topics

11/9/25

INDEX

Prosthetic joint infections I-183

classification of, 1051

clinical features of, 1045, 1051, 1051f

dental procedures and, 262

diagnosis of, 1045, 1051

enterococcal, 1200

epidemiology of, 1051

global considerations in, 1052

gram-negative bacteria in, 1249

microbiology of, 1051

pathogenesis of, 1050

prevention of, 1052

treatment of, 1045, 1050t, 1051

Prosthetic valve endocarditis (PVE)

diagnosis of, 1025, 1026

etiology of, 1023, 1023t

incidence of, 1023, 1023t

late-onset, 1025

staphylococcal, 1183, 1185

in transcatheter implanted aortic valve. See

Transcatheter aortic valve implantation

(TAVI)

treatment of, 1028, 1029–1030t, 1030–1031,

1032, 1187

Protamine sulfate, 930, 2099

Protease activation receptor 1 (PAR1), 921

Protease inhibitors. See Combination antiretroviral

therapy (cART)

Proteasome, 552, 2691

Proteasome inhibitors, 1964

Protein(s)

aggregation of, in neurologic disease, 3297–3298

digestion and absorption of, 2460

energy deficiency and, 2539

lipoprotein-associated, 3135

prion, 3416

quality control mechanisms. See Proteostasis

network

recommended intake of, 2521t

requirement for, 2517, 2539

secretory, 2694

serum binding, 2929

TAP, 2691

thyroid hormone binding, 2929

Proteinase 3, 2696t, 2803

Protein C, 452, 452f, 457

Protein-catabolic intensity, 2541

Protein C deficiency

DIC in, 915

high-altitude symptoms of, 3621

thrombosis risk in, 923

warfarin-induced skin necrosis in, 399, 410, 935

Protein-enhanced formulas, for enteral nutrition,

2542

Protein folding disorders

with aggregation propensity, 3850

aging and, 3848, 3848f, 3850

with enhanced misfolding, 3849. See also Cystic

fibrosis (CF)

infections and, 3850

proteostasis network and, 3846, 3847f

with secretion of aggregated protein, 3850. See

also Amyloidosis

stress and, 3850

with toxic aggregates and loss of function, 3849.

See also Mechanical ventilation

PSVT. See Paroxysmal supraventricular tachycardia

(PSVT)

Psychiatric/psychological disorders, 3540

abdominal pain in, 111t

in alcohol use disorder, 3558

anxiety disorders. See Anxiety disorders

biology of, 3534

bipolar disorder. See Bipolar disorder

in cancer survivors, 742–743

classification of, 3541

in cobalamin deficiency, 769

vs. dementia, 3378

depression. See Depression/depressive disorders

in displaced persons, 3731

fatigue in, 162

feeding and eating disorders, 3552

in fibromyalgia, 2868–2869

in folate deficiency, 769

gait disorders in, 176

genetic considerations in, 3535–3537, 3536f

global considerations in, 3541, 3712–3713

at high altitudes, 3621

IBS and, 2491

inflammatory mechanisms in, 3539–3540

insomnia in, 211

in military veterans, S7

mood disorders. See Mood disorders

movement disorders in, 3409–3410

INDEX

palpitations in, 287 I-185

personality disorders, 3553

prevalence of, 3540

primary care physician’s responsibility in, 13,

3540–3541

schizophrenia. See Schizophrenia

seizures in, 3316

sensory symptoms of, 173

signal transduction in, 3537–3538, 3538f

somatic symptom disorder, 3552

substance use and, 3577

syncope in, 129, 157–158

systems neuroscience of, 3538–3539, 3539f,

3540t

taste disorders in, 236

in Wilson’s disease, 2936

in women, 3067

Psychogenic amnesia, 3378

Psychogenic polydipsia, 2920, 2922

Psychosis(es). See also Schizophrenia

alcohol-induced, 3558

in Huntington’s disease, 3405

in PD, 3398

postictal, 3323

in SLE, 2741

THC-induced, 3568

Psychosocial short stature, 2899

Psychostimulants. See also specific substances

acute intoxication, 3576

adulteration of, 3574–3575

clinical effects of, 3540t, 3574

combined with other drugs, 3574

overdose of, 3574

prescribed use of, 82, 3574

withdrawal from, 3575

Psychostimulant use disorder, 3575, 3576

Psychotherapy

for depression, 3544

for panic disorder, 3543

for phobic disorders, 3545

for PTSD, 3546

referral for, 3540–3541

Psyllium, 2494, 2496t

PT. See Prothrombin time (PT)

PTCH gene mutations, 503t, 586

PTEN, 744f

PTEN gene mutations

in autism spectrum disorders, 3535

in brain tumors, 702, 703t

in breast cancer, 614, 3663

cancers associated with, 503t

in cervical cancer, 698

in Cowden’s syndrome, 395, 677, 2984t,

2992

in endometrial cancer, 699

genetic testing for, 3664

in hepatocellular carcinoma, 645

in lung cancer, 597t

in melanoma, 582–583

in ovarian cancer, 695

Pterygium, 219

PTGER4 gene mutations, 2472t

PTH. See Parathyroid hormone (PTH)

PTH(1-84), 3187

PTH gene mutations, 721, 3186

Pthiriasis palpebrum, 3611

Pthirus pubis (pubic lice), 3610–3611

PTH-related peptide, 356

PTHrP. See Parathyroid hormone–related protein

(PTHrP)

