INDEX

I-114 Immune checkpoints, 506, 2705, 2706t

Immune-complex formation, 2698f, 2699

Immune deficiency diseases, primary. See Primary

immune deficiency diseases

Immune-enhancing formulas, for enteral nutrition,

2542

Immune homeostasis, 2702

Immune-mediated brachial plexus neuropathy

(IBPN), 3499

Immune-mediated necrotizing myopathy, 2819t,

2822, 2822f, 2824–2825, 2825t

Immune memory, 2672

Immune privilege, 3295

Immune reconstitution inflammatory syndrome

(IRIS)

in cryptococcosis, 1669

in histoplasmosis, 1660

in HIV infection

clinical features of, 1574, 1574t

with molluscum contagiosum infections, 1494

pathogenesis of, 1546

with progressive multifocal

leukoencephalopathy, 1099–1100

with TB, 1368

with tuberculosis, 1397, 1567

pathogenesis of, 1546, 1574

in Whipple’s disease, 1346

Immune response/immune system, 2671

adaptive. See Adaptive immune system

aging and, 3736

antitumor effects, 532

cell-mediated immunity, 532, 1361, 1556t, 1558

cellular interactions in regulation of, 2694–2695

cellular migration in, 2698f

circadian regulation of, 3810–3811

clinical evaluation of, 2700

components of, 2709

dysregulation of

in aging, 2706

in autoimmune disease, 2705–2706. See also

Autoimmune diseases

genetic considerations in, 2704t

endogenous derangements of, 2732. See also

Autoimmunity

endothelium in, 1801

epigenetic influences on, 3795–3796

evasion of, by cancer, 527–528, 527f

exogenous derangements of, 2732

in functional dyspepsia, 294–295

of gut, dysfunction of, 2382

in HIV infection. See HIV infection, immune

response to

in IBD, 2473–2474

innate. See Innate immune system

at mucosal surfaces, 2695

pattern recognition in. See Pattern recognition

receptors (PRRs)

in sepsis/septic shock, 2244

suppression by cancer cells, 527–528, 527f

terminology related to, 2671–2672

in women, 3066

Immune thrombocytopenia, 837

Immune thrombocytopenic purpura, 447, 906–907

Immune tolerance, 913, 2695

Immunization, 981. See also Vaccine(s)

for adults, 39t, 982

administration of, 986–987, 987f

contraindications to, 983, 985–986t

determining need for, 982–983

for international travel, 990t, 991–996, 992t,

994–995f

practice standards, 983

provider recommendation for, 988

recommendations for, 982

requirements for, 988

schedules for, 983, 984f

system support for, 988

in cancer patients, 557t, 565

consumer access to and demand for, 988

documentation of, 987

in HCT recipients, 901

for health care workers, 988, 1136

in HIV infection, 984f

for international travelers, 991–992, 992t

microbiome and response to, 3699

in nonmedical settings, 988–989

in older adults, 3743

performance monitoring, 989

in pregnancy, 983, 984f, 3768

for transplant recipient, 1146–1147, 1147t

Immunization Action Coalition, 986

Immunoblastic lymphomas, 1583. See also Diffuse

large B-cell lymphoma (DLBCL)

Immunochemiluminometric assays (ICMAs), 2931

Immunocompromised patient. See also Transplant

recipient

abdominal pain in, 110

actinomycosis in, 1343

antibacterial therapy in, 1151

bite-wound infection in, 1125

Candida infections in, 381

CMV infections in, 1488t, 1489

diarrhea in, 300, 1063

dysphagia in, 290

immunization in, 983, 984f

international travel by, 998–999

primary CNS lymphoma in, 706

sexual practices of, 565

skin cancer in, 420–421

Immunodeficiency viruses, 1527, 1528f,

1531–1532. See also HIV

Immunodeficiency with centromere instability and

facial anomalies (ICF), 2715, S8

Immunodysregulation polyendocrinopathy

enteropathy X-linked syndrome (IPEX),

2733, 2996

Immunodysregulation polyendocrinopathy

enteropathy X-linked (IPEX) syndrome,

2706, 2718

Immunoediting, 2702

Immunofluorescent stains, S11

Immunoglobulin(s). See also Antibody(ies)

in adaptive immunity, 2693–2694

classification of, 866

electrophoresis of, 866, 868f

gene rearrangements in, 866, 867f, 2693–2694

properties of, 2693t

replacement of, 2717

structure of, 866, 867f, 2693–2694, 2693t

types of, 2688

Immunoglobulin A (IgA), 2693t, 2694, 2695,

2696t

Immunoglobulin A (IgA) deficiency, 2463, 2717

Immunoglobulin A (IgA) nephropathy. See IgA

nephropathy

Immunoglobulin A (IgA) vasculitis. See IgA

vasculitis

Immunoglobulin D (IgD), 2693t, 2694

Immunoglobulin E (IgE)

assays for, 2725

in asthma, 2155

in atopic dermatitis, 374

desensitization, 2728

functions of, 2693t, 2707t

Immunoglobulin E (IgE) antibody. See

Omalizumab

Immunoglobulin E (IgE) receptor, 2696t

Immunoglobulin G (IgG), 2717

in paraneoplastic pemphigus, 402

in pemphigus foliaceus, 402

in pemphigus vulgaris, 400

properties of, 2693t, 2694

receptors for, 2684

in red blood cells, 884

in rubella, 1613

transplacental transfer of, 444

Immunoglobulin gene superfamily, 2691

Immunoglobulin heavy chain (IGHV) mutation,

834–835, 839, 839t

Immunoglobulin M (IgM)

in Brucella infections, 1313

in lymphoplasmacytic lymphoma, 849

properties of, 2693t, 2694

in red blood cells, 884

in rubella, 1613

Immunoglobulin replacement, 565, 2717

Immunohistochemical stains, S11

Immunologic memory, 2689

Immunologic priming, 2689

Immunologic synapse, 2691

Immunomodulation, transfusion-related, 895

Immunoproliferative small intestinal disease, 868,

877

Immunoreceptor tyrosine-based activation motifs

(ITAMs), 2690f, 2691

Immunoregulatory antibodies, 527–528, 527f, 535,

536f, 537

Immunosenescence, 3736

Immunosuppression

by cancer cells, 527–528, 527f

in sepsis/septic shock, 2244

UV-induced, 420

Immunosuppressive therapy

after cardiac transplantation, 1974

after kidney transplantation, 2327–2329, 2328t

after liver transplantation, 2637–2638

chronic meningitis associated with, 1117

complications of, 740, 1974, 2275

COVID-19 disease risk and, 3516

dyslipidemia during, 3145

immunization during, 983

lymphoid malignancies and, 841–842

osteoporosis associated with, 3196

skin cancer associated with, 420–421, 586

Immunotactoid glomerulopathy, 2345

Immunotherapy

for allergic rhinitis, 2725

for anaphylaxis prevention, 2728

for asthma, 2155

for autoimmune and inflammatory diseases,

2700–2701

for cancer, 527–528. See also Cancer biologic

therapy

contraindications to, 2725

Immunotoxicity, 3686t

Impaired physician, 71

Impella device, 2071

Impetigo, 379

bullous, 379, 392, 1035, 1192

clinical features of, 370t, 379–380, 380t, 1192,

1192f

differential diagnosis of, 1192

etiology of, 379–380, 380t, 1192

S. aureus, 379, 380t, 1192, A1, A5

streptococcal, 1192, A5

treatment of, 380, 380t, 1191t, 1192

INDEX

Impetigo contagiosa, 1035 I-115

Impingement syndrome, 2878–2879

Implantable cardioverter-defibrillator (ICD). See

Cardiovascular implantable electronic

devices (CIEDs)

Implicit memory, 202

Imprinting

disorders caused by, 3645, 3654

genomic, 3644–3645, 3647f

penetrance and, 3651

Inappropriate antidiuresis. See Syndrome of

inappropriate antidiuresis (SIAD)

