergometry, 627 systematic auscultation, 612, squamous cells, urinary sediment, Streptococcus bovis infection, subphrenic abscesses, pleural 612−613 847−849, 849 colon carcinoma, 155 effusion, 248 systemic arteriovenous fistulas, stab cells, 198 Streptococcus infections subungual hyperkeratosis, 74 high output heart failure, 655 stable angina pectoris see angina angina, 138 subungual splinter hemorrhages, systemic illness, coma, 1005 pectoris necrotizing fasciitis, 479 74 systemic inflammatory response staccato speech, 102 pneumonia, 525, 526 subvalvular stenosis, tricuspid syndrome (SIRS), 152 stance, neurological examination, sepsis, 154 atresia, 688 systemic lupus erythematosus 32 skin changes, 71 sudden cardiac death see cardiac (SLE), 181−183 Stanford classification, aortic skin infections, 119−120 death, sudden abdominal pain, 272 dissection, 244 Streptococcus pneumoniae Sudeck atrophy, edema, 390 anti-phospholipid antibody stannosis, 559 infection, 523, 524 Sudeck disease, 334 syndrome, 183 Staphylococcus aureus infection sepsis, 154 Sudeck syndrome, 305 autoantibodies, 177 bone infections, 126 Streptococcus pneumoniae Sulcus-ulnaris syndrome, 308 clinical diagnostic criteria, endocarditis, 155 infections, hemolytic uremic sulfonamides, 710 182−183 food poisoning, 149 syndrome, 416 urinary crystals, 850 clinical features, 181−182, 182 sepsis, 153 Streptococcus pyogenes infection, sunburn, 14 collagen vascular disease, 320 Staphylococcus epidermidis sepsis, 154 superficial thrombophlebitis, 328 definition, 181 infection, endocarditis, 155 stress, atherosclerosis risk, 226 superinfection, pneumonia, 545 drug-induced, 181 Staphylococcus infections stress echocardiography superior laryngeal neuralgia, 217 facial appearance, 91 acute nephritic syndrome, 866 arrhythmias, 715 superior sinus venous defect, 703 fever, 115 pneumonia, 525, 525 cardiac dyspnea, 623 supranuclear gaze paresis, 962 immunological diagnosis, 183 scalded skin syndrome, 57 chronic stable angina pectoris, supravalvular stenosis, 642 laboratory testing, 182, 183, sepsis, 153−154 231 supraventricular extrasystoles, 1026 skin changes, 71−72 dobutamin, 231 719−720 pericardial effusion, 243 skin infections, 119 stress testing, 34−35 ECG presentation, 720 pleural effusions, 248 stature, 79−86 cardiac dyspnea, 627 supraventricular tachycardias skin manifestations, 182 short, 82−86 stress ulcers, 281 clinical examination, 715 systemic mycoses, 114 tall, 79−82 gastric ulcers, 2 syncope, 978 systemic necrotizing vasculitis, status epilepticus, 983 striae rubrae, Cushing syndrome, tachycardia-induced 307 Stauffer syndrome, 889 741, 741 cardiomyopathy, 674 systemic sclerosis see sclerosis steatorrhea stridor, 30 swallow reflex, manometry, 805 systolic ankle pressures, bile acid malabsorption, strokes, bilateral, 997 sweat test, cystic fibrosis, 514 peripheral artery disease, 317 824−825 Strongyloides stercoralis, 149 Sweet syndrome, 67, 67, 118 systolic-diastolic murmurs, 618 chronic pancreatitis, 294 struvite stones, 887 swineherd disease, 135 systolic dysfunction hypomagnesemia, 942 ST segment elevation myocardial sympathomimetic drugs, coma, cardiac dyspnea, 607 malassimilation, 821 infarction (STEMI), 235−237, 1006 eccentric hypertrophy, 635 normal small bowel histology, 237 symptomatic epilepsy, 981 systolic ejection murmur, 616, 618 823 stupor, 990 symptomatic retroperitoneal aortic stenosis, 640, 641 Stein−Leventhal syndrome, 73 Sturge−Weber syndrome, 71, 71 fibrosis, 268 arterial hypertension, 635 stent implantation sty, diabetes mellitus, 94 symptoms chronic aortic insufficiency, 646 angina pectoris, 224 subacromial irritation, diffuse cardinal, 6 hypertrophic cardiomyopathy, balloon dilation, 232 idiopathic skeletal hyperostosis, masking, 10 664 technique, 224 346 nonspecific, 11 systolic heart failure, differential steppage gait, 86 subacute cutaneous lupus see also individual symptoms; diagnosis, 607 sterile leukocyturia, 847 erythematosus (SCLE), 181 specific