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ACKNOWLEDGMENTS
Dr. Schiffman and I wish to thank first of all, the authors of the 128 chapters that make up the tenth edition
of Cecil Essentials of Medicine. They have worked diligently to compose the material for each chapter and
apply their mastery as they added the newest information, in clear language, to the text. Their efforts are
apparent in the excellence of the book, and we are immensely grateful for their work. We wish to also thank
Marybeth Thiel, Jennifer Ehlers, and Dan Fitzgerald from Elsevier who guided and supported our work as
editors and whose expertise has made this volume possible. Finally, we are always thankful to our wives,
Dr. Rena Wing and Ms. Gerri Schiffman, without whose love, support, and especially humor, this book
would not have happened.
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CONTENTS
SECTION I Introduction to Medicine
1 Introduction to Medicine, 2
Edward J. Wing, Fred J. Schiffman
SECTION II Cardiovascular Disease
2 Structure and Function of the Normal Heart and
Blood Vessels, 4
Nicole L. Lohr, Ivor J. Benjamin
3 Evaluation of the Patient With Cardiovascular Disease, 10
James Kleczka, Noura M. Dabbouseh
4 Diagnostic Tests and Procedures in the Patient With
Cardiovascular Disease, 24
Esseim Sharma, Alan R. Morrison
5 Heart Failure and Cardiomyopathy, 43
Daniel J. Levine, Hyeon-Ju Ryoo Ali, Rayan Yousefzai
6 Congenital Heart Disease, 55
Scott Cohen, Michael G. Earing
7 Valvular Heart Disease, 64
Christopher Song
8 Coronary Heart Disease, 77
David E. Lewandowski, Michael P. Cinquegrani
9 Cardiac Arrhythmias, 99
Marcie G. Berger, Jason C. Rubenstein, James A. Roth
10 Pericardial and Myocardial Disease, 123
Jennifer L. Strande
11 Other Cardiac Topics, 131
Jinnette Dawn Abbott, Sena Kilic
12 Vascular Diseases and Hypertension, 139
Thomas Sperry, Wanpen Vongpatanasin
SECTION III Pulmonary and Critical Care Medicine
13 Lung in Health and Disease, 162
Sharon Rounds, Debasree Banerjee, Eric J. Gartman
14 General Approach to Patients With Respiratory
Disorders, 165
Michael Raymond Goggins, Brian Casserly, Eric J. Gartman
15 Evaluating Lung Structure and Function, 169
Patrick Koo, F. Dennis McCool, Jigme Michael Sethi
16 Obstructive Lung Diseases, 185
Zoe G.S. Vazquez, Matthew D. Jankowich, Debasree Banerjee
17 Interstitial Lung Diseases, 199
Abhinav Kumar Misra, Matthew D. Jankowich, Barry S. Shea
18 Pulmonary Vascular Diseases, 216
Christopher J. Mullin, James R. Klinger
19 Disorders of the Pleura, Mediastinum, and
Chest Wall, 221
Eric J. Gartman, F. Dennis McCool
20 Respiratory Failure, 227
Andrew E. Foderaro, Abhinav Kumar Misra
21 Transitions in Care From Pediatric to Adult Providers for
Individuals With Pulmonary Disease, 234
Kate E. Powers, Debasree Banerjee, Robin L. McKinney
SECTION IV Preoperative and Postoperative Care
22 Preoperative and Postoperative Care, 240
Kim A. Eagle, Kwame Dapaah-Afriyie, Arkadiy Finn
SECTION V Renal Disease
23 Renal Structure and Function, 251
Orson W. Moe, Javier A. Neyra
24 Approach to the Patient With Renal Disease, 258
Rajiv Agarwal
25 Fluid and Electrolyte Disorders, 268
Biff F. Palmer
26 Glomerular Diseases, 282
Sanjeev Sethi, An S. De Vriese, Fernando C. Fervenza
27 Major Nonglomerular Disorders of the Kidney, 298
Nilum Rajora, Shani Shastri, Pooja Koolwal, Ramesh Saxena
28 Vascular Disorders of the Kidney, 312
Abdallah Geara, Jeffrey S. Berns
29 Acute Kidney Injury, 324
Mark A. Perazella, Jeffrey M. Turner
30 Chronic Kidney Disease, 334
T. Alp Ikizler, Anna Marie Burgner, Beatrice P. Concepcion
SECTION VI Gastrointestinal Disease
31 Common Clinical Manifestations of Gastrointestinal
Disease: Abdominal Pain, 343
Charles M. Bliss, Jr.