Incapacitating/behavior-altering agents, S4

Incidentalomas, adrenal, 2967–2968, 2967t, 2968f

Incisional biopsy, 529

Inclisiran, 3142t

Inclusion body myopathy with Paget’s disease and

frontotemporal dementia (IBMPFD), 3210

Inclusion body myositis (IBM)

clinical features of, 2819t, 2822, 2823f, 3518

diagnosis of, 2819t, 2822

differential diagnosis of, 2820

global considerations in, 2826

histopathology of, 2823, 2824f

pathogenesis of, 2823

prognosis of, 2823

Inclusion cyst, epidermoid, 372f

Incompetent patient

advance directives for, 75–76

assessing capacity to make medical decisions, 68

choice and role of surrogates, 68

end-of-life care for, 86

Incomplete penetrance, 3651

Incontinence

fecal. See Fecal incontinence

urinary. See Urinary incontinence

Incontinentia pigmenti, 391, 3645t

Indacaterol, 2156

India, 50, 50t, 3724–3725

India ink, S11

“Indiana pouch,” 679

Indian hedgehog, 3158

Indigestion, 294

approach to the patient, 295–296

definition of, 291

differential diagnosis of, 295, 2411

in esophageal disease, 2423

in GERD. See Gastroesophageal reflux disease

(GERD)

mechanisms of, 294–295

treatment of, 296–297

Indinavir

adverse effects of, 1571, 2560, 2591. See also

specific drugs

drug interactions of, 1703t, 3787

metabolism of, 467t

molecular structure of, 1590f

Indirect antiglobulin (Coombs) test, 893, 893f

Indirect calorimetry, 2538t

Indirect fraction, bilirubin, 2553

Indomethacin

for acute idiopathic pericarditis, 2021

adverse effects of, 3132

for cough headache, 3368

for exercise headache, 3368

for gout, 2864

for hemicrania continua, 3368

for hypnic headache, 3369

for medullary thyroid cancer, 306

for nephrogenic diabetes insipidus, 2922

for pain, 95t

for paroxysmal hemicrania, 3367

for postprandial orthostatic hypotension, 3436

for sex headache, 3368

for stabbing headache, 3369

Indoor air pollution, 2172

Indoor residual spraying, 3709

Indoor tanning, 420

Induced pluripotent stem cells, 3299–3300,

3797–3798

Inebilizumab, 223, 3479

Ineffective osmoles, 338

Inert gas dilution, 2138–2139

Infant botulism, 1215–1216, 1219

Infantile poikilocytosis, 785

Infants. See also Neonates

atopic dermatitis in, 374

cobalamin deficiency in, 770

cradle cap in, 377

C. trachomatis infections in, 1450

hypercalcemia in, 3181

microbiome of, 3693

nutrient requirements in, 2519–2521t

seizures in, 3309–3310, 3310t

water requirement in, 2517

Infection, 948

Infection-control programs

for A. baumannii, 1278–1279, 1278f

in critical care setting, 2223

employee health service issues in, 1136

for filovirus infections, 1652

genomics in, 970

isolation techniques in, 1132

organization, responsibilities, and scrutiny of, 1128

for respiratory tract infections, 1513–1514

for S. aureus, 1188

surveillance by, 1128

Infection susceptibility syndromes, 447, 448f

Infectious (septic) arthritis, 1040. See also specific

types

approach to the patient, 1040–1041

bacterial

anaerobic bacterial, 1354

Brucella, 1312

gonococcal, 1042–1043, 1238, 1238f, 1239f,

1240t

microbiology of, 1041

mycobacterial, 1043

nongonococcal, 1041–1042, 1041f

nontyphoidal Salmonella, 1297

pathogenesis of, 1041

S. aureus, 1182, 1187–1188

from bite-wound infections, 1125

etiology of, 1040, 1040t

fungal, 1044, 1044f

in HIV infection, 1573–1574

Lyme arthritis, 1043, 2696t

parasitic, 1044–1045

postinfectious, 1045. See also Reactive arthritis

prevention of, 1045

in prosthetic joints. See Prosthetic joint

infections

in sickle cell disease, 2872

syphilitic, 1043

viral, 1044

Infectious diseases, 941. See also specific diseases

and agents

approach to the patient, 942. See also Acute

febrile illness

climate change and. See Climate change

emerging, 1132–1134, 3713, 3714, 3714t, 3718.

See also specific infections

epigenetic influences on, 3795–3796

fatigue in, 163

gene therapy for, 3686t

genomics of, 960

in antibiotic resistance detection, 961t,

965–967

COVID-19 pandemic and, 973

in drug and vaccine development, 968–969

epidemic potential and, 971–972

epidemiology and, 961t, 969–971, 971f

global considerations in, 972–973

host-based diagnostics and, 967–968

limitations and progress of, 960–963

in microbial diagnostics, 960, 961f, 961t

in organism identification, 961t, 963–964

in pathogen discovery, 961t, 964–965, 965f

in pathogen evolution, 972

public health implications of, 963

in therapeutics, 968–969

global considerations in, 941, 942f

historical perspective, 941

history in, 942–943

imaging in, 945–946

immune status in, 943

infection control for, 946

laboratory diagnosis of, 944–945, S11

microbial pathogenesis in. See Bacterial

infections, pathogenesis of

microbiome and, 3694–3695, 3695f, 3698–3699

perspective on, 948

physical examination in, 943–944

sexually transmitted. See Sexually transmitted

infections (STIs)

skin signs of, 944, A5

specialist consultation for, 946

treatment of, 946, 947–948t

vaccine-preventable, 981t, 982

in war veterans, S6

Infectious mononucleosis

clinical features of, 134t, 163, 253t, 254,

1483–1484, 1484t

CMV, 1488

complications of, 794, 1484–1485

diagnosis of, 1484, 1485–1486

differential diagnosis of, 1486, 1486t, 1761t

lymphadenopathy in, 458, 459

oral manifestations of, 258t

prevention of, 1487

rash in, 134t, 141, 393, 1484, 1484f

splenomegaly in, 461

treatment of, 1486

Infective endarteritis, 1022

Infective endocarditis, 1022

Abiotrophia, 1028

abscesses in, 1018, 1024

actinomycotic, 1341

acute, 1022

anaerobic bacterial, 1354

aortic regurgitation and, 1987t

Aspergillus, 1678

AV conduction block in, 1882

Bartonella, 1024, 1030, 1030t, 1331t, 1332

Brucella, 1314

in cancer patient, 561

Candida, 1023t, 1030, 1676

as cause of fever of unknown origin, 146, 147

clinical features of, 142, 979, 1024–1025, 1024t,

1025f, 1816

clubbing/hypertrophic osteoarthropathy

in, 274

complications of, 1033

Corynebacterium, 1030

Coxiella burnetii, 1024, 1030t, 1034, 1439, 1440

culture-negative, 147, 1023t, 1024

INDEX

I-116 Infective endocarditis (Cont.):

diagnosis of

CT-PET, 1856, 1857f

Duke criteria, 1025, 1026t

echocardiography, 1026–1027, 1027f, 1027t,

1855–1856, 1857f

laboratory studies, 1025–1026

embolic events in, 1025, 1025f, 1032

Enterobacter, 1027t, 1030

enterococcal

clinical features of, 1199–1200

echocardiography in, 1026, 1027t

incidence of, 1023t

treatment of, 1028, 1029t, 1201t

epidemiology of, 1022–1023, 1978

etiology of, 975t, 979, 1023–1024, 1023t

Gemella morbillorum, 1028, 1029t

glomerulonephritis associated with, 2336t, 2337

Granulicatella, 1028

HACEK group

clinical features of, 1024, 1246–1247

epidemiology of, 1246–1247

etiology of, 1023, 1246–1247

incidence of, 1023t

pathogenesis of, 1246–1247

treatment of, 1029t, 1030, 1247, 1247t

health care–associated, 1025, 1183

heart failure in, 1022, 1024

IgM antibodies in, 2694

murmur in, 279

mycotic aneurysm in, 1025, 1033

Nocardia, 1337

nontyphoidal Salmonella, 1297t, 1298

osteomyelitis and, 1047

outcome of, 1033

P. aeruginosa, 1030, 1287t, 1288

paravalvular infection in, 1022

pathogenesis of, 1024

in persons who inject drugs, 1023–1024, 1025,

1033, 1182

pneumococcal, 1023t, 1030

polymicrobial, 1023t

prevention of, 1033, 1033t

antibiotic prophylaxis for dental care, 262,

1033–1034, 1034t

prophylaxis for dental care, 1034t, 1162t

in surgical patient, 3773

in prosthetic valve. See Prosthetic valve

endocarditis (PVE)

retinal hemorrhage in, 221

septic emboli and, 3340

septic emboli in, 1025, 1025f, A1, A5

skin manifestations of, 137t, 142, 145, 979

splenomegaly in, 460

staphylococcal

clinical features of, 137t, 1024, 1025, 1026f,

1182–1183, A1

diagnosis of, 1183

echocardiography in, 1026, 1027t

emboli in, 1025, 1025f, 1183, 1183f

epidemiology of, 1182–1183

etiology of, 1023

incidence of, 1023t, 1182

pathogenesis of, 1024

treatment of, 1028, 1029t, 1030, 1187

streptococcal

clinical features of, 137t, 1024, A5

diagnosis of, 1027t

group C or D, 1194–1195

group D, 1196

incidence of, 1023t

treatment of, 1028, 1029t

subacute, 1022

in transcatheter implanted aortic valve. See

Transcatheter aortic valve implantation

(TAVI)

