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The Washington Manual of Medical Therapeutics
Inhaler Pharmacotherapy for Chronic Asthma and Chronic Obstructive Pulmonary Disease
Table of Contents
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Acute Coronary Syndromes, Unstable Angina
Adverse Drug Reactions
Alpha (1)-Antitrypsin Deficiency
Calculator - Fractional Excretion of Sodium
Calculator - Fractional Excretion of Urea
Figure - Acetaminophen (Rumack-Matthew) Nomogram
Figure - Activation of the Sympathetic Nervous System
Flowchart - Advanced Cardiac Life Support Pulseless Arrest Algorithm
Flowchart - Bradycardia Algorithm
Heparin-Induced Thrombocytopenia
Inflammatory Bowel Disease
Qualitative Platelet Disorders
Rheumatoid Arthritis
Table - 4T Scoring System for Pretest Probability of Heparin-Induced Thrombocytopenia
Table - AASLD Treatment Guidelines for Chronic Hepatitis B
1. Inpatient Care in Internal Medicine
1. Inpatient Care in Internal Medicine
Acute Inpatient Care
Acute Hypertensive Episodes
Acute Inpatient Care
Altered Mental Status
Chest Pain
Dyspnea
Fever
Pain
Figure(s)
1-1. Cardiac Evaluation Algorithm for Noncardiac Surgery
General Care of the Hospitalized Patient
Perioperative Management of Specific Conditions
Acute Renal Failure
Adrenal Insufficiency and Corticosteroid Management
Anemia and Transfusion Issues in Surgery
Chronic Renal Insufficiency and ESRD
Diabetes Mellitus
Hypertension
Liver Disease
Pacemakers and ICDs
Pulmonary Disease and Preoperative Pulmonary Evaluation
References
Perioperative Medicine
Perioperative Anticoagulation and Antithrombotic Management
Perioperative Medicine
Preoperative Cardiac Evaluation
Prophylactic Measures
Decubitus Ulcers
Venous Thromboembolism Prophylaxis
Table(s)
1-1. Equipotent Doses of Opioid Analgesics
2. Nutrition Support
2. Nutrition Support
Assessment of Nutritional Status
Enteral Nutrition
Nutrient Requirements
Parenteral Nutrition
References
Table(s)
2-1. Estimated Energy Requirements for Hospitalized Patients Based on Body Mass
2-2. Recommended Daily Protein Intake
2-3. Trace Minerals, Fat-Soluble Vitamins, and Water-Soluble Vitamins: Recommended Daily Intake,
2-4. Guidelines for Vitamin and Mineral Supplementation in Patients with Severe
2-5. Electrolyte Concentrations in Gastrointestinal Fluids
2-6. Enteral Feeding Formulas: Comparing Composition
2-7. Major Mineral Daily Requirements, Deficiency, Toxicity, and Diagnostic Evaluation
3. Preventive Cardiology
3. Preventive Cardiology
Dyslipidemia
Hypertension
References
Table(s)
3-1. Manifestations of Target Organ Disease
3-10. Statin Therapy Regimens by Intensity
3-2. Classification of Blood Pressure for Adults Age 18 Years and Older
3-3. Lifestyle Modifications and Effects
3-4. Commonly Used Antihypertensive Agents by Functional Class
3-5. Parenteral Antihypertensive Drug Preparations
3-6. Physical Properties of Plasma Lipoproteins
3-7. Differential Diagnosis of Major Lipid Abnormalities
3-8. Review of Major Genetic Dyslipoproteinemias
3-9. Nutrient Composition of the Therapeutic Lifestyle Change Diet
4. Ischemic Heart Disease
4. Ischemic Heart Disease
Acute Coronary Syndromes, Unstable Angina
Coronary Heart Disease and Stable Angina
Figure(s)
4-1. Approach to the Evaluation and Management of the Patient with
4-2. Fourteen-Day Rates of Death, MI, or Urgent Revascularization from the
4-3. Diagnostic and Therapeutic Approach to Patients Presenting with Acute Coronary
4-4. The Benefit of Coronary Reperfusion is Inversely Related to Ischemia
4-5. Strategies for Coronary Reperfusion and Risk Assessment
References
ST-Segment Elevation Myocardial Infarction
Table(s)
4-1. Canadian Cardiovascular Society (CCS) Classification System
4-10. Killip Classification
4-11. Appropriate Selection of Routine Invasive Versus Ischemia-Driven Revascularization Strategy in
