topics

11/9/25

INDEX

I-196 Salvia divinorum, 3576

SAM, 3793

153Samarium therapy, 79, 488, 553, 716

SAME. See Syndrome of apparent

mineralocorticoid excess (SAME)

Same-sex attraction, 3079t

Sand flea, 3614

Sandfly

in Carrión’s disease, 1333

in Coclé virus disease, 1640

in Leishmania infections, 1742, 1742t

in pemphigus foliaceus, 402

in Punta Toro virus disease, 1640

in Toscana virus disease, 1639–1640

Sandfly fever, S6

Sandfly fever viruses, 1629t, 1639–1640

Sandhoff disease, 3256t, 3258, 3413t

Sanfilippo syndromes, 3255t

Sanjad-Sakati syndrome, 3186

SA (sinoatrial) node, 1824, 1824f, 1868, 1873,

1874f

SA (sinoatrial) node disease/dysfunction. See

Sinoatrial (SA) node disease/dysfunction

Sapanisertib, 652f

Saphenous vein bypass graft, 2067, 2110, A11

SAPHO syndrome, 1052, 2802

SAPIEN valve, 2070, A11

Sapovirus, 1597, 1597t, 1598f

Saquinavir, 467t, 1590f, 1703t

Sarcoglycans, 3521, 3526f

Sarcoidosis, 2829

clinical features of, 2830, 2831t

alopecia, 384

azotemia, 335

bone marrow involvement, 2832

breast lesions, 2833

cardiac, 2833, A9

myocarditis, 1962, 1963f

ventricular tachycardia, 1921, 1930

cough, 268

cutaneous

characteristics of, 397, 1816, 2831

figurate lesions, 385

lupus pernio, 397, 2831, 2832f

maculopapular lesions, 2831, 2832f, A5

extrahepatic cholestasis, 319

fever of unknown origin, 147

hepatic, 2832

hypercalcemia, 356, 2832, 3180–3181

hypocalcemia, 357

hypopituitarism, 2897

indigestion, 295

interstitial lung disease, 2190t, 2193f,

2195–2196

lymphadenopathy, 458, 459

musculoskeletal, 2833, 2833f

nephritis, 2281, A4

neurologic, 2833

cranial neuropathy, 3444

facial palsy, 3440

meningitis, 1115t

myelitis, 3451

neuropathy, 3489

ocular, 220, 221, 2832

oral, 261

pulmonary, 2830–2831, 2831f

pulmonary hypertension, 2126–2127

renal, 2832–2833

spleen, 2832, 2832f, 2833f

weakness, 167

complications of, 2833

definition of, 2829

diagnosis of

approach to, 2834, 2834f

chest radiograph, 2831f, 2834

CT, 2193f, 2831f, 2832f

laboratory findings, 2834

MRI, 2834, A16

PET, 2833f, 2834

renal biopsy, A4

urinalysis, A4

differential diagnosis of, 397, 2789t, 2834

drug-induced, 409

etiology of, 2829

global considerations in, 2829–2830

immunopathogenesis of, 2830, 2830f

incidence of, 2829

vs. occupational lung disease, 2170

prognosis of, 2835

treatment of, 2835–2837, 2835f, 2836f, 2836t

Sarcomas, 712

bone. See Bone sarcomas

cardiac, 2027

deaths from, 484t

definition of, 508

follicular dendritic cell, 865

granulocytic, 396

histiocytic, 865

interdigitating dendritic cell, 865

Langerhans cell, 865

mast cell, 2730

metastatic, 708t

paraneoplastic syndromes in, 722t

soft tissue. See Soft tissue sarcomas

synovial, 2877

uterine, 700

Sarcomere, 1803–1804

Sarcomeric proteins, 1955, 1956t, 1957f

Sarcopenia, 3736

Sarcoplasmic reticulum, 1803f, 1804f, 1933

Sarcoptes scabei, 3608. See also Scabies

Sarcosinemia, 3269t

sar gene, 1179

Sarilumab, 2763

Sarin (GB), 3592t, S4

SARMs (selective androgen receptor modulators),

3023

SARS. See Severe acute respiratory syndrome (SARS)

SARS-CoV-1 (severe acute respiratory syndrome

coronavirus 1), 980, 1458, 1507.

See also Diarrhea

Secretory leukocyte protease inhibitor (SLPI), 1535

Secretory protein, 2694

Secukinumab, 379t, 2708t, 2795–2796, 2796f, 2800

Sedation

of mechanically ventilated patient, 2221

for STEMI, 2060

Sedative-hypnotics, 3585, 3592t. See also specific

drugs

Segawa syndrome (dopa-responsive dystonia),

3269t, 3389–3390, 3402

Seizure(s), 3305. See also Epilepsy

absence, 3306–3307, 3315f

after traumatic brain injury, 3310, 3459

in alcohol withdrawal, 3562

approach to the patient, 3312, 3313f

atonic, 3306

in brain abscess, 1118

in brain tumor, 701, 702

in cancer patient, 571, 711, 711t

chemotherapy-induced, 711t

classification of, 3305–3306, 3306t, 3315f

coma in, 185

continuous. See Status epilepticus

definition of, 3305

delirium and, 181, 3377

differential diagnosis of, 3315–3316, 3315t

drug-induced, 3311t

eclamptic, 3763

EEG in, 3312–3314, 3314f, 3315f

in encephalitis, 1094

etiology of, 3308–3310, 3310t, 3311t

evolution of, 3306

febrile, 133, 3309–3310

focal, 3306, 3352

focal sensory, 173

generalized, 3306–3307

genetic testing in, 3314–3315

in heatstroke, 3637

history and examination in, 3312

in HIV infection, 1578, 1578t

in hyperperfusion disorders, 2274

INDEX

I-198 Seizure(s) (Cont.):

in hypocalcemia, 358

in hyponatremia, 343

imaging in, 3314

laboratory studies in, 3312

lactic acidosis in, 361

magnetoencephalography in, 3314

in malaria, 1724

mechanisms of, 3310–3311

in meningitis, 1102

myoclonic, 3306

in neurocysticercosis, 1791, 1792

in overdosage/poisoning, 3585, 3588

in parasitic infections, 1699t

in pregnancy, 3763

psychogenic, 3316

pyridoxine-dependent, 3270t

in schistosomiasis, 1787

sudden cardiac death risk and, 2259

vs. syncope, 157, 3315–3316, 3315t

temporal lobe, 203

tonic-clonic, 3306

treatment of, 702, 3316. See also Epilepsy,

treatment of

Selectins, 442, 443f, 897

Selection bias, 494

Selective androgen receptor modulators (SARMs),

3023

Selective estrogen response downregulators

(SERDs), 613t

Selective estrogen response modulators (SERMs)

actions of, 512f, 515, 2889, 3203

for breast cancer, 613t, 617, 620

for breast cancer prevention, 614

in osteoporosis management/prevention, 3203

Selective IgG2 deficiency, 2717

Selective serotonin reuptake inhibitors (SSRIs)

adverse effects of, 3542t, 3549

osteoporosis, 3196

peptic ulcer disease, 2440

SA node dysfunction, 1875t

serotonin syndrome. See Serotonin syndrome

sexual dysfunction, 3058, 3549

SIADH, 343

for dementia, 194

for depression, 3542t, 3549, 3549f

for depression in AD, 3375

for depression in terminally ill patient, 82–83

drug interactions of, 478, 3543t, 3549

for functional dyspepsia, 297

genetic variations in response to, 478

for IBS, 2495, 2496t

for inappropriate sinus tachycardia, 1892

overdosage/poisoning with, 3595t

for pain, 99

for panic disorder, 3541

pharmacology of, 3549

for premature ejaculation, 3057

for PTSD, 3546, S7

for vertigo, 162, 162t

Selegiline

adverse effects of, 3542t

for depression, 3542t, 3549

overdosage/poisoning with, 3590t

for PD, 175, 3395, 3396t

Selenium, 493, 682, 2520t, 2533, 2533t

Selenium deficiency, 1965, 2533t, 2534

Selenium sulfide, 380t, 381, 387t, 389t

Selenocysteine, 2533

Selenosis, 2534

Selexipag, 2127, 2129t

Seligman’s disease (alpha heavy chain disease), 877

Selinexor, 549t, 552, 847, 874t, 875

Sella chordomas, 2906–2907

Sellar mass lesions, 2902

clinical features of, 2902–2903, 2902t

histologic investigation of, 2904

hypogonadotropic hypogonadism and, 3016

hypothalamic. See Hypothalamic disease/masses

laboratory investigation of, 2904, 2904t

mass effects of, 2902, 2903f

MRI in, 2903–2904, 2904f

ophthalmologic evaluation in, 2904

pituitary. See Pituitary tumors (adenomas)

