INDEX

imaging in, 2048 I-157

incidence of, 2046

pathophysiology of, 2046, 2047f

risk stratification in, 2048

treatment of, 2048

ACE inhibitors, 2049

antithrombotic therapy, 926, 2049–2051, 2050t

beta blockers, 2048, 2050t

calcium channel blockers, 2048–2049, 2050t

invasive vs. conservative strategy, 1821, 2051f

long-term management, 2052

monitoring, 2048

morphine, 2049, 2050t

nitrates, 2048, 2050t

PCI, 2051, A11. See also Percutaneous

coronary interventions (PCI)

statins, 2049

Nonsustained ventricular tachycardia (NSVT).

See Ventricular tachycardia (VT),

nonsustained

Nonthyroidal illness. See Sick euthyroid syndrome

Nontoxic multinodular goiter, 2946–2948. See also

Thyroid nodular disease

Nontropical sprue. See Celiac disease (gluteninduced enteropathy)

Nontuberculous mycobacterial (NTM) infections,

1392

bronchiectasis, 1393, 1394, 2173, 2175. See also

Bronchiectasis

in children, 1394

clinical features of, 1394–1395

diagnosis of, 1395–1396, 1395f, 1404

epidemiology of, 1392–1393, 1404

global considerations in, 1393, 1396

M. abscessus, 1394, 1396, 1405

M. avium complex. See Mycobacterium avium

complex (MAC) infections

M. fortuitum, 1394

M. kansasii, 1394, 1396

M. marinum. See Mycobacterium marinum

infections

M. ulcerans, 1395

pathobiology of, 1393–1394, 1393f

prevention of, 1396

prognosis of, 1396

treatment of, 1396, 1404–1406

Nontyphoidal salmonellosis. See Salmonella spp.

infections

Noonan’s syndrome, 2004, 2119, 3650t

NOP10 gene mutations, 3682t

Norepinephrine

actions of, 3427

in cardiac contraction, 1805

for cardiogenic shock, 2253

in cardiovascular regulation, 2073

for sepsis/septic shock, 2247t, 2248

for shock, 2241

in vascular smooth-muscle cells, 1802

Norethindrone, 3043, 3049

Norfloxacin

actions of, 1149, 1164t

adverse effects of, 784t

for donovanosis, 1335

for infectious diarrhea, 1065t

for peritonitis, 324

for peritonitis prophylaxis, 1055

resistance to, 1164t, 1167

Norgestimate, 3042

Normal-pressure hydrocephalus, 175, 193, 194f,

3375–3376

Normal saline. See Saline

Normeperidine, 96

Normochromia, 425

Noroviruses, 1597, 1598f

Norovirus (Norwalk virus) infections

clinical features of, 292, 300, 300t, 1598, 1598t

diagnosis of, 1599

epidemiology of, 300, 1063, 1064t, 1597

etiology of, 1597, 1597t

health care–associated, 1133

immunity to, 1598–1599

pathogenesis of, 1597–1598

prevention of, 1599

in transplant recipient, 1141

treatment of, 1599

Norrie’s disease, 244t

North Queensland tick typhus, 134t

Nortriptyline

adverse effects of, 3542t

for chronic daily headache, 114

for depression, 3474, 3542t, 3544, 3549

genetic variations in response to, 477

for migraine prevention, 3364, 3365t

for nausea and vomiting, 294t

for neuropathic pain, 79, 97, 98

for pain, 95t, 98, 3474

for smoking cessation therapy, 595, 3566

Norway, 45

Norwegian (crusted) scabies, 1575, 3608

Nose

in granulomatosis with polyangiitis, 1816, 2806

in lepromatous leprosy, 1386

in relapsing polychondritis, 1816, 2827, 2828f

swab, specimen collection and transport, S11

No-see-um midges, 3614

Nosema spp., 1767

Nosocomial infections. See Health care–associated

infections

NO SPECS mnemonic, in Graves’ disease, 2939

NOTCH1 gene mutations, 419, 835–836, 846t, 1979

NOTCH2 gene mutations, 856

NOTCH3 gene mutations, 3343

NOTCH4 gene mutations, 2771

Notch pathway, 505t

NOTES (natural orifice transluminal endoscopic)

surgery, 2393, 2396

Nothnagel’s syndrome, 229

Novichok nerve agents, S4

NOX2, 447

NPAS2 genes, 3801, 3805t, 3808

NPC1/2 gene mutations, 3259

NPH insulin, 3108, 3108t

NPHP2 gene mutations, 2355

NPHS1/2 gene mutations, 2282, 2332

NPM1 gene mutations, 810, 811, 812t, 851

NPRL3, 756

NR0B1 gene mutations, 3015t

NR1H4 gene mutations, 2562

NR5A1 gene mutations, 2896, 2999, 3003t, 3005t

NRAMP1, 1361

NRAS gene mutations

cancers associated with, 500t

in lung cancer, 596f, 597t

in mastocytosis, 864

in melanoma, 420, 582, 585

in multiple myeloma, 872

NREM sleep, 204–205, 205f

NRF2, 2181

NRL gene mutations, 3645t

NRTK gene mutations, 552

NRXN1 gene mutations, 3535

NSAIDs. See Nonsteroidal anti-inflammatory drugs

(NSAIDs)

NSE. See Neuron-specific enolase (NSE)

NSIAD (nephrogenic syndrome of inappropriate

diuresis), 2924

NSIP (non-specific interstitial pneumonia), 2190t,

2193–2194, 2193f, 2194f

NSMF gene mutations, 3015t

NSTE-ACS. See Non-ST-segment elevation acute

coronary syndrome (NSTE-ACS)

NSVT (nonsustained ventricular tachycardia).

See Ventricular tachycardia (VT),

nonsustained

N-terminal pro-BNP (NT-proBNP), 1939, 2124

NTM infections. See Nontuberculous

mycobacterial (NTM) infections

NTRK gene mutations, 596, 596f, 597t, 607

NTS (nucleus of the solitary tract), 234

Nuchal rigidity, 1102

Nuclear factor-κB (NF-κB)

activation defects of, 446t, 2714

essential modulator. See NEMO (NF-κB essential

modulator)

inhibition of, 515, 518f, 955–957

receptor activator of. See RANK (receptor

activator of NFκB)

systems biology analysis of, 3814

Nuclear magnetic resonance (NMR), 3832–3833,

3833t

Nuclear membrane, inherited defects of, 1955, 1956t

Nuclear-mitochondrial genomic cross-talk, 3676,

3677f

Nuclear receptor(s), 2885–2886, 2887, 2889, 2889f,

3645t

Nuclear weapons, S5, S7

Nucleic acid tests

amplification, 960t, 962, 1458–1459, 1560, 1560t,

S11

applications, S11

next-generation and metagenomic, S11

probes for direct detection of pathogens, S11

quantitative strategies, S11

Nucleocapsid, viral, 1453, 1453f

Nucleophosmin, 810–811

Nucleoside reverse transcriptase inhibitors. See

Combination antiretroviral therapy

(cART)

Nucleosome, 3641f, 3646f, 3790

Nucleosome remodeling enzymes, 3792

5’-Nucleotidase, 2555

Nucleotide repeat expansion disorders, 3655, 3655t

Nucleotide reverse transcriptase inhibitors. See

Combination antiretroviral therapy

(cART)

