INDEX

pathology of, 2978, 2978f, 2980f I-165

treatment of, 2978–2979

Paraganglioma syndromes, 2978f, 2980

Paragonimus spp. See Lung flukes (Paragonimus

spp.)

Parainfluenza virus infections

in cancer patient, 561

clinical features of, 248–249, 255, 1506

in transplant recipient, 1140

virology, 1506, 1506t

Paralysis

in botulism, 1217

definition of, 165

periodic

hyperkalemic periodic paralysis (HyperKPP),

353, 3519, 3530, 3667t

hypokalemic. See Hypokalemic periodic

paralysis (HypoKPP)

thyrotoxic, 3530

in rabies, 1621

secondary hyperkalemic, 353

sleep, 208t, 209

tick-bite, 3609

Todd’s, 3306

tongue, 3443

Paralytic poliomyelitis, 1603. See also Poliovirus

infection

Paralytic shellfish poisoning, 3606–3607

Paramyotonia congenita, 3519, 3530

Paramyxoviridae, 1454t, 1455f, 1506, 1506t

Paramyxovirus infections

Hendra virus, 1514

measles. See Measles (rubeola)

mumps. See Mumps

Nipah virus, 1094, 1514

parainfluenza virus. See Parainfluenza virus

infections

Paranasal sinus cancer. See Head and neck cancer

Paraneoplastic syndromes

ataxia in, 3423

definition of, 721

endocrinologic, 721

ectopic ATCH production. See

Adrenocorticotropic hormone (ACTH),

ectopic production of

ectopic hCG production, 725

etiology of, 721–722, 722t

hypercalcemia. See Hypercalcemia,

malignancy-associated

oncogenic osteomalacia, 725

tumor-associated SIAD, 723. See also

Syndrome of inappropriate antidiuresis

(SIAD)

tumor-induced hypoglycemia, 724–725

hematologic, 725, 725t

immunopathology of, 2696–2697t

intrahepatic cholestasis, 320

joint involvement in, 2877

in lung cancer, 598–599

membranous nephropathy, 2283

neurologic, 728, 728t

anti-Hu neuropathy, 3508

approach to the patient, 728–729

autoimmune autonomic ganglionopathy, 3434

cerebellar degeneration/atrophy, 734, 2697t

vs. Creutzfeldt-Jakob disease, 3421

diagnosis of, 728–729, 730f

dorsal root ganglionopathy, 734–735

encephalitides with antibodies to cell-surface

or synaptic proteins, 731–734, 731f

encephalitides with NMDA receptor

antibodies, 3377

encephalomyelitis and focal encephalitis,

729–731, 731f, 2697t

immune-related necrotizing myopathy, 736

Lambert-Eaton myasthenic syndrome. See

Lambert-Eaton myasthenic syndrome

(LEMS)

opsoclonus-myoclonus syndrome, 734, 2697t

pathogenesis of, 728, 728t, 729t

peripheral neuropathies, 735–736

sensory neuroneuropathy/ganglionopathy,

734–735, 3491

spinal cord, 734

stiff-person syndrome, 734, 735f, 2697t

visual syndromes, 736

pemphigus, 392, 401t, 402, 2697t

in renal cell carcinoma, 674

Paranoá virus, 1629t

Paraparesis, 167, 167f

Paraphasia, 196

Paraplegin gene, 3414t, 3416

Parapneumonic effusion, 1175, 2198

Parapoxvirus infection, 1493, 1494

Paraproteinemia, 454. See also Plasma cell disorders

Parapsoriasis, 383

Parasite(s), 425

Parasitic infections. See also Cestodes/cestode

infections; Helminths/helminthic

infections; Nematodes/nematode

infections; Protozoa/protozoal infections;

Trematodes/trematode infections

approach to the patient, 1698, 1700

arthritis in, 1044–1045

as cause of fever of unknown origin, 146t, 149t

hepatobiliary, 2651–2652

laboratory diagnosis of, S12

myocarditis in, 1961–1962

by organ system, 1699–1700t

renal involvement in, 71

by signs/symptoms, 1699–1700t

in transplant recipient, 1138

treatment of, 1701

Parasomnias, 212–213

Parathyroid disorders

adenoma, 3173

carcinoma, 3174, 3177

genetic considerations in, 3174–3175, 3174f

hyperparathyroidism. See Hyperparathyroidism

hyperparathyroidism-jaw tumor (HPT-JT)

syndrome, 2984t, 2990, 2991t, 3174, 3175

hyperplasia, 3173

hypoparathyroidism. See Hypoparathyroidism

in MEN syndromes. See entries at Multiple

endocrine neoplasia

Parathyroidectomy, 3177, 3190

Parathyroid hormone (PTH), 3169

actions of, 356–357, 356f, 2890, 3169–3170

assessment of, 2891

bone effects of, 3206–3207

in calcium homeostasis, 2291, 3160, 3179f

in CKD, 2313–2315

deficiency of, 357

ectopic production of, 357, 599, 721, 722t

excess of, 356f

half-life of, 2886

in hypercalcemia, 3182–3183

for hypoparathyroidism, 358, 3187

metabolism of, 3171

in primary hyperparathyroidism, 3176–3177,

3176f

vs. PTHrP, 3171–3172, 3171f

receptor cross-talk of, 2885

regulation of, 3170–3171

resistance to, 3188–3189, 3189f

structure and physiology of, 3170, 3171f

synthesis of, 3170

Parathyroid hormone (PTH)/PTHrP receptor,

2885, 2888t, 3171–3172, 3172f, 3179f

Parathyroid hormone–related protein (PTHrP), 3171

actions of, 3171–3172, 3172f

ectopic production of, 356, 721, 722, 722t

vs. PTH, 2885, 3171–3172, 3171f

structure and physiology of, 3171–3172, 3171f

Parathyroid hormone (PTH) therapy. See Teriparatide

Paratonia (gegenhalten), 165

Parcopa, 3396t

PARD3B gene, 1552t

Parechoviruses, 1094, 1507, 1507t, 1607

Parenteral iron therapy, 752

Parenteral nutrition

cholestasis in, 320

complications of, 2544–2545, 3252

in critically ill patient, 2544–2545

diabetes mellitus and, 3118

discontinuation of, 2544

hypercalcemia in, 357

initiation and monitoring of, 2543–2544

iron concentration during, 2544–2545

metabolic alkalosis in, 366

nutrient composition of, 2521, 2542

Parenting trends, vaccine hesitancy and, 16

Paresis, 165, 1410. See also Periodic paralysis

Paresthesia, 169, 358, 2468t

Parietal cell, 2434, 2435f, 2436–2437

Parietal cell antibodies, 771

Parietal cortex, posterior, 199, 199f

Parietal lesions, 230

Parietofrontal network, 199, 199f

Parinaud’s syndrome/complex, 216, 231, 706, 1317,

1329, V3

Paritaprevir/ritonavir, 2607, 2608–2609t, 2609

Paritaprevir/ritonavir/ombitasvir/dasabuvir, 1468t,

1469

Parkes-Weber syndrome, 2116

Parkin gene mutations, 3297, 3391t, 3392

Parkinsonism

ALS and, 3414

atypical, 3389–3390, 3390t

definition of, 3388

differential diagnosis of, 3387f

drug-induced, 3289, 3408

with dystonia, 3403t

gait disorders in, 174

lower body, 174–175

in multiple system atrophy, 3432

secondary, 3389, 3390t

in Wilson’s disease. See Wilson’s disease

Parkinson’s disease (PD), 3386

AD and, 3370

chronic traumatic encephalopathy and, 3461

clinical features of, 3386–3387, 3387t

autonomic disturbances, 3398

cardinal, 3387, 3387t

constipation, 308, 3398

delirium, 179

dementia, 190, 3370, 3380, 3385, 3398

dysphagia, 289, 291

frontal lobe syndrome, 203

motor, 174–175, 3386–3387, 3387t, 3399, V1

nonmotor, 3387t, 3398–3399

ocular, 230

olfactory dysfunction, 232, 236

psychoses, 3398

seborrheic dermatitis, 377

sleep disorders, 211, 213, 3399

INDEX

I-166 Parkinson’s disease (PD) (Cont.):