Selpercatinib, 513t, 544, 546t, 607, 2990

Selumetinib, 707

SEMA3A gene mutations, 3015t

Semaglutide, 2623, 3110t, 3111

Semantic dementia, 202

Semantic paraphasia, 196

Semantic primary aphasia, 199

Semen analysis, 3011, 3051

Seminiferous tubules, 2907f, 3009–3010

Seminoma. See also Testicular cancer

pathology of, 690

risk classification of, 691, 693t

staging of, 692–693f

treatment of, 691–694, 692–694f

Semliki Forest virus, 1625t

Senataxin, 3412, 3413t

Sendai virus, 3299

Senescence. See also Aging

carcinogenesis and, 508t, 510–511

definition of, 518

negligible, 3733, 3734f

Senescence-associated secretory phenotype (SASP),

3735

Senile purpura, 453, 910

Senior-Loken syndrome, 2351t, 2355

Senna, 79, 80t, 302, 307

Sennetsu fever, 1437

Senning (atrial switch) procedure, 2013–2014,

2016f, 2016t

Sensation

abnormalities of, 168

in brainstem lesions, 173

in cortical lesions, 173

falls and, 177

in focal seizures, 173

localization of, 172

in nerve and root lesions, 172

psychogenic causes of, 173

in spinal cord lesions, 172–173

in thalamic lesions, 173

treatment of, 173

anatomy of, 169, 170f, 171f

examination of, 169

cortical, 171–172

primary, 169–171, 170t

quantitative sensory, 172

positive and negative phenomena, 168–169

terminology in, 169

Sensitivity, 24–25, 493, 494t, S10

Sensitization, 91, 2719

Sensory ataxia, 169, 175, 176t

Sensory balance training, 177

Sensory dissociation, 172

Sensory examination, 3281

Sensory neuropathy. See Peripheral neuropathy

Sentinel bleeds, subarachnoid, 3354

Sentinel lymph node biopsy, 583–584, 617, 618

Seoul virus, 1628t, 1642

Sepsis/septic shock

anaerobic bacteremia and, 1354

approach to the patient, 2244

without clear focus, 975t, 976

clinical features of, 975t, 976–978, 2242t,

2244–2245

clostridial, 1221t, 1225

complications of

AKI, 2245

encephalopathy, 2273

hypoglycemia, 3133

hypothermia, 3631

hypovolemia, 341

intracranial hemorrhage, 3351

neurologic, 180–181, 2245

renal, 2297–2298, 2303t

in critically ill patient, 2222

definition of, 2241–2242, 2242t

diagnosis of, 2245–2246, 2245f, 2246f

epidemiology of, 2242

etiology of, 975t, 976, 2242

global considerations in, 2242

hemodynamic patterns in, 2254t

pathogenesis of, 1262, 2242–2244, 2243f

in pneumococcal infections, 1176

post-splenectomy, 556

prevention of, 2249

prognosis of, 2249

puerperal, 1194, 1242

treatment of, 975t, 2247t

adjunctive, 2248t, 2249

antibiotics, 947t, 2241, 2248t

de-escalation of, 2249

early, 2246–2247

empirical, 975t

monitoring, 2248

organ function support, 2248–2249

vasopressin, 2241

Septal ablation, A11

Septal panniculitis. See Erythema nodosum

Septic arthritis. See Infectious (septic) arthritis

Septic diskitis. See Osteomyelitis, vertebral

Septic emboli, 1025, 1025f, A1, A5

Septicemia

hemolysis in, 786t

meningococcal. See Meningococcemia

in plague, 1322

respiratory alkalosis in, 368

in yersiniosis, 1327

Septic thrombosis, 1124

Septic thrombosis, intracranial, 978–979

Seqirus, 3603, 3605

SERCA2a, 1952

Serelaxin, 1944, 1946t

Serine kinase receptors, 2885t, 2887f, 2888–2889

Serine metabolism disorders, 3269t

Serine protease autotransporters (SPATEs), 959

SERMs. See Selective estrogen response modulators

(SERMs)

Serotonin (5-HT)

in carcinoid syndrome, 668, 668f

in IBS, 2492

in migraine, 3357

pain and, 92f

Serotonin norepinephrine reuptake inhibitors

(SNRIs), 194, 3542t

Serotonin (5-HT1B/1D) receptor agonists (triptans),

294, 3357, 3362t, 3363

Serotonin (5-HT1F) receptor agonists (ditans),

3362t, 3364

Serotonin (5-HT4

) receptor agonists, 294, 294t,

2495, 3357

Serotonin (5-HT3

) receptor antagonists

adverse effects of, 293–294

INDEX

for IBS, 2495 I-199

for nausea and vomiting, 80, 115, 294, 294t, 554

Serotonin release assay, 931

Serotonin syndrome

clinical features of, 3549, 3595t

etiology of, 3408, 3595t

mechanism of, 3595t

with SSRIs, 3549

treatment of, 3588, 3595t

SERPINA1, 2184, 3849

SERPINF1/PEDF gene mutations, 3221, 3222t

SERPINH1 gene mutations, 3221, 3222t

Serra Norte virus, 1629t

Serratia spp. infections, 1273

antibiotic resistance in, 1273

in cancer patient, 558t

clinical features of, 1273

diagnosis of, 1273

ecthyma gangrenosum, 399

epidemiology of, 1262, 1273

treatment of, 1273

Sertoli-Leydig tumor, 697

Sertraline

adverse effects of, 3542t, 3549

for depression, 82, 487, 3474, 3542t, 3549

for obsessive-compulsive disorder, 3546

for panic disorder, 3542

for phobic disorders, 3544

for PTSD, 3546

Serum albumin. See Albumin, serum

Serum ascites-albumin gradient (SAAG), 323

Serum bilirubin. See Bilirubin, serum

Serum-binding proteins, 2886–2887

Serum creatinine. See Creatinine, serum

Serum ferritin. See Ferritin, serum

Serum proteins, electrophoresis of, 866, 868f

Serum sickness

with antivenom, 3599, 3603

with ATG treatment, 797

clinical features of, 408, 416t, 2816, 3599

immunologic mechanisms of, 473, 2803

pathogenesis of, 408, 411

treatment of, 797, 3599

urticaria/angioedema in, 394, 2723

urticaria-like eruptions in, 139t, 143

Serum sickness–like illness, 394, 408, 416t

“Setting sun” sign, 231

Sevelamer, 2314, 3161

Seven transmembrane helix family, 2688. See also G

protein–coupled receptors (GPCRs)

Severe acute respiratory syndrome (SARS)

clinical features of, 980, 1507

diagnosis of, 964

epidemiology of, 980, 1133, 3714

etiology of, 980, 1507

genome sequence of, 964

imaging in, A12

Severe acute respiratory syndrome coronavirus 2.

See SARS-CoV-2

Severe combined immunodeficiency (SCID)

clinical features of, 2713, S8

diagnosis of, 2713

etiology of, 2713–2714

genetic considerations in, 2688

HCT in, 898, 901, 902t

T cell differentiation and, 2713f

treatment of, 3686–3687, 3686t

Severe congenital neutropenia (SCN), 444,

2710–2711, 2710f, S8

Severe fever with thrombocytopenia syndrome,

1625t, 1643

Severe sepsis, 2241

Severity-of-illness (SOI) scoring systems, 2217,

2217t, 2218t

Sex chromosome(s), 3640, 3651

Sex chromosome disorders, 2998t

Klinefelter syndrome. See Klinefelter syndrome

ovotesticular DSD, 3001–3002, 3001t

Turner syndrome. See Turner syndrome

45,X/46,XY mosaicism (mixed gonadal

dysgenesis), 3001, 3001t

Sex cord tumors, ovarian, 697

Sex development, 2997f, 2998–2999, 2999f, 3000f

Sex development disorders. See Disorders of sex

development (DSDs)

Sex differences, 3063, 3069. See also Men’s health;

Women’s health

Sex headache, primary, 3368

Sex hormone-binding globulin (SHBG), 3008,

3009f, 3030, 3041, 3061

Sex-influenced trait, 3651

Sex-limited trait, 3651

Sex reversal, 3645t, 3649, 3651

Sex therapy, 3061

Sexual abuse, 326, 1238, 1239, 3058, 3758t

Sexual arousal disorder, female, 3062

Sexual assault, 3068, S7

Sexual dysfunction

alcohol use and, 3559

female, 3061–3063, 3061t, 3125

incidence of, 3057

male, 3072. See also Erectile dysfunction (ED)

in MS, 3463, 3474

SSRI-related, 3549

Sexually transmitted infections (STIs), 1078. See

also specific infections

cervical cancer and, 698

in children, 1238

circumcision and reduced risk of, 1533–1534

classification of, 1078–1079, 1079t

epidemiology of, 1079–1080, 1079t

etiology of, 1080t

global considerations in, 1079, 1089

HIV transmission and, 1533

in LGBT people, 3078

in older adults, 3743–3744

partner notification in, 1093

prevention and control of, 1092, 1092f, 3077

risk assessment for, 1080, 1081t, 3077

screening for, 1092–1093, 3077

Sexual orientation, 3079, 3079t

Sexual pain disorder, 3062

Sexual response, physiology of, 3055–3057, 3056f,

3062

Sez6I2 antibodies, 729t, 734

Sézary’s syndrome, 384, 424, 850, A6

SF1 (steroidogenic factor 1), 2956, 2999

SF1 gene mutations, 2999, 3003t, 3005t, 3015t

SF3B1 gene mutations, 799, 800, 835–836, 836t

SGCE gene mutations, 3403, 3403t

S genes, of HBV, 2563, 2564f

SH2B1 gene mutations, 3084t, 3085

Shadow plaques, 3464

Shah-Waardenburg syndrome, 388, 3645t

Shaking rigors, 3633

Shapiro’s syndrome, 3631

Shared epitope, 2754

Shark bite-wound, 1127t

Shawl sign, 2820, 2820f

SHBG (sex hormone-binding globulin), 3008,

3009f, 3030, 3041, 3061

Sheehan’s syndrome, 2897

Shellfish poisoning, 3311, 3606–3607

Shelterin, 3681f

Shewanella spp. infections, 1248t, 1249

Shift cells, 435, 435f

Shift work, 3801t

Shift work sleep disorder, 214, 3806

Shiga toxin–producing E. coli (STEC), 1061, 1066,

1266t, 1268. See also Escherichia coli

infections, intestinal

Shigella spp.