Nucleus of the solitary tract (NTS), 234,

234f

Nucleus pulposus, herniated, 110, 3450

Nudge, in behavioral economics, 3776, 3779

NUDT15, 478

Number needed to treat, 29

Numbness, 169. See also Sensation

Nummular eczema, 376

Nummular headache, 3369

Nummular skin lesions, 370t

Nurse-like cell, in CLL, 836

Nursing homes, funding of, 46–47

Nusinersen, 3415, 3685

Nutrient(s)

definition of, 2517

digestion and absorption of, 2381, 2459. See also

specific nutrients

Nutrient requirements, 2517

in critically ill patient, 2223–2224

factors altering, 2518, 2521–2522

recommended intakes, 2517, 2519–2521t

INDEX

I-158 Nutrient-sensing pathways, 3734–3735, 3735f

Nutritional monitoring, 2522

Nutritional physiology, 2539–2540

Nutritional Screening Initiative, 310

Nutritional short stature, 2899

Nutritional supplements, 2518, 3786

Nutritional support/therapy. See also Enteral

nutrition; Parenteral nutrition

for acute pancreatitis, 2663

after bariatric surgery, 3094

for dementia, 2546

for diabetes mellitus, 3105, 3105t

for gastrointestinal disease, 2385

for hypertension, 2082, 2082t

for IBS, 2493–2494, 2494t

for metabolic syndrome, 3155

for obesity, 3089–3091

optimized voluntary, 2541

for STEMI, 2060

Nutrition assessment, 2522–2523, 2536

in acute care setting, 2522

in ambulatory setting, 2522–2523

anthropometric data in, 2537, 2538t

of cancer patient, 489

dietary assessment in, 2537

global considerations in, 2523

in high-risk patient, 2523

history and physical examination in, 2535–2536t,

2536–2537

instruments for, 2541

laboratory evaluation in, 2537, 2538t

NY-114 virus, 1492t

Nyando virus, 1628t

NYHA (New York Heart Association), classification

of cardiovascular disease, 1797t, 1936t,

2033t

Nylon flock exposure, 2171

Nystagmus, 231, V3

congenital, 231

etiology of, 231

gaze-evoked, 231

jerk, 231

patterns of, 159, 159t, 160

rotary, in stimulant overdose, 3584

vestibular, 231

in vestibular dysfunction, 176

Nystatin, 380t, 381, 1657, 1675t, 2330

O

OA. See Osteoarthritis (OA)

OATB1B1 (organic anion transport protein 1B1),

2557, 2561

OATs (organic anion transporters), 3249, 3249f,

3250

Obesity, 3087

central adiposity in, 3150–3151

comorbid conditions, 3088, 3088t

asthma, 2153

bone and joint disorders, 2857–2858

diabetes mellitus, 3097, 3101

dyslipidemia, 3086, 3144, 3147

erectile dysfunction, 3057

PCOS, 3036

complications of, 3085, 3085f

cancer, 491, 523, 613, 3087

cardiovascular disease, 1814, 1965, 2040, 3086

cutaneous disorders, 3086

diabetes mellitus, 3086

endocrine disorders, 3086

gastrointestinal disorders, 3086

hypertension, 2072, 2082

hypogonadotropic hypogonadism, 3016

impaired response to infection, 3087

insulin resistance, 3086, 3086f

liver disease, 2620–2621, 3086

mechanistic considerations in, 3085–3086,

3086f

neurologic disease, 3087

reproductive disorders, 3086

rheumatologic disorders, 3087

sleep deprivation, 3088

definition of, 3081, 3081f

dyspnea in, 265

epidemiology of, 3081

evaluation of, 3087–3089, 3088t

fatigue and, 163

genetic subtypes of, 3085, 3085t

global burden of, 1814, 3081, 3712

gut microbiome and, 3695–3696

heart failure and, 1939

high-altitude travel and, 3622

history focused on, 3087–3088

hyperpigmentation in, 390

in hypothalamic disorders, 2907

infertility and, 3051–3052

in metabolic syndrome, 3150–3151, 3151t

NALFD and, 2621, 2622

pancreatic cancer risk and, 658

pathobiology of, 3080

energy intake and expenditure, 3082–3083

environmental factors, 3082–3083

genetic syndromes, 3083–3084, 3083t

genetic vs. environmental factors in, 3082

homeostatic regulation, 3081–3082, 3082f,

3083f

leptin in, 3083, 3084–3085, 3084t

nutrient storage in adipose tissue, 3082

pregnancy and, 3765

prevalence of, 12, 2883t, 3081

pulmonary function values in, 2137–2138, 2138f

screening/testing for, 39t, 2883t

secondary to other disorders, 3085

severity staging in, 3088, 3089f

treatment of, 3089

algorithm for, 3090f

bariatric surgery, 3093–3094, 3093f

behavioral therapy, 3091

diet therapy, 3089–3091

endoscopic, 2414, V5

goal of, 3089

incentive programs for, 3779–3781, 3780g,

3781f

intraluminal gastric balloons, 3094

in metabolic syndrome, 3155–3156

pharmacotherapy, 3091–3093, 3092t

physical activity, 3091

readiness to change and, 3088–3089

selection of, 3089, 3090t

in women vs. men, 3067

Obesity hypoventilation syndrome, 2203–2204

Obiltoxaximab, S3

Obinutuzumab

actions of, 536, 536f, 2707t

adverse effects of, 573

for CLL, 839

for follicular lymphoma, 848

indications for, 2707t

for SLE, 2747

Object recognition, 201

Obligate anaerobes, 1348

Observational data, 29

Obsessive-compulsive disorder (OCD),

3546

Obstructive shock, 2236, 2236t

Obstructive sleep apnea/hypopnea syndrome

(OSAHS)

cardiovascular effects of, 2208

clinical features of, 2206

daytime sleepiness in, 208, 2206, 2208

definition of, 2205

diagnosis of, 208t, 2202t, 2203, 2206–2207,

2207f, 2207t

epidemiology of, 11–12, 2205–2206

fatigue and, 163

in heart failure, 1950

heart failure and, 1939

hypertension and, 2079, 2208

in metabolic syndrome, 3155

obesity and, 2079, 2205, 3086

in older adults, 3755

pathophysiology of, 2138, 2205, 2205f, 2207f

polysomnography in, 2206, 2207f

pulmonary hypertension in, 2124

quality of life in, 2208

risk factors for, 2205–2206

screening for, 12

severity scale for, 2207t

sudden cardiac death and, 2259

treatment of, 208t, 2208–2209, 2208t

Obturator sign, 2514t

Occam’s razor, 22, 3814

Occipital adenopathy, 458

Occipital lobe stroke, 225

Occipital nerve injection, 3367, 3367t

Occipitotemporal network, 201–202

Occupational illness. See also Health care workers

animal bite-wounds, 1125

asthma, 2153

contact dermatitis, 375–376

hand eczema, 376

hearing loss, 247, 247t

lung disease, 2132, 2166

asbestos-related. See Asbestos-related disease

categories of, 2167t

characteristics of agents causing, 2167

chest imaging in, 2166

chronic beryllium disease, 2170

coal worker’s pneumoconiosis, 2169–2170

COPD, 2184

disability assessment in, 2172

exposure assessment in, 2166

history in, 2166

hypersensitivity pneumonitis. See

Hypersensitivity pneumonitis

incidence of, 2166

inorganic dusts, 2167t, 2170

organic dusts, 2167t, 2170

pulmonary function tests in, 2166

silicosis, 2168–2169, 2169f

toxic chemicals, 2170–2171, 2171t

in World Trade Center rescuers, 2171

osteoarthritis, 2858

shift-work disorder, 214

tularemia, 1315–1316

OCD (obsessive-compulsive disorder), 3546

OCG (oral cholecystography), 2645

Ochlerotatus mosquitos, 1637

Ochrobactrum spp., 1249, 1311

Ochronosis, 3272

Ochronotic arthritis, 3272

Ocrelizumab, 3468–3470, 3470t, 3473

OCT (optical coherence tomography), 1865, 1865f

Octopus envenomation, 3604

Octreotide

for acromegaly, 2913

adverse effects of, 2913

INDEX

for carcinoid syndrome, 306, 636, 669 I-159

for chemotherapy-related diarrhea, 542, 555

for dumping syndrome, 2452

in end-of-life care, 80

for extrapancreatic NET, 671, 671t

for gastrinoma, 2985

for hepatorenal syndrome, 2307

for hypoglycemia, 3135

for hypomotility of small bowel, 2786

for insulinoma, 3133

for intestinal pseudoobstruction, 293, 294t

for oncogenic osteomalacia, 725

for postprandial orthostatic hypotension, 3436

structure, 669f

for thyroid dermopathy, 2943

for variceal bleeding, 311, 2630

for vascular ectasias, 312–313

for ZES, 2455

Ocular alignment, 217

“Ocular bobbing,” 186

Ocular disorders, 215. See also Optic neuritis;