differential diagnosis of, 3388–3389, 3388t, 3390t

ECG in, A8

etiology of, 3390–3391

falls in, 177

familial, 3390

genetic considerations in, 3297, 3390–3391,

3391t

imaging in, 3388, 3389f

microbiome and, 3297

mitochondrial dysfunction in, 3796

pathogenesis of, 3391–3392, 3392f

pathology of, 3387, 3387f

pathophysiology of, 3392, 3393f

prevalence of, 3386

prions in, 3391, 3416

vs. progressive supranuclear palsy, 3380

protein aggregation in, 3795, 3796, 3850

sex differences in, 3064

treatment of, 3392

amantadine, 3396

anticholinergics, 3396

approach to, 3399, 3400f

COMT inhibitors, 3395–3396, 3396t

deep brain stimulation, 3397

dopamine agonists, 3395, 3396t

experimental, 3397–3398

gene therapy, 3398

levodopa, 3392–3394, 3394f, 3396t

MAO-B inhibitors, 3395, 3396t

neuroprotective agents, 3397

for nonmotor and nondopaminergic features,

3398–3399

nonpharmacologic, 3399

on-demand therapies for “off ” periods,

3396–3397

stem cell therapy, 3303, 3397–3398, 3799

surgical, 3397

PARN gene mutations, 3682t

Paromomycin

actions of, 1159, 1711

adverse effects of, 1159, 1702t, 1711,

1745

for amebiasis, 1711, 1718

for cutaneous leishmaniasis, 1747

for D. fragilis infections, 1768

for Giardia infections, 1765

indications for, 1702t

pharmacology of, 1711

in pregnancy and lactation, 1702t

for visceral leishmaniasis, 1745

Paronychia, 381, 410, 1289, 1672

Parotid gland, 590, 2789t

Parotitis, 261, 1616–1617, 1616f,

1617f

Paroxetine

adverse effects of, 3087, 3542t, 3549

for anxiety disorders, 3544

for depression, 83, 487, 3542t, 3549

drug interactions of, 467t, 471t, 478

for IBS, 2495

for menopausal symptoms, 3045

metabolism of, 467t

for panic disorder, 3542

pharmacology of, 3549

for PTSD, 3546

Paroxysmal cold hemoglobinuria, 786t, 787

Paroxysmal dyskinesias, 3408

Paroxysmal hemicrania, 113, 114t, 3366t, 3367

Paroxysmal kinesigenic dyskinesia (PKD), 3408

Paroxysmal nocturnal dyspnea, 1936

Paroxysmal nocturnal hemoglobinuria, 788

clinical features of, 317, 438, 788–789, 794

diagnosis of, 789

global considerations in, 788

natural history of, 789

pathophysiology of, 789, 790f

treatment of, 489–790, 790f, 791f

Paroxysmal nonkinesigenic dyskinesia (PNKD),

3408

Paroxysmal supraventricular tachycardia

(PSVT). See also Supraventricular

tachyarrhythmias

accessory pathways and, 1896–1897

AV nodal reentry tachycardia, 1888t, 1893f,

1895, 1895f, A8

definition of, 1888

junctional tachycardia, 1896

mechanisms of, 1893f

orthodromic AV reentry tachycardia, 1897

preexcited tachycardias, 1897, 1898f

treatment of, 1897–1899, 1899f

PARP (poly-ADP-ribose polymerase)

actions of, 515f, 516

functions of, 3792

PARP (poly-ADP-ribose polymerase)

inhibitors

action and targets of, 507, 515f, 550–551t, 553

adverse effects of, 550–551t, 625

for breast cancer, 613t, 620, 622, 625

indications for, 550–551t

for ovarian cancer, 516, 697

for pancreatic cancer, 662

for prostate cancer, 688

Parrotfish poisoning, 3606

Parrot’s pseudoparalysis, 1043

Parsonage-Turner syndrome, 3499

Pars planitis, 221

Partial anomalous pulmonary venous return, 2011,

2012f

Partial gonadal dysgenesis, 3002

Partial response (PR), to chemotherapy, 533

Partner notification, 1093

Parulis, 256

PARV4/5 viral sequences, 1497

Parvovirus(es), 1454t, 1455f, 1456, 1495, 1511

Parvovirus B19 infections, 1495

aplastic crisis in, 778

clinical features of, 1496, 1496f

diagnosis of, 1496, 1497t

epidemiology of, 1495

erythema infectiosum. See Erythema

infectiosum

hydrops fetalis, 1496, 1497t

myocarditis in, 1961

pathogenesis of, 1495–1496, 1495f

in pregnancy, 1496, 3768

prevention of, 1497

pure red cell aplasia, 798, 799f, 1496. See also

Pure red cell aplasia

transfusion-transmitted, 896, 896t

in transplant recipient, 1141

treatment of, 798, 1497

Parvus et tardus pulse, 281, 1821

Pasireotide, 2916, 2963

Passenger mutation, 505

Passive euthanasia, 87t

Passive leg raise test, 2240

Passive transport, 2290

Pasteur effect, 272

Pasteurella spp. infections

in cat-bite wound, 1037, 1125

cellulitis, 1037

clinical features of, 1041, 1125, 1248

in dog-bite wound, 1124

epidemiology of, 1248

treatment of, 1037, 1039t, 1126, 1127t, 1247t,

1248

Pastia’s lines, 142, 1191f, 1192

Patch (skin lesion), 369t

Patched gene, 419

Patch testing, 374, 2147

Patent ductus arteriosus (PDA), 273, 284, 1815,

2007, 2012, 2013f

Patent foramen ovale, 2069, 3341t, 3347–3348,

3619

Paternal age, 3072, 3646, 3652

Paternalism, in behavioral economics, 3775

Pathogen-associated molecular patterns (PAMPs)

in autoimmunity, 2732

characteristics of, 2672

masking of, 955

in response to viruses, 1457

in sepsis/septic shock, 2243, 2243f

Patient

expectations of, 7

feedback from, 4

hospital experience of, 3

Internet use by, 6–7

Patient autonomy, 68

Patient care, 2–5

Patient-centeredness, 67

Patient-controlled analgesia, 96

Patient Health Questionnaire-2 (PHQ-2)

Depression Screen, S7

Patient-physician relationship. See Physicianpatient relationship

Patient satisfaction, 63, 63f

Patiromer, 355

Pattern recognition, 21

Pattern recognition receptors (PRRs). See also Tolllike receptors (TLRs)

in autoimmunity, 2732

definition of, 2672

of inflammasomes, 957

in innate immune system, 955, 955t, 2674, 2674t,

2676

ligands of, 955, 955t, 2675t

pathogen avoidance of, 955

in sepsis/septic shock, 2243

signaling pathways of, 2675f

Patterson-Kelly syndrome, 626

PAX3-FOXO1 gene mutations, 500t

PAX3 gene mutations, 388, 3645t

PAX5, 842

PAX8 gene mutations, 2926, 2934t, 2950

PAX8-PPARG gene mutations, 500t

Pay-for-performance system, 54

Pazopanib

actions and targets of, 526, 548t, 552

adverse effects of, 548t, 552, 739

for NETs, 671t, 672

for renal cell carcinoma, 676t

for soft tissue sarcomas, 714

PBC. See Primary biliary cholangitis (PBC)

PBPs (transpeptidase enzymes), 1166

PC1 gene mutations, 3015t

PCA (pulse contour analysis), 2248

PCC (prothrombin complex concentrate), 913, 915,

917, 918, 936

PCI. See Percutaneous coronary interventions

(PCI)

PCM1-JAK2 associated myeloid/lymphoid

neoplasm, 863t, 864

PCNSL. See Primary central nervous system

lymphoma (PCNSL)

INDEX

PCOS. See Polycystic ovarian syndrome (PCOS) I-167

PCP. See Phencyclidine (PCP); Pneumocystis

pneumonia (PCP)

PC-PTSD (Primary Care PTSD) Screen, S7

PCR. See Polymerase chain reaction (PCR)

PCSK1 (prohormone convertase 1), 3084t, 3085

PCSK9 deficiency, 3139t, 3145

PCSK9 gene mutations, 479, 3140–3141, 3145

PCSK9 inhibitors, 479, 3141, 3142t, 3143, 3149,

3156

PCT. See Porphyria cutanea tarda (PCT)

PCT (procalcitonin), 1012

PCV (pressure-control ventilation), 2231, 2231t.