in transplant recipient, 1146

treatment of

antimicrobial therapy, 975t, 1027–1031,

1029–1030t, 1201t

antithrombotic therapy, 1031

empirical, 947t, 1030

monitoring, 1031

outpatient, 1031

partial oral, 1031

surgical, 1031–1032, 1032t

T. whipplei, 1024, 1345–1346

vegetations in, A5

Inferior petrosal venous sampling, in Cushing’s

syndrome, 2915–2916

Inferior vena cava diameter, in shock, 2240

Inferior vena cava filter, 727, 2098, 2099

Infertility, 3050

after Hodgkin’s lymphoma, 855

after testicular cancer, 694

in CAH, 3005

chemotherapy-related, 555, 741

in cystic fibrosis, 2176

definition of, 3050

diagnostic evaluation of, 2884t,

3050–3051

etiology of, 3050, 3051f

in Klinefelter syndrome, 2999, 3000

male, 3010, 3051f, 3052, 3072, 3559

ovulatory dysfunction/failure in, 3036, 3052,

3651

pelvic inflammatory disease and, 1089

preconception counseling, 3051–3052

prevalence of, 2884t, 3050

psychological aspects of, 3053

radiation therapy-related, 741

STIs causing, 1080t

treatment of, 3052–3053, 3052t

tubal disease and, 3052

in Turner syndrome, 3001

Infestations

delusional, 3615, 3616f

fly, 3611

leech, 3611–3612

louse, 3610–3611

maggot, 3611

scabies. See Scabies

tongue worms, 3611

INFGR1/2 gene mutations, 1394

Inflammaging, 3736

Inflammasome(s)

characteristics of, 2671, 2676

diseases associated with, 2842–2843

functions of, 957

mutations associated with clinical disease,

2678–2679t

pathogen avoidance of, 956f, 957

in sepsis/septic shock, 2243, 2243f

Inflammation

aging and, 3736

anemia and, 437, 751t, 752–753

in asthma, 2150, 2151f

atherosclerosis and, A10

cardinal signs of, 440f

endothelium in, 1801

heart failure and, 1935

hypertension and, 2075

in IC/BPS, 325

immune cells at sites of, 2698f

laboratory identification of, S11

in malnutrition, 2535–2536, 2541

nociceptor-induced, 92

in obesity, 523, 3086

in psychiatric disorders, 3539–3540

in sepsis/septic shock, 2243, 2243f

thrombosis and, A10

trafficking molecules in, 2699t

in vivo assessment of, 449

Inflammatory bowel disease (IBD), 2469. See also

Crohn’s disease; Ulcerative colitis

after infectious diarrhea, 1064t

atypical colitides mimicking, 2480

cancer risk in, 2489

clinical features of, 304, 349

colorectal cancer in, 638, 2422t, 2489, 2489f

COVID-19 disease and, 2489–2490

differential diagnosis of, 1304, 2479–2480, 2479t

disorders associated with, 2472t

dysplasia in, 2489, 2489f

early-onset, 2470, 2472t

epidemiology of, 2469–2470, 2470t

etiology of, 2470–2471

extraintestinal manifestations of, 2481t

cardiopulmonary, 2482

dermatologic, 399, 2480

hepatobiliary, 2482

metabolic bone disorders, 2482

neuropathy, 3490

ocular, 221, 2480

oral, 257

rheumatologic, 2480

spondyloarthritis, 2801–2802

thromboembolic disorders, 2382

urologic, 2382

familial patterns of, 2470

genetic considerations in, 2471–2473, 2471f,

2472t

global considerations in, 2470

gut microbiome in, 2471f, 2473, 2495–2496,

2496f, 3696

immune regulation in, 2473

inflammasome mutations in, 2678–2679t

inflammatory cascade in, 2473–2474

noninfectious diseases mimicking, 2479–2480

pathogenesis of, 2470–2471, 2471f, 3696

in pregnancy, 2488–2489, 3767

racial and ethnic differences in, 2470

smoking and, 2470

treatment of, 2482, 2488f

antibiotics, 2483

anti-integrins, 2485–2486

anti-TNF therapies, 2484–2485

5-ASA agents, 2482–2483, 2483t

azathioprine, 2483–2484

biologic therapies, 2484–2486, 2487t

cyclosporine, 2484

glucocorticoids, 2483

6-mercaptopurine, 2483–2484

methotrexate, 2484

nutritional therapies, 2486

ozanimod, 2486

during pregnancy, 2488–2489

small molecules, 2486

surgery, 2486–2488, 2488t

tacrolimus, 2484

tumor markers in, 487t

Inflammatory diarrhea, 304. See also Diarrhea

Inflammatory mediators, in sensitization, 91

Inflammatory myopathies. See also

Dermatomyositis; Inclusion body

myositis; Polymyositis

INDEX

diagnosis of, 2819–2820 I-117

differential diagnosis of, 2819–2820

drug-induced, 2825–2826, 3531–3532

epidemiology of, 2819

global considerations in, 2826

overlap syndromes, 2821–2822

treatment of, 2824–2825, 2825t

Inflammatory response, 2473–2474

Infliximab

adverse effects of

common, 2487t, 2762t

cutaneous, 408

infections, 448, 557, 2485

in pregnancy, 2489

septic arthritis, 1041

serious, 379t, 2485, 2487t, 2762t

antibodies to, 2485

for autoimmune and inflammatory diseases,

2701

for axial spondyloarthritis, 2794

for IBD, 2484, 2487t

for IBD-associated arthritis, 2802

monitoring during treatment with, 2487t, 2762t

for psoriasis/psoriatic arthritis, 379t

for rheumatoid arthritis, 2761, 2762t

for sarcoidosis, 2836, 2836t

Influenza, 1515

in cancer patient, 561

clinical features of, 980, 1505, 1518, 1518t

complications of, 1505, 1518–1519

COVID-19 and, 1515, 1518f

definition of, 1515

diagnosis of, 968–969, 1519

differential diagnosis of, 248, 1519

epidemiology of, 972, 1515–1517

etiology of, 1515

global considerations in, 1515

immune response in, 1517

monocyte dysfunction in, 448

morbidity and mortality from, 73t, 1516f, 1517,

1517f, 1518f, 3767

myocarditis in, 1961

pandemics, 1505, 1515, 1516f, 1516t

pathogenesis of, 1517

pathogen evolution of, 1515

pneumonia and, 1518–1519, 1518f

in pregnancy, 1518, 1521, 3767

prevention of, 1133, 1463–1464, 1463t. See also

Influenza vaccine

risk factors for, 1517t

in transplant recipient, 1141

treatment of, 1463–1464, 1463t, 1512, 1520–1521

Influenza A viruses, 1515–1516, 1515f, 1516t, 3718

Influenza B viruses, 1516–1517

Influenza C viruses, 1517

Influenza H1N1, 972, 980, 1505, 3718

Influenza H3N2, 972, 1505

Influenza H5N1, 972, 980

Influenza vaccine

adverse effects of, 1520

categories of, 1513, 1519–1520, 1520t

contraindications to, 985t, 1520

in COPD, 2188

coverage in U.S., 988

Guillain-Barré syndrome and, 3501–3502

inactivated, 984t, 985t, 1520

live attenuated, 984t, 985t, 986, 1520

microbiome and response to, 3699

performance of, 1520

precautions for, 985t, 1520

recommended administration of

in adults, 40t, 984f, 1015, 1520, 1520t

in cancer patients, 557t, 565

in children, 1520, 1520t

in HIV infection, 1564t

in international travelers, 992t, 993

in liver disease, 2553

in pregnancy, 3767

in transplant recipient, 1147

in transplant recipients, 1147t

Influenza virus

antigenic drift in, 1505, 1515

antigenic shift in, 1515

epigenetics of, 3796

genetic reassortment in, 1505, 3718

pathogen evolution of, 972

replication strategies of, 1456

subtypes of, 1516t

virology of, 1515

Information technology, 1, 4–5

Informed consent, 5, 68, 3658, 3666

Infradian rhythm, 3801t

Infusate, contaminated, 1132

Ingenol mebutate, 589

Inguinal lymph node, 458

Inguinal syndrome, 1448

INH. See Isoniazid (INH)

inhA gene, 1375

Inhalational anthrax, 979, S3

inherited tubule growth and development

disorders. See Tuberous sclerosis

Inhibin, 2895, 3010, 3030

Inhibitor of apoptosis proteins (IAP), 518f, 519

Inhibitory NK cell receptors (iNKRs), in HIV

infection, 1550

Injection drug users. See Persons who inject drugs

(PWID)

