topics

11/9/25

INDEX

I-218 TNSALP (tissue nonspecific alkaline phosphatase),

3214

TNXB gene mutations, 3225t, 3227

Tobacco grower’s lung, 2160t

Tobacco use, 3068. See also Smoking

Tobin index, 2234

Tobramycin

actions of, 1148, 1164t

adverse effects of, 1159

for community-acquired pneumonia, 1018t

for hospital-acquired pneumonia, 947t, 1018t

indications for, 1156t

for infective endocarditis, 1030

inhaled, for bronchiectasis prophylaxis, 2176

resistance to, 1156t, 1164t, 1201

for sepsis/septic shock, 2248t

for ventilator-associated pneumonia, 1018t

Tocilizumab

actions of, 2701, 2708t, 2763

adverse effects of, 2762t, 2763, 2805, 2805t,

2812

for CAR-T neurotoxicity, 575, 2276

for COVID-19 disease, 1510

for cytokine release syndrome, 574, 2275

for giant cell arteritis, 223, 2107, 2812

indications for, 2708t

for rheumatoid arthritis, 2762t, 2763

for systemic sclerosis, 2784

for Takayasu arteritis, 2813

α-Tocopherol, 492, 493. See also Vitamin E

α-Tocotrienol, 3678

Todd’s paralysis, 3306

Toe(s)

gout of, A15

osteoarthritis of, 2858f

Tofacitinib

actions of, 2763

adverse effects of, 2487t, 2489, 2763t, 2764

for axial spondyloarthritis, 2796

for IBD, 2486, 2487t

for psoriatic arthritis, 2800

for rheumatoid arthritis, 2763, 2764

testing before and during treatment, 2487t

TOF (time-of-flight) imaging, 3285f, 3288, A16

To-fro murmur, 284, 284f

Togaviruses, 1454t, 1455–1456, 1455f, 1630. See

also Alphaviruses

Togavirus infections. See Alphavirus (togavirus)

infections

Tolaparib, 625

Tolbutamide, 319

Tolcapone, 3395, 3396t

Tolerable upper levels, 2518

Tolerance, 79, 1200, 2672

Tolerance induction, 2729

Tolfenamic acid, 3362t

Toll-like receptor (TLR) pathway deficiencies, 2712

Toll-like receptors (TLRs)

in adaptive immune response, 955, 955t, 2674,

2676

in autoimmunity, 2732

fever and, 131

in glomerular disease, 2332

in IC/BPS, 325

in innate immune response, 1173, 1457

ligands and functions of, 2675t

in platelets, 921

in rheumatoid arthritis, 2756, 2757f

in sepsis/septic shock, 2243, 2243f

signaling pathways of, 2675f

in Sjögren’s syndrome, 2788

Tolosa-Hunt syndrome, 228, 229, 1684, 3444

Tolterodine, 3474

Tolvaptan

adverse effects of, 345, 599

for heart failure, 1945

for polycystic kidney disease, 2353

for SIAD, 345, 599, 723, 2924–2925, S1

Tonate virus, 1625t

Tone, 165

Tongue

alterations of, 261t

bald, 261t

black hairy, 260t

fissured (scrotal), 261t, A3

geographic, 261t, 372f, A3

paralysis of, 3443

raspberry, 261t

strawberry, 261t

ulcer on, A3

white coated, A3. See also Thrush

Tongue worms, 3611

Tonic-clonic seizures, 3307, 3315t. See also

Seizure(s)

Tonicity, 2294, 2295f

Tonic pupil, 217

Tonsillectomy, 453

Tonsillitis, 249

Tonsils, orange, 1816

Tooth. See Teeth

Tophi, 396, 2854f

Topiramate

adverse effects of, 236, 3092, 3317, 3319t,

3365t

for cluster headache prevention, 3367t

for hemicrania continua, 3368

for migraine prevention, 3364, 3365t

for nausea and vomiting, 294, 294t

overdosage/poisoning with, 3592t

for pain, 79

pharmacology of, 3319t

with phentermine, for obesity, 3091–3092, 3092t

for posttraumatic headache, 116

for raised CSF pressure headache, 116

for seizures, 702, 3317, 3319t

for SUNCT/SUNA prevention, 3368

“Top of the basilar” syndromes, 3332

Topoisomerase I (Scl-70), 539, 2696t, 2776t

Topoisomerase II, 539, 553

Topoisomerase IV, 1149

Topoisomerase inhibitors, 740, 800, 810

Topoisomerase poisons, 539, 540t, 541–542. See

also specific drugs

Topology, of biologic system, 3812–3813, 3813f

Topotecan

actions of, 541

adverse effects of, 540t, 541

for Ewing’s sarcoma, 715

interactions and issues, 540t

for lung cancer, 609–610

for ovarian cancer, 697

Toppling falls, 177. See also Fall(s)

TOR1A gene mutations, 3402, 3403t

TORC1 (target of rapamycin complex 1), 3535

Toroviruses, 1598f, 1601

Torsades de pointes. See Ventricular tachycardia,

polymorphic

Torsemide, 366, 1946t, 2256

Torticollis, 3402

TOS (true neurogenic thoracic outlet syndrome),

128

Toscana virus, 1094, 1629t, 1639–1640

Tositumomab, 2707t

Total artificial heart, 1977

Total body water, 2294, 2295f, S1

Total energy expenditure (TEE), 2539

Total iron-binding capacity

in anemia evaluation, 432

in hypoproliferative anemia, 437, 753t

in iron-deficiency anemia, 749f

in microcytic anemia, 751t

normal, 436, 750

Total lung capacity (TLC), 2134, 2134f, 2135f, 2138f

Total parenteral nutrition. See Parenteral nutrition

Touch localization test, 172

Touch sensation, 170–171, 170t, 1388, 3281

Touraine-Solente-Golé syndrome, 205. See also

Hypertrophic osteoarthropathy

Tourette’s syndrome, 3406

Tourniquet, for snakebite, 3598

Toxic adenoma, 2948, 2949f

Toxic epidermal necrolysis (TEN)

vs. AGEP, 414

clinical features of, 137t, 142, 391, 413, 413f,

416t, A1

drugs associated with, 391, 414, 416t

epidemiology of, 137t

etiology of, 137t

genetic considerations in, 409

immune pathways of, 408–409, 408t

non-drug causes of, 413

prevention of future episodes, 415

vs. staphylococcal scalded skin syndrome, 142,

392, 1035

treatment of, 414, 415, 1035

Toxic erythema of chemotherapy, 410, 411f

Toxic granulations, neutrophils, 441

Toxic megacolon, 1300, 1301, 2475–2476

Toxic multinodular goiter, 2948. See also Thyroid

nodular disease

Toxic oil syndrome, 2773

Toxic optic neuropathy, 223–224

Toxic shock syndrome (TSS)