See also Mechanical ventilation

PD. See Parkinson’s disease (PD)

PD-1, 527, 528f, 537, 645, 2702–2703, 2703f

PD-1 antibodies. See also specific drugs

action and targets of, 527, 528, 528f, 537, 2701,

2703–2704, 2703f

adverse effects of

adrenal insufficiency, 573

colitis, 2480

cutaneous, 383, 409

endocrine dysfunction, 741, 2996

hepatotoxicity, 2591

myocarditis, 1963

myositis, 2825–2826

for anal cancer, 588

for bladder cancer, 680

for colorectal cancer, 642

for esophageal cancer, 629

for gastric adenocarcinoma, 633

for head and neck cancer, 593

indications for, 2705t

for melanoma, 420, 584t, 585

for Merkel cell carcinoma, 588

microbiome and effectiveness of, 3697

for pancreatic cancer, 662

PDA (patent ductus arteriosus), 273, 284, 1815,

1822, 2007, 2012, 2013f

PDC (pyruvate dehydrogenase complex), 2627,

2696t

PDGF (platelet-derived growth factor), 524f, 2687

PDGFRA gene mutations, 634, 635

PDGF (platelet-derived growth factor) receptors,

524f, 544

PDGFR gene mutations, 702, 713

PDGFR-mutated eosinophilia, 863, 863t

PD-L1

in breast cancer, 613t

in hepatocellular carcinoma, 645

in Hodgkin’s lymphoma, 852

in immune system evasion by cancer, 527, 528f,

537

in lung cancer, 599

PD-L1 antibodies. See also specific drugs

action and targets of, 514t, 527, 528, 528f, 537,

2704, 2705t

adverse effects of, 573, 1963, 2591, 2825–2826,

2996

for bladder cancer, 680

indications for, 2705t

for Merkel cell carcinoma, 588

PE. See Pulmonary embolism (PE)

Peanut allergy, 2729

Pearson’s syndrome, 3674t, 3675

Peau d’orange skin, 1192, 2119

Pectoriloquy, 2132

Pectus carinatum (pigeon chest), 1816, 3229

Pectus excavatum (funnel chest), 1816, 3229

Pedal edema, 2132

PEDF gene mutations, 3224

Pediculiasis, 3610–3611

Pediculicides, 3611

Pediculus capitis (head lice), 3610–3611

Pediculus humanus (body lice), 1422, 1435, 3610–

3611. See also Epidemic (louse-borne)

typhus

Pedigree analysis

in family history, 3657–3658

in genetic counseling, 3662–3663, 3663f

in Mendelian disorders, 3652, 3652f

in mtDNA diseases, 3669f, 3670

standard symbols for, 3652f

Peduncular hallucinosis, 3328f, 3329

PEEP (positive end-expiratory pressure), 2228,

2230, 2230f. See also Mechanical

ventilation

PEG-ADA, 3687

Pegcetacoplan, 791f

Pegfilgrastim, 554t

PEG IFN-α2a. See Pegylated interferon-α2a (PEG

IFN-α2a)

PEG IFN-α2b. See Pegylated interferon-α2b (PEG

IFN-α2b)

Pegloticase, 784, 2865

Pegvisomant, 2913–2914

Pegylated interferon-α2a (PEG IFN-α2a)

for chronic HBV infection, 1165t, 1467, 2595t,

2597–2598, 2599f, 2601t

for chronic HCV infection, 2605–2606, 2605f

for chronic HDV infection, 1467, 2603

for myelofibrosis, 807

for polycythemia vera, 804–805

Pegylated interferon-α2b (PEG IFN-α2b)

for chronic HBV infection, 2597

for chronic HCV infection, 1165t, 1467, 2606

PELD system, in liver transplantation, 2552

Pel-Ebstein fever, 132, 853

Pelger-Hüet anomaly, 430f, 440, 442f

Peliosis hepatitis, 2588

Pelizaeus-Merzbacher disease, 3293, 3303–3304,

3416

Pellagra

in carcinoid syndrome, 668

clinical features of, 391, 2524t, 2527, 3376, 3497,

A15

risk factors for, 2527

treatment of, 2527, 3497

Pelvic abscess, 1353

Pelvic congestion, 3038

Pelvic floor dysfunction, 308

Pelvic floor retraining, 309, 329

Pelvic fractures, 3191

Pelvic inflammatory disease (PID), 1087

abdominal pain in, 109, 111

anaerobic, 1353

clinical features of, 1087–1088

C. trachomatis, 1447

diagnosis of, 1088

epidemiology of, 1087

etiology of, 1080t, 1087, 1443, 3037

follow-up for, 1089

pelvic pain in, 3037

prevention of, 1089

prognosis of, 1089

treatment of, 1088–1089, 1088t

Pelvic organ crosstalk, 326

Pelvic pain, 3037

acute, 3037–3038

approach to the patient, 3037

in cervical cancer, 699

chronic, 3038

etiology of, 3037, 3037t

in IC/BPS, 326

in pelvic inflammatory disease. See Pelvic

inflammatory disease (PID)

PEM (post-exertional malaise), 3533, 3533t, 3534

Pemberton’s sign, 2946

Pembrolizumab

action and targets of, 514t, 536f, 537, 2705t

adverse effects of, 576, 2275, 2301, 2591

for bladder cancer, 679, 680

for carcinoma of unknown primary, 719

for endometrial cancer, 700

for gastric cancer, 633

for head and neck cancer, 593, 2705t

for hepatocellular carcinoma, 653

for Hodgkin’s lymphoma, 854, 2705t

for lung cancer, 607, 608t, 2705t

for melanoma, 584t, 585, 2705t

for pancreatic cancer, 662

for progressive multifocal leukoencephalopathy,

1100

for prostate cancer, 688

for renal cell carcinoma, 676, 676t

Pemetrexed

actions of, 542

adverse effects of, 541t, 542

interactions and issues, 541t

for lung cancer, 604, 609

for primary central nervous system lymphoma,

706

Pemigatinib, 513t, 544, 546t, 656

Pemoline, 82

Pemphigoid

bullous, 402

clinical features of, 401t, 402, 403f, A5

drug-induced, 409

histology of, 401t, 402–403

immunopathology of, 401t, 403, 2696t

treatment of, 403

esophageal involvement/dysphagia in, 290

gestational, 401t, 403

mucous membrane, 257, 259t, 401t, 404

Pemphigus

drug-induced, 409

paraneoplastic, 392, 401t, 402, 2697t

Pemphigus foliaceus, 402

clinical features of, 401t, 402

drug-induced, 402

histology of, 401t

immunopathology of, 401t, 402, 2696t

treatment of, 402

Pemphigus vulgaris, 400

clinical features of, 400–401, 401f, 401t, A5

diagnosis of, 402

histology of, 401t

immunopathology of, 401t, 402, 2696t, 2735

oral manifestations of, 257, 259t

skin manifestations of, 392

treatment of, 402

penA, 1236

penB, 1236

Penciclovir, 1460, 1478t

Pendred’s syndrome, 242, 244t, 2927, 2934t

Pendrin, 2927, 2934t

Penetrance, 3651, 3663

Penetrating injury, cardiac, 2029–2030

Penetrating radiation, S5

d-Penicillamine

adverse effects of

autoimmune myasthenia gravis, 3511

cutaneous, 379, 402, 409, 3236

lupus syndrome, 2847t

myopathy, 2847t, 3531t

INDEX

I-168 d-Penicillamine, adverse effects of (Cont.):

optic neuropathy, 224

pyridoxine and, 2527

vasculitis, 2847t

zinc deficiency, 2532

for cystine stone prevention, 2373

for cystinuria, 3274

for mercury poisoning, 3581t

for systemic sclerosis, 2784

for Wilson’s disease, 3236, 3409

Penicillin(s)

