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CURRENT
Medical Diagnosis
& Treatment
SIXTY-FOURTH EDITION
Edited by
Maxine A. Papadakis, MD
Professor of Medicine, Emeritus
Department of Medicine
University of California, San Francisco
Kenneth R. McQuaid, MD
University of California, San Francisco
Monica Gandhi, MD, MPH
Division of HIV, ID, and Global Medicine
San Francisco General Hospital
University of California, San Francisco
Michael W. Rabow, MD
Professor of Medicine and Urology
Division of Palliative Medicine
Department of Medicine
University of California, San Francisco
Professor of Medicine
Department of Medicine
Associate Editor
Professor of Medicine
With Contributing Authors
Current Medical Diagnosis & Treatment 2025, Sixty-Fourth Edition
https://t.me/med1917
Copyright © 2025 by McGraw Hill. All rights reserved. Printed in the United States of America. Except as permitted under
the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any
means, or stored in a database or retrieval system, without prior written permission of the publisher.
Previous editions copyright 2000 through 2024 by McGraw Hill Education; copyright © 1987 through 1999 by Appleton &
Lange; copyright 1962 through 1986 by Lange Medical Publications.
1 2 3 4 5 6 7 8 9 0 LWI 28 27 26 25 24 23
ISBN 978-1-2662-6623-2
MHID 1-2662-6623-2
ISSN 0092-8682
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in
treatment and drug therapy are required. The authors and the publisher of this work have checked with sources
believed to be reliable in their efforts to provide information that is complete and generally in accord with the
standards accepted at the time of publication. However, in view of the possibility of human error or changes in
medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation
or publication of this work warrants that the information contained herein is in every respect accurate or complete,
and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information
contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For
example and in particular, readers are advised to check the product information sheet included in the package of each
medication they plan to administer to be certain that the information contained in this work is accurate and that
changes have not been made in the recommended dose or in the contraindications for administration. This
recommendation is of particular importance in connection with new or infrequently used medications.
This book was set in Minion Pro by KnowledgeWorks Global Ltd.
The editors were Kay Conerly, Jennifer Bernstein, and Sylvia Choi.
The production supervisor was Jeffrey Herzich.
Project management was provided by Tasneem Kauser at KnowledgeWorks Global Ltd.
The copyeditors were Greg Feldman, Kathryn Whitley, and Kim McAllister.
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Contents
https://t.me/med1917
Commonly Used Acronyms & Abbreviations
Authors vii
Preface xv
Dedication xvii
YEAR IN REVIEW:
KEY CLINICAL UPDATES IN CMDT 2025
1. Disease Prevention & Health Promotion 1
Michael Pignone, MD, MPH
2. Common Symptoms 15
Paul L. Nadler, MD, &
Ralph Gonzales, MD, MSPH
3. Preoperative Evaluation & Perioperative
Management 42
Hugo Q. Cheng, MD
4. Geriatric Disorders 52
Leah J. Witt, MD, Rossana Lau-Ng, MD, &
G. Michael Harper, MD
5. Palliative Care & Pain Management 69
Michael W. Rabow, MD, Kara E. Bischoff, MD,
Ann Cai Shah, MD, Lawrence Poree, MD, MPH, PhD,
& Karin Sinavsky, MD, MS
11. Heart Failure & Cardiomyopathy 390
Christopher B. Granger, MD
12. Disorders of Cardiac Rhythm 410
Kevin P. Jackson, MD
13. Systemic Hypertension 431
Michael Sutters, MD, MRCP (UK)
14. Blood Vessel & Lymphatic Disorders 460
Warren J. Gasper, MD, James C. Iannuzzi, MD, MPH,
& Meshell D. Johnson, MD
15. Blood Disorders 488
Lloyd E. Damon, MD, &
Charalambos Babis Andreadis, MD, MSCE
