topics

11/9/25

INDEX

in pancreatic disease evaluation, 2654t, I-207

2657

specimen collection and transport for,

S11

Stool-bulking agents, 2494

Stool culture, 301

Stool softeners, 79, 80, 80t

STOP-Bang survey, 2203

Storage pool disorder, platelet, 908

Straight back syndrome, 1816, 2000

Straight-leg raising sign, 119

Strategic National Stockpile (SNS), S3

Stratford virus, 1626t

Strawberry gallbladder, 2649

Strawberry gums, 257

Strawberry tongue, 261t, 393, 1192

Strength testing, 3280

Streptobacillus moniliformis, 136t, 1125

Streptocerciasis/Mansonella streptocerca, 1778t,

1783, S12

Streptococcal infections. See also Group A

Streptococcus (GAS) infections; Group B

Streptococcus (GBS) infections

aortitis, 2107

brain abscess. See Brain abscess

in cancer patient, 556, 556t, 558t

in dog-bite wound, 1124

endocarditis. See Infective endocarditis,

streptococcal

epiglottitis, 255

global considerations in, 1978

glomerulonephritis following. See

Poststreptococcal glomerulonephritis

in human bite-wound, 1125

laryngitis, 255

mastoiditis, 251

meningitis. See Meningitis

osteomyelitis, 1047, 1049t, 1050t

otitis media, 248

in sepsis/septic shock, 2242

skin infections, 1035, 1037

toxic shock syndrome. See Toxic shock syndrome

(TSS), streptococcal

in transplant recipient, 1138t

Streptococci

anaerobic, 1196–1197. See also Anaerobic

bacteria

characteristics of, 1188–1189, 1189t

classification of, 1188–1189, 1189t

laboratory identification of, S11

nutritionally variant, 1196

viridans, 1156–1157t, 1189, 1189t, 1196

Streptococcus agalactiae, 1188, 1189t, 1195. See also

Group B Streptococcus (GBS) infections

Streptococcus bovis infections. See Group D

Streptococcus infections

Streptococcus dysgalactiae, 1194

Streptococcus iniae, 1196

Streptococcus milleri, 1189t, 1194, 1196

Streptococcus mutans, 256

Streptococcus pneumoniae. See also Pneumococcal

infections

antibiotic resistance in, 1013, 1104, 1156t, 1163,

1166, 1172–1173, 1176

immune response to, 1173

laboratory identification of, 1169–1170, 1169f

molecular typing of, 1171

nasopharyngeal carriage of, 1171, 1171f

replicative niche, 951

serotype distribution of, 1171

virulence factors in, 1170–1171, 1170f

Streptococcus pyogenes, 1189

Streptococcus pyogenes infections. See Group

A Streptococcus (GAS) infections;

Necrotizing fasciitis

Streptococcus suis, 1196

Streptogramins. See Quinupristin-dalfopristin

Streptokinase, 937, 937f, 2060

Streptomycin

actions of, 1148, 1404

adverse effects of, 224, 1159, 1378, 1404

for Brucella infections, 1313

dosage of, 1404

indications for, 1159

pharmacology of, 1404

for plague, 1324, 1324t, S3

in pregnancy and lactation, 1152t, 1378

resistance to, 1166, 1201, 1404

for TB, 1371–1372, 1376, 1376t, 1404

for tularemia, 1318, 1319t, S3

for verruga peruana, 1331t

Streptozotocin, 488, 671, 2986

Stress, 3, 2890

Stress disorders, 3545, 3788. See also Posttraumatic

stress disorder (PTSD)

Stress incontinence, 3753, 3757f, 3757t

Stress testing

ECG. See Electrocardiography (ECG), stress

echocardiography. See Echocardiography, stress

myocardial perfusion imaging. See Myocardial

perfusion imaging

in peripheral arterial disease, 2108

risk stratification using, 1844, 1845f, 3769–3770

Stress ulcers, 2223

Stridor, 2132

Strimvelis, 3686t, 3687

“String sign,” 2476

Stroke, 3324. See also Intracranial hemorrhage;

Ischemic stroke

approach to the patient, 3324–3325, 3325f

vs. botulism, 1218

circadian variations in, 215

clinical features of, 3324

aphasia, 196, 197, 198

coma, 188

delirium, 181

depression, 3547

gait disorders, 174

ocular, 225, 231

seborrheic dermatitis, 377

weakness, 167

in critically ill patient, 2224

deaths from, 73t

definition of, 3324

dementia and, 3382

dental care after, 262

etiology of, 3324

fatigue following, 163

global considerations in, 1811–1812

global mortality from, 3704

at high altitudes, 3621

in HIV infection, 1579

hypokalemia and progression of, 350

hypothermia in, 3631

imaging studies in

cerebral angiography, 3334

CT, 3333–3334, 3334f, 3348f

MRI, 3334, 3335f, A16

perfusion studies, 3334f, 3335, 3335f

ultrasound, 3334–3335

inflammatory mediators in, 2699t

with left ventricular assist systems, 1976

localization of

anterior cerebral artery, 3326f, 3327, 3327f

anterior choroidal artery, 3327, 3328f

basilar artery, 3331–3333

common carotid artery, 3328

internal carotid artery, 3327–3328, 3327–3328f

middle cerebral artery, 3325–3327,

3326–3327f

posterior cerebral artery, 3328, 3328f, 3333f

vertebral and posterior inferior cerebellar

arteries, 3328f, 3329f, 3330–3331

osteoporosis following, 3195

postmenopausal hormone therapy and, 3045,

3046t, 3048f

in pregnancy, 3766

prevention of. See Ischemic stroke, prevention of

risk factors for, 3342t, 3344–3345

in sickle cell disease, 759t

in transplant recipient, 2275

treatment of, 937, 2087, 3325, 3325f, 3819–3820,

3820f

Stroke centers, 3338–3339

Stroke volume, 1806, 1808f, 1808t, 2236

Stroma-directed (antiangiogenic) antibodies, 525f,

526–527, 526f, 536f, 537

Stromal cell–derived factor (SDF), 1546, 2684t

Stromal tumors, ovarian, 697–698

Strongyloides stercoralis/strongyloidiasis

adult T-cell leukemia/lymphoma and, 1525

clinical features of, 1699t, 1774t, 1775–1776, S6

diagnosis of, 1776, S6, S12

eosinophilia in, 945t, 2166, S12

epidemiology of, 945t, 1697, 1699t, 1775, S6, S12

incubation period for, S6

life cycle of parasite, 1774t, 1775, 1776f, S12

prevention of, 998

treatment of, 1709, 1774t, 1776, S6

in war veterans, S6 90Strontium exposure, S5

Strontium ranelate, 3201, 3208

89Strontium therapy, 79, 488, 716

Structure (quality theory), 52

Struma ovarii. See Teratoma, ovarian

Struvite stones, 2373. See also Nephrolithiasis

ST-segment elevation, 1828, 1829, 1830t

ST-segment elevation myocardial infarction

(STEMI), 2053. See also Myocardial

infarction

circadian variations in, 2054

classification of, 2057t

clinical features of, 101t, 2054

complications of, 2056, 2061

arrhythmias, 2062–2063, 2064f

cardiogenic shock, 2062, 2250, 2253f. See also

Cardiogenic shock

heart failure, 2062

hypovolemia, 2062

left ventricular aneurysm, 2064–2065

pericarditis, 2064

pulmonary edema, 2255. See also Pulmonary

edema

recurrent chest pain, 2064

right ventricular infarction, 2062

thromboembolism, 2064

ventricular dysfunction, 2062

diagnosis of

biomarkers, 2055, 2055f

CMR, 2056

ECG, 1829, 1830t, 2053f, 2055, A7, A11

echocardiography, 2056, A9

physical examination, 2054

radionuclide imaging, 2056

differential diagnosis of, 2054

epidemiology of, 2053

INDEX

I-208 ST-segment elevation myocardial infarction

(STEMI) (Cont.):

hemodynamic assessment in, 2062

incidence of, 2046, 2053

nonspecific reaction to, 2056

painless, 2054

pathophysiology of, 2053–2054, 2053f. See also

Atherosclerosis; Coronary artery disease

(CAD)

