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Machine Translated by Google

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Textbook for medical schools

Team of authors

Internal illnesses. Volume 1

"SpetsLit"

2015

Machine Translated by Google

UDC 615 616

Team of authors

Internal illnesses. Volume 1 / Team of authors - "SpetsLit", 2015 - (Textbook for medical universities)

ISBN 978-5-299-00474-5

The textbook was written by leading specialists of therapeutic clinics of medical universities in St. Petersburg. The first volume of the publication is devoted to diseases of the cardiovascular and

digestive systems, diseases of the kidneys and respiratory organs. The second volume contains chapters that deal with diseases of the blood system, endocrine glands, systemic lesions of the connective tissue and joint diseases, immunodeficiencies, chronic fatigue syndrome, pharmacotherapy in geriatric practice, and allergic diseases. The presentation is built according to the traditional plan with a description of the etiology and pathogenesis, modern classification, clinical manifestations, methods for diagnosing and treating diseases of internal

organs. Each section provides examples of the formulation of diagnoses, describes the most common complications of diseases and methods for their prevention. The textbook complies with the program approved by

the Ministry of Health of the Russian Federation, and is intended for students of the 4

UDC 615 616

ISBN 978-5-299-00474-5

© Team of authors,

 

2015 © SpecLit, 2015

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. The team of authors. "Internal illnesses. Volume 1"

Content

CONVENTIONAL ABBREVIATIONS

7

FOREWORD Chapter 1

12

 

thirteen

1.1. RISK FACTORS FOR CARDIOVASCULAR

thirteen

DISEASES

 

1.2. ATHEROSCLEROSIS

sixteen

1.3. HYPERTENSION 1.4. ISCHEMIC

28

HEART DISEASE 1.4.1. Angina pectoris (angina

59

pectoris) 1.4.2. Myocardial infarction 1.5.

60

INFECTIOUS ENDOCARDITIS 1.6.

75

MYOCARDITIS 1.7. PERICARDITIS 1.8. HEART

97

DEFECTS 1.8.1. Congenital heart defects 1.8.2.

108

Acquired heart defects 1.9. CARDIOMYOPATHY

116

1.9.1. Hypertrophic cardiomyopathy 1.9.2.

124

Dilated cardiomyopathy 1.9.3. Restrictive

124

cardiomyopathy 1.9.4. Arrhythmogenic

129

dysplasia of the right ventricle 1.9.5.

146

Unclassifiable cardiomyopathies 1.10.

146

TUMORS OF THE HEART 1.10.1. Myxoma

150

1.10.2. Non-myxomatous benign tumors

153

1.10.3. Sarcomas 1.10.4. Secondary malignant tumors

156

 

158

 

160

 

160

 

161

 

161

 

162

1.11. HEART FAILURE

163

1.11.1. Acute heart failure 1.11.2. Pulmonary

163

edema 1.11.3. Cardiogenic shock 1.11.4.

163

Chronic heart failure

166

 

170

1.12. HEART RHYTHM AND CONDUCTIVITY DISORDERS 1.12.1.

198

Anatomy and physiology of the conduction system

199

hearts. Mechanisms of formation of arrhythmias

 

1.12.2. The main methods of examination of patients with

200

arrhythmias

 

1.12.3. Supraventricular arrhythmias

205

1.12.4. Ventricular arrhythmias

217

1.12.5. Violations of the function of the sinus

227

node 1.12.6. Conduction disorders (blockade) of the

231

heart 1.13. TREATMENT OF ARRHYTHMIAS QUESTIONS

238

TESTS ANSWERS TO QUESTIONS ANSWERS TO TESTS

247

 

249

 

254

 

256

4

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. The team of authors. "Internal illnesses. Volume 1"

 

Chapter

258

2 2.1. DEFECTS AND HEREDITARY

258

CONDITIONED RESPIRATORY DISEASES

 

2.1.1. Lung malformations 2.1.2.

258

hereditary lung diseases

261

2.2. ACUTE RESPIRATORY DISEASES 2.3. ACUTE

267

BRONCHITIS 2.4. PNEUMONIA 2.5. CHRONIC BRONCHITIS

271

2.6. PULMONARY EMPHYSEMA 2.7. BRONCHIAL

274

ASTHMA 2.8. CHRONIC OBSTRUCTIVE PULMONARY

286

DISEASE 2.9. BRONCHIOECTATIC DISEASE 2.10.

297

INFECTIOUS DESTRUCTIONS OF THE LUNGS 2.11.