clostridial, 1221t, 1225

diarrhea in, 301

etiology of, 977

focal infections and, 979

skin manifestations of, 393, 977–978

staphylococcal

clinical features of, 137t, 142, 393, 977, 1183,

1184t

diagnosis of, 1183–1184

pathogenesis of, 131, 1180–1181, 1183, 2692

rash in, 137t, 142

tampon-associated, 1188

treatment of, 1188

streptococcal

case definition of, 1194, 1194t

clinical features of, 137t, 142, 393, 977, 1194,

1194t

diagnosis of, 1194

epidemiology of, 137t

etiology of, 137t, 1194

rash in, 137t, 142

treatment of, 1191t, 1194

Toxic sponges, 3605

Toxidrome, 3583

Toxins. See also specific toxins

bacterial, 949

hepatic effects of, 2584, 2586t

neurologic effects of, 3493, 3495–3496, 3495t

pulmonary effects of, 2167t, 2170–2171, 2171t

testicular effects of, 3017

in undiagnosed disease, 3853–3854

Toxocara canis/cati, 945t, 1771, S12. See also Larva

migrans, visceral

INDEX

Toxoplasma gondii, 1698, 1757, 1757f, S12 I-219

Toxoplasma gondii infection (toxoplasmosis), 1757

asymptomatic, 1759

clinical features of, 1698

cardiac, 1759, 1882, 1962

chronic meningitis, 1114t

CNS, 1120, 1578, 1578f, 1759, 1760f

gastrointestinal, 1759

in immunocompetent patient, 1760

in immunocompromised patient, 560, 560t,

1699t, 1760, 1760f, 1962

lymphadenopathy, 458, 1759, 1760

myelopathy, 3452

ocular, 221, 1759, 1761, 1762

pulmonary, 1759

renal, 2349

seizures, 1699t

weakness, 167

congenital, 1699t, 1757, 1761, 1762

diagnosis of, 1761–1762, S12

differential diagnosis of, 1486t, 1761, 1761t

epidemiology of, 1758, S12

etiology of, 1757–1758, 1757f

global considerations in, 1760

in HIV infection, 1563–1564t, 1565f, 1578,

1578f, 1760, 1760f, 1962

immune response to, 1759

pathogenesis of, 1758–1759

pathology of, 1759

in pregnancy, 1698, 1699t, 1758, 1759, 1762

prevention of, 1763

prophylaxis for, 1142t, 1763

transmission of, 1757f, 1758

in transplant recipient, 1138, 1138t, 1142t, 1143,

1144, 2275

treatment of, 1120, 1712, 1762–1763

TP53 gene mutations

aflatoxin B1

and, 644

in AML, 810

in bladder cancer, 677

in carcinoma of unknown primary, 719

in cholangiocarcinoma, 654

in CLL, 835–836, 836t, 839t

in CML, 820

in esophageal cancer, 626

in gastric adenocarcinoma, 630, 630f

genetic testing for, 3664

in hepatocellular carcinoma, 644–645, 645t

in lung cancer, 597

in multiple myeloma, 872

in myelodysplastic syndromes, 800

in ovarian cancer, 695

in pancreatic cancer, 658

tumors associated with, 503t

tPA. See Alteplase (rtPA); Tissue plasminogen

activator (tPA)

TPIT gene mutations, 2896

TPM1 gene mutations, 1956t

TPMT (thiopurine S-methyltransferase), 467t,

476t, 478, 2328

TPMT (thiopurine S-methyltransferase) deficiency,

3668

TPN (total parenteral nutrition). See Parenteral

nutrition

TPO (thyroid peroxidase), 2696t, 2926, 2927, 2934t

TPO (thyroid peroxidase) antibodies, 2932, 2934, 2938

TPP (thyrotoxic periodic paralysis). See Hypokalemic

periodic paralysis (HypoKPP)

TPP1 gene mutations, 3260

TPPA (T. pallidum particle agglutination) test, 1411

TR (thyroid hormone receptor), 2889, 2930, 2930f

TRα gene mutations, 2930

TRβ gene mutations, 2930

TRAb (thyroid-stimulating hormone receptor

antibody), 2932, 2935

Trabectedin, 539, 540t, 700, 714

Trabeculectomy, 226

Trace minerals. See Mineral(s)

Tracheal intubation, 188

Trachelectomy, 698–699

Tracheobronchitis, Aspergillus, 1678

Tracheomalacia, 2135

Trachoma, 220, 1450–1451

Traditional Chinese medicine, 3785t, 3786, 3787, 3789

TRAIL, 518, 518f, 519

Trail-making test, 2549

Trained immunity, 2672

TRALI (transfusion-related acute lung injury),

888, 894

Tramadol

adverse effects of, 3311t, 3488t

for back pain, 125

for fibromyalgia, 2870

for neuropathy, 3125, 3488t

overdosage/poisoning with, 3595t

for pain, 78f, 95t, 99

Trametinib

actions and targets of, 513t, 547t, 552

adverse effects of, 547t, 739

for lung cancer, 607

for melanoma, 552, 584t, 585

“Tram-track” sign, 2174, 2341, A4

Trandolapril, 1948t

Tranexamic acid, 804, 808, 909, 913

TRANK1 gene mutations, 3551

Trans, 3079t

Transaminases, 931, 2554

Transarterial chemoembolization (TACE), 650–651

Transbronchial biopsy, 2141, 2192

Transbronchial needle aspiration, 2141–2142

Transcatheter aortic valve implantation (TAVI)

AV block following, 1881

endocarditis following

clinical features of, 1025

diagnosis of, 1025–1026

etiology of, 1023, 1023t

incidence of, 1023, 1023t

outcome, 1033

treatment of, 1030, 1032

with mitral valve repair, 2007

outcomes of, 1986t, 2070, A11

patient selection for, 1983f, 1984, 1985f, 1986t,

1990, A11

procedure for, A11

valve models for, 1984, 1984f, 2070, A11

Transcatheter mitral valve replacement, 1999,

1999f, 2008, A11

Transcobalamin, 766

Transcobalamin deficiency, 772, S8

Transcortical aphasia, 196t, 197

Transcranial direct current stimulation, 3823, 3823f

Transcranial magnetic stimulation (TMS)

for major depression, 3550, 3823

for migraine, 3362t, 3363t, 3364

principles of, 3823, 3823f

Transcription coactivator p75, 2696t

Transcription factors

defects in, diseases caused by, 3645t

in gene expression, 3793

gene expression and, 3642–3644, 3642f

in signal transduction in cancer cells, 511–516

in stem cells, 747

Transcriptome, 960t, 3641, 3644

Transcriptomics, 3644

Transcutaneous supraorbital nerve stimulation,

3362t, 3364

Transcytosis, 953

Transdifferentiation, of stem cells, 3798

Transduction, 3685

Transesophageal echocardiography (TEE)