Ptosis, 228, 229, 1217

PTPN2 gene mutations, 2472, 2472t

PTPN11 gene mutations, 861

PTPN22 gene mutations, 2734, 2755

PTPS (6-pyruvoyl-tetrahydropterin synthase)

deficiency, 3269t

PTSD (posttraumatic stress disorder), 742–743,

3545–3546, 3545t, S7

Puberty

definition of, 3006

delayed. See Delayed puberty

female, 3031–3032, 3031t

male, 3006, 3006f

precocious. See Precocious puberty

Pubic lice (Pthirus pubis), 3610–3611

Puborectalis muscle, 299f

PUBS (percutaneous umbilical blood sampling),

3660

Pudendal nerve terminal motor latency,

2503

“Puff of smoke” lesion, 3343

Pulmonary abscess. See Lung abscess

Pulmonary angiography, 2097

Pulmonary arterial hypertension (PAH). See also

Pulmonary hypertension

in β thalassemia, 763t

in congenital heart disease, 2126

in connective tissue disease, 2126

diagnosis of, A9

familial, 3814, 3818t

future research needs in, 2128

genotypes of, 33

in HIV infection, 1567, 2126

idiopathic, 2126, A9

pathobiology of, 2121, 2121f, 2122t

pathophysiology of, 2121–2122, 2123f

portal hypertension and, 2126

in sarcoidosis, 2831

in sickle cell disease, 759t

in systemic sclerosis, 2126, 2773t, 2777, 2777f,

2781, 2786

systems biology applied to, 3814, 3818t

treatment of, 33, 2127–2128, 2129t

Pulmonary artery catheter, 1939, 2223, 2240, 2248,

2252, 2255

Pulmonary artery wedge pressure, 1817–1818, 2124

Pulmonary capillary wedge pressure, 2240, 2245,

2255

Pulmonary edema

acute, 1931

cardiogenic, 2255

chest radiography in, A12

cyanosis in, 274

diagnosis of, 2255

echocardiography in, 2255

hemodynamic patterns in, 2254t

hemoptysis and, 270

high-altitude. See High-altitude pulmonary

edema (HAPE)

in hyponatremia, 343

in malaria, 1725, 1733

noncardiogenic, 2255

pathophysiology of, 2136

physical examination in, 2132

reexpansion, 2256

treatment of, 2255–2256

in upper airway obstruction, 2256

Pulmonary embolism (PE), 2091

adequacy of ventilation in, 2136

after subarachnoid hemorrhage, 3356

chest pain in, 101t, 102

classification of, 2094

diagnosis of

blood tests, 2095

cardiac biomarkers, 2096

chest CT, 2096–2097, 2097f

chest radiograph, 106, 2096

clinical decision rules, 2095, 2095t

clinical evaluation, 2094–2095

clinical pearls, 2095

CT, A12

ECG, 105–106, 2096, 2096f, A7

echocardiography, 2097

imaging algorithms, 2095f, 2098f

lung scan, 2097

MRI, 2097

pulmonary angiography, 2097

Wells clinical prediction rule, 27t

differential diagnosis of, 2095t

dyspnea in, 266, 2095

epidemiology of, 922, 2091–2092, 2092f

hemoptysis in, 105, 270

in HIV infection, 1575

incidence of, 919

in mitral stenosis, 1992

mortality from, 2092, 2092f

nonthrombotic, 2095

palpitations in, 287

paraneoplastic, 726–727

pathophysiology of, 2093–2094, 2094f

pleural effusion in, 2198–2199

postmenopausal hormone therapy and, 3045,

3046t

in pregnancy, 3766

prevention of, 2100–2101, 2100t

readmission rate for, 2092

right ventricular dysfunction in, 1838, 2094

risk stratification in, 2098

septic, 1183, 1183f

treatment of

algorithm for, 2098f

anticoagulants, 2098–2099, 2099t

catheter-directed therapy, 2070, 2100

duration of anticoagulation, 2099, 2099t

emotional support, 2100

fibrinolysis, 2100

inferior vena cava filter, 2099

in massive PE, 2099–2100

pulmonary embolectomy, 2100

pulmonary thromboendarterectomy, 2100

ventilation-perfusion heterogeneity in, 2136

Pulmonary fibrosis

bleomycin-related, 739

bronchiectasis in, 2173, 2174, 2174t

chemotherapy-associated, 539, 542

in dyskeratosis congenita, 3682

idiopathic. See Idiopathic pulmonary fibrosis

as late consequence of cancer/cancer therapy, 739

pathophysiology of, 2136

pulmonary function values in, 2137, 2138f

radiation-induced, 532

rheumatoid arthritis, A12

in systemic sclerosis, 2776–2777, 2777f

telomere dysfunction and, 3682–3683, 3684f

treatment of, 739

Pulmonary function tests

in asthma, 2154

common abnormalities in, 2138f

in COPD, 2182, 2182t, 2185

in hypersensitivity pneumonitis, 2161

in interstitial lung disease, 2192

in occupational lung disease, 2166

in pulmonary hypertension, 2124

in respiratory disease evaluation, 2132–2133,

2172

Pulmonary heart disease. See Cor pulmonale

INDEX

I-186 Pulmonary hypertension, 2121

arterial. See Pulmonary arterial hypertension

chronic thromboembolic, 2124, 2126

classification of, 2124–2126, 2125f

clinical features of, 2122

chest pain, 101t, 102

dyspnea, 265t, 266, 2122

tricuspid regurgitation, 2122

diagnosis of, 2122–2124, 2125f

chest radiography, 2124f

CT, 2123

ECG, 2124f, A7

echocardiography, 2122, 2124f, A9

heart sounds, 284t, 1821f, 1822, 2122

pulmonary function tests, 2124

right heart catheterization, 2124

serology, 2124

sleep studies, 2124

vasoreactivity testing, 2124

ventilation-perfusion scan, 2123

high-altitude, 3622

in left heart disease, 2126

in lung disease, 2126

in mitral stenosis, 1992

pathobiology of, 2121, 2121f, 2122t

pathophysiology of, 2121–2122

in pregnancy, 3763

Raynaud’s phenomenon in, 2113–2114

in sarcoidosis, 2126–2127

in schistosomiasis, 2127

in sickle cell disease, 2127

thromboembolic, 2126

treatment of, 2127–2128, 2128f

Pulmonary infarction, 110, 2095

Pulmonary infiltrates with eosinophilia

ABPA. See Allergic bronchopulmonary

aspergillosis (ABPA)

acute eosinophilic pneumonia, 2163, 2163t

chronic eosinophilic pneumonia, 2163–2164

classification of, 2162–2163

C. pseudotuberculosis, 1207

disorders associated with, 2163t

drug- and toxin-induced, 2165–2166

in EGPA. See Eosinophilic granulomatosis with

polyangiitis

global considerations in, 2166

hypereosinophilic syndromes. See

Hypereosinophilic syndromes (HES)