INK4/ARF system, 3735–3736

Inkoo virus, 1627t

Innate immune system, 2672. See also Immune

response/immune system

adaptive immune system and, 2672

components of, 2672, 2674t

definition of, 2671

effector cells of, 2676, 2679t

basophils. See Basophil(s)

dendritic cells. See Dendritic cells

eosinophils. See Eosinophil(s)

macrophages. See Macrophage(s)

monocytes. See Monocyte(s)

neutrophils. See Neutrophil(s)

NK cells. See Natural killer (NK) cells

overview of, 945f

pathogen avoidance of. See Bacterial infections,

pathogenesis of

pattern recognition receptors in, 2672, 2674,

2675t, 2676

primary deficiency of. See Primary immune

deficiency diseases, of innate immune

system

response to viruses, 1457

Innate lymphoid cells (ILCs)

in adaptive immunity, 2679t

in asthma, 2150

definition of, 2672

development and function of, 2676, 2678–2679,

2686–2687f

in innate immunity, 2679t

Inolimomab, 3479t

Inorganic dusts, 2167t, 2170

Inotuzumab, 536f, 542, 833, 833t

Inoue balloon technique, mitral commissurotomy,

1994f

Inpatient care, 3

Inpatient deaths, 73–74, 73f

INR (International Normalized Ratio), 455–456,

934, 2538t

Insect bites/stings, 370t, 396, 402, 3613. See also

specific insects

Insecticides, 471t, 3592t

Insecticide-treated bed nets, 3709

Insertions/deletions, 474, 475t, 501, 3647

Insomnia

assessment of, 84

drug-induced, 211

etiology of, 84

evaluation of, 210–211

fatal familial, 211

in medical disorders, 211

in neurologic disorders, 211

psychiatric disorders and, 206, 211

psychophysiologic factors in, 210

sleep hygiene and, 210–211

in terminally ill patient, 84

treatment of, 84, 206, 211–212, 211t

Institute of Medicine. See National Academy of

Medicine

Insulin. See also Insulin therapy

actions of, 2890, 3098–3099, 3129, 3130f, 3130t

biosynthesis of, 3098

ectopic production of, 722t

effectors of, 2885t

secretion of, 3098, 3098f, 3101

signaling pathways of, 2885t

structure of, 2885

Insulin aspart, 3108, 3108t

Insulin autoimmune syndrome (Hirata’s

syndrome), 2696t, 2996

Insulin-dependent diabetes mellitus (IDDM). See

Diabetes mellitus, type 1

Insulin detemir, 3108, 3108t

Insulin glargine, 3108, 3108t

Insulin glulisine, 3108, 3108t

Insulin infusion devices, 3106f, 3109

Insulin-like growth factor I (IGF-I)

in acromegaly, 2912

actions of, 2894

adverse effects of, 2894

factors affecting levels of, 2894

in gastroduodenal mucosal defense and repair,

2436f

hypoglycemia and, 3133

injected, 2894

in obesity, 523

in puberty, 3006

signaling pathway, 645, 2885t, 3735, 3735f

structure of, 2885

in thyroid hormone synthesis, 2928

Insulin-like growth factor II (IGF-II)

actions of, 2894

ectopic production of, 722t, 724–725

in sarcoma, 712

Insulin-like growth factor II gene, 724–725,

3654

Insulin lispro, 3108, 3108t

Insulinoma

clinical features of, 664–665, 664t, 2985

diagnosis of, 2985, 3133–3134

endogenous hyperinsulinism due to, 3133

incidence of, 3133

in MEN 1, 2985

screening tests for, 2985t

treatment of, 664t, 665, 2985–2986, 3134

weight gain in, 3085

Insulin receptor, 2696t, 2889

Insulin receptor substrates, 3099

INDEX

I-118 Insulin resistance

autoimmune, 2696t, 2735, 2996

colorectal cancer and, 637

dyslipidemia and, 3144, 3146

free fatty acids in, 3151

in metabolic syndrome. See Metabolic syndrome

obesity and, 3085–3086

in pregnancy, 3765

syndromes of, 3101–3102

treatment of, 3157

Insulin secretagogues

incretins, 3110t, 3111, 3113

sulfonylureas. See Sulfonylureas

for type 2 diabetes mellitus, 3110t

Insulin therapy

adverse effects of, 3087

for diabetic ketoacidosis, S1

for DKA, 3116

for hyperkalemia, 355

hypokalemia and, 348

intensive, 3106f, 3107

in older adults, 3746t

in parenteral nutrition, 2544

in pregnancy, 3765

for type 1 diabetes mellitus, 3108–3109, 3108t

for type 2 diabetes mellitus, 3110t, 3112–3113

Insulin tolerance test, 2898t, 2956–2957

Integrase, 1528

Integrase inhibitors. See Combination antiretroviral

therapy (cART)

Integrative health care. See Complementary and

integrative therapies and practices

Integrative medicine, 3784

Integrin(s)

alpha-4, 2706, 2708t

of innate immune system, 2674

in neutrophil adhesion, 442

stem cell, 744, 897

in tumor angiogenesis, 523f, 524, 525f, 526f

Integrin α4β7, 1547–1548

Intellectual disability, 3275t

Intensivists, 3, 2217

Interactome, 33, 34f, 3818f

Intercalated cells, 2291f, 2294

Intercellular adhesion molecule 1 (ICAM-1), 1555,

2791

Interdigitating dendritic cell sarcoma (reticulum

cell sarcoma), 865

Interface hepatitis, 2415

Interferon(s)

adverse effects of, 384, 410, 1467, 2594

genetic variations in response to, 477t,

3796

pharmacology of, 1466–1467

structure of, 2688

in viral infections, 1466–1467

Interferon-α (IFN-α)

actions and targets of, 537

for adult T-cell leukemia/lymphoma, 1526

adverse effects of, 537, 2594

cardiac, 1964

cutaneous, 410

depression, 82

thyroid dysfunction, 2944

for anogenital warts, 1464

for chronic HBV infection, 2594–2595

for chronic HCV infection, 2605

for chronic HDV infection, 1467, 2603

for CML, 827

for genital warts, 1503, 1503t

for hairy cell leukemia, 856

for hypereosinophilic syndromes, 449, 864

for Kaposi’s sarcoma, 1582, 1582t

for mastocytosis, 865

for NETs, 671t

for polycythemia vera, 804

production of, 2676

source, target, and biologic activity of, 2682t

for systemic mastocytosis, 2731

Interferon-α2a (IFN-α2a). See Pegylated interferonα2a (PEG IFN-α2a)

Interferon-α2b (IFN-α2b). See Pegylated

interferon-α2b (PEG IFN-α2b)

Interferon-β (IFN-β)

adverse effects of, 3472

for MS, 3470t, 3472, 3473

source, target, and biologic activity of, 2682t

Interferon-β1a (IFN-β1a), 3470t, 3472

Interferon-β1b (IFN-β1b), 3470t, 3472

Interferon-γ (IFN-γ)

in Brucella infections, 1312

for chronic granulomatous disease, 450, 2701

functions of, 448

in fungal infection susceptibility, 1655, 1655f

in HIV infection, 448

indications for, 450

in NTM infections, 1393, 1393f

source, target, and biologic activity of, 2682t

suppression of erythropoietin production by,

752, 753f

in T-cell lymphoma, 448

Interferon-γ (IFN-γ) release assays (IGRAs), 147,

1361, 1371, 1395

Interleukin(s), 2681–2682t

Interleukin-1 (IL-1)

in anemia of inflammation, 752

in familial Mediterranean fever, 448

in fever induction, 131, 131f, 151

in pneumonia, 1009

source, target, and biologic activity of, 2681t

in vasculitis syndromes, 2804

Interleukin-1 receptor antagonist (IL-1ra), 2701.