antibiotic resistance in, 1300–1301

characteristics of, 948, 950, 1298

genomic signatures of, 1298

infectivity of, 1299, 1299f

laboratory identification of, 1300, S11

mTOR reactivation by, 958

NF-κβ inhibition by, 956

niche, 949, 949t

survival in cytosol, 953

survival in vacuole, 952

Shigella spp. infections, 1298

clinical features of, 300t, 1064t, 1299–1300

complications of, 301, 1240, 1301

diagnosis of, 1065, 1300, S11

epidemiology of, 1298–1299

global considerations in, 1298–1299

in HIV infection, 1568

vs. IBD, 1300

pathogenesis of, 1299, 1299f

prevention of, 1302

reactive arthritis and, 2797

treatment of, 1301, 1301t

Shingles. See Herpes zoster (shingles)

Shingrix, 1482

Shivering, 130, 3631

Shock

in acute pancreatitis, 2659

approach to the patient, 2218–2220, 2219f, 2235

cardiogenic. See Cardiogenic shock

classification of, 2236–2237, 2236t

cyanosis in, 274

definition of, 2235

distributive, 2236, 2236t

ECG in, 2239

effect on drug concentration and response, 471

history in, 2237–2238

hypotension in, 2219

hypovolemic. See Hypovolemic shock

hypoxia in, 273

laboratory evaluation of, 2238–2239, 2239t

lactic acidosis in, 361

mixed, 2237

obstructive, 2236t, 2237

pathophysiology of, 1229, 2235

physical examination in, 2238

point-of-care ultrasound in, 2239–2240

respiratory failure in, 2220–2221

septic. See Sepsis/septic shock

stages of, 2237

treatment of

antibiotics, 2241

initial, 2240

mechanical ventilation, 2220, 2220f

oxygenation and ventilation support, 2241

principles of, 2237, 2238t

vasopressor and inotropic support, 2240–2241

volume resuscitation, 2240

undifferentiated, 2237

Shock index (SI), 2238

Shockwave intravascular lithotripsy, A11

Shohl’s (sodium citrate) solution, 361, 364, S1

Shokwe virus, 1627t

Shone’s complex, 1979

Short-bowel syndrome, 361, 2465, 2530

INDEX

I-200 Short-chain fatty acids, 2460, 2461, 2463, 2468t,

3700

Short QT syndrome, 1925

Short stature, 2899, 3001

Short tandem repeats, 3656

Shotgun sequencing, 964

Shots Heard Round the World, 16

Shoulder

anatomy of, 2878f

bursitis of, 2878

“frozen,” 2879

pain in, 129, 2849–2850, 2849f

tendinitis of, 2878–2879

Shprintzen-Golberg syndrome, 3229

Shuni virus, 1628t

Shunt

intracardiac, 1863–1864

pulmonary, 273, 274, 2136, 2137f

Shwachman-Diamond syndrome, 444, 794

Shy-Drager syndrome. See Multiple system atrophy

(MSA)

SI (shock index), 2238

SIAD. See Syndrome of inappropriate antidiuresis

(SIAD)

Sialadenitis, 236, 261

Sialidosis, 3256t

Sialolithiasis, 261, A3

Siberian tick typhus, 134t

Sib pair analysis, 3659t

Sick euthyroid syndrome, 2930, 2944, 3633

Sickle cell anemia, 757t

Sickle cell crisis

clinical features of, 759, 2872

hyperbilirubinemia in, 317

splenic infarction in, 460

treatment of, 760

Sickle cell disease, 757

clinical features of

hand-foot syndrome, 2872

musculoskeletal, 2872–2873, 2872t

nephropathy, 2336t, 2348, 2362, 2367

priapism, 3057

pulmonary hypertension, 2127

splenic abscess, 1059–1060

stroke, 3342

testicular atrophy, 3017

complications of, 758, 759t

acute chest syndrome, 760

acute painful episodes, 758, 760. See also

Sickle cell crisis

autosplenectomy, 463

cholestasis, 320

folate deficiency, 773

jaundice, 316

leg ulcers, 760

osteonecrosis, 760

stroke, 759t

diagnosis of, 757–758, 757t, 759f, A16

genetic considerations in, 3649, 3653, 3814,

3815f

genetic testing for, 3659

genotypes of, 757, 757t

high-altitude travel and, 3622

malaria resistance and, 1723, 3657

origin, spread, and epidemiology of, 757

pathophysiology of, 757, 757t, 758f

peripheral blood smear in, 427f

reticulocyte index in, 438

screening, 761

systems biology applied to, 3814, 3815f,

3816f

treatment of, 760–761, 898, 901, 3687

Sickle cell trait (HbAS), 757t, 760

Sickle thalassemia syndrome, 757t

Sick sinus syndrome, 1874, 1875, A8

Sideroblast(s), 436

marrow, 749f, 750

ringed, 438, 799f, A6

Sideroblastic anemia

diagnosis of, 751t

in myelodysplasia, 438

X-linked, 3238f, 3238t, 3246

Sievert (Sv), S5

Sigmoidoscopy

for colorectal cancer screening, 39t, 40, 495t,

497, 640

in constipation, 307

in diarrhea, 301, 306

in gastrointestinal bleeding, 314

indications for, 2390

in ulcerative colitis, 2475

Sigmoid resection, 2499–2500, 2500f

Sigmoid volvulus, 2410, 2414f, 2509, 2512

Signal recognition protein (SRP54), 2696t

Signal transduction pathways

in cancer cells, 505, 505t, 511–516, 512f, 518f

membrane receptor families and, 2885t

in psychiatric disorders, 3537–3538

“Signet-ring” sign, 2174

Sign of Leser-Trelat, 390

Sildenafil

actions of, 3056, 3057f

adverse effects of, 3060, 3060t

characteristics of, 3060t

contraindications to, 3060, 3060t

development of, 472

drug interactions of, 689

for erectile dysfunction, 3059–3060, 3474

for heart failure, 1941

interaction with nitrates, 2048, 2057

for lower urinary tract symptoms, 689

for pulmonary arterial hypertension, 2128,

2129t, 2786

for Raynaud’s phenomenon, 2114, 2785

Silent mutation, 3648f

Silent (painless) thyroiditis, 2944

Silibinin, 2586

Silica, 2167t, 2168

Silica exposure, 2168–2169, 2169f, 2340, 2739

Siltuximab, 574, 2708t

Silver, skin deposits, 391

Silver sulfadiazine, S4

SIM1 gene mutations, 3083f, 3084t, 3085

Simeprevir, 1468t, 1469

Simethicone, 297, 2495

Simian immunodeficiency virus (SIV), 1528f

Simple goiter, 2946

Simple systems, 3813

Simplicity heuristic, 22

Simultanagnosia, 200f, 201, 230

Simultaneous bilateral stimulation test, 200

Simvastatin. See also Statins

adverse effects of, 905t, 2847t, 3142t

drug interactions of, 1703t

genetic variations in response to, 475, 477t

for lipoprotein disorders, 3142t

Sindbis virus infection, 1625t, 1634

Sinecatechins, 381, 1503

Singapore

hospital funding in, 44

patient care financing in, 43–44, 43t

primary care access in, 45

Single-balloon enteroscopy, 2391

Single-minded 1. See SIM1 gene mutations

Single-nucleotide polymorphisms (SNPs)

in breast cancer, 614

in CFTR gene, 3643f

definition of, 960t

drug response and, 475, 475t

effects of, 3656

frequency of, 3641

haplotype, 3641, 3643f, 3649

in undiagnosed disease, 3852t

Single photon emission computed tomography

(SPECT). See SPECT

Single pulse transcranial magnetic stimulation,

3362t, 3363t, 3364, 3365t

Single-stranded DNA viruses, 1456

Single ventricle physiology, 2016, 2018f

Sin Nombre virus, 1629t, 1640

Sinoatrial (SA) conduction time (SACT), 1875

Sinoatrial (SA) nodal artery ischemia and

infarction, 1877

Sinoatrial (SA) node, 1824, 1824f, 1868, 1873, 1874f

Sinoatrial (SA) node disease/dysfunction, 1874

diagnosis of, 1874–1875, 1874f, 1876f

reversible causes of, 1875, 1875t, 1878

subtypes of

carotid sinus hypersensitivity and neurally

mediated bradycardia, 1877–1878

chronotropic incompetence, 1875–1877

ischemia and infarction, 1877

sinus node exit block, 1874f, 1875, 1877f

sinus node fibrosis, 1877

tachycardia-bradycardia syndrome, 157, 1875,

1877f

treatment of, 1878–1880, 1879f, 1879t. See also

Pacemaker

Sinus bradycardia, 2063, A7

Sinusitis

actinomycotic, 1341

acute, 251

allergic fungal, 1679

anaerobic bacterial, 1351

antibiotic prescribing criteria for, 251,

252t

Aspergillus, 561, 1675t, 1679, A16

brain abscess and, 1018

chronic, 252, 1351

in cystic fibrosis, 2176

differential diagnosis of, 251

ear pain in, 249

H. influenzae, 1242

in HIV infection, 1565

hospital-associated, 251

maxillary, 261

M. catarrhalis, 1245

mucormycosis, A16

Nocardia, 1337, 1339t

olfactory dysfunction in, 235, 237

pneumococcal, 1175

recurrent, 251

subdural empyema and, 1120

Sinus node, 1891, 1891f

Sinus node fibrosis, 1877

Sinus node recovery time (SNRT), 1875

Sinusoidal obstructive syndrome, 899

Sinus pause, 1874f, 1875

Sinus rhythm, 1891, 1891f

Sinus tachycardia, 1891

ECG in, A7, A8

epidemiology of, 1870

evaluation and treatment of, 1892f

inappropriate, 1888t, 1891–1892

physiologic, 1891, 1892f, 1892t

in pulmonary edema, 2256

INDEX

in pulmonary embolism, 105 I-201

in thyrotoxicosis, 2939

Siponimod, 3473

Sipuleucel-T, 536f, 538, 688

Sirolimus (rapamycin)