infectious causes of, 2165, 2166t

pathophysiology of, 2163

Pulmonary lymphangioleiomyomatosis, A12

Pulmonary mass/nodule, 602, 603f, 603t, 1662,

A12. See also Lung cancer

Pulmonary rehabilitation, 2188

Pulmonary renal syndrome, 2285f

Pulmonary risk assessment, preoperative, 3772–

3773, 3772t

Pulmonary valve replacement, 2005, 2013, 2070

Pulmonary veins, anomalous drainage of, A9

Pulmonic regurgitation, 283, 284, 1822, 2005

Pulmonic stenosis, 2004

clinical features of, 2004

diagnosis of, 2004–2005

etiology of, 2004

heart sounds/murmur in, 279f, 281, 282f, 1820,

1822, 2004

pathophysiology of, 2004

treatment of, 2005, 2069

Pulp, dental, 256

Pulpitis, 256, 1351

“Pulsatile tinnitus,” 3353

Pulse, 1818, 1819f, 1820f, 2108

Pulse contour analysis (PCA), 2248

Pulsed-field gel electrophoresis, S11

Pulsed wave Doppler, 1832–1833, 1833f. See also

Echocardiography

Pulseless disease. See Takayasu’s arteritis

Pulseless electrical activity, 2260, 2261t, 2262f. See

also Cardiac arrest

Pulse oximetry, 2133, 2222

Pulse pressure, 2072, 2219, 2220f, A10

Pulsus alternans, 1818–1819

Pulsus paradoxus

in dyspnea evaluation, 265t, 266

echocardiography in, A9

etiology of, 1818

measurement of, 1818

in obstructive lung disease, 2132

in pericardial tamponade, 1823

Pulsus parvus et tardus, 1818, 1981

Punch biopsy, 372

“Punch drunk” syndrome. See Chronic traumatic

encephalopathy (CTE)

Punding, 3394

Punta Toro virus, 1629t, 1640

Pupils

assessment of, 216–217, 217f

in coma, 186, 186f

Pure alexia without agraphia, 196t, 198

Pure autonomic failure (PAF), 3434

Pure red cell aplasia, 798

classification of, 798t

clinical associations of, 798

congenital (Diamond-Blackfan anemia), 798

definition of, 798

differential diagnosis of, 798, 799f

drug-induced, 472, 798t

etiology of, 798

parvovirus B19 infection and, 798, 799f, 1496

thymoma and, 798

treatment of, 798

Pure tone audiometry, 244

Pure white cell aplasia, 798

Pure word deafness, 196t, 197–198

Purified protein derivative (PPD)/tuberculin skin

test (TST)

in fever of unknown origin, 147

limitations of, 960–961, 1371

in NTM infections, 1395

in TB diagnosis, 1362

in TB screening, 1371, 1379, 1379t

Purine metabolism disorders, 2713, 3250, 3251t,

3253, S8

Purine nucleoside phosphorylase deficiency, 2713,

3251t

Purkinje fibers, 1800, 1868

Purpura, 133, 144, 398

nonpalpable, 133, 398

palpable, 133, 397, 399, 2814

posttransfusion, 895

senile, 453

solar, 398

vascular, 910

wet, 905, 906

Purpura fulminans

clinical features of, 140t, 144, 144f, 398

epidemiology of, 140t

etiology of, 975t, 977

genetic considerations in, 915, 923

in meningococcemia, 1229, 1231, A1, A5

treatment of, 917, 975t, 977

Purupuru (pinta), 1414t, 1416, 1416f

Pus, 443

Push enteroscopy, 314, 2391

Push packages, S3

Pustular lesions, 133, 369t, 386, 414

Pustular psoriasis. See Psoriasis, pustular

Puumala virus, 1628t

PUVA photochemotherapy

actions of, 424

adverse effects of, 378

for atopic dermatitis, 385t

for morphea, 407

for mycosis fungoides, 424, 850

for polymorphous light eruption, 421

for psoriasis, 378, 385t, 424

for vitiligo, 389t, 424

PVCs. See Premature ventricular contractions

(PVCs)

PVE. See Prosthetic valve endocarditis (PVE)

pVHL (elongin), 2991

PVL (Panton-Valentine leukocidin) toxin, 1013,

1038, 1180

PVNS (pigmented villonodular synovitis), 2877,

2877f

P wave, 1866

PWID. See Persons who inject drugs (PWID)

PYCR1 (pyrroline-5-carboxylate reductase 1)

deficiency, 3269t

PYCR2 (pyrroline-5-carboxylate reductase 2)

deficiency, 3269t

Pyelonephritis. See also Urinary tract infections

(UTIs)