See also Anakinra

Interleukin-1 receptor–associated kinase (IRAK-4),

1173

Interleukin-1β (IL-1β)

in gout, 2864

in heart failure, 1934

in HIV infection, 1549

in osteoarthritis, 2856, 2856f

Interleukin-2 (IL-2), 2681t, 2737–2738

Interleukin-2 (IL-2) receptor, 2327

Interleukin-2 (IL-2) receptor antagonist, 2213

Interleukin-2 (IL-2) therapy

actions and targets of, 537

adverse effects of, 82, 277t, 409, 537, 2944

for melanoma, 537, 584t, 585

for renal cell carcinoma, 537

Interleukin-3 (IL-3), 2150, 2681t

Interleukin-4 (IL-4), 420, 2681t

Interleukin-4 (IL-4) receptor alpha subunit,

2707t

Interleukin-5 (IL-5), 449, 2150, 2681t, 2708t

Interleukin-6 (IL-6)

in blastomycosis risk, 1665

in COVID-19 disease, 1098

in depression, 3539

excess of, 726, 2708t, 3736

in fever induction, 131, 131f

in HIV infection, 1552t, 1561t

in rheumatoid arthritis, 2755

source, target, and biologic activity of,

2681t

Interleukin-6 (IL-6) receptor, 2708t

Interleukin-7 (IL-7), 1549, 2681t

Interleukin-7A (IL-7RA), 1552t

Interleukin-8 (IL-8), 443, 2181, 2681t

Interleukin-9 (IL-9), 2681t

Interleukin-10 (IL-10), 420, 1552t, 2681t,

2733

Interleukin-11 (IL-11), 2681t

Interleukin-12 (IL-12), 448, 1393, 1393f, 1655,

2681t, 2736, 2737

p40 subunit of, 2708t

Interleukin-12B (IL-12B), 2197

Interleukin-13 (IL-13), 2681t

Interleukin-14 (IL-14), 2681t

Interleukin-15 (IL-15), 2681t

Interleukin-16 (IL-16), 2681t

Interleukin-17 (IL-17)

in axial spondyloarthritis, 2791

in fungal infection restriction, 1654–1655

in psoriasis, 2706

in psoriatic arthritis, 2799

in rheumatoid arthritis, 2757f, 2758

source, target, and biologic activity of, 2681t

Interleukin-17A (IL-17A), 2708t

Interleukin-18 (IL-18), 2681t, 2788

Interleukin-21 (IL-21), 2681t

Interleukin-22 (IL-22), 2681t

Interleukin-23 (IL-23), 2681t, 2708t, 2791, 2796f

Interleukin-24 (IL-24), 2681t

Interleukin-25 (IL-25, IL-17E), 2682t

Interleukin-26 (IL-26), 2682t

Intermediate-density lipoproteins (IDLs), 3135,

3136f

Intermediate metabolizers, 475

Internal carotid artery, 3327–3328, 3327f, 3328f,

A14

Internalities, in behavior, 3775

International Certificate of Vaccine Prophylaxis

(ICVP), 992

International Health Regulations, 3703

International Normalized Ratio (INR), 455–456,

934, 2538t

International Prognostic Index, for non-Hodgkin’s

lymphoma, 845, 845t

International Sensitivity Index (ISI), 455, 934, 2555

International travelers, 989

activity-specific infection risks in, 998

epidemiology of medical problems in, 989–990

gastrointestinal illness in. See Travelers’ diarrhea

to high altitudes, 998, 3621–3622. See also Highaltitude illness

immunizations for, 991–996, 992t, 994–995f

infectious disease exposure in, 943

infectious disease spread and, 941, 1135

injuries in, 998

jet lag in, 214–215, 991t, 998

leptospirosis in, 1418

malaria prevention for, 1734–1736, 1734t

online resources for, 991t

outbreaks and emerging infectious diseases,

1000–1001

post-travel care, 1000

with preexisting medical conditions, 991t, 998

HIV infection, 999

immunosuppression, 998–999, 1142t

pregnancy, 999

severe allergies, 999

transplant recipient, 1147

pre-travel consultation for, 990–991, 990t

pre-travel preparations, 999–1000

prevention of arthropod-borne infections in, 996

special populations, 1000, 1000t

venous thromboembolism in, 998

INDEX

Internet resources I-119

on complementary and integrative therapies,

3789t

on dietary supplement–drug interactions,

3787t

on genomics and genetic disorders, 3640t

on HIV disease, 1586t

for medical information, 6–7

vaccine hesitancy and, 16

Internuclear ophthalmoplegia, 230, 231f

Intersex, 3079t. See also Disorders of sex

development (DSDs)

Interstitial cystitis/bladder pain syndrome (IC/

BPS), 325

approach to the patient, 327, 327t

clinical features of, 326

complications of, 331

definition of, 325

diagnosis of, 327–328, 327t

epidemiology of, 326

etiology and pathogenesis of, 325–326

global considerations in, 331

prognosis of, 331

treatment of

algorithm for, 329f

clinical phenotyping for, 328

conservative measures, 329

pharmaceutical, 329–330

surgical, 330–331

Interstitial fluid, 275

Interstitial lung diseases (ILDs)

acute exacerbations of, 2195

classification of, 2190–2191, 2191f, 2192

in dermatomyositis/polymyositis, 2196

diagnosis of, 2191–2192

dyspnea in, 265t, 266

eosinophilic. See Pulmonary infiltrates with

eosinophilia

genetic considerations in, 2196–2197

global considerations in, 2197

granulomatous, 2196. See also Eosinophilic

granulomatosis with polyangiitis;

Granulomatosis with polyangiitis

in hypersensitivity pneumonitis. See

Hypersensitivity pneumonitis

idiopathic pulmonary fibrosis. See Idiopathic

pulmonary fibrosis

imaging in, A12

pneumonia. See Interstitial pneumonia

pneumonitis, A12

pulmonary hypertension in, 2126

pulmonary lymphangioleiomyomatosis, A12

in rheumatoid arthritis, 2196, 2753

in sarcoidosis, 2190t, 2193f, 2196. See also

Sarcoidosis

smoking-related, 2134–2195

in systemic sclerosis, 2190t, 2195–2196, 2780,

2780f, 2785–2786, 2785f. See also

Systemic sclerosis

Interstitial nephritis. See Acute interstitial nephritis

(AIN)

Interstitial pancreatitis, 2659, 2660t, 2661

Interstitial pneumonia

in HCT recipient, 899

in HIV infection, 1567

lymphoid, 1567

nonspecific, 1567

non-specific (NSIP), 2190t, 2193–2194, 2193f,

2194f

Interstitial pneumonitis, A12

Interstitial space, 338

Intertrigo, Candida, 1672

Interventional cardiology, 2066, 2071. See also

Percutaneous coronary interventions

(PCI)

Interventional nephrology, 2377

Interventional neuroradiology, 3292

Interventional pulmonary medicine

for asthma, 2216

for central airway obstruction, 2215–2216, 2215f,

2215t

for COPD, 2216

for early-stage lung cancer, 2216

endobronchial ultrasound-guided transbronchial

needle aspiration, 2141–2142, 2141f,

2214, 2214f

lung denervation, 2216

lung volume reduction, 2216

peripheral bronchoscopy, 2215

for pleural disease, 2216

for pneumothorax and persistent air leak, 2216

Intervertebral disk

anatomy of, 117, 117f

herniation of, 118f, 120–121, 121f

replacement, 126

Intestinal flukes, 1784t, 1788t, 1789, 1789t, S12

Intestinal ischemia, 2506

acute, 2507–2508, 2507t

anatomy of, 2506, 2506f

arterio-occlusive, 2506, 2507t

chronic, 2507

clinical features of, 111t, 292, 295, 2507

diagnosis of, 2507

epidemiology of, 2506

incidence of, 2506

mesenteric venous thrombosis, 2506, 2507t, 2508

nonocclusive, 2506, 2507t, 2508

pathophysiology of, 2507

treatment of, 2507–2508, 2507t

Intestinal lymphangiectasia

clinical features of, 304, 2119

congenital, 304

small-intestinal mucosal biopsies in, 2465f

Intestinal necrosis, 355

Intestinal obstruction, 2508

in cancer, 567

clinical features of, 567, 2510–2511

abdominal pain, 109, 111t, 2510–2511

abdominal swelling, 321, 2510–2511

lactic acidosis, 361

nausea and vomiting, 292, 2510–2511

closed-loop, 2510

in cystic fibrosis, 2176

diagnosis of, 85, 112, 2410, 2414f, 2511–2512,

2511f

differential diagnosis of, 109, 111

epidemiology of, 2508, 2509t

etiology of, 2508–2509, 2509t

pathophysiology of, 2509–2510, 2510f

physical examination in, 2510–2511

postoperative, 2512

in systemic sclerosis, 2781–2782, 2786

treatment of, 567, 2410, 2414f, 2512, V5

Intestinal pseudoobstruction (Ogilvie’s disease)