diseases/disorders systolic hypertension, isolated, steroids see corticosteroids subacute sclerosing syncope, 952−953 732, 734 Stevens−Johnson syndrome, 59 panencephalitis (SSPE), 995 acute coronary syndrome with systolic murmurs see heart allergic reactions, 195 subacute stent thrombosis, 224 ST elevation, 236 murmurs Stewart−Treves syndrome, 388 subacute thyroiditis see aortic stenosis, 640 systolic ventricular pressure stiff heart syndrome, 666 thyroiditis arrhythmias, 714 changes, constrictive Still disease, 340 subarachnoid headache bradyarrhythmias, 976 pericarditis, 661 skin presentation, 68 CCT, 207 causes, 975 stimulants, coma, 1006 cerebrospinal fluid findings, diagnostic evaluation, 974−975 stomach 133 differential diagnosis, 974 diseases/disorders, 282−283 subarachnoid hemorrhage, history taking, 974 adenocarcinoma, thrombosis, 207−208 overview, 951−953 469 1100

T tendomyalgia, 352 thromboangiitis obliterans, thyroid hormones tendon xanthoma 319−320 cardiac dyspnea, 618 tabes dorsalis, 273, 302 dyslipoproteinemia, 227 gangrene, 315 subacute thyroiditis, 483 central facial pain, 217 hyperlipidemia, 228 phlebopathy, 328 thyroid function tests, 482 tachyarrhythmias, 721−728 tenesmus, ulcerative colitis, 813 thrombocytopathies treatment with, secondary cardiac dyspnea, 610 tennis elbow, 353 acquired, 457−458 osteoporosis, 369−370 classification, 721 tenosynovitis, 353 congenital, 457, 458 see also thyroxine (T4); clinical differentiation, 721 tension headache, 214−215 see also specific disorders triiodothyronine (T3) ECG artifact mimicking, 728, tension pneumothorax, 250 thrombocytopenia, 457, 459 thyroiditis, 483−484 728 spontaneous, 250 abnormal platelet production, causes, 483 focal, 714 teratomas, 569 460 chronic autoimmune, 484 induced cardiomyopathy, 674 neck, 477 acute leukemia, 422 acquired hypothyroidism, induced syncope, 976 territorial infarcts, head pain, 209 alcohol-induced hepatitis, 779 488 medical history, 714 Terson syndrome, 207 congenital, 458 chronic, nontoxic goiter vs., 483 narrow-complex tachycardia, tertian malaria, 171 drug-induced, 461 subacute, 483−484 721−725 course, 172 GPIlb-Illa-receptor fever, 193 non-structural cardiac disease, tertiary esophageal contractions, antagonist-induced, 461 nontoxic goiter vs., 483 976−978 806 increased peripheral thyroid myxedema, Graves origin, 714 tertiary peritonitis, 150 consumption, 460−461 disease, 486 paroxysmal supraventricular tertiary syphilis, 161 pernicious anemia, 407 thyroid nodules, 484−485 clinical differentiation, 721 testicles petechial skin hemorrhage, 455 causes, 485 medical history, 714 atrophy, hereditary Waldenström disease, 444 thyroid stimulating hormone pulmonary edema, 630 hemochromatosis, 788 thrombocytopenic purpura, (TSH) reentrant, 714 pain, nephrolithiasis, 885 diarrhea, 148 chronic autoimmune structural cardiac disease, 976 testosterone, laboratory thrombocytosis, 457 thyroiditis, 484 symptoms, 721 parameters, 1061−1062 thrombopathy, 457 Graves disease, 486 syncope, 976−978 test results thrombophilia laboratory parameters, 1062 termination, 721 distribution, 7 acquired, 467, 468−469 measurement, 36 wide-complex, 725−728 errors, 10 cancer patients, 469 pituitary insufficiency, 1004 differential diagnosis, specificity and sensitivity, 7 congenital, 450 receptor blocking antibodies, 725−726 tetanus, facial expression, 91 thrombophilic diathesis, 466−469 484 medical history, 725 tetracycline, teeth, discoloration acquired thrombophilia, secondary hypothyroidism, 489 postmyocardial infarction, of, 76 468−469 thyroid function tests, 482 725 tetraiodothyronine see thyroxine clinical approach, 466 toxic multinodular goiter, 488 QRS duration, 726 (T4) hereditary thrombophilia, thyrotoxic crises, 193 ratio of atrial-ventricular tetralogy of Fallot, 684−686, 685 467−468 thyrotoxicosis see beats, 725 anatomy, 684−685 thrombophlebitis hyperthyroidism ventricular activation axis, auscultation, 685 fever, 195 thyrotropin, laboratory 725−726 chest