actinomycotic, 1342

approach to the patient, 1073

definition of, 1070

emphysematous, 1073, 1073f, 1077

M. hominis, 1443

in pregnancy, 3767

prognosis of, 1078

renal biopsy in, A4

risk factors for, 1071

treatment of, 1077

xanthogranulomatous, 1073, 1073f, 1077

Pyemotes, 3609, 3610f

Pyknodysostosis, 3213

Pyoderma. See Impetigo

Pyoderma gangrenosum

clinical features of, 399, 1037, A5

differential diagnosis of, 397

diseases associated with, 399

in IBD, 2480, 2481t

Pyoderma vegetans, 2480, 2481t

Pyogenic arthritis, pyoderma gangrenosum, and

acne (PAPA) syndrome, 448, 2843

Pyogenic granuloma, 257, 410

Pyomyositis, 1038, 1182

Pyostomatitis vegetans, 2480, 2481t

Pyramidal (corticospinal) system, 166f

Pyrantel pamoate, 1222, 1706t, 1712

Pyrazinamide

actions of, 1401

adverse effects of, 1374, 1378, 1401

dosage of, 1401

genetic variations in response to, 476t

for MDR-TB, 1376–1377, 1376t

pharmacology of, 1401

in pregnancy, 1401

resistance to, 1375, 1401

for TB, 1372–1373, 1372t, 1373t, 1398t, 1401

for tuberculous meningitis, 1109

Pyrethrins, 3611

Pyridostigmine

adverse effects of, 3514, S7

for gastroparesis, 293, 294t

for Lambert-Eaton myasthenic syndrome, 3513

INDEX

for myasthenia gravis, 3514 I-187

for orthostatic hypotension, 156, 3436

Pyridoxal 5’-phosphate (PLP), 3214

Pyridoxine (vitamin B6

), 2527

adverse effects of, 3494t

for alcohol-induced acidosis, 363, S1

deficiency of, 391, 801, 2524t, 2527, 3497

dietary sources of, 2527

for ethionamide toxicity, 1404

functions of, 2525f, 2527

for homocystinuria, 3272

for isoniazid toxicity, 1373, 1381, 1397t, 1400,

3497, 3588, 3594t

for nausea and vomiting in pregnancy, 294, 2527

recommended intake of, 2519t

for sideroblastic anemia, 3246

structure of, 2525f

for TB prophylaxis, 1563t

toxicity of, 2527–2528, 3493, 3494t

for tuberculous meningitis, 1109

Pyridoxine-dependent seizures, 3270t

Pyrilamine, 3590t

Pyrimethamine

actions of, 1712

adverse effects of, 773, 1704t, 1712, 1732t, 1735

for C. belli infections, 1766

for CNS toxoplasmosis, 1120

drug interactions of, 1704t

for malaria, 1730t, 1732t

for PCP prophylaxis, 1563t, 1695t

pharmacology of, 1712, 1732t

in pregnancy and lactation, 1704t

resistance to, 1735

for toxoplasmosis, 1762

for toxoplasmosis prophylaxis, 1563t, 1763

Pyrimidine-5’-nucleotidase (P5N) deficiency, 781t,

785, 3253t

Pyrimidine-5’-nucleotidase (P5N) superactivity,

3253t

Pyrimidine metabolism, 3253f

Pyrimidine metabolism disorders, 3253t, 3254

PYRIN domains, 448, 2840

Pyrin inflammasome, 957, 2840

Pyrin protein, 2840

Pyrogens, 131

Pyroglutamic acid, 363

Pyronaridine, 1706t, 1712, 1732t

Pyroptosis, 957, 1545–1546

Pyrosis. See Heartburn

Pyrroline-5-carboxylate reductase 1 (PYCR1)

deficiency, 3269t

Pyrroline-5-carboxylate reductase 2 (PYCR2)

deficiency, 3269t

Δ1

-Pyrroline-5-carboxylate synthase deficiency, 3269t

Pyruvate dehydrogenase complex (PDC), 2627,

2696t

Pyruvate kinase deficiency, 316, 777f, 781–782,

781t, 782f

6-Pyruvoyl-tetrahydropterin synthase (PTPS)

deficiency, 3269t

Pyuria, 337

Q fever

acute, 1432t, 1439

chronic, 1439

clinical features of, 146, 1962, S6

diagnosis of, 146, 1439–1440, 1440t

epidemiology of, 1432t, 1438–1439

etiology of, 1432t, 1438

fatigue syndrome following, 1439

global considerations in, 1439

incubation period for, S6

prevention of, 1441, S6

treatment of, 1034, 1440–1441, S6

in war veterans, S6

Q fever vaccine, 1441

QRS complex, 1824, 1825–1826, 1827f, 1868

QRS interval, prolonged, 1935

QRS voltage, low, 1830, 1831f

qSOFA (quick Sequential Organ Failure

Assessment Score), 2238, 2246

QT interval

prolonged, 350, 357, 358, 469, 1830,

1831f

shortened, 1830, 1831f

Quadrantanopia, 219f

Quadriparesis, 167–168, 168t

Quadriplegic fever, 3455

Quality in health care. See Health care quality

“Quality of life” issues, 5–6

Quality theory, 52

QuantiFERON-TB Gold test, 1371

Quantitative sensory testing (QST), 326

Quantitative sudomotor axon reflex test, 3432,

3432t

Quaranfil virus, 1630t

Quaranjaviruses, 1624, 1630t

Quartan malarial nephropathy, 1726

Queensland tick typhus, 1434

Queer, 3079t

Questioning, in LGBT terminology, 3079t

Quetiapine

adverse effects of, 3555t

for bipolar disorder, 3551

for delirium, 83t

for dementia, 194

overdosage/poisoning with, 3590t

for psychosis in Huntington’s disease, 3405

for psychosis in PD, 3398

for schizophrenia, 3554, 3555t

Quick Sequential Organ Failure Assessment Score

(qSOFA), 2238, 2246

Quinacrine

actions of, 1712

adverse effects of, 315, 410, 1706t

drug interactions of, 1702t, 1706t

pharmacology of, 1712

in pregnancy and lactation, 1706t

for SLE, 2746

Quincke’s pulse, 283, 1988

Quinidine

actions of, 1872t

adverse effects of

arthralgias, 2847t

cardiac, 1713

common/frequent, 1706t, 1732t

cutaneous, 383

fever, 147

lupus syndrome, 2847t

occasional, 1706t

rare, 1732t

renal, 1713

SA node dysfunction, 1875t

thrombocytopenia, 473, 905t

for arrhythmias, 1913

drug interactions of, 467t, 471t, 1706t

azoles, 1703t

mefloquine, 1710

SSRIs, 3543t

for malaria, 975t, 1730t, 1732t

metabolism of, 467t

pharmacology of, 1712, 1732t

in pregnancy and lactation, 1706t

Quinine

actions of, 1712

adverse effects of

common/frequent, 1706t, 1732t

hearing loss, 240

hypoglycemia, 3132

microangiopathic hemolytic anemia, 907

occasional, 1706t

oral pigmentation, 260t

rare, 1732t

renal, 1712–1713

thrombocytopenia, 473, 905, 905t

TTP, 2365

for Babesia infection, 975t, 1740–1741, 1740t

drug interactions of, 1706t, 1710, 1712

for malaria, 975t, 1732t

overdosage/poisoning with, 3595t

pharmacology of, 1712

in pregnancy and lactation, 1706t

Quinolones. See also Fluoroquinolones

actions of, 1149, 1164t, 1165f

adverse effects of, 391, 2301, 2847t, 3132

overdosage/poisoning with, 3595t

resistance to, 1164t, 1165f, 1167, 1187, 1236

Quinsy. See Peritonsillar abscess

Quintan (trench) fever, 1331–1332, 1331t

Quinupristin-dalfopristin

actions of, 1149, 1161, 1164t

adverse effects of, 1154t, 1161

drug interactions of, 1155t, 1161

indications for, 1157t, 1161

in pregnancy and lactation, 1152t

resistance to, 1157t, 1164t, 1166–1167

Quorum sensing, 1306

Q wave, 1824, 1828–1829, 1829f, 2055, A7

R5 viruses, 1547

R5X4 viruses, 1547

RA. See Rheumatoid arthritis (RA)

