topics

11/9/25

INDEX

I-60 Death, leading causes of (Cont.):

in men, 3064f, 3069

in United States and Britain, 73t

in women, 3064f

worldwide, 1812f, 3704, 3706t

site of, 73–74, 73f

of spouse, 89

sudden cardiac. See Sudden cardiac death

Death adders, 3596

Death rattle, 88, 88t

Death receptors, 518, 518f, 519, 2695, 2697f

deaths from, 73t, 1010

Debranching enzyme deficiency (type IIIa/b GSD),

1967, 3262, 3263t, 3528

DEB-TACE (drug-eluting bead

chemoembolization), 651

DEC. See Diethylcarbamazine (DEC)

Deception, 69

Decerebrate rigidity, 186

Decision limits, S10

Decision-making. See Clinical reasoning

Decision support tools, 27

Decitabine

actions of, 549t, 552, 3794, 3796

adverse effects of, 549t, 801

for AML, 815

for myelodysplasia, 801

for primary myelofibrosis, 807

Declaration of Alma Ata, 3718

Decompression sickness, 3626t, 3629–3630, 3630t

Deconditioning, 265t, 266

Decongestants

adverse effects of, 2077t

for nasal congestion, 2725

overdosage/poisoning with, 3584, 3590t

for upper respiratory infection, 249

Decorin, 3219t

Decorporation, S5

Decorticate rigidity, 186

Decremental conduction, 1880

Dectin-1, 1672

Decubitus (pressure) ulcers, 1037, 3455

Deep brain stimulation (DBS)

for depression, 3544, 3824

for dystonia, 3404

for headache, 3367

for obsessive-compulsive disorder, 3546

for PD, 3397, 3823

for seizures, 3321

Deep venous thrombosis (DVT), 2091

asymptomatic, 2097

classification of, 2094

in critically ill patient, 2223

diagnosis of, 2094–2097, 2095f, 2095t, 2096f,

2098f

differential diagnosis of, 2095, 2095t

d-dimer test for, 452

embolization of, 2093, 2094f

epidemiology of, 922

history in, 454–455

in HIV infection, 1575

isolated calf, 2098

oral contraceptives and, 3054

paraneoplastic, 726–727, 727t

perioperative prophylaxis for, 3773

postmenopausal hormone therapy and, 3045,

3046t, 3048f

in pregnancy, 3766

prevention of, 2098, 2100–2101, 2100t, 2223, 3356

risk factors for, 454–455, 455f

treatment of, 2097–2098, 3766

upper extremity, 2097–2098

Deerpox, 1492t

Deer tick. See Ixodes spp. ticks

Defaults/status quo bias, 3776t, 3779

Defecation, 299, 299f

Defecography, 308

Defensins, 440

Defensive medicine, 24

Deferasirox, 763, 1685, 3234

Deferiprone, 763

Deferoxamine, 763, 3234, 3593t

Defibrillator, implantable. See Cardiovascular

implantable electronic devices (CIEDs)

Deformity, joint, 2848, 2848t

Degarelix, 686, 687f

Deglutitive inhibition, 288

Dehalogenase 1 (IYD), 2934t

Dehydrated stomatocytosis, 780

Dehydration

in cholera, 1307–1308, 1308t

delirium in, 180

in diarrhea, 302

in hypothermia, 3632

mechanisms of, 2294, 2295f

in terminally ill patient, 88t

Dehydroemetine. See Emetine

Dehydroepiandrosterone (DHEA)

for adrenal insufficiency, 2973

adverse effects of, 2744t

in hirsutism, 3040

for SLE, 2744t, 2746

synthesis of, 2955f

Deiodinase(s), 2926f, 2929–2930

Déjérine-Roussy syndrome, 173, 3328, 3350

Delafloxacin, 1149, 1157t, 1164t, 1186t, 1187

Delamanid, 1372, 1376, 1378, 1398t, 1403

Delavirdine, 1590f

Delayed afterdepolarizations (DADs), 1869, 1869f,

1869t

Delayed puberty

in β thalassemia, 763t

female, 3032t, 3033, 3033t

male, 3012t, 3013

Delayed sleep-wake phase disorder, 207, 213, 3804

Delayed-type hypersensitivity reaction, 408–409,

1361–1362, 1387, 2700

Deletion. See Insertions/deletions

Delirium, 178

approach to the patient, 179

assessment of, 83, 179–180, 182t

clinical features of, 178

in critically ill patient, 178–179, 183, 2224,

2272–2273

dementia and, 178

diagnosis of, 181, 181t

drug-induced, 179, 180, 181t, 2060

epidemiology of, 178–179

etiology of, 83, 180–181, 181t

at high altitudes, 3621

history in, 179–180

morbidity of, 179

in older adults, 178, 2272–2273, 3751–3753,

3752f, 3752t

pathogenesis of, 179

physical examination in, 180

postoperative/ICU, 2224

prevention of, 183

reversibility of, 178

risk factors for, 178, 3752t

in sepsis/septic shock, 2245

in terminally ill patient, 83–84, 83t

treatment of, 83–84, 83t, 182–183, 182f, 2273

Delirium tremens, 178, 3561–3562

Delta fraction, 316

Delta hepatitis. See Hepatitis D virus (HDV)

infection

Delta receptors, 3569t

Deltaretroviruses. See Human T-cell lymphotropic

virus (HTLV-1)

Delusional infestations, 3615, 3616f

Delzicol, 2482, 2483t

Demeclocycline, 345, 599, 723, S1

Dementia, 189

in AD. See Alzheimer’s disease

aging and, 3736

aphasia in, 198–199

approach to the patient, 191

clinical features of, 191t, 192, 236

cognitive examination in, 155

in Creutzfeldt-Jakob disease. See CreutzfeldtJakob disease (CJD)

definition of, 189

delirium and, 178

diagnosis of, 191t, 192–193

differential diagnosis of, 190t

epidemiology of, 3751

etiology of, 189–190, 190t, 3375–3378

frontotemporal. See Frontotemporal dementia

(FTD)

functional anatomy of, 189

genotypes of, 33

global considerations in, 194

history in, 191–192, 191t

HIV-associated, 1576, 1577f, 1577t

imaging in, 193f

insomnia in, 211

with Lewy bodies. See Dementia with Lewy

bodies

molecular basis of, 191t

neurologic examination in, 191t, 192–193

nutritional support in, 2546

obesity and, 3087

in PD, 190, 3370, 3385, 3398

physical examination in, 191t, 192–193

postmenopausal hormone therapy and, 3046t,

3047–3048

prevalence of, 189

semantic, 202

treatment of, 194–195, 3752–3753, 3753t

types of, 190

vascular, 190, 191t

Dementia pugilistica. See Chronic traumatic

encephalopathy

Dementia with Lewy bodies

vs. AD, 3385, 3385t

clinical features of, 178, 190, 191t, 192, 204, 213,

3385

vs. Creutzfeldt-Jakob disease, 3420

diagnosis of, 3386

glucocerebrosidase in, 3298

molecular basis of, 191t

olfactory dysfunction in, 236

vs. Parkinson’s disease dementia, 3385, 3398,

3751

pathogenesis of, 3386

pathology of, 3385–3386

prions in, 3297f

treatment of, 3386

Demethylation, of DNA, 517

Demodex spp., 386

Demyelination, in MS, 3464, 3465, 3465f

Dendritic cells

in autoimmunity, 2733

definition of, 2671

functions of, 2676, 2678–2679, 2679t, 2680f

INDEX

hematopoietic differentiation of, 746f, 2676, I-61

2680f

in HIV infection, 1550

myeloid, 2676, 2679t

neoplasms of, 855t, 865

plasmacytoid 1, 2676, 2679t

for prostate cancer, 2701

Dengue viruses, 1626t

Dengue virus infection

climate change and, 1004–1005, 1005f, 1006f,

1008f

clinical features of, 135t, 393, 978, 1640, A1

diagnosis of, 1640

epidemiology of, 135t, 141, 978, 1640

Aedes distribution and, 1005f, 3715

climate change and, 1004–1005, 1005f, 1006f

El Niño and, 1008, 1008f

severe, 978, 1640, 1644

vaccine, 996, 3718

Denmark, 42, 43t

Dennie-Morgan folds, 374

Denosumab

actions of, 514t, 520, 3206

adverse effects of, 3206

for bone metastases, 625

for hypercalcemia, 357, 723, 3184, 3184t

indications for, 3206

for metastatic bone disease, 716

for multiple myeloma, 715

for osteoporosis management/prevention, 3045,

3205–3206, 3206f

for Paget’s disease of bone, 3212

prophylactic, in prostate cancer, 688

Dense deposit disease, 2340, 2340t, A4

See also Membranoproliferative

glomerulonephritis

Dense-granules, 920

Dental care/procedures

bleeding with, 453

in medically complex patient, 262

preventive, 256

prophylactic antibiotics for, 262, 1004t,

1033–1034, 1033t, 1034t, 1162t

Dental disease

brain abscess and, 1117

calculus, A3

caries, 256, 1351, A3

ear pain in, 249

gingivitis. See Gingivitis

high-altitude travel and, 3622

involuntary weight loss in, 309

lymphadenopathy in, 458

in osteogenesis imperfecta, 3223

periodontitis. See Periodontal disease

(periodontitis)