16. Disorders of Hemostasis, Thrombosis, &
Antithrombotic Therapy 534
Andrew D. Leavitt, MD, &
Erika Leemann Price, MD, MPH
17. Gastrointestinal Disorders 568
Kenneth R. McQuaid, MD
6. Dermatologic Disorders 101
Nathan W. Rojek, MD, Scott Worswick, MD,
Kanade Shinkai, MD, PhD, & Lindy P. Fox, MD
7. Disorders of the Eyes & Lids 166
Jacque L. Duncan, MD, Neeti B. Parikh, MD, &
Gerami D. Seitzman, MD
8. Otolaryngology Disorders 200
Elliott D. Kozin, MD, Rosh Sethi, MD, &
Lawrence R. Lustig, MD
9. Pulmonary Disorders 242
Rime Abbas, MD, Mazen El Ali, MD,
Meghan E. Fitzpatrick, MD, &
Belinda Rivera-Lebron, MD, MS, FCCP
10. Coronary Artery Disease, Valvular Disease,
& Other Key Topics in Cardiology 316
Todd Kiefer, MD
18. Liver, Biliary Tract, & Pancreas
Disorders 665
Lawrence S. Friedman, MD
19. Breast Disorders 726
Armando E. Giuliano, MD, FACS, FRCSEd, &
Sara A. Hurvitz, MD, FACP
20. Gynecologic Disorders 752
Jill Brown, MD, MPH, MHS, FACOG, &
Katerina Shvartsman, MD, FACOG
21. Obstetrics & Obstetric Disorders 783
Vanessa L. Rogers, MD, & Scott W. Roberts, MD
22. Rheumatologic, Immunologic, &
Allergic Disorders 809
Rebecca L. Manno, MD, MHS,
Jinoos Yazdany, MD, MPH,
Teresa K. Tarrant, MD, & Mildred Kwan, MD, PhD
iii
iv CMDT 2025
https://t.me/med1917
CONTENTS
23. Electrolyte & Acid-Base Disorders 864
Nayan Arora, MD, & J. Ashley Jefferson, MD, FRCP
24. Kidney Disease 893
Tonja C. Dirkx, MD, & Tyler B. Woodell, MD, MCR
25. Urologic Disorders 931
Mathew Sorensen, MD, MS, FACS,
Marah C. Hehemann, MD, &
Maahum A. Haider, MD, MPH
26. Nervous System Disorders 958
Vanja C. Douglas, MD, &
Michael J. Aminoff, MD, DSc, FRCP
27. Psychiatric Disorders 1035
Kristin S. Raj, MD, Nolan R. Williams, MD,
Charles DeBattista, DMH, MD, &
Meshell D. Johnson, MD
28. Endocrine Disorders 1085
Paul A. Fitzgerald, MD
29. Diabetes Mellitus & Hypoglycemia 1179
Umesh Masharani, MB, BS
30. Lipid Disorders 1223
Michael J. Blaha, MD, MPH
31. Nutrition, Nutritional Disorders, &
Obesity 1235
Katherine H. Saunders, MD,
Leon I. Igel, MD, FACP, FTOS, &
Sarah Fink, RD, CDN, CNSC
32. Common Problems in Infectious
Diseases & Antimicrobial Therapy 1255
Monica Fung, MD, MPH, Katherine Gruenberg,
PharmD, MAEd, & Peter V. Chin-Hong, MD
33. HIV Infection & AIDS 1297
Monica Gandhi, MD, MPH, &
Matthew A. Spinelli, MD, MAS
35. Bacterial & Chlamydial Infections 1429
Kelly A. Johnson, MD, MPH, &
Emma D. Bainbridge, MD, MPH
36. Spirochetal Infections 1470
Susan S. Philip, MD, MPH
37. Protozoal & Helminthic Infections 1487
Philip J. Rosenthal, MD
38. Mycotic Infections 1523
Stacey R. Rose, MD, FACP, FIDSA, &
Richard J. Hamill, MD, FACP, FIDSA
39. Disorders Related to Environmental
Emergencies 1537
Jacqueline A. Nemer, MD, FACEP, &
Marianne A. Juarez, MD
40. Poisoning 1553
Craig Smollin, MD
41. Cancer 1583
Sunny Wang, MD, Tiffany O. Dea, PharmD, BCOP,
Lawrence S. Friedman, MD, Carling Ursem, MD,
Kenneth R. McQuaid, MD, & Marc A. Dall’Era, MD
42. Genetic & Genomic Disorders 1647
Reed E. Pyeritz, MD, PhD
43. Orthopedic Disorders &
Sports Medicine 1657
Anthony Luke, MD, MPH, & C. Benjamin Ma, MD
44. Sexual & Gender Minority Health 1693
Patricia A. Robertson, MD, Nicole Rosendale, MD,
Kevin L. Ard, MD, MPH, Kenneth H. Mayer, MD,
& Mitzi Hawkins, MD, MAS
45. Substance Use Disorders 1715
J. Janet Ho, MD, MPH, FASAM,
Julian A. Mitton, MD, MPH, & Jessica Ristau, MD
34. Viral & Rickettsial Infections 1338
Eva H. Clark, MD, PhD, Patrycja Ashley, MD, &
Wayne X. Shandera, MD
CONTENTS
https://t.me/med1917
CMDT 2025
v
The following chapters are available online
without subscription at
www.accessmedicine.com/CMDT
e1. Anti-infective Treatment: Antibiotic,
Antifungal, and Antiviral Agents
Katherine Gruenberg, PharmD, MAEd, &
Emily Kaip, PharmD
e2. Diagnostic Testing & Medical
Decision-Making
Chuanyi Mark Lu, MD
e3. Information Technology in
Patient Care