Visual loss

acne rosacea and, 383

in axial spondyloarthritis, 2793

in Behçet syndrome, 221, 2818

in cat-scratch disease, 1329, 1330f, 1331t

in diabetes mellitus. See Diabetes mellitus (DM),

complications of; Diabetic retinopathy

in granulomatosis with polyangiitis, 2806

at high altitudes, 3621

in IBD, 2480

infections. See also Conjunctivitis; Keratitis;

Retinitis

Candida, 1673, 1673f, 1676

L. loa. See Loa loa (African eye worm)/loiasis

Nocardia, 1338

Onchocerca, 1782

P. aeruginosa, 1287t, 1288

parasitic, 1699t

T. gondii, 1759, 1761, 1762

Toxocara, 1771

in malnutrition, 2536t

in Marfan syndrome, 3229

in MS, 3462

in mucormycosis, 1682–1683

in myasthenia gravis, 3510

in osteogenesis imperfecta, 3223

in relapsing fever, 1423

in relapsing polychondritis, 2828

in sarcoidosis, 2832, 3451

in Sjögren’s syndrome, 2788

SLE and, 2743, 2743t

trachoma, 220, 1450–1451

in tularemia, 1317

Ocular flutter, 231, V3

Ocular lubricants, 220

Ocular movements, 159, 186–187, 186f, 216, 217,

V3

Oculocephalic reflexes, 186f, 187, 3380

Oculocutaneous albinism, 386–387

Oculomotor apraxia, 201

Oculomotor nerve, 3279–3280

Oculomotor nerve palsy, 216, 229, V3

Oculopharyngeal dystrophy, 228, 3527

Oculovestibular response, 186f, 187

Odanacatib, 3208

Odontoid fracture, A16

Odynophagia, 287, 290, 295, 627, 2424, 2432

ODZ4 gene mutations, 3551

Ofatumumab

actions of, 536, 536f, 833t, 2707t

adverse effects of, 573

for MS, 3470, 3470t, 3473

Ofloxacin

actions of, 1164t

for C. trachomatis infection, 1450

for enteric fever, 1295

for epididymitis, 1082

for leprosy, 1390

resistance to, 1164t, 1390, 1443

for tularemia prophylaxis, 1319t

Ogilvie’s disease. See Intestinal pseudoobstruction

17OHP (17-hydroxyprogesterone), 2955f, 2975

Oka. See Varicella vaccine

OKT3, 277t, 2275, 2637

Olanzapine

for acute alcohol intoxication, 3561

adverse effects of, 3087, 3554, 3555t

for bipolar disorder, 3551

for delirium, 83, 83t

for nausea and vomiting, 79, 293, 294, 294t, 555

overdosage/poisoning with, 3590t

for schizophrenia, 3554, 3555, 3555t

Olaparib

action and targets of, 513t, 551t, 552

adverse effects of, 551t

for breast cancer, 551t, 622, 625

gene mutations and response to, 3838

for ovarian cancer, 551t, 697

for pancreatic cancer, 551t, 662

for prostate cancer, 688

Olaratumab, 514t

Older adults. See also Aging

abuse and neglect, 68, 3758–3759, 3758t

ALL in, 832

anemia in, 754, 3747–3748

antidepressant use in, 3549

appendicitis in, 2515

assessment of, 3741–3742, 3743t

asthma in, 2159

benign forgetfulness of, 190

cancer in, 3747

care transitions for, 3740, 3741t

cerumen impaction in, 242

co-managed care of, 3740–3741

COVID-19 disease in, 3759

decision-making skills in, 3742, 3744f

delirium in, 178–179, 3751–3753, 3752f, 3752t.

See also Delirium

dementia in, 3751–3753, 3753t. See also

Dementia

demographics of, 3733, 3733f, 3739, 3739f

diabetes mellitus in, 2894t, 3104t, 3119,

3746–3747

diagnostic test interpretation in, 3742

driving impairment in, 3742, 3743t

drug-induced illness in, 471

drug management in, 3750–3751, 3751t

drug use in, 471

end-of-life and palliative care, 3759. See also

End-of-life care; Palliative care

falls in

causes of, 3749t, 3750t

epidemiology and impact of, 173, 176, 3748

evaluation of, 3743t, 3748f, 3749f

interventions to reduce, 177

management of, 3749–3750, 3750t

risk factors for, 176, 177t

frailty in, 3755, 3757

hearing loss in, 240–241, 241f

heat-related illness in, 3635

hemoglobin/hematocrit in, 433t

hepatitis in, 2579

hyperlipidemia in, 3747

hypernatremia in, 46

hypertension in, 3744, 3746

hypothermia in, 3631, 3633

involuntary weight loss in, 309

levothyroxine dosage in, 2937

liver abscess in, 1059

memory impairment in, 3751, 3751f

multimorbidity in, 3736, 3739–3740, 3740f

musculoskeletal disease in, 2847, 2855

olfactory dysfunction in, 234, 234f, 238

oral health, 262–263

osteoarthritis treatment in, 3747

PD in. See Parkinson’s disease

person-centered care of, 3740, 3740f, 3741,

3742t

polypharmacy in, 3750–3751, 3751t

preventive care for, 3742–3744, 3745t

rheumatoid arthritis in, 2765

screening tests in, 41t

seizures in, 3310, 3310t

sleep disorders in, 3754–3755, 3757t

specialized nutritional support in, 2546

urinary incontinence in, 3753–3754, 3754t,

3755f, 3756t, 3757f, 3757t

vitamin D deficiency in, 3167

water requirement of, 2518

weight regulation in, 309

Olecranon bursitis, 2878

Oleoresin, 375

Olfactory bulb, 232, 232f, 233f

Olfactory disorders, 234

after traumatic brain injury, 3459

diseases and conditions associated with, 235–

236, 235t

in early PD, 3387

epidemiology of, 234–235, 234f

etiology of, 234–235, 235t

evaluation of, 236–237

in gonadotropin deficiency, 3014, 3015t, 3033

taste disorders and, 236

treatment of, 237–238

Olfactory nerve, 3279

Olfactory system, 232–233, 232f

Oligoastrocytomas, 705

Oligodendrocyte precursor cells, 3293

Oligodendrocytes, 3293

Oligodendroglioma, 705

Oligomenorrhea, 3034

Oligomer(s), 3298, 3372

Oliguria, 336, 2218

Olivopontocerebellar atrophy. See Spinocerebellar

ataxia (SCA)