plaque, 256, 1351, A3

root cavity, A3

Dentatorubropallidoluysian atrophy, 3425, 3655t

Dentin, 256

Dent’s disease, 2292t, 2293, 3161

Dentures, 262–263, A3

Denys-Drash syndrome, 3002

Deoxycoformycin, 856

Deoxycorticosterone (DOC), 2955f, 2958, 2964

Deoxyhemoglobin, 756f

DEPDC5 gene mutations, 3308t

Dependence

alcohol. See Alcohol use disorder (alcoholism)

substance. See Substance use disorders

Depilatory, 3042

“De-prescribing,” 3750

Depression/depressive disorders, 3547

agitated, 3550

assessment of, 82

asthma exacerbations and, 2154

in cancer patient, 487, 621, 742–743, 3547

in cardiovascular disease, 3547

chemosensory alterations in, 236

circadian disruption and, 3809

clinical features of, 3547–3548, 3547t

in diabetes mellitus, 3547

diagnosis of, 3547t

dizziness in, 161–162

drug-related, 3547

etiology of, 82, 3547, 3548

headache and, 113

heart failure outcome and, 1939, 1950–1951

in HIV infection, 3547

in hypothyroidism, 3547

insomnia in, 211

involuntary weight loss in, 310

major depression, 3547–3548, 3547t, 3549f

in medical illness, 3547

in military veterans, S7

nausea and vomiting in, 292

in neurologic disorders, 3547

AD, 3374–3375

epilepsy, 3323

Huntington’s disease, 3405

MS, 3463, 3474

PD, 3398

pain and, 97–98

pathophysiology of, 3538, 3539f, 3548

persistent, 3548

postpartum, 3067

screening for, 39t

sexual dysfunction in, 3058, 3062

in terminally ill patient, 82–83

treatment of, 3548

algorithm for, 3549f

antidepressants, 3542t, 3543t, 3548–3550

in cerebral function disorders, 204

complementary and integrative therapies,

3786, 3788

St. John’s wort, 3786

supportive, 3548

in terminally ill patient, 82–83

transcranial magnetic stimulation, 3550, 3823

unipolar, 3548

in women, 3067, 3548

de Quervain’s tenosynovitis, 2849, 2849f, 2879

de Quervain’s (subacute) thyroiditis, 261,

2943–2944, 2943t, 2944f

Dermacentor spp. ticks, 1432, 1640, 3609. See also

Tick-borne diseases

Dermal papillae, 1034f

Dermatitis, 374

atopic. See Atopic dermatitis

contact. See Contact dermatitis

seborrheic. See Seborrheic dermatitis

stasis. See Stasis dermatitis

Dermatitis herpetiformis, 403

celiac disease and, 403, 2463

clinical features of, 371, 372f, 401t, 403, A5

diagnosis of, 403

histology of, 401t, 403–404

HLA gene association with, 403

immunopathology of, 401t, 403–404

treatment of, 403–404

Dermatofibroma, 370t, 372f

Dermatofibrosarcoma protuberans, 589, 589f,

714

Dermatofibrosis lenticularis disseminata

(Buschke-Ollendorff syndrome), 3214

Dermatographism (dermographism), 394, 2722,

2722f, A5

Dermatoheliosis, 419

Dermatomes, 171f

Dermatomyositis (DM)

clinical features of, 168, 404–405, 2819t, 2820

cutaneous, 404–405

on face, 405f

on hands, 405f, 2820, 2820f, A5

rash, 2820, 2820f, A5

telangiectasias, 386, 405

interstitial lung disease, 2196

myocarditis, 1963

Raynaud’s phenomenon, 2113

diagnosis of, 405f, 2819t, 2820–2821

histopathology of, 2821, 2821f

immunopathogenesis of, 2696t

in lung cancer, 599

pathogenesis of, 2821

prognosis of, 2821

treatment of, 405, 2824–2825, 2825t

Dermatomyositis sine myositis, 405

Dermatophagoides spp., 2724

Dermatophytosis, 380

clinical features of, 370t, 377t, 380, 380t, 1653t,

1690–1691

diagnosis of, 373, 380, 1035, 1653t, 1691

epidemiology of, 1690

etiology of, 380, 380t, 1690

histologic features of, 377t

pathogenesis of, 1690

risk factors for, 1653t

treatment of, 380–381, 380t, 990t, 1691

Dermographism (dermatographism), 394, 2722,

2722f, A5

Dermoid cysts, 698, 707

Dermopathy, thyroid, 2939f, 2943

Dermoscopy, 373, 580, 581f, 587f

DES (diethylstilbestrol), 491t, 686

Descending perineum syndrome, 307

Desensitization, 416, 2729

DES gene mutations, 1956t

Desipramine

adverse effects of, 3542t, 3549

for depression, 487, 3474, 3542t, 3549

for neuropathic pain, 98

for pain, 95t, 97, 3474

Desirudin, 932, 933t

Desloratadine, 2723

Desmin, 1955, 1956t, 2696t

Desmogleins, 401, 402, 2696t, 2735

Desmoplakin, 2697t

Desmopressin (DDAVP)

for adult hypopituitarism, 2899t

adverse effects of, 909

for coagulation disorders in CKD, 2317

for diabetes insipidus, 347, 2922, 2922f, S1

for hemophilia, 913

for hypernatremia, 347

for hypodipsic hypernatremia, 2923

for hyponatremia, 346, S1

for orthostatic hypotension, 156

for platelet function disorders, 909

for sleep enuresis, 213

structure of, 2918f

for von Willebrand disease, 910

Desmosome complexes, 1956t, 1957f, 1966

Desvenlafaxine, 3542t, 3549

Desynchrony, 3801t, 3804

Des-γ-carboxy prothrombin (DCP), 646

Detergent worker’s lung, 2160t

Detrusor hyperreflexia/dyssynergia, 3474

INDEX

I-62 Detumescence, 3056f, 3057

Developing world. See Low- and middle-income

countries

Device-related infections. See Health care–

associated infections

Devic’s disease. See Neuromyelitis optica (NMO)

Devil’s claw, 3786

DEXA (dual-energy x-ray absorptiometry), 2538t,

2633, 3175, 3196

Dexamethasone

actions of, 1151

adverse effects of, 3531

for altitude illness, 3618t, 3619, 3620, 3622

for amyloidosis, 881

for brain abscess, 1119

for brain metastases, 570

for CAH, 2975, 3042

for cerebral edema, 702

for COVID-19 disease, 980, 1510

drug interactions of, 1703t

for enteric fever, 1295

for fatigue, 81

for hemophagocytic syndrome, 865

for high-altitude pulmonary edema, 2256

for increased intracranial pressure, 2270t

for lymphoplasmacytic lymphoma, 849

for meningitis, 947t, 975t, 1104, 1105, 1243

for multiple myeloma, 873–875, 874t

for nausea and vomiting, 80, 294t, 488, 554

for neurocysticercosis, 1120

for pain, 79

as premedication for taxanes, 543

for prenatal treatment of CAH, 3005

for spinal cord compression, 3448

for tuberculous meningitis, 1109

Dexamethasone suppression test, 2956, 3042

Dexlansoprazole, 296, 2443t, 2444

Dexmedetomidine, 183, 2224, 2273

Dexrazoxane, 541

Dextroamphetamine, 79, 81, 82, 210

Dextrocardia, A7

Dextromethorphan, 249, 269, 3574, 3595t

Dextrose, 341, 347, 355

DF (discriminant function) value, 2626

DGM (diphosphoglycerate mutase) deficiency, 781t

DHCR7 gene mutations, 3003t

DHEA. See Dehydroepiandrosterone (DHEA)