Russ Cucina, MD, MS
e4. Podiatric Disorders
Monara Dini, DPM, & Charles B. Parks, DPM
e5. Women’s Health Issues
Brigid M. Dolan, MD, MEd, &
Judith Walsh, MD, MPH
e6. Appendix: Therapeutic Drug
Monitoring, Laboratory Reference
Intervals, & Commonly Used Blood
Specimen Collection Tubes
Chuanyi Mark Lu, MD
Index 1729
Authors
https://t.me/med1917
Rime Abbas, MD
Clinical Assistant Professor, Division of Pulmonary,
Allergy, Critical Care, and Sleep Medicine,
Department of Medicine, University of Pittsburgh
School of Medicine, Pittsburgh, Pennsylvania
Pulmonary Disorders
Michael J. Aminoff, MD, DSc, FRCP
Distinguished Professor Emeritus, Department of
Neurology, University of California, San Francisco
Nervous System Disorders
Charalambos Babis Andreadis, MD, MSCE
Professor of Clinical Medicine, Division of Hematology/
Oncology, Department of Medicine, University of
California, San Francisco
Blood Disorders
Kevin L. Ard, MD, MPH
Faculty, Division of Infectious Diseases, Massachusetts
General Hospital; Medical Director, National
LGBTQIA+ Health Education Center, Fenway Institute;
Assistant Professor of Medicine, Harvard Medical
School, Boston, Massachusetts
Sexual & Gender Minority Health
Nayan Arora, MD
Associate Professor, Division of Nephrology, Department
of Medicine, University of Washington, Seattle,
Washington
Electrolyte & Acid-Base Disorders
Patrycja Ashley, MD
Infectious Diseases Attending, Houston Methodist
Hospital, Houston, Texas
Viral & Rickettsial Infections
Emma D. Bainbridge, MD, MPH
Assistant Clinical Professor, Division of Infectious
Diseases, Department of Medicine, University of
California, San Francisco
Bacterial & Chlamydial Infections
Kara E. Bischoff, MD
Associate Professor and Associate Division Chief for
Outpatient Palliative Care, University of California,
San Francisco
Palliative Care & Pain Management
Michael J. Blaha, MD, MPH
Professor of Medicine, Division of Cardiology,
Department of Medicine; Director of Clinical Research,
Ciccarone Center for the Prevention of Cardiovascular
Disease; Johns Hopkins University School of Medicine,
Baltimore, Maryland
Lipid Disorders
Jill Brown, MD, MPH, MHS, FACOG
Associate Professor, Department of Gynecologic Surgery
and Obstetrics, Uniformed Services University of the
Health Sciences, Bethesda, Maryland
Gynecologic Disorders
Mandy Brown, PharmD
Associate Clinical Professor, School of Pharmacy,
University of California, San Francisco
Drug References
Hugo Q. Cheng, MD
Clinical Professor of Medicine, Division of Hospital
Medicine, Department of Medicine, University of
California, San Francisco
Preoperative Evaluation & Perioperative Management
Peter V. Chin-Hong, MD
Associate Dean for Regional Campuses, Professor of
Medicine, Division of Infectious Diseases, Department
of Medicine, University of California, San Francisco
Common Problems in Infectious Diseases & Antimicrobial
Therapy
Eva H. Clark, MD, PhD
Assistant Professor, Department of Medicine (Section of
Infectious Diseases) and Department of Pediatrics
(Division of Tropical Medicine), Baylor College of
Medicine, Houston, Texas
Viral & Rickettsial Infections
Russ Cucina, MD, MS
Professor of Hospital Medicine, Department of Medicine;
Vice President, Genetic and Genomic Services and
Chief Health Information Officer, UCSF Health
System; University of California, San Francisco
CMDT on AccessMedicine—Information Technology in
Patient Care
Marc A. Dall’Era, MD
Professor of Urology, Department of Urologic Surgery,
UC Davis Health, University of California, Davis
Cancer
Lloyd E. Damon, MD
Professor of Clinical Medicine, Division of Hematology/
Oncology, Department of Medicine; Director of
Quality for the Adult Hematologic Malignancies and
Blood and Marrow Transplantation Program,
University of California, San Francisco
Blood Disorders
vii
viii CMDT 2025
https://t.me/med1917
AUTHORS