RAA system. See Renin-angiotensin-aldosterone

(RAA) system

Rabeprazole

adverse effects of, 2444

for GERD, 296

for peptic ulcer disease, 2443t, 2444

for ZES, 2455

Rabies, 1618

clinical features of, 1097, 1620–1621, 1621f, 1621t

diagnosis of, 1097, 1621–1622, 1621f, S6

differential diagnosis of, 1097, 1622

epidemiology of, 1619–1620, 1619f

global considerations in, 1619, 1619f

incubation period for, S6

in military forces, S6

pathogenesis of, 1019f, 1620

postexposure prophylaxis for, 1127, 1127t,

1622–1623, 1623f

prognosis of, 1622

treatment of, 1622

Rabies immune globulin, 1127, 1622–1623

Rabies vaccine

after bite-wounds, 1127

Guillain-Barré syndrome and, 3502

for international travelers, 992t, 995–996

postexposure, 1623

preexposure, 1623

for travelers, 1623

Rabies virus, 1457, 1618

“Raccoon-eye” sign, 880, 880f

Raccoon pinworm. See Baylisascaris procyonis

infections

INDEX

I-188 Raccoon sign, 3457

“Rachitic rosary,” 3169

Racial/ethnic disparities in health care, 59

clinical decision-making and, 64

health system interventions for, 65–66

implications for clinical practice, 67

life expectancy and, 60f, 61f

mistrust and, 64–65

nature and extent of, 59–60, 62f

patient interventions for, 66

provider interventions for, 66

recommendations to address, 65–66

root causes of, 60–62, 63f

health system factors, 62–63

patient-level factors, 64–65, 65f

provider-level factors, 63–64, 63f, 64f

sudden cardiac death rate, 2257–2258

Racism, 60

Rad, 531, S5

Radial artery, for PCI access, 2066

Radial neuropathy, 3498

Radiation, S5. See also Ionizing radiation

Radiation dose, 531

Radiation enteritis, 2469t

Radiation esophagitis, 2433

Radiation sensitizers, 532

Radiation syndrome, acute, S5

Radiation terrorism, S5

decontamination methods, S5

dispersal events, S5

hospital management of casualties, S5

medical assay of exposure level, S5

medical management of casualties, S5

Radiation therapy, 531

for acromegaly, 2914

adverse effects of, 532

bowel complications, 304, 685

breast cancer, 532, 613

cardiovascular, 737, 1968–1969, 2023

cataract, 225

cobalamin malabsorption, 772

dry eye, 220

dysphagia, 289

head and neck, 590

hepatic, 742

in HIV infection, 1582

hyperbaric oxygen therapy for, 3626t

hypopituitarism, 2897, 2905

late, 854–855

long-term, 738t

lymphedema, 2119

nephropathy, 2366

neurologic, 710–711, 741, A16

pericarditis, 567, 737, 2023

pituitary, 2970t

plexopathy, 3500–3501

pneumonitis, 561, 576

pulmonary, 576, 739, 2165

reproductive dysfunction, 741

second malignancy, 532, 740

testicular dysfunction, 3017

thyroid cancer, 2950

urinary function, 685

vascular, 532

xerostomia, 261

for anal cancer, 643

biologic effects of, 531

for bone pain, 79

brachytherapy, 532, 685, 713

for brain metastases, 709

for cervical cancer, 699

for colorectal cancer, 642

cranial, prophylactic in lung cancer, 610

curative, 531–532

dosage of, 531

for epidural metastases, 710

for esophageal cancer, 629

external beam, 685, 713

for follicular lymphoma, 848

for gastric cancer, 633

for glioblastoma, 704

for head and neck cancer, 593

for Hodgkin’s lymphoma, 854

hyperbaric oxygen therapy for enhancement of,

3626t

for leptomeningeal metastases, 710

for lung cancer, 603–604, 605, 610

modalities of, 531–532

physical properties of, 531

for pituitary tumors, 2905

for plasmocytoma, 873

postlumpectomy/postmastectomy, 618

for primary central nervous system lymphoma,

705–706

for prostate cancer, 685

quantitation of, 531

for renal cell carcinoma, 675

second malignancy and, 854, 2905

for skin cancer, 588

for soft tissue sarcomas, 713

systemic, 532, 553

for testicular cancer, 691

Radiative forcing, 1002t, 1003f

Radiculopathy, 117, 3498, 3499t

Radioallergosorbent tests, 2155

Radiocontrast media. See Contrast agents

Radioembolization, 651

Radiofrequency ablation

for cardiac arrhythmias, 1872, 1872f

characteristics of, 532

for chronic venous disease, 2117–2118

for hepatocellular carcinoma, 649t, 650

for metastatic lesions, 532, 670

Radiofrequency denervation, 126, 2085

Radiofrequency thermal rhizotomy, 3438–3439

Radioiodine therapy

for Graves’ disease, 2941–2942

for hyperfunctioning solitary thyroid nodule,

2948–2949

for hyperthyroidism, 3765

for nontoxic multinodular goiter, 2947–2948

safety precautions for, 2941–2942

for thyroid cancer, 2952

for toxic multinodular goiter, 2948

Radioiodine uptake, in thyroid evaluation,

2932

Radionuclide contamination, S5