4-12. Antiplatelet Agents in UA/NSTEMI
4-13. Anticoagulant Medications
4-14. Electrocardiogram-Based Anatomic Distribution
4-15. Criteria for ST-Segment Elevation for Prior LBBB or RV-Paced Rhythm
4-16. Differential Diagnosis of ST-Segment Elevation on ECG Excluding STEMI
4-17. Upstream Medical Therapy
4-18. Fibrinolytic Agents
4-19. Contraindications to Thrombolytic Therapy
4-2. Pretest Probability of Coronary Artery Disease by Age, Gender, and
4-3. Differential Diagnosis of Chest Pain Excluding Epicardial Atherosclerosis
4-4. Conditions That May Provoke or Exacerbate Ischemia/Angina Independent of Worsening
4-5. Diagnostic Accuracy of Common Stress Testing Modalities in Patients Without
4-6. Exercise Stress Testing: Duke Treadmill Score
4-7. Beta-Blockers Commonly Used for Ischemic Heart Disease
4-8. Calcium Channel Blockers Commonly Used for Ischemic Heart Disease
4-9. Nitrate Preparations Commonly Used for Ischemic Heart Disease
5. Heart Failure and Cardiomyopathy
5. Heart Failure and Cardiomyopathy
Cardiomyopathy
Dilated Cardiomyopathy
Heart Failure with Preserved Ejection Fraction
Hypertrophic Cardiomyopathy
Peripartum Cardiomyopathy
References
Restrictive Cardiomyopathy
Figure(s)
5-1. Activation of the Sympathetic Nervous System
5-2. Chronic Medical Therapies for Heart Failure with Reduced Ejection Fraction
5-3. Chronic Medical Therapies for Heart Failure with Preserved Ejection Fraction
Heart Failure
Acute Heart Failure and Cardiogenic Pulmonary Edema
Heart Failure
Table(s)
5-1. American College of Cardiology/American Heart Association Guidelines of Evaluation and
5-2. New York Heart Association (NYHA) Functional Classification
5-3. Heart Failure Etiology
5-4. Drugs Commonly Used for Treatment of Heart Failure
5-5. Inotropic/Sympathomimetic Agents
6. Pericardial and Valvular Heart Disease
6. Pericardial and Valvular Heart Disease
Figure(s)
6-1. Pathophysiology of Aortic Stenosis
6-2. Acute Mitral Regurgitation
6-3. Chronic Mitral Regurgitation
6-4. Acute Aortic Regurgitation
6-5. Chronic Aortic Regurgitation
6-6. Anticoagulation Management in Pregnant Patients with Prosthetic Valves
Pericardial Disease
Acute Pericarditis
Cardiac Tamponade
Constrictive Pericarditis
Valvular Heart Disease
Aortic Regurgitation
Aortic Stenosis
Infective Endocarditis in Native or Prosthetic Valves
Management of Pregnant Patients with Prosthetic Heart Valves (Figure 6-6)
Mitral Regurgitation
Mitral Stenosis
Prosthetic Heart Valves
References
Valvular Heart Disease
7. Cardiac Arrhythmias
7. Cardiac Arrhythmias
Bradyarrhythmias
Bradyarrhythmias
References
Syncope
Figure(s)
7-1. Diagnostic Approach to Tachyarrhythmias
7-2. A and B, Brugada Criteria for Distinguishing Ventricular Tachycardia from
7-3. Approach to Bradyarrhythmias
7-4. Examples of Sinus Node Dysfunction
7-5. Examples of Atrioventricular Block (AVB)
7-6. Pacemaker Rhythms
7-7. Algorithm for the Evaluation of Syncope
Table(s)
7-1. Treatment of Common Supraventricular Tachyarrhythmias
7-2. Common Vagal Maneuvers and Adenosine
7-3. Pharmacologic Agents Used for Heart Rate Control in Atrial Fibrillation
7-4. Annual Stroke Risk in Patients with Nonvalvular Atrial Fibrillation Not
7-5. Commonly Used Antiarrhythmic Drugs
7-6. Causes of Bradycardia
Tachyarrhythmias
Approach to Tachyarrhythmias
Atrial Fibrillation
Supraventricular Tachyarrhythmias
Ventricular Tachyarrhythmias
8. Critical Care
8. Critical Care
Airway Management and Endotracheal Intubation
Figure(s)
8-1. Flow-Time and Pressure-Time Tracings
8-2. Troubleshooting Ventilator Alarms: What to Do When the Patient is
8-3. Early Goal-Directed Therapy Protocol
8-4. Cardiac Ultrasound
8-5. Lung Ultrasound
Mechanical Ventilation
Noninvasive Oxygen Therapy
References
Respiratory Failure
Shock
Table(s)
8-1. Causes of Shunt
8-2. Drugs to Facilitate Endotracheal Intubation
