Approach to Internal Medicine: A Resource Book for Clinical Practice

Approach to Internal Medicine PulmonaryMedicine Pages1–24 Cardiology Pages25–66 Nephrology Pages67–88 CriticalCare Pages89–110 Gastroenterology Approach to Internal Medicine Pages111–142 AResourceBookforClinicalPractice Hematology Pages143–184 Third Edition Oncology Pages185–232 by InfectiousDiseases Pages233–272 David Hui, MD, M.Sc., FRCPC Rheumatology Pages273–296 Neurology Edited by Pages297–336 Alexander Leung, BSc(Med), MD(STIR), Endocrinology Pages337–360 DABIM, MRCP(UK), FRCPC Dermatology and Pages361–376 Raj Padwal, MD, M.Sc., FRCPC Geriatrics Pages377–388 PalliativeCare Pages389–402 Nutrition Pages403–408 ObstetricMed Pages409–416 GeneralMed Pages417–430 1 3 ACLS Page431 Index Pages443–458 DavidHuiMD,M.Sc.,FRCPC TheUniversityofTexasM.D.Anderson CancerCenter Houston,TX77030USA dhui@mdanderson.org Author:DavidHui Associateeditors:AlexanderLeung,RajPadwal Firstedition,firstprinting,April2006 Secondedition,firstprinting,August2007 Secondedition,secondprinting,November2007 Secondedition,thirdprinting,March2008 Secondedition,fourthprinting,July2008 Secondedition,fifthprinting,November2008 Secondedition,sixthprinting,June2009 Thirdedition,firstprinting,January2011 ApproachtoInternalMedicine:AResourceBookforClinicalPractice Additionalmaterialtothisbookcanbedownloadedfromhttp://extras.springer.com. ISBN978-1-4419-6504-2 e-ISBN978-1-4419-6505-9 DOI10.1007/978-1-4419-6505-9 SpringerNewYorkDordrechtHeidelbergLondon LibraryofCongressControlNumber:2010933485 #SpringerScienceþBusinessMedia,LLC2006,2007,2011 Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewritten permissionofthepublisher(SpringerScienceþBusinessMedia,LLC,233SpringStreet,NewYork,NY 10013,USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarlyanalysis.Useinconnection withanyformofinformationstorageandretrieval,electronicadaptation,computersoftware,orby similarordissimilarmethodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,eveniftheyare notidentifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornottheyaresubject toproprietaryrights. Whiletheadviceandinformationinthisbookarebelievedtobetrueandaccurateatthedateofgoingto press,neithertheauthorsnortheeditorsnorthepublishercanacceptanylegalresponsibilityforany errorsoromissionsthatmaybemade.Thepublishermakesnowarranty,expressorimplied,withrespect tothematerialcontainedherein. Printedonacidfreepaper SpringerispartofSpringerScienceþBusinessMedia(www.springer.com) To Ella and Rupert David Hui Disclaimer Approach to Internal Medicine is meant to be a practical field guide. Dosagesofmedicationsareprovidedforquickreferenceonly.Readers should consult other resources before applying information in this manual for direct patient care. The author, editors, and publisher of ApproachtoInternalMedicinecannotbeheldresponsibleforanyharm, directorindirect,causedasaresultofapplicationofinformationcon tainedwithinthismanual. vii Preface Practiceissciencetouchedwithemotion. ConfessioMedici,StephenPaget,1909 ThethirdeditionofApproachtoInternalMedicinebuildsuponpreviouseffortstocreateapractical, evidencebased,andconciseeducationalresourceforeverydayclinicaluseandexaminationpreparation. ApproachtoInternalMedicinenowhasanexpandedrepertoireofover250internalmedicinetopics, classified under 17 subspecialties. With the input of a new editor and publisher, we were able to significantlyexpandandupdatethecontentandsubstantiallyimprovethelayout,whilemaintaining thesameconcisenessandpracticalityfoundinpreviouseditions. Undereachtopic,thesectionsondifferentialdiagnoses,investigations,andtreatmentsaredesigned fortherapidretrievalofhighyieldclinicalinformationandcanbeparticularlyusefulwhenoneisallalone assessingapatientat3o’clockinthemorning.Othersectionscontainmanyclinicalpearlsthatareintended tohelponetoexcelinpatientcare.Wealsoincludedmanycomparisontablesaimedathighlightingthe distinguishingfeaturesbetweenvariousclinicalentitiesandnumerousmnemonics(markedbyw).In additiontoeverydaypractice,ApproachtoInternalMedicinecanbeeffectivelyusedasanexaminationstudy guideandteachingscript. Forthisnewedition,weareveryfortunatetohaverecruitedanewassociateeditor,Dr.Alexander Leung,whobringswithhimawealthofknowledgeandoutstandingcommitmenttomedicaleducation. We are most grateful to our section editors and contributors for their meticulous review of each subspecialty,providingexpertinputonthemostuptodateinformation.Wewouldalsoliketotake thisopportunitytothankJeanClaudeQuintalasaresidentreviewerandtheCanadianFederationof MedicalStudentsforitssupportofthepreviousedition.Finally,wewouldliketothankallpreviousand currentusersofthismanualfortheirsupportandfeedback. WearepleasedthatSpringerhastakenthistitleunderitsdirectionandhashelpedtoimproveits qualityinpreparationforinternationalrelease.InadditiontoInternationalSystem(SI)units,thisedition alsoprovidesUScustomaryunits[insquarebrackets]forquickreference.Wewouldparticularlyliketo thank Laura Walsh, senior editor, and Stacy Lazar, editorial assistant, from Springer for their expert guidanceandsupportthroughoutthismammothprojectfromdesigntoproduction.Wewouldalsolike tothankWalterPagel,directorofscientificpublishingatM.D.AndersonCancerCenter,forbelievingin thisworkandmakingthiscollaborationpossible. Whileeveryefforthasbeenmadetoensuretheaccuracyofinformationinthismanual,theauthor, editors,andpublisherarenotresponsibleforomissions,errors,oranyconsequencesthatresultfrom applicationoftheinformationcontainedherein.Verificationoftheinformationinthismanualremains theprofessionalresponsibilityofthepractitioner.Readersarestronglyurgedtoconsultotherappro priate clinical resources prior to applying information in this manual for direct patient care. This is ix