for actinomycosis, 1343, 1343t

actions of, 1148, 1153, 1164t

adverse effects of

acid-base disorders, 366

cross-sensitivity and, 416

cutaneous immunologic, 408

desensitization to, 416

erythema nodosum, 397

erythroderma, 384

hemolytic anemia, 472, 788

hypokalemia, 349

neutropenia, 444

pemphigus, 402

platelet dysfunction, 909

rash, 392, 411

renal, 2301

seizure, 3311, 3311t

serum sickness–like reactions, 408

toxic epidermal necrolysis, 391

urticaria, 411

vasculitis, 2816

for anaerobic bacterial infections, 1356

for anthrax, S3

for asymptomatic pharyngeal GAS carriage, 1191

for bite-wound infections, 1126, 1127t

for Capnocytophaga infections, 1126, 1247t

for clostridial myonecrosis, 975t

for enterococcal infections, 1201t

for epidural abscess, 975t

for erysipelas, 1191t

for gas gangrene, 1039t, 1224

for GAS infections, 1191t

for group B Streptococcus infections, 1195

for group C or G streptococcal infections,

1194–1195

for HACEK infections, 1247t

for infective endocarditis, 1028, 1029t, 1030

for leptospirosis, 1421t

for meningococcemia, 975t

for necrotizing fasciitis, 975t, 1191t

for pharyngitis, 1191t

for pneumonia, 1191t

in pregnancy and lactation, 1152t

resistance to

in anaerobic bacteria, 1356

mechanisms of, 1163–1166, 1164t, 1264, 1264t

in meningococci, 1231

in N. gonorrhoeae, 1236

in pneumococci, 1013, 1105, 1175–1176

in staphylococci, 1185

for rheumatic fever, 2768–2769

for streptococcal pharyngitis, 254, 254t

for tetanus, 1213

for toxic shock syndrome, 1191t

Penicillin-binding proteins, 1148, 1150, 1170f,

1176, 1185, 1202

Penicillin G

for diphtheria, 1206

for group B Streptococcus infections, 1195,

1196

indications for, 1153, 1156t

for Lyme disease, 1430, 1430f

for meningitis, 1103t, 1104, 1104t

for neurosyphilis, 1412, 1412t

for nongonococcal bacterial arthritis, 1042

for osteomyelitis, 1049t, 1050t

for pharyngitis, 1191t

for pneumococcal infections, 1175–1176

for relapsing fever, 1424, 1424f

resistance to, 1156t

for staphylococcal infections, 1186t

for syphilis, 1411–1412, 1412t

for syphilitic meningitis, 1109

Penicillin V

for diphtheria, 1206

for rheumatic fever prophylaxis, 2770

Penicillium marneffei infection (penicilliosis). See

Talaromyces marneffei infection

Penile cancer, 381, 1499

Penile prosthesis, 3061

Penile tumescence, 3055

Penile warts. See Condyloma acuminata

Pentamidine

actions of, 1711, 2294

adverse effects of

acid-base disorders, 364

bronchospasm, 1695t

frequent, 1706t, 1756

hyperkalemia, 353

hypotension, 1694

hypovolemia, 340

nephrotoxicity, 2301

occasional, 1706t, 1756

pancreatic, 1571

rare, 1706t

renal, 1571

for cutaneous leishmaniasis, 1747

for human African trypanosomiasis, 1756, 1756f,

1756t

for PCP, 1694, 1695t

for PCP prophylaxis, 1563t, 1566, 1695t

pharmacology of, 1711

in pregnancy and lactation, 1706t

Pentasa, 2483, 2483t

Pentastomiasis, 3611

Pentavalent antimonials, 1701, 1702t, 1745, 1747,

1748

Pentazocine, 2847t

Pentobarbital, 3322f, 3592t

Pentosan polysulfate sodium (PPS), 329

Pentostatin, 575, 740

Pentoxifylline

for alcohol-associated liver disease, 2626

for intermittent claudication, 2109

for leprosy reactions, 1390

Penumbra, 2268

PEO. See Progressive external ophthalmoplegia

(PEO)

PEP. See Postexposure prophylaxis (PEP)

PEPFAR (U.S. President’s Emergency Plan for

AIDS Relief), 3703

Peppermint oil, 2494, 3786

Pepsin, 2437

Peptic ulcer disease, 2434

clinical features of, 101t, 105, 111t, 295,

2441–2442

complications of

bleeding

endoscopic treatment of, 2403, 2406f

incidence of, 2442

recurrent, prevention of, 311, 2403, 2407f

gastric outlet obstruction, 2442

perforation, 2442

conditions related to

gastritis. See Gastritis

Ménétrier’s disease, 2458

stress-related mucosal injury, 312, 2223,

2455–2456

Zollinger-Ellison syndrome. See ZollingerEllison syndrome (ZES)

deaths from, 2434

diagnosis of, 2442–2443

barium studies, 2442, 2442f

endoscopic, 2389f, 2403, 2412, 2442, 2443f

with hemorrhage, 2403, 2405f, 2406f

H. pylori detection, 2442, 2443t

differential diagnosis of, 2442

duodenal ulcers in. See Duodenal ulcers

epidemiology of, 2434, 2437–2438

etiology of, 295, 2440–2441, 2441t

gastroduodenal mucosal defense and, 2436–2437

genetic considerations in, 2441

H. pylori–related. See Helicobacter pylori

infections, in peptic ulcer disease

NSAID-induced, 2440, 2440f, 2449, 2449t

pathology of, 2438

pathophysiology of, 2438

in polycythemia vera, 804

recurrence of, 2451–2452

refractory, 2450

risk factors for, 2437–2438

stomach cancer and, 630

treatment of, 2443, 2443t

antacids, 2443

approach to, 2449–2450, 2450f

bismuth-containing preparations, 2445

H2

 receptor antagonists, 2443–2444

H. pylori eradication. See Helicobacter pylori

infections, treatment of

NSAID-induced, 311, 2449, 2449t

PPIs, 2444–2445

prostaglandin analogues, 2445

in refractory disease, 2450

sucralfate, 2445

surgical, 2450–2453, 2451f

ZES and, 2453. See also Zollinger-Ellison

syndrome (ZES)

Peptide(s)

antimicrobial, 2671, 2674t

ovarian, 3030

Peptide receptor radioligand therapy, 671

Peptide YY, 3081, 3082f

Peptidoglycan, 1148

Peptostreptococcus spp. infections, 1125, 1189t,

1349, 1351, 1354. See also Anaerobic

bacterial infections, mixed

PER1 gene mutations, 3805t

PER2 gene mutations, 213, 3805t, 3811

PER3 gene mutations, 3805t, 3809

Peramivir, 1141, 1463, 1463t, 1512, 1521

Perampanel, 3319t, 3320

Percent transferrin saturation, 749f, 751, 753t

Perchlorate, 2945

Percussion

of chest, 266, 2132

of spleen, 461

Percutaneous coronary interventions (PCI), 2066, A11

for adult congenital heart disease, 2069

antiplatelet agents in, 2049–2050, 2066,

2067–2068

for aortic valve replacement. See Transcatheter

aortic valve implantation (TAVI)

aortic valvuloplasty, 1984

atherectomy, 2067

for atrial septic defect repair, 2069, A11

INDEX

balloon angioplasty and stenting, 2066–2067, I-169

2066f, 2067f

for cardiogenic shock, 2252

circulatory support during, 2070–2071

complications of, 2057t, 2067–2068, A11

distal protection device for, 2067, A11

embolic protection device for, 2067

Impella device for, 2071

indications and patient selection for, 2068–2069

intimal dissection in, 2067, 2067f

intraaortic balloon for circulatory support in,

2070–2071

for left atrial appendage closure, A11

vs. medical therapy in acute coronary

syndromes, 2069

mitral balloon commissurotomy, 1994–1995

mitral balloon valvotomy, 1994f

mitral valve repair, 1999, 1999f

multivessel, A11

for paravalvular leak, A11

prophylactic, before noncardiac surgery,

3770–3771, 3770f

for revascularization in stable ischemic heart

disease, 2043

of bifurcation lesions, A11

vs. CABG, 2045, 2045f, 2068–2069

of chronic total occlusion, A11

efficacy of, 2044

fractional flow reserve-guided, A11

indications and patient selection for, 2043

orbital atherectomy and shockwave lithotripsy,

A11

restenosis after, 2044

risks of, 2043–2044

saphenous vein graft with distal protection,

2067, A11

stent thrombosis in proximal LAD lesion

following, A11

in unprotected left main coronary artery, A11

steerable guidewire in, 2066

for STEMI

NSTE-ACS, 2051f, A11

rescue, 2060

STEMI. See ST-segment elevation myocardial

infarction (STEMI), treatment of

time from symptom onset to, 2059

urgent, 2060

STEMI related to, 2067

success of, 2067, 2068f

techniques for, 2066–2067

transluminal coronary angioplasty, 2066

for valvular heart disease, 2069–2070

Percutaneous interventions

for carotid atherosclerosis, 3347

for cerebral vasospasm, 3356, 3356f

coronary. See Percutaneous coronary

interventions (PCI)