radiograph, 686 septic, 156 parameters, 1062 wide complex tachycardia, clinical features, 685 thrombophlebitis migrans, thyroxine (T4) 725−728 ECG, 685−686 chronic pancreatitis, 296 biosynthesis defects, 483 see also specific types echocardiography, 686 thromboplastin time, 1058 free see free thyroxine (fT4) tachycardias see tachyarrhythmias thrill, 612 thrombose par effort, 330−331 laboratory parameters, 1063 tachypnea, 605 thalamic hand, 301 thrombosis thyroid function tests, 482 Taenia solium, 137 thalassemia-b, 405 DVT see deep vein thrombosis tibialis anterior syndrome, Tahyna virus infection, 163 thalassemias, 404−405 (DVT) 327−328 Takayasu arteritis, 320 hemoglobinopathy, 417 fever, 195 tickborne infections, 157−159 tall stature, 79, 79−82 skin presentations, 69 idiopathic pulmonary Tietze syndrome, 252, 252 childhood, 80−82 target cells, 399 hypertension, 640 tilt table testing, arrhythmias, 715 congenital syndromes, 79−80 thallium 201, myocardial polycythemia rubra vera, 434 Tinel sensitivity, Pronater Teres Tamm−Horsfall mucoprotein, 849 scintigraphy, 231−232 risk factors, 543 syndrome, 308 Tarsal tunnel syndrome, 310 thallium poisoning, abdominal thrombotic thrombocytopenic Tinel sign, radicular compression, T cells see T lymphocytes pain, 268 purpura (TTP), 416, 460, 470 305 teardrop erythrocytes, thiamine deficiency, coma, 1005 thrush, oral see Chlamydia tinnitus, 98 myelodysplastic syndrome, 411 thiazide diuretics infection tissue degradation, fever, 194 99m-technetium-labeled hyperparathyroidism, 375 thunderclap headache, 215 tissue filariases, 175 pertechnetate, thyroid function, hypovolemic hyponatremia, thymoma, 593−595 tissue plasminogen activator 482 902 pure red-cell aplasia, 411 (tPA), liver disease, 462 99m-technetium-labeled sestamibi Thibierge−Weissenbach thymus gland tumors, 595, 597 T lymphocytes, 190 myocardial scintigraphy, 231 syndrome, 90, 183, 185 thyroglossal duct deficiencies, 187, 190 99m-technetium-labeled thin basement membrane cysts, 476, 477 lymphoma tetrofosmin myocardial nephropathy, 877 fistulae, 476 angioimmunoblastic scintigraphy, 231 third degree atrioventricular thyroidectomy, edema, 384 lymphadenopathy, 441 teeth, 76−77 block, 717, 718 thyroid gland celiac disease, 822 abscesses, head/facial pain, 212 third heart sounds, dilated disease see thyroid gland toadstool poisoning, diarrhea, 812 hyperparathyroidism, 375 cardiomyopathy, 669 diseases tobacco smoking, 12−13 teichopsia, 214 thirst see polydipsia function, diagnostic tests, 482 atherosclerosis risk, 226 telangiectasia, 64 thirst test, 905 hormones see thyroid bronchitis, 510 chronic liver disease, 767 thoracic deformities, cyanosis, hormones emphysema, 513 Köhlmeier−Degos syndrome, 683 physical examination, 27, 27 hemoptysis, 495 272 thoracic kyphosis, 85 size and morphology, lung cancer association, 592 mitral stenosis, 657 thoracic outlet syndrome (TOS), evaluation, 482 pulmonary emphysema, 512 Osler−Weber−Rendu disease, 307, 333−334 thyroid gland diseases, 482−489 thromboangiitis obliterans, 464 peripheral artery aneurysms, cancer, 484−485 319−320 urticaria pigmentosa, 55 323 cysts, ultrasonography, 482 voice, 102 telesystolic mitral insufficiency, thoracotomy, 250 hyperplasia, 483−485 Todd paresis, migraine vs., 214 615 thrill, 612 causes, 483 togavirus, 122 telesystolic murmur, 614 aortic stenosis, 640 nontoxic goiter, 483 Tolosa−Hunt syndrome, 211, 212 temporal arteritis, giant cell cyanosis, 683 hypotension, 751 head pain, 214 arteritis, 320 mitral stenosis, 657 screening, 36 tongue, 78, 78 temporal artery thrombin inhibitor, 463 see also specific biting, seizures, 983 biopsy, 178 diseases/disorders iron deficiency anemia, 403 pain, 178 Sjögren syndrome, 340 1101