8-3. Procedure for Endotracheal Intubation, Needle Cricothyrotomy, and Cricothyrotomy
8-4. Commonly Used Sedation Medications in the Intensive Care Unit
8-5. Hemodynamic Patterns Associated with Specific Shock States
9. Obstructive Lung Disease
9. Obstructive Lung Disease
Asthma
Chronic Obstructive Pulmonary Disease
Figure(s)
9-1. Management Algorithm Based on Level of Control
References
Table(s)
9-1. Pharmacotherapy for Smoking Cessation
9-10. Classification of Asthma Severity on Initial Assessment
9-11. Assessment of Asthma Control
9-12. Classification of Asthma Exacerbation Severity
9-13. Conditions That Can Present As Refractory Asthma
9-14. Comparative Daily Adult Dosages for Inhaled Corticosteroids
9-15. Fda-Approved Biologics for Asthma
9-2. Chronic Obstructive Pulmonary Disease Assessment Tool (CAT)
9-3. Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index
9-4. Classification of Severity of Airflow Limitation in Chronic Obstructive Pulmonary
9-5. Refined Abcd Assessment Tool for Chronic Obstructive Lung Disease
9-6. Inhaler Pharmacotherapy for Chronic Asthma and Chronic Obstructive Pulmonary Disease
9-7. Pharmacotherapy for Acute Exacerbations of Chronic Obstructive Pulmonary Disease
9-8. Indications and Contraindications for Noninvasive Ventilation in Acute Exacerbations of
9-9. Indications for Invasive Mechanical Ventilation in Acute Exacerbations of Chronic
10. Pulmonary Diseases
10. Pulmonary Diseases
Cystic Fibrosis
Figure(s)
10-1. Algorithm for Diagnostic Workup of Pulmonary Hypertension
10-2. Algorithm for Management of Pulmonary Arterial Hypertension
10-3. Usual Interstitial Pneumonitis
10-4. Nonspecific Interstitial Pneumonitis
10-5. Algorithm for Evaluation of Hemoptysis
10-6. Diagnostic and Therapeutic Management of Low- and Intermediate-Risk Pulmonary Nodules
Hemoptysis
Interstitial Lung Disease
Obstructive Sleep Apnea-Hypopnea Syndrome
Pleural Diseases
Pulmonary Hypertension
References
Solitary Pulmonary Nodule
Table(s)
10-1. Clinical Classification of Pulmonary Hypertension: Dana Point (2008) Classification System
10-10. Epidemiology of Hemoptysis
10-11. Currently Fda-Approved Cftr Modulators
10-12. Assessment of the Probability of Malignancy
10-13. Differential Diagnosis of the Solitary Pulmonary Nodule (SPN)
10-14. Causes of Pleural Effusion
10-15. Criteria for Defining an Effusion
10-16. Helpful Features of Exudative Pleural Effusions
10-2. Vasomodulator/Vasodilatory Therapy for Pulmonary Arterial Hypertension
10-3. Validated Risk Assessment Tools in Pah
10-4. Symptoms Associated with Obstructive Sleep Apnea-Hypopnea Syndrome
10-5. Mallampati Airway Classification
10-6. Clinical and Radiologic Features of Interstitial Lung Diseases
10-7. Medical Treatment of Selected Interstitial Lung Diseases
10-8. Scadding Staging of Sarcoidosis
10-9. Etiology of Hemoptysis
11. Allergy and Immunology
11. Allergy and Immunology
Adverse Drug Reactions
Anaphylaxis
Eosinophilia
Immunodeficiency
References
Table(s)
11-1. Immunologically Mediated Drug Reactions
11-2. Anaphylaxis
11-3. Causes of Eosinophilia
11-4. Classification of Eosinophilia Based on the Peripheral Blood Eosinophil Count
Urticaria and Angioedema
12. Fluid and Electrolyte Management
12. Fluid and Electrolyte Management
Acid-Base Disturbances
Acid-Base Disturbances
Metabolic Acidosis
Metabolic Alkalosis
References
Respiratory Acidosis
Respiratory Alkalosis
Calcium
Calcium
Hypercalcemia
Hypocalcemia
Disorders of Sodium Concentration
Disorders of Sodium Concentration
Hypernatremia
Hyponatremia
Figure(s)
12-1. Algorithm Depicting the Diagnostic Approach to Hyponatremia
12-2. Algorithm Depicting the Diagnostic Approach to Hypernatremia
Fluid Management and Perturbations in Volume Status
Fluid Management and Perturbations in Volume Status
The Euvolemic Patient
The Hypervolemic Patient