clinical features of, 292, 349, 2410

diagnosis of, 2410, 2414f

etiology of, 2509

treatment of, 293, 294t, 2410, 2414f

Intestinal resection, 303, 2465

Intestinal stagnant loop syndrome, 772

Intima, 1801

Intimal dissection, 2067, 2067f

Intimate partner violence. See Domestic abuse/

violence

Intraabdominal abscess/infections

actinomycosis, 1341–1342, 1342f

anaerobic bacterial, 1353, 1356

C. septicum, 1353

enterococcal, 1200

etiology of, 1266

intraperitoneal, 1057–1058, 1058f

liver. See Liver abscess

nontyphoidal Salmonella, 1297

perinephric, 1060

psoas, 1060

renal, 1060

splenic. See Splenic abscess

in transplant recipient, 1145

treatment of, 947t, 1356

Intraaortic balloon pump (IABP), 2070–2071, 2253,

2256

Intraarticular injections, 2861, 2861t

Intracellular fluid, 338

Intracranial atherosclerosis, 3341, 3348

Intracranial hemorrhage, 3348

aphasia in, 197

brain tumor and, 3350

clinical features of, 3349–3350

coma in, 187–188

diagnosis of, 3348, 3348f, 3351

emergency management of, 3348–3349

etiology of, 3324, 3349–3350, 3349t

headache in, 113

hypertension and, 2075–2076, 2087, 3348f,

3349–3350

lobar, 3350

ocular manifestations of, 225

prevention of, 3352

prognosis of, 3351t

in transplant recipient, 2275

in traumatic brain injury, 3350, 3458

treatment of, 3351–3352

vascular malformations and, 3352–3353

Intracranial hypotension, 3376

Intracranial infections, 975t, 978–979

Intracranial meningitis, 1110

Intracranial pressure (ICP), increased

in bacterial meningitis, 1102, 1105

from brain metastases, 570

in chronic meningitis, 1110, 1112

in coma, 185

idiopathic, headache with, 116

in intracranial hemorrhage, 3352

monitoring of, 2269, 2270f

nausea and vomiting in, 292

ocular manifestations of, 224, 224f, 230

pathophysiology of, 2268–2269

signs of, 2270

in subarachnoid hemorrhage, 3355–3356

treatment of, 570, 2269–2270, 2270t, 3355–3356

Intracytoplasmic sperm injection (ICSI), 3010,

3052, 3052t

Intraductal papillary neoplasms, 658

Intrahepatic cholangiocarcinoma, 654–655, 654f

Intrahepatic cholestasis of pregnancy, 3767

Intraluminal gastric balloons, 3094

Intramedullary syndromes, 3446

Intramuscular injection, of vaccines, 986–987,

987f

Intraocular pressure, increased, 221

Intraperitoneal abscess, 1057–1058, 1058f

Intraperitoneal cavity, 1054, 1054f

Intrathecal administration, opioids, 96

Intrauterine devices (IUDs), 1342, 1342f, 3036,

3054, 3054t, 3055

Intrauterine growth retardation, 3004

INDEX

I-120 Intrauterine insemination, 3052, 3052t

Intravascular device-related infections. See

Catheter-related bloodstream infections

Intravascular large B-cell lymphoma, 857

Intravascular space, 338

Intravenous immunoglobulin (IVIg)

adverse effects of, 352, 2825t, 3515

for antiphospholipid syndrome, 2751

for autoimmune and inflammatory diseases,

2701

for chronic inflammatory demyelinating

polyneuropathy, 3507

for CMV pneumonia, 1139

for dermatomyositis, 405

for drug-induced hypersensitivity syndrome, 412

for epidermolysis bullosa acquisita, 404

for Guillain-Barré syndrome, 3504

for hypogammaglobulinemia in cancer patients,

565

for immune thrombocytopenic purpura, 907

for inflammatory myopathies, 2825, 2825t

for Kawasaki disease, 2816

for MS, 3473

for mucous membrane pemphigoid, 404

for multifocal motor neuropathy with

conduction block, 3415

for myasthenia gravis, 3515

for parvovirus B19 infection, 798, 1141, 1497

for rheumatic fever, 2769–2770

for streptococcal toxic shock syndrome, 1191t,

1194

for toxic epidermal necrolysis, 1035

for viral meningitis, 1108

Intraventricular hemorrhage, primary, 3350–3351

Intravesical anesthetic bladder challenge, 328

Intravesical therapy

for bladder cancer, 678–679

for IC/BPS, 330

Intrinsic factor (IF), 766, 771, 2696t

Intrinsic pathway, coagulation, 451, 451f, 911f

Introns, 3641

Intussusception, 292, 308, 312, 2512

Invariant natural killer (NK) cells, 3700

Invasin, 1326

Inverse psoriasis, 377. See also Psoriasis

Investing in Heath, 3704

In vitro fertilization (IVF), 3010, 3052, 3052t,

3660

Involuntary active euthanasia, 87t

Involuntary weight loss, 309

assessment of, 310–311, 310t, 2535t

in cancer, 489

in chronic pancreatitis, 2667

in esophageal cancer, 627

etiology of, 309–310, 310t

in HIV infection, 1581

in liver disease, 2549

in lung cancer, 598t, 599

in malabsorption disorders, 2468t

in malnutrition, 2535t, 2536

in older adults, 309

in pancreatic cancer, 659

significance of, 309

in thyrotoxicosis, 2939

treatment of, 311

Iodides, adverse effects of, 397, 449

Iodine, 2534

deficiency of. See Iodine deficiency

excess intake of, 2936

for goiter, 2946

intake during pregnancy, 2927

recommended intake of, 2520t, 2927

tolerable upper intake level of, 2533t

toxicity of, 2533t

Iodine deficiency

clinical features of, 2533t, 2927

global considerations in, 2927, 2928f

goiter and, 2946

hypothyroidism and, 2936

prevention of, 2936

Iodine dermatitis, 1709

131Iodine-ethiodol, S5

131Iodine-MIGB, 2979

Iodoquinol

actions of, 1709

adverse effects of, 1704t, 1709

for amebiasis, 1709, 1718t

contraindications to, 1709

pharmacology of, 1709

in pregnancy and lactation, 1704t

Ion absorption, congenital defects in, 303

Ion channels, cardiac, 1867–1868, 1868f

Ion exchangers, S5

Ionization, 531

Ionizing radiation

AML and, 810

aplastic anemia and, 793

breast cancer and, 613

from cardiac imaging, 1839–1840

CML and, 820

lung cancer and, 594

pulmonary fibrosis and, A12

skin damage from, 386

Ion trap mass spectrometry, 3834

Iopanoic acid, 905t, 2930t

IP-10 (IFN-γ-inducible protein-10), 2684t

IPAA (ileal pouch-anal anastomosis), 2486

Ipecac syrup, 3588, S5

IPEX (immunodysregulation polyendocrinopathy

enteropathy X-linked) syndrome, 2472t,

2706, 2718, 2733, 2996

IPF. See Idiopathic pulmonary fibrosis (IPF)

IPF1 gene mutations, 3645t

Ipilimumab

action and targets of, 514t, 536f, 537, 2705t

adverse effects of, 537, 585

autoimmunity, 573

cutaneous, 410

hepatotoxicity, 2591

nephrotoxicity, 2301

neurological, 711, 2275

for hepatocellular carcinoma, 652f

for high-grade NETs, 673

indications for, 537, 2701

for lung cancer, 607

for melanoma, 537, 584t, 585, 2705t

for renal cell carcinoma, 675, 676t, 2705t

Ipodate, 2930t

ipr1 gene, 1361

Ipratropium bromide, 249, 2186, 2725

Iptacopan, 791f

Iquitos virus, 1628t, 1639

IRAK-4, 1173

IRAK-4 deficiency, 446t

Iraqi Jewish population, factor XI deficiency in, 914

IREB2, 2184

IRGM gene mutations, 2472t

Iridectomy, laser, 221

Iridium exposure, S5

Iridocyclitis. See Uveitis

Irinotecan

actions of, 541

adverse effects of, 478, 540t, 541–542, 577, 642

for carcinoma of unknown primary, 720

for colorectal cancer, 642

drug interactions of, 571, 3787

for Ewing’s sarcoma, 715

for gastric cancer, 633

genetic variations in response to, 476t, 478

in Gilbert syndrome, 2560

interactions and issues, 540t

for lung cancer, 610

metabolism of, 467t, 468

for pancreatic cancer, 661, 662, 662t

for soft tissue sarcomas, 714

IRIS. See Immune reconstitution inflammatory

syndrome (IRIS)