during PCI, 2057t, 2067

recurrent, 2065

risk factors for, 2054

risk stratification and management after, 2065

secondary prevention after, 2065

silent, 2057t

stages of, 2054

TIMI grading system, 2059

treatment of

ACE inhibitors, 2061

activity restriction, 2060

antiplatelet agents, 2057

antithrombotic therapy, 2060–2061

ARBs, 2061

beta blockers, 2057, 2061

bowel management, 2060

diet therapy, 2060

in emergency department, 2056–2057, 2058f

fibrinolytic therapy, 2059–2060

hospital/coronary care unit, 2060

implantable cardioverter-defibrillator, 2063,

2064f

integrated approach to, 2058f, 2060

limitation of infarct size, 2059

morphine, 2057

nitrates, 2057

oxygen therapy, 2057

pacemaker, 2063

pain control, 2057

PCI, 2058f, 2059, A11

prehospital care, 2056

reperfusion therapy, 2058f, 2059, 2060

sedation, 2060

STUB1 gene mutations, 3015t

Stupor, 183

Sturge-Weber syndrome, A16

STW 5, 297, 2386

Sty (hordeolum), 220

Stylostome, 3609

Subacromial bursitis, 2878

Subacute combined degeneration, 3454

Subacute necrotizing myelopathy, paraneoplastic,

728t

Subacute sclerosing panencephalitis (SSPE), 1100,

1611

Subarachnoid hemorrhage

vs. bacterial meningitis, 1104

clinical features of, 3354

coma in, 188

in critically ill patient, 2224

diagnosis of, 3355, 3355f

DVT prophylaxis after, 3356

ECG in, 1830, 1831f

epidemiology of, 3353

etiology of, 3353–3354

fundus examination in, 185

grading of, 3354t

headache in, 113, 113t, 3354

at high altitudes, 3621

hyponatremia in, 342, 3354

hypothermia in, 3631

neurologic deficits after, 3354

in polycystic kidney disease, 2352

traumatic, 3458

treatment of, 3355–3356, 3356f

Subconjunctival hemorrhage, 219

Subcortical aphasia, 198

Subcutaneous panniculitis-like T-cell lymphoma,

851, 858

Subdural empyema, 1120

clinical features of, 978, 1121

definition of, 1120, 1122f

diagnosis of, 1122, 1122f

differential diagnosis of, 1122

epidemiology of, 1120

etiology of, 978, 1120, 1352

pathophysiology of, 1120

prognosis of, 1122

treatment of, 1122

Subdural hematoma

acute, 3457, 3457f

chronic, 3457–3458, 3458f

dementia in, 3377

imaging in, 184f, 3457f, 3458f, A16

spinal, A16

weakness in, 168

Subependymal giant cell astrocytomas, 708

Suberosis, 2160t

Subfascial endoscopic perforator surgery, 2118

Subjective Global Assessment, of nutrition, 2534

Subluxation, 2848, 2848t

Submandibular abscess, 255

Submandibular space infections, 256, 1351

Submucosal plexus, 298

Subperiosteal abscess, 251

Sub-Saharan Africa, 3721, 3721f, 3724

Substance P, 92, 92f, 288, 298

Substance use disorders. See also Persons who

inject drugs (PWID); specific substances

delirium in, 180

dementia in, 3378

emerging drugs in, 3577

future treatment approaches to, 3577

genetic considerations in, 3795

global considerations in, 3577

in LGBT people, 3078

in men, 3069

mental health issues and, 3577

neuropathology of, 3539, 3540t

pathogenesis of, 3538, 3538f, 3539, 3539f

polydrug, 3573

prevalence of, 3540

in women, 3068

Substernal goiter, 2946

Substrate reduction therapy, 3259

Succimer (DMSA), 3580–3581t

Succinate dehydrogenase (SDH) enzyme, 2976

Succinylcholine, 352–353, 467t, 476t

Suck response, 3281

Sucralfate, 296, 2443t, 2445

Sudan virus disease, 1646, 1648f, 1649f

Sudden cardiac arrest (SCA), 2257

Sudden cardiac death

circadian variations in, 215

definition of, 2257, 2258t

epidemiology of, 2257–2258, 2258f

etiology of, 2259–2260, 2260t

during exercise, 11

in heart failure, 1951

in hypertrophic cardiomyopathy, 1971,

1972t

precipitating factors in, 2259

prevention of

in general population, 2265–2266

in high-risk populations, 2261, 2265t, 2266t

in low-risk patients, 2264, 2266t

risk stratification for, 2261

risk factors for, 2258–2259, 2258f, 2266t

Sudden unexpected death in epilepsy, 3323

Sudeck’s point, 2506, 2506f

Sudomotor function, 3432, 3432t

Sugars, malabsorption of, 303

Suicide

assessment for risk of, 13

deaths from, 73t

in LGBT people, 3078

physician-assisted, 87, 87t

worldwide, 3712

Sulbactam, 1153, 1166, 1277, 1277t. See also

Ampicillin-sulbactam

Sulfacetamide, 220

Sulfadiazine

actions of, 1149, 1164t

adverse effects of, 1571, 1704t

drug interactions of, 1704t

in pregnancy and lactation, 1704t

resistance to, 1164t

for toxoplasmosis, 1120, 1762

for toxoplasmosis prophylaxis, 1563t

for Whipple’s disease, 1347

Sulfadoxine, 1704t, 1730t, 1735

Sulfamethoxazole

actions of, 1149, 1164t

adverse effects of, 319, 407, 416, 784t, 1704t,

2281

drug interactions of, 1704t

in pregnancy and lactation, 1704t

resistance to, 1164t

Sulfasalazine

adverse effects of, 147, 773t, 2358, 2482,

2762t

for axial spondyloarthritis, 2796

for IBD, 2482, 2483t

monitoring during treatment with, 2762t

for reactive arthritis, 2798

for rheumatoid arthritis, 2761, 2762t

Sulfhemoglobin, 274

Sulfisoxazole, 1149, 1164t

Sulfocystinuria, 3270t

Sulfonamides

actions of, 1149, 1164t, 1165f

adverse effects of

cross-sensitivity and, 416

cutaneous

erythroderma, 384

exanthem, 393

fixed drug eruption, 412

hyperpigmentation, 391

hypoglycemia, 3132

maculopapular eruptions, 411

red lesions, 397

vesicles/bullae, 392

desensitization to, 416

eosinophilia, 449

fever, 147

frequent, 1704t

in G6PD deficiency, 784t

hepatotoxicity, 2585

hypersensitivity, 412. See also Drug-induced

hypersensitivity syndrome (DIHS)

nephritis, 2281, 2301

nephrotoxicity, 2358

neutropenia, 444

optic neuropathy, 224

phototoxicity, 422t

in pregnancy, 1077

rare, 1704t

INDEX

SJS or TEN, 44, 392, A1. See also Stevens- I-209

Johnson syndrome (SJS); Toxic epidermal

necrolysis (TEN)

thrombocytopenia, 905, 905t

vasculitis, 2816

drug interactions of, 1704t

indications for, 1157t

metabolism of, 467t

overdosage/poisoning with, 3593t

in pregnancy and lactation, 1152t

resistance to, 1164t, 1165f, 1167

Sulfonylureas

actions of, 3110t, 3111

adverse effects of, 422t, 3087, 3111

contraindications to, 3110t, 3123

drug interactions of, 3111

in older adults, 3746t

for type 2 diabetes mellitus, 3110t, 3111

Sulfur-containing shampoo, 380t

Sulfur dioxide exposure, 2171t

Sulfur granules, 1341, 1341f, 1343

Sulfur mustard, S4

Sulindac, 319, 492, 638

Sumatriptan, 294, 294t, 3362t, 3363, 3363t, 3366

Summer catarrh, 3694

Summer grippe, 1603

Summer-type pneumonitis, 2160t

Sunburn, 418, 418t, 491

SUNCT/SUNA, 114t, 3366t, 3367

Sundowning, 180, 182, 3809

Sun exposure, 417

melanoma and, 420, 491, 491t, 578, 580

nonmelanoma skin cancer and, 419–420, 491,

491t, 586

skin effects of

acute, 418, 418t

immunologic, 420

immunosuppressive, 420–421

malignant, 420, 491t

molecular targets of, 417–418

nonmalignant, 419–420

vitamin D synthesis and, 418–419

Sunflower cataracts, 3236

Sunitinib

actions and targets of, 507, 511, 513t, 526, 548t, 552

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

drug interactions of, 571

for gastrointestinal stromal tumor, 511, 714

for hepatocellular carcinoma, 511, 652f

for malignant pheochromocytoma, 2980

for NETs, 671t, 672, 720

for renal cell carcinoma, 511, 552, 675, 676t

Sunscreen(s)