DHF (dihydrofolate) reductase, 553, 767, 768f,

1164t

DHF (dihydrofolate) reductase inhibitors, 1704t,

1712

DHH gene mutations, 3003t

Dhori virus, 1630t

DHPR (dihydropteridine reductase) deficiency,

3269t

DHT (dihydrotestosterone), 3006, 3009f, 3041. See

also Testosterone

DHX377 gene mutations, 3003t

Diabetes insipidus (DI), 2920

adipsic, 347

clinical features of, 2920

differential diagnosis of, 2921–2922, 2922f

etiology of, 2920–2921, 2920t

gestational, 346, 2920–2921

nephrogenic

clinical features of, 338, 346, 2286, S1

diagnosis of, 337f, 346

early interventions for, 3667t

etiology of, 337f, 338, 346, 2920–2921, 2920t,

genetic considerations in, 2292t

genetic testing for, 3667t

lithium-associated, S1

pathophysiology of, 346, 2921, 2921f

treatment of, 347, S1

pituitary (central, neurohypophyseal)

clinical features of, 337–338, 346, 2920

diagnosis of, 337f, 346

early interventions for, 3667t

etiology of, 337f, 338, 2920, 2920t

genetic considerations in, 2920, 2920t, 3649

genetic testing for, 3667t

pathophysiology of, 2921, 2921f

treatment of, 347, 2922

primary polydipsia, 2920, 2920t, 2921, 2922

treatment of, 2922, 2922f

Diabetes mellitus (DM), 3094

abdominal pain in, 111, 111t

acromegaly and, 2912

anemia in, 437

approach to the patient, 3102–3103

atypical, 3096

celiac disease and, 2463

classification of, 3095, 3095f, 3095t, 3103

complications of, 3120, 3120t

cardiovascular. See Cardiovascular disease, in

diabetes mellitus

carotenoderma, 315

cutaneous, 3128

detection and prevention of, 3104, 3104t

diabetic ketoacidosis. See Diabetic

ketoacidosis (DKA)

dyslipidemia, 3126–3127

erectile dysfunction, 3057, 3125

female sexual dysfunction, 3062, 3125

gastrointestinal, 292, 3125

genitourinary, 1071, 3125

glycemic control and, 3120–3121, 3120f

hyperglycemic hypermolar state, 3114, 3115t,

3117

hyperkalemia, 352

hypertension, 3124, 3127

hypoglycemia, 3129, 3130–3132, 3131f

infections, 3128

lactic acidosis, 361

lower extremity, 1046, 1053, 1053f, 3103,

3127–3128

mechanisms of, 3121

muscle involvement, 3531

neuropathy. See Diabetic neuropathy

ocular

abducens nerve palsy, 230

cataracts, 225

epiretinal membrane, 227

oculomotor nerve palsy, 192

retinopathy. See Diabetic retinopathy

tonic pupil, 217

vitreous degeneration, 224

renal. See Diabetic nephropathy

retinopathy. See Diabetic retinopathy

contrast agent risk in, 1860, 3123

cystic fibrosis–related, 2176

deaths from, 73t

definition of, 3094

depression in, 3547

in developing countries, 1814, 3711

diagnosis of, 3096–3097, 3097f, 3097t

diarrhea in, 304, 306

epidemiology of, 3096

erythropoietin deficiency in, 437

etiology of, 3095, 3095t

genetic considerations in, 3095, 3095t, 3645t,

3649, 3655, 3656t

gestational, 3066, 3096, 3119, 3764–3765

global considerations in, 1814, 3096, 3096f, 3711

HCV infection and, 2604

in hemochromatosis, 3233

high-altitude travel and, 3622

history in, 3102–3103

immunization recommendations for, 984f

incidence of, 3096

involuntary weight loss in, 310

in Kearns-Sayre syndrome, 3529

latent autoimmune in the adult, 3103

lipodystrophic, 3119

maturity-onset of the young (MODY), 3095,

3102, 3645t, 3656t

nausea and vomiting in, 292

obstructive sleep apnea and, 2206

oral manifestations of, 257

pancreatic cancer risk and, 658

parenteral nutrition in patient with, 3118

physical examination in, 3103

polyuria in, 338

in pregnancy, 3764–3765

preoperative evaluation and management of,

3773

prevalence of, 3096, 3096f

prevention of, 3712

screening for, 39t, 3097, 3745t

skin manifestations of, 256–257, 392, 395, 3128,

A15

stroke risk in, 3342t

systems biology applied to, 3818t

taste disorders in, 236

treatment and management of, 3104

blood glucose monitoring in, 3106

emerging therapies, 3114

during glucocorticoid therapy, 3118–3119

glycemic control monitoring, 3106–3107,

3106f

glycemic control targets, 3104t, 3107

goals and principles of, 3104, 3104t

in hospitalized patients, 3117–3118

multidisciplinary team in, 3104

nutrition therapy in, 3105, 3105t

in older adults, 3104t, 3119, 3746–3747, 3746t

ongoing aspects of, 3104–3106, 3104t

outpatient, improvement of, 53

during parenteral nutrition therapy, 3118

physical activity, 3105

in pregnancy, 3119. See also Gestational

diabetes mellitus

psychosocial care, 3105–3106

self-management education and support,

3104–3105

stem cell therapy for, 3798–3799

type 1, 3099

APS-1 and, 2994t, 3125

APS-2 and, 2994, 2995t

environmental factors in, 3100

genetic considerations in, 3099, 3102

HLA gene association with, 3697

hypertension management, 3124

immunologic markers in, 3099–3100

immunopathogenesis of, 2696t, 2699

inflammasome mutations in, 2678t

KIRs with, 2687t

microbiome and, 3697

pathogenesis of, 3099

pathophysiology of, 3099–3100, 3099f

treatment and management of, 3107

adverse effects of, 3114

emerging therapies, 3114

goals of, 3104t, 3107

insulin preparations, 3108, 3108t

INDEX

insulin regimens, 3108–3109 I-63

intensive management, 3107

pramlintide, 3109

type 2, 3100

bariatric surgery and, 3094

breast cancer risk and, 613

dyslipidemia and, 3144

genetic considerations in, 480, 3100, 3655,

3656t, 3658f

hypertension management, 3124

insulin resistance syndromes in, 3101–3102

ketosis-prone, 3103

metabolic abnormalities in, 3100f, 3101

metabolic syndrome and, 3151, 3154

obesity and, 3086

pathophysiology of, 3100–3101, 3100f

postmenopausal hormone therapy and,

3046t

prevalence of, 2883t

prevention of, 3102

protein aggregation in, 3850

risk factors for, 3097

in schizophrenia, 3556

screening/testing for, 2883t

treatment and management of, 3109, 3109f,

3110t

adverse effects of, 3114

biguanides, 3110–3111

bile acid–binding resins, 3112

bromocriptine, 3112

combination therapy, 3113–3114

emerging therapies, 3114

α-glucosidase inhibitors, 3111–3112

insulin secretagogues, 3111

insulin therapy, 3112–3113

selection of initial agents, 3113, 3113f

sodium-glucose co-transporter 2 inhibitors,

3112

surgical therapy, 3114

thiazolidinediones, 3112

in women, 3066

Diabetic diarrhea, 304, 306

Diabetic ketoacidosis (DKA), 3114

clinical features of, 3114–3115, 3115t

complications of, 3117

diagnosis of, 3115, 3115t, S1

euglycemic, 3115, 3115t

hypokalemia in, 348

hyponatremia in, 342

pathophysiology of, 362, 3115

prevention of, 3117

treatment of, 362, 3115–3117, 3116t, S1

Diabetic nephropathy, 3122

albuminuria in, 3122–3123, 3123f

clinical features of, 2335t

epidemiology of, 2344

glycemic control and, 3121, 3123f, 3124

microalbuminuria in, 2344

natural history of, 2344, 3122–3123, 3123f

pathogenesis of, 2312, 2332, 2344, 3122–3123

renal biopsy in, 2344, A4

treatment of, 2344–2345, 3123–3124

in type 1 vs. type 2 diabetes mellitus, 2344, 3123

Diabetic neuropathy, 3124

autonomic, 3124, 3125, 3433, 3488–3489

constipation in, 308

distal symmetric sensory and sensorimotor

polyneuropathy, 3488

mononeuropathy, 3124–3125, 3489

pathophysiology of, 94

polyneuropathy, 3124, 3488

polyradiculopathy, 3124–3125

prevalence of, 3124

risk factors for, 3124

screening for, 3103

treatment of, 97, 3125, 3488t

Diabetic retinopathy

advanced, 226–227, 226f

clinical features of, 3122, 3122f

detection system for, 3829

glycemic control and, 3121, 3122f

treatment of, 226–227, 3122

“Diabetic skin spots,” 3128

Diacetyl exposure, 2171

Diagnosis

“don’t miss,” 57, 57t

errors in

cognitive biases and, 55, 55t

definition of, 55, 55f

as patient safety issue, 55

traditional approaches to, 56–57t

failure to reach. See Undiagnosed disease

health information technology and, 58, 59t

improving, 55, 55f, 56–57t, 58–59

meaning and context of, 77

pitfalls in, 57–58, 58t

quality of care and, 28

safety culture and, 58

uncertainty in, 55–56

Diagnostic hypothesis, 22

Diagnostic imperative, 22

Diagnostic tests. See Clinical laboratory tests

Diagnostic verification, 22

Dialectical behavior therapy (DBT), 3553

Dialysate, 2321

Dialysis. See Hemodialysis; Peritoneal dialysis

Dialysis access, 2322

Dialyzer, 2321, 2323

3,4-Diaminopyridine, 3474, 3512

Diamond-Blackfan anemia, 794, 798

Diapedesis, 442, 443f

Diaper rash, 1672

Diaphyseal aclasis (multiple exostoses), 3216

Diarrhea

acute, 299. See also Diarrhea, infectious

approach to the patient, 301, 301f

etiology of, 300–301

treatment of, 302

after cholecystectomy, 2649

antibiotic-associated, 302. See also Clostridioides

difficile–associated disease (CDI)