Radionuclide scans/scintigraphy

for colonic transit measurement, 308

in gallbladder disease, 2645, 2645t

in gastrointestinal bleeding, 314

in musculoskeletal disease evaluation, 2853,

2853t

in prostate cancer staging, 683–684

Radium-226 exposure, S5

Radium-233, 688, 716

Radon exposure, 594, 2172

Raf kinase inhibitors, 512f, 534f

RAG1/2 gene mutations, 2704t

Ragged red fibers, 3529

Rales, 1937, 2132

Raloxifene

for breast cancer prevention, 492

for gynecomastia, 3019

for osteoporosis prevention/management, 3045,

3203, 3205f

for vertebral fracture prevention, 3205f

Ralstonia spp., 1249

Raltegravir, 1588t, 1591f, 1592t

Ramelteon, 183

Ramipril, 2083t

Ramosetron, 80

Ramsay Hunt syndrome (herpes zoster oticus), 160,

249, 261, 1480, 3440

Ramucirumab

action and targets of, 514t, 526, 536f, 2707t

adverse effects of, 653

for gastric cancer, 633

for hepatocellular carcinoma, 649, 649t, 651f,

652f, 653

indications for, 2707t

for lung cancer, 609

Randall’s plaque, 2369

Range of motion, 2848, 2848t

Ranibizumab, 226, 2707t

Ranitidine

for gastrinoma, 2985

for GERD, 296

for peptic ulcer disease, 2443t, 2444

for urticaria, 2723

Ranitidine bismuth, 2446

RANK (receptor activator of NFκB)

in bone metastasis, 520

in bone remodeling, 3193, 3194f

in osteoclast and osteoblast differentiation, 3210f

in Paget’s disease of bone, 3210

in rheumatoid arthritis, 2757f

RANKL (RANK ligand)

antibody. See Denosumab

in bone remodeling, 3158, 3193, 3194f

in psoriatic arthritis, 2799

receptors for, 520

in rheumatoid arthritis, 2757f, 2758

Ranolazine, 1872t, 2042, 2042t

RANTES, 2683t

Raoultella, 1275

Rapamycin. See Sirolimus

Rapeseed oil, 2847t

Rapid acetylators, 478

Rapid cycling, in bipolar disorder, 3550

Rapid detection tests

for Group A streptococcal infections, 253

for parasites, S12

Rapid plasma reagin (RPR) test, 1411

RAS (reticular activating system), 184

Rasagiline, 175, 3395, 3396t

Rasburicase

adverse effects of, 574, 784, 784t

genetic variations in response to, 477t, 478

for tumor lysis syndrome treatment/prophylaxis,

574, 3252

for uric acid nephropathy, 814

RAS gene mutations

cancers associated with, 515, 2908

in juvenile myelomonocytic leukemia, 861

in melanoma, 582

in thyroid cancer, 2951

Rash. See also Skin disorders/lesions; specific

diseases

after transfusion, 891t

centrally distributed maculopapular eruptions,

133, 134–136t, 141

confluent desquamative erythemas, 137t, 142

drug-induced, 141, 411f, A1. See also Druginduced illness, cutaneous

with fever, 133, 134–140t, 399–400, 1229, A1

INDEX

in glucagonoma, 384, 665, 665f I-189

in infections, 976–978. See also specific infections

morbilliform, 369t, 392–393, 393t

nodular eruptions, 139t, 142–143

in parasitic infections, 1699t

peripheral eruptions, 136–137t, 141–142

petechial, 1229t, 1433, 1433f, A1

purpuric eruptions, 139–140t, 144, 1229, 1229t

pustular eruptions, 138–139t, 142

scarlatiniform, 393, 393t

ulcers and eschars, 140t, 144

urticaria-like eruptions, 139t, 143, 143f

vesiculobullous eruptions, 138–139t, 142–143

Rasmussen’s aneurysm, 270, 1364

Rasmussen’s encephalitis, 2696t

RAS pathway, 505t

Raspberry tongue, 261t

Ras protooncogene, 512f

RAS/RAF/MEK inhibitors, 546–547t, 552

Rastelli procedure, 2014, 2016t

Rat(s). See Rodent(s); Rodent-borne viruses

Rat-bite fever (Haverhill fever), 136t, 1125

Rat-bite fever (sodoku), 135t, 1125

Rat bite-wound, 1125

Rat flea, 3614

Rathke’s cysts, 2906

Rational world bias, 3776t, 3779

Rationing, 53

Rat lungworm. See Angiostrongylus spp. infections

Rattlesnake bite, 3596, 3597f, 3600t, 3601. See also

Snakebites

Ravn virus disease, 1646, 1648f, 1649f

Ravulizumab, 789–790, 791f

Raw (airway resistance), 266, 2138f, 2139

Raxibacumab, S3

Raynaud’s phenomenon, 2112

chilblain in, 3634

clinical features of, 2112–2113, 2113f

cyanosis in, 274

in dermatomyositis, 405

drug-induced, 2114

localized hypoxia in, 273

pathophysiology of, 2112, 2696t, 2771

primary (Raynaud’s disease), 266, 2112–2113

secondary causes of, 2113–2114, 2113t

in Sjögren’s syndrome, 2788, 2788t

in systemic sclerosis, 406, 2113, 2771, 2773t,

2778, 2778f

treatment of, 2114, 2783–2784

RB1 gene mutations

in bladder cancer, 677

cancers associated with, 503t, 712

in CML, 820

in lung cancer, 597

in ovarian cancer, 695

in parathyroid carcinoma, 3175

Rb gene mutations, 3655

RBM20 gene mutations, 1956t

Rb (retinoblastoma) protein, 509, 552, 579, 595

RCC. See Renal cell carcinoma (RCC)