The Hypovolemic Patient
Magnesium
Hypermagnesemia
Hypomagnesemia
Magnesium
Phosphorus
Hyperphosphatemia
Hypophosphatemia
Phosphorus
Potassium
Hyperkalemia
Hypokalemia
Potassium
Table(s)
12-1. Commonly Used Parenteral Solutions
12-2. Expected Compensatory Responses to Primary Acid-Base Disorders
12-3. The Four Primary Acid-Base Disorders and Their Common Etiologies
13. Renal Diseases
13. Renal Diseases
Acute Kidney Injury
Deposition Disorders/Dysproteinemias
Diabetic Nephropathy
Evaluation of the Patient with Renal Disease
Figure(s)
13-1. Stages of Chronic Kidney Disease
Focal Segmental Glomerulosclerosis
Glomerulopathies
IgA Nephropathy/Henoch-Schonlein Purpura
Lupus Nephritis
Management of Chronic Kidney Disease
Membranoproliferative Glomerulonephritis
Membranous Nephropathy
Minimal Change Disease
Nephrolithiasis
Polycystic Kidney Disease
Postinfectious Glomerulonephropathy
Pulmonary-Renal Syndromes
Renal Replacement Therapies
Approach to Dialysis
Hemodialysis
Peritoneal Dialysis
References
Transplantation
Table(s)
13-1. Causes of Acute Renal Failure
13-2. Laboratory Findings in Oliguric Acute Kidney Injury
14. Treatment of Infectious Diseases
14. Treatment of Infectious Diseases
Bioterrorism and Emerging Infections
Anthrax
Bioterrorism and Emerging Infections
Botulism
Plague
References
Viral Hemorrhagic Fevers
Bite Wounds
Animal Bites
Human Bites
Bloodstream Infections and Catheter-Related Bloodstream Infections
Bloodstream Infections
Catheter-Related Bloodstream Infections
Cardiovascular Infections
Infective Endocarditis
Myocarditis
Pericarditis
Central Nervous System Infections
Brain Abscess
Encephalitis
Meningitis
Neurocysticercosis
Fungal and Atypical Organisms
Actinomycosis
Aspergillosis
Blastomycosis
Candidiasis
Coccidioidomycosis
Cryptococcosis
Fungal and Atypical Organisms
Histoplasmosis
Mucormycosis
Nocardiosis
Nontuberculous Mycobacteria
Sporotrichosis
Gastrointestinal and Abdominal Infections
Chronic Diarrhea
Hepatobiliary Infections
Infectious Gastroenteritis
Intra-Abdominal Infection
Other Infections
Peritonitis
Genitourinary Infections
Asymptomatic Bacteriuria
Cystitis
Genitourinary Infections
Genitourinary Infections in Men
Health Care-Associated Infections
Catheter-Associated Urinary Tract Infection
Health Care-Associated Infections
Hospital- and Ventilator-Associated Pneumonia
Lower Respiratory Tract Infections
Acute Bronchitis
Community-Acquired Pneumonia
Coronavirus Disease 2019 (Covid-19)
Influenza Virus Infection
Lung Abscess
Tuberculosis
Mosquito-Borne Infections
Arboviruses
Chikungunya
Dengue
Malaria
West Nile Virus
Zika Virus
Principles of Therapy
Skin, Soft-Tissue, and Bone Infections
Anaerobic Myonecrosis (Gas Gangrene)
Complicated Skin and Soft-Tissue Infections
Infected Decubitus Ulcers and Limb-Threatening Diabetic Foot Ulcers
Necrotizing Fasciitis
Nonpurulent Skin and Soft-Tissue Infections (Erysipelas and Cellulitis)
Osteomyelitis
Purulent Skin and Soft-Tissue Infections (Furuncles, Carbuncles, Abscesses)
Table(s)
14-1. Treatment of Toxic Shock Syndromes
14-10. Empiric Therapy Examples for Intra-Abdominal Infections
14-11. Empiric Therapy for Urinary Tract Infections
14-12. Dosing Examples for Urinary Tract Infections
14-13. Treatment of Fungal Infections, Nocardia, and Actinomyces
14-14. Emerging Infectious Diseases
14-2. Treatment of Osteomyelitis
14-3. Typical Cerebrospinal Fluid Findings in Meningitis
14-4. Treatment of Common Pathogens Associated with Bloodstream Infections and Catheter-Related
14-5. Modified Duke Criteria for the Diagnosis of Infective Endocarditis
14-6. Definition of Infective Endocarditis (IE) by Modified Duke Criteria
14-7. Treatment of Endocarditis Caused by Specific Organisms
14-8. Endocarditis Prophylaxis
14-9. Empiric Treatment for Community-Acquired Pneumonia
Tick-Borne Infections
Babesiosis
Ehrlichiosis and Anaplasmosis