32 Common Clinical Manifestations of Gastrointestinal
Disease: Gastrointestinal Hemorrhage, 347
Waihong Chung, Abbas Rupawala
33 Common Clinical Manifestations of Gastrointestinal
Disease: Malabsorption, 351
Brisas M. Flores, Sharmeel K. Wasan
34 Common Clinical Manifestations of Gastrointestinal
Disease: Diarrhea, 358
Ronan Farrell, Sean Fine
35 Endoscopic and Imaging Procedures, 363
Andrew Canakis, Christopher S. Huang
36 Esophageal Disorders, 370
Harlan Rich, Zilla Hussain, Neal D. Dharmadhikari
37 Diseases of the Stomach and Duodenum, 379
Alma M. Guerrero Bready, Akwi W. Asombang, Steven F. Moss
38 Inflammatory Bowel Disease, 392
Talha A. Malik, Michael F. Picco, Francis A. Farraye
39 Diseases of the Pancreas, 402
David R. Lichtenstein, Pushpak Taunk
SECTION VII Diseases of the Liver and
Biliary System
40 Laboratory Tests in Liver Diseases, 417
Michael B. Fallon, Ester Little
41 Jaundice, 420
Mohanad T. Al-Qaisi, Mashal Batheja, Michael B. Fallon
xxi
xxii CONTENTS
42 Acute and Chronic Hepatitis, 426
Nayan M. Patel, Jen Jung Pan, Michael B. Fallon
43 Acute Liver Failure, 434
Anil Seetharam, Michael B. Fallon
44 Cirrhosis of the Liver and Its Complications, 437
Shivang Mehta, Michael B. Fallon
45 Disorders of the Gallbladder and Biliary Tract, 448
Stacie A. F. Vela, Michael B. Fallon
SECTION VIII Hematologic Disease
46 Hematopoiesis and Hematopoietic Failure, 457
Eunice S. Wang, Nancy Berliner
47 Clonal Disorders of the Hematopoietic Stem Cell, 470
Eunice S. Wang, Nancy Berliner
48 Disorders of Red Blood Cells, 489
Ellice Wong, Michal G. Rose, Nancy Berliner
49 Clinical Disorders of Granulocytes and Monocytes, 501
Ellice Wong, Michal G. Rose, Nancy Berliner
50 Disorders of Lymphocytes, 506
Iris Isufi, Stuart Seropian
51 Normal Hemostasis, 522
Lauren Shevell, Alfred I. Lee
52 Disorders of Hemostasis: Bleeding, 530
Aric Parnes
53 Disorders of Hemostasis: Thrombosis, 550
Rebecca Zon, Nathan T. Connell
SECTION IX Oncologic Disease
54 Cancer Biology, 563
Andre De Souza, Wafik S. El-Deiry
55 Cancer Epidemiology, 571
Gary H. Lyman, Nicole M. Kuderer
56 Principles of Cancer Therapy, 577
Davendra P.S. Sohal, Alok A. Khorana
57 Lung Cancer, 583
Zoe G.S. Vazquez, Jason M. Aliotta, Christopher G. Azzoli
58 Gastrointestinal Cancers, 589
Khaldoun Almhanna
59 Genitourinary Cancers, 595
Andre De Souza, Benedito A. Carneiro, Anthony Mega,
Timothy Gilligan
60 Breast Cancer, 601
Mary Anne Fenton, Rochelle Strenger
61 Gynecological Cancer, 607
Christina Bandera, Tarra B. Evans, Don Dizon
62 Other Solid Tumors (Head and Neck, Sarcomas,
Melanoma, Unknown Primary), 615
Christopher G. Azzoli, Ariel E. Birnbaum, Maria Constantinou, Thomas
A. Ollila
63 Complications of Cancer and Cancer Treatment, 620
Pamela Egan, Ari Pelcovits, John Reagan
SECTION X Endocrine Disease and Metabolic
Disease
64 Hypothalamic-Pituitary Axis, 626
Diana Maas, Jenna Sarvaideo
65 Thyroid Gland, 635
Theodore C. Friedman
66 Adrenal Gland, 645
Theodore C. Friedman
67 Male Reproductive Endocrinology, 657
Glenn D. Braunstein
68 Diabetes Mellitus, Hypoglycemia, 662
Robert J. Smith
69 Obesity, 678
Osama Hamdy, Marwa Al-Badri
70 Malnutrition, Nutritional Assessment, and Nutritional
Support in Adult Patients, 686
Thomas R. Ziegler
71 Disorders of Lipid Metabolism, 692
Russell Bratman, Geetha Gopalakrishnan
SECTION XI Women’s Health
72 Women’s Health Topics, 701
Vidya Gopinath, Yael Tarshish, Kelly McGarry
SECTION XII Men’s Health
73 Men’s Health Topics, 714
Niels V. Johnsen, Douglas F. Milam, Joseph A. Smith, Jr.