tonsillar carcinoma, lymph node head pain, 208−209 laboratory parameters, 1063 tumor(s) metastasis, 480 migraine vs., 214 thyroid function tests, 482 anemia, 403 tonsillitis, 138 transient myocardial ischemia, triple phosphates, urinary benign, 592−595 acute, perifocal cellulitis, 478 left ventricle hypertrophy, 223 sediment, 850 bone, 356 bacterial, 138 transitional epithelial cells, triplet extrasystoles, 719 neck, 479 tooth see teeth urinary sediment, 849 ECG presentation, 720 pleural, 249 tophaceous gout, chronic, 345, transjugular intrahepatic Triplo X syndrome, 21 pulmonary, 569 345 portosystemic shunt (TIPS), 771 trisomy 21 see Down syndrome salivary glands, 481 topical neurological syndromes, hemolysis with erythrocyte trochlear nerve paresis (IV), 960 small bowel, 817 unilateral leg pain, 308−310 fragmentation, 415 Tropheryma whipelii, 149, 824 see also adenomas; polyps topical steroids, skin atrophy, 66 translocation hyponatremia, 901 arthropathies, 343 bone marrow, 412 topoisomerase-II inhibitor, acute transmural fistula, Crohn disease, endocarditis, 156 etiology, 18−20 myelogenous leukemia, 428 816 trophic skin changes, jaundice, lifestyle factors, 13 Torsades de pointes, 727, 727 transmural ischemia 767 extrahepatic cholestasis, 794 total body sodium, 898 ECG changes, 232 tropical diseases, 14, 170−175 fever, 194, 194 Touraine−Solente−Golé syndrome, left bundle branch block, 236 see also specific malignant 364 transplantation see organ diseases/disorders neck, 479−480 toxic adenoma, 486−487 transplants tropical pulmonary eosinophilia, salivary glands, 481 toxic cardiomyopathy, 669−670 transposition of great arteries 175, 546 see also cancer toxic epidermal necrolysis, 59−60, complete (D-TGA), 691−693, 693 tropical sprue, 823 markers, 17−18 60 anatomy, 691−692 celiac disease, common CA 19−9, 35−36 toxic hyperostosis, 363 chest radiograph, 692−693 histology, 822 CA-125, 35 toxic hypotension, 750 clinical features and folic acid deficiency, 409 liver, 769−770 toxic leukopenia, 198 auscultation, 692 iron malabsorption, 403 skin changes due to, 66−67

toxic liver damage, 772 double inlet ventricle, 697 vitamin B12 deficiency, 407 vanishing, 570 toxic megacolon, ulcerative ECG and echocardiography, troponins see also neoplasms; specific colitis, 814 693 acute coronary syndrome, 238 types/locations toxic multinodular goiter, congenitally corrected (L-TGA), elevated levels, causes, 239 tumor necrosis factor (TNF), 487−488 693−694, 694 laboratory parameters, 1064 anemia, 404 toxic neutrophils, 198, 199 tricuspid atresia, 688, 690 non-STEMI, 235 tumor necrosis factor toxic shock syndrome (TSS), 12, ventricular septal defect, with, trypanosomosis, 175, 669 receptor-associated periodic 119−120, 154 690 achalasia, 804 fever (TRAPS), 193 rash, 118 transthoracic echocardiography, 6 coma, 995 differential diagnosis, 192 skin presentation, 57, 119 transthoracic needle biopsy, 247 tubercular meningitis, 135 Turcot syndrome, 819 toxic syndromes, 1005 transudate ascites, 784 cerebrospinal fluid findings, Turner syndrome, 21, 82−83, 83 toxidromes, 1005 transudate pleural fluid, 247, 247 132 hair loss, 73 toxin related diarrhea, 811−812 trastuzumab, dilated tuberculin skin test see Mantoux 24-hour urine, 841 toxins, acute tubular necrosis, 854 cardiomyopathy, 670 test (tuberculin skin test) Cushing syndrome, 741 Toxocara canis, 162 traumatic neuralgia, head/facial tuberculoid leprosy, 120 primary aldosteronism, 738 Toxocara cati, 162 pain, 217 tuberculoma, postprimary twilight states, 991 Toxoplasma gondii, 128, 162 traumatic purpura, 465 pulmonary tuberculosis, 534, two-dimensional toxoplasmosis, 128, 162 traumatic vertigo, 971 534, 569 echocardiography, cardiac cerebral, 137 travel and tropical diseases, tuberculosis, 143−144, 584 dyspnea, 623 fever without localized 170−175 Addison disease, 752 typhoid symptoms, 114 treadmill testing constrictive pericarditis, 660 diarrhea, 148 lymph nodes, 128 cardiac dyspnea, 627 diarrhea, 149 rose spots, 148, 148 trachea, dyspnea, 506 peripheral artery disease, 317 erythema nodosum, 61 typhoid fever, rash, 118 tracheobronchitis, 141 Treitz ligament, mechanical ileus, exudative, 531, 532 typhus, 121 traction diverticulum, 804 262 fibroproliferative, 534, 534 typhus