Heartland and Bourbon Virus
Lyme Disease
Rocky Mountain Spotted Fever
Tick-Borne Infections
Tularemia
Toxic Shock Syndrome
Staphylococcal Tss
Streptococcal Tss
Toxic Shock Syndrome
Toxin-Mediated Infections
Clostridioides Difficile Infection
Tetanus
Upper Respiratory Tract Infections
Epiglottitis
Pharyngitis
Rhinosinusitis
Zoonoses
Brucellosis
Cat Scratch Disease (Bartonellosis)
Leptospirosis
Q Fever
Zoonoses
15. Antimicrobials
15. Antimicrobials
Antifungal Agents
Amphotericin B Formulations
Azoles
Echinocandins
Miscellaneous
Antimicrobial Agents
Aminoglycosides
Carbapenems
Cephalosporins
Colistin and Polymyxin B
Cyclic Lipopeptide
Fluoroquinolones
Lipoglycopeptides
Long-Acting Lipoglycopeptides
Macrolides and Lincosamides
Monobactams
Nitroimidazole
Oxazolidinones
Penicillins
Pleuromutilin
Streptogramin
Sulfonamides and Trimethoprim
Tetracyclines
Uncomplicated UTI Agents
Vancomycin
Antimycobacterial Agents
Antimycobacterial Agents
Ethambutol
Isoniazid
Pyrazinamide
Rifamycins
Streptomycin
Antiviral Agents
Anti-Covid-19 Agents
Anticytomegalovirus Agents
Antiherpetic Agents
Anti-Influenza Agents
Antiviral Agents
Figure(s)
15-1. Nomograms for Extended-Interval Aminoglycoside Dosing
Introduction
Table(s)
15-1. Activity of Novel Gram-Negative Antibiotics Versus Resistant Organisms
15-2. Indications for Vancomycin Use
16. Sexually Transmitted Infections, Human Immunodeficiency Virus, and Acquired Immunodeficiency Syndrome
16. Sexually Transmitted Infections, Human Immunodeficiency Virus, and Acquired Immunodeficiency Syndrome
Associated Neoplasms
Cervical and Perianal Neoplasias
Kaposi Sarcoma
Lymphoma
Central Nervous System and Retinal Disease
CMV Retinitis
Cryptococcus Neoformans
JC Virus
Toxoplasma Gondii
Varicella-Zoster Virus
Diarrhea
Cryptosporidium
Cyclospora, Cystoisospora, Microsporidia, and Campylobacter Jejuni
Esophagitis
Candida
Febrile Syndromes
Coccidioides Immitis Infection
Histoplasma Capsulatum Infections
Mycobacterium Avium Complex Infection
Other Endemic Fungi
Figure(s)
16-1. Recommended Laboratory HIV Testing Algorithm for Serum or Plasma Specimens
Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
HIV Type 1
Opportunistic Infections
Pulmonary Syndromes
Mycobacterium Tuberculosis
Pneumocystis Jirovecii Pneumonia
Sexual History and Gender-Affirming Care
Taking a Sexual History
Transgender Medicine
Sexually Transmitted Infections in Patients with HIV
Additional Resources
Genital Herpes
Genital Warts
References
Sexually Transmitted Infections in Patients with HIV
Syphilis
Sexually Transmitted Infections: Ulcerative Diseases
Chancroid
Genital Herpes
Lymphogranuloma Venereum
Sexually Transmitted Infections: Ulcerative Diseases
Syphilis
Sexually Transmitted Infections: Vaginitis and Vaginosis
Bacterial Vaginosis
Cervicitis/Urethritis
Pelvic Inflammatory Disease
Trichomoniasis
Vulvovaginal Candidiasis
Table(s)
16-1. Treatment of Sexually Transmitted Infections
16-2. Opportunistic Infection Prophylaxis
17. Solid Organ Transplant Medicine
17. Solid Organ Transplant Medicine
Graft Rejection
Acute Rejection, Heart
Acute Rejection, Kidney
Acute Rejection, Liver
Acute Rejection, Lung
Acute Rejection, Pancreas
Chronic Allograft Dysfunction
Graft Rejection
References
Solid Organ Transplant Basics
Table(s)
17-1. Calcineurin Inhibitors
17-2. Differential Diagnosis of Renal Allograft Dysfunction
17-3. Timing and Etiology of Posttransplant Infections
18. Gastrointestinal Diseases
18. Gastrointestinal Diseases
Constipation
Diarrhea
Dysphagia and Odynophagia
Gastrointestinal Bleeding
Luminal Gastrointestinal Disorders
Esophageal Motor Disorders
Functional Gastrointestinal Disorders
Gastroesophageal Reflux Disease
Inflammatory Bowel Disease
Intestinal Pseudo-Obstruction (Ileus)
Peptic Ulcer Disease
Nausea and Vomiting
Other Gastrointestinal Disorders
Anorectal Disorders