bile acid, 2461, 2461t

bloody, 300t, 301, 1700t

Brainerd, 301

in carcinoid syndrome, 668

in celiac disease, 2463

chemotherapy-related, 555

chronic, 302

approach to the patient, 304–306, 305f, 305t

definition of, 299

endoscopic findings in, 2392f, 2417, 2423f

etiology of, 302–304, 302t

treatment of, 306

in war veterans, S6

in Crohn’s disease, 2476

definition of, 299

diabetic, 304, 306

differential diagnosis of, 2382t, 2383, 2459

with enteral nutrition, 2543

epidemiology of, 297

factitious, 304

fatty acid, 2461, 2461t

in HIV infection, 1568–1570, 1570f

hypernatremia in, 346

hypokalemia in, 349

hyponatremia in, 342

hypovolemia in, 340

in IBS, 2490

idiopathic secretory, 303

infectious, 300, 1061. See also Gastroenteritis;

Travelers’ diarrhea

approach to the patient, 1062, 1063f

bacterial vs. viral, 1598t

Campylobacter. See Campylobacter spp.

infections

clinical features of, 300–301, 300t, 1598t

complications of, 1063, 1064t

C. perfringens, 1221. See also Clostridium

perfringens infections

E. coli. See Escherichia coli infections,

intestinal

Edwardsiella, 1274

epidemiology of, 300, 1062–1063

food-related, 300, 1064, 1064t. See also Foodrelated illness

Giardia spp. See Giardia spp. infections

host defenses against, 1062

in immunodeficient persons, 300

inflammatory, 1061t

in institutionalized persons, 300

laboratory evaluation of, 1064–1065

noncholera Vibrio, 1309–1310, 1309t

noninflammatory, 1061t

parasitic, 1700t

pathogenesis of, 300–301, 1061–1062, 1061t

penetrating, 1061t

prevention of, 1066

protozoal, 1765–1768

Salmonella. See Salmonella spp. infections

Shigella. See Shigella spp. infections

with systemic manifestations, 301

treatment of, 1065–1066, 1065t, 1269–1270

T. whipplei, 1345

V. cholera. See Cholera

Yersinia, 1326

in malabsorption disorders, 2459, 2468t

metabolic acidosis in, 340, 364

osmotic, 346, 2459, 2467

overflow, 299

paraneoplastic, 722t

persistent, 299

postvagotomy, 2452

in protein-losing enteropathy, 2467

secretory, 346, 2459

in short bowel syndrome, 2465

in small-bowel bacterial overgrowth, 2461

travelers’. See Travelers’ diarrhea

in tropical sprue, 2464

in ulcerative colitis, 2475, 2475t

water loss in, 2517

in Whipple’s disease, 2464

in ZES, 2453

Diarrhetic shellfish poisoning, 3607

Diascopy, 373

Diastolic blood pressure, 2076t

Diastolic dysfunction, 1809, 1809f, 1838, 1839f

Diastolic failure. See Heart failure (HF)

Diastolic murmur. See Heart murmurs

Diatrizoate meglumine, 905t

Diazepam

for agitation, 3577

for alcohol withdrawal, 3561

for anxiety disorders, 3544t

for cocaine intoxication, 3576

drug interactions of, 1703t, 2444

for insomnia, 84

INDEX

I-64 Diazepam (Cont.):

for marine envenomations, 3603

for nerve agent exposure, S4

overdosage/poisoning with, 3592t

pharmacology of, 3544t

for sedation after STEMI, 2060

for spasticity, 3455, 3474

for vertigo, 162t

Diazoxide, 410, 3133, 3134

Dibasic aminoaciduria (lysinuric protein

intolerance), 2292t

DIC. See Disseminated intravascular coagulation

(DIC)

Dicarboxylic aminoaciduria, 3275t

Dichloralphenazone, 3362t, 3364

Dichromat, 218

Dichuchwa (endemic syphilis), 1414t, 1416, 1416f

Dick test, 1191

Diclofenac

adverse effects of, 422t, 905t

with gastric protective agent, 2449

for migraine, 3362t

for osteoarthritis, 2861t

for pain, 94

Dicloxacillin

adverse effects of, 319, 349

for impetigo, 1192

indications for, 1153

for staphylococcal skin/soft tissue infections,

375, 948t, 1186t

Dicyclomine, 2494

Didanosine (ddI), 1590f, 2591

Dideoxynucleosides, 1579–1580

DIDMOAD (Wolfram’s) syndrome, 2920, 2997

Dientamoeba fragilis, 945t, 1709, 1765t, 1767–1768

Diet

asthma risk and, 2152

breast cancer and, 613

for cancer prevention, 490–491

cardiovascular disease and, 1813

circadian clock and, 3808

colorectal cancer and, 637

composition of, 2518

dyslipidemia and, 3144

energy density of, 3091

global considerations in, 1813

head and neck cancer and, 590

infectious disease exposure and, 943

low-bacteria, 564

microbiome and, 3694

nephrolithiasis and, 2369, 2373

pancreatic cancer and, 658

peptic ulcer disease and, 2441

prostate cancer and, 681

Dietary assessment. See Nutrition assessment

Dietary fiber

cancer and, 490–491

colorectal cancer and, 637

for constipation, 307, 308

for diverticular disease, 2498–2499, 2499t

for IBS, 2494

recommended intake of, 2521t

Dietary Guidelines for Americans, 2020–2025,

10–11, 10t

Dietary reference intakes, 2518

Dietary supplements, 2518, 2590–2591, 3785t,

3786–3787, 3787t

Dietary Supplements Health and Education Act

(DSHEA), 3786

Diet history, 2522

Diethylcarbamazine (DEC)

actions of, 1708

adverse effects of, 1706t, 1780

for loiasis, 1783

for lymphatic filariasis, 1780

pharmacology of, 1708

for tropical pulmonary eosinophilia, 1781

Diethylene glycol poisoning, 2301, S1

Diethylpropion, 3091

Diethylstilbestrol (DES), 491t, 686

Diet therapy. See Nutritional support/therapy

Dieulafoy’s lesion, 312, 2405, 2409f, V5

Differentiation, in cancer cells, 534

Diffuse alveolar hemorrhage, 270

Diffuse esophageal spasm, 289, 2428–2429, 2428f,

2429f

Diffuse fasciitis with eosinophilia, 407

Diffuse idiopathic skeletal hyperostosis (DISH),

2794

Diffuse infiltrative lymphocytosis syndrome

(DILS), 1573

Diffuse large B-cell lymphoma (DLBCL), 846

clinical features of, 846

CLL and, 838

diagnosis of, 846–847, 846f

frequency of, 842f

gastric, 634

genetic considerations in, 844t

in HIV infection, 1583

lymph node examination in, A6

treatment of, 512, 634, 847, 3686t

Diffuse leprosy of Lucio and Latapí, 1383, 1387

Diffuse nontoxic goiter, 2946. See also Thyroid

nodular disease

Diffuse (periventricular) white matter disease

(leukoaraiosis), 193f, 3343

Diffusion capacity of the lung for carbon monoxide

(DLCO), 2138f, 2139

Diffusion tensor imaging (DTI), 3290, 3290f

Diffusion-weighted imaging, 3335, 3335f

Diflunisal, 883, 1968

DiGeorge’s (velocardiofacial) syndrome, 2714,

3186, 3535, S8

Digestion. See Absorption

Digitalis

actions of, 1805

adverse effects of, 224, 473, 1893, 3018

ECG effects of, 1830

for pulmonary edema, 2256

Digital necrosis, in systemic sclerosis, 2778,

2778f

Digital rectal examination, 496t, 497, 639, 682

Digit span tests, 180, 203

Digoxin

adverse effects of, 905t, 1875t, 1881, 1885

for atrial fibrillation, 1905

distribution of, 467–468

drug interactions of, 467t, 471t

azithromycin, 1705t

azoles, 1703t

PPIs, 2444

pyronaridine, 1712

for heart failure, 1949

metabolism of, 467t

overdosage/poisoning with, 352, 3592t

for supraventricular arrhythmias, 2063

toxicity of, 350, 352, 355

DIHS. See Drug-induced hypersensitivity

syndrome (DIHS)