actions of, 512f, 2328t, 2825t, 3535

adverse effects of, 2328, 2328t, 2330, 2365,

2637–2638, 3145

for Castleman’s disease, 33

in drug-eluting stents, 2067, 2068f

drug interactions of, 1703t

for immunosuppression, 1974t, 2328, 2328t,

2637–2638, 2825t

for Kaposi’s sarcoma, 1143

for lifespan enhancement, 3738

for polycystic kidney disease, 2353

for reducing skin cancer risk in transplant

recipients, 421

structure of, 3738f

for subependymal giant cell astrocytomas, 708

SIRS (systemic inflammatory response syndrome),

2245f

SIRT1 agonist. See Resveratrol

Sirtuins, 3734, 3735, 3735f

Sister Mary Joseph’s nodule, 318, 630, 658

Sister of p-glycoprotein (bile salt excretory protein),

2562

Siti (endemic syphilis), 1415t, 1416, 1416f

Sitosterolemia, 3139t, 3141–3142

SIV (simian immunodeficiency virus), 1528f

Sixth disease. See Exanthem subitum (roseola)

Sixth nerve palsy, 3354

Sjögren’s syndrome, 2787

autoimmune diseases associated with, 2787

clinical features of, 2788–2789, 2788t, 2789t

cutaneous, 394, 399

extraglandular, 2788t

lymphoma, 2789

myelopathy, 3451

nephritis, 2281

neuropathy, 3483, 3489

ocular, 220, 2788

renal, 2358, S1

trigeminal neuropathy, 3439

vasculitis, 2788–2789

xerostomia, 261, 2788

definition of, 2787

diagnosis of, 2788t, 2789, 2789t, 2790f

differential diagnosis of, 2788t, 2789, 2789t

epidemiology of, 2787

in HCV infection, 2604

in HIV infection, 1573

pathogenesis of, 2696t, 2788

in rheumatoid arthritis, 2753

vs. rheumatoid arthritis, 2759

in SLE, 2743

treatment of, 2789

SJS. See Stevens-Johnson syndrome (SJS)

Skeletal dysplasias, 3228

Skeletal maturation, somatic growth and, 2899

Skerljevo (endemic syphilis), 1415t, 1416, 1416f

Skew deviation, 231

Skin

actinically damaged, 386

age-related changes in, 419

in cardiovascular system examination, 1815–1816

color of, 418

complete examination of, 496t, 498

in cyanosis, 273–274

disorders/lesions. See Skin disorders/lesions

Fitzpatrick classification of, 418, 418t

in malnutrition, 2536t

microbiota of, 3693, 3693f

structural components of, 1034–1035, 1034f

ultraviolet radiation effects on. See Sun exposure

yellowing, 315. See also Jaundice

Skin biopsy

in dermatomyositis, 2821

in Leishmania spp. infections, S12

in leprosy, 1388

in peripheral neuropathy, 3483

technique for, 372

in vasculitic syndromes, A14

Skin blister assay, in vivo, 449

Skin cancer, 578

in CLL, 837

genetic considerations in, 500t

global considerations in, 420

melanoma. See Melanoma

nonmelanoma, 419, 586, 589, A5

basal cell carcinoma. See Basal cell carcinoma

extramammary Paget’s disease, 589

Kaposi’s sarcoma. See Kaposi’s sarcoma

Merkel cell carcinoma. See Merkel cell

carcinoma

pathophysiology and etiology of, 586

risk factors for, 420

squamous cell carcinoma. See Squamous cell

carcinoma, skin

in transplant recipient, 420–421, 1146,

2330

paraneoplastic syndromes in, 722t

prevention of, 588–589

screening for, 496t, 498

self-examination for, 491

sun/UV exposure and, 420, 491, 491t,

586

UV light therapy and, 378

Skin disorders/lesions. See also Rash; specific

diseases

approach to the patient, 369

burrowing, 1037

cancer. See Skin cancer

crusts, 1034f, 1035, 1036t

descriptions of, 369t

diagnosis of, 372–374

distribution of, 369, 370t, 371, 372f

drug-induced. See Drug-induced illness; specific

drugs

eschars, 1036f, 1037

esophageal manifestations of, 2434

folliculitis. See Folliculitis

history in, 371

immunologically mediated, 400, A5

induration, 2771, 2772t

infections, 1034. See also specific infections

anaerobic bacterial, 1353–1354

in cancer patient, 556

diagnosis of, 1038–1039

parasitic, 1699t

pathophysiology of, 1034–1035, 1034f

treatment of, 948t, 1039–1040, 1039t

light-induced. See Photosensitivity diseases

as manifestations of internal/systemic disease,

383, A5. See also specific diseases

acneiform eruptions, 386

alopecia, 384–386, 387t. See also Alopecia

erythroderma, 384, 384t, 385t

exanthems, 392–393, 393t. See also Rash

figurate lesions, 384–385, 387t

hyperpigmentation, 390–391, 390t

hypopigmentation, 386–390, 388t, 389t

papulosquamous lesions, 383, 383t

purpura, 133, 398

pustular lesions, 386

telangiectasias, 386, 388t

urticaria, 394–395

morphology of, 370t

nodules, 1035, 1036f, 1037

papules, 1036f, 1037

papulonodular lesions. See Papulonodular

lesions

physical examination in, 371

purpura. See Purpura

shape of, 371

smallpox vaccination and, 383

telangiectasias. See Telangiectasia(s)

ulcers. See Cutaneous ulcers

vesicles/bullae. See Vesicles/bullae

Skin snip, S12

Skin tag (acrochordon), 371t, 372f, 391, 2480

Skull fractures, 3457

SLAMF7, 2708t

Slapped-check disease. See Erythema infectiosum

SLC01B1 gene, 475, 477t, 478

SLC2A1 gene mutations, 779t, 781, 3308t, 3317

SLC3A1 gene mutations, 2293

SLC4A1 gene mutations, 352, 779t, 781

SLC5A1 gene mutations, 2463

SLC7A7 gene, 3274

SLC7A9 gene mutations, 2293

SLC12A3 gene mutations, 2293

SLC22A5 gene mutations, 2472t

SLC22A12 gene, 3252

SLC25A13 gene, 3274

SLC30A8 gene, 480

SLC35C1 gene mutations, 445

SLC39A13 gene mutations, 3226t, 3227

SLC/TCA-4/Exodus 2, 2683t

SLE. See Systemic lupus erythematosus (SLE)

SLED (slow low-efficiency dialysis), 2308

Sleep, 204

age-related changes in, 205, 205f

AV conduction block during, 1883,

1883f

behavioral changes in, 207

insufficient, 205, 209

neuroanatomy of, 205–206

neurochemistry of, 205–206

NREM, 204–205

optimal amounts of, 11

organization of, 205

physiology of, 204–207

REM, 204–205, 205f

states and stages of, 205, 207

Sleep apnea, 209. See also Obstructive sleep apnea/

hypopnea syndrome (OSAHS)

in acromegaly, 2912

central, 209, 1936, 1939, 2207f, 2209

complex, 2209

daytime sleepiness and, 209

heart failure and, 1939, 1950

mixed, 209

SA node dysfunction in, 1875

Sleep bruxism, 213

Sleep deprivation, 205, 209, 2891, 3088, 3809–3810

Sleep disorder(s), 207

approach to the patient, 207–208

circadian rhythm, 213–214

complementary and integrative therapies for,

3788

costs of, 204

daytime sleepiness in, 208–209, 208t

driving rights and, 209

epidemiology of, 11–12, 204

fatigue and, 163

INDEX

I-202 Sleep disorder(s) (Cont.):

in fibromyalgia, 2868–2869

at high altitudes, 3620

insomnia. See Insomnia

narcolepsy. See Narcolepsy

in older adults, 3754–3755, 3757t

parasomnias, 212–213

in PD, 3398

periodic limb movement disorder, 212

restless legs syndrome, 212

screening for, 12

Sleep enuresis, 213

Sleep hygiene, 11, 84, 210–211, 211t, 3757t

Sleepiness, vs. fatigue, 208

Sleeping sickness. See Human African

trypanosomiasis

Sleep paralysis, 208t, 209

Sleep terrors, 213

Sleep-wake cycle, 205–206, 205f, 3803

Sleepwalking, 212–213

SLGT2 (sodium-glucose co-transporter 2), 1934

SLGT2 (sodium-glucose co-transporter 2)

inhibitors, 1934–1935, 1942, 1948–1949,

1948t, 3110t, 3113, 3746t

Sliding filament model, for muscle contraction,

1804–1805

“Slip” (error), 51

“Slipping clutch” syndrome, 175

Slit-skin smear, 1388

Slovenia Republic, health system financing in, 43t

Slow acetylators, 478

Slow low-efficiency dialysis (SLED), 2308

SLPI (secretory leukocyte protease inhibitor), 1535

Sly syndrome, 3260

SMA (spinal muscular atrophy), 3413t, 3415, 3686t,

3688

SMAC, 518, 518f

SMAD2 gene mutations, 3229, 3229t

SMAD3 gene mutations, 2102, 3229, 3229t

SMAD4 gene mutations, 499f, 503t, 653, 654

Smads, 2888

SM-AHNMD (systemic mastocytosis associated

with clonal hematologic non–mast cell

lineage disease), 2729

Small airways disease. See Chronic obstructive

pulmonary disease (COPD)