Tiffany O. Dea, PharmD, BCOP
Oncology Pharmacist, Veterans Affairs Health Care
System, San Francisco, California; Adjunct Professor,
Thomas J. Long School of Pharmacy and Health
Sciences, Stockton, California
Cancer
Charles DeBattista, DMH, MD
Professor of Psychiatry and Behavioral Sciences,
Department of Psychiatry and Behavioral Sciences;
Director, Depression Clinic and Research Program;
Director of Medical Student Education in Psychiatry,
Stanford University School of Medicine, Stanford,
California
Psychiatric Disorders
Monara Dini, DPM
Associate Clinical Professor of Orthopedics, Department
of Orthopedic Surgery, University of California,
San Francisco
CMDT on AccessMedicine —Podiatric Disorders
Tonja C. Dirkx, MD
Chief, Nephrology Section, Veterans Affairs
PortlandHealth Care System;Associate Professor of
Medicine, Division of Nephrology, Department of
Medicine, Oregon Health & Science University,
Portland, Oregon
Kidney Disease
Brigid M. Dolan, MD, Med
Associate Professor of Medicine and Medical Education,
Division of General Internal Medicine, Departments of
Medicine and Medical Education, Northwestern
University Feinberg School of Medicine
CMDT on AccessMedicine—Women’s Health Issues
Sarah Adler Fink, RD, CDN, CNSC
Dietetic Internship Program Coordinator, Department of
Food and Nutrition, New York-Presbyterian Hospital,
New York, New York
Nutrition, Nutritional Disorders, & Obesity
Paul A. Fitzgerald, MD
Clinical Professor of Medicine, Division of Endocrinology,
Department of Medicine, University of California,
San Francisco
Endocrine Disorders
Meghan E. Fitzpatrick, MD
Assistant Professor of Medicine, Division of Pulmonary
and Critical Care Medicine, Department of Medicine,
University of Pittsburgh School of Medicine,
Pittsburgh, Pennsylvania
Pulmonary Disorders
Lindy P. Fox, MD
Professor of Clinical Dermatology, Associate Chief,
Complex and Consultative Dermatology, Director,
Complex Medical Dermatology Fellowship,
Department of Dermatology, University of California,
San Francisco
Dermatologic Disorders; Callosities & Corns of Feet or Toes
(CMDT on AccessMedicine—Podiatric Disorders)
Lawrence S. Friedman, MD
Professor of Medicine, Harvard Medical School; Professor
of Medicine, Tufts University School of Medicine,
Boston, Massachusetts; The Anton R. Fried, MD, Chair,
Department of Medicine, Newton-Wellesley Hospital,
Newton, Massachusetts; Assistant Chief of Medicine,
Massachusetts General Hospital, Boston
Liver, Biliary Tract, & Pancreas Disorders; Cancer
Vanja C. Douglas, MD
Sara & Evan Williams Foundation Endowed
Neurohospitalist Chair, Professor of Clinical
Neurology, Department of Neurology, University of
California, San Francisco
Nervous System Disorders
Jacque L. Duncan, MD
Chair and Distinguished Professor, Department of
Ophthalmology, University of California,
San Francisco
Disorders of the Eyes & Lids
Mazen El Ali, MD
Clinical Assistant Professor of Medicine, Division of
Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine; Director, Sleep Medicine
Fellowship Program, University of Pittsburgh Medical
Center, Pittsburgh
Pulmonary Disorders
Monica Fung, MD, MPH
Associate Professor, Division of Infectious Diseases,
Department of Medicine, University of California,
San Francisco
Common Problems in Infectious Diseases & Antimicrobial
Therapy
Robert H. Gaffey, MD
Obesity Medicine Fellow and Instructor in Medicine,
Weill Cornell Medicine, New York, New York
References
Monica Gandhi, MD, MPH
Professor,Division of HIV, ID, and Global Medicine,
San Francisco General Hospital; University of
California, San Francisco
HIV Infection & AIDS
Warren J. Gasper, MD
Associate Professor of Clinical Surgery, Division of
Vascular and Endovascular Surgery, Department of
Surgery, University of California, San Francisco
Blood Vessel & Lymphatic Disorders
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