for gastrostomy tube placement, 2396

for ischemic stroke, 3337–3338

mechanical thrombectomy, 2111, 3338, A11

peripheral artery, 2070, 2071f, 2109–2110

for pulmonary embolism, 2070

for refractory hypertension, 2070

transluminal renal angioplasty, 2078

Percutaneous transhepatic cholangiogram, 2647,

2651t

Percutaneous umbilical blood sampling (PUBS),

3660

Perennial nonallergic rhinitis, 2724

Perennial nonallergic rhinitis with eosinophilia

syndrome (NARES), 2724

Perfringolysin, 1223

Perfusion magnetic resonance imaging, 3290

Pergamino virus, 1629t

Pergolide, 2114, 3590t

Perianal disease. See Anorectal disorders

Periapical disease, 256, 1351

Periappendicitis, 1088

Peribunyaviruses, 1630, 1637

Pericardial effusion

after cardiac injury, 2029

cardiac imaging in, 1851–1854, 1854f

chronic, 2023–2024

in Churg-Strauss syndrome, A14

ECG in, 1830, 1831f

echocardiography in, 2021f, A9

etiology of, 1851

malignant, 489, 566–567

in pericarditis, 2020

physical examination in, 1822

tuberculous, 2025

Pericardial friction rub

in pericarditis, 1822, 2020

in STEMI, 2054, 2064

Pericardial knock, 321

Pericardial tamponade, 566–567, 1823

Pericardiocentesis, 2022–2023

Pericarditis, 2019

abdominal pain in, 110, 111t

acute

clinical features of, 2019–2020, 2033, 2054,

2064

CMR in, 2021f, A9

differential diagnosis of, 2023

ECG in, 105, 2020, 2020f, A7

echocardiography in, 2020–2021, 2021f

postcardiac injury, 2023

treatment of, 2021

viral/idiopathic, 2023

cardiac tamponade in. See Cardiac tamponade

chest pain in, 101t, 102, 104, 2019

in CKD, 2023, 2316

classification of, 2019t

in collagen vascular disease, 2023

constrictive

clinical features of, 2022t, 2024

CMR in, 1855f, 1859v, A9

differential diagnosis of, 1861, 1863t, 2021,

2022t, 2024

dyspnea in, 264, 265t

ECG in, 2022t, 2024

echocardiography in, 2022t, 2024

hemodynamic profile in, 2024

pathophysiology of, 2022f, 2024

pulse pressure in, 2024

treatment of, 2024–2025

differential diagnosis of, 2023

etiology of, 2019t

infectious causes of, 1337, 1519, 1604, 2023

in neoplastic disease, 2023

pericardial effusion in, 2020, 2021f

pericardial friction rub in, 1823, 2020

pyogenic, 2023

radiation-induced, 532, 567, 737, 2023

recurrent, 2023

in rheumatoid arthritis, 2753

in SLE, 2023, 2743

in STEMI, 2064

subacute effusive-constrictive, 2025

tuberculous, 1366, 2023, 2025

Pericardium

congenital defects of, 2019

metastases to, 567

structure and function of, 2019

Pericytes, 1801, 1801f

Perihepatitis (Fitz-Hugh-Curtis syndrome),

1087–1088, 1447

Perihilar cholangiocarcinoma, 653f, 656

Perilymphatic fistula, 241

Perimenopause, 3043–3044, 3043f

Perineal descent, 299f, 308

Perinephric abscess, 1060

Perinuclear ANCA (pANCA), 2803

Periodic acid–Schiff stain, 380, S11

Periodic fever with aphthous stomatitis,

pharyngitis, and cervical adenitis

(PFAPA), 2678t, 2843

Periodic hypothermia syndrome, 2906

Periodic leg movement disorder, 3408

Periodic limb movement disorder, 212

Periodic paralysis

hyperkalemic, 353, 3519, 3530, 3667t

hypokalemic. See Hypokalemic periodic

paralysis (HypoKPP)

thyrotoxic, 3530

Periodontal disease (periodontitis)

abscess in, 1351

AIDS-related, 256

clinical features of, 256, A3

in Ehlers-Danlos syndrome, 3227

etiology of, 256, 1351

localized juvenile, 256

in older adults, 262

prevention of, 256, 450

rheumatoid arthritis and, 2755

risk factors for, 256

Periodontium, 256

Periostitis, in lung cancer, 599

Peripartum cardiomyopathy, 1963, 3764

Peripharyngeal space infections, 1351

Peripheral artery disease, 2107

cardiovascular disease and, 925,

2108–2109

clinical features of, 2108

cyanosis in, 274

diagnosis of, 1818–1819, 1820f, 2108–2109,

2108f

hypertension and, 2076

pathophysiology of, 2107–2108

preoperative risk assessment in, 2110

prognosis of, 2108–2109

treatment of

exercise program, 2109

pharmacologic, 2109

revascularization, 2070, 2071f, 2109–2110

Peripheral artery pulses, 1818

Peripheral blood smear, 424. See also specific

disorders

Howell-Jolly bodies in. See Howell-Jolly

bodies

normal, 426f, 430f, 433f, 904f

red cell defects on, 432–433

red cell fragmentation on, 434f

reticulocytes in, 426f, 435f

spur cells in, 435f

target cells in, 428f, 434f

Peripheral clocks, 3801t

Peripheral cyanosis, 274–275, 274t, 1815. See also

Cyanosis

Peripherally inserted central catheter (PICC),

2097–2098

Peripheral nerve(s)

components of, 91f

cutaneous fields of, 171f

hyperexcitability, 733, 735–736

pain mechanisms, 93–94

INDEX

I-170 Peripheral neuropathy, 3480. See also Plexopathies;

Polyneuropathy

in acute intermittent porphyria, 3243

in alcohol use disorders, 3558

in amyloidosis, 3488. See also Amyloidosis

approach to, 3480, 3480f

electrodiagnostic studies in, 3482, 3482t

key questions in, 3480–3482, 3481t

laboratory studies in, 3482–3483

nerve biopsy in, 3483

pattern recognition in, 3481t, 3482

skin biopsy in, 3483

autonomic dysfunction and, 3433

in celiac disease, 3489–3490

in chronic liver disease, 3490

in CKD, 2317, 3490

in CMV infections, 3491

in COVID-19 disease, 3491

critical illness polyneuropathy, 2276, 3490

cryptogenic sensory and sensorimotor

polyneuropathy, 3497

in diabetes mellitus. See Diabetic neuropathy

in diphtheria, 1205, 3490–3491

drug-induced/toxic, 3492, 3494–3495t

amiodarone, 3492

antiretrovirals, 3493

arsenic, 3496

cancer chemotherapy, 711, 711t, 3492, 3493t

chloroquine, 3492

colchicine, 3492

hexacarbons, 3493

hydroxychloroquine, 3492

isoniazid, 3493

lead, 3493

mercury, 3495

pyridoxine, 3493

thalidomide, 3492

thallium, 3495–3496

in EBV infections, 3491

in hepatitis, 3491

hereditary, 3483, 3484–3485t, 3486t

adrenoleukodystrophy. See

Adrenoleukodystrophy

adrenomyeloneuropathy, 3486–3487

Charcot-Marie-Tooth disease. See CharcotMarie-Tooth (CMT) disease

in Fabry disease, 3486. See also Fabry disease

familial amyloid polyneuropathy, 3487–3488

hereditary neuralgic amyotrophy, 3486

hereditary neuropathy with liability to

pressure palsies, 3486

hereditary sensory and autonomic neuropathy,

3486

in porphyria, 3487. See also Porphyria(s)

Refsum’s disease, 227, 3487

Tangier disease, 1816, 3139t, 3146, 3487

in herpes zoster, 3491

in HIV infection, 1579–1580, 3491

in hypereosinophilic syndrome, 3489

in hypothyroidism, 3489

in IBD, 3490

in leprosy, 1388–1389, 3490

in Lyme disease, 3412, 3490

in malabsorption disorders, 2468t

malignancy-related, 3491–3492

in mixed connective tissue disease, 3490

mononeuropathies, 3497–3498

in nutritional deficiencies, 768–769, 3496–3497

paraneoplastic, 734–735

plexopathies, 3498–3500

in pregnancy, 3767

radiculopathies, 3498, 3499t

in rheumatoid arthritis, 3489

in sarcoidosis, 3489

in Sjögren’s syndrome, 3489

in SLE, 3489

in systemic sclerosis, 3489

weakness in, 167, 168, 3481, 3481t

Peripheral node addressin (PNad), 2699

Peripheral sensitization, 91

Peripheral synovitis, 2791

Peripheral T-cell lymphoma, 844t, 845, 850

Peripheral tolerance, 2705, 2706t

Peripherin, 227

Periplasmic space, 1148

Peristalsis, 288

Peristaltic sounds, 111

Perisylvian network, 196

Peritoneal carcinomatosis, 322–323, 322f, 720

Peritoneal dialysis

access for, 2323–2324, 2377

complications of, 2324

continuous ambulatory, 1056–1057, 2308, 2323

continuous cyclic, 2321, 2323

dose for, 2324

for hypercalcemia, 3185

principles of, 2323

solutions for, 2323

Peritoneal equilibrium test, 2324

Peritoneal inflammation, 108–109

Peritoneal lavage, as rewarming strategy, 3633

Peritoneal papillary serous carcinoma, 720

Peritoneovenous shunt, 489

Peritonitis, 1054, 2516

abdominal pain in, 108–109, 111, 111t, 1054–1055

acute, 2516

ascites and, 324, 2632

aseptic, 2516

clinical features of, 324, 1054–1055, 2516

diagnosis of, 1055, 1055f

etiology of, 1054, 1266, 2516, 2516t

hypovolemia in, 341

pathophysiology of, 1054, 1054f

in peritoneal dialysis, 1056–1057, 2324

postoperative, 1056

prevention of, 1055

primary (spontaneous bacterial), 324,

1054–1055, 2516, 2632

prognosis of, 1054, 2516

recurrence of, 1055, 1162t

secondary, 324, 1056, 2516

spontaneous bacterial, 324, 2632

in transplant recipient, 1141t, 1145

treatment of, 1054–1055, 1056, 2516

tuberculous, 1366

tumor markers in, 487t

Peritonsillar abscess, 255, 1351

Periventricular (diffuse) white matter disease

(leukoaraiosis), 3343

Perkinsus marinus, 1003

Perleche, 372f, 381

Permanent junctional reciprocating tachycardia,

1897

Permethrin, 3608, 3611

Permissive underfeeding, 2539

Pernicious anemia

APS-1 and, 2994t

APS-2 and, 2994t, 2995t

autoantibodies in, 2696t, 2995t

cobalamin absorption in, 771

diagnosis of, 771

gastritis in, 2457

juvenile, 771

oral manifestations of, 257

Pernio (chilblains), 2113f, 2114, 3634, 3635

Peroneal neuropathy, 3498

Peroral endoscopic myotomy (POEM), 2396, 2397f

Peroral endoscopic tumorectomy (POET), 2396, 2398f

Peroxisomal catalase, 2625

Peroxisome proliferator-activated receptor γ

(PPARγ), 2482, 3112

Perphenazine, 3555t, 3556

PERRLA, 216

Persistent light reaction, 422

Persistent müllerian duct syndrome, 3004

Persistent vegetative state, 183, 189

Personality disorders, 3553

Personalized medicine. See Precision medicine

Personalized (precision) medicine, 507, 3639, 3658

Person-centered care, of older adults, 3741, 3742t

Persons who inject drugs (PWID)