Celiac Sprue
Diverticular Disease
Gastroparesis
Ischemic Intestinal Injury
References
Pancreaticobiliary Disorders
Acute Pancreatitis
Chronic Pancreatitis
Gallstone Disease
Table(s)
18-1. Forrest Classification of Peptic Ulcers
18-2. Commonly Used Antiemetics
18-3. Regimens Used for Eradication of Helicobacter Pylori
18-4. Medications for Inflammatory Bowel Disease
19. Liver Diseases
19. Liver Diseases
Cirrhosis
Acute Kidney Injury in Patients with Cirrhosis and HRS
Ascites
Cirrhosis
Hepatic Encephalopathy
Hepatocellular Carcinoma
Liver Transplantation
Portal Hypertension
References
Spontaneous Bacterial Peritonitis
Complications of Cholestasis
Nutritional Deficiencies
Osteoporosis
Pruritus
Evaluation of Liver Disease
Immune-Mediated Liver Diseases
Autoimmune Hepatitis
Primary Biliary Cholangitis
Primary Sclerosing Cholangitis
Metabolic Liver Diseases
Alpha (1)-Antitrypsin Deficiency
Hereditary Hemochromatosis
Wilson Disease
Miscellaneous Liver Disorders
Acute Liver Failure
Hepatic Vein Thrombosis
Ischemic Hepatitis
Nonalcoholic Fatty Liver Disease
Portal Vein Thrombosis
Table(s)
19-1. Clinical and Epidemiologic Features of Hepatotropic Viruses
19-2. Viral Hepatitis Serologies
19-3. Use of Hepatitis B Virus (HBV) Markers in Clinical Practice
19-4. AASLD Treatment Guidelines for Chronic Hepatitis B
19-5. Diagnostic Criteria of HRS-AKI
Viral Hepatitis
Alcoholic Liver Disease
Drug-Induced Liver Injury
Hepatitis A Virus
Hepatitis B Virus
Hepatitis C Virus
Hepatitis D (Delta) Virus
Hepatitis E Virus
Viral Hepatitis
20. Disorders of Hemostasis and Thrombosis
20. Disorders of Hemostasis and Thrombosis
Acquired Coagulation Disorders
Acquired Inhibitors of Coagulation Factors
Disseminated Intravascular Coagulation
Liver Disease
Vitamin K Deficiency
Figure(s)
20-1. Coagulation Cascade
Hemostasis Disorders
Hemostatic Disorders
Inherited Bleeding Disorders
Hemophilia A
Hemophilia B
von Willebrand Disease
Platelet Disorders
Gestational Thrombocytopenia
Heparin-Induced Thrombocytopenia
Immune Thrombocytopenia
Posttransfusion Purpura
Qualitative Platelet Disorders
Thrombocytopenia
Thrombocytosis
Thrombotic Thrombocytopenic Purpura and Hemolytic-Uremic Syndrome
Table(s)
20-1. Factor Deficiencies That Cause Prolonged Prothrombin Time and/or Activated Partial
20-2. Classification of Thrombocytopenia
20-3. 4T Scoring System for Pretest Probability of Heparin-Induced Thrombocytopenia
20-4. International Society on Thrombosis and Haemostasis Disseminated Intravascular Coagulation Scoring
20-5. European Society of Cardiology Mortality Risk Classification of Patients Who
20-6. Anticoagulants for Treatment of Venous Thromboembolism (Vte)
Venous Thromboembolic Disorders
Approach to Venous Thromboembolism
References
21. Hematologic Disorders and Transfusion Therapy
21. Hematologic Disorders and Transfusion Therapy
Anemia
Anemias Associated with Decreased RBC Production
Anemia in Cancer Patients
Anemia of Chronic Disease/Inflammation
Anemia of Chronic Renal Insufficiency
Aplastic Anemia
Iron Deficiency Anemia
Macrocytic/Megaloblastic Anemia
Sideroblastic Anemias
Thalassemia
Anemias Associated with Increased RBC Destruction
Anemias Associated with Increased Erythropoiesis
Autoimmune Hemolytic Anemia
Drug-Induced Hemolytic Anemia
G6pd Deficiency
Microangiopathic Hemolytic Anemia
Sickle Cell Disease
Bm Disorders
Myelodysplastic Syndrome
Myeloproliferative Neoplasms
Monoclonal Gammopathies
Amyloidosis
Monoclonal Gammopathy of Unknown Significance
Multiple Myeloma
References
Transfusion Medicine
Waldenstrom Macroglobulinemia
Table(s)
21-1. Oral Iron Preparations
21-2. IV Iron Preparations
21-3. Thalassemias
21-4. Erythropoietin Dosing
21-5. WHO 2016 Diagnostic Criteria for Polycythemia Vera
21-6. WHO 2016 Diagnostic Criteria for Primary Myelofibrosis (PMF)
White Blood Cell Disorders