Iritis. See Uveitis

Iron

absorption of, 748, 748f

accumulation in brain, 3409

average intake of, 749

in bone marrow, A6

deficiency of, 212, 2533t. See also Iron-deficiency

anemia

distribution in body, 748, 748t

excessive ingestion of, 3232

excess of. See Iron overload

homeostasis, pathways of, 3231f

metabolism of, 748–749, 748f

nutritional balance of, 749

parenchymal, in liver, 3232

recommended intake of, 749, 2520t

serum, 432, 436. See also Ferritin, serum

in hypoproliferative anemia, 437, 552, 753t

in iron-deficiency states, 749f

levels by sex and age, 750, 750f

stores of, 748, 748f, 748t, 750t, 3232, 3233t

supplements. See Iron supplements

toxicity of. See Iron overload

Iron cycle, 748–749, 748f

Iron-deficiency anemia, 749

clinical features of, 750

diagnosis of, 750–751, 750t

differential diagnosis of, 751, 751t

etiology of, 750, 750t

from gastrointestinal bleeding, 314, 2416–2417

gastrointestinal cancer and, 626, 640

global considerations in, 749

in hookworm infections, 1775

in-hospital, 2545

jaundice in, 317

menorrhagia and, 453

pathophysiology of, 437–438

peripheral blood smear in, 425, 426f, 433f

stages of, 749–750, 749f

surgery-related, 2452

treatment of, 751–752, 751t

Iron-deficient erythropoiesis, 749f, 750

Iron dextran, 752

Iron gluconate, 752

Iron-hematoxylin stain, S12

Iron overload

acute, 749

chronic, 777

clinical features of, 2533t

CMR in, 1851, 1859v

etiology of, 3230t, 3232

in hemochromatosis. See Hemochromatosis

in porphyria cutanea tarda, 423

secondary, 3232

transfusion-related, 754, 761, 798, 895

in Wilson’s disease. See Wilson’s disease

Iron poisoning, 3594t

Iron sucrose, 752

Iron supplements, 751–752, 751t

INDEX

Iron supply studies, 436 I-121

Iron tolerance test, 752

Irregular sleep-wake rhythm, 3806

Irreversibly sickled cells (ISCs), 757, 758f

Irritable bowel syndrome (IBS), 2490

approach to the patient, 2492–2493

clinical features of, 2490–2491

abdominal pain/pressure, 110, 111t, 321, 2490

altered bowel habits, 301, 304, 307t, 2490

diarrhea, 304

gas and flatulence, 2391

nausea and vomiting, 292

upper gastrointestinal, 2391

diagnostic criteria for, 2490, 2490t

differential diagnosis of, 306, 2493

IC/BPS and, 326

incidence of, 301

pathophysiology of, 2491–2492, 2491f, 2492f,

2493f

postinfectious, 1064t, 2491–2492

psychological features in, 2491

severity spectrum of, 2496t

treatment of, 306, 2493–2497, 2494t, 2496f,

2496t, 3786

Irritant contact dermatitis. See Contact dermatitis

Irritant inhalation, 2152, 2153

Irukandji syndrome, 3602, 3603

Isaacs’ syndrome, 735–736, 3520

Isatuximab, 536f, 874t, 875

Isavuconazole, 1657, 1663, 1675t, 1683, 1685t, 1686

Isavuconazonium sulfate, 1667

Ischemia

acute limb, 2110–2111

cardiac. See Ischemic heart disease

cerebral, 3324, 3335, 3336f. See also Ischemic

stroke

intestinal. See Intestinal ischemia

Ischemic cascade, 2268

Ischemic colitis, 301, 2392f, 2479, 2508

Ischemic heart disease, 2030

angina. See Angina

arrhythmia in, 2033

asymptomatic (silent), 2033–2034, 2045–2046

cardiomegaly in, 2033

cardiomyopathy and, 2033

in CKD, 2315

diagnosis of

approach to, 2035f

cardiac imaging, 2036f, 2037

coronary arteriography, 2038

ECG, 1828–1829, 1828f, 1829f, 1830t, 2034,

2035f

history, 2033–2034

laboratory tests, 2034

physical examination, 2034

stress testing, 2034–2037, 2035f, 2036f, 2037t

dyslipidemia and, 2040

epidemiology of, 2030

functional classification of, 1797–1798, 1797t,

2033t

global considerations in, 2052, 3704

heart failure in, 2033, 2043

neck pain in, 128

pathogenesis of, 2030–2031, 2031f, 2032f. See

also Atherosclerosis; Coronary artery

disease (CAD)

prognosis of, 2038

risk factors for, 2040

symptomatic, 2032–2033

treatment of, 2039

ACE inhibitors, 2042

activity adaptation, 2039, 2039t

aggravating conditions, 2039

algorithm for, 2043f

antiplatelet drugs, 2042

beta blockers, 2040t, 2041, 2042t

CABG. See Coronary artery bypass grafting

(CABG)

calcium channel blockers, 2041–2042, 2041t,

2042t

enhanced external counterpulsation, 2045

explanation and reassurance, 2039

ICD, 2265t

initial therapy, 2042, 2042t

lipid-lowering therapy, 2040

nicorandil, 2043

nitrates, 2040t, 2041, 2042t

PCI. See Percutaneous coronary interventions

(PCI), for revascularization

principles, 1799

ranolazine, 2042, 2042t

risk factor management, 2040

stem cell therapy, 3798

in women, 2040

Ischemic penumbra, 3334

Ischemic stroke, 3335

after TIA, 3344, 3344t

clinical features of, 3325

etiology of, 3339, 3339f, 3340t

artery-to-artery embolic, 3340–3341

CADASIL, 3343–3344

cardioembolic, 3339–3340, 3341t

drug-related, 3343

Fabry disease, 3258, 3344

fibromuscular dysplasia, 3343

giant cell arteritis, 3343

hypercoagulable disorders, 3342

leukoaraiosis, 3343

moyamoya disease, 3343

necrotizing arteritis, 3343

posterior reversible encephalopathy

syndrome, 3343

sickle cell anemia, 3343

small-vessel, 3341, 3342f

vasculopathy, 3343, 3343f

venous sinus thrombosis, 3342

imaging of. See Stroke, imaging studies in

localization of. See Stroke, localization of

pathophysiology of, 3335, 3336f

prevention of, 3344

anticoagulation therapy for, 3346–3347

antiplatelet agents for, 3341t, 3345–3346

in atrial fibrillation, 926, 1906–1907, 1907t

risk factor management in, 3344

treatment of, 3335

algorithm for, 3325f, 3336f

anticoagulants, 3338

endovascular techniques, 3337–3338

intravenous thrombolysis, 3337, 3338t

medical support, 3337

neuroprotection, 3338

platelet inhibitors, 3338

stroke centers and rehabilitation in, 3338–3339

Ischial bursitis, 2878

ISCs (irreversibly sickled cells), 757, 758f

Isfahan virus, 1630t

Ishak fibrosis scale, liver disease, 2452

Ishihara color plates, 218

ISI (International Sensitivity Index), 455, 934, 2555

Islet-1, 1799

Islet amyloid polypeptide (IAPP), 3098

Islet cell(s)

pancreatic, 3098

regeneration of, 3798–3799

transplantation of, 2668

tumors of. See Neuroendocrine tumors (NETs),

pancreatic

Islet cell autoantibodies, 3099–3100

Isobutyl-CoA dehydrogenase deficiency, 3270t

Isocarboxazid, 3542t

Isocyanate exposure, 2171t

Isoflavones, 2529

Isoforms, 3641

Isolation aphasia, 196t, 197

Isolation techniques, 1132, 1513–1514

Isoleucine metabolism disorders, 3271t

Isometheptene, 3362t, 3364

Isomorphic (Koebner) phenomenon, 377,

1581

Isoniazid (INH)