Small-bowel bacterial overgrowth, 295, 303, 306,

2461, 2781, 2786

Small-bowel ultrasound, 2477

Small-cell carcinoma, bladder, 677, 678f. See also

Bladder cancer

Small-cell lung cancer. See Lung cancer, small-cell

Small intestine

absorption and secretion in, 749

benign tumors of, 636

bleeding from, 312–313

blood supply to, 2506, 2506f

double-balloon enteroscopy of, 2391, 2394f

endoscopy of, 2390–2391. See also Capsule

endoscopy

fluid absorption and secretion in, 298–299, 299f

functions of, 2381

ischemia of. See Intestinal ischemia

malignant tumors of, 635

motility of, 298t, 299

mucosal biopsy of, 2465f, 2468–2469, 2469t

neuroendocrine tumors of, 635–636, 666–667,

666f. See also Neuroendocrine tumors

(NETs)

nutrient digestion and absorption in, 2458, 2462

obstruction of, 109, 292, 2508. See also Intestinal

obstruction

resection of, 2532

in systemic sclerosis, 2781–2782, 2781t

Small-molecule inhibitors, 518f, 526

Small noncleaved cell lymphoma. See Burkitt’s

lymphoma

Smallpox

in bioterrorism, S3

clinical features of, 138t, 1493, S3

diagnosis of, S3

differential diagnosis of, 142–143, 1481

eradication of, 982

hemorrhagic, S3

incidence pre- and postvaccine, U.S., 981t

malignant, S3

prevention of, S3

skin manifestations of, 138t, 142–143, 1035, A1, S3

treatment of, 1464, S3

Smallpox vaccine, 383, 1493, 1494, S3

Small-vessel stroke, 3341, 3342f. See also Ischemic

stroke

SMARC gene mutations, 3794

“Smart pumps,” 52

SMCHD1 gene mutations, 3527 153Sm-EDTMP, 688

Smell. See Olfactory disorders; Olfactory system

Smith-Lemli-Opitz syndrome, 2970t, 3003t

SMN1 gene mutations, 3688

SMOCs, 955, 956f, 957

SMO gene mutations, 588

SMO inhibitors, 588

Smoke inhalation, 2171

Smokeless tobacco, 257, 260t, 490, 590

Smoking. See also Smoking cessation

asthma and, 2152

cancer and, 3563t, 3564

bladder, 677

cervical, 698–699

colorectal, 639

esophageal, 626

head and neck, 590

lung, 594

oral, 257

pancreatic, 657

renal cell carcinoma, 673

skin, 586

cardiovascular disease and, 3563t, 3564

global considerations in, 1813

ischemic heart disease, 2040

peripheral artery disease, 2109

stroke risk, 3342t

deaths related to, 3563

drug interactions with, 3564, 3565t

erectile dysfunction and, 3057

global considerations in, 3712

hemoglobin elevation and, 432

IBD and, 2470

infertility and, 3052

interstitial lung disease and, 2192, 2194–2195

in Leber hereditary optic neuropathy, 3678

leukoplakia and, 260t

of lower tar and nicotine cigarettes, 3565–3566

meningococcal infections and, 1227, 1228

neutrophil counts in, 444

osteoporosis and, 3196

pancreatitis and, 2665

passive exposure to

in children, 2152, 3564

COPD and, 2184

lung cancer and, 490, 594, 3564

respiratory disease and, 2132, 2172

peptic ulcer disease and, 2440

polycythemia in, 439

in pregnancy, 3564

prevalence of, 3563

prevention of, 3566

respiratory disease and, 1511, 2132, 3563t, 3564

COPD, 2181–2182, 2183, 2183f

rheumatoid arthritis and, 2755

second malignancy and, 491

in women, 3068

Smoking cessation

after lung cancer diagnosis, 595

complementary and integrative therapies for,

3786

in COPD, 2181, 2186

global considerations in, 1813, 3712

in ischemic heart disease treatment, 2040

life expectancy increase following, 38t

in peripheral artery disease, 2109

pharmacologic therapy for, 595, 2186, 3566,

3566t

physician intervention in, 3566, 3566t

preoperative, 3772t

in preventive care, 13

stages of, 490

success rates of, 490, 3566

in thromboangiitis obliterans, 2110

Smoothened gene, 419

Smooth muscle, vascular, 1801f, 1802, 1803f

Smudge cells, 425

Snakebites, 3596

clinical features of, 788, 3596, 3597f

complications of, 3601

epidemiology of, 3596, 3597f

field management of, 3597–3598

global considerations in, 3601–3602

hospital management of, 3598–3601, 3600–3601t

morbidity and mortality from, 3601

snake identification, 3596

wound infections following, 1125, 1126, 1127t

SNAREs, 953, 1215

SNCA gene mutations, 3390–3391, 3391t

Snellen chart, 216, 216f

Snowshoe hare virus, 1627t

SNPs. See Single-nucleotide polymorphisms (SNPs)

SNRIs (serotonin norepinephrine reuptake

inhibitors), 194, 3542t

SNRPN gene, 2897, 3653

SNRT (sinus node recovery time), 1875

SNS (Strategic National Stockpile), S3

Sochi virus, 1628t

Social distancing, 1133

Social history, 2

Social jetlag, 215, 3806

Social justice, 6

Social media, 16, 70

Social phobia, 3544, 3545

SOD1, 3297, 3298, 3302, 3412, 3413t, 3414,

3415

SOD3, 2181

Sodium

blood pressure regulation and, 2072–2073

in CKD, 2312–2313

fractional excretion of, 334t

hormonal regulation of, 2295–2296, 2295f

intake, hypertension and, 2072

recommended intake of, 2520t

renal absorption/excretion of, 339f, 340, 340f,

2290–2291f, 2293–2296, 2295f, S1

urine levels, in AKI, 334, 334t

Sodium bicarbonate

adverse effects of, 2443

for alcohol-induced acidosis, S1

for hyperkalemia, 355

INDEX

for prevention of contrast-induced nephropathy, I-203

1860

for uric acid nephropathy, 3252

for ventricular arrhythmias in overdose/

poisoning, 3590t, 3591t

Sodium channels

cardiac, 1867, 1868f

muscle, 353, 3519, 3530

in seizure initiation, 3310

Sodium citrate (Shohl’s) solution, 361, 364, S1

Sodium current, in cardiac action potential, 1868f

Sodium diarrhea, congenital, 303

Sodium docusate, 80t

Sodium ferric gluconate, 752

Sodium-glucose co-transporter 2 (SLGT2), 1934

Sodium-glucose co-transporter 2 (SLGT2)

inhibitors

for diabetes mellitus, 3110t, 3113, 3746t

for heart failure, 1934–1935, 1942, 1948–1949,

1948t

for NAFLD, 2623

Sodium hippurate, 1195

Sodium hypochlorite, 375, S4

Sodium iodide symporter (NIS), 2696t, 2927, 2934t

Sodium ipodate, 2930t

Sodium loading test, 2965

Sodium modeling, in dialysis, 2321

Sodium nitrite, S4

Sodium phosphate enema, 80t

Sodium picosulfate, 308

Sodium polystyrene sulfonate (SPS), 355

Sodium restriction, 323, 2082, 2082t

Sodium retention, 276, 276f

Sodium stibogluconate, 1701, 1745, 1746t, 1748

Sodium sulfacetamide, 383

Sodium thiosulfate, S4

Sodium tyropanoate, 2930t

Sodium valproate. See Valproate/valproic acid

Sodoku (rat-bite fever), 135t, 1125

SOFA score, for sepsis, 2217–2218, 2217t, 2245f,

2246, 2246f

Sofosbuvir

actions of, 1467, 2607

for chronic HCV infection, 1467, 1468t

with daclatasvir, 1468–1469, 2608t, 2609–2610

with ledipasvir, 1467, 1468t, 2607, 2608t

with velpatasvir, 1467–1468, 1468t, 2608–

2609t, 2610–2611

with velpatasvir and voxilaprevir, 1468, 1468t,

2608t, 2611

pharmacology of, 1467, 2607

Soft (argasid) tick, 3609. See also Tick(s)