Ollier’s disease (enchondromatosis), 697,

3216

Olmesartan, 302, 304

Olodaterol, 2156

Omacetaxine, 824, 824t

Omadacycline

actions of, 1149, 1160, 1164t

adverse effects of, 1154t, 1160

for Citrobacter infections, 1274

for Enterobacter infections, 1273

for enterococcal infections, 1202

for gram-negative bacterial infections,

1263–1264

indications for, 1157t, 1160

for Klebsiella infections, 1271

for MRSA infections, 1186t, 1187

for NTM infections, 1396

in pregnancy and lactation, 1153t

resistance to, 1157t, 1164t, 1166, 1263

for Serratia infections, 1273

INDEX

I-160 Omalizumab

for ABPA, 2165

actions of, 2708t

adverse effects of, 408

for allergic rhinitis, 2725

for asthma, 2157

indications for, 2708t

for urticaria, 2723

Omapatrilat, 1947

Ombitasvir, 1168t, 1469, 2607, 2608–2609t, 2609

Omecamtiv mecarbil, 1948t, 1949

Omega-3 fatty acids (fish oils), 454

adverse effects of, 3142t, 3148

antiplatelet effects of, 454

for heart failure, 1950

for hypertriglyceridemia, 3142t, 3148

for metabolic syndrome, 3156

for rheumatoid arthritis, 3786

Omenn syndrome, 2714, 2718

Omentectomy, 696

Omeprazole

actions of, 2444

drug interactions of, 471t

formulations of, 2444

for gastrinoma, 2985

genetic variations in response to, 476t, 478

for GERD, 296

in H. pylori eradication, 1283t, 2446

metabolism of, 467t, 478

for peptic ulcer disease, 2443t, 2444, 2450

for ZES, 2455

OmpA protein, 1276

Omsk hemorrhagic fever virus, 1626t, 1644

OMVs (outer-membrane vesicles), 1233, 1233f,

1276

Onabotulinum toxin A. See Botulinum toxin

Onasemnogene abeparvovec, 3686t

Onchocerca volvulus/onchocerciasis

characteristics of parasite, 1778t, 1781

clinical features of, 221

lymph nodes, 1782

ocular, 1699t, 1782

onchocercomata, 1782

skin, 387, 1037, 1699t, 1781–1782, 1781f

systemic, 1782

diagnosis of, 945t, 1699t, 1782, S12

epidemiology of, 945t, 1697, 1778t, 1781

etiology of, 1781

pathogenesis of, 1781

prevention of, 1782

treatment of, 1710, 1782

Oncogene(s), 498, 499–500, 500t, 508, 520f. See

also Cancer genetics

Oncogene addiction, 515, 515f, 544

Oncogene checkpoint, 510f

Oncologic emergencies. See Cancer, emergencies in

Oncology, 530

Oncolytic viruses, 536f, 539, 3689–3690

Oncostatin M (OSM), 2683t

Oncotype DX Recurrence Score, 619

Oncovin, 3017

Ondansetron

for ataxia/tremor in MS, 3474

for nausea and vomiting, 80, 115, 293, 294, 294t,

488, 554

for scombroid poisoning, 3606

Ondine’s curse, 2204

One-and-a-half syndrome, 230, V3

“Onionskin” lesion, 2090

“Onion skinning,” 2366

Online Mendelian Inheritance in Man, 3639, 3640t

Onycholysis, 378, 381, 410

Onychomadesis, 410

Onychomycosis, 380, 1657, 1672, 1677, 1691, 1691t

O’nyong-nyong virus infection, 1044, 1625t, 1633

Oocyte donation, 3036, 3679–3680, 3679f

Oogonia, 3027, 3028f

Oophorectomy, 531, 613t, 614, 620, 695, 698

Oophoritis, 1617

OPA1, 950, 950t, 1235, 3298

OPC-31260, 2353

OPC-67683. See Delamanid

Open-access endoscopy, 2420–2422

OPG. See Osteoprotegerin (OPG)

Ophthalmia neonatorum, 1238, 1240t

Ophthalmomyiasis, 3611

Ophthalmopathy

diabetic. See Diabetic retinopathy

Graves’. See Graves’ (thyroid-associated)

ophthalmopathy

Ophthalmoplegia

internuclear, 230, 231f, V3

progressive external. See Progressive external

ophthalmoplegia

Opicapone, 3395, 3396t

Opioid(s)

actions of, 96, 3538, 3538f, 3540t

adverse effects of, 79, 125, 249, 2861t, 3569

delirium, 180

dysphagia, 290

hypogonadism, 3016

management of, 96

pruritus, 411

respiratory depression, 96

SA node dysfunction, 1875t

for back pain, 125

chronic/long-term use of, 73t, 98, 99t

for cough, 249

COX inhibitor combinations, 96–97

cross-tolerance among, 79

dosage of, 78–79

for dyspnea, 81, 267

endogenous, 94

for frostbite, 3634

guidelines for prescribing, 98, 99t

for migraine, 3362t, 3364

most commonly abused, 3569. See also Opioid

use disorders

neurobiology of, 3569–3570, 3569t, 3570f

for osteoarthritis, 2861t, 2862

overdosage/poisoning with, 184, 3571, 3571t,

3584–3585, 3595t

for pain, 78–79, 78f, 95t, 96–97

pharmacology of, 3570–3571

for restless legs syndrome, 212

routes of administration of, 96

for sickle cell pain, 760

systems effects of, 3570–3571

withdrawal from, 3571–3572

Opioid antagonists, 3571, 3571t, 3572

Opioid receptors, 94, 3569–3570, 3569t, 3570f

Opioid use disorders, 3569

clinical features of, 3570–3571

complications of, 3570–3571

diagnosis of, 3569

epidemiology of, 3569

pathogenesis of, 3538, 3538f

prescription opioids and, 98

prevention of, 3572

in terminally ill patient, 79

treatment of, 3571–3572, 3571t

Opisthorchis/opisthorchiasis, 653, 945t, 1784t,

1788–1789, 1788t, 1789t

Opsoclonus, 231

Opsoclonus-myoclonus syndrome, paraneoplastic,

734, 2697t

Opsonization, 2685

Optical coherence tomography (OCT), 1865, 1865f

Optic ataxia, 201

Optic atrophy, 223, 223f, 1410, 3287, 3298

Optic chiasm, 218, 2902t

Optic cup, 225, 225f

Optic disc, 218, 224, 224f

Optic disc drusen, 224, 224f

Optic gliomas, 2907

Optic nerve, 215

disorders of, 218. See also Optic neuritis; Optic

neuropathy

examination of, 3279

injuries of, 3459

tumors of, 227

Optic neuritis, 216

color desaturation in, 218

epidemiology of, 223

ethambutol-related, 1401

in MS, 223, 3462

in neuromyelitis optica. See Neuromyelitis optica

(NMO)

paraneoplastic, 728t, 736

recurrent, 223

retrobulbar, 216, 223, 223f

in sarcoidosis, 2833

treatment of, 223, 3293

visual field defects in, 218

Optic neuropathy

anterior ischemic, 222–223, 222f

drug-induced, 223–224

in giant cell arteritis, 2812

Leber’s. See Leber’s hereditary optic neuropathy

posterior ischemic, 223

toxic, 223–224, 223f

Opt-in vs. opt-out policies, 3779

Optokinetic reflex, 215

Oral cancer

clinical features of, 257, 259t, 591, A3

diagnosis of, 257

incidence of and deaths from, 481t

prevention of, 490

risk factors for, 257, 379, 3559

smoking and, 490

Oral cavity. See also Oral mucosa

anaerobic bacterial infections of, 1349, 1351

dry. See Xerostomia

healthy, A3

infections of, 559–560

lesions in reactive arthritis, 2797–2798

in malnutrition, 2536t

systemic disease signs in, 256, A3

Oral cholecystography (OCG), 2645

Oral contraceptives, 3053

for acne vulgaris, 382

adverse effects of

cholestasis, 319, 2586t

cutaneous, 139t, 382, 391, 397

dyslipidemia, 3144

hair loss, 410

hepatotoxicity, 2586

hirsutism, 410

hyperkalemia, 353

hypertension, 3066

oral pigmentation, 260t

pigmentation changes, 409

venous thrombosis, 923

for amenorrhea, 3036

benefits of, 3054

breast cancer risk and, 612

INDEX

contraindications to, 3042, 3053t, 3054 I-161

drug interactions of, 471t, 473, 3323–3324

for dysmenorrhea, 3038

effectiveness of, 3054t

for endometriosis, 3038

for hirsutism, 3042

HIV infection risk and, 1534

for PCOS, 3036

in perimenopause, 3043–3044

progestin-only, 3054

Oral-facial-digital syndrome type I, 2351t

Oral glucose tolerance test, 3097

Oral hairy leukoplakia, 1485, 1485f, 1486–1487,

1568, 1569f

Oral mucosa

age-related changes in, 262

pigmented lesions, 260t

vesicular, bullous, or ulcerative lesions, 258–259t

white lesions, 260t

Oral pain, nondental, 257, 259, 261

Oral rehydration solution (ORS)