in aortic dissection, 2105

in aortic regurgitation, 1988

in aortic stenosis, 1847, 1981

in atrial fibrillation, 1905

indications for, 1833–1834

in infective endocarditis, 1026–1027, 1027f

in mitral regurgitation, 1997

in mitral valve prolapse, 2001, 2001f

in murmur evaluation, 286

principles of, 1833–1834

in valvular heart disease, 1993

Transfalcial herniation, 184, 184f

Trans fats, 3144

Transferase variants, 478

Transfer dysphagia, 287, 2413. See also Dysphagia

Transferrin

diferric, 748

iron content of, 748t

in iron metabolism, 748, 748f

laboratory measurement of. See Total ironbinding capacity

monoferric, 748

in nutrition assessment, 2538t

Transferrin-binding proteins, 1235

Transferrin receptor(s), 748, 3231, 3231f, 3232

Transferrin receptor protein, 751

Transferrin saturation, 436, 437, 748f, 749t, 750

Transformation, bacterial, 1163

Transforming growth factor-α (TGF-α), 524, 2435,

2436f, 2458

Transforming growth factor-β (TGF-β)

in aortic aneurysm, 2102

in axial spondyloarthritis, 2791

driver genes of, 505t

in familial pulmonary arterial hypertension, 3814

in heritable thoracic disease, 3229t, 3230

in hypercalcemia of malignancy, 723

mutations in, 3814

in oncogene signaling pathway, 520f

in preeclampsia, 3763

in radiation-induced fibrosis, 739

source, target, and biologic activity of, 2683t

in thyroid hormone synthesis, 2928

Transfusion(s)

ABO compatibility in, 887t, 891, 893

adverse reactions to, 888

immune-mediated

allergic, 894

alloimmunization/platelet refractoriness, 895

febrile nonhemolytic, 894

graft-versus-host disease, 894

hemolytic reactions, 888, 892f, 893–894

immunomodulation, 895

posttransfusion purpura, 895

transfusion-related acute lung injury, 894

incidence of, 888

infectious, 895–896, 896t, 1327, 2573

nonimmunologic

fluid overload, 895

hypotension, 895

iron overload, 754, 761, 798, 895

massive transfusion-associated reactions,

317, 353, 895

of uncertain cause, 895

prevention of, 891, 895

warnings signs for, 891t

INDEX

I-220 Transfusion(s) (Cont.):

alternatives and perspectives, 896

alternatives to, 896

for AML, 817

for anemia, 438, 754

for aplastic anemia, 797–798

for chemotherapy-associated anemia/

thrombocytopenia, 554

cryoprecipitate, 890t

for DIC, 917

donor mononuclear cells, 890t

efficacy evaluation of, 889–890t

granulocyte concentrates, 890t

for hemophilia, 912–913

indications for, 889–890t

for iron-deficiency anemia, 751

metabolic alkalosis in, 366

multicomponent, 890t

packed red blood cell

for AML, 817

for aplastic anemia, 797–798

for hypoproliferative anemia, 754

for iron-deficiency anemia, 751

plasma, 889t

platelet. See Platelet transfusion

reducing need for, 896

risks of, 754, 1737

for sepsis/septic shock, 2248

for sickle cell disease, 761

whole blood, 890t

Transfusion-associated circulatory overload

(TACO), 888, 895

Transfusion-related acute lung injury (TRALI),

888, 894

Transgender, 3079, 3079t

Transhemorrhoidal dearterialization, 2504

Transient acantholytic dermatosis, 371t

Transient aplastic crisis, 1496, 1497t

Transient elastography, 2550, 2556, 2618, 2622

Transient global amnesia, 202, 3377

Transient ischemic attack (TIA), 3344

in basilar artery distribution, 3330

definition of, 3324

at high altitudes, 3621

prevention of, 3344

in SLE, 2741–2742

small-vessel, 3341

stroke risk following, 3344, 3344t

treatment of, 3325f, 3344

visual symptoms of, 225

Transient myeloproliferative disorder (TMD), 862

Transition (mutation), 3646

Transition/affirmation, in LGBT terminology,

3079t

Transitional cell (urothelial) carcinoma, 677, 678f.

See also Syphilis

Treponema pallidum particle agglutination (TPPA)

test, 1411

Treponematoses, 1413

clinical features of, 1415–1416, 1415f, 1416f

comparison of, 1414t

control of, 1416

diagnosis of, 1416

epidemiology of, 1414–1415, 1414f

treatment of, 1416

Treprostinil, 2127, 2129t, 2786

TREs (thyroid response elements), 2930, 2930f

Tretinoin. See All-trans-retinoic acid (ATRA)

TREX1 gene mutations, 2738, 2739

TRH (thyrotropin-releasing hormone), 2888t,

2892, 2895

Triamcinolone, 3531

Triamterene, 2083t, 2084, 2294

Triazolam

for anxiety disorders, 3544t

drug interactions of, 1703t

for insomnia, 212

overdosage/poisoning with, 3592t

pharmacology of, 3544t

Tribeč virus, 1626t

Tribendimidine, 1713

Trichiasis, 1451

Trichinella/trichinellosis, 1770

clinical features of, 1114t, 1770, 1962

diagnosis of, 1770–1771, 1771f, S12

eosinophilia in, 945t, S12

epidemiology of, 945t, 1770

life cycle of parasite, 1770, 1770f

pathogenesis of, 1697, 1770

prevention of, 1771

treatment of, 1713, 1771, 1771t

Trichloroethylene, 2584

Tricholemmoma, 395

Trichomonas vaginalis, 1768

Trichomonas vaginalis infections, 1083–1084,

1084t, 1092, 1768, S11

Trichophyton, 380, 387t, 1690. See also

Dermatophytosis

Trichosporon spp. infections, 564, 1653t, 1689t, 1690

Trichostatin A, 3796

Trichostrongylus/trichostrongyliasis, 1777

Trichotillomania, 387t

Trichromat, 218

Trichrome stain, S12

Trichuris trichiura/trichuriasis (whipworm), 945t,

1697, 1774t, 1776–1777, S12

Triclabendazole, 1703t, 1713, 1788t

Tricuspid atresia, 2016

Tricuspid regurgitation, 2002

in carcinoid heart disease, 670, 670f

clinical features of, 322, 2002–2003

diagnosis of, 2003

etiology of, 2002t, 2003

in mitral valve disease, 2006

murmur in, 279f, 280, 283, 283f

in pulmonary hypertension, 2122

treatment of, 2003–2004, 2003f

with tricuspid stenosis, 2007–2008

Tricuspid stenosis, 2001

clinical features of, 1816, 2001–2002

vs. constrictive pericarditis, 2024

diagnosis of, 2002

ECG in, 1802

etiology of, 2001, 2002t

heart sounds/murmur in, 279f, 284, 1822, 2002

imaging in, 2002

pathophysiology of, 2001

treatment of, 2002

with tricuspid regurgitation, 2007–2008

Tricuspid valve repair, 2007–2008

Tricyclic antidepressants (TCAs)