chronic actinic dermatitis and, 422

ingredients in, 424t

jellyfish-safe, 3603

for melanoma prevention, 580

for polymorphous light eruptions, 421

for skin cancer prevention, 491

in SLE, 2744t, 2746

SPF of, 423

water resistance of, 423

suPAR (soluble urokinase plasminogen activator

receptor), 2305

Superantigens, 131, 2692

Superior mesenteric artery occlusion, 109–110, 292

Superior orbital fissure, 3444

Superior sagittal sinus thrombosis, 979, 1124, A16

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

606

Superior vena cava syndrome, 565, 566f, 598, 598t,

1337, 1816

Supersaturation, 2368

Supine hypertension, 156

Suppurative thrombophlebitis, intracranial,

1123–1124

Suprachiasmatic nucleus (SCN), 216, 3801, 3801t,

3802, 3803f

Supraclavicular lymph node, 458

Supraspinatus tendon, 2878–2879, 2878f

Supraventricular tachyarrhythmias, 1888

atrial fibrillation. See Atrial fibrillation

atrial flutter. See Atrial flutter

atrial tachycardia. See Atrial tachycardia

clinical features of, 1888

definition of, 1894

ECG in, 1888t, 1890f

initial evaluation of, 1888–1889, 1889f, 1890f

mechanisms of, 1888, 1888t

in overdosage/poisoning, 3587

paroxysmal. See Paroxysmal supraventricular

tachycardia (PSVT)

sinus tachycardia. See Sinus tachycardia

in STEMI, 2063

treatment of, 1888, 1890t

vs. ventricular tachycardia, 1919–1920, 1920f

Sural nerve biopsy, A14

Suramin

actions of, 1713

adverse effects of, 711t, 1707t, 1756, 3493t

for human African trypanosomiasis, 1756, 1756t

pharmacology of, 1713

Surfactant replacement therapy, 2228, 2229t

Surfer’s myelopathy, 3450

“Surge-event” preparedness, 1136

Surgical ablation, for ventricular arrhythmias, 1909,

1915

Surgical myectomy, 1971

Surgical patient

aortic stenosis in, 3773

blood loss in, 792

diabetes mellitus in, 3773

infective endocarditis prophylaxis in, 3773

mortality risk in, 3772t

perioperative risk modification strategies

ACE inhibitors, 3771

β-adrenergic antagonists, 3771

coronary revascularization, 3770–3771

oral antiplatelet agents, 3771–3772

pulmonary, 3772–3773, 3773t

statins, 3771

preoperative evaluation of, 3769

for anesthesia, 3772

cardiac risk assessment, 3769–3770, 3770f,

3771f, 3771t

functional status, 3771t

intermediate- to high-risk patient, 3769

preoperative questionnaire, 3769t

pulmonary risk assessment, 3772–3773, 3772t

specialized nutritional support for, 2545–2546

VTE prophylaxis in, 2100–2101, 2100t, 3773

Surgical-site infections

diagnosis of, 1031

prevention of, 1031, 1131t, 1161, 1162t

risk factors for, 1031

sternal, 1052, 1144

treatment of, 1031

Surgical ventricular restoration, 1952

Surrogates, for health care decisions, 68

Surufatinib, 511, 672

Susceptibility testing, S11

Sustainable Development Goals (SDGs),

3703–3704

Sutimlimab, 788

Suvorexant, 212

Sv (sievert), S5

Swallowing, 287–288, 288f, 291. See also

Dysphagia

Swan-Ganz catheter. See Pulmonary artery catheter

Swan-neck deformity, 2752

S wave, 1824

Sweat/sweating

excess, 3434–3435

initiation of, 3635

in pheochromocytoma, 2976

potassium loss in, 349

sodium loss in, 340

water loss in, 341, 2517

Sweat testing, 2147, 2177–2178

Sweden

elective specialist access in, 46

health system financing in, 42, 43t

health system governance in, 48

primary care access in, 45

Sweet syndrome

in cancer patient, 559

clinical features of, 139t, 144, 396–397, 559

differential diagnosis of, 397

disorders associated with, 396–397

epidemiology of, 139t

etiology of, 139t

in IBD, 2480, 2481t

myelodysplasia and, 800

skin manifestations of, 139t, 144, 396, 399, A1,

Sweet taste sensation, 233

Swimmer’s ear (otitis externa), 249, 1287t, 1289

Swimmer’s itch, 1035, 1697, 1786

Swine influenza viruses, 980, 1133, 1515. See also

Influenza

Swinging flashlight test, 216, 217f

Switzerland, 43t, 46

Swyer’s syndrome (complete gonadal dysgenesis),

3002

Sydenham’s chorea, 2732, 2768, 3406

Syk, 2719

Sympathectomy, 2114

Sympathetic dyspraxia, 198

Sympathetic postganglionic neuron, 91f

Sympatholytic agents, 2083t, 2084–2085, 3584,

3591t

Sympathomimetics, 2965t, 3590t

Symplicity device, 2070

Symporters (cotransporters), 2290

Synaptobrevin (VAMP2), 1212

Synaptophysin, 596, 718t

Synaptotagmin, 2697t

Syncope, 152

after vaccination, 987

in aortic stenosis, 1981

approach to the patient, 157

cardiac. See Cardiac syncope

definition of, 152

diagnosis of, 158

differential diagnosis of, 157–158, 3541

ECG in, 129, 158

epidemiology of, 152

heat-related, 3636

high-risk features of, 152t

natural history of, 152

neurally mediated (reflex, vasovagal)

classification of, 153–154

clinical features of, 155

pacemaker for, 1879

pathophysiology of, 152–153, 154f

treatment of, 155

INDEX

I-210 Syncope (Cont.):

in orthostatic hypotension. See Orthostatic

hypotension

pathophysiology of, 152–153

in psychiatric disorders, 129, 157–158

vs. seizure, 157–158, 3315–3316, 3315t

in ventricular tachycardia, 1911, 1912

Syndrome of apparent mineralocorticoid

excess (SAME, 11β-hydroxysteroid

dehydrogenase deficiency)

clinical features of, 349, 2080t, 2965

diagnosis of, 350

genetic considerations in, 349, 2080t, 2964,

2965t

pathogenesis of, 2080, 2081f

treatment of, 350

Syndrome of inappropriate antidiuresis (SIAD)