299

DISEASES OF THE PLEURA

318

 

327

 

333

 

341

2.11.1. Pleurisy

341

2.11.2. Spontaneous pneumothorax

355

2.12. SARCOIDOSIS OF THE RESPIRATORY

360

ORGANS 2.13. INTERSTITIAL LUNG DISEASES 2.13.1. Idiopathic

366

fibrosing alveolitis

366

(Hammen-Rich disease)

 

2.13.2. Exogenous allergic alveolitis

371

2.14. PNEUMOCONIOSIS

376

2.15. PULMONARY EMBOLISM

384

2.16. LUNG CANCER TASKS

392

TESTS ANSWERS TO TESTS

401

ANSWERS TO TESTS Chapter 3

407

 

415

 

417

 

418

3.1. DISEASES OF THE ESOPHAGUS

418

3.1.1. Gastroesophageal reflux disease 3.1.2.

418

Achalasia of the cardia 3.1.3. Cancer of the

427

esophagus 3.2. DISEASES OF THE STOMACH 3.2.1.

429

Acute gastritis 3.2.2. Chronic gastritis 3.2.3. Peptic ulcer

432

3.2.4. Cancer of the stomach 3.3. DISEASES OF THE

432

SMALL INTESTINE 3.3.1. Malabsorption syndrome

435

3.3.2. Celiac disease (gluten disease) 3.3.3. Whipple's

446

disease 3.4. DISEASES OF THE COLON 3.4.1.

474

Inflammatory bowel disease - ulcerative

478

 

478

 

484

 

490

 

494

 

494

colitis and Crohn'sdisease

 

3.4.2. Irritable bowel syndrome 3.4.3. colorectal

503

cancer

515

5

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. The team of authors. "Internal illnesses. Volume 1"

3.5. DISEASES OF THE LIVER AND BILIOLOGY

519

WAYS

 

3.5.1. Pigmentary hepatoses

519

3.5.2. Fatty degeneration of the liver (the first stage of fatty

522

liver disease)

525

3.5.3. Chronic hepatitis 3.5.4.

Cirrhosis of the liver 3.5.5.

544

Idiopathic hemochromatosis 3.5.6.

557

Liver tumors 3.5.7. Dysfunctional

559

biliary disorders

564

tract

 

3.5.8. Gallstone disease 3.5.9.

569

Postcholecystectomy syndrome 3.5.10.

579

Chronic acalculous cholecystitis 3.5.11.

581

Tumors of the biliary system 3.6. DISEASES

582

OF THE PANCREAS 3.6.1. Chronic pancreatitis 3.6.2.

586

Tumors of the pancreas QUESTIONS AND TESTS

586

Chapter 4 4.1. CLASSIFICATION OF KIDNEY

596

DISEASES 4.2. AMYLOIDOSIS 4.3. GLOMERULONEPHRITIS

603

 

615

 

616

 

619

 

626

4.3.1. Acute endocapillary diffuse

627

proliferative glomerulonephritis

638

4.3.2. Chronic glomerulonephritis

4.4. DIABETIC NEPHROPATHY 4.5.

659

pyelonephritis 4.5.1. Acute pyelonephritis

682

4.5.2. Chronic pyelonephritis 4.6.

683

RENAL FAILURE

686

 

694

4.6.1. Acute renal failure 4.6.2. Chronic

694

renal failure QUESTIONS

697

 

713

6

Machine Translated by Google

. The team of authors. "Internal illnesses. Volume 1"

Internal illnesses. Volume 1

CONVENTIONAL ABBREVIATIONS

5-NAA - 5-nucleotidase

AAP - antiarrhythmic drugs AV - atrioventricular (th, - th, - th) AH - arterial hypertension AHA - antigliadin antibodies BP - blood pressure ADA - adenosine deaminase ADP - adenosine diphosphate AIH - autoimmune chronic hepatitis AK - calcium antagonists ACTH - associated clinical conditions ACTH - adrenocorticotropic hormone

ALG - antilymphocyte globulin ALT - alanine aminotransferase ANA - antinuclear antibodies ANF - antinuclear factor APTT - activated partial thromboplastin time ACE - angiotensin converting enzyme APC - antigen-presenting cells ARC - branched

chain amino acids AST - ROS aspartate – reactive oxygen species BA – bronchial asthma BAB – beta-adrenergic blockers BAS – biologically active substances CD – Crohn'sdisease LSD – basal acid production LBBB – left bundle branch block BM – basement membranes ARB – angiotensin II receptor blockers BTK – tyr blockers osine kinase BU - Whipple'sdisease VBCP - secondary biliary cirrhosis IBD - inflammatory bowel disease VIP - vasoactive intestinal peptide WHO - World Health Organization – hypertension GBM – glomerular basement membranes GGTP – gamma-glutamyl transpeptidase GC – glucocorticoids