R-CHOP regimen, 634, 847, 848

RCRI (Revised Cardiac Risk Index), 3769, 3771f

RDW (red blood cell distribution width), 425, 432

Reactive arthritis, 2796

after infectious diarrhea, 1064t

after nontyphoidal Salmonella infections, 1297

after Shigella infections, 1300

after Yersinia infections, 1327

clinical features of, 1045, 2797–2798

aortic aneurysm, 2102

diarrhea, 301

oral, 257, 2797–2798

C. trachomatis, 1446–1447, 1449t

diagnosis of, 2798

epidemiology of, 2797

etiology of, 2797

vs. gonococcal arthritis, 1238, 1239f, 2798

historic background of, 2796–2797

in HIV infection, 1573

vs. Lyme arthritis, 1429

pathogenesis of, 2797

pathology of, 2797

vs. relapsing polychondritis, 2829

treatment of, 1328, 2798

Reactive hyperemia, 2112

Reactive lymphocytes, 425

Reactive oxygen species (ROS)

in aging, 3677

in asthma, 2151

damage to mtDNA by, 3677, 3677f

in endothelium, 1801

generation of, 418

in hyperbaric oxygen therapy, 3623

skin damage caused by, 418, 419

Reactive skin decontamination lotion (RSDL), S4

“Readback,” 52

Reading, assessment of, 196

Reassortment, genetic, 3718

REBNEB3, S3

Rebound tenderness, 111

Rebuck skin window test, 449

Receiver operative characteristic curve (ROC), 25,

25f

Receptors, in bacterial adherence, 950–951

Receptor tyrosine kinase, 511, 512f, 2885t

Receptor tyrosine kinase receptors, 518f

RECIST (Response Evaluation Criteria in Solid

Tumors), 487, 533

Recluse spider bite, 3612

Recombinant tissue plasminogen activator (rtPA).

See Alteplase (rtPA)

Recombination, genetic, 3642, 3644f

Recommended dietary allowance, 2517

Recoverin, 728t, 2697t

Rectal bleeding

in colorectal cancer. See Colorectal cancer

in hemorrhoidal disease. See Hemorrhoidal

disease

in rectal prolapse, 2501

in ulcerative colitis, 2475, 2475t

Rectal cancer, 642. See also Colorectal cancer

Rectal neuroendocrine tumors, 667. See also

Neuroendocrine tumors (NETs)

Rectal prolapse, 1301, 2501, 2501f

Rectal snip, S12

Rectal temperatures, 130

Rectoanal (anorectal) angle, 299, 299f

Rectocele, 308

Rectopexy, 2501–2502, 2502f

Rectus sheath, hematoma of, 110

Red blood cell(s)

agglutination of, 425, 427f

in anemia, 431. See also Anemia

antigens and antibodies, 884, 887–888, 887t

complement activation and, 790f

excess of. See Polycythemia

folate in, 774

fragmented, 427f, 434f

glycolysis in, 777, 777f

hematopoietic differentiation of, 746f

immune destruction of, 786, 788f

iron content in, 748

life cycle of, 748, 777

mechanical destruction of, 785, 786t

membrane-cytoskeleton complex of, 778, 778f

nucleated, 425, 428f

osmotic fragility of, 779

in peripheral blood smear, 425, 426–430f

production of, 431–432, 431f

protoporphyrin levels in, 749f, 750

rare phenotypes, 888

stippled, 429f

transfusions. See Transfusion(s)

urinary casts, 335, A4

Red blood cell concentrate (RBCC), 889t

Red blood cell distribution width (RDW), 425, 432

Red blood cell indices, 432t, 433t

Red blood cell scintigraphy, 314

Red blood cell survival study, 777

Red cell anion exchanger (AE1), 352

Red clover, 454t

“Red flags,” 57

Red hair color (RHC) phenotype, 579

Red hepatization, 1010

Red light, for basal cell carcinoma, 418

Red man syndrome, 411, 1154t, 1158

Red pulp, of spleen, 460, 460f

“Red tide,” 3606

5α-Reductase, 3041

5α-Reductase inhibitors, 492–493, 682

5α-Reductase type 2 deficiency, 3002

Reductionism, 30, 31f, 3812

Reduviid bugs, 1698, 1752, 1961, 3615

Reed-Sternberg cells, 852, 852f, A6

Reentry, 1869–1870, 1869f, 1869t

Refeeding edema, 278

Refeeding syndrome, 2546

Reference values, clinical laboratory tests, S10

Referred pain, 92, 93f, 109t, 110, 118, 124

Reflex myoclonus, 3407

Reflex sympathetic dystrophy. See Complex

regional pain syndrome (CRPS)