for cholera, 1307–1308, 1307t

composition of, 1065, 1301, 1308, 1308t

for infectious diarrhea, 302, 1065, 1065t

for Shigella infections, 1301

Oral sex, HIV transmission and, 1533t, 1534

Oral ulcers, 257, 259t, 2818, A3

Orán virus, 1629t

Orbital atherectomy, A11

Orbital pseudotumor, 228, 2838t, V3

Orbit, disorders of, 227–228, 2839f, A16

Orbitofrontal cortex, 232

Orbiviruses, 1626t, 1631, 1640

Orchidopexy, 690

Orchiectomy, 531, 544, 687, 690

Orchitis, 1617, 1618, 3017

Orexin (hypocretin), 171, 205, 206f, 236

Orf, 1035, 1492t, 1493

Organic acid(s), renal transport of, 2292

Organic anion transporters (OATs), 3249, 3249f

Organic anion transport protein 1B1 (OATP1B1), 2557

Organic dusts, 2167t, 2170

Organ of Corti, 238, 239f

Organoids, 3300

Organophosphates, 301, 3495t, 3592t

Organ transplantation. See Solid organ

transplantation

Oriboca virus, 1627t

Orientia tsutsugamushi, 977, 1437. See also Scrub

typhus

Oritavancin

actions of, 1148, 1164t

adverse effects of, 1154t, 1159

drug interactions of, 1155t

for enterococcal infections, 1202

indications for, 1156t, 1158

in pregnancy and lactation, 1152t

resistance to, 1156t, 1164t

for staphylococcal infections, 1186t, 1187

Orlistat, 2532, 3093, 3155

ORMDL2 gene mutations, 2472, 2472t

Ornithine decarboxylase, 1708

Ornithine metabolism disorders, 3270t

Ornithine transcarbamylase deficiency, 3270t, 3273

Ornithodoros spp. tick, 1422, 1422f

Oromandibular dystonia, 3402

Oropharyngeal disease

cancer, 491–492, 591, 593, 1499. See also Head

and neck cancer

dysphagia in, 289

in systemic sclerosis, 2781, 2781t

in tularemia, 1317

Oropouche virus, 1628t, 1639

Orotic aciduria, 775, 3253t, 3254

Oroya fever, 1331t, 1333–1334

Orphenadrine, 3590t, 3593t

ORS. See Oral rehydration solution (ORS)

Orthobunyaviruses, 1627–1528t, 1630, 1639

Orthobunyavirus infections, 1627–1528t, 1639

Orthodeoxia, 2549

Orthodromic AV reciprocating tachycardia, 1888t,

1896f, 1897

Orthohantaviruses, 1628–1629t, 1630

Orthomyxoviruses, 1454t, 1455f, 1505, 1624. See

also Influenza virus

Orthomyxovirus infections, 1632–1633t, 1640

Orthonairoviruses, 1629t, 1630

Orthopnea, 265, 1936

Orthopoxvirus infections

clinical features of, 1493, 1493f, 1494

epidemiology of, 1492–1493

in humans, 1492t

pathogenesis of, 1492–1493

zoonotic characteristics of, 1492t

Orthopoxvirus vaccine, 1494

Orthostatic hypotension

approach to the patient, 3431–3432

clinical features of, 156, 3429, 3430t

definition of, 1818

diabetic neuropathy and, 3125

diagnosis of, 3431–3432

dizziness in, 159

drug-related, 3431t, 3435

etiology of, 3431t

in hypovolemia, 341

neurogenic, 156

in opioid use disorders, 3571

pathophysiology of, 126f, 153–154, 1818

in PD, 3398

in pheochromocytoma, 2073

prevalence of, 3430t

treatment of, 156, 3125, 3386, 3435–3436, 3436t

Orthostatic proteinuria, 2334

Orthostatic tachycardia, 341

Orthostatic tremor, 175

Orungo virus, 1626t

OSAHS. See Obstructive sleep apnea/hypopnea

syndrome (OSAHS)

Osborn wave, 1830

Oscillopsia, 159, 160

Oseltamivir

actions of, 1463

adverse effects of, 1463

for influenza, 1141, 1463–1464, 1463t, 1512,

1521

for influenza prophylaxis, 1015, 1463t, 1564t

pharmacology of, 1463

resistance to, 1463, 1464

Osilodrostat, 2916, 2963

Osimertinib

action and targets of, 511, 513t, 544, 546t

adverse effects of, 546t

drug interactions of, 546t

gene mutations and response to, 3838

for lung cancer, 604, 606, 606t

Osler maneuver, 2081

Osler’s nodes, 1816

Osler-Weber-Rendu syndrome (hereditary

hemorrhagic telangiectasia)