SECTION XIII Diseases of Bone and Bone Mineral
Metabolism
74 Normal Physiology of Bone and Mineral
Homeostasis, 729
Clemens Bergwitz, John J. Wysolmerski
75 Disorders of Serum Minerals, 739
Emily M. Stein, Yi Liu, Elizabeth Shane
76 Metabolic Bone Diseases, 748
Marcella D. Walker, Thomas J. Weber
77 Osteoporosis, 757
Susan L. Greenspan, Mary P. Kotlarczyk
SECTION XIV Musculoskeletal and Connective
Tissue Disease
78 Approach to the Patient With Rheumatic Disease, 767
Niveditha Mohan
79 Rheumatoid Arthritis, 771
Larry W. Moreland, Rayford R. June
80 Spondyloarthritis, 778
Douglas W. Lienesch
81 Systemic Lupus Erythematosus, 783
Sonia Manocha, Tanmayee Bichile, Susan Manzi
82 Systemic Sclerosis, 794
Anna Papazoglou, Robyn T. Domsic
83 Systemic Vasculitis, 801
Kimberly P. Liang, Kelly V. Liang
84 Crystal Arthropathies, 807
Pooja Bhadbhade, Ghaith Noaiseh
85 Osteoarthritis, 813
Joanne S. Cunha, Zuhal Arzomand, Philip Tsoukas
86 Nonarticular Soft Tissue Disorders, 818
Niveditha Mohan
87 Rheumatic Manifestations of Systemic Disorders and
Sjögren’s Syndrome, 822
Andreea Coca, Ghaith Noaiseh
CONTENTS
xxiii
SECTION XV Infectious Disease
88 Host Defenses Against Infection, 830
Richard Bungiro, Edward J. Wing
89 Laboratory Diagnosis of Infectious Diseases, 842
Kimberle Chapin
90 Fever and Febrile Syndromes, 848
Maria D. Mileno
91 Bacteremia and Sepsis, 858
Russell J. McCulloh, Steven M. Opal
92 Infections of the Central Nervous System, 865
Su N. Aung, Allan R. Tunkel
93 Infections of the Head and Neck, 882
David Kim, Roberto Cortez, Tareq Kheirbek
94 Infections of the Lower Respiratory Tract, 887
John R. Lonks, Edward J. Wing
95 Infections of the Heart and Blood Vessels, 895
Raul Macias Gil, Cheston B. Cunha
96 Acute Bacterial Skin and Skin Structure Infections, 903
Sajeev Handa
97 Intraabdominal Infections, 910
Eric Benoit
98 Infectious Diarrhea, 916
Awewura Kwara
99 Infections Involving Bone and Joints, 922
Jerome Larkin
100 Urinary Tract Infections, 925
Abdullah Chahin, Steven M. Opal
101 Health Care–Associated Infections, 929
Paul G. Jacob, Thomas R. Talbot
102 Sexually Transmitted Infections, 935
Philip A. Chan, Susan Cu-Uvin
103 Human Immunodeficiency Virus Infection, 944
Joseph Metmowlee Garland, Timothy Flanigan, Edward J. Wing
104 Infections in the Immunocompromised Host, 963
Dimitrios Farmakiotis, Ralph Rogers
105 Infectious Diseases of Travelers: Protozoal and
Helminthic Infections, 973
Jessica E. Johnson, Rebecca Reece
112 Autonomic Nervous System Disorders, 1013
William P. Cheshire, Jr.