Dihydroartemisinin, 1702t, 1707

Dihydroergotamine

for exercise headache, 3368

for medication-overuse headache, 115

for migraine, 3362t, 3363, 3363t

Dihydrofolate (DHF) reductase, 553, 767, 768f,

1149, 1164t

Dihydrofolate (DHF) reductase inhibitors, 1704t, 1712

Dihydropteridine reductase (DHPR) deficiency,

3269t

Dihydropteroate synthetase, 1149, 1164t

Dihydropteroate synthetase inhibitors, 1704t

Dihydropyridines. See Calcium channel blockers

(CCBs)

Dihydropyrimidinase deficiency, 3253t

Dihydropyrimidine dehydrogenase (DPYD), 476t,

478

Dihydropyrimidine dehydrogenase (DPYD)

deficiency, 3253t, 3254

Dihydrorhodamine oxidation test, 449

Dihydrotestosterone (DHT), 3006, 3009f, 3041. See

also Testosterone

1,25-Dihydroxyvitamin D. See also Vitamin D

actions of, 356, 356f, 3166–3167

overproduction of, 356, 722t, 723

synthesis of, 419

underproduction of, 725

Diisocyanate exposure, 2171

Dilated cardiomyopathy, 1957

alcohol-related, 1963–1964

chemotherapy-related, 1964

in CKD, 2315

clinical features of, 1955t

diagnosis of, 1955t

echocardiography in, 1958f

familial, 1956t, 1965–1966, 1966f

genetic considerations in, 1926, 1955, 1956t, 3650t

heart failure in, 1937. See also Heart failure (HF)

in hemochromatosis, 1965, 1965f

in HIV infection, 1961

idiopathic, 1959t, 1966

metabolic causes of, 1959t, 1964–1965

myocarditis and. See Myocarditis

natural history of, 1797

pathophysiology of, 1957–1958, 1958f, 1960f,

2696t

Takotsubo (stress-related), 102, 1966

toxic, 1959t, 1963–1964

ventricular tachycardia in, 1921, 1921f, 1926

DILIN (Drug-Induced Liver Injury Network), 2586

Diloxanide furoate, 1703t, 1708

DILS (diffuse infiltrative lymphocytosis syndrome),

1573

Diltiazem

for accessory pathway-mediated tachycardia,

1898

adverse effects of, 1881, 1885, 2041t, 2847t

for aortic dissection, 2106

for atrial fibrillation, 1905

for AV nodal reentrant tachycardia, 1896

contraindications to, 1897

drug interactions of, 1706t, 2043, 2328, 2637

for hypertension, 2083t, 2084

for hypertension in CKD, 2319

for ischemic heart disease, 2041, 2041t

for NSTEMI-ACS, 2048

overdosage/poisoning with, 3591t

for Raynaud’s phenomenon, 2114, 2784

for sex headache prevention, 3368

for supraventricular arrhythmia, 2063

Dilute Russell’s viper venom test, 456, 919, 2745

Dimenhydrinate, 162t, 293, 294t

Dimercaprol, 3580–3581t

d-dimer test, 452

in DIC, 916, 917t

in HIV infection, 1561t

in VTE/PE, 2095

INDEX

1,3-Dimethlamylamine (DMAA), 3787 I-65

Dimethyl fumarate (DMF), 3470t, 3471

Dimethyl sulfoxide (DMSO), 330

Dimethyltryptamine (DMT), 3576

Dim-light melatonin onset (DLMO), 213, 3801t,

3804

Dimorphic fungi, 1675t

Dinutuximab, 514t

Dioxin exposure, S7

Dipeptidyl peptidase-4 (DPP-IV) inhibitors, 402,

3110t, 3111, 3113, 3746t

Diphenhydramine

adverse effects of, 2723, 3431t

for anaphylaxis, 3599

for insomnia, 211

overdosage/poisoning with, 3590t, 3595t

as premedication for rituximab, 575

as premedication for taxanes, 543

for pruritus, 375, 411

Diphenoxylate, 306, 2503

Diphenylhydantoin, 458

Diphosphoglycerate mutase (DGM) deficiency,

781t

Diphtheria, 1203

approach to the patient, 1204

clinical features of, 253t, 254, 1204–1205, 1205f,

1962, 3490–3491

complications of, 1205

cutaneous, 1204, 1205, 1205f, 1206

diagnosis of, 1205

epidemiology of, 1203–1204

etiology of, 1203

global considerations in, 1204

incidence pre- and postvaccine, U.S., 981t, 1204

pathogenesis of, 1204

pathology of, 1204

prevention of, 984f, 1206–1207

prognosis of, 1206

prophylaxis for close contacts, 1207

treatment of, 1206

Diphtheria antitoxin, 1206

Diphtheria-tetanus-pertussis vaccine (DTaP), 1146,

1147t, 1206–1207, 1261. See also Tetanus,

diphtheria, acellular pertussis (Tdap)