vs. cerebral salt wasting, 342

clinical characteristics of, 2924

differential diagnosis of, 344, 2924, 2925t

etiology of, 342, 343t, 2924, 2924t

in HIV infection, 1572

hyponatremia in, 342–343, 2924, S1

in lung cancer, 599

pathophysiology of, 342, 2923f, 2924

subtypes of, 342, 2924–2925

treatment of, 345, 599, 2924–2925, 2925f, S1

tumor-associated, 723, S1

Syndrome X. See Metabolic syndrome

Syndromic panels, 963

SYNJ1 gene mutations, 3391t

Synkinesis, 3439

Synovectomy, 2872, 2877

Synovial chondromatosis, 2877f

Synovial effusion, 2850

Synovial fluid analysis

in calcium oxalate deposition disease, 2867,

2867f

in calcium pyrophosphate deposition disease,

2866

interpretation of, 2852, 2852f

in rheumatoid arthritis, 2759

Synovial sarcoma, 712, 2877f. See also Soft tissue

sarcomas

Synovitis, 2856, 2856f, 2877, 2877f

Synthetic lethality, 515f, 516, 544

α-Synuclein, 3387, 3422

Syphilis, 1406

CNS involvement in. See Neurosyphilis

congenital

clinical features of, 1043, 1410

global considerations in, 1410

incidence of, 1407, 1410

oral manifestations of, 257, 258t, 1410

treatment of, 1412–1413

diagnosis of, 961, 1410–1411

endemic, 1414t, 1416, 1416f

epidemiology of, 1080, 1407, 1407f

etiology of, 1406–1407

follow-up of response to therapy, 1413

global considerations in, 1407

in HIV infection, 1411, 1571–1572

immunity to, 1413

incidence of, 1079, 1407f

latent, 1409

pathogenesis of, 1407–1408

in pregnancy, 1407, 1410, 1412, 1412t

prevention of, 1412

primary

clinical features of, 1408

differential diagnosis of, 1408

natural course of, 1407–1408

skin manifestations of, 1037, 1090, 1091t,

1408, 1408f, A1, A5

treatment of, 1411–1412, 1412t

reinfection, 1409

secondary, 1408

articular manifestations of, 1043

cardiovascular manifestations of

aortic aneurysm, 2102

aortic regurgitation, 1987

aortitis, 1410, 2107

epidemiology of, 1407, 1407f

hepatitis in, 1408

lymphadenopathy in, 458

natural course of, 1408

neurologic manifestations of. See

Neurosyphilis

ocular involvement in, 1408

oral manifestations of, 258t

renal involvement in, 71, 2336t

skin manifestations of, 136t, 141, 384, 393,

397, 1408

alopecia, 384

condylomata lata, 1408, A1

figurate lesions, 385

histopathology of, 1408

mucous patch, 1408

on palms and soles, 1409f, A1, A5

papulosquamous eruption, 1037, 1409f,

A1, A5

vs. pityriasis rosea, 141, 377t, 379

vs. psoriasis, 378

on tongue, A1

treatment of, 1412, 1412t

tertiary

clinical features of, 258t, 1037, 1408, 1410

treatment of, 1412, 1412t

transmission of, 1407

untreated, natural course of, 1407–1408

Syringomyelia, 3453, 3453f

Syrinx cavities, 3453, 3453f

Systematic reviews, 28

Systemic inflammatory response syndrome (SIRS),

2245f

Systemic lupus erythematosus (SLE), 2736

antiphospholipid syndrome and, 2747–2748

autoantibodies in, 2737–2738, 2737f, 2738t,

2740t, 2745

clinical features of, 135t, 2736, 2740, 2743t

autoimmune hemolytic anemia, 786

cardiovascular, 2743, 2743t

AV conduction block, 1882

pericarditis, 2023, 2743

cutaneous, 396, 2740, 2743t

alopecia, 384, 387t

characteristics of, 135t, 141

discoid. See Discoid (chronic cutaneous)

lupus erythematosus

discoid (chronic), 2740

distribution of, 396

malar erythema, A1, A5

panniculitis, 396

papulonodular red lesions, 396

papulosquamous lesions, A5

subacute, 2740, A1

telangiectasias, 386

treatment of, 2746, 2748

vasculitis, 394

fever of unknown origin, 147

gastrointestinal, 2743, 2743t

hematologic, 794, 2743, 2743t

hemoptysis, 270

lymphadenopathy, 458

musculoskeletal, 2740, 2743t

neurologic, 1115t, 2741, 2743t, 3406, 3451,

3489

ocular, 2743, 2743t

oral, 257

pulmonary, 2742–2743, 2743t

Raynaud’s phenomenon, 2113

renal, 2359. See also Lupus nephritis

splenomegaly, 461

sterile endocarditis, 147

systemic, 2740, 2743t

course of, 2743

definition of, 2736

diagnosis of, 2738t, 2740t, 2741t, 2745

drug-induced, 378, 409, 472, 478, 2748–2749

EBV and, 2739

environmental factors in, 2737f, 2739

epidemiology of, 2736

genetic considerations in, 2737f, 2738–2739

incidence and prevalence of, 2736

inflammasome mutations in, 2678t

inflammatory mediators in, 2699t

microvascular thrombotic crisis in, 2748

pathogenesis of, 2736–2739, 2737f, 2738t

pathoimmunology of, 2696t, 2734, 2740t

pathology of, 2739, 2739t

pregnancy and, 2747

prognosis of, 2748

sex-related factors in, 2739

survival rates, 2748

treatment of, 2742f, 2745

experimental therapies, 2748

life-threatening disease, 2746–2747

non–life-threatening disease, 2746

pharmacologic, 2744–2745t, 2745–2746

during pregnancy, 2747

for prevention of complications, 2747

in special conditions, 2747–2748

Systemic lytic state, 937

Systemic mastocytosis. See Mastocytosis, systemic

Systemic mastocytosis associated with clonal

hematologic non–mast cell lineage

disease (SM-AHNMD), 2729

Systemic necrotizing vasculitis, 2684

Systemic sclerosis (scleroderma), 2771

cancer associated with, 2783

classification of, 2773t

clinical features of, 2772f, 2777, 2778t

acro-osteolysis, 2779, 2779f

cardiac, 1882, 1969, 2023, 2777, 2782

cutaneous, 406, 2772f, 2772t, 2773t,

2779–2780

alopecia, 384

calcinosis, 406, 2779–2780, 2780f

vs. dermatomyositis, 404

digital necrosis, 406f, 2778, 2778f

dystrophic calcification, 394

facial, 406, 406f, 407f, A5

hyperpigmentation, 391

hypopigmentation, 388

limited vs. diffuse, 2773t

nails, 2778, 2778f, 2779f

pathology of, 2776, 2777f

sclerodactyly, 2779f

telangiectasias, 386, 388t, 406, 2779f

vascular, 2779, 2779f

esophageal involvement/dysphagia, 289, 290,

2433

gastrointestinal, 292, 2777, 2781–2782, 2781t,

2786

initial presentation, 2778

musculoskeletal, 2782–2783, 2847t

INDEX

neuropathy, 3489 I-211

ocular, 2783

pulmonary

interstitial lung disease, 2190t, 2195–2196,

2780, 2780f, 2785–2786

pathology of, 2776–2777, 2777f

pulmonary arterial hypertension, 2126,

2777, 2777f, 2781, 2786

Raynaud’s phenomenon, 2113, 2771, 2778,

2778f

renal, 2366, 2777, 2782, 2782f, 2786, A4

vasculopathy, 2771

definition of, 2771

diagnosis of, 2773t, 2783, 2784f

diffuse cutaneous, 2773t

environmental factors in, 2773

epidemiology of, 2771

genetic considerations in, 2771, 2773,

2774f

inflammasome mutations in, 2678t

limited cutaneous, 2773t

localized, 2787

natural history of, 2786–2787

pathogenesis of, 2687t, 2696t, 2773–2776, 2773f,

2774f, 2775f, 2776t

pathology of, 2776–2777, 2777f

pregnancy in, 2783

prognosis of, 2787

risk factors for, 2773, 2774f

staging of, 2783

treatment of, 2783

antifibrotic therapy, 2784

for gastrointestinal complications, 2786

immunosuppressive agents, 2783–2784

for interstitial lung disease, 2785–2786, 2785f

for musculoskeletal complications, 2786

principles of, 2783, 2785t

for pulmonary arterial hypertension, 2786

for renal complications, 2366, 2786

skin care, 2786

vascular therapy, 2784–2785

Systemic vascular resistance, 284–285, 1862, 2218–

2219, 3762

Systems biology, 3812

human disease classification and, 3814–3819,

3815f, 3816f, 3817f, 3818t

in medical practice, 6

pathobiology applications of, 3814

properties of biologic systems, 3812–3814, 3813f

Systems neuroscience, 3538–3539

Systems theory, 51, 51f

Systolic blood pressure, 2076t

Systolic click-murmur syndrome. See Mitral valve

prolapse

Systolic failure. See Heart failure (HF)

Systolic murmurs. See Heart murmurs

SYT gene mutations, 712

. See Triiodothyronine (T3

)

-resin uptake test, 2931

. See Thyroxine (T4

)