bleeding in, 453

clinical features of, 386

gastrointestinal bleeding in, 312

skin manifestations of, 386, 1816

vascular malformations in, 910, 3352

OSM (oncostatin M), 2683t

Osmolality, 338

Osmolar gap, 363

Osmolytes, 344

Osmoreceptive, 2294

Osmoreceptors, 338, 2295f, 2918

Osmoregulation, 2294, 2295f, 2923, 2923f

Osmotic demyelination syndrome (central pontine

myelinolysis), 344, 346, 2273, 2273f,

3356, S1

Osmotic diarrhea, 303, 346, 2459, 2467. See also

Diarrhea

Osmotic diuresis, 340

Osmotic equilibrium, 338

Osmotic fragility, 779

Osmotic laxatives. See Laxatives

OspA, 1426

OspC, 1426

Ospemifene, 3045, 3050

Ossa virus, 1627t

Ossification, extraskeletal, 3216–3217, 3216t

Osteitis fibrosa cystica, 358, 2313, 3175, 3190

Osteoarthritis (OA), 2854

in acromegaly, 2871

back pain in, 122–123

clinical features of, 2859–2860

definition of, 2855

diagnosis of, 2855, 2859, 2859f

global considerations in, 2855

joints affected by, 2855, 2855f

hand, 2855, 2855f

hip, 2857, 2859

knee, 2855, 2857, 2857f, 2859, 2859f

toe, 2858f

neck pain in, 128

oral pain in, 257

pain sources in, 2858–2859

pathogenesis of, 185–186, 2856f

pathology of, 2858, 2858f

prevalence of, 2855

risk factors for, 2856–2858, 2857f

treatment of, 2860, 2861t

acetaminophen, 2861

cartilage regeneration, 2862

COX-2 inhibitors, 2861

exercise, 2860

intraarticular injections, 2861

malalignment correction, 2860–2861

NSAIDs, 2861

in older adults, 3747

opioid analgesics, 2862

surgical, 2862

Osteoarthropathy, hypertrophic. See Hypertrophic

osteoarthropathy

Osteoblast(s), 3158f, 3159f, 3170, 3210f

Osteoblastic lesion, 715, 716

Osteoblastoma, 722t

Osteochondrodysplasias, 3216

Osteochondroma, 714, 715

Osteochondromatosis (multiple exostoses), 3216

Osteoclast(s), 3158, 3158f, 3159f, 3170, 3210f

Osteoclast activating factor, 869

Osteocyte(s), 3157

Osteodystrophy, renal, 334, 3182

Osteogenesis, 715

Osteogenesis imperfecta, 3221

classification of, 3221, 3222t

clinical features of, 239, 1816, 1987, 2000, 3221–3223

diagnosis of, 3224

genetic considerations in, 3222t, 3223–3224, 3650

incidence of, 3221

treatment of, 2528, 3224

INDEX

I-162 Osteolytic lesion, 715

Osteoma cutis, 395

Osteomalacia

axial, 3214

diagnosis of, 3168–3169

in hypophosphatasia, 3214

hypophosphatemia and, 3168

oncogenic (tumor-induced), 722t, 725, 3161,

3163

pathogenesis of, 3168

postgastrectomy, 2452

secondary hyperparathyroidism and, 3182

Osteomyelitis, 1046

actinomycotic, 1341f, 1342

anaerobic bacterial, 1354

from bite-wound infections, 1125

Blastomyces, 1666, 1667, 1667t

Brucella, 1312

classification of, 1046

E. coli, 1267

enterococcal, 1200

foot, 1053, 1053f, 1288

in long bones, 1048–1050, 1049t, 1050t, 1051f

nontyphoidal Salmonella, 1297

P. aeruginosa, 1287t, 1288

in prosthetic joints. See Prosthetic joint infections

psoas abscess in, 1060

S. aureus, 1181–1182, 1182f

skull, 1354

sternal, 1052–1053, 1052f

treatment of, 1187–1188, 3127

tuberculous, 1043, 1047, 1050, 1052

vertebral, 1288

clinical features of, 123, 146, 1047, 1181–1182

complications of, 1048

diagnosis of, 123, 1047, 1048f, 1182f

epidemiology of, 1046

global considerations in, 1048

microbiology of, 1046–1047

pathogenesis of, 1046

treatment of, 1047–1048, 1049t, 1050t

in war veterans, S6

Osteonecrosis

drug-induced, 2847t

femoral head, 2854f

in HIV infection, 1574

in IBD, 2481t, 2482

of jaw, 262, 3184, 3205, A3

in sickle cell disease, 760

Osteopathic medicine, 3785t, 3789

Osteopenia, 2668, 2847t

Osteopetrosis, 3212–3213

Osteopoikilosis, 3214

Osteopontin, 745

Osteoporosis, 3191

with androgen deprivation therapy, 3076

approach to the patient, 3197

back pain in, 123

chemotherapy-related, 741

definition of, 3191

diagnosis of, 3196f, 3197–3199, 3198t, 3199t

diet and, 2521

differential diagnosis of, 3198–3199

epidemiology of, 3191–3192

fractures in

epidemiology of, 3191, 3191f

management of, 3199–3200

prevention of, 3200, 3204f, 3205f. See also

Osteoporosis, treatment of

risk factors for, 3045, 3191–3192, 3193f, 3193t,

3196–3197, 3198f

vertebral. See Vertebral fractures

glucocorticoid-induced, 2531, 3208–3209

heparin-induced, 931

in HIV infection, 1574

in IBD, 2481t, 2482

in liver disease, 2633

pathophysiology of, 3192–3193, 3193f

prednisone and, 2761

prevalence of, 2884t

prevention of, 3045, 3046t

in rheumatoid arthritis, 2753

risk factors for, 3191–3192, 3193t

chronic disease, 3195, 3195t

cigarette smoking, 3196

estrogen status, 3195

low calcium intake, 3194

medications, 3196, 3196t

pancreatitis, 2668

physical inactivity, 3195

reduction in, 3200

vitamin D deficiency, 3194–3195

screening for, 38, 39t, 2884t, 3745t

in short-bowel syndrome, 2466

treatment of, 123, 3199

abaloparatide, 3207–3208

bisphosphonates, 3203–3205, 3204f

calcitonin, 3205

calcium, 3200–3201, 3200t

denosumab, 3205–3206, 3206f

estrogens, 3202, 3202f

exercise, 3201

indications for, 3202

monitoring of, 3208

nonpharmacologic, 3208

nutritional recommendations, 3200–3201

progestins, 3203

risk factor reduction, 3200

romosozumab, 3208

SERMs, 3203

strontium ranelate, 3208

teriparatide, 3206–3207, 3207f

unapproved agents, 3208

vitamin D, 3201

in women, 3067

Osteoprotegerin (OPG)