vaccine

in cancer patients, 557t

Diphtheria-tetanus vaccine. See Tetanus-diphtheria

(Td) vaccine

Diphyllobothrium latum (fish tapeworm), 772,

1697, 1700t, 1796, S12

Diploid, 3640, 3641

Diplopia, 229

in abducens nerve palsy, 229, 230

evaluation of, 229

in horizontal gaze disorders, 230

monocular vs. binocular, 229

in multiple ocular nerve palsies, 230

in myasthenia gravis, 229. See also Myasthenia

gravis

in nystagmus. See Nystagmus

in oculomotor nerve palsy, 229

in opsoclonus, 231

in supranuclear disorders of gaze, 230

in trochlear nerve palsy, 229

in vertical gaze disorders, 230–231

Diplotype, 475

Dipsogenic polydipsia, 2920, 2922

Dipteran bite, 3614

Dipylidium caninum/dipylidiasis, 1796

Dipyridamole, 927, 928f, 2904t, 3345

Direct antiglobulin (Coombs) test, 893, 893f

Directional atherectomy catheter, 2067

Direct thrombin inhibitors, parenteral, 932–933,

933t, S9. See also Argatroban; Bivalirudin

Dirofilaria infections, 1783

Disability, 2172

Disability-adjusted life years (DALY), 3704, 3705f,

3706t, 3736, 3736f

Disaster medicine, 1276

DISC1 gene mutations. See DiGeorge’s

(velocardiofacial) syndrome

Discectomy with fusion, cervical, 129

Discoid (chronic cutaneous) lupus erythematosus

alopecia in, 384

clinical features of, 406

diagnosis of, 406

oral manifestations of, 257

skin manifestations of, 406, 406f, 2740, A1, A5

telangiectasias in, 386

treatment of, 406

Discriminant function (DF) value, 2626

Discrimination, 64

Disease

classification of, 3814, 3815f

definition of, 948

genotype-phenotype relationships in, 3814–

3816, 3815f

germ theory of, 941

networks, 3814–3816, 3816f, 3817f, 3818f

nosology, 30, 31f

probability, measures of, 25–26

of unknown etiology. See Undiagnosed disease

Disease Control Priorities in Developing Countries,

3704, 3706–3707

Disease-modifying antirheumatic drugs

(DMARDs), 2761, 2762–2763t,

2763–2764

Disequilibrium, 176. See also Balance

DISH (diffuse idiopathic skeletal hyperostosis),

2794

Disk/agar diffusion method, S11

Diskography, 3291–3292

Disk-space infection. See Osteomyelitis, vertebral

Dislocation, 2848, 2848t

Disopyramide, 1894, 1907, 1913

Disorders of sex development (DSDs), 2997

chromosomal sex disorders. See Sex

chromosome disorders

classification of, 2998t

clinical presentation by life stage, 2998t

global considerations in, 3005

gonadal and phenotypic sex disorders

46,XX disorders. See 46,XX disorders of sex

development

46,XY disorders. See 46,XY disorders of sex

development

holistic approach to, 2997–2998

Disposable soma theory of aging, 3733

Disseminated intravascular coagulation (DIC), 915

in acute promyelocytic leukemia, 813

chronic, 916

clinical features of, 916

diagnosis of, 916, 917t

differential diagnosis of, 916

etiology of, 915–916, 916t

in filovirus infections, 1647–1648

in leptospirosis, 1419

pathophysiology of, 915–916, 916f

skin manifestations of, 398, 977

treatment of, 917

Distal cholangiocarcinoma, 653f, 656

Distal convoluted tubule, 2291f, 2292t, 2293

Distal myopathies, 3525t, 3526f, 3527

Distribution, of drugs, 467–468, 1150

Distributive shock

hemodynamic characteristics of, 2236t

history in, 2237–2238

pathophysiology of, 2236

physical examination in, 2238

treatment of, 2241

Disulfiram, 223, 1705t, 3494t, 3562

Ditans (5-HT1F receptor agonists), 3362t, 3364

Diuresis

for hypercalcemia, 3183–3184, 3184t

postobstructive, 2376

water, 2919, 2919f

Diuretics. See also Loop diuretics; Thiazide

diuretics

abuse of, 350

actions of, 341

adverse effects of, 240

acid-base disorders, 366

gout, 2847t

hypokalemia, 349, 350

hyponatremia, 342

hypovolemia, 340

renal, 334

xerostomia, 261

aldosterone-renin ratio effects of, 2966t

for ascites, 323–324

for chronic venous disease, 2117

for heart failure, 1943–1944, 1946t, 1949, 2062

for hyperkalemia, 355

for hypertension, 2083–2084, 2083t

for pulmonary edema, 2256

for vertigo, 162t

Diurnal rhythm, 3801t

Divalent metal transporter, 749

Divalproex sodium. See Valproate/valproic acid

Divergent phenotype, 31, 32f

Divers Alert Network, 3605, 3630

Diversion colitis, 2480

Diverticular disease, 2497

anatomy of, 2497

bleeding in, 313, 2498

clinical features of, 2498, 2498t

diagnosis of, 2408, 2412f, 2498

epidemiology of, 2497

esophageal, 2425–2426, 2426f

jejunal, 2462f

pathophysiology of, 2497, 2497f

recurrent, 2501

treatment of, 2412f, 2498–2500, 2500f, 2500t, V5

Zenker’s, 289, 293, 2425–2426, 2426f

Diverticulitis

clinical features of, 111t, 146, 301, 2498, 2498t

definition of, 2497

diagnosis of, 2498

Hinchey classification of, 2498, 2498f

vs. IBD, 2479

Diving medicine, 3628

Dix-Hallpike maneuver, 160

Dizziness, 159. See also Vertigo

DJ-1, 21

DJ1 gene mutations, 3391t

DKA. See Diabetic ketoacidosis (DKA)

DKC1 gene mutations, 794, 3680, 3682t

DKK-1, 2758, 2792

DLBCL. See Diffuse large B-cell lymphoma

(DLBCL)

DLCO (diffusion capacity of the lung for carbon

monoxide), 2138f, 2139

DLMO (dim-light melatonin onset), 213, 3801t, 3804

DLT (dose-limiting toxicity), 533

DM. See Dermatomyositis (DM); Diabetes mellitus

(DM)

INDEX

I-66 DM1/2. See Myotonic dystrophy

DMAA (1,3-dimethlamylamine), 3787

DMARDs (disease-modifying antirheumatic

drugs), 2761, 2762–2763t, 2763–2764

DMD gene mutations, 1955, 1956t, 3647, 3650

DMF (dimethyl fumarate), 3470t, 3471

DMPK gene mutations, 1956t

DMSA (succimer), 3580–3581t

DMSO (dimethyl sulfoxide), 330

DMT (dimethyltryptamine), 3576

DMT1, 3231f

DMXL2 gene mutations, 3015t

DNA

cell-free. See Cell-free DNA (cfDNA)

circulating tumor. See Circulating tumor DNA

(ctDNA)

demethylation of, 517

epigenetic modifications of, 3644–3645, 3646f

hypermethylation of, 516

instability of, aging and, 3734–3735

methylation of, 3644, 3646f, 3647f, 3792, 3793, 3795

mitochondrial. See Mitochondrial DNA

(mtDNA)

repair, 417–418

repair defects, 2714, 3647–3648

repetitive, 3641

replication of, 3642, 3642f

structure of, 3641, 3641f

unstable sequences, 3648

DNA-dependent nucleoside-stimulated ATPase,

2696t

DNA gyrase, 1149

DNA-interactive agents, 539, 540t. See also specific

drugs

DNAJB11 gene mutations, 2350

DNAJC6 gene mutations, 3391t

DNAJC12 deficiency, 3269t

DNA methylation inhibitors, 3794

DNA methyltransferase inhibitors, 516, 517f, 549t,

552

DNA repair, 3647–3648

DNA repair defects, S8

DNA repair pathway modulators. See PARP (polyADP-ribose polymerase) inhibitors

DNA sequencing, 3659, 3853, 3854

DNA topoisomerase II, 2697t

DNA viruses, 1454t, 1455f, 1456. See also specific

viruses

DNMT1, 3790–3791, 3792

DNMT3A/3B, 3790

DNMT3A gene mutations, 796, 809, 812, 812t, 861

Dobrava virus, 1628t

Dobutamine

for cardiogenic shock, 2241, 2253

for heart failure, 1945, 1946t

for pulmonary edema, 2256

for sepsis/septic shock, 2247t

in stress testing, 1834

DOC (deoxycorticosterone), 2955f, 2958, 2964

Docetaxel

actions of, 543

adverse effects of, 541t, 543, 575, 2847t, 3493t

for bladder cancer, 679

for breast cancer, 621, 625

drug interactions of, 1703t

for gastric cancer, 633

for head and neck cancer, 593

interactions and issues, 541t

for lung cancer, 604, 606t, 609, 610

premedication for, 541t, 543

for prostate cancer, 687, 688

for soft tissue sarcomas, 714

DOCK8 deficiency, 446t, 449

Docosanol, 1460

Doctor, The, 1f

Docusate, 79, 80t

Dofetilide

actions of, 1872t

adverse effects of, 1872t, 1907, 1914

for atrial fibrillation, 1907

for atrial flutter, 1901

dosage in kidney disease, 470

dosage monitoring, 469–470

drug interactions of, 1703t

for ventricular arrhythmias, 1913–1914

Dog(s)

bite-wounds, 977, 1124

antibiotic prophylaxis for, 1126–1127

approach to the patient, 1126

cellulitis in, 1037

epidemiology of, 1124

infections from, 1124–1125, 1247–1248

microbiology of, 1124

rabies prophylaxis for, 1127

treatment of, 1039t, 1126, 1127t

filarial infections, 1783

fleas, 3614

tapeworms, 1796

ticks, 1431

Döhle bodies, 425, 430f, 441, 441f

Dolasetron, 80, 554

Dolastatin, 543

“Doll’s eyes,” 187

Dolor, 440f

Dolutegravir, 1380, 1588t, 1591f, 1592t

Domestic abuse/violence

human bite-wounds in, 1126

incidence of, 3068, 3556

lifetime cumulative risk of, 38t

mandated reporting of, 68

screening for, 39t, 3556

Domoic acid intoxication (amnestic shellfish

poisoning), 3311, 3607

Domperidone, 115, 293, 294t, 2786, 3364

Donafenib, 652f

Donath-Landsteiner antibodies, 787

Donepezil, 175, 195, 238, 1875t, 3374,

3386

Dong quai, 454t

Do-not-resuscitate (DNR) orders, 86

Donovan bodies, 1334, 1335f

Donovanosis, 1334

clinical features of, 1091t, 1334f

diagnosis of, 1335, 1335f

epidemiology of, 1089, 1334

etiology of, 1271, 1334

treatment of, 1335, 1335t

l-Dopa. See Levodopa

Dopamine

in cardiovascular regulation, 2073

deficiency of, in PD, 3392

for heart failure, 1945

for hypothermia, 3633

in migraine, 3357

in PD, 3392

for pulmonary edema, 2256

for sepsis/septic shock, 2248

Dopamine-2 receptor antibodies, 729t, 733

Dopamine agonists

for acromegaly, 2914

adverse effects of, 212, 2910–2911, 3395

for PD, 3395, 3396t

for prolactinoma, 2910–2911

for restless legs syndrome, 212

Dopamine receptor antagonists, 293, 294t, 3362t,

3364

Dopa-responsive dystonia (Segawa syndrome),

3269t, 3389–3390, 3402

Doppler ultrasound, 1832–1833, 1833f. See also

Echocardiography

Doripenem

for anaerobic bacterial infections, 1356

indications for, 1158

for intraabdominal infections, 947t

for P. aeruginosa infections, 1287t

for sepsis/septic shock, 2248t

Dormancy, in cancer cells, 534

Dornase, 2175

Dorsal midbrain syndrome (Parinaud’s syndrome/

complex), 216, 231, 706, 1329, V3

Dorsal respiratory group, 2201

Dorsal root ganglia, 91, 91f, 92

Dorsal root ganglionopathy, 734–735

Dose-limiting toxicity (DLT), 533

Dosulepin, 3365t

DOTS/DOTS-Plus strategy, for TB, 1381, 3708

Double-balloon endoscopy/enteroscopy, 2384,

2384t, 2391, 2393f, 2421f, V5

Doublecortin, 3308t

Double equipoise, 650

Double minute, 500

Double-stranded DNA viruses, 1456

Double-stranded RNA viruses, 1456

Double vision. See Diplopia

Downbeat nystagmus, 231

Down’s syndrome (trisomy 21)