Tabes dorsalis, 1410, 3454

Tabun (GA), 3592t, S4

TAC3 gene mutations, 3015t, 3029

TAC3R gene mutations, 3015t

Tacaiuma virus, 1627t

TACE (transarterial chemoembolization), 650–651

Tăchéng tick virus, 1630t

Tâche noire, 1434, 3609

Tachycardia

in anemia, 432

atrioventricular nodal reentry, 1895–1896, 1895f

in hypovolemia, 341

preexcited, 1897, 1898f

in pulmonary edema, 2256

in sepsis/septic shock, 2238, 2245

supraventricular. See Supraventricular

tachyarrhythmias

syncope in. See Cardiac syncope

ventricular. See Ventricular tachycardia

Tachycardia-bradycardia syndrome, 157, 1875,

1877f, 1878

Tachypnea, 185, 2238, 2245

TACO (transfusion-associated circulatory

overload), 888, 895

Tacrine, 3374, 3592t

Tacrolimus

actions of, 2328t, 2637

adverse effects of, 2328, 2328t, 2637, 2745t, 2825t

hyperkalemia, 353

hyperperfusion syndrome, 2274t, 2275

microangiopathic hemolytic anemia, 907

myopathy, 2847t

nephrotoxicity, 2363, 2637

osteoporosis, 3196

seizures, 3311t

skin cancer, 421

thrombotic microangiopathy, 2365

for atopic dermatitis, 375, 385t

drug interactions of, 1703t, 2328, 2637, 2864

genetic variations in response to, 476t, 477

for IBD, 2484

for immunosuppression

after cardiac transplantation, 1974t

after kidney transplantation, 2328, 2328t,

2825t

after liver transplantation, 2637

for inflammatory myopathies, 2825t

for lupus dermatitis, 2746

metabolism of, 467t, 2637

for myasthenia gravis, 3515

for SLE, 2745t, 2747

TACSTD2 gene mutations, 613t

Tactile fremitus, 2132

Tadalafil

actions of, 3056, 3057f

adverse effects of, 3060, 3060t

characteristics of, 3060t

contraindications to, 3060, 3060t

for erectile dysfunction, 3059–3060, 3474

for high-altitude pulmonary edema, 3620

for lower urinary tract symptoms, 689

for pulmonary arterial hypertension, 2128,

2129t

for Raynaud’s phenomenon, 2114

Taenia asiatica, 1790–1791

Taenia multiceps, 1796

Taenia saginata (beef tapeworm) infection, 1790,

S12

Taenia serialis, 1796

Taenia solium (pork tapeworm) infection

clinical features of, 1697, 1699t, 1700t, 1791. See

also Cysticercosis

diagnosis of, 1791–1792, S12

epidemiology of, 1112, 1791

geographic distribution of, S12

life cycle of, 1791, S12

pathogenesis of, 1791

prevention of, 1793

treatment of, 1792–1793

Tafamidis, 883, 1968

Tafasitamab, 536f, 847

Tafenoquine, 1702t, 1713

TAFI (thrombin-activatable fibrinolysis inhibitor),

452, 923

TAFI gene mutations, 3403, 3403t

Tagraxofusp, 551t, 553

Tag SNPs, 3657

Tahyña virus, 1627t

Tai chi, 3201, 3785t, 3788

Taï Forest virus disease, 1646, 1648f, 1649f

Takayasu’s arteritis, 2102, 2106, 2813, 3328, 3343,

A14

Takotsubo (stress-related) cardiomyopathy, 102,

1966, 2256

Takotsubo syndrome, 2029

TAL1-TCTA gene mutations, 500t

Talaromyces marneffei infection (talaromycosis,

penicilliosis), 1564t, 1581, 1687t, 1688

Talazoparib, 513t, 551t, 622

Talc dust, 2167

Talc, intrapleural, 489

Talimogene laherparepvec, 536f, 539, 584, 584t

T-ALL (T-cell lineage ALL), 829, 830t, 832t. See

also Acute lymphoid leukemia (ALL)

Tamdy virus, 1629t

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

2301, 2355, 2360

Tamoxifen

actions of, 512f, 515, 543

adverse effects of

depression, 82

endometrial cancer, 543, 620, 699, 740

hepatotoxicity, 2586

hot flashes, 620

long-term, 738t

thrombocytopenia, 905t

thromboembolism, 543

tumor lysis syndrome, 573

visual loss, 711t

for breast cancer, 515, 543, 620

for breast cancer prevention, 40t, 492, 3203

drug interactions of, 478, 1400

for ductal carcinoma in situ, 616

genetic variations in response to, 476t, 478

for gynecomastia, 687, 3019

metabolism of, 468

for osteoporosis management/prevention, 3203

for uterine cancer, 700

Tamsulosin, 689

Tanapox, 1492t, 1493, 1494

TandemHeart, 2071

Tandem mass spectrometry, 3833–3834

Tandospirone, 296

Tangier disease (ABCA1 deficiency), 1816, 3139t,

3146, 3487

Tanning, 418, 420, 580, 586

Tapentadol, 99, 3125

Tapeworms/tapeworm infections, 1696–1697,

1700t. See also Cestodes/cestode

infections

Tapia syndrome, 3444

TAP (transporters associated with antigen

processing) proteins, 2691

Tap test, 3613

Tarantulas, 3612–3613

TARC, 2683t

Tardive dyskinesia, 175, 293, 3407–3408, 3556

Tardive dystonia, 3408

Tardive syndromes, 3407–3408

TARDP gene mutations, 3379, 3413t

Target cells, 425, 428f, 434f

Target lesion revascularization, 2068

Target of rapamycin complex 1 (TORC1), 3535

Target vessel revascularization, 2068

INDEX

I-212 Target volume, in radiation therapy, 532

Tartrate-resistant acid phosphatase (TRAP), 3213

Tarui disease (phosphofructokinase deficiency,

type VII GSD), 781t, 3263t, 3528

Taste buds, 233, 233f, 236

Taste disorders

after traumatic brain injury, 3459

diseases and conditions associated with, 236

drug-related, 236

etiology of, 236

evaluation of, 236–237

olfactory dysfunction and, 236

radiation therapy-related, 593

treatment of, 237–238

in zinc deficiency, 2532

Taste pore, 233, 233f

Taste system, 233, 233f

TATA-binding protein, 3645t

Tataguine virus, 1628t

TAT/tat, 1523, 1523f, 1555

Tau gene mutations, 3412

Tau protein

in AD, 3375

in chronic traumatic encephalopathy, 3461–3462

in neurodegenerative diseases, 191t, 3422

PET imaging of, 193–194

Tau protein antibodies, 3375

Taurursodiol, 3415

TAVI (transcatheter aortic valve implantation). See

Transcatheter aortic valve implantation

(TAVI)

Taxanes. See also specific drugs

adverse effects of, 410, 554, 577, 621, 738t, 3493t

for breast cancer, 621, 625

characteristics of, 541t, 543

drug interactions of, 571

resistance to, 543

for soft tissue sarcomas, 714

Taxonomy, 3691, 3691f

Tax/tax, 1524

Tay-Sachs disease, 3258

adult, 3258, 3413t, 3415

“cherry red” spot in eye in, A15

enzyme deficiency in, 3255t

genetic screening for, 3258, 3659

infantile, 3258

juvenile, 3255t, 3258

Tazarotene, 378

Tazemetostat, 550t, 552, 714, 848

TAZ gene mutations, 1956t, 1966

Tazobactam, 1166. See also Ceftolozanetazobactam; Piperacillin-tazobactam

TB. See Tuberculosis (TB)

TBCE protein, 3186

TBG (thyroxine-binding globulin), 2929, 2930t,

2931

TBI. See Traumatic brain injury (TBI)

TBII (thyrotropin-binding inhibitory

immunoglobulin), 2935, 2938

TBP gene mutations, 3405–3406

TBX gene mutations, 3186, 3645t

TCAB1, 3680

TCAs. See Tricyclic antidepressants (TCAs)