113 Headache, Neck and Back Pain, and
Cranial Neuralgias, 1017
Shane Lyons, Timothy J. Counihan
114 Disorders of Vision and Hearing, 1025
Eavan Mc Govern, Timothy J. Counihan
115 Dizziness and Vertigo, 1033
Jonathan Cahill
116 Disorders of the Motor System, 1037
Ruth B. Schneider, Adolfo Ramirez-Zamora, Christopher G. Tarolli
117 Congenital, Developmental, and Neurocutaneous
Disorders, 1048
Kristin A. Seaborg, Jennifer M. Kwon
118 Cerebrovascular Disease, 1056
Mitchell S. V. Elkind
119 Traumatic Brain Injury and Spinal Cord Injury, 1069
Geoffrey S.F. Ling, Jeffrey J. Bazarian
120 Epilepsy, 1073
Andrew S. Blum
121 Central Nervous System Tumors, 1087
Bryan J. Bonder, Lisa R. Rogers
122 Demyelinating and Inflammatory Disorders, 1092
Anne Haney Cross
123 Neuromuscular Diseases: Disorders of the Motor Neuron
and Plexus and Peripheral Nerve Disease, 1101
Carlayne E. Jackson, Ratna Bhavaraju-Sanka
124 Muscle Diseases, 1111
Johanna Hamel, Jeffrey M. Statland
125 Neuromuscular Junction Disease, 1122
Emma Ciafaloni
SECTION XVII Geriatrics
126 The Aging Patient, 1126
Laura A. Previll, Mitchell T. Heflin, Harvey Jay Cohen
SECTION XVIII Palliative Care
SECTION XVI Neurologic Disease
106 Neurologic Evaluation of the Patient, 981
Frederick J. Marshall
107 Disorders of Consciousness, 986
Leah Dickstein, Paul M. Vespa
108 Disorders of Sleep, 992
Sagarika Nallu, Selim R. Benbadis
109 Cortical Syndromes, 997
Sinéad M. Murphy, Timothy J. Counihan
110 Dementia and Memory Disturbances, 1001
Frederick J. Marshall
111 Major Disorders of Mood, Thoughts, and Behavior, 1007
Jeffrey M. Lyness, Jennifer H. Richman
127 Palliative Care, 1141
Brandon J. Wilcoxson, Erin M. Denney-Koelsch,
Robert G. Holloway
SECTION XIX Alcohol and Substance Use
128 Alcohol and Substance Use, 1151
Richard A. Lange, Joaquin E. Cigarroa
APPENDIX Coronavirus Disease 2019 (COVID-19), 1166
Edward J. Wing
Index, 1174
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VIDEO CONTENTS
3 Evaluation of the Patient With Cardiovascular Disease
James Kleczka, Noura M. Dabbouseh
Audio 3.1: Ebstein Abnormalities
Audio 3.2: Mitral Valve Prolapse
4 Diagnostic Tests and Procedures in the Patient With
Cardiovascular Disease
Esseim Sharma, Alan R. Morrison
Video 4.1: 3D Echocardiographic Imaging
Video 4.2: Color Doppler Imaging
Video 4.3: Dynamic Contrast Echocardiographic Image
Video 4.4: Transesophageal Echocardiography
Video 4.5: Cardiac Single- Photon Emission Computed
Tomography Imaging
Video 4.6: Dynamic Cardiac MRI Image
Video 4.7: ECG- Gated Dynamic CT Imaging
35 Endoscopic and Imaging Procedures
Andrew Canakis, Christopher S. Huang
Video 35.1: Capsule Endoscopy of the Normal Small
Intestine
Video 35.2: Capsule Endoscopy Video of an Actively
Bleeding Vascular Ectasia
Video 35.3: Capsule Endoscopy Image and Video of an
Ulcerated Small Intestinal Tumor
37 Diseases of the Stomach and Duodenum
Alma M. Guerrero Bready, Akwi W. Asombang, Steven F. Moss
Video 37.1: Esophagastroduodenoscopy (EGD)
39 Diseases of the Pancreas
David R. Lichtenstein, Pushpak Taunk
Video 39.1: ERCP for Gallstone Pancreatitis With
Sphincterotomy and Common Bile Duct Stone
Extraction
45 Disorders of the Gallbladder and Biliary Tract
Stacie A. F. Vela, Michael B. Fallon
Video 45.1: Endoscopic Ultrasound of Large Gallbladder
Stone
Video 45.2: Sphincterotomy
65 Thyroid Gland
Theodore C. Friedman
Video 65.1: Thyroid Examination
115 Dizziness and Vertigo
Jonathan Cahill
Video 115.1: Gaze- Evoked Nystagmus
Video 115.2: Unidirectional, Peripheral Vestibular
Spontaneous Pattern of Nystagmus
Video 115.3: Nystagmus of Posterior Canal Benign
Paroxysmal Positional Vertigo
https://t.me/medicalRobinHood
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Introduction to Medicine
1 Introduction to Medicine, 2
SECTION
I
11
1
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Introduction to Medicine
Edward J. Wing, Fred J. Schiffman