Candida infections in, 1044

endocarditis in, 1023–1024, 1025, 1033, 1182

HIV infection in, 1533t, 1534, 1596, 3573

tetanus in, 1212

wound botulism in, 1215

Pertactin, 1257, 1261

Perthes test, 2116

Pertussis, 1257

clinical features of, 1259–1260, 1259t

complications of, 1260

diagnosis of, 1260

differential diagnosis of, 1260

epidemiology of, 1258–1259, 1258f, 1259f

global considerations in, 1258, 1258f

immune response in, 1259

infection control measures, 1260–1261

pathogenesis of, 1259

prevention of, 1261

treatment of, 1260, 1261t

Pertussis toxin, 1257, 1259

Pertussis vaccine, 1259, 1261. See also Tetanus,

diphtheria, acellular pertussis (Tdap)

vaccine

Pertuzumab

actions and targets of, 512, 514t, 537

adverse effects of, 537, 622, 742

for breast cancer, 613t, 621, 625

PET. See Positron emission tomography (PET)

Petechiae. See also Purpura

in anemia, 432

in coma, 185

etiology of, 1229t

in fat embolism, 399

in meningococcemia, 976, 1229

in Rocky Mountain spotted fever, 1433, 1433f

Petrous bone fractures, 3459

Peutz-Jeghers syndrome

gastrointestinal carcinoma in, 630, 635

lesions associated with, 638t

oral manifestations of, 260t

ovarian sex cord tumors in, 697

pancreatic cancer in, 658t

polyp distribution in, 638t

skin manifestations of, 390

Pexidartinib, 548t

Peyer’s patches

in immune-mediated damage, 2699

in Salmonella infections, 1292, 1293

in yersiniosis, 1326

Peyote, 3576

PF-4 (platelet factor 4), 906, 929, 2684t

PFA-100, 455, 457

PFAPA (periodic fever with aphthous stomatitis,

pharyngitis, and cervical adenitis), 2678t,

2843

INDEX

Pfeiffer’s syndrome (acrocephalopolysyndactyly), I-171

3649

PGD (primary graft dysfunction), 2213

P gene mutations, 386

3-PGHD (phosphoglycerate dehydrogenase)

deficiency, 3269t

PGL-1 (phenolic glycolipid), 1382, 1388

P-glycoprotein (PGP), 466, 467t, 470f, 519, 553

pH

arterial, 359

esophageal, 295

urine, 2369

Phaeohyphomycoses, 1653t, 1688–1689, 1689t

Phagocyte(s). See also Neutrophil(s)

mononuclear. See Monocyte(s)

in primary immune deficiency diseases, 2710,

2710f

in sepsis/septic shock, 2244

in vitro tests of, 449

Phagocyte activation defects, 446t, 447

Phagocytosis, 1360

Phagophobia, 287

Phalen’s sign, 2849, 3498

Phantom pain

limb, 3820, 3821f

oral, 259

Pharmaceutical companies, physicians’

relationships with, 71

Pharmacodynamics

of antibacterial drugs, 1150, 1150f

definition of, 465

genetic considerations in, 478–479

interactions in, 471t

principles of, 469

Pharmacogenes, 474, 475t

Pharmacogenetics, 465, 3639

candidate gene studies in, 475

in clinical practice, 479

drug development and, 479–480

of platelet inhibitors, 921–922, 922t

Pharmacogenomics, 474

in clinical practice, 3660, 3668

definition of, 474, 3641

genome-wide association studies in, 475,

476–477t

Pharmacokinetics, 465, 466

absorption, 466, 1150

of antibacterial drugs, 1150, 1150f

distribution, 467–468, 1150

elimination/excretion, 468, 1150

genetic variants affecting, 475

high-risk, 468–469

interactions in, 471t

metabolism, 468, 1150

Pharmacology, 465

clinical, 465

diseases affecting drug concentration and

response, 470–471

genetic determinants of response to drugs,

474–475

global considerations in, 465

Pharmacometabolomics, 3835

Pharyngitis

arcanobacterial, 135t, 1208

C. imitans, 1208

clinical features of, 253, 253t

C. ulcerans, 1207

differential diagnosis of, 253, 253t, 1205

in diphtheria, 1204–1205, 1205f

ear pain in, 249

etiology of, 1190t

in GERD, 295

gonococcal, 254, 1237, 1240, 1240t

in infectious mononucleosis, 1483, 1484t

nonstreptococcal, 253t, 254

streptococcal

clinical features of, 253, 1190

complications of, 254, 1191

diagnosis of, 253–254, 253t, 1190

differential diagnosis of, 1486t

epidemiology of, 1190

treatment of, 254, 254t, 1190–1191,

1191t

vs. tularemia, 1317

viral, 1190t

clinical features of, 2280

coxsackievirus, 1605

Y. pestis, 1322

Phase response curve (PRC), 3801t, 3803

Phenacetin, 491t, 2362, 2364

Phenazopyridine, 1077, 3593t

Phencyclidine (PCP)

abuse of, 3576, 3577

actions of, 3540t

delirium and, 180

overdosage/poisoning with, 3584, 3588

Phendimetrazine, 3091

Phenelzine

adverse effects of, 3364, 3542t

for depression, 3542t

for migraine prevention, 3364

for new daily persistent headache, 116

overdosage/poisoning with, 3590t

Phenformin, 467t, 771t

Phenobarbital

adverse effects of, 318, 382, 412, 3319t

drug interactions of, 472, 1703t, 1705t, 1706t,

2637, 3319t

overdosage/poisoning with, 3592t

for seizures, 3319t, 3320

Phenocopy, 477, 3650

Phenol exposure, 315

Phenolic glycolipid (PGL-1), 1382, 1388

Phenolphthalein, 412

Phenothiazines

for acute intermittent porphyria, 3244

adverse effects of

cardiac, 1875t

cutaneous, 379, 409, 422t

heat-related illness, 3635

ocular, 227

orthostatic hypotension, 156

for dyspnea, 81

for nausea and vomiting, 554

overdose/poisoning with, 3584

Phenotoxicity, 3686t

Phenotype, 3649

convergent, 31, 32f

divergent, 31, 32f

oversimplification of, 30

in precision medicine, 32–33, 36

sex-influenced, 3651

Phenotypic heterogeneity, 3649, 3650t

Phenotypic sex, 2997f, 2999, 3000f

Phenoxybenzamine

for bladder dysfunction, 3474

for frostbite, 3634t

for hypertension, 2083t, 2979

Phentermine, 3091, 3155

Phentermine/topiramate (PHEN/TPM), 3091–

3092, 3092t, 3155

Phentolamine

for adrenergic crisis, 2087

for cocaine intoxication, 3576

for high-altitude pulmonary edema, 3620

for hypertension, 2979

for hypertensive emergencies, 2087, 2087t

for Irukandji syndrome, 3603

for nerve agent exposure, S4

for sympathomimetic overdosage/poisoning,

3590t

Phenuiviruses, 1630

Phenylacetate, 3273

Phenylalanine metabolism disorders,

3269t

Phenylbutazones, 471t, 810

Phenylbutyrate, 3415

Phenylephrine

for allergic rhinitis, 2725

overdosage/poisoning with, 3590t

for sepsis/septic shock, 2248

Phenylketonuria, 3269t, 3271, 3651

Phenylpropanolamine, 3590t

Phenytoin

adverse effects of, 3488t

cross-sensitivity and, 416

cutaneous, 382, 384, 391, 393

fever, 147

folate deficiency, 773, 773t

gingival hyperplasia, 257

hepatotoxicity, 2584

hirsutism, 3039

hypersensitivity, 412. See also Drug-induced

hypersensitivity syndrome (DIHS)