T cell(s)

activation of, 958, 2702–2703, 2703f

age-related reduction in, 3736

antigen recognition by, 2690–2691, 2690f

in autoimmune diseases, 2695, 2732–2733,

2732t, 2735

autoreactive, in MS, 3465

central memory, 2689

co-stimulation of, 2702

cytotoxic. See CD8+ T cells

deficiencies of, 2709t, 2712–2713, 2712f, S8

cartilage hair hypoplasia, 444, 2715

with DNA repair defects, 2714, S8. See also

Ataxia telangiectasia (AT)

functional defects, 2714

with hyper IgE. See Hyper-IgE (Job) syndrome

in hyper-IgM syndrome, 2715–2716

in Omenn syndrome, 2714

in severe combined immunodeficiency. See

Severe combined immunodeficiency

(SCID)

in thymic defects, 2714

in Wiskott-Aldrich syndrome, 444, 2472t,

2716

definition of, 2672

development of, 2689–2690, 2689f

differentiation of, 746f, 844f, 2712–2713, 2712f,

2713f

effector memory, 2689

exhaustion of, 2702

helper. See CD4+ T cells

immune tolerance checkpoints in, 2706t

inactivation by tumor cells, 527–528, 527f, 528f

locations of, 2689–2690

MHC class-restricted, 2690

monoclonal antibodies to, for autoimmune and

inflammatory diseases, 2701

negative selection, 2689

NK. See Natural killer T (NK-T) cells

positive selection, 2689

in psoriasis, 378

in response to S. aureus, 1181

in sarcoidosis, 2830f

in SLE, 2737

in vasculitis, 2804

in viral infections, 1457, 1458f

T cell exhaustion, 2672, 2691–2692

T-cell large granular lymphocytic leukemia, 857–

858, 2753

T-cell lineage ALL (T-ALL), 829, 830t, 832t. See

also Acute lymphoid leukemia (ALL)

T cell–mediated therapies, 538, 538t

T-cell prolymphocytic leukemia, 463, 857

T cell receptors (TCRs)

for antigens, 2672, 2690–2691

defective rearrangements of, 2713–2714

diversity of, 2690

retargeting of, 3689, 3689f

signaling through, 2690f

T cell superantigens, 2692

TCIRG1 gene mutations, 3213

TCL1 gene mutations, 857

Tdap vaccine. See Tetanus, diphtheria, acellular

pertussis (Tdap) vaccine

TDF (testis-determining factor), 3653

TDP43 gene mutations, 3297, 3412

TDP43 protein, 191t, 3379, 3412, 3414

Td vaccine. See Tetanus-diphtheria (Td) vaccine

Teaching, physician engaged in, 8

Team-based care, 2–3

Teardrop cells, 428f

Teardrop fracture, A16

99mTechnetium, 1834t, 1835, S5 99mTechnetium pyrophosphate scan, A9

TECK (thymus expressed chemokine), 2684t

Tecovirimat, 1464, 1494, S3

Tedizolid

actions of, 1149, 1164t, 1187

adverse effects of, 1154t

drug interactions of, 1155t

for enterococcal infections, 1202

indications for, 1157t, 1161

for MRSA infections, 1186t

in pregnancy and lactation, 1152t

resistance to, 1157t, 1164t, 1203

for staphylococcal infections, 1187

Teduglutide, 2466

TEE. See Transesophageal echocardiography (TEE)

TEE (total energy expenditure), 2539

Teeth. See also Dental entries

age-related changes in, 262

development of, 256

discolored, 257

diseases of, 256, A3

extraction of, 259, 262

Hutchinson’s, 257

loss of, 257, 262

in osteogenesis imperfecta, 3223

structure of, 256

TEF (thyrotrope embryonic factor), 2892, 2892t

Tefinostat, 652f

Tegafur, 476t, 478

Tegaserod, 308, 2495

Tegoprazan, 2445

Teicoplanin, 1148, 1164t

Telangiectasia(s), 386. See also Ataxia telangiectasia

(AT)

capillary, 3353

in cardiovascular disease, 1816

definition of, 369t, 2115

etiology of, 388t

hereditary hemorrhagic. See Osler-Weber-Rendu

syndrome

linear, 386

mat, 386

nailfold, 386

periungual, 405

in systemic sclerosis, 2779, 2779f

treatment of, 2786

Telaprevir, 2606–2607, 2608t

Telavancin

actions of, 1148, 1164t, 1187

adverse effects of, 1154t, 1159, 1187

for enterococcal infections, 1202

indications for, 1156t, 1158

for MRSA infections, 1186t

in pregnancy and lactation, 1152t

resistance to, 1164t, 1166

for staphylococcal infections, 1187

Telbivudine

actions of, 1466

adverse effects of, 2598

for chronic HBV infection, 1465t, 1466, 2595t,

2598, 2599f, 2601t

pharmacology of, 1466

in pregnancy, 2602

resistance to, 1466, 2601t

Telemedicine, 2850–2851, 3762

Teletherapy, 532

Telitacicept, 2747

Telithromycin

actions of, 1149, 1159, 1164t

adverse effects of, 1159

drug interactions of, 1159

indications for, 1159

for NTM infections, 1406

resistance to, 1164t, 1166–1167

Telmisartan, 3345

Telogen, 3039

Telogen effluvium, 384, 387t, 410

Telomerase, in cancer cells, 510–511, 3654

Telomere(s), 510–511, 3654, 3680–3681, 3681f,

3734

INDEX

Telomere disease, 3680 I-213

circadian disruption and, 3810

clinical features of, 3681–3683, 3683f

dyskeratosis congenita. See Dyskeratosis

congenita (Hoyeraal-Hreidarsson

syndrome)

genetic considerations in, 3681, 3682t, 3684

mechanisms of, 3680–3681

telomere length measurement in, 3683–3684

treatment of, 3684

Telotristat, 669

Temazepam

for anxiety disorders, 3544t

for insomnia, 212

overdosage/poisoning with, 3592t

pharmacology of, 3544t

for sleep impairment at high altitudes, 3620

TE method, hepatic fibrosis assessment, 2552t

Temozolomide

actions of, 539

adverse effects of, 540t, 711

for astrocytoma, 704

for glioblastoma, 704

interactions and issues, 540t

for malignant pheochromocytoma, 2980

for oligodendroglioma, 705

for pancreatic NETs, 671–672, 671t

for primary central nervous system lymphoma,

706

resistance to, 553

for ZES, 2455

Temperature sense, 170, 170t

Temporal arteritis. See Giant cell arteritis (temporal

arteritis)

Temporal bone, fracture of, 241

Temporal lobectomy, 3321

Temporal lobe epilepsy, 202, 3310

Temporomandibular joint disorder, 257

Temsirolimus

actions and targets of, 511, 513t, 550t, 552

adverse effects of, 550t, 552, 575, 739

drug interactions of, 571

TEN. See Toxic epidermal necrolysis (TEN)

Tenapanor, 308, 2314, 2495

Tenatoprazole, 2445

Tender point assessment, in fibromyalgia, 2868,

2868f

Tendinitis, 2847t, 2850, 2878–2879

Tendinous xanthomas, 2549, A15

Tenecteplase

actions of, 938

for acute limb ischemia, 2111

contraindications to, 1948

domain structure of, 938, 938f

indications for, 938

for ischemic stroke, 3337

for STEMI, 2059

Tenofovir alafenamide (TAF)

for chronic HBV infection, 2599

for HIV infection, 1466, 1587t, 1589

structure of, 1590f

Tenofovir disoproxil fumarate (TDF)