exanthematicus, 121 transaminases Trendelenburg test, primary hilar lymph node, 595, 595−596 typical angina, definition, 221 alcoholic fatty liver, 778 varicosis, 331 miliary, 144, 144, 531, 533, 533 tyrosinemia, 65 alcohol-induced hepatitis, 779 Treponema pallidum see syphilis jaundice, 145 autoimmune hepatitis, 778 triage, 4, 4−5 lymphopenia, 200 U congested liver, 789 Trichinella spiralis, 162 pulmonary see pulmonary extrahepatic cholestasis, 793 trichinosis, 162 tuberculosis ulcerative colitis, 813−814, 814, hepatitis B, 774 tricuspid valve specific lymphadenitis, 478 815 hepatocellular damage, 768 atresia, 687−690 tuberculous cavity, 531−533, 532 ulcerative jejunitis, T-cell laboratory parameters, atrial septal defect, 689 tuberculous effusion, 248 lymphoma, 822 1022−1023 clinical features and tuberculous paravertebral ulcerative proctitis, 813 liver cirrhosis, 780 investigations, 690 abscess, 597−599 ulcers, 119, 276−279 liver lesions, space occupying, transposition of great tuberculous peritonitis, 150 carcinoma, 280 795 arteries, with, 690, 691 tubero-eruptive xanthoma, clinical features, 277 postoperative jaundice, 792 ventricular septal defect, 689 dyslipoproteinemia, 227 differential diagnosis, 277 transarterial chemoembolization endocarditis, 654 tuberous sclerosis, 69, 70 disease associations, 279 (TACE), 771 insufficiency, 653−654 phakomatoses, 889−890 gastric ulcer, 277, 278 transcellular third space, 896 dilated cardiomyopathy, 669 pigmentation disturbances, 54 late complications, 279 transesophageal jugular pulse, 610 tubular proteinuria, 845 oral cavity, 77 echocardiography, 625−626 phonocardiogram, 653 tubulointerstitial nephritis (TIN), skin, 62 atrial myxoma, 659 pulmonary hypertension, 636 878−882 see also specific types/locations transferrin venous congestion, 611 acute, 879−880 ultrasonography anemia of chronic disease, 404 regurgitant murmur, Ebstein diagnosis, 879 abdominal, secondary hereditary hemochromatosis, anomaly, 706 drug causes, 879 hypertension, 733 788 stenosis, 659 urinary sediment patterns, cholelithiasis, 287 nephrotic syndrome, 869 murmur, 617 851 Doppler see Doppler ultrasound saturation, 1064 phonocardiogram, 659 causes, 878 duplex see duplex sonography transglutaminase, celiac disease, trigeminal neuralgia, 216 classification, 878 fasting hypoglycemia, 1001 822 trigeminus, 719 diagnosis, 878 jaundice, 771 transient eosinophilic pulmonary triglycerides, nephrotic syndrome, intrarenal kidney failure, 853 mechanical ileus, 260 infiltrates, 546 869 tubulointerstitial nephropathies, renal, 882−890 transient global amnesia, 991 triiodothyronine (T3) urinary sediment analysis, 847 umbilical abdominal pain, transient hyperlipidemia, 271 biosynthesis defects, 483 tularemia, 128 differential diagnosis, 259 transient ischemic attacks (TIA), free see free triiodothyronine Tullio phenomenon, 971 uncal syndrome, 993 979−980 (fT3) unconjugated bilirubin, 763 1102

undifferentiated sample collection and vascular tumors, 360 chest radiograph, 620 spondylarthropathy, 344 processing, 841 vasculitis, 17, 115, 554 ECG, 618 unilateral diaphragmatic sediment, 847−851 autoantibodies, 177 myocardial infarction, paralysis, 502−503 analysis, 847−851 Churg−Strauss syndrome, 547 hypotension, 240 unilateral exophthalmos, 93, 94 practical value, 850 classification, 177 ventricular activation axis, unilateral hydronephrosis, 884 typical patterns, 851 fever, 176 wide-complex tachycardias, unilateral neurogenic arm pain, vaginal contamination, 847 imaging methods, 115 725−726 306−308 volume, 842 large vessels, 178 ventricular arrhythmias unilateral neurogenic leg pains, see also urinalysis medium-sized vessels, 178−180 arrhythmogenic right 308−310 urobilinogen, 845−846 small vessels, 180−187 ventricular cardiomyopathy unilateral pupillary areflexia, 96 urogenital tuberculosis, 847 differential diagnosis, 181 (ARVC, 670 unilateral renal disease, 735 uropathies, obstructive, 882 vasoactive intestinal peptide left ventricular