Soft tissue, 1034f

Soft tissue infections. See also Cellulitis

A. baumannii, 1277

actinomycotic, 1342

anaerobic bacterial, 1353–1354

deep. See Myositis; Necrotizing fasciitis

enterococcal, 1200

treatment of, 1039–1040, 1039t

V. vulnificus, 1310

in war veterans, S6

Soft tissue sarcomas, 712

classification of, 712–713

diagnosis of, 713

epidemiology of, 712

genetic considerations in, 712

incidence, 484t, 712

staging and prognosis of, 713

treatment of, 713–714

SOI (severity-of-illness) scoring systems, 2217,

2217t, 2218t

Solar elastosis, 418, 419

Solar purpura, 398

Solar radiation, 417

Solar urticaria, 394, 2722

Solid organ transplantation. See also Transplant

recipient

donor screening for, 1136

heart. See Cardiac transplantation

kidney. See Kidney transplantation

liver. See Liver transplantation

lung. See Lung transplantation

organisms transmitted by, 1136, 1737

Solifenacin, 3474

Solitary pulmonary nodule, 602, 603t, 604f. See also

Lung cancer

Solitary rectal ulcer syndrome, 313, 2479–2480

Solriamfetol, 210

Soluble urokinase plasminogen activator receptor

(suPAR), 2305

Solute diuresis, 338

Somali famine, 1003

Soman, 3592t

Soman (GD), S4

Somatic hypermutation, 2692, 2693

Somatic mosaicism, 3653

Somatic mutations

cancer development and, 498, 499f, 3654–3655,

3654f

effects of, 3645

in mitochondrial DNA, 3653

Somatic symptom disorder, 3552

Somatization, 287

Somatosensory cortex, 92, 92f, 195f

Somatosensory deficits, 176

Somatosensory evoked potentials (SSEPs), 2271

Somatosensory pathways, 170f

Somatostatin

actions of, 2436, 2894

half-life of, 2886

synthesis of, 2894

Somatostatin analogues

for acromegaly, 2913

adverse effects of, 669, 2353, 2914

for carcinoid syndrome, 306, 668, 669f

for Cushing’s disease, 2916

for esophageal varices, 311

for gastrinoma, 664, 664t

for glucagonoma, 665

for nausea and vomiting, 294t

for NETs, 670–671

for polycystic kidney disease, 2353

structure, 669f

for TSH-secreting adenomas, 2918

for VIPoma, 665

for ZES, 2455

Somatostatinoma, 303, 665

Somatotropin, 2898t

Somnambulation, 212–213

Somogyi effect, 3811

Songling virus, 1629t

Sonidegib, 551t, 553, 588, 652f

Sorafenib

actions and targets of, 507, 511, 513t, 526, 548t,

552

adverse effects of, 315, 410, 548t, 552, 652, 739

drug interactions of, 571

for hepatocellular carcinoma, 511, 649, 649t,

651–652, 651f, 652f

for pancreatic NETs, 672

for renal cell carcinoma, 511

for thyroid cancer, 511

Sorbitol, 303, 2495, 2496t

Sore throat, 253. See also Pharyngitis

Sotalol

actions of, 1872t

adverse effects of, 1875t, 1914

for atrial fibrillation, 1907

for atrial flutter, 1900

dosage in kidney disease, 470

dosage monitoring, 469–470

for focal atrial tachycardia, 1894

overdosage/poisoning with, 3591t

for ventricular arrhythmias, 1913–1914, 1927

Sotorasib, 552, 3838

Sour taste sensation, 233

Southeast Asia ovalocytosis, 779t, 780

Southern tick-associated rash illness (Master’s

disease), 135t, 141, 1429

South Korea

hospital funding in, 44

long-term care funding in, 47

patient care financing in, 43t, 44

pharmaceutical expenditures in, 48

primary care access in, 45

Sowdah, 1782

SOX2 gene mutations, 3014

SOX3 gene mutations, 2971t, 3186

SOX9 gene, 2999, 2999f

SOX9 gene mutations, 3002, 3003t, 3004,

3005t

SOX10, 2696t

SOX10 gene mutations, 388, 3015t

SOX18 gene mutations, 2118

SP7 gene mutations, 3221, 3222t

Sp110 deficiency, 2716, S8

Spain, 43t, 48

SPARC gene mutations, 3221, 3222t

Sparganosis, 1796

Spasmodic dysphonia, 3402

Spasms

hemifacial, 3440

in MS, 3462, 3474

muscle, 3520

in tetanus, 1212

Spasticity, 165, 174, 3455, 3474

Spastin gene, 3416

Spastin gene mutations, 3416

SPATEs (serine protease autotransporters), 959

Spatial orientation, 199–201, 200f

Specialist care, access to, 45–46

Specialized nutritional support. See Enteral

nutrition; Parenteral nutrition

Specific (secondary) granule, 440

Specific granule deficiency, 446t, 447

Specificity

in immune response, 2672

of tests, 24–25, 494, 494t, S10

SPECT (single photon emission computed

tomography)

for myocardial perfusion imaging. See

Myocardial perfusion imaging

in parathyroid surgery, 3177

radiopharmaceuticals for, 1834t, 1835

Spectinomycin, 1148, 1236, 1240, 1240t

Speech, 196, 3279, V2

Speech audiometry, 245

Speech reception threshold, 245

Spermatogenesis, 2907f, 3009–3010, 3010f, 3646,

3651

Sperm banking, 555, 694, 3017

Spermidine, 3738, 3738f

Sperm, mutations in, 3646

Spherocytosis. See Hereditary spherocytosis

Spherules, 1661, 1661f

INDEX

I-204 Sphincter of Oddi, 2642

Sphincteroplasty, 2503

Sphincterotomy, endoscopic, 2391, 2395f

Sphingobacterium, 1249

Sphingomonas spp., 1249

Spider angioma, 321, 2549, 2625, 2625f

Spider bites, 396, 788, 3612

Spike surface protein, 973

SPIN11 gene mutations, 658t

Spina bifida occulta, 124

Spinal accessory nerve, 3280

Spinal angiography, 3292

Spinal cord

anatomy of, 3445, 3447f

compression of. See Spinal cord compression

disorders of. See Spinal cord disease/injury

pain mechanisms of, 92, 93f

Spinal cord compression

in hematomyelia, 3449

IgG4-related, 2838t, 2839f

neoplastic

clinical features of, 568–569, 3447–3448

diagnosis of, 568–569, 569f, 3447–3448, 3448f

in intradural mass lesions, 3448, 3448f

in lung cancer, 598, 600

metastatic, 568–569, 710, 710f, 3447–3448, A16

pathogenesis of, 3447–3448

in primary intramedullary tumors, 3448,

3449f

treatment of, 569–570, 569f, 3448

in spinal epidural abscess, 975t, 3448–3449,

3449f

in spinal epidural hematoma, 3449

Spinal cord disease/injury, 3445

anatomic considerations in, 3445–3446, 3445t,

3447f

approach to the patient, 3445–3446, 3445t

autonomic dysfunction in, 3433, 3455

cervical. See Cervical spine

compressive. See Spinal cord compression

constipation in, 308

erectile dysfunction in, 3057

in HIV infection, 1579

imaging in, A16

infarction, 3450, A16

infectious. See Meningitis

level of lesion in, 3282t, 3445–3446, 3445t

in multiple sclerosis, A16

myelopathies. See Myelopathy

osteoporosis and, 3195

paraneoplastic syndromes, 734

patterns of, 3446

prognosis of, 3455t

radiation-induced, 532, 741

referred abdominal pain from, 110

remyelination after, 3799

sensory abnormalities in, 172–173

sinus bradycardia in, 1878

stem cell therapy for, 3304, 3799

testicular function in, 3017

treatment of, 3455

vascular malformations, 3452, 3453f

Spinal epidural abscess

clinical features of, 123, 979, 3448–3449

diagnosis of, 3449, 3449f

etiology of, 979, 3449

risk factors for, 3449

treatment of, 975t, 3449

Spinal epidural hematoma, 3449, A16

Spinal fusion, 125, 126

Spinal manipulative therapies, 129, 3785t, 3788,

3789

Spinal meningitis, 1110

Spinal muscular atrophy (SMA), 3413t, 3415,

3686t, 3688

Spinal osteomyelitis. See Osteomyelitis, vertebral

Spinal stenosis, 121, 122f

Spindle cell tumor, 402

Spine

anatomy of, 116–117, 117f

cervical. See Cervical spine

lumbar. See Lumbar spine

pain sensitive structures in, 118

sacral, 125

SPINK1 gene mutations, 2659, 2665

Spinobulbar muscular atrophy (Kennedy’s disease)

vs. ALS, 3415

clinical features of, 3017, 3415

genetic considerations in, 3413t, 3415, 3645t,

3648, 3655, 3655t

Spinocerebellar ataxia (SCA)