actions of, 3537

adverse effects of, 97–98, 3488t, 3542t,

3548–3549

autonomic overactivity, 3435

erectile dysfunction, 3058

hypertension, 2077t

hypothermia, 3631

orthostatic hypotension, 156

SA node dysfunction, 1875t

weight gain, 3087

for back pain, 126

contraindications to, 3549

for depression, 3542t, 3548, 3549f

distribution of, 467–468

drug interactions of, 467t, 471t, 1703t, 3543t

for functional dyspepsia, 297

genetic variations in response to, 476t, 477

for headache, 114, 116

for IBS, 2494–2495, 2496t

metabolism of, 467t

for migraine prevention, 3365t

for narcolepsy, 210

for nausea and vomiting, 293, 294, 294t

for neuropathy, 3125, 3488t

overdosage/poisoning with, 1830, 1831f, 3584,

3591t, 3592t, 3595t, A7

for pain, 95t, 97–98, 98t

pharmacology of, 3549

Trientine, 3236, 3409

Trifascicular block, 1886. See also Atrioventricular

(AV) conduction block

Trifluoperazine, 3555t

Trifluorothymidine, 1477

Trifluridine, 1461t, 1462

Trifluridine/tipiracil, 541t

Trigeminal autonomic cephalalgias, 113, 3358t,

3365–3366, 3366t

Trigeminal nerve

anatomy of, 3437, 3438f

disorders of, 236, 3436–3439, 3439t

examination of, 3280

Trigeminal neuralgia, 3437

clinical features of, 3437

diagnosis of, 3437

differential diagnosis of, 3437

ear pain in, 249

incidence of, 3437

in MS, 3463

oral pain in, 259

pathophysiology of, 3437

treatment of, 99, 3437–3439

vs. trigeminal autonomic cephalgias,

3366

Trigeminal neuropathy, 3439

Trigeminovascular system, 113

Triggered arrhythmias/activity, 1869, 1869f, 1869t

Trigger mechanism, bacterial, 951–952, 952f

Trigger, migraine, 3357

Trigger point injection, for IC/BPS, 330

Triglycerides

elevated levels of. See Hypertriglyceridemia

long-chain, 2458, 2460f

medium-chain, 2460

in NALFD, 2621

Trihexyphenidyl, 3396, 3404, 3555

Triiodothyronine (T3

)

characteristics of, 2929t

free, 2929, 2931

half-life of, 2886

laboratory evaluation of, 2929t, 2931

receptor binding of, 2930, 2930f

in sick euthyroid syndrome, 2944–2945

structure of, 2926f

in subacute thyroiditis, 2943–2944, 2944f

total, 2931

transport and metabolism of, 2929–2930

Trilostane, 2916

TRIM5-α protein, 1528

Trimethoprim

actions of, 767, 773, 1149, 1164t, 1165f, 2294

adverse effects of, 340, 353, 364, 773, 1704t

drug interactions of, 1704t

indications for, 1704t

for PCP, 1695t

resistance to, 1164t, 1165f, 1167

Trimethoprim-polymyxin, 220

Trimethoprim-sulfamethoxazole (TMP-SMZ)

actions of, 1160

adverse effects of, 1076t, 1154t, 1160, 1694, 1695t

cholestatic hepatitis, 319

in G6PD deficiency, 784t

hepatotoxicity, 2584, 2590

in HIV infection, 1571, 1573

neutropenia, 444

photosensitivity, 409

in pregnancy, 1211

serum sickness–like reaction, 408

thrombocytopenia, 905t

vasculitis, 2847t

for B. cepacia infections, 1287t

for bite-wound infections, 1126, 1127t

for blastocystosis, 1767

for Brucella infections, 1313–1314

for C. belli infections, 1766

for chronic granulomatous disease, 450

for Cyclospora infections, 1766

for cystitis, 1076, 1076t

for donovanosis, 1335t

drug interactions of, 1155t

for enteric fever, 1294t

for glanders, 1287t

for granulomatosis with polyangiitis, 2809

indications for, 1157t, 1160

for L. monocytogenes infections, 1211

for melioidosis, 1287t

for meningitis, 1105

for MRSA infections, 375, 948t, 1186t,

1187

for Nocardia infections, 1336t, 1339

for nontyphoidal Salmonella infections, 997t

for osteomyelitis, 1049t, 1050t

for paracoccidioidomycosis, 1687t

for PCP, 1566, 1694, 1695t

for PCP prophylaxis, 2330, 2806

for pertussis, 1260, 1261t

for plague, S3

INDEX

I-222 Trimethoprim-sulfamethoxazole (TMP-SMZ)

(Cont.):

prophylactic

in chronic neutropenia, 450

in HIV infection, 1563t

for PCP, 1563t, 1695, 1695t

for peritonitis, 1055

for toxoplasmosis, 1763

in transplant recipient, 901t, 1138, 1142t,

1143, 1144

for pyelonephritis, 1077

resistance to

in B. cepacia and S. maltophilia, 1287t

in E. coli, 1071, 1076–1077, 1157t

in Enterobacteriaceae, 1264, 1264t

mechanisms of, 1167

in S. aureus, 1157t

for S. maltophilia infections, 1287t

for staphylococcal soft tissue infections,

1186t

for Whipple’s disease, 1347

Trimethylamine N-oxide (TMAO), 3696–3697

Trimethylaminuria (fish odor syndrome),

2529

Trimetrexate, 1703t

Trimipramine, 3542t

Trinucleotide repeat disorders, 3648, 3655, 3655t

Triose phosphate isomerase deficiency, 781t

Tripeptidyl peptidase II, 2704t

Triple A syndrome, 2970t

Triple-negative breast cancer, 608, 614

Triptans, 3357, 3362t, 3363, 3595t

Triptorelin, 613t, 620

Trismus (lockjaw), 1212, 3439

Trisomy 12, 835, 835f

Trisomy 13, 2119

Trisomy 18, 2119

Trisomy 21. See Down’s syndrome (trisomy 21)

Tritium exposure, S5

TrkB gene mutations, 3084t, 3085

TRK gene mutations, 2951

Trochanteric bursitis, 2850, 2851f

Trochlear nerve, 192, 3279–3280, 3459

Troglitazone, 2586, 3112

TROP-2 overexpression, 613t

Tropheryma whippelii, 1047, 1344, 1345, 2464. See

also Whipple’s disease

Trophic factors, 3398

Trophozoites, Plasmodium, 1721

Tropical pulmonary eosinophilia, 449, 1781

Tropical spastic paraparesis. See HAM (HTLV-1-

associated myelopathy)

Tropical sprue, 303, 772, 2464

Tropical storms, 3729–3731, 3730f

Tropisetron, 80

Tropomyosin, 1804–1805, 1957f

Troponins

in cardiac contraction, 1804–1805, 1804f

in cardiac trauma, 2029

in chest pain evaluation, 106

in CKD, 2315

in NSTE-ACS, 2047–2048

in STEMI, 2055, 2055f

Trousseau’s sign, 358, 660

Trousseau’s syndrome, 599, 659, 726

TRPM6 gene mutations, 2293

TRP proteins, 233

TRPV1 channel antagonists, 270

TRPV1 channels, 2492

Trubanaman virus, 1627t, 1631

True bug bites, 3615

True-negative tests, 24–25

True neurogenic thoracic outlet syndrome (TOS),

128

True-positive tests, 24–25

Trust, between patient and health care provider,

64–65, 67

Trypanids, 1754

Trypanosoma spp.