Leukocytosis and Leukopenia
Platelet Disorders
22. Cancer
22. Cancer
Gastrointestinal Malignancies
Colorectal Cancer
Esophageal Cancer
Gastric Cancer
Hepatocellular Carcinoma
Pancreatic Cancer
General Principles
Background
General Principles
Staging
Genitourinary Malignancies
Bladder Cancer
Prostate Cancer
Renal Cancer
Testicular Cancer and Germ Cell Tumors
Gynecologic Malignancies
Cancer of Unknown Primary
Central Nervous System Tumors
Cervical Cancer
Melanoma
Ovarian Cancer
Sarcoma
Uterine Cancer
Hematologic Malignancies
Acute Lymphoblastic Leukemia
Acute Myeloid Leukemia
Chronic Lymphocytic Leukemia
Chronic Myeloid Leukemia
Hairy Cell Leukemia
Hodgkin Lymphoma
Multiple Myeloma
Myelodysplastic Syndrome
Non-Hodgkin Lymphoma
Principles of Stem Cell Transplantation
Oncologic Emergencies and Supportive Care
Oncologic Emergencies
References
Supportive Care
Solid Malignancies
Breast Cancer
Head and Neck Cancer
Lung Cancer
Table(s)
22-1. Estimated New Cancer Cases and Rates of Death for Most
22-10. Select Chromosomal Abnormalities in B-Cell Non-Hodgkin Lymphomas
22-11. Revised-International Staging System and Risk Stratification in Myeloma
22-12. Oncologic Emergencies
22-2. List of Selected Familial Cancer Syndromes with High Penetrance
22-3. Eastern Cooperative Oncology Group (ECOG) and Karnofsky Score
22-4. Summary of Selected Response Evaluation Criteria in Solid Tumors (RECIST)
22-5. Revised International Prognostic Scoring System (IPSS-R) for Myelodysplastic Syndromes
22-6. Acute Leukemias with Recurrent Genetic Abnormalities
22-7. Cytogenetic Abnormalities in Acute Myeloid Leukemia and Associated Prognosis
22-8. Chronic Lymphocytic Leukemia Clinical Staging
22-9. Lugano Staging of Lymphomas
23. Diabetes Mellitus and Related Disorders
23. Diabetes Mellitus and Related Disorders
Chronic Complications of Diabetes Mellitus
Chronic Complications of Diabetes Mellitus
Diabetic Nephropathy
Diabetic Neuropathy
Diabetic Retinopathy
Diabetes Mellitus
Diabetes Mellitus
Diabetes Mellitus in Hospitalized Patients
Diabetic Ketoacidosis
Hyperosmolar Hyperglycemic State
Management
Type 1 Diabetes
Type 2 Diabetes
Macrovascular Complications of Diabetes Mellitus
Coronary Heart Disease
Heart Failure
Peripheral Vascular Disease
Miscellaneous Complications
Erectile Dysfunction
Hypoglycemia
References
Table(s)
23-1. Diagnosis of Diabetes
23-2. Treatment of Diabetic Ketoacidosis
23-3. Treatment of Hyperosmolar Hyperglycemic State
23-4. Approximate Kinetics of Insulin Preparations
23-5. Noninsulin Medications for Diabetes
24. Endocrine
24. Endocrine
Acromegaly
Adrenal Failure
Cushing Syndrome
Evaluation of Thyroid Function
Goiter, Thyroid Nodules, and Thyroid Carcinoma
Hyperprolactinemia
Hyperthyroidism
Hypothyroidism
Incidental Adrenal Nodules
Osteomalacia
Paget Disease
Pituitary Adenomas and Hypopituitarism
References
Table(s)
24-1. Effects of Drugs on Thyroid Function Tests
24-2. Differential Diagnosis of Hyperthyroidism
24-3. Major Causes of Hyperprolactinemia
Transgender Medicine
25. Arthritis and Rheumatologic Diseases
25. Arthritis and Rheumatologic Diseases
Basic Approach to Joint Pain
Crystalline Arthritis
Crystalline Arthritis
Gout
Idiopathic Inflammatory Myopathies
Other Crystalline Arthritis
Pseudogout/Calcium Pyrophosphate Deposition Disease
Raynaud Phenomenon
Spondyloarthritis
Systemic Lupus Erythematosus
Systemic Sclerosis
Vasculitis
Figure(s)
25-1. Approach to Joint Pain
Large Vessel Vasculitis
Giant Cell Arteritis
Takayasu Arteritis
Medications in Rheumatology
Disease-Modifying Antirheumatic Drugs
Glucocorticoids
References
Medium Vessel Vasculitis
Polyarteritis Nodosa
Rheumatoid Arthritis
Small Vessel Vasculitis
Anca-Associated Vasculitis
Eosinophilic Granulomatosis with Polyangiitis
Granulomatosis with Polyangiitis
Microscopic Polyangiitis
Table(s)
25-1. Synovial Fluid Analysis