7

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. The team of authors. "Internal illnesses. Volume 1"

GCS - glucocorticosteroids

GM-CSF - granulocyte-macrophage colony-stimulating factor GP receptors - glycoprotein receptors GPGA - glucocorticoid suppressed hyperaldosteronism dichlorodiphenyltrichloroethane DN – diabetic nephropathy DNA – deoxyribonucleic acid DPP – dipeptidyl peptidase VC – lung vital capacity GSD – cholelithiasis GIT – gastrointestinal tract VT – ventricular tachycardia ACE inhibitor – angiotensinconverting enzyme inhibitor CHD – coronary heart disease interstitial lung disease IC - immune complex ICD - implantable cardioverterdefibrillator, implantable cardioverter-defibrillator IL - see IL MI - myocardial infarction BMI - body mass index IMF - idiopathic PI - polycythemia vera PPI - proton pump inhibitors ISAH - isolated systolic arterial hypertension ELISA - idiopathic fibrosing alveolitis hormone CRC - colorectal cancer CSF - colony stimulating factors CT - computed tomography CPK - creatine phosphokinase KSh - coronary bypass grafting LAP - leucine aminopeptidase LH - luteinizing hormone LDH - lactate dehydrogenase HDL - high density lipoproteins LDL - low density lipoproteins VLDL - very low density lipoproteins

eight

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. The team of authors. "Internal illnesses. Volume 1"

LIPP - intermediate density lipoproteins MA - microalbuminuria MAC - membrane attack

complex UA - uric acid INR - international normalized ratio MRD - minimal residual

disease MPGN - membranous proliferative glomerulonephritis MP therapy - melphalan and

prednisolone therapy MRI - magnetic resonance imaging resonance cholangiopancreatography MS - metabolic syndrome NADP - nicotinamide dinucleotide phosphate NAFLD - non-alcoholic fatty liver disease NASH - non-alcoholic steatohepatitis LMWH - low molecular weight heparins NSAIDs - non-steroidal

anti-inflammatory drugs NES - lower esophageal sphincter NS - nephrotic syndrome UFH -

unfractionated heparin NERD - non-erosive reflux disease OAF - osteoclast activating factor OH - acute gastritis AGN - acute glomerulonephritis TL - total lung capacity OL - residual lung volume OB - lifestyle APGN - acute poststreptococcal glomerulonephritis AKI - acute renal failure t ARI - acute respiratory diseases FEV1 - forced expiratory volume in the first second PBCP - primary biliary cirrhosis of the liver PDF - fibrin degradation product PEP - end plate potential PNH - paroxysmal nocturnal hemoglobinuria POM - target organ damage PRL - prolactin PSV - peak expiratory flow PSM – sulfonylurea drugs PTH – parathyroid hormone PCT – polychemotherapy PCR

– polymerase chain reaction PET – positron emission tomography PAM – pathogen-associated molecular structures GC – gastric cancer RNHA – indirect hemagglutination reaction RNA – ribonucleic acid RP

– esophageal cancer RS-virus – respiratory -syncytial virus RSK - complement fixation reaction

nine

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. The team of authors. "Internal illnesses. Volume 1"

HI - hemagglutination inhibition reaction RE - reflux esophagitis SBP - systolic blood pressure DM - diabetes mellitus FFA - free fatty acids EFR - stimulated acid production GFR - glomerular filtration rate CM - malabsorption syndrome HF - heart failure ESR - erythrocyte sedimentation rate SR - sinus rhythm CRP

C-reactive protein IBS – irritable bowel syndrome SSS – sick sinus syndrome SU

sinus node FNA – fine needle aspiration biopsy TBCA – transluminal balloon coronary angioplasty TBM – tubular basement membranes TG – triglycerides TLT – thrombolytic therapy TNF – tumor necrotic factor TSH – thyroid-stimulating

hormone PE – pulmonary embolism Ultrasound – ultrasound EF – von Willebrand factor FVD – respiratory function FDC – follicular dendritic cell FC – functional class TNF-a (TNF-a) – tumor necrosis factor-á AF – atrial fibrillation FR – risk factor FSH - follicle stimulating hormone FEGDS - fibroesophagogastroduodenoscopy CKD - chronic kidney disease CG - chronic gastritis CGN - chronic glomerulonephritis CKD - chronic kidney disease CM - chylomicrons COPD - chronic obstructive pulmonary disease CP - chronic pancreatitis CPB - chronic kidney disease CKD - chronic renal failure cholesterol cAMP - cyclic adenosine monophosphate CNS - central nervous system RR - respiratory rate PR - pelvicalyceal complex HR - heart rate AP - alkaline phosphatase

ten

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