isolated unilateral vocal cord paralysis, urothelial carcinomas, 890 (VIP), 826 noncompaction, 670 506 analgesic nephropathy, 880 vasopressinase, 906 see also specific unstable angina pectoris, 222 urticaria, 63, 119, 389−390 vasopressin, osmoregulation, 896 diseases/disorders coronary angiography, 234 acute, 63 vasospastic Raynaud syndrome, ventricular extrasystoles, 720 upper airway stenosis, 497, 499 urticaria pigmentosa, 55, 56 325 ECG presentation, 720 urea, laboratory parameters, 1065 mastocytosis, 363 vasovagal syncope, 978 ventricular fibrillation, 728 urease, Helicobacter pylori uterine carcinoma, 13 vegetarian diet, vitamin B12 ventricular septal defect (VSD), detection, 277 uveitis, 97 deficiency, 407 699−702, 701 uremia vegetative dystonia, fever, 193 anatomy and pathophysiology, coma, 1004 V veins 699−700 diarrhea, 811−812 diseases of, 328−333 central cyanosis, 683 encephalopathy, 860 vaccinations, 33−34 see also entries beginning clinical features, 700−701 myopathy, 860 plexus lesions, 307 venous; individual vessels differential diagnosis, 701 pericardial effusion, 243 see also specific diseases vena cava superior syndrome, 596 double inlet ventricle, 695 pericarditis, renal insufficiency, vagal schwannoma, 479 venereal diseases heart sounds, 614 859 vagal stimulation, acute coronary anorectum, 814 hypotension in myocardial polyneuropathy, 860 syndrome with ST elevation, see also specific infarction, 240 ureter 236 diseases/disorders investigations, 701−702 compression, hydronephrosis, vaginal contamination, urinary venom, hemolytic anemia, 413 murmur, 617 884 sediment, 847 veno-occlusive disease, 790 partially restrictive, 699 obstruction vaginitis, 882−883 venous claudication, 314 perimembranous, 699 hydronephrosis, 884 vagotomy, diarrhea following, 284 venous congestion pulmonary atresia, 689 retroperitoneal fibrosis, 268 vagotonic atrioventricular block abdominal symptoms, 609 right-to-left shunt, 685 urethritis, 151, 882−883 see atrioventricular (AV) block jugular vein, 610 thrill, 612 uric acid Valleix pressure point, radicular signs, 609 tricuspid atresia, 689 calculi, 886 compression, 305 venous edema, 385 ventricular tachycardias crystals, 850, 851 valve replacement, paravalvular venous flow, changes, 610−611 clinical differentiation, 721 euvolemic hyponatremia, 903 regurgitation, 652 venous hypertension, 333 clinical examination, 715 laboratory parameters, valvular aplasia, congenital, 333 venous insufficiency, chronic, coronary heart disease patients, 1065−1066 valvular heart disease 331−333, 332 726 uricosuria, 24-hour urine, 841 insufficiency childhood onset, 333 diagnostic criteria, 726 urinalysis, 841 cardiogenic shock, 632 clinical findings, 331 fusion beats, with, 727 acute renal failure, 856 echocardiography, 624 definition, 331 myocardial infarction, previous, dipsticks, 841, 843, 843 edema, 384 edema, 385 721 microbiology, 846 Kawasaki disease, 129 pathogenesis, 331−333 syncope, 976 urinary tract palpable thrill, 612 postthrombotic damage, 333 ventricular extrasystoles, 720 diseases, 840 stenosis, echocardiography, 624 venous sinus thrombosis, 210, 210 Verner−Morrison syndrome, 826 infections see urinary tract tachyarrhythmias, 976 venous thromboembolism, cancer verrucous endocarditis, 182 infections (UTIs) see also individual heart valves patients, 469 vertebral artery dissection, 208 obstruction, 884−887 vanishing bile duct syndrome venous ulcer, 332 vertigo, 951−953 tumors, 876 (VBDS), 793 ventilation, pulmonary cyanosis, auditory symptoms, 954 analgesic nephropathy, 881 vanishing tumor, 245, 246 707 brief attacks, 955 urothelial carcinomas see varicella, 122 ventricle, left cardinal disorders of, 952 below clinical manifestations, 123 decompensation, arterial central postural, peripheral urinary tract infections (UTIs), skin presentation, 58 hypertrophy, 635 positioning vs., 970 882−884 varicophlebitis, 328, 328 emptying disorders, 978 central vestibular, 972−973 causative agents, 846 varicose