T. brucei gambiense/rhodesiense, 1114t, 1698,

1753–1754, 1753f, 1961, S12. See also

Human African trypanosomiasis

T. cruzi, 1698, 1749, 1961, S12. See also Chagas

disease

Trypanothione reductase, 1701

Trypsinogen, 2460

l-Tryptophan

contamination of, 407, 449, 2773, 3787

drug interactions of, 3543t

overdosage/poisoning with, 3595t

Tryptophan hydroxylase, 668, 668f, 2492, 2696t

Tryptophan metabolism disorders, 3269t, 3270t

TSC1/2 gene mutations

in HCC, 645, 645t

in lymphangioleiomyomatosis, 2197

in psychiatric disorders, 3535, 3537

in tuberous sclerosis, 503t, 663, 674t, 707–708,

2354

in urothelial carcinoma, 677

T-scores, 3191, 3196, 3196f, 3201

Tsetse flies, 1753

TSH. See Thyroid-stimulating hormone (TSH)

TSI (thyroid-stimulating immunoglobulin), 2932

T-SPOT TB assay, 1371

TSS. See Toxic shock syndrome (TSS)

TTF-1. See Thyroid transcription factor-1 (TTF-1)

TTF-2, 2926, 2934t

TTKG (transtubular K+ concentration gradient),

350, 353, 354f, S1

TTN gene mutations, 1956t, 1965

TTP. See Thrombotic thrombocytopenic purpura

(TTP)

TTR (transthyretin), 878, 878t, 882, 2538t, 2930t,

Tubal (ectopic) pregnancy, 85, 111t, 112, 3037, 3038

Tubal sterilization, 3053, 3054t

TUBB3 gene mutations, 3015t

Tubby syndrome, 3084t

Tuberculin skin test (TST). See Purified protein

derivative (PPD)/tuberculin skin test

(TST)

Tuberculoid leprosy, 389–390, 1385, 1385f

Tuberculoma, 1366

Tuberculosis (TB), 1357

bronchiectasis in, 2174

in cancer patient, 556t, 557, 558t

as cause of fever of unknown origin, 147, 151

in children, 1362–1363, 1363f, 1372t, 1378

as chronic disease, 3709–3710

complications of, 1367

diagnosis of

biomarkers, 1371

culture, 1369

drug susceptibility testing, 1369–1370

genomics in, 961t

IFN-γ release assays, 1371

imaging, 1363f, 1370, A12, A16

invasive procedures, 1370

limitations of, 960–961

microscopy, 1369

nucleic acid amplification, 1368–1369,

S11

serologic tests, 1371

tuberculin skin testing, 1362, 1371

epidemiology of, 1357–1359, 1358f, 1397,

3709–3710

etiology of. See Mycobacterium tuberculosis

extensively drug-resistant, 1359, 1373t, 3708

extrapulmonary

adrenal, 1367

aortic aneurysm, 2102

congenital, 1367

gastrointestinal, 323, 1366

genital, 1087

genitourinary, 1365, 1365f, 3035

in HIV infection, 1367–1368

lymphadenitis, 458, 459, 1363f, 1364

lymphedema, 2119

mastitis, 1367

meningitis, 560, 946t, 968, 1113t, 1365–1366,

A16

miliary, 147, 1363f, 1366–1367, 1378

ocular manifestations, 1367

oral manifestations, 258t, 261

otitis, 1367

pericardial, 2023, 2025

pericarditis, 1366

pleural, 1364

skin manifestations, 397, 1037, 1367

spinal/skeletal

vs. Brucella infection, 1312, 1312t

clinical features of, 1043, 1365

diagnosis of, 147, A16

osteomyelitis, 1043, 1047, 1052

Poncet’s disease, 1043

Pott’s disease, 123, 1060, 1365, 1365f

treatment of, 1378

tuberculoma, 1366

upper airway, 1365

global burden of, 1357–1359, 1358f, 1397,

3709–3710

in HIV infection

antiretroviral therapy and, 1368, 1397

clinical features of, 1367–1368, 1566–1567

control of, 1381

in developing countries, 1367, 1381–1382,

3707f, 3708

epidemiology of, 1359, 1367, 1367f, 1566

immune reconstitution inflammatory

syndrome in, 1368, 1397, 1567

interaction of, 1545

prophylaxis for, 1379t, 1380–1381, 1380t,

1563t

risk of, 1359–1360, 1360t

treatment of, 1377–1378, 1402, 1567

incubation period for, S6

infection control measures, 1133–1134, 1595

inflammasome mutations in, 2677t

innate resistance to, 1361

latent infection

diagnosis of, 967

screening for, 1379–1380, 1379t, 2763

treatment of, 1379–1381, 1380t, 1397, 1397t

multidrug-resistant

detection of, 961t, 965, 966

epidemiology of, 1357–1359, 1375–1376,

1375f

treatment of, 1373t, 1375–1377, 1376t, 1377t,

1399, 1399t, 3708

natural history of, 1360

pathogenesis of, 1360–1362

prevention and control of, 1381–1382, 3708

pulmonary

cough in, 269, 1364

hemoptysis, 270

INDEX

hemoptysis in, 1364 I-223

pleuritis in, 2199

postprimary disease, 1359, 1363–1364, 1363f

primary disease, 1359, 1362–1363, 1363f

risk factors for, 1359–1360, 1360t

silica exposure and, 2169

transmission of, 1359–1360

in transplant recipient, 1138, 1140, 1142t, 1146

treatment of, 1372, 1397

adherence to, 1373–1374

adverse effects of, 1374–1375, 1400–1402

in children, 1372t, 1378

DOTS/DOTS plus strategy, 1374, 1398–1399,

3708

for drug-resistant strains, 1375–1377, 1376t,

1377t, 1399, 1399t

drug susceptibility testing, 1369–1370

in extrapulmonary disease, 1378t

failure and relapse, 1375

first-line antituberculosis drugs, 1372t,

1399–1402

ethambutol. See Ethambutol

isoniazid. See Isoniazid (INH)

pyrazinamide. See Pyrazinamide

rifabutin, 1402

rifampin. See Rifampin

rifapentine, 1402

fixed-dose combination products, 1374

monitoring response to, 1374–1375, 1398t

patient care and support, 1373–1374

in pregnancy, 1373t, 1378t

preventive, 1379–1381, 1379t, 1397, 1397t

principles of, 1397–1399, 1398t

regimens, 1372–1373, 1372t, 1398t

second-line antituberculosis drugs, 1402–1404

simplified approach to, 1397, 1398t

streptomycin, 1371–1372

in war veterans, S6

Tuberous sclerosis (Bourneville disease)

brain tumors in, 703, 708

clinical features of, 388, 703t, 708, 2351t, 2354,

3535

genetic considerations in, 503t, 674t, 703t, 707–

708, 2351t, 2354

MRI in, A16

NETs in, 663

pathogenesis of, 708, 2354

renal cell carcinoma and, 674t, 2354

skin manifestations of, 374, 388, 395

treatment of, 708

Tuberous xanthoma, 395, A15

Tublin, 674t, 2696t

Tuboovarian abscess, 1342, 1342f, 1353

Tubuloglomerular feedback, 2288, 2295f, 2297

Tubulointerstitial diseases, 2357

acute interstitial nephritis. See Acute interstitial

nephritis (AIN)