AD and, 3373

ALL in, 828

AML in, 809–810

autoimmune polyendocrine deficiencies

in, 2997

clinical features of, 2119

hypothyroidism in, 2934

myelodysplasia in, 800

myeloid neoplasms in, 862

noninvasive prenatal testing for, 3844

oral manifestations of, 256

transient myeloproliferative disorder in, 862

Doxazosin, 2083t, 2114

Doxepin

adverse effects of, 3542t

for depression, 3542t

for insomnia, 212

overdosage/poisoning with, 3591t, 3592t

for pain, 95t

for pruritus, 375

for urticaria, 2723

Doxercalciferol, 3169

Doxorubicin

actions of, 541

adverse effects of, 540t, 541

acral erythema, 410

cardiotoxicity, 541, 737, 1964

myelosuppression, 541

pigmentation changes, 410

pulmonary, 739

for bladder cancer, 680

for breast cancer, 621, 625

for DLBCL, 847

for Ewing’s sarcoma, 715

for gastric lymphoma, 634

for hepatoblastoma, 650

for hepatocellular carcinoma, 656

for insulinoma, 2986

interactions and issues, 540t

for lung cancer, 611

INDEX

for osteosarcoma, 715 I-67

for ovarian cancer, 697

in pregnancy, 625

for salivary gland tumors, 594

for soft tissue sarcomas, 714

timing of administration of, 3811

Doxycycline

for acne rosacea, 383

for acne vulgaris, 382

for actinomycosis, 1343t

actions of, 1149, 1159, 1164t

adverse effects of, 391, 1160, 1732t

for anthrax, S3

for bacillary angiomatosis/peliosis, 1039t,

1331t

for Bartonella endocarditis, 1331t

for Bartonella prophylaxis, 1564t

for bite-wound infections, 1039t, 1126, 1127t

for B. miyamotoi infection, 1425

for Brucella infections, 1313–1314

for bullous pemphigoid, 403

for cat-scratch disease, 1331t

for chlamydial infections, 1240t

for cholera, 1308

for community-acquired pneumonia, 1014t

for C. trachomatis infections, 1449–1450, 1451

for donovanosis, 1335t

for ehrlichioses, 1438

for endemic treponematoses, 1416

for epidemic typhus, 1436

for human granulocytotropic anaplasmosis, 1438

indications for, 1156t, 1159

for infective endocarditis, 1030t

for leptospirosis, 1421t

for Lyme disease, 1043, 1429–1430, 1430f

for Lyme disease prophylaxis, 1430, 3609

for lymphatic filariasis, 1780

for malaria, 1730t, 1732t

for malaria prophylaxis, 1734t, 1735

for M. hominis infections, 1444

for M. pneumoniae infections, 1443

for MRSA infections, 375, 1186t, 1187

for mucopurulent cervicitis, 1086

for onchocerciasis, 1782

for pelvic inflammatory disease, 1088–1089,

1088t, 3038

for pericardial effusion, 489

for plague, S3

for plague prophylaxis, 1325t

for plague treatment, 1324, 1324t

for pleural effusion, 489

for proctitis, 1092

prophylactic, 1162t

for Q fever, 1440

for reactive arthritis, 2798

for relapsing fever, 1424–1425, 1424f

resistance to, 1156t, 1164t, 1166

for rickettsial disease, 977

for rickettsialpox, 1435

for Rocky Mountain spotted fever, 975t, 1434

for scrub typhus, 1437

for sinusitis, 252

for syphilis, 1412, 1412t

for trench fever, 1331t

for tularemia prophylaxis, 1319, 1319t

for tularemia treatment, 1318, 1319t, S3

for Ureaplasma infections, 1444

for Whipple’s disease, 1347

Doxylamine, 294, 3590t

DPP-IV (dipeptidyl peptidase-4) inhibitors, 402,

3110t, 3111, 3113, 3746t

DPPX antibodies, 729t, 733

DPYD (dihydropyrimidine dehydrogenase), 476t,

478

DPYD (dihydropyrimidine dehydrogenase)

deficiency, 3253t, 3254

Dracunculus medinensis/dracunculiasis (guinea

worm infection)

arthritis in, 1044–1045

clinical features of, 1783

diagnosis of, 1483, S12

etiology and epidemiology of, 1783

skin lesions in, 1037, 1699t

treatment of, 1713, 1784

Dravet’s syndrome, 3308t

Drawer sign, 2850

DRESS (drug reaction with eosinophilia and

systemic symptoms). See Drug-induced

hypersensitivity syndrome (DIHS)

Dressing apraxia, 201

Dressings, for chronic venous disease, 2117

Driver mutations, 505

Driving ability/privileges, 204, 209, 3323, 3742,

3743t

DRK1, 1665

Dronedarone

actions of, 1872t

adverse effects of, 1875t, 1907

for arrhythmias, 1907, 1914, 1951

drug interactions of, 1400

Drop attacks, 177. See also Fall(s)

Droplet precautions, 1513–1514

Dropped head syndrome, 3517

Drospirenone, 353, 3042

Drowning, A12

Drowsiness, 79, 183

Droxidopa, 3125, 3436

Drp1, 3298

Drug(s)

adherence to regimens for, 3781–3782

adverse reactions to. See Adverse drug reactions;

Drug-induced illness

benefits of, 465

bioavailability of, 466

clearance of, 468

development of

for cancer, 483f, 533–534

genetics and, 479–480

genomics in, 968–969

systems biology and, 3814, 3818t

target molecules in, 473–474

distribution of, 467–468

dose-response relations, 465–466, 465f

dose selection, 469

elimination of, 468

expenditures on, 47–48

failure of efficacy of, 469–470

genetic determinants of response to, 474

half-life of, 467, 468f

indications for, 465–466

interactions between. See Drug interactions

intravenous administration of, 468

medication errors, 4

metabolism of

active metabolites in, 468

enzymes in, 1150

first-pass effect, 466, 466f, 1150

genetic variations in, 474–475, 476–477t, 476f

in men vs. women, 3067

microbiome and, 3694

network-based precision repurposing of, 33, 35f

new, skews in research for, 3722

overdosage of. See Poisoning/drug overdose

plasma concentration of, 466, 466f, 470, 470f

prescribing for older adults, 3750–3751, 3751t

prescription, use in U.S., 407

risks of, 465–466

slow-release formulation of, 466

sustained-release formulation of, 466

time-of-day effects on, 215, 3811

Drug-dependent antibodies, 905

Drug disposition. See Drug(s), metabolism of

Drug dosage

dosing interval, 467

in heart failure and shock, 471

in kidney disease, 470

in liver disease, 470

loading dose, 468, 468f

maintenance dose, 470

in older adults, 471

plasma concentration as guide to therapy, 468

selection of, 469–470

Drug-eluting bead chemoembolization (DEBTACE), 651

Drug fever, 399

Drug history, 473

Drug-induced hypersensitivity syndrome (DIHS)

clinical features of

erythroderma, 384

fever and rash, 137t, 142, 147, A1

frequent signs and symptoms, 416t

systemic, 412, 412f

diagnosis of, 412, 415t

drugs associated with, 412, 416t

etiology of, 137t, 384, 412

genetic considerations in, 409

immune pathways of, 408–409, 408t

time of onset, 412

treatment of, 412–413, 415

Drug-induced illness. See also Adverse drug

reactions; Poisoning/drug overdose

anaphylaxis, 411

autonomic dysfunction, 3429, 3431t

chronic meningitis, 1115t

cutaneous, 141, 407, 555

cross-sensitivity in, 415–416

delayed hypersensitivity, 408–409

desensitization for prevention of, 416, 2729

diagnosis of, 415, 415t, 416

drug selection after, 416

exacerbation or induction of dermatologic

disease, 409

exanthematous eruption, A1

exanthems, 134t, 393

fixed drug eruption, 412, 412f

genetic considerations in, 409

global considerations in, 409

hair disorders, 410

hyperpigmentation, 390–391

hypersensitivity syndrome. See Drug-induced

hypersensitivity syndrome (DIHS)

immediate, 408

immune complex–dependent, 408

incidence of, 407–408

irritant/contact dermatitis, 412, 412f

maculopapular eruptions, 410–411, 411f

management of, 415, 416

nail disorders, 410

overlap hypersensitivity syndromes, 414

pathogenesis of, 408–409

photosensitivity eruptions, 409, 421–422, 421t

pigmentation changes, 409–410

pruritus, 411

pustular eruptions, 414. See also Acute

generalized eruptive/exanthematous

pustulosis (AGEP)