hypertrichosis, 410

in kidney disease, 470

long-term, 3317

lupus syndrome, 2695, 2847t

neurologic, 3319t, 3494t

osteopenia, 2847t

SJS/TEN, 414. See also Stevens-Johnson

syndrome (SJS); Toxic epidermal

necrolysis (TEN)

systemic, 3319t

thrombocytopenia, 905t

vasculitis, 2816

drug interactions of, 471t, 571

acetaminophen, 472

azoles, 1703t

cyclosporine, 471t, 2637

fluoxetine, 3319t

glipizide, 467t

isoniazid, 1400

losartan, 471t

methadone, 471t

oral contraceptives, 471t

PPIs, 2444

quinidine, 471t, 1706t

rifampin, 1401

rufinamide, 3319t

sulfonamides, 1704t, 3319t

tacrolimus, 2637

TMP-SMX, 1155t

warfarin, 469, 471t

genetic variations in response to, 476t,

477t, 478

metabolism of, 467t

for neuropathy, 3488t

overdosage/poisoning with, 3592t

for pain, 98, 3474

for paroxysmal symptoms in MS, 3474

pharmacology of, 3317, 3319t

for seizures, 3317, 3319t

for seizures from CNS metastases, 571

for status epilepticus, 2224, 3322f

for trigeminal neuralgia, 3438

INDEX

I-172 Pheochromocytoma, 2976

clinical features of, 2976

cardiac, 287, 1965

by frequency of occurrence, 2977t

hypertension, 2073, 2080t

orthostatic hypotension, 2073

paraneoplastic syndromes, 724

sympathetic overactivity, 2990, 3435

definition of, 2976

diagnosis of, 2976, 2989f, 2990

biochemical testing, 2976–2977, 2977t

imaging, 2977–2978, 2977t, 2978f, 2979f

pathology, 2967, 2978, 2980f

differential diagnosis of, 2978

epidemiology of, 2976

etiology of, 2976

familial, 2079, 2980

genetic considerations in, 2976

mutation distribution, 2981–2982, 2981t,

2982f

RET gene mutations, 2080t

malignant, 2979–2980

in MEN syndromes, 2079, 2080t, 2980, 2990

in neurofibromatosis, 2079, 2080t, 2980, 2991

in paraganglioma syndromes, 2980

pathogenesis of, 2976, 2977f

in pregnancy, 2980

treatment of, 2079, 2978–2979, 2990

tumor markers in, 487t

in von Hippel-Lindau syndrome, 2980

Pheomelanin, 418, 420

PHEX gene mutations, 3161

PHI (Prostate Health Index), 683

Philadelphia chromosome

in ALL, 828, 832–833, 832t

in CML, 500–501, 501f, 818–819, 819f, 821, 821t

drug response and, 477t, 479

PHKA1 gene mutations, 3266

PHKG1 gene mutations, 3266

Phlebectasia corona, 2116

Phlebotomy

for erythrocytosis, 726

for hemochromatosis, 3234

for polycythemia, 439, 804

for porphyria cutanea tarda, 423, 3245

Phleboviruses, 1629t, 1630

Phlebovirus infections

Punta Toro virus, 1629t, 1640

Rift Valley fever, 978, 1008, 1008f, 1643

sandfly fever, 1629t, 1640

severe fever with thrombocytopenia syndrome,

1625t, 1643

Toscana virus, 1094, 1629t

Ph-like ALL, 829–830, 832t

Phobic disorders, 3544

Phonemic paraphasia, 196, 197

Phoneutria spp., 3613

Phonic tics, 3406

Phonological loop, 196

Phosgene, 2171t, S4

Phosphate crystals, in urine, A4

Phosphate nephropathy, 2360, A4

Phosphate/phosphorus

adverse effects of, 357

deficiency of. See Hypophosphatemia

for diabetic ketoacidosis, S1

excess of. See Hyperphosphatemia

homeostasis of, 2293

for hypercalcemia, 357, 723, 3184t, 3185

metabolism of, 3160–3161

recommended intake of, 2520t

renal tubular transport of, 2290f, 2293

tolerable upper intake level of, 2533t

toxicity of, 2533t

Phosphatidylinositol-3-kinase (PI3K), 515, 3099

Phosphatonin, ectopic production of, 722t

Phosphodiesterase type 3 inhibitors, 2256

Phosphodiesterase type 4 inhibitors, 375, 378, 378t

Phosphodiesterase type 5 inhibitors

actions of, 472, 3056, 3056f, 3057f

adverse effects of, 3060t

characteristics of, 3060t

contraindications to, 3060t

drug interactions of

nitrates, 2048, 2057, 3060

tamsulosin, 689

for erectile dysfunction, 3056, 3060t

for high-altitude pulmonary edema, 3620

for lower urinary tract symptoms, 689, 3075

for pulmonary arterial hypertension, 2128,

2129t, 2786

for Raynaud’s phenomenon, 2114, 2785

Phosphofructokinase deficiency (type VII GSD,

Tarui disease), 781t, 3263t, 3528

Phosphoglycerate dehydrogenase (3-PGHD)

deficiency, 3269t

Phosphoglycerate kinase deficiency (type X GSD),

781t, 3263t, 3528

Phosphoglycerate mutase deficiency, 3263t

Phospholamban, 1806, 1806f, 1956t

Phospholipase A2

, 133, 418t

Phospholipase Cγ2, 2704t

Phospholipids, 2749. See also Antiphospholipid

antibodies

Phospholipid transfer protein (PLTP), 3137

Phosphoribosylpyrophosphate (PRPP), 3250

Phosphoribosylpyrophosphate (PRPP) synthetase

overactivity, 3251t, 3253

Phosphorus-32 exposure, S5

Phosphorylase kinase deficiency (type IX

glycogenosis), 2292t

Phosphorylase kinase deficiency (type IX GSD),

3263t, 3266

Phosphorylation, histone, 3791

Photoaging, 419

Photoallergy, 422, 422t

Photochemotherapy, 421, 424

Photodynamic therapy

actions of, 418

for basal cell carcinoma, 588

for esophageal cancer, 629

Photoimmunology, 420–421

Photon, 531

Photopatch testing, 422

Photoproducts, 418

Photoprotection, 423–424, 424t. See also

Sunscreen(s)

Photopsia, 224, 227

Photoreceptors, 215

Photosensitivity diseases, 421

classification of, 421t

diagnosis of, 421, 423f

drug-induced, 409–410, 421–422, 422t

management of, 422, 423f

polymorphous light eruption, 396, 421

porphyrias. See Porphyria(s)

Photosensitizer, 422, 423

Phototest procedures, 422

Phototherapy. See also PUVA photochemotherapy

actions of, 424

adverse effects of, 424

for atopic dermatitis, 385t

for cancer treatment, 532

for delayed sleep-wake phase disorder, 213

for morphea, 407

for neonatal jaundice, 2558

for pityriasis rosea, 379

for psoriasis, 378, 385t

for psoriatic arthritis, 2800

for shift-work disorder, 214

for vitiligo, 389t

Phototoxic eruptions, 391

Phototoxicity, 421–422, 422t. See also

Photosensitivity diseases

PHP. See Pseudohypoparathyroidism (PHP)

PHQ-2 (Patient Health Questionnaire-2)

Depression Screen, S7

Phrygian cap, 2643

Phthalocyanines, 532

Phthisis. See Tuberculosis (TB)

Phylloquinone, 2532. See also Vitamin K

Physical abuse, 3758t

Physical activity. See Exercise/physical activity

Physical Activity Guidelines for Americans, 11, 12t

Physical examination, 1–2, 37, 39t

Physical restraints, in delirium, 84, 178, 182

Physical therapy, 120, 162t

Physician. See also Medical practice

brain drain, 3709

as citizen, 7–8

claims of conscience by, 70

conflicts of interest for, 70–71

continuing education for, 7

errors of, 4, 51, 71

as gatekeeper, 70

humanistic qualities of, 5–6

impaired, 71

moral distress of, 70

oaths and codes of, 70

occupational risks of, 70

personal values of, 70

research and teaching by, 8

social media use by, 70

as student, 7

trainee, ethical issues for, 71

virtue ethics and, 69

work hours of, 214

working hours of, 7, 51

Physician-assisted suicide, 87, 87t

Physician-induced demand, 24

Physician Orders for Life-Sustaining Treatment

(POLST), 77

Physician-patient relationship, 2, 5–6, 63–64, 64f

Physostigmine

for anticholinergic overdose, 188, 3586, 3590t

for belladonna alkaloid overdose, 3590t

for mushroom/plant poisoning, 3591t

overdosage/poisoning with, 3592t

PI3K, 511, 552, 699

PI3K/AKT pathway

in cancer, 511, 519

in head and neck cancer, 590

in hepatocellular carcinoma, 645

in melanoma, 582–583

PI3K inhibitors, 550t, 552, 553, 738t, 742, 839

PI3Kδ, 2704t

Pian. See Yaws

Pibrentasvir/glecaprevir, 1468t, 1469, 2611

Pica, 3552

PICALM gene mutations, 3373–3374

PICC (peripherally inserted central catheter),

2097–2098

Pick’s disease, 3379, 3380f, 3381f

Picobirnaviruses, 1598f, 1601

Picornaviruses

enteroviruses, 1506, 1507

INDEX

name changes in, 1506, 1507t I-173

parechoviruses, 1094, 1507

replication strategies of, 1455–1456

rhinoviruses, 1506. See also Rhinovirus

infections

structure of, 1454t, 1455f

treatment of, 1464

“Picture frame” vertebra, 3211

PID. See Pelvic inflammatory disease (PID)