autosomal dominant, 2355

chronic, 2281–2282, 2357t, 2360

analgesic nephropathy, 2362, 2362f

aristolochic acid nephropathy, 2282, 2301,

2362, 2364

calcineurin-inhibitor nephropathy, 2330, 2363

clinical features of, 2357

in glomerulonephritis, 2362

heavy metal nephropathy, 2363

karyomegalic tubulointerstitial nephritis,

2356, 2362

lithium-associated nephropathy, 2362–2363

sickle cell nephropathy, 2336t, 2348, 2362

vesicoureteral reflux and reflux nephropathy,

2360–2361, 2361f

classification of, 2357t

global considerations in, 2364

metabolic, 2357t

hyperkalemic nephropathy, 2363

hypokalemic nephropathy, 2364

noninflammatory, 2281–2282

uric acid nephropathy. See Uric acid nephropathy

Tubulointerstitial nephritis with uveitis (TINU),

2281, 2359, 2359f

Tucatinib, 513t, 544, 546t, 613t, 625

Tularemia, 1314

animal bite-related, 1125

at-risk exposures and populations, 1315–1316

in bioterrorism, S3

clinical features of, 140t, 1037, 1316–1317, A1,

complications of, 1317

diagnosis of, 1317–1318, S3

epidemiology of, 1315, 1315f

etiology of. See Francisella tularensis

global considerations in, 1315

pathogenesis of, 1316

prevention of, 1319, S3

prognosis of, 1319

septic shock in, 976

severe type A, 1316

treatment of, 1318–1319, 1319t, S3

Tula virus, 1628t

Tullio phenomenon, 240

Tumbu fly, 3611

Tumor, 508. See also specific types and sites

Tumor (sign of inflammation), 440f

Tumor (skin lesion), 369t

Tumoral calcinosis, 2314, 2314f, 3163–3164,

3216–3217

Tumor burden, 484, 3839

Tumor heterogeneity, 506–507, 506f

Tumor-induced osteomalacia, 722t, 725, 3161, 3163

Tumor-infiltrating lymphocytes, 2702

Tumor lysis syndrome

AKI in, 2301, 2303t, 2304

clinical features of, 573, 2301

hyperkalemia in, 353

hypocalcemia in, 358

treatment of, 573–574, 574f, 3252

uremic syndrome in, 2285f

Tumor markers, 487, 487t, 717, 717t

Tumor necrosis factor (TNF), 131, 131f, 752, 753f,

2830, 2830f

Tumor necrosis factor receptor(s), 518

Tumor necrosis factor (type III) receptor family,

2688

Tumor necrosis factor-α (TNF-α)

in axial spondyloarthritis, 2791

in Brucella infections, 1311

in depression, 3539

elevated levels, in aging, 3736

functions of, 448, 2707t

in heart failure, 1934

in HIV infection, 1546

monoclonal antibodies targeting, 2707t

in NTM infections, 1393

in rheumatic fever, 2767

in rheumatoid arthritis, 2757f, 2758

source, target, and biologic activity of, 2682t

in vasculitis syndromes, 2804

Tumor necrosis factor-α (TNF-α) inhibitors. See

also specific drugs

adverse effects of, 2485, 2762t, 2794

antibody development, 2485

cutaneous, 383, 409, 586, 2485

encephalopathy, 2274t

hepatosplenic T-cell lymphoma, 2485

immunosuppression, 420

infections, 132, 2485, 2763, 2794

latent tuberculosis reactivation, 2763

non-Hodgkin’s lymphoma, 2485

periodic syndrome (TRAPS), 132, 151, 448,

2841t, 2842–2843

pulmonary, 2192

serious, 375, 379t, 2762t

for alcohol-associated liver disease, 2626

for autoimmune and inflammatory diseases,

2701

for axial spondyloarthritis, 2794, 2796f

contraindications to, 375, 450, 2795

for IBD, 2484–2485

for IBD-associated arthritis, 2802

monitoring during treatment with, 2762t

for psoriasis or psoriatic arthritis, 375, 379t

for psoriatic arthritis, 2796f, 2800

for rheumatoid arthritis, 2761, 2762t, 2763

for sarcoidosis, 2836

Tumor necrosis factor-α receptor-associated

periodic syndrome (TRAPS), 132, 151,

448, 1115t, 2841t, 2842–2843

Tumor necrosis factor-β (TNF-β), 2682t

Tumor neoantigens, 2702

Tumor-suppressor genes

definition of, 499

epigenetic silencing of, in cancer, 516–517, 517f

inactivation of, 501

in lung cancer, 597

role of, 501

in thyroid cancer, 2950–2951

Tumor vaccines, 538

Tumstatin, 526f

Tunari virus, 1629t, 1641

Tunga penetrans, 3614

Tungiasis, 3615

Tungsten carbide exposure, 2170

Tunica media, 1801, 1801f

Tunneled catheters, 2322, 2324, 2377

Turcot’s syndrome, 637, 638t

Turcot syndrome, 703t, 706

Turkey, 50, 50t

Turkey handling disease, 2160t

Turmeric, 454t

Turner sign, 2659

Turner syndrome, 3000

aortic aneurysm in, 2102

aortic valve disease in, 1979

autoimmune polyendocrine deficiencies in,

2995t, 2997

clinical features of, 3000, 3001t

coarctation of the aorta in, 2079

genetic considerations in, 3653

IBD and, 2472t

lymphedema in, 2119

pathophysiology of, 3000

prevalence of, 2884t

primary ovarian insufficiency in, 3036

screening/testing for, 2884t

treatment of, 3000–3001

Tusavirus, 1497

Tuskegee study, 65

T wave, 1826, 1868

Twiddler’s syndrome, 1880

Twinkle gene mutations, 3529

Two-point discrimination test, 172, 3281

Tylosis palmaris et plantaris, 627

Tympanic membrane, 238, 239f, 242, 246, 250

Tympanic membrane perforation, 239

Tympanic membrane thermometer, 130

INDEX

I-224 Tympanogram, 245

Tympanometry, 245

Tympanoplasty, 239, 246

Tympanostomy tubes, 246, 250, 251

Typhilitis (neutropenic enterocolitis), 560, 577,

577f, 1353

Typhoidal tularemia, 1317

Typhoid fever. See Enteric (typhoid) fever

Typhoid fever vaccine, 992t, 993, 1147, 1295

Typhus

endemic. See Endemic (murine) typhus

epidemic. See Epidemic (louse-borne) typhus

scrub. See Scrub typhus

Tyramine, 3395

Tyrosinase, 418, 2696t

Tyrosinase gene mutations, 386

Tyrosine hydroxylase, 2696t

Tyrosine kinase inhibitors (TKIs)

actions and targets of, 511

adverse effects of, 410, 593, 739, 741, 825, 827,

1964

for ALL, 722t, 832–833

for AML, 816t

for breast cancer, 613t, 621–622

for CML, 823–825, 824t, 826t

cost of, 827–828

discontinuation of, 825

global considerations in, 827–828, 828f

for head and neck cancer, 593

for lung cancer, 606, 606t

for NETs, 672

non-receptor-linked, 544, 545t

in pregnancy, 827

receptor-linked, 544, 545–546t

resistance to, 820–821

Tyrosine kinase receptors, 2887f, 2888

Tyrosine metabolism disorders, 3269t

Tyrosinemia, 3269t

Tzanck smear, 373

UBA1 gene mutations, 2828

Ubiquitin, 3404, 3410

Ublituximab, 839

Ubrogepant, 3362t, 3363–3364, 3363t

UDCA. See Ursodeoxycholic acid (UDCA)