INDEX

I-68 Drug-induced illness, cutaneous (Cont.):

reporting of, 416

severe. See Stevens-Johnson syndrome; Toxic

epidermal necrolysis

testing for, 371

“treating through” an eruption, 415

urticaria/angioedema, 411

vasculitis, 414–415, 414f, 2816

vesicles/bullae, 391–392

fatigue, 163

fever of unknown origin, 147

gingival overgrowth, 257

liver injury. See Liver disease/failure,

drug-induced

lupus-like disease, 378, 409, 472, 478, 2748–2749

movement disorders, 3407

musculoskeletal conditions, 2847t

neutropenia, 444, 444t

primary immunodeficiencies, S8

vasculitis, 2847t

in women vs. men, 3067

Drug-Induced Liver Injury Network (DILIN),

2586

Drug interactions, 469, 471. See also specific drugs

with herbal/dietary supplements, 3787, 3787t

pharmacodynamic, 471t

pharmacokinetic, 471t

Drug reaction with eosinophilia and systemic

symptoms (DRESS). See Drug-induced

hypersensitivity syndrome (DIHS)

Drug-receptor interaction, 469

Drug-target network analysis, 3814

Drusen, 224, 224f, 226, 226f

Dry beriberi, 2524–2525, 3496

Dry eye. See Keratoconjunctivitis sicca

Dry mouth. See Xerostomia

“Dry tap,” 856, 856t

DSDs. See Disorders of sex development (DSDs)

DSE gene mutations, 3226t

DSG1/2 gene mutations, 1956t

DSHEA (Dietary Supplements Health and

Education Act), 3786

DSP gene mutations, 1956t

DTaP. See Diphtheria-tetanus-pertussis vaccine

(DTaP)

DTIC. See Dacarbazine (DTIC)

DTPA, S5

Dual-energy x-ray absorptiometry (DEXA), 2538t,

2633, 3175, 3196

Dual-process theory, 21

Dual-task walking, 174

Dubin-Johnson syndrome, 318, 2557, 2560–2561,

2561t

Duchenne muscular dystrophy, 3521, 3526f, 3650,

3667t, 3685

Duck fever, 2160t

Ductal carcinoma in situ (DCIS), 616–617

Duct of Luschka, bile leak from, 2396f

Duffy RBC group system, 887t

Dugbe virus, 1629t

Duke criteria, for infective endocarditis, 1025,

1026t

Dulaglutide, 3110t, 3111

Duloxetine

adverse effects of, 3488t, 3542t

for back pain, 126

for depression, 3542t, 3549

for fibromyalgia, 2870

for neuropathic pain, 98, 3125, 3488t

for osteoarthritis, 2862

for pain, 95t, 98

Dumping syndrome, 2452

Duodenal ulcers

clinical features of, 2441–2442

complications of, 2441–2442

diagnosis of, 2387, 2389f, 2405f, 2442–2443,

2442f, 2443f

differential diagnosis of, 2442

epidemiology of, 2437

gastroduodenal mucosal defense and, 2436–2437

H. pylori and. See Helicobacter pylori infection

NSAID-induced, 2449, 2449t

pathology of, 2438

pathophysiology of, 2438

recurrence of, 2451–2452

refractory, 2450

treatment of, 2403, 2406f, 2407f, 2449–2453,

2450f, V5. See also Peptic ulcer disease,

treatment of

Duodenitis, 312

Duodenoscope, infections related to, 1135

DUOX, 2927, 2934t

Dupilumab, 375, 2707t

Duplication cyst, 312

Dupuytren contracture, 2549

Durable power of attorney for health care, 77

Dural sinus thrombosis, 3348

Dura matter grafts, 3419

Dura, vascular malformations of, 3349t, 3353, 3452,

3453f

Duroziez’s sign, 1988

Durvalumab

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

adverse effects of, 576, 2275

for bladder cancer, 2705t

for non-small-cell lung cancer, 605, 609, 2705t

DUSP6 gene mutations, 3015t

Dutasteride, 493, 682, 687f, 3042, 3075

Duvelisib, 550t, 553, 839, 848

Duvenhage virus, 1623

DUX4 gene mutations, 3527

DVT. See Deep venous thrombosis (DVT)

Dwarf tapeworm (Hymenolepiasis nana), 945t,

1710, 1794–1795, S12

DXM, 3576

Dynamic mutation, 3648

Dynamic visual acuity, 160

Dysbetalipoproteinemia, familial, 3139t, 3143

Dyschondroplasia (Ollier’s disease), 3216

Dyschromic macules, 1416

Dysembryoplastic neuroepithelial tumors, 707

Dysentery

in amebiasis. See Amebiasis

etiology of, 301, 1061

in Shigella infections. See Shigella spp. infections

treatment of, 302, 1065

V. parahaemolyticus, 1309

Dysesthesia, 169. See also Sensation, abnormalities of

Dysferlinopathy (LGMD2B), 3522, 3523t

Dysfibrinogenemia, 915, 918

Dysfunctional uterine bleeding, 3034

Dysgerminoma, 698, 2907

Dysgeusia. See Taste disorders

Dysgraphia, 196, 198

Dyshematopoietic syndrome, 907

Dyshidrotic eczema, 370t, 372f, 376, 376f, A5

Dyskeratosis congenita (Hoyeraal-Hreidarsson

syndrome)

clinical features of, 391, 511, 794, 2715,

3681–3682

genetic considerations in, 794, 2715, 3682, 3682t,

pathogenesis of, 510–511

telomere length measurement in, 3682, 3683f

Dyskerin, 794, 3680, 3681f

Dyskinesia(s)

diphasic, levodopa-related, 3393

exercise-induced, 3408

paroxysmal, 3408

pathophysiology of, 3393f

tardive, 175, 293, 3407–3408, 3556

Dyslipidemias. See Lipoprotein disorders

Dysmenorrhea, 124, 3038

Dyspareunia, 3062

Dyspepsia. See also Indigestion

clinical features of, 292, 2410

endoscopy in, 2410–2411

functional (essential), 295, 1281, 2442

new-onset, approach to, 2449, 2450f

nonulcer, 2412

Dysphagia, 287

approach to the patient, 289–291, 290f

in botulism, 1217

in cranial nerve disorders, 3441

diagnosis of, 290–291, 2413, 2417f

esophageal, 289, 2424

in esophageal cancer, 295, 627

in gastric cancer, 630

in GERD, 2429

history in, 289–290

involuntary weight loss and, 310

in myasthenia gravis, 3510

oropharyngeal, 289

pathophysiology of, 288–289

physical examination in, 290

propulsive (motor), 288–289

radiation therapy–related, 593

with solids vs. liquids, 289

structural, 289

in terminally ill patient, 88t

transfer, 2413

treatment of, 291, 2413–2414, 2418f, 2419f, V5

Dysphonia, 3441

Dysplasia(s)

of bone. See Bone disease

fibromuscular, 2078, 2088, 2110, 3343

pituitary, 2896

skeletal (chondrodysplasias), 3228

Dysplastic nevus, 580, 582f, A5

Dyspnea, 263

in aortic stenosis, 1981

approach to the patient, 264, 266f

assessment of, 80–81, 263, 264t, 2131

in cardiovascular disease, 265, 265t, 267, 1797

in COPD, 2185

definition of, 263

differential diagnosis of, 263–264, 265t

efferent-afferent mismatch in, 263, 264f

epidemiology of, 263

history in, 265–266

imaging in, 266

in interstitial lung disease, 2191

laboratory studies in, 266–267

nocturnal, 265

in orthostatic hypotension, 156

pathophysiology of, 263, 264f

physical examination in, 266

in pulmonary hypertension, 2122

in respiratory acidosis, 366

in respiratory disease, 263, 265t, 267, 2131

in terminally ill patient, 80–81, 81t

treatment of, 81, 81t, 267

Dyspraxia, sympathetic, 198

Dysreflexia, autonomic, 3433

Dysthymic disorder, 3548

Dystonia, 3401

INDEX

clinical features of, 174, 3401–3402, 3401t I-69

combined, 3402–3403, 3403t

complex, 3403

drug-induced, 83, 3403, 3407–3408

focal, 3402

generalized, 3402

genetic considerations in, 3402–3403, 3403t

isolated, 3403t

pathophysiology of, 3403

tardive, 3407–3408

treatment of, 3403–3404

in Wilson’s disease, 3235

Dystonic storm, 3404

Dystroglycans, 3521, 3526f

Dystrophia myotonica. See Myotonic dystrophy

Dystrophic calcification, 394, 3216t, 3217

Dystrophin, 1955, 1957f, 3521, 3526f, 3650

Dystrophin gene mutations, 3521

EACA. See ε-Aminocaproic acid

EADs (early afterdepolarizations), 1869, 1869f,

1869t

EAEC (enteroaggregative E. coli), 1266t, 1269.

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