Piebaldism, 388, 389t

PIEZO1 gene mutations, 779t, 780–781

PIG-A gene mutations, 794

Pigbel (enteritis necroticans), 1221, 1222

Pigeon chest (pectus carinatum), 1816, 3229

Pigmented pretibial papules, 3128

Pigmented villonodular synovitis (PVNS), 2877,

2877f

Pigment stones, 2644–2645, 2644t

PIK3CA gene mutations, 500t

in breast cancer, 613t, 623, 3838

in Cowden’s syndrome, 2984t, 2992

in lung cancer, 596, 596f, 597, 597t

in ovarian cancer, 695

PIK3CA pathway, 505t

Pili (fimbriae), bacterial, 949–950, 950t

of B. Pertussis, 1257

E. coli, 949–950

of enterococci, 1198

of Neisseria spp., 950

of N. gonorrhoeae, 1235

of P. aeruginosa, 1285, 1285t

of S. pneumoniae, 1170f

type IV, 950

Pill esophagitis, 290, 295, 2433

Pilocarpine

for acute angle-closure glaucoma, 221

in diagnosis of tonic pupil, 217

for oral dryness, 237

overdosage/poisoning with, 3592t

for sicca symptoms, 2789

for xerostomia, 261

Pilocytic astrocytoma, 703

Pilosebaceous unit, 3039

Pimavanserin, 3386, 3398, 3555t

Pimecrolimus, 375, 385t

Pimozide, 1703t, 3615

Pinch purpura, 395

Pindolol, 2040t, 3543, 3544, 3591t

Pineal gland, 3802

Pineal region tumors, 706

Pinguecula, 219

PINK1 gene mutations, 3297, 3391t, 3392

“Pink puffers,” 2185

Pinna. See Ear

Pinta, 1414t, 1416, 1416f

Pintides, 1416

Pinworm. See Baylisascaris procyonis infections;

Enterobius vermicularis/enterobiasis

Pioglitazone, 677, 2529, 2623, 3110t, 3112

Piperacillin, 905t, 1153, 2499

Piperacillin-tazobactam

for actinomycosis, 1343t

for anaerobic bacterial infections, 1355t

for community-acquired pneumonia, 1014t

for febrile neutropenia, 563

for gram-negative bacterial infection, 1264

for hospital-acquired pneumonia, 947t

indications for, 1153, 1156t

for intraabdominal infections, 947t

for osteomyelitis, 1049t, 1050t

for P. aeruginosa infections, 1287t

for peritonitis, 1055, 1056

for pyelonephritis, 1077

resistance to, 1156t, 1271, 1355t, 1356

for septic shock, 947t, 975t, 2248t

for ventilator-associated pneumonia, 1018t

Piperaquine, 1702t, 1711, 1732t, 1736f

Piperazine, 1706t, 1711

Piracetam, 3407

Piranha bite-wound, 1125, 1127t

Pirfenidone, 2193, 2196

Piroxicam, 402, 422t, 492

Piry virus, 1630t

Pit-1 (PIT-1)

in anterior pituitary development, 2892, 2892t, 2896

in congenital hypothyroidism, 2934t

in growth hormone deficiency, 2899

Pitavastatin, 3142t. See also Statins

Pitolisant, 210

Pitting, 460

Pitting edema, 276, 1816. See also Edema

Pituitary apoplexy, 227, 2897, 2971t

Pituitary axes, 2893f

Pituitary disorders

anterior

insufficiency. See Hypopituitarism

tumors. See Pituitary tumors (adenomas)

IgG4-related, 2838t

posterior

diabetes insipidus. See Diabetes insipidus (DI)

hypodipsic hypernatremia. See Hypodipsic

hypernatremia

Pituitary gland

anatomy of, 2891–2892

development of, 2892, 2892t

dysplasia, 2896

hormones produced by. See Pituitary hormones

insufficiency of. See Hypopituitarism

tests of function of, 2898t

Pituitary hormones, 2891. See also specific types

expression and regulation of, 2892t, 2918

in ovarian function regulation, 3028–3029, 3029f

secretion of, 2891, 2893f

Pituitary snuff taker’s lung, 2160t

Pituitary tumors (adenomas), 2907

ACTH-producing. See Cushing’s disease

aggressive, 2918

classification of, 2907, 2907t

clinical features of, 2902, 2902t, 2987

etiology of, 2907–2908

familial syndromes of, 2908, 2908t, 2988

gonadotropin-producing, 2904t, 2916–2917

histologic evaluation in, 2904

hormone-excess syndromes due to, 2907–2908

hypogonadotropic hypogonadism and, 3016

laboratory investigation of, 2904, 2904t

local mass effects of, 2902, 2903f

in MEN 1, 2908, 2908t, 2984t, 2987

metastatic, 2907

MRI in, 2903–2904, 2904f, 2906f, A16

nonfunctioning, 2916–2917

ocular signs in, 218, 227

pathogenesis of, 2907–2908

secondary adrenal insufficiency and, 2971t

treatment of, 2904–2906, 2905f, 2987

TSH–secreting, 2904t, 2917–2918, 2943

Pit viper bite, 3596, 3600t, 3601

Pityriasis rosea, 379

clinical features of, 377t

distribution, 370t, 372f, 377t

lesion characteristics, 379

morphology, 370t

papulosquamous lesions, 383

patches on trunk, 379f, A5

differential diagnosis of, 141

drug-induced, 383

histologic features of, 377t

treatment of, 379

Pityriasis rubra pilaris, 385t

Pityriasis versicolor. See Tinea versicolor

Pivmecillinam, 1075, 1076, 1076t, 1301t

Pizotifen, 3365t

PKCδ (protein kinase Cδ) deficiency, 2704t

PKD (paroxysmal kinesigenic dyskinesia), 3408

PKD gene mutations, 2350

PKHD1 gene mutations, 2353–2354

Placebo effect, 93, 93f

Plague, 1320

in bioterrorism, 1320, S3

bubonic, 1322, 1322f, S3

case definitions of, 1323t

clinical features of, 1037, 1322, 1322f, S3

diagnosis of, 1322–1324, 1323f, 1323t, S3

epidemiology of, 1008f, 1320–1321, 1320f

etiology of, 1320. See also Yersinia pestis

global considerations in, 1320, 1320f

multidrug-resistant, S3

pathogenesis of, 1321

pneumonic, 976, 1322, 1323f, S3

prevention of, 1324–1325, 1325t, S3

septicemic, 1322, S3

treatment of, 1324, 1324t, S3

Plague vaccine, 1325, S3

PLAID (PLCγ-associated antibody deficiency and

immune dysregulation), 2718

Plan-Do-Check-Act cycle, 52, 53f

Plantar fasciitis, 2880

Plantar reflex, 3281

Plantar warts, 381

Plant-based diets, 3731, 3732f

Plaque

atherosclerotic. See Atherosclerosis, pathogenesis

of

dental, 256, 1351, A3

microbiota of, 3693f

neuritic, in AD, 3372, 3372f

Plaque (skin lesion), 133, 369t, 370f

Plasma

clinical uses, 889t

collection and manufacturing processes, 886t

fresh-frozen, 915, 917, 918, 3351

Plasma cell(s), A6

Plasma cell disorders, 866

acid-base disorders in, 360

amyloidosis. See Amyloidosis

genetic considerations in, 866, 867f

heavy chain diseases, 877

multiple myeloma. See Multiple myeloma

paraproteinemia in, 454

pathophysiology of, 866–867, 868f

POEMS syndrome. See POEMS syndrome

(Crow-Fukase syndrome)

proteinuria in, 336

Waldenström’s macroglobulinemia. See

Waldenström’s macroglobulinemia

Plasma cell leukemia, 872

Plasmacytic lymphoma of the oral cavity, 1583

Plasmacytoid 1 dendritic cells, 2676, 2679t. See also

Dendritic cells

Plasmacytoma, 871, 871t, 873

Plasma exchange/plasmapheresis

for chronic inflammatory demyelinating

polyneuropathy, 3507

efficacy evaluation of, 889t

for Guillain-Barré syndrome, 3504

for hemolytic-uremic syndrome, 2365