25-10. Nomenclature
25-11. Biologic Dmards
25-2. Acute Gout Treatment
25-3. Urate-Lowering Therapies
25-4. Distinguishing Manifestations
25-5. Synthetic Dmards
25-6. Myositis-Specific Antibodies (Msa)
25-7. Vasculitis Classification
25-8. Vasculitis Features by Vessel Size
25-9. Sensitivity of Anca Antibodies
26. Medical Emergencies
26. Medical Emergencies
Airway Emergencies
Emergent Airway Adjuncts
Emergent Airway Management
Pneumothorax
Cold-Induced Illness
Chilblains
Cold-Induced Illness
Deep Frostbite
Frostnip (Superficial Frostbite)
Hypothermia
Immersion Injury (Trench Foot)
References
Heat-Induced Illness
Heat Exhaustion
Heat Stroke
Heat Syncope
Heat-Induced Illness
27. Neurologic Disorders
27. Neurologic Disorders
Acute Spinal Cord Dysfunction
Alterations in Consciousness
Alzheimer Disease
Cerebrovascular Disease
Figure(s)
27-1. Treatment of Status Epilepticus
27-2. Brain and Systemic Pathology in Prolonged Convulsive and Nonconvulsive Status
Head Trauma
Headache
Multiple Sclerosis
Neuromuscular Disease
Disorders with Rigidity
Guillain-Barre Syndrome
Myasthenia Gravis
Other Neuromuscular Disorders
References
Parkinson Disease
Seizures
Table(s)
27-1. Causes of Altered Mental Status
27-10. Differential Diagnosis of Parkinson Disease
27-11. Differential Diagnosis of Acute Immune Demyelinating Polyneuropathy
27-2. Ape2 Score
27-3. Differential Diagnosis of Alzheimer Dementia
27-4. Etiologies of Seizures
27-5. Disease-Modifying Therapies Approved for Use in Relapsing-Remitting Multiple Sclerosis
27-6. Inclusion and Exclusion Criteria for t-PA for Acute Ischemic Stroke
27-7. Inclusion and Exclusion Criteria for Endovascular Thrombectomy (Washington University Stroke
27-8. Secondary Stroke Prevention ('Blasted')
27-9. Causes of Acute Spinal Cord Dysfunction
28. Toxicology
28. Toxicology
Alcohols
Ethanol
Toxic Alcohols
Analgesics
Acetaminophen
Nonsteroidal Anti-Inflammatory Drugs
Opioids
Salicylates
Anticonvulsants
Carbamazepine and Oxcarbazepine
Other Anticonvulsants
Phenytoin and Fosphenytoin
Valproic Acid
Cardiovascular Agents
Beta Blockers and Calcium Channel Antagonists
Clonidine and Other Sympatholytics
Digoxin
Other Antihypertensives
Environmental Toxins
Carbon Monoxide
Cyanide
References
Figure(s)
28-1. Qt Interval Nomogram
28-2. Acetaminophen (Rumack-Matthew) Nomogram
Psychotropics
Antipsychotics
Lithium
Monoamine Oxidase Inhibitors
Selective Serotonin Reuptake Inhibitors
Serotonin Syndrome
Tricyclic Antidepressants
Sedative-Hypnotics
Barbiturates
Benzodiazepines
Other Sedatives
Sympathomimetics
Amphetamines
Bupropion
Cocaine
Methylxanthines
Table(s)
28-1. Toxidromes
28-2. King's College Criteria
28-3. Dosing of N-Acetylcysteine
28-4. Medications for Opioid Use Disorder
28-5. Other Anticonvulsants
28-6. Effects of Selected Antipsychotics
28-7. Other Antihypertensives
28-8. Other Sedatives
The Poisoned Patient
Appendices
A. Immunizations and Postexposure Therapies
A. Immunizations and Postexposure Therapies
T - A-1. Selected Adult Immunization Recommendations in the United States
T - A-2. Selected Adult Postexposure Prophylaxis Recommendations
T - A-3. Selected Postexposure Guidelines for Healthcare Personnel
T - A-4. Rabies Postexposure Prophylaxis Recommendations
B. Infection Control and Isolation Recommendations
B. Infection Control and Isolation Recommendations
F - B-1. World Health Organization's My Five Moments for Hand Hygiene
T - B-1. Healthcare Isolation Recommendations for Specific Infections
C. Advanced Cardiac Life Support Algorithms
C. Advanced Cardiac Life Support Algorithms
F - C-1. Advanced Cardiac Life Support Pulseless Arrest Algorithm
F - C-2. Bradycardia Algorithm
F - C-3. Advanced Cardiac Life Support Tachycardia Algorithm
Front Matter
Contributors
Dedication
Department Chair's Note
Preface
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