actions of, 1466

adverse effects of, 1466, 1571, 1586, 1587t, 2301

for chronic HBV infection, 2598–2599

comparison to other antivirals, 2595t, 2599f,

2601–2602

dosage for, 1465t, 1466

in HIV infection, 2602

therapeutic monitoring of, 1465t, 2601, 2640

drug interactions of, 1380

for HIV infection, 1466, 1587t, 1589, 3699

for HIV pre-exposure prophylaxis, 1589

resistance to, 1466, 1592f, 2601t

structure of, 1590f

Tenosynovitis, 2879

Tension pneumothorax, 103, 2200, 2238, 2239

Tension-type headache, 113t, 3358t, 3365

Teplizumab, 3100

Tepotinib, 607

Teprenone, 2445

Teratoma

midline, A16

ovarian, 698, 729t, 733f, 734, 2943, 3654

parasellar, 2907

pineal, 706

testicular, 690

Terazosin, 2083t, 2114, 3455, 3474

Terbinafine

adverse effects of, 236, 409, 2847t

for onychomycosis, 380, 1657, 1691, 1691t

for ringworm, 1657

for Sporothrix infections, 1687t

for tinea, 387t, 1691, 1691t

Terbutaline, 3590t

TERC, 3680

TERC gene mutations, 794–795, 3682, 3682t

TERF2 gene mutations, 3682t

Teriflunomide, 3470t, 3472

Teriparatide, 3045, 3206–3207, 3207f, 3209

Terlipressin, 311, 2307

Terminal extubation, 86

Terminal hair, 3039

Terminally ill patient, 72

advance care planning for, 75–77, 76t

assessment of, 74–75

with cancer, 489–490

care during last hours, 88–89, 88t

clinical courses of, 88t

communicating bad news to, 74, 75t

continuous goal assessment, 74–75

delirium in, 181

depression in, 82–83

euthanasia and physician-assisted suicide for,

87, 87t

existential needs of, 85

financial burdens of, 84

futile care of, 86–87

managing last stages for, 85–89

physical symptoms of, 77, 77t

anorexia, 88t

apnea, 88t

constipation, 80, 80t

dehydration, 88t

delirium, 88t

dysphagia, 88t

dyspnea, 80–81, 81t

fatigue, 81–82, 88t

incontinence, 88t

nausea and vomiting, 80

pain, 77–79

psychological symptoms of, 77t, 82, 83t

social needs of, 84–85

withholding/withdrawal of care of, 85–86

Terminal restlessness, 181

Terminal weaning, 86

Terrorism

chemical, 3592t, S4, S7

microbial/biological, 1136, S3, S6

radiation, S5

TERT, 3680, 3681f

TERT gene, 3680

TERT gene mutations

in bone marrow failure, 794–795

in glioblastoma, 704

in hepatocellular carcinoma, 644, 645t

in interstitial lung disease, 2192, 2197

in melanoma, 579

in telomerase disease, 3682, 3682t

in thyroid cancer, 2951

Tertiary prevention, 8

Testes/testicles, 3006

biopsy of, 3011

development of, 2998–2999, 3006, 3006f

disorders of. See also Male reproductive system

disorders

acquired defects, 3017–3018

adrenal rest tumors, 2975, 2975f, 3004

alcohol use disorder and, 3559

cancer. See Testicular cancer

in Carney complex, 2992

cryptorchidism, 3004, 3016

in disorders of sex development. See 46,XY

disorders of sex development

in Klinefelter syndrome, 3016. See also

Klinefelter syndrome

non-germ cell tumors, 694

swelling/mass, 690

torsion, 1082, 3017

dysgenetic, 3002, 3003t

physical examination of, 3010

referred pain from, 110

regulation of function of

androgen in, 2907f, 3007–3009, 3009f

hypothalamic-pituitary-testis axis in, 2907f,

3006–3007

seminiferous tubules in, 3009–3010

structure of, 3006

Testicular cancer, 689

clinical features of, 690

diagnosis of, 690

epidemiology of, 690

genetic considerations in, 690

global considerations in, 690

incidence of, 690

non-germ cell tumors, 694

nonseminoma, 691

paraneoplastic syndromes in, 722t

pathology of, 690

risk factors for, 690

seminoma, 691

staging of, 691, 692–693f

treatment of

chemotherapy, 691

HCT, 903

infertility after, 694

initial, 690

late effects of, 694

postchemotherapy surgery, 693

in relapsed disease, 694

stage-based, 691–694, 692–693f

Testicular dysgenesis, 3002, 3003t

Testicular feminization syndrome. See Androgen

insensitivity syndrome (AIS)

Testis-determining factor (TDF), 3653

Testosterone

age-related changes in levels of, 3069–3072, 3070f

assays of, 3010–3011, 3020

bioavailable, 3011

in hirsutism, 3041

in men with prostate cancer, 3076

outcomes in older men and levels of, 3070, 3070t

synthesis of, 2955f, 3009f

total, tests of, 3010–3011

transport and metabolism of, 3007–3008, 3009f

unbound, measurement of, 3011

INDEX

I-214 Testosterone cypionate, 3021, 3022t

Testosterone enanthate, 3021, 3022t

Testosterone-lowering drugs. See Androgen

deprivation therapy (ADT)

Testosterone therapy

abuse of. See Anabolic-androgenic steroid (AAS)

abuse

for adult hypopituitarism, 2899t

adverse effects of, 410, 3019, 3024t, 3025t, 3061,

3147

for androgen deficiency, 3019, 3021

contraindications to, 3024, 3024t

for delayed puberty, 3013

efficacy of, 3019, 3024

for erectile dysfunction, 3060–3061

formulations of, 3021–3022, 3022t

for gonadotropin deficiency, 2902

gonadotropin inhibitors and, 3023

for hypogonadism, 2902

indications for, 3023

for male contraception, 3023

in men with history of prostate cancer, 3024,

3076

monitoring of, 3024–3025, 3025t, 3061

in older men, 3070–3072, 3071f, 3071t, 3072f

pharmacology of, 3022t

regimens for, 3023–3024

Testosterone undecanoate, 3021, 3022t

Testotoxicosis, 3012

TET2 gene mutations, 800, 809, 812, 812t, 850

Tetanospasmin, 1212

Tetanus, 1211

approach to the patient, 1212, 1213f

clinical features of, 1212, 1213f

complications of, 1213

definition of, 1211

diagnosis of, 1212–1213

epidemiology of, 1212

etiology of, 1211

global considerations in, 1212, 1214

incidence pre- and postvaccine, U.S., 981t, 1212

neonatal, 1211, 1212, 1214

pathogenesis of, 1212

in pregnancy, 1211

prevention of, 40t, 984f, 1214

prognosis of, 1214, 1214t

prophylaxis, for bite-wounds, 1127

treatment of, 1213

Tetanus booster, for bite-wounds, 1127

Tetanus, diphtheria, acellular pertussis (Tdap)

vaccine

contraindications to, 985t

precautions for, 985t

recommended administration of

in adults, 984f, 1207, 1214, 1261

in children, 1207, 1214, 1261

in international travelers, 993

in pregnancy, 984f, 1214, 1261, 3768

Tetanus-diphtheria (Td) vaccine

contraindications to, 985t

recommended administration of, 40t, 984f, 1207,

1214

Tetanus immune globulin (TIG), 1127, 1213, 1214

Tetanus toxoid, 1214

Tetany, in malabsorption disorders, 2468t

TET enzymes, 3791

Tethered cord syndrome, 124, 3454

Tetherin, 1529

Tetrabenazine, 3389, 3404, 3405, 3408

Tetracycline(s)

for acne rosacea, 383

for acne vulgaris, 382

for actinomycosis, 1343t

actions of, 1149, 1159, 1164t, 1165f

adverse effects of, 1154t, 1160, 2446

cutaneous, 391, 392, 409, 412, 1707t

folate deficiency, 773t

frequent, 1707t, 1732t

lupus syndrome, 2847t

nail disorders, 410

papilledema, 224f

phototoxicity, 422t

rare, 1707t

renal failure, 1732t

teeth discoloration, 257, 410, 1324

for balantidiasis, 1767

for Brucella infections, 1313–1314

for cholera, 1308

contraindications to, 1424

for C. pneumoniae infection, 1452

for C. trachomatis infection, 1450

for donovanosis, 1335t

drug interactions of, 471t, 1155t, 1703t, 1707t

for ehrlichioses, 1438

for endemic treponematoses, 1416

in H. pylori eradication, 1283t, 2446, 2447t, 2448t

indications for, 1159–1160

for malaria, 1730t, 1732t

for meibomitis, 220

for M. hominis infection, 1144

for M. pneumoniae infections, 1443

for parasitic infections, 1707t

pharmacology of, 1732t

for plague, 1324, 1324t

for plague prophylaxis, 1325t

in pregnancy and lactation, 1152t, 1707t

for psittacosis, 1451

for relapsing fever, 1424–1425, 1424f

resistance to, 1164t, 1165f, 1166, 1264t, 1308,

2446

for Rocky Mountain spotted fever, 1434

for syphilis, 1412, 1412t

for tropical sprue, 2465

for tularemia, 1318

Tetrahydrocannabinol (THC), 294t, 3567. See also

Marijuana

Tetrahydrofolate, 767, 768f

Tetrahydrozoline, 3591t

Tetralogy of Fallot

clinical features of, 439

epidemiology of, 2012

hypoxia in, 273

murmur in, 282f, 283

pathophysiology of, 2012, 2014f

primary repair of, 2012, 2014f

repaired, sequelae of, 2012, 2015t

arrhythmias, 1921–1922, 2012

interventions for, 2013

in pregnancy, 3764

pulmonic regurgitation, 2005, 2012

sudden cardiac death, 2012, 2260, 2261t

Tetrathiomolybdate, 3236–3237, 3409

TF (tissue factor), 451, 451f

T follicular helper cells (Tfh), 2327, 2327f, 2672. See

also CD4+ T cells

Tg. See Thyroglobulin (Tg)