Cecil Essentials of Medicine presents a core of internal medicine and
neurology information that every physician should know. This book
provides an essential framework so physicians can appropriately assemble the key elements of history, physical examination, and laboratory
data to understand their patient’s illness and develop an appropriate
diagnostic and therapeutic strategy. Furthermore, in order to understand advances in medicine, physicians must have a strong background
for the acquisition and categorization of new medical knowledge.
Cecil Essentials of Medicine is designed for medical students as well
as physicians in training, and we hope it will be an appropriate vehicle
for course and examination review. We also believe, however, that physicians at all stages in their careers will find it to be a valuable resource
for review and reference. This book also serves as a companion to the
26th edition of Goldman-Cecil Medicine, which is more comprehensive
in scope and detailed in its content.
Cecil Essentials of Medicine is organized into sections, most often
representing organ systems, with introductory and then organspecific, disease-based chapters. The chapters themselves are subdivided. For example, the cardiovascular disease chapter is divided into
Epidemiology, Anatomy, Pathophysiology, Clinical Diagnosis, and
Treatment. The Suggested Readings sections at the end of each chapter
include selected critical reviews, guidelines, and important randomized controlled trials. They are not meant to be an exhaustive reference
list, but rather to highlight the essential information that physicians
should know.
We believe that the information in Cecil Essentials of Medicine will
encourage evidence-based diagnostic and therapeutic decision making. Importantly, the rational approach to medical problem-solving
must be interwoven with the attentive presence of the physician at
the bedside, clinic or office, undistracted by electronic devices (particularly the computer), displaying mindful humanistic patient care.
Humanistic practice includes integrity, compassion, altruism, respect,
service, and empathy, but also excellence. Both the art and the science
of medicine must be part of the approach to any patient encounter.
The editors believe that these concepts have been best expressed by
Frances Peabody, who famously stated that “the significance of the
intimate personal relationship between physician and patient cannot
be too strongly emphasized, for in an extraordinary large number of
cases both the diagnosis and treatment directly depend upon it. One
of the essential qualities of the clinician is interest in humanity for the
secret of the care of the patient is in caring for the patient,” and by
Sir William Osler, who said, “The practice of medicine is an art not
a trade; a calling not a business; a calling in which your heart will be
exercised equally with your head.”
We believe that the fundamentally important bond between caregiver and patient is the starting point to the care of the patient. This is
followed by a thorough history and a directed physical examination,
which allow a diagnosis in the great majority of encounters. Laboratory
data and imaging are supplementary. The focus of the diagnostic process should be on diseases that are common and treatable. Common
presentations of common diseases account for the vast majority of
cases; next in frequency are unusual presentations of common diseases;
less common are typical presentations of rare diseases. Concentrate on
common diseases, but know the rare ones as well.
We sincerely hope that Cecil Essentials of Medicine will be used to
provide the basic and clinical data that are essential for us to practice
medicine in a manner informed by both compassion and evidence, so
that we may truly heal those with whose care we are entrusted.
https://t.me/medicalRobinHood
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