actions of, 1399–1400

adverse effects of, 1400

cutaneous, 391

fever, 147

hepatotoxicity

features of, 2584, 2586t, 2589

genetic considerations in, 478

monitoring for, 1381, 1398t, 1400

lupus syndrome, 2847t

neuropathy, 1400, 3493, 3494t

optic neuropathy, 224

pellagra, 2527

pure red cell aplasia, 798t

pyridoxine for prevention of, 1373, 1400,

2527, 3497

in renal failure, 1378

seizure, 3311t

dosage of, 1400

drug interactions of, 1400, 1703t

genetic variations in response to, 476t, 478

metabolism of, 467t

for NTM infections, 1396

overdosage/poisoning with, 3588, 3594t

pharmacology of, 1000

resistance to, 1000, 1375–1377

for TB

active infection, 1372–1373, 1372t, 1373t,

1398t, 1399–1400

high-dose, 1377, 1399t

monitoring and management of, 1398t

prophylaxis, 1563t

for TB preventive treatment, 1380–1381, 1380t,

1397, 1397t, 1398t

for tuberculous meningitis, 1109

Isoprinosine, 1100

Isopropyl alcohol poisoning, 363

Isoproterenol, 1883, 1885

Isosexual precocity, 3011

Isosorbide, 1947, 1948t, 2040t, 2062, 2256

Isospora belli/isosporiasis. See Cystoisospora belli/

cystoisosporiasis

Isotope dilution techniques, 2538t

Isotretinoin

for acne vulgaris, 382

adverse effects of, 382, 384, 410, 2847t,

3144

for oral leukoplakia, 492

for pityriasis rubra pilaris, 385t

Isotypes, 866

Isovaleric acidemia, 3270t

Isradipine, 2041t, 2042, 2114

Issyk-Kul virus, 1629t

Istradefylline, 3396t

Italy, health system financing in, 43t

ITAMs (immunoreceptor tyrosine-based activation

motifs), 2690f, 2691

INDEX

I-122 Itaquí virus, 1627t

ITITM5 gene mutations, 3221, 3222t

ITLN1 gene mutations, 2472t

ITPA gene, 477t

Itraconazole

for ABPA, 2165

adverse effects of, 349, 1657, 1703t

for Aspergillus infections, 1680, 1681t

for Aspergillus prophylaxis, 1681

for Blastomyces infections, 1667, 1667t

for Candida prophylaxis, 1676

for Coccoides infections, 1663

contraindications to, 380

for dermatophyte infections, 1691, 1691t

drug interactions of, 380, 467t, 1703t, 2637, 3060

for Histoplasma infections, 1109, 1660, 1660t

indications for, 1656–1657

for Malassezia infections, 1690

for onychomycosis, 380, 1691, 1691t

for paracoccidioidomycosis, 1687, 1687t

for phaeohyphomycoses, 1689t

in pregnancy and lactation, 1703t

prophylactic use, 1564t

resistance to, 1680

for Sporothrix infections, 1687, 1687t

susceptibility testing for, 1675t, S11

for talaromycosis, 1687t

IUDs (intrauterine devices), 1342, 1342f, 3054,

3054t, 3055

Ivabradine, 1875t, 1892, 1948

Ivacaftor, 477t, 2178

IV drug users. See Persons who inject drugs

(PWID)

Ivermectin

actions of, 1709

adverse effects of, 1704t, 1709, 1780, 1782, 1783

for ascariasis, 1774

for cutaneous larva migrans, 1771t

for gnathostomiasis, 1771t

indications for, 1709

for loiasis, 1783

for lymphatic filariasis, 1780

for onchocerciasis, 1782

pharmacology of, 1709

in pregnancy and lactation, 1704t

resistance to, 1709

for scabies, 3608

for strongyloidiasis, 1776

for trichuriasis, 1777

IVF (in vitro fertilization), 3010, 3052, 3660

IVIg. See Intravenous immunoglobulin (IVIg)

“Ivory vertebra,” 3211

Ivosidenib, 514t, 656, 818

Ixabepilone, 541t, 543

Ixazomib, 513t, 515, 549t, 552, 874t, 876, 882

Ixekizumab, 379t, 2708t, 2795–2796, 2800

Ixodes spp. ticks. See also Tick(s)

in Babesia infections, 1737. See also Babesia spp.

infections

in B. miyamotoi transmission, 1422

characteristics and life cycle of, 1426, 3609

climate change and habitat of, 1006, 1006f

in human granulocytotropic anaplasmosis,

1438

in Lyme borreliosis, 1426, 3609. See also Lyme

borreliosis (Lyme disease)

in relapsing fever transmission. See Relapsing

fever

removal of, 3609

Ixodid (hard) tick, 3609

IYD (dehalogenase 1), 2934t

Izumi fever, 1326

J

Jackhammer esophagus, 2429f

Jacksonian epilepsy, 1791

“Jacksonian march,” 3306

Jacobsen’s syndrome, S8

Jaffe reaction, S10

JAK (Janus family of protein tyrosine kinases),

2758, 2883

JAK (Janus kinases) 1 and 2, 544, 2688

JAK2 gene mutations

in essential thrombocytosis, 807, 808

in IBD, 2472t

in MDS/MPN, 862

in polycythemia vera, 439, 803, 804

in primary myelofibrosis, 805, 806

JAK2 inhibitors, 805

JAK3 deficiency, 2689

JAK3 gene mutations, 857, 861

JAK inhibitors, 511, 544, 1655–1656, 2486,

2763–2764, 2763t

JAK/STAT pathway, 505t

Jamaica bush tea, 319

Jamestown Canyon virus, 1536, 1627t

Janeway lesions, 979, 1025, 1025f, 1816, A1

Jansen’s chondrodystrophy, 3161

Jansen’s disease, 3179, 3179f

Japan

health system financing in, 43t

long-term care funding in, 47

pharmaceutical expenditures in, 48

primary care access in, 45

Japanese encephalitis virus, 1626t, 1636

Japanese encephalitis virus vaccine, 992t, 994–995

Japanese spotted fever, 1434

Jargon aphasia, 196

Jarisch-Herxheimer reaction

in leptospirosis, 1421

in Lyme disease, 1329

in relapsing fever, 1423, 1425

in syphilis, 1413, 1572

in Whipple’s disease, 1347

Jaundice, 315

in acute viral hepatitis, 2575

approach to the patient, 316, 317f

with ascites, 318

breast milk, 2558

in cardiovascular disease, 1816

in cholangiocarcinoma, 654

in choledocholithiasis, 2650

in cholestatic disorders, 319–320, 319t, 2646

in chronic hepatitis, 2594

in clinical drug trials, 2586

differential diagnosis of, 315, 2382t, 2383

drug-induced, 318, 319, 319t

global considerations in, 320–321

in hemolytic anemia, 776

in hepatocellular conditions, 318–319,

319t

history in, 318

laboratory evaluation of, 316, 318

in leptospirosis, 1420

in liver disease, 2548

neonatal, 781, 2558

in pancreatic cancer, 658

pathophysiology of, 315–316

physical examination in, 318, 2549

Jaw, osteonecrosis of, 262, 3184, 3205

J chain, 2694

JC virus infection

in cancer patient, 560t, 562

in HIV infection, 1578–1579

natalizumab treatment and, 3470–3471

in progressive multifocal leukoencephalopathy,

1099

respiratory tract, 1511

in transplant recipient, 1141, 1143, 2330

Jefferson fracture, A16

Jejunal vascular ectasia, 2393f, 2421f

Jejunostomy tube feeding, 293

Jellyfish sting, 3602–3603

Jerk nystagmus, 231

Jervell and Lange-Nielsen syndrome, 242, 244t

Jetlag disorder, 214–215, 991t, 998, 3806

Jigger, 3615

Jimson weed, 3591t

Jin Bu Han, 2590

JK bacillus infection, 558t

JMML (juvenile myelomonocytic leukemia),

861–862

Job syndrome. See Hyper-IgE (Job) syndrome

Jod-Basedow effect, 2945, 2947

Joint(s)

disorders of. See Arthritis; Musculoskeletal

disorders; Osteoarthritis

failure of, 2855–2856, 2856f

malalignment of, 2850, 2857, 2857f

position testing, 170t, 171

prosthetic, infections in. See Prosthetic joint

infections

protective mechanisms of, 2855–2856

Joint Commission, infection-control guidance and

oversight, 1128

Joint replacement, 2862

Joint United Nations Program on HIV/AIDS

(UNAIDS), 3707

Jones criteria, 2768, 2769t

Joubert’s syndrome, 2352f, 2355

JPH3 gene mutations, 3405

Jugular septic thrombophlebitis. See Lemierre’s

disease/syndrome

Jugular venous pressure, 1816–1817, 1817f

Jugular venous pulse/distension

in ascites, 321

in heart failure, 1937

in hypovolemia, 341

in shock, 2219, 2238

Junctional bradycardia, ECG in, A8

Junctional tachycardia, 1896

Junín/Argentinian hemorrhagic fever, 1626t,

1642

Juquitiba virus, 1628t

Justice, 69

Juvenile arthritis, 2678t

Juvenile goiter, 2946

Juvenile granulosa tumors, 697

Juvenile myelomonocytic leukemia (JMML),

861–862

Juvenile myotonic epilepsy, 3307

Juvenile-onset spondyloarthritis, 2801

Juvenile Paget’s disease, 3210

Juvenile pernicious anemia, 771

Juvenile polyposis, 503t, 638t

Juvenile polyps, 637

Juxtaglomerular apparatus, 2289f

K

K+. See Potassium

Kabuki syndrome, 3795

KAL1 gene mutations, 3014, 3015t

Kala-azar, S12. See also Visceral leishmaniasis

KAL gene mutations, 2896

Kallikrein inhibitor, 2723

Kallikreins, 683

Kallmann syndrome, 237, 2896–2897, 3014