Udd (tibial) muscular dystrophy, 3525t, 3527

UDP (uridine diphosphate)

glucuronosyltransferase, 315, 318, 2557,

2557f

UDPGT gene mutations, 318

UGT1A1

in bilirubin metabolism, 2557, 2557f

in Crigler-Najjar syndrome, 2559

drug disposition and, 467t

drug response and, 476t

frequency of variants in, 475t

in Gilbert syndrome, 478, 2560

in neonatal jaundice, 2558

UGT1A1 gene, 467t, 2557, 2558f

UGT1A1 gene mutations, 784, 2644

UGT1 gene complex, 2557, 2558f, 2559

UGT2B17 gene, 3074

Uhthoff ’s symptom, 3463

Ularitide, 1944, 1946t

Ulcer(s). See also specific types

cutaneous. See Cutaneous ulcers

definition of, 2434, 2437

foot, 3127. See also Diabetes mellitus,

complications of

genital. See Genital ulcer(s)

leg, 760, 763t

oral, 257, A3

pressure, 1037, 3455

Ulcerative colitis. See also Inflammatory bowel

disease (IBD)

clinical features of, 399, 2475, 2475t

diarrhea, 304

extraintestinal, 304, 399

colorectal cancer in, 2489, 2489f

complications of, 2475–2476

diagnosis of, 2475, 2475t, 2476f

differential diagnosis of, 1304, 2479–2480,

2479t

epidemiology of, 2469–2470, 2470t

etiology of, 2470

familial patterns of, 2470

genetic considerations in, 2471–2473, 2472t

global considerations in, 2470

immune regulation in, 2473

pathogenesis of, 2695

pathology of, 2474, 2474f

in pregnancy, 2488–2489

racial and ethnic differences in, 2470

serologic markers in, 2477–2478

smoking effects on, 2470

spondyloarthritis and, 2801–2802

treatment of. See Inflammatory bowel disease

(IBD), treatment of

tumor markers in, 487t

Ulipristal acetate, 3055

Ulnar neuropathy, 3498

Ultradian rhythm, 3801t

Ultrafiltration, 1944, 2322

Ultra-rapid metabolizers, 475, 476f

Ultrasonography

in appendicitis, 2515

in bile duct disease, 2651t

in bone mass measurement, 3197

in cholestatic conditions, 319

in chronic venous disease, 2116

of deep leg veins, 2096, 2096f

endobronchial, 599

endoscopic. See Endoscopic ultrasound (EUS)

in fever of unknown origin, 147

in gallbladder disease, 2645, 2645t, 2646f

for hepatocellular carcinoma screening, 646

in infertility evaluation, 3051

intravascular coronary artery, 1865, 1865f

in liver disease evaluation, 2550, 2551t, 2556

in lymphadenopathy, 459

in musculoskeletal disease evaluation, 2853

in pancreatic disease evaluation, 2654t, 2655

in peripheral arterial disease, 2108

pleural, 2133

point-of-care, 2239–2240

renal arteries, 2088

of renal arteries, 2089t

in renal disease evaluation, 2287

in rheumatoid arthritis, 2760, 2760f

scrotal, 690

small-bowel, 2477

in splenomegaly, 461

in stroke, 3334–3335

in thyroid dysfunction evaluation, 2932

in thyroid nodule evaluation, 2932, 2947f, 2948f,

2954

transvaginal, 496t, 497, 695

in urinary tract obstruction, 2375

Ultratrace elements, 2534

Ultraviolet light, 417, 420. See also Sun exposure

Ultraviolet light therapy. See Phototherapy

Umami taste sensation, 233

Umbilical cord stem cells, 746, 898, 3798

Umbilical venous hum, 322

Umbralisib, 839

Umbrella cells, 326

UMOD gene mutations, 2355

UMP (uridine-5’-monophosphate synthetase)

deficiency, 3253t, 3254

UNAIDS (Joint United Nations Program on HIV/

AIDS), 3707

Una virus, 1625t

Uncal transtentorial herniation, 184, 184f

Underweight, 3088t

Undiagnosed disease

approach to the patient, 3851, 3855f

challenges in, 3854

data collection for, 3851–3852, 3851t

effect on patient, 3851

exposure assessment in, 3853–3854

factors contributing to, 3851t

genomics in, 3853

periodic reevaluation in, 3853

rare, 3851

research approaches in, 3854

testing strategies and new technologies, 3851–

3852, 3851t, 3853t

validation of subjective and objective findings in,

3851–3852

Undifferentiated pleomorphic sarcoma, 713

Undulant fever. See Brucella spp. infections

Unequal Treatment (IOM report), 62–66

Unfractionated heparin. See Heparin

Uniform Manifold Approximation and Projection

(UMAP), 3827t, 3828

Uniparental disomy, 700, 3654

Unipolar depressive disorders, 3548. See also

Depression/depressive disorders

Uniporters, 2290

United Kingdom

elective specialist access in, 46

health system financing in, 42, 43t

health system governance in, 48

hospital funding in, 44

pharmaceutical expenditures in, 47

primary care access in, 45

United Nations, 3703–3704

United Network of Organ Sharing (UNOS), 2635,

2636t

United States

health system financing in, 44

health system governance in, 48

life expectancy, at birth by county, 61f

life expectancy, by race and sex, 60f

long-term care funding in, 47

patient care financing in, 43

primary care access in, 45

Universal coverage reforms, 3722–3723, 3723f

University of Pennsylvania Smell Identification

Test, 234f, 237

Unstable angina, 101t, 102, 2046. See also NonST-segment elevation acute coronary

syndrome (NSTE-ACS)