TGFB2/3 gene mutations, 3229, 3229t

TGFRB1 gene mutations, 3229, 3229t

TGFRB2 gene mutations, 698, 3229, 3229t

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

2436f, 2458

TGF-β. See Transforming growth factor-β (TGF-β)

1 T cells

characteristics of, 2672

in inflammatory disease processes, 2699t

in rheumatoid arthritis, 2758

in SLE, 2738

2 T cells, 2672, 2699t

9 T cells, 2672

13 T cells, 2672

17 T cells

characteristics of, 2672

in psoriatic arthritis, 2799

in rheumatoid arthritis, 2758

Thailand, 50, 50t

Thalamic astasia, 177

Thalamic hemorrhage, 187, 3350. See also

Intracranial hemorrhage

Thalamus, 173, 233

Thalassemia syndromes, 755t, 761

α thalassemia, 763

classification of, 763, 764t

clinical features of, 764t

complications of, 764

diagnosis of, 764

epidemiology of, 763

pathophysiology of, 763–764

screening for, 764

treatment of, 764

α thalassemia trait, 764t

α thalassemia with myelodysplasia, 764t

arthropathy in, 2873

β thalassemia, 761, 2873, 3648f, 3649

classification of, 761–762, 762t

complications of, 762, 763t

diagnosis of, 762, 762f, 762t

epidemiology of, 761

global considerations in, 761

screening for, 762–763

treatment of, 763, 3686t, 3687

β thalassemia intermedia, 762, 762f, 762t, 2873

β thalassemia minor, 2873

β thalassemia trait, 762, 762t

differential diagnosis of, 751, 751t

genetic considerations in, 761

HCT for, 898, 901, 902t

jaundice in, 316

malaria resistance and, 761, 1723

peripheral blood smear in, 425, 428f, 434f

reticulocyte index in, 438

splenomegaly in, 461

Thalidomide

actions and targets of, 536f, 537

adverse effects of, 537

neuropathy, 711, 3492, 3494t

in pregnancy, 1390

for leprosy reactions, 1390

for lupus dermatitis, 2748

for malignant pheochromocytoma, 2980

for multiple myeloma, 537, 873–875, 874t

for POEMS syndrome, 2996

for primary myelofibrosis, 807

for vascular ectasias, 313

Thallium-201, 1834t, 1835

Thallium poisoning, 224, 3495–3496, 3495t,

3582

THAP1 gene mutations, 3402, 3403t

Thawing, for frostbite, 3634, 3634t

THBR (thyroid hormone binding ratio), 2931

THC (tetrahydrocannabinol), 294t, 555, 3567. See

also Marijuana

Thelarche, 3031, 3031t

Theophylline

adverse effects of, 348, 368, 2156, 2188, 3311t

for COPD, 2188

dosage of, 470

INDEX

drug interactions of, 471t I-215

ciprofloxacin, 1706t

fluoroquinolones, 1155t

PPIs, 2444

thiabendazole, 1703t, 1713

overdosage/poisoning with, 351, 3590t

for SA node dysfunction, 1878

Therapeutic diet, 2522

Therapeutic hypothermia, 2263

Therapeutic index/ratio/window, 465–466, 465f,

532

Thermoregulation, 130, 207, 3631, 3635

THF starvation, 768

Thiabendazole, 1703t, 1713

Thiamine (vitamin B1

), 2524

for alcohol-induced acidosis, S1

deficiency of. See Thiamine (vitamin B1

)

deficiency

food sources of, 2524, 3496

functions of, 2524, 2525f

recommended intake of, 2519t

structure of, 2525f

supplements, 363, 2526, 3561

toxicity of, 2526

Thiamine (vitamin B1

) deficiency. See also Beriberi

in alcoholism, 2524

clinical features of, 2524–2525, 2524t. See also

Wernicke’s disease/encephalopathy

acid-base disorders, 361

ataxia, 3423

delirium, 180

dementia, 3376

neuropathy, 3496

optic neuropathy, 224

diagnosis of, 3496

risk factors for, 2524–2525, 2524t

treatment of, 2526, 3496

Thiazide diuretics

actions of, 2291f

adverse effects of, 3058

acid-base disorders, 366

cutaneous, 379, 383, 391, 409

hypercalcemia, 3181

hypokalemia, 349, 350

hyponatremia, 342, 344

nephritis, 2281

phototoxicity, 422t

in pregnancy, 444

vasculitis, 2816

for CKD, 2312

drug interactions of, 1704t, 1706t

for heart failure, 1943–1944

for hyperkalemia, 355

for hypertension, 2083–2084

for hypoparathyroidism, 3187

for nephrogenic diabetes insipidus, 347,

2922

for nephrolithiasis, 2373

for pseudohypoaldosteronism, 355

Thiazolidinediones

actions of, 3110t, 3112

adverse effects of, 277t, 3087, 3110t, 3196

contraindications to, 3110t

for metabolic syndrome, 3157

for NALFD, 2623

in older adults, 3746t

for type 2 diabetes mellitus, 3110t, 3112,

3113

Thick-filament myopathy, 2276

Thienopyridines, 926–927. See also Clopidogrel;

Prasugrel; Ticlopidine

Thiethylperazine, 294t, 555

Thimerosal, 376

Thin basement membrane disease, 337, 2335t,

2347, A4

6-Thioguanine, 476t, 541t, 542

Thiopental, 3322f

Thiopurine S-methyltransferase (TPMT), 467t,

476t, 478, 2328, 2805

Thiopurine S-methyltransferase (TPMT)

deficiency, 3668

Thioridazine, 83t, 410, 3554, 3555t, 3590t,

3591t

Thiotepa, 571, 711t

Thiothixene, 3554, 3555t

Third disease. See Rubella

Third nerve palsy, 3354

Third spacing, 341

Third window, inner ear, 239, 245

Thirst

activation of, 338

mechanism of, 2294, 2295f, 2919–2920

in older adults, 345

Thogotoviruses, 1624, 1630t

Thomsen disease, 3530

Thoracentesis, 489, 2140

Thoracic adenopathy, 459

Thoracic aortic aneurysm. See also Aortic

aneurysm

clinical features of, 2102–2103

diagnosis of, 2103f

in giant cell arteritis, 2812, A14

heritable, 3229–3231, 3229t. See also Marfan’s

syndrome

treatment of, 2103

Thoracic fracture, 3191. See also Vertebral fractures

Thoracic lavage, as rewarming strategy, 3633

Thoracic meningioma, 3448f

Thoracic outlet, 128

Thoracic outlet syndromes, 128, 2111–2112

Thoracic spinal lesions, 3446

Thoracoscopy, medical, 2140, 2216

Thoracotomy, 2140

Thorium-232, S5

3TC. See Lamivudine (3TC)

Threonine kinase gene mutations, 390

Threonine metabolism disorders, 3271t

Throat swab, 253–254, S11

Thrombectomy, percutaneous mechanical, 2111,

3338, A11

Thrombin, 451, 451f, 911, 919, 924, 925f

Thrombin-activatable fibrinolysis inhibitor (TAFI),

452, 923

Thrombin generation test, 457

Thrombin time, 456t, 457, 911f, 911t

Thromboangiitis obliterans, 2110, 2113

Thrombocytopenia, 904

approach to the patient, 905, 905f

bleeding in, 454

chemotherapy-related, 554

drug-induced, 473, 905–906, 905t

familial, with propensity to acute AML,

3645t

in filovirus infections, 1649

heparin-induced. See Heparin-induced

thrombocytopenia

in HIV infection, 905, 906, 1575

infection-induced, 905

inherited, 904, 907

in leptospirosis, 1419, 1420

peripheral blood smear in, 429f, 722f, 904–905

in pregnancy, 3766

refractory. See Myelodysplasia

skin manifestations of, 398

in SLE, 2743

treatment of, 554

Thrombocytopenia with absent radii, 907

Thrombocytopenic purpura, 1281, 2696t, 2734.

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