classification of, 3423

clinical features of, 3423

genetic considerations in, 3645t

SCA1, 227

SCA2, 3655t

SCA3 (Machado-Joseph disease), 3424–3425,

3655t

SCA6, 3425, 3655t

SCA7, 3425, 3655t

SCA8, 3425

SCA12, 3655t

treatment of, 3426–3427

Spinosad, 3608

Spinothalamic tract, 92, 92f, 169, 170f

Spiral enteroscopy, 2391, 2393f

Spiramycin, 1705t, 1713, 1762

Spiration Valve System, 2216

Spirillum infection, 1125

Spirillum minus, 135t

Spirometra, 1796

Spirometry

in COPD, 2182, 2182t, 2185

preoperative, 3772, 3772t

in respiratory disease evaluation, 2132–2133,

2134f, 2138–2139

Spironolactone

actions of, 2293

adverse effects of, 2084

androgen blockade, 3017

erectile dysfunction, 3058

gynecomastia, 323

hyperkalemia, 323, 3042

hyponatremia, 323

hypotension, 3042

for ascites, 323, 2631

for heart failure, 1941, 1946t, 1947, 1948t

for hirsutism, 3042

for hypertension, 2074, 2083t, 2084

for male precocious puberty, 3013

for mineralocorticoid excess, 2966–2967

for PCOS, 3036

for syndrome of apparent mineralocorticoid

excess, 350

Spleen

accessory, 459

congenital absence of, 463, 984f, 2711, S8

infarction of, 111t, 460

palpation of, 461

percussion of, 461

rupture of, 111t, 460, 463, 1484, 1741

structure and function of, 459–460, 460f

Splenectomy, 462

for autoimmune hemolytic anemia, 787

for β thalassemia, 763t

for CML, 827

complications of, 463

for congenital erythropoietic porphyria, 3246

for hereditary spherocytosis, 780

for Hodgkin’s lymphoma staging, 462

for immune thrombocytopenic purpura, 910

immunizations after, 780, 984f, 1146

infections after, 556–557, 780, 975t, 976

in leukemia, 462–463

long-term effects of, 463

for lymphoma, 463

for marginal zone lymphoma, 849

for myelofibrosis, 807

for polycythemia vera, 805

for pyruvate kinase deficiency, 782

sepsis/septic shock after, 2248t

for sickle cell disease, 759t

for splenic abscess, 1060

Splenic abscess

abdominal pain in, 110, 111t, 1059

actinomycotic, 1342f

clinical features of, 1059

etiology of, 1059–1060

in infective endocarditis, 1033

treatment of, 1060

Splenic marginal zone lymphoma, 463, 841, 844t,

849, 856, 856t

Splenic vein thrombosis, 2664

Splenomegaly, 459

abdominal swelling in, 321

approach to the patient, 460–461

clinical features of, 460–461

in CML, 821

congestive, 461

differential diagnosis of, 461, 1744

diseases associated with, 462t

in Gaucher disease, 3258

in hemolytic anemia, 438

in hepatocellular carcinoma, 649

hyperreactive malarial, 1726

laboratory evaluation of, 461

in liver disease, 2549

with lymphadenopathy, 458–459

massive, 461, 462t

in myelodysplasia, 800

in myelofibrosis, 805, 807

neutrophil destruction and, 444

in parasitic infections, 1699t

in polycythemia vera, 439, 804

in portal hypertension, 2630–2631

in sarcoidosis, 2832, 2833f

in schistosomiasis, 1787

in β thalassemia, 763t

in visceral leishmaniasis, 1744, 1744f

Splenosis, 463

Splinter hemorrhages, 1816

Spondylitis

ankylosing. See Axial spondyloarthritis

(ankylosing spondylitis)

in psoriasis, 378

tuberculous (Pott’s disease), 123, 1060, 1365, 1365f

Spondyloarthritis

axial. See Axial spondyloarthritis (ankylosing

spondylitis)

IBD-associated, 2801–2802

juvenile-onset, 2801

KIRS in, 2687t

peripheral, 2800–2801, 2801t

psoriatic. See Psoriatic arthritis

reactive arthritis. See Reactive arthritis

undifferentiated, 2800

INDEX

Spondylodiskitis. See Osteomyelitis, vertebral I-205

Spondylolisthesis, 122–123

Spondylolysis, 124

Spondylosis, 123, 128, 174

Spondylotic myelopathy, 3452

Spongiosis, 374f

Spontaneous bacterial peritonitis (SBP), 324, 1054–

1055, 2516, 2632. See also Peritonitis

Spontaneous breathing trial, 2234, 2234f

Spontaneous speech, 196

Sporadic goiter, 2946

Spore, anthrax, S3

Sporogony, 1722

Sporothrix infections, 1686

clinical features of

arthritis, 1044

crusted lesions, 1035

lymphocutaneous, 1654t

meningitis, 1113t

nodules, 396, 1394, 1686–1687, 1687f

diagnosis of, 986, 1654t

etiology of, 1686

pathogenesis of, 1686

risk factors for, 1654t

treatment of, 1687, 1687t

Sporothrix schenckii, 1686

Sporozoites, Plasmodium, 1720, 1721f

Sports. See Athlete(s)

Spousal abuse. See Domestic abuse/violence

Sprouting, 523, 523f. See also Angiogenesis

SPRY4 gene mutations, 3015t

SPS (sodium polystyrene sulfonate), 355

SPTA1 gene mutations, 779t

SPTB gene mutations, 779t

SPTLC1 gene mutations, 3434

Spur cell(s), 435f

Spur cell anemia, 317

Spurling’s sign, 128

Sputum analysis

in asthma, 2155

in cough, 268

Gram’s stain, 1011

in Legionella pneumonia, 1254

in lung cancer, 599

in nocardial pneumonia, 1338f

in pneumonia, 1011–1012

in respiratory disease evaluation, 2133,

2146–2147

specimen collection and transport, S11

in TB, 1369

SQSTM1 gene, 3210

Squamous cell carcinoma

anal, 643

bladder, 677, 678f. See also Bladder cancer

cervix. See Cervical cancer

endometrium. See Endometrial cancer

esophagus, 626–627, 627t. See also Esophageal

cancer

genetic considerations in, 3793

head and neck region, 590. See also Head and

neck cancer

lung, 595, 595f. See also Lung cancer

oral, 257, 259t, 379

skin

BRAF inhibitors and, 585

clinical features of, 371t, 586–587, 587f, A5

distribution of, 372f

epidemiology of, 586

genetic considerations in, 586

infections in, 556t

natural history of, 588

pathophysiology of, 586

prevention of, 588–589

risk factors for, 586

screening for, 498

sun exposure and, 419, 586

in transplant recipient, 586

treatment of, 588

of unknown primary, 720, 720f

Square root sign, 2024

Square-wave jerks, V3

SRD5A2 gene mutations, 3002, 3003t, 3018

SREB, 1665

SRP54 (signal recognition protein), 2696t

SRS (stereotactic radiosurgery), 706, 707, 708, 2905

SRSF2 gene mutations, 806

SRY gene, 3006

SRY gene mutations

in disorders of testis development, 2999, 3002,

3003t, 3651, 3653

in testicular/ovotesticular disorders of sex

development, 3004, 3005t

transcription factor in, 3645t

SSc sine scleroderma, 2771. See also Systemic

sclerosis (scleroderma)

SSEPs (somatosensory evoked potentials), 2271

SSKI (saturated solution of potassium iodide),

1687, 1687t

SSPE (subacute sclerosing panencephalitis), 1100, 1611

SSRIs. See Selective serotonin reuptake inhibitors

(SSRIs)