Unstable hemoglobins, 765, 765t

Unverricht-Lundborg disease (Baltic myoclonus),

3308t, 3407

Upadacitinib, 2763t, 2796

Upbeat nystagmus, 231

UPOINT, 327

Upper airway cough syndrome, 269

Upper esophageal sphincter, 288

Upper motor neuron diseases, 3413–3414t,

3415–3416, 3482

Upper motor neuron pathways, 166f

Upper motor neuron weakness, 165, 165t

INDEX

Upper respiratory infections (URIs). See I-225

Respiratory tract infections

Upshaw-Schulman syndrome, 907, 2365

Uranium-235 exposure, S5

Urate(s), 3248–3249

Urate nephropathy (urate nephrosis), 2360, 3251

Urate oxidase. See Rasburicase

Urate transporter 1 (URAT1), 3249, 3249f

Urea breath test, 1281t, 1282

Urea cycle, 3272–3273, 3273f

Urea cycle defects, 3270t, 3272

Ureaplasma infections, 1080, 1443–1444, 1443t

Urea, urinary, 2541

Ureidopropionase deficiency, 3253t

Uremia

abdominal pain in, 110

in AKI, 2306

peripheral blood smear in, 428f, 434f

polyneuropathy in, 3490

Uremic acidosis, 364

Uremic fetor, 2317

Uremic syndrome, 2284, 2285f, 2312. See also

Chronic kidney disease (CKD)

Ureteral cancer, 676

Ureteral infections, 562

Ureteral obstruction, 108

Ureteral reflux, 2286

Ureterectomy, 680

Ureteric bud, 2287, 2288f

Urethritis

in men

approach to the patient, 1081

C. glucuronolyticum, 1208

chlamydial, 1446, 1449t

clinical features of, 1081, 1236

etiology of, 1080, 1080t, 1236

gonococcal, 1236–1237, 1236f

nongonococcal, 1446, 1449t

postgonococcal, 1446, 1449t

in reactive arthritis and, 2797

treatment of, 1081–1082, 1082t

Mycoplasma, 1443

Ureaplasma, 1443

in women, 337, 1083, 1237, 1447–1448, 1449t

Urge incontinence, 3753, 3757f, 3757t

Uric acid

decreased excretion of, 2292t, 3251t, 3252

increased production of. See Hyperuricemia

laboratory evaluation of, 2851

metabolism of, 3248–3249, 3248f, 3249f

stones, renal, 2373, 3252. See also Nephrolithiasis

tissue deposition of (tophi), 2854f

urine, 2369, 3249, A4

Uric acid nephropathy

in AML, 814

hyperuricemia and, 2363, 3251–3252

pathophysiology of, 2363

treatment of, 2363, 3252

Uric acid stones, renal, 2368, 2373, 3252. See also

Nephrolithiasis

Uricosuric compounds, 3249, 3249t

Uridine-5’-monophosphate synthetase (UMP)

deficiency, 3253t, 3254

Uridine diphosphate galactose 4-epimerase

deficiency, 3264t, 3267

Uridine diphosphate-glucuronosyl transferase

(UDPGT), 315, 318

Urinalysis

in abdominal pain evaluation, 111

in AKI, 2302, 2304f

atlas of, A4

in hematuria, 337. See also Hematuria

in IC/BPS, 328

in nephrolithiasis, 2370f, 2371

in nutrition assessment, 2538t

parasites in, S12

in proteinuria, 336–337. See also Proteinuria

specimen collection and transport, S11

in urinary tract infections, 1075

Urinary alkalinization, for overdosage/poisoning,

3589

Urinary analgesics, 1077

Urinary diversion, 679

Urinary electrolyte free-water clearance, 345f, 347

Urinary incontinence

after prostatectomy, 685

in older adults, 3753–3754, 3754t, 3755f, 3756t,

3757f, 3757t

postmenopausal hormone therapy and, 3046t

in terminally ill patient, 88t

Urinary tract

bleeding from. See Hematuria

congenital abnormalities of, 2356, 2373, 2374t

Urinary tract infections (UTIs), 1070

approach to the patient, 1072–1073, 1075f

in cancer patient, 562

catheter-associated, 1077–1078, 1129–1130,

1131t

clinical features of, 1072–1073

complicated, 1070, 1073, 1077

definitions in, 1070–1071

delirium in, 180

in diabetes mellitus, 3125, 3128

diagnosis of, 1073–1074, 1074f

epidemiology of, 1071

etiology of, 1071

A. baumannii, 1277

Citrobacter, 1273

C. urealyticum, 1207

E. coli, 1072, 1076, 1266

enterococcal, 1199, 1201t

K. pneumoniae, 1271, 2373

Morganella, 1284

nontyphoidal Salmonella, 1297

P. aeruginosa, 1287t, 1289

Proteus, 1272, 2373

Providencia, 1284, 2373

S. aureus, 1183

S. saprophyticus, 1184

tuberculous, 1365

genetic considerations in, 1072

in IC/BPS, 325

vs. IC/BPS, 328

in men, 1071, 1077

in MS, 3474

nephrolithiasis and, 2373

pathogenesis of, 1071–1072, 1072f, 1073f

in pregnancy, 1071, 1077, 3767

prevention of, 1078

prognosis of, 1078

pyelonephritis. See Pyelonephritis

recurrent, 1070, 1071, 1078

renal abscess and, 1060

risk factors for, 1071

in transplant recipient, 1142

treatment of

asymptomatic bacteriuria, 1077

Candida infection, 1078

catheter-associated, 1077–1078, 1130

complicated infection, 1077

drug resistance and, 1071, 1075

E. coli infection, 1267

in men, 1077

in pregnancy, 1077

pyelonephritis, 1077

uncomplicated cystitis in women, 135–137, 1076t

urinary tract obstruction in, 2375

Urinary tract obstruction, 2373

AKI and, 334, 2301, 2302f

in cancer, 567–568

clinical features of, 332t, 568, 2374–2375

diagnosis of, 332t, 2375–2376, 2375f

diuresis following, 2376

etiology of, 2373–2374, 2374t

hyponatremia in, 342

pathophysiology of, 2374–2375, 2374t

prognosis of, 2376

treatment of, 2307, 2376

Urinary d-xylose test, 2468

Urination, painful

in cystitis. See Cystitis

in urinary tract infections. See Urinary tract

infections (UTIs)

Urine

abnormalities of, 332t, 336. See also Urinalysis

casts, 337, A4

crystals, 3274, A4

hematuria. See Hematuria

polyuria. See Polyuria

proteinuria. See Proteinuria

pyuria, 337

black, 3272

nephrolithiasis risk and, 2369

osmolality of, 334t, 337, 344, 347

sodium loss in, 341, 344

tea/cola-colored, 315, 2280

Urine bilirubin, 316, 2553, 2556t, 2557

Urine culture, 1075

Urine dipstick test, 316, 1075

Urine output, 2237, 2517

Urobilinogens, 316, 2557

Urobilins, 316

Urocanic acid, 420

Urocanic aciduria, 3269t

Urochromes, 2318

URO-decarboxylase, 3239t, 3240, 3240t, 3245

UROD gene mutations, 423, 3244, 3245

Urogenital secretions, specimen collection and

transport, S11

Urography, 2376

UROIII, 718

Urokinase, 938

Urokinase-type plasminogen activator (u-PA), 452,

452f

Urologic chronic pelvic pain syndrome (UCPPS), 325

Uromodulin (Tamm-Horsfall protein), 336, 337,

2301, 2355, 2360

Uropathogenic E. coli (UPEC), 949–950, 950t.

topics

11/9/25

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