in bone metastasis, 520

in bone remodeling, 3193, 3194f

in osteopetrosis, 3210f, 3213

in primary myelofibrosis, 805

in rheumatoid arthritis, 2757f, 2758

Osteosarcoma, 257, 715

Osteosclerosis, 124, 805, 3214. See also Paget’s

disease of bone

Ostium primum, 281, A11

Ostium secundum, 281, A11

Otitis externa, 249, 1287t, 1289, 1679, 3128

Otitis media

acute, 249–250, 250t, 1175, 1176

anaerobic bacterial, 1351

antibiotics for, 250, 250t

brain abscess associated with, 1018

C. auris, 1208

chronic, 1351

clinical features of, 1175

with effusion, 250

hearing loss in, 239

H. influenzae, 1242

in influenza, 1519

M. catarrhalis, 1245

in nasopharyngeal cancer, 590

treatment of, 1176

Otoacoustic emissions, 241

Otorrhea, 250

Otosclerosis, 241, 245, A16

Otoscopy, 239

OTUD4 gene mutations, 3015t

Outcome (quality theory), 52

Outcome evaluation, 4

Outer-membrane proteins, 1235

Outer-membrane vesicles (OMVs), 1233, 1233f,

1276

Outpatient care, 3

Ova and parasite examination, 301

Ovalocytosis, malaria resistance and, 1723

Ovarian cancer, 695

breast cancer and, 695

carcinoma of unknown primary and, 720

clinical features of, 695–696

deaths from, 481t, 483f, 484t

epidemiology of, 695

epithelial, 695

genetic considerations in, 500t, 503t, 614,

695–696

germ cell tumors, 698

incidence of, 481t, 695

infections in, 556t

in Lynch syndrome, 638, 695

metastatic, 398, 458

oral contraceptives and, 3054

paraneoplastic syndromes in, 722t, 723, 728t

pathogenesis of, 695–696

pathology of, 695

postmenopausal hormone therapy and, 3046t,

3048

in pregnancy, 3766t

prognosis of, 696t, 697

protective factors for, 695

recurrent, 697

risk factors for, 695

screening for, 496t, 497, 696

staging of, 696, 696t

stromal tumors, 217–218

surgical prevention of, 493

treatment of, 696–697, 697f

tumor markers in, 487t, 696

Ovarian follicles, 3027–3028, 3028f

Ovarian reserve, 3051

Ovary

development of, 2999, 3027, 3027f, 3028f

disorders of

borderline tumors, 217

cancer. See Ovarian cancer

cyst, 111, 112, 453, 3037, 3038

drug-related, 2747

dysfunction/failure, 3035–3036, 3052, 3651

teratoma. See Teratoma, ovarian

function of, 3028

assessment of, 3031

hypothalamic secretion in, 3028–3029, 3029f

ovarian peptides in, 3030

ovarian steroids in, 3029–3030, 3029f. See also

Estrogen(s); Progesterone

pituitary secretion in, 3029f, 3030

metastatic disease to, 696

Overactive bladder, 327, 3075, 3753, 3754t, 3756t

Overdiagnosis, 494, 597

Overdosage. See Poisoning/drug overdose

Overflow diarrhea, 299

Overhydrated stomatocytosis, 781

Overlapping sphincteroplasty, 2503

Overoptimism, 3776t, 3777

Overweight, 12, 3081, 3081f, 3088t. See also Obesity

Ovotesticular disorders of sexual development,

3001–3002, 3001t

Ovulation assessment, 3051, 3052

INDEX

OXA-48 (OXA group carbapenemase), 1165 I-163

Oxacillin

adverse effects of, 349, 2584

for cellulitis, 1039t

for epidural abscess, 975t

indications for, 1153, 1156t

for infective endocarditis, 1028

for nongonococcal bacterial arthritis, 1042

for osteomyelitis, 1049t, 1050t

resistance to, 1028, 1156t

for staphylococcal infections, 1185, 1186t

Oxalate, 361, 363, 2369

Oxaliplatin

actions of, 539

adverse effects of, 539, 540t, 642, 738t, 2586

for colorectal cancer, 642

for gastric cancer, 633

interactions and issues, 540t

for NETs, 671t

for pancreatic cancer, 661, 662t

for testicular cancer, 694

Oxalosis, 2867, 2867f, A4

Oxamniquine, 1706t, 1711

Oxandrolone, 3021

Oxazepam, 2060, 3544t, 3592t

Oxazolidinones. See Linezolid; Tedizolid

Oxcarbazepine

adverse effects of, 3317, 3319t, 3551t

for anxiety disorders, 3544

for bipolar disorder, 3551, 3551t

drug interactions of, 3319t

overdosage/poisoning with, 3592t

for pain, 79, 95t

pharmacology of, 3319t

for seizures, 3317, 3319t

for trigeminal neuralgia, 3438

Oxicam, 414

Oxidative burst, 955

Oxidative phosphorylation, 3528

Oxidative stress, 2075, 3151, 3733, 3739

P450 Oxidoreductase deficiency, 2974t

Oximes, S4

5-Oxoproline, 363

3-Oxothiolase deficiency, 3271t

Oxybutynin, 213, 3398, 3455, 3474

Oxycodone

abuse of, 98. See also Opioid use disorders

for dyspnea, 81t

for pain, 95t

Oxycodone extended-release, 95t, 98

Oxygen delivery, 2222–2223, 2236

Oxygen-hemoglobin dissociation curve, 273, 432,

755–756, 756f

Oxygen therapy

for anaphylaxis, 2728

for cluster headache, 3366

for COPD, 2188

for COPD exacerbation, 2189

for dyspnea, 81, 267

for high-altitude pulmonary edema, 3620

hyperbaric. See Hyperbaric oxygen therapy

for hyponatremia, 345

for hypothermia, 3632

for pulmonary edema, 2255

for respiratory acidosis, 368

for shock, 2241

for STEMI, 2057

Oxygen toxicity, 3624

Oxygen uptake, 2136

Oxymetazoline, 249, 2725

Oxyntic cell, 2434, 2435f

Oxyntic gland, 2434, 2434f

Oxyphenbutazone, 905t

Oxytocin, 2918f, 2920

Ozanimod, 2486, 3470t, 3471

Ozone exposure, 2171t

P

P1PK RBC group system, 887t

P3H1 gene mutations, 3221, 3224

P5N (pyrimidine-5’-nucleotidase) deficiency, 3253t

P5N (pyrimidine-5’-nucleotidase) superactivity,

3253t

p14ARF, 499, 509

p16, 582, 658, 658t, 820, 3793

p16Ink4a, 509, 516, 745

p21Cip2/Waf1, 509

p24, 962, 962f

p24 antigen capture assay, 1559–1560, 1560t

p27Kip1, 509

P50, 755, 756f

p53

activation of, 509–510, 510f

adenoviral-mediated expression of, 3688–3689

in brain tumors, 702

in cancer cells, 509–510, 524, 2695, 2697t

in colon cancer, 500t

in hepatocellular carcinoma, 645

in melanoma, 579

in SLE, 2697t

VEGF inhibition and, 525f

p53 gene mutations

in B-cell prolymphocytic leukemia, 856

in breast cancer, 614, 618

in cancer, 509–510, 510f, 3645t, 3849–3850

in carcinoma of unknown primary, 716

in colorectal cancer, 637

in glioma, 702

in head and neck cancer, 590

in Li-Fraumeni syndrome, 703t, 712

in lung cancer, 595

in skin cancer, 419, 586

in skin response to sun, 418

in thyroid cancer, 2951

p57, 745

p62, 2697t, 2823, 2824f

p63, 596, 3793

p70S6K, 512f

p-80-Collin, 2696t

P450 oxidoreductase deficiency, 2974t, 3002

PA 824. See Pretomanid

PABA (p-aminobenzoic acid), 423, 424t, 1149, 1167

Pacemaker(s), 1878

for AV conduction block, 1885–1887, 1886f,

1887f

CMR in patient with, 1840

complications of, 1880

five-letter codes for, 1878

indications for, 1873, 1878–1879, 1879f, 1879t,

1885–1886, 1886f

nomenclature of, 1878

pacing mode, 1878

for pulmonary edema, 2256

for SA node dysfunction, 1878, 1879t

for STEMI, 1886, 2063

temporary, 1878, 1885

types of, 1887, 1887f

Pacemaker cells, 1873

Pachydermoperiostosis. See Hypertrophic

osteoarthropathy

Packed red blood cells. See Transfusion(s), packed

red blood cell

Paclitaxel

actions of, 543

adverse effects of, 541t, 543

hypersensitivity reaction, 578, 2728

lupus syndrome, 2847t

myopathy, 2847t

neurologic, 3493t

pulmonary, 575

for bladder cancer, 679

for breast cancer, 621, 625

for carcinoma of unknown primary, 720

in drug-eluting stents, 2067

for endometrial cancer, 700

for gastric cancer, 633

interactions and issues, 541t

for lung cancer, 605t, 610

for metastatic cervical cancer, 699

for ovarian cancer, 696

premedication for, 541t, 543

for testicular cancer, 694

PAD14 gene mutations, 2755

PAF (pure autonomic failure), 3434

Paget-Schroetter syndrome, 2112

Paget’s disease, extramammary, 586, 589f

Paget’s disease of bone, 3209

back pain in, 124

clinical features of, 3210–3211

complications of, 3211

diagnosis of, 3211–3212, 3211f

epidemiology of, 3209

etiology of, 3209–3210, 3210f

genetic considerations in, 3210

juvenile, 3210

multiple-site, A15

oral manifestations of, 257

pathophysiology of, 3210

of tibia, A15

treatment of, 3212, 3212t

PAH. See Pulmonary arterial hypertension (PAH)

PAI-1 (plasminogen activator inhibitor I), 923, 937,

937f, 1801

Pain

acute, treatment of, 94

acetaminophen for. See Acetaminophen

aspirin for. See Aspirin

nonsteroidal anti-inflammatory drugs for. See

Nonsteroidal anti-inflammatory drugs

opioids for. See Opioid(s)

approach to the patient, 118–120

assessment of, 78, 3281

cancer, 488

chronic, 73t, 97, 98t, 99t, S7. See also Opioid(s)

complementary and integrative therapies for,

3785-3788

depression and, 97

etiology of, 77–78

frequency of, 77

neuropathic, 77, 94, 98–99. See also Neuropathy

nociceptive, 77

pathophysiology of, 91

central mechanisms, 92–93, 92f

neuropathic pain, 94

pain modulation, 93–94, 93f

peripheral mechanisms, 91–92, 91f, 92f

perception of, 85, 112

psychological variables, 97

racial/ethnic disparities in treatment of, 60

referred, 92, 92f, 109t, 110, 118, 124

sympathetically maintained, 94

in terminally ill patient, 73t, 77–79, 78f

testing sense of, 169–170, 170t

visceral, 77

Painful articular syndrome, 1573

Painless (silent) thyroiditis, 2944

INDEX

I-164 PALB1 gene mutations, 614

PALB2 gene mutations, 658, 658t, 695

Palbociclib

action and targets of, 513t, 549t, 552

adverse effects of, 549t

for breast cancer, 552, 613t, 622, 624

for hepatocellular carcinoma, 652f

Palifermin, 555, 899

Palilalia, 3406

Paliperidone, 3554, 3555t

Palivizumab, 1140, 1464, 1513

Palla’s sign, 2096

Palliative care, 74, 85, 487, 488, 531, 555, 3759. See

also End-of-life care

Palliative sedation, 82

Pallister-Hall syndrome, 2907

Palmar crease, 432, 1816

Palmar erythema, 2549, 2625, 2625f

Palmar fasciitis, 2877

Palmomental response, 3281

Palonosetron, 80, 554

Palovarotene, 3217

Palpation

of abdomen, 111

of chest, 2132

of heart, 1819

of spleen, 461

Palpitations, 286

Palsy(ies)