SSX1/2 gene mutations, 712

Stabbing headache, primary, 3369

Stab phlebectomy, 2118

Staghorn calculi, 2373

Stagnant bowel syndrome. See Small-bowel

bacterial overgrowth

Staining, S11

Standard precautions, 1132, 1513

Stanford V regimen, 854

Stapedectomy, 239, 246

Stapes, 238, 239f

Staphylococcal infections, 1178

aortitis, 2107

in cancer patient, 556t, 558, 558t, 559t

catheter-related bloodstream, 1132

cellulitis, 1037

clinical syndromes, 1185

diagnosis of, 1181, 1184–1185

in dog-bite wound, 1124

endocarditis. See Infective endocarditis,

staphylococcal

food-borne, 1064, 1064t

meningitis. See Meningitis

osteomyelitis, 1047, 1049t, 1050t, 1052

pathogenesis of, 1184

of prosthetic devices, 1185

S. aureus. See Staphylococcus aureus infections

in scabies, 3609

surgical-site, 1131

in transplant recipient, 1143

treatment of, 1156–1157t, 1185–1188, 1186t

Staphylococcal scalded skin syndrome

clinical features of, 137t, 142, 142f, 1184

pathogenesis of, 1180

vs. scarlet fever, 142

skin manifestations of

generalized desquamation, 1184, 1184f, A1

Nikolsky’s sign, 142, 142f

progression, 392

rash, 137t, 142, 142f, 392

vesicles/bullae, 392, 1035

vs. toxic epidermal necrolysis, 142, 392, 1035

Staphylococcus argenteus, 1178

Staphylococcus aureus

antibiotic resistance in, 1156t, 1165, 1166, 1168, 1185

antimicrobial susceptibility testing, S11

enterotoxins, 949

evasion of host defenses by, 1180

genome of, 1179

laboratory identification of, 1178, 1178f, 1181

methicillin-resistant. See Methicillin-resistant

Staphylococcus aureus (MRSA) infections

pathologic response to, 1179

T cell activation by, 958

vancomycin-resistant, 1185

virulence regulation in, 1179–1180

Staphylococcus aureus infections

in atopic dermatitis, 374, 375, 3698

in cancer patient, 558, 558t, 559t

CAPD peritonitis, 1057

catheter-related bloodstream, 1132

clinical syndromes, 1181t

in diabetes mellitus, 3128

diagnosis of, 1181, S11

endocarditis. See Infective endocarditis,

staphylococcal

epidemiology of, 1178–1179

food-borne

clinical features of, 300t, 1064, 1064t

diagnosis of, 1183

differential diagnosis of, 300t, 1183

pathogenesis of, 1181

sources of, 300, 1064t, 1183

host response to, 1180

in human bite-wound, 1125

in leukocyte adhesion deficiency, 445

meningitis. See Meningitis, bacterial

methicillin-resistant. See Methicillin-resistant

Staphylococcus aureus (MRSA) infections

musculoskeletal, 1180

osteomyelitis, 1047, 1052, 1053, 1181–1182,

1182f

pyomyositis, 1038, 1182

septic arthritis, 1041, 1182. See also Infectious

(septic) arthritis

nausea and vomiting in, 292

otitis externa, 249

parotitis, 261

pathogenesis of, 1179–1181

peritonitis, 2632

prevention of, 1188

prosthetic device–related, 1183

psoas abscess, 1056

respiratory tract, 270, 1020–1021, 1181

risk factors for, 1178

in sepsis/septic shock, 2242

skin and soft tissue, 1181

cellulitis, 1037

folliculitis, 386, 1035, 1181

furunculosis, 380, 1181

impetigo, 379, 380t, 1192. See also Impetigo

mastitis, 1181

staphylococcal scalded skin syndrome. See

Staphylococcal scalded skin syndrome

vesicles/bullae, 392

splenic abscess, 1059

surgical-site, 1131

toxic shock syndrome. See Toxic shock

syndrome, staphylococcal

toxin-mediated disease, 1180–1181

in transplant recipient, 1144

treatment of, 1156–1157t, 1185–1188, 1186t

urinary tract, 1071, 1130, 1183

vaginal, 1086

ventilator-associated pneumonia, 1131

INDEX

I-206 Staphylococcus epidermidis, 1184

Staphylococcus epidermidis infections, 1184

Staphylococcus lugdunensis infections, 1024, 1184

Staphylococcus pseudintermedius, 1178

Staphylococcus saprophyticus infections, 1071, 1083,

1184

Staphylococcus schleiferi infections, 1184

StAR (steroidogenic acute regulatory protein),

2886, 3002, 3003t

Starfish envenomation, 3603–3604, 3603f

STARI (Southern tick-associated rash illness), 135t,

141, 1429

Starling forces, 338

STARR (stapled transanal rectal resection)

procedure, 2502, 2502f

Starvation-related malnutrition, 2535, 2540

Stasis dermatitis, 376

clinical features of, 370t, 372f, 376, 385t, A5

evolution of, 376f

treatment of, 376–377, 385t

Stasis ulcer, 372f, 376, 376f

STAT1 gene mutations, 1393, 1394, 1672, 2704t,

2716

STAT3 deficiency. See Hyper-IgE (Job) syndrome

STAT3 gene mutations, 1655, 1655f, 2472t, 2704t,

2718

STAT4 gene mutations, 2738

STAT5, 744f

STAT5b gene mutations, S8

STAT factors, 512f, 2689, 2883

Statins

adverse effects of, 3142t

hepatotoxicity, 2584, 2590, 3149, 3156

myopathy, 2822, 2847t, 2873, 3149, 3531,

3531t

tendinitis, 2847t

for colorectal cancer prevention, 492

for dementia prevention, 3375

in diabetes mellitus, 3126

drug interactions of, 471t, 1703t, 3149

for heart failure, 1950

for intermittent claudication, 2109

for lipoprotein disorders

approach to, 3148–3149

dosage of, 3142t

in ischemic heart disease, 2040

in metabolic syndrome, 3156

in NAFLD/NASH, 2623

in older adults, 3747

metabolism of, 467t

for NSTE-ACS, 2049, 2052

perioperative, 3771

for prostate cancer prevention, 681

for stroke prevention, 3345

timing of administration of, 3811

Status asthmaticus, 2158

Status epilepticus, 3322

complex partial, 3377

in critically ill patient, 2224, 2271, 2271f, 2272

definition of, 3322

in nerve agent exposure, S4

nonconvulsive, 3322

treatment of, 3322f

Stauffer’s syndrome, 320, 674

Stavudine (d4T), 1586, 1590f, 1592f, 2591

Steady state, 467, 468f, 469

Steatohepatitis, nonalcoholic. See Nonalcoholic

steatohepatitis (NASH)

Steatorrhea

definition of, 2459

diagnosis of, 2459, 2467

etiology of, 303, 2461t, 2467

lipid digestion and absorption defects in, 2460t

in pancreatitis, 2460t, 2668

in protein-losing enteropathy, 2467

in small-bowel bacterial overgrowth, 2461

in tropical sprue, 2464

in Whipple’s disease, 303–304

STEC (Shiga toxin–producing E. coli), 1061, 1066,

1266t, 1268. See also Escherichia coli

infections, intestinal

Steele-Richardson-Olszewski syndrome. See

Progressive supranuclear palsy syndrome

Steel factor, 544

Steinert’s disease, S8

Stem cell(s)

cancer. See Cancer stem cells

cell division in, 744

cord blood, 746, 898, 3798

exhaustion, aging and, 3736

functions of, 744, 744f

as gene therapy target, 747

hematopoietic. See Hematopoietic stem cells

imaging of, 3799

induced pluripotent, 3299–3300, 3797–3798

mesenchymal, 3304–3305

mtDNA mutations, 3678

neural, 3299–3300, 3799

niche site, 744–745

quiescence of, 745

relationship to cancer, 747

self-renewal of, 745–747, 746f

transdifferentiation of, 3798

Stem cell factor (SCF), 2683t, 2706

Stem cell therapy, 3796

for age-related macular degeneration, 3304

for ALS, 3302

for diabetes mellitus, 3798–3799

ethical issues in, 3800

future directions for, 3799–3800

for ischemic heart disease, 3798

for liver disease, 3799

for neurologic disorders, 3799–3801

for PD, 3303, 3397–3398

sources of cells for, 3299–3300, 3797–3798

for spinal cord injury, 3304

strategies for, 3303–3305, 3796–3797, 3797f

Stem cell transplantation. See Hematopoietic cell

transplantation (HCT)

STEMI. See ST-segment elevation myocardial

infarction (STEMI)

Stemmer’s sign, 2119

Stenotrophomonas maltophilia infections, 559,

1287t, 1291, S11

Stent(s)

for aortic aneurysm, 2104, 2104f

biliary, in pancreatic cancer, 2416, 2420f

coronary artery. See also Percutaneous coronary

interventions (PCI)

characteristics of, 2067, 2067f

drug-eluting, 926, 2044, 2067, 2068f

restenosis in, 2044, 2068, A11

esophageal, for malignant dysphagia, 2414, 2419f

for peripheral artery disease, 2109–2110

for renal artery stenosis, 2078, 2089

Steppage gait, 176

Stereognosis, 172, 3281

Stereopsis, 217

Stereotactic body radiotherapy (SBRT), 529,

569–570, 603–604, 713

Stereotactic radiation cardiac ablation, 1923, 1923f

Stereotactic radiosurgery (SRS), 706, 707, 708, 2905

Stereotyping, 64, 67

Sterilization, 3053, 3054t

Sternal osteomyelitis, 1052–1053, 1052f, 1144

Sternoclavicular joint, infectious arthritis of, 1041,

1041f

Steroid(s). See specific hormones

Steroidogenesis. See specific hormones and glands

Steroidogenic acute regulatory protein (StAR),

2886, 3002, 3003t

Steroidogenic enzyme pathways, disorders of, 3002,

3003t, 3004f

Steroidogenic factor 1 (SF1), 2956, 2999

Steroid purpura, 398

Stevens-Johnson syndrome (SJS)

in cancer patient, 559

clinical features of, 137t, 142, 392, 413–414, 413f,

415t, 416t

diagnosis of, 415

differential diagnosis of, 413

drugs associated with, 414, 416t

epidemiology of, 137t

etiology of, 137t, 392

genetic considerations in, 409, 478

in HIV infection, 1576

immune pathways of, 408t

in M. pneumoniae infection, 1442

oral manifestations of, 259t, A3

prevention of future episodes, 415

toxic epidermal necrolysis overlap with, 413,

413f

treatment of, 414, 415

Stickler syndrome, 3228

Stiff-legged gait, 174

Stiff-person syndrome

clinical features of, 3520

gait disorders in, 174

paraneoplastic, 728t, 734, 735f, 2697t

pathogenesis of, 2696t, 3520

Still’s disease, 135t, 141, 147, 151, 394, 395, A1

Still’s murmur, 281

Stimulant use disorder, 3575–3576. See also

Psychostimulants

Stinging ants, 3614

Stingray injury, 3604

STIs. See Sexually transmitted infections (STIs)

STK11 gene mutations, 516, 658, 658t

Stokes-Adams attack, 157

Stomach

acid and hormone secretion in, 2435–2437,

2437f

biopsy in cobalamin deficiency, 771

epithelial anatomy of, 2434, 2434f, 2435f

functions of, 2381

mucosal defense and repair in, 2434–2435, 2436f

Stomach tumors

adenocarcinoma. See Gastric adenocarcinoma

lymphoma, 633–634

neuroendocrine tumors. See Neuroendocrine

tumors (NETs)

Stomatitis, 372f, 379, 402, 2468t

Stomatocytes, 425, 428f

Stomatocytosis, 428f, 779t, 780f, 781

Stonefish sting, 3604

Stony coral injury, 3605

Stool

microbiota of, 3692, 3693f

osmolality of, 2467

retained, abdominal swelling and, 321

Stool analysis

antigen test, for H. pylori, 1281t, 1282

in chronic diarrhea, 306

for intestinal parasite detection, S12

in malabsorption disorders, 2467

for occult blood. See Fecal occult blood

topics

11/9/25

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