complex, 331 enlargement, chest radiograph, cerebral causes, 972−973 complicated, 883 varicose syndrome, 331 619−620 definition, 951 nitrite identification, 846−847 varicose veins, 331 failure, 583 duration of, 955 pH of urine, 842 cyanosis, 681 clinical manifestations, 607 medical history, 954−956 special patient groups, fever, primary, 331 filling disorders, syncope, 978 multisensory, 973 111 secondary, 333 hypertrophy nature of, 954−955 uncomplicated infections, 151 variegate porphyria (VP), 268, 270 angina pectoris, 223−224 ocular, 955 urinary sediment analysis, 847 variola, 124 chest radiograph, 619, 620 onset, 954, 956 urinary sediment patterns, 851 vascular bleeding diathesis, ECG, 618 peripheral positioning, central women, 151 463−465 isolated noncompaction, 670, postural vs., 970 urinary tract syndrome, 882−887 vascular bruits, thoracic outlet 672 peripheral vestibular, 968−971 urine syndrome, 333 ventricle, right phobic swaying, 973 abnormalities vascular imaging, peripheral arrhythmogenic physiologic stimulus-induced asymptomatic, 875−876 artery disease, 317 cardiomyopathy vertigo, 968 crystals, 849−850, 851 vascular lung diseases ECG changes, 976 prolonged episodes, 955 nonglomerular bleeding, 876 dyspnea, 496 tachyarrhythmias, 976 proprioceptive, 973 chloride, metabolic alkalosis, pulmonary dyspnea, 500 dilation, tricuspid insufficiency, psychogenic, 973 923 vascular malformations, neck, 653 traumatic, 971 color, 841−842 476−477 enlargement vesicles, 118 composition, 841 vascular structural defects, chest radiograph, 620 vesicular skin diseases, 57−58 culture, 846 464−465 heart configuration, 621 vessel walls electrophoresis, 845 vascular syncope, 978−980 failure, clinical manifestations, abnormal composition, 464 osmolarity, 842−843, 862 organic (cerebrovascular) 607 cardiac dyspnea, 610 pH values, 842 causes, 979−980 hypertrophy infiltration of, 465

1103

vestibular disorders vital capacity (VC), 497 acute heart failure, 628, Wermer syndrome, 279 central bronchial asthma, 507 628−629 Wernicke encephalopathy, duration, 954 extrapulmonary restriction, 502 chronic, 614, 644 1005 vertigo, 954 vital signs volume status, 610−611 Wernicke’s aphasia, 101, 991 duration, 954 consciousness disturbances, volvulus, mechanical ileus, 261 clinical features, 101 peripheral 991 vomiting, 41 West Nile virus, 137, 163 duration, 954 evaluation, 5, 5 causes, 42 wet status, perfusion, 611

prolonged vertigo, 955 vitamin B1 deficiency, coma, 1005 gastric carcinoma, 280 wheezing spontaneous nystagmus, 965 vitamin B6, sideroachrestic ketoacidotic coma, 1002 cardiac dyspnea, 605 vertigo, 954, 968−971 anemia, 405 von Hippel−Lindau syndrome, 71 paroxysmal nocturnal dyspnea,

see also vertigo; specific vitamin B12 phakomatoses, 889 609 diseases/disorders deficiency von Recklinghausen disease, 54, Whipple disease, 824 vestibular epilepsy, 972 causes, 407 54, 69−71 arthropathies, 343 vestibular labyrinth, anatomy, myelodysplastic syndrome, von Willebrand disease, 461−462 diarrhea, 149 957, 957 432 acquired, 462 endocarditis, 155 vestibular migraine, 972 pernicious anemia, 406, 407 clinical features, 462 reactive arthritis, 126 vestibular nerve, 970 laboratory parameters, 1066 pathogenesis and classification, ‘whirlpool dermatitis,’ 14 vestibular neuritis, 970 vitamin C 461 white coat hypertension, 732 vestibular nuclei (VN), medial deficiency, 464 von Willebrand factor (vWF), whooping cough, 141 longitudinal fasciculus, 962 urinary sediment, 849 hemolytic uremic syndrome, wide-complex tachycardias see vestibular system vitamin D 416 tachyarrhythmias disorders see vestibular biosynthesis, 930 VOR fixation suppression, 958 Wilson disease, 96, 788−789 disorders deficiency arthropathies, 348 lesions, 972 differential diagnosis, 932 W Wiskott−Aldrich syndrome, 190, vestibulo-cerebellar dysfunctions, hyperparathyroidism, 376 458, 460 Wallenberg syndrome, 301 hypocalcemia, 933 Waldenström disease, 439, 441− facial lesions, 460 vestibulo-ocular reflexes (VOR), hypophosphatemia, 939−940 444 Wuchereria bancrofti, 174, 389 consciousness, examination of, intestinal absorption, Waldeyer tonsillar ring, 480 993 reduced, 939−940 walking test, peripheral artery X vestibulopathy, bilateral, 971 metabolism diseases, 933 disease, 317 Vibrio cholerae, 149 nephrotic syndrome, 869 walking-through phenomenon, xanthelasma vigilance, 951, 988 osteomalacia, 371−373 223, 314 biliary cirrhosis, 767 evaluation, 991 excess Wallenberg syndrome, 208, 217, dyslipoproteinemia, 227 examination, 992 differential diagnosis, 936 301−302 hypercholesterolemia, 228 increased, 990 hypercalcemia, 935 central facial pain, 217 xanthogranulomatous villous adenoma, 818 hyperphosphatemia, 941 vertigo, 954 pyelonephritis, 883 VIPoma, 826 increased intestinal Warthin−Starry staining, Heli- xanthoma, tendons see tendon viral arthritis, 126 absorption, 941 cobacter pylori detection, 277 xanthoma viral hemorrhagic fevers, metabolism, 372 Warthin tumor, 481 X-chromosomal inheritance, 22 123−124, 124 osteomalacia, 372 water distribution, adult body, xerostomia, 77

viral infections 1,25-(OH)2 vitamin D3 895 ximelagatran, platelet inhibition, acute lymphoblastic leukemia, biosynthesis, 933 water homeostasis disorders, 862, 450 423 calcium homeostasis regulation, 895−906 X-linked agammaglobulinemia, cellular immune deficiencies, 929 physiologic principles, 895−898 189 190 hyperphosphatemia, 937 volume disorders, 899−900 X-linked hypophosphatemic erythrocyte sedimentation rate, phosphate homeostasis Waterhouse−Friderichsen syn- rickets, 372−373 197 regulation, 929 drome, 133 XYY syndrome, 80 fever, 114 vitamin K water intoxication, 1004 multiple organ involvement, deficiency, 462 water retention Y 157 oral anticoagulation, 462 heart failure, 382 idiopathic thrombocytopenic vitiligo, 54, 90 nephrotic syndrome, 868 yellowfever,175 purpura, 459 vitreous body, 97 Waterston shunt yellow nail syndrome, 76, 76, 387 maculopapular exanthema, 118 vocal cords aortopulmonary connections, pleural effusion, 248 meningitis see meningitis inflammation, 506 698 Yersinia enterocolitica, 149 myocarditis, 672, 672 seizures, 983 definition, 678 Yersinia enterocolitica infection, opportunistic, 168 unilateral paralysis, 506 tetralogy of Fallot, 685 147 pericarditis, 242, 660 vocal fremitus, palpation, 28 waxy casts, urinary sediment, diarrheal disease, 811 pneumonia see pneumonia volume depletion, 899 849, 850 Yersinia pestis, 128−129 polyarteritis nodosa, 178 differential diagnosis, 900 weakness, cardiac dyspnea, 609 Yersinia pseudotuberculosis, 149 pulmonary hypertension, 637 signs of, 899 Weber−Christian syndrome, 87 Young syndrome, 515−516 skin, 72 volume expansion, 899 Wegener granulomatosis, 93, 93, skin rash, with, 122−124 differential diagnosis, 900 180, 570, 571, 873 Z thrombocytopenia, 460 increased intake, 900 differential diagnosis, 181 see also specific signs of, 899 laboratory findings, 873 Zeive syndrome, 779 organisms/infections volume homeostasis, 896−898 organs involved, 873 Zenker diverticulum, 804, 804 virilism, 73 feedback loop, 896−898 polyarteritis nodosa vs., 179 zidovudine, nail changes, 75, 75 virilization, 73 overview, 898, 898 weight loss Zieve syndrome, 410 viruses volume homeostasis disorders, Addison disease, 752 zinc, laboratory parameters, nonpneumotropic pneumonia, 899−900 chronic pancreatitis, 293 1066−1067 536 clinical features, 899 diabetes mellitus type 1, 39 Zollinger−Ellison syndrome, 826 tumor etiology, 20 diagnosis, 899 malassimilation, 821 ulcers, 279 see also viral infections laboratory parameters, 899 see also anorexia zona glomerulosa, visceral abdominal pain, 256 see also volume depletion; Weil disease, 162 mineralocorticoid hypertension, visceral abscesses, 150−151 volume expansion; volume Wenckebach second degree atri- 738 visceral leishmaniasis, 172 overload oventricular block, 716 zoonosis, 161−163 visceral pain, localization, 256 volume overload ECG presentation, 717 Zygomycetes, 169 acute, 644

1104