Bell’s. See Bell’s palsy

cranial nerve. See Cranial nerve disorders

2-PAM Cl (2-pralidoxime chloride), 3592t, S4

Pamidronate

for bone pain, 79

for hypercalcemia, 357, 723, 3184, 3184t

for metastatic bone disease, 716

for multiple myeloma, 875

for Paget’s disease of bone, 3212t

p-aminobenzoic acid (PABA), 423, 424t, 1149, 1167

PAMPs. See Pathogen-associated molecular

patterns (PAMPs)

Pan American Sanitary Bureau, 3703

pANCA (perinuclear ANCA), 2803

Pancoast tumor, 2849, 3499

Pancoast tumor (superior sulcus tumor), 129, 598,

606

Pancreas

anatomy of, 658, 659f

annular, 2668–2669

beta cells of, 3098, 3100

biopsy of, 2656

disorders of. See Pancreatic disease

exocrine secretion in, 2657

in autoprotection of pancreas, 2658

enteropancreatic axis and feedback inhibition

in, 2658

enzymes in, 2657

insufficient, 2667. See also Chronic

pancreatitis

laboratory evaluation of, 2654t, 2656–2657

regulation of, 2657

in steatorrhea, 2460

water and electrolyte content of, 2657

transplantation, 1145, 3114, 3123f, 3132

Pancreas divisum, 2669

Pancreatectomy, 2668

Pancreatic agenesis, 3645t

Pancreatic cancer, 657

clinical features of, 397, 659

deaths from, 481t, 482f, 484t, 657

diagnosis of, 659, 660f

epidemiology of, 657

extrahepatic cholestasis in, 320

gastroparesis in, 292

genetic considerations in, 500t, 516, 658, 658t

incidence of, 481t

in mumps, 1617

obstruction due to, 2416, 2420f

paraneoplastic syndromes in, 722t

pathology and molecular considerations in,

658–659, 659f

risk factors for, 657–658

staging of, 660, 661t

treatment of, 660–662, 661t, 662t

tumor markers in, 487t

Pancreatic cholera. See VIPoma (vasoactive

intestinal peptidoma)

Pancreatic disease. See also Pancreatitis

abdominal pain in, 109

annular pancreas, 2668–2669

approach to the patient, 2652

ascites in, 323

back pain in, 124

cancer. See Pancreatic cancer

in cystic fibrosis, 2176. See also Cystic fibrosis (CF)

diagnosis of

biopsy, 2655, 2656

imaging, 2653f, 2654t, 2655–2656, 2656t

pancreatic enzymes, 2653–2655, 2654t

pancreatic function tests, 2654t, 2656–2657

endocrine tumors. See Neuroendocrine tumors

(NETs), pancreatic

epidemiology of, 2652–2653

etiology of, 2652

indigestion in, 295

macroamylasemia, 2669

mucinous cysts, 2653, 2653f

pancreas divisum, 2669

skin manifestations of, 397

Pancreatic enzyme(s)

activation of, in pancreatitis, 2657

in pancreatic disease diagnosis, 2653–2655,

2654t, 2656t

Pancreatic enzyme preparations, 306, 2495, 2668

Pancreatic intraepithelial neoplasias, 658

Pancreatic necrosis, 2393, 2419, 2662f, 2663, V5

Pancreatic neuroendocrine tumors (pNETs). See

Neuroendocrine tumors (NETs), pancreatic

Pancreaticopleural fistula, 2662f

Pancreatic polypeptide-secreting tumors (PPomas),

2986

Pancreatitis. See also Acute pancreatitis; Chronic

pancreatitis

ascites in, 323

autoimmune, 2666, 2666t, 2837, 2838t

choledocholithiasis and, 2650

cobalamin malabsorption in, 772

diagnosis of, 85, 112

differential diagnosis of, 2660

endoscopic findings in, 2419

gallstone, 2410, 2663

hereditary, 2668

hypocalcemia in, 358

hypovolemia in, 341

in IBD, 2481t

in mumps, 1617

nausea and vomiting in, 292

pancreatic cancer risk and, 658

pleural effusions in, 2659

post-ERCP, 2396

tumor markers in, 487t

Pancuronium, 2276

Pancytopenia, 788, 792, 793t

Pandemic, 1515

Panencephalitis, 1100

Pangender, 3079t

Pangolin, 3716

Panic attack, 287

Panic disorder, 101t, 105, 3541

Panitumumab

action and targets of, 514t, 536f

adverse effects of, 537, 574, 642

for colorectal cancer, 642

genetic variations in response to, 477t

PANK (pantothenate kinase–associated

neurodegeneration), 3409

Panniculitis, 397, 2843

Panobinostat, 513t, 517, 549t, 552, 874t, 875, 3796

Pansexual, 3079t

Panton-Valentine leukocidin (PVL) toxin, 1013,

1038, 1180

Pantoprazole, 296, 2443t, 2444, 2456

Pantothenate kinase–associated neurodegeneration

(PANK), 3390, 3409

Pantothenic acid (vitamin B5

), 2519t, 2528

Panuveitis, 221

PAPA (pyogenic arthritis, pyoderma gangrenosum,

and acne) syndrome, 448, 2843

Papez circuit, 202

Papillary fibroelastoma, 2027

Papillary necrosis, 2282, 2362, 2362t

Papillary renal carcinoma, 503t, 504, 673, 674t. See

also Renal cell carcinoma (RCC)

Papillary thyroid cancer, 2950t, 2951–2952, 2951f

Papilledema, 185, 224, 224f

Papillomaviruses, 1455f. See also Human

papillomavirus (HPV)

Papillon-Lefevre syndrome, 257

Pap smear, 38, 38t, 39t, 495t, 497, 698–699

Papular acrodermatitis of childhood, 2579

Papular eruptive xanthomas, A15

Papular mucinosis, 395

Papule, 133, 369t, 370f

Papulonodular lesions, 394

blue, 394t, 397

etiology of, 1035, 1036f, 1037

pink, 394t, 395

purple, 394t, 397–398

red, 394t, 396–397

red-brown, 394t, 397

skin-colored, 394t, 395

violaceous, 394t, 397

white, 394–395, 394t

yellow, 394t, 395–396

Papulosquamous lesions, 265t, 377, 377t

PAR1 (protease activation receptor 1), 921

Para-aminosalicylic acid, 771t, 905t, 1376t, 1404

Paraballism, 3406

Paracellular transport, 2289

Paracentesis, abdominal, 323, 324, 489

Paracoccidioidomycosis, 1654t, 1687–1688, 1687t

Paracrine regulation, 2891

Paradoxical pulse, 2020f

Paradoxical undressing, 3631

Paraesophageal hernia, 2424

Parafacial respiratory group, 2201

Parafibromin, 2984t, 2988, 2990

Paraganglioma

cardiac, 2027

definition of, 2976

diagnosis of, 2976–2977, 2977t, 2978f

genetic considerations in, 2079, 2976,

2981–2982, 2981t, 2982f

hypertension in, 2079

malignant, 2979

pathogenesis of, 2976, 2977f