Reflex syncope. See Syncope, neurally mediated

Reflex testing, 3280–3281. See also specific reflexes

Reflux nephropathy, 2360–2361, 2361f

Refractive state, 216

Refsum’s disease, 227, 3487

Refusal of care, 69, 87–88

Registries, 29

REGN-EB3, S3

Regorafenib

actions and targets of, 513t, 526, 548t

adverse effects of, 548t, 653

for colorectal cancer, 511, 552

for gastrointestinal stromal tumor, 714

for hepatocellular carcinoma, 511, 648, 649, 649t,

651f, 652f, 653

Regret aversion, 3776, 3776t, 3778–3779

Regulatory intramembrane proteolysis (RIP), 3224

Regurgitation

in achalasia, 2427

definition of, 291

in esophageal disease, 2423

in GERD, 295, 2430

nasal, 289

Rehabilitation

after leprosy treatment, 1391

in alcohol use disorder, 3562

in ischemic stroke management, 3338–3339

neurotherapeutic. See Neurotherapeutic

technologies

in opiate use disorders, 3572

pulmonary, 2188

in spinal cord disorders, 3455, 3455t

Reifenstein’s syndrome (partial androgen

insensitivity syndrome), 3003–3004

INDEX

I-190 Rejection

in cardiac transplantation, 1974

cfDNA in detection of, 3840–3842, 3841f

inflammatory mediators in, 2699t

in kidney transplantation, 2327, 2329–2330

in liver transplantation, 2639, A13

in lung transplantation, 2213

Relapsing fever, 1421

clinical features of, 132, 135t, 1423, S6

diagnosis of, 1423–1424, 1424f, S6

differential diagnosis of, 1424

epidemiology of, 1422

etiology of, 1422, 1422f, 1422t

global considerations in, 1422

incubation period for, S6

louse-borne, 1422, 1422t

pathogenesis of, 1422–1423

prevention of, 1425

prognosis of, 1425

tick-borne, 1422, 1422f, 1422t

treatment of, 1424–1425, 1424f, S6

Relapsing polychondritis, 249, 1816, 2102, 2826

Relative afferent pupil defect, 216, 217f

Relative bradycardia (Faget’s sign), 943, 944t

Relaxation techniques, 3785t

Relaxin, 3030

Relebactam, 1153, 1166

Relugolix, 544, 686, 687f

Remdesivir, 1098, 1463t, 1464

Reminder systems, 40

REM sleep, 204–205, 205f

REM sleep behavior disorder, 213, 215v, 236, 3385,

3385t, 3387, 3399

Renal abscess, 1060

Renal amyloidosis, 2345, A4

Renal artery stenosis, 2088

azotemia in, 335

diagnosis of, 2078, 2089, 2089t

hyperaldosteronism and, 349

impaired oxygen delivery in, 431

incidence of, 2088

pathophysiology of, 2088–2089

treatment of, 2078, 2089, 2090t

Renal artery thrombosis, 335

Renal biopsy, A4

in acute interstitial nephritis, A4

in acute nephritic syndromes, A4

in AKI, 2305, A4

in Alport’s syndrome, 2347, A4

in antiglomerular basement membrane disease,

2339, A4

assessment of, 2336

in CKD, 2319

in diabetic nephropathy, 2343, A4

in Fabry disease, 2345, A4

in focal segmental glomerulosclerosis, A4

in glomerular diseases, 2336, A4

in granulomatosis with polyangiitis, 2340, A4,

A14

in hemolytic-uremic syndrome, 2348, A4

in hypertensive nephrosclerosis, 2347, A4

in IgA nephropathy, 2339, A4

indications for, 2287

in lupus nephritis, 2338, A4

in membranoproliferative glomerulonephritis,

2341, A4

in membranous glomerulonephritis, 2343, A4

in minimal change disease, 2341, A4

in multiple myeloma, 2360f, A4

in oxalosis, A4

in poststreptococcal glomerulonephritis, 2337,

in pyelonephritis, A4

stains for, 2336

in vasculitic syndromes, A14

Renal cell carcinoma (RCC), 673

clinical features of, 674

diagnosis of, 674, 2286–2287

epidemiology of, 673

genetic considerations in, 673–674, 674t

global considerations in, 673, 676

intrahepatic cholestasis in, 320

metastatic, 708t

paraneoplastic syndromes in, 674, 726

pathology of, 673–674, 674t

polycystic kidney disease and, 2351

prognosis of, 675, 675f

staging of, 674, 675f

treatment of, 547t, 552, 675–676, 676t

tuberous sclerosis and, 674t, 2354

von Hippel–Lindau syndrome and, 573, 674t,

2991

Renal colic, 2368, 2370, 2371f, 2374, 2376. See also

Nephrolithiasis

Renal coloboma syndrome, 2356

Renal cysts. See Polycystic kidney disease

Renal cysts and diabetes syndrome, 2351t

Renal disease/failure

acute. See Acute kidney injury (AKI)

chronic. See Chronic kidney disease (CKD)

glomerular. See Glomerular diseases

inherited tubule growth and development

disorders, 2350

autosomal dominant, 2355

congenital abnormalities of kidney and

urinary tract, 2356

with cystic phenotype, 2351t

diagnostic considerations in, 2356

global considerations in, 2356

karyomegalic tubulointerstitial nephritis,

2356, 2362

medullary sponge kidney, 2356

in mitochondrial disease, 2356

nephronophthisis, 2351t, 2355

polycystic kidney disease. See Polycystic

kidney disease

tuberous sclerosis. See Tuberous sclerosis

von Hippel–Lindau disease. See von

Hippel–Lindau disease/syndrome

nephrolithiasis. See Nephrolithiasis

tubulointerstitial diseases. See Tubulointerstitial

diseases

vascular. See Renovascular disease

Renal medullary carcinoma, 673, 674t

Renal natriuretic peptide, 2294

Renal osteodystrophy, 334, 3182

Renal pelvis, carcinoma of. See Kidney cancer;

Renal cell carcinoma (RCC)

Renal transplantation. See Kidney transplantation

Renal tubular acidosis (RTA)

distal (type I), 349, 350, 364, 2292t, 2375, S1

proximal (type II), 364, 2292t

treatment of, 2789

type IV, 364, 3123

Renal tubular defects, 332t

Renal vein renin ratio, 2078

Renal vein thrombosis, 2368

Renin

ectopic production of, 722t

renal vein renin ratio, 2078

synthesis and secretion of, 2074

Renin-angiotensin-aldosterone (RAA) system

assessment of, 2957

in blood pressure regulation, 2073–2074, 2074f

in edema, 275

in glomerular filtration rate regulation, 2288,

2289f

in heart failure pathogenesis, 1934, 1934f

in mineralocorticoid synthesis, 2957, 2957f

in potassium regulation, 347–348, 353

in sodium regulation, 2295–2296

Renovascular disease, 2088

atheroembolic, 2089–2090, 2303t

atherosclerotic nephropathy, 2347

diagnosis of, 2089, 2089t

hypertension and, 2074, 2077–2078, 2090–2091

hypertensive nephrosclerosis, 2078, 2091,

2347–2348, A4

renal artery stenosis. See Renal artery stenosis

thromboembolic, 2090, 2091f

thrombotic microangiopathic. See Thrombotic

microangiopathy, renal

Reovirus(es), 1454t, 1455f, 1456, 1607, 1631

Reovirus infections, 1632–1633t, 1634t, 1640

Repaglinide, 3110t, 3111

Repetition, assessment of, 196

R-EPOCH regimen, 634, 847

Representativeness heuristic, 22

Reproduction number (Ro), 972, 3717

Reproductive system disorders. See Female

reproductive system disorders; Male

reproductive system disorders

Reptilase time, 456

Reptile bites. See Snakebites

Research

ethical issues in, 71, 72

physician engaged in, 8

skews in, global effects of, 3722

Reserpine, 2083t

Resident physicians, working hours of, 7, 214

Residual volume (RV), 2134, 2134f, 2135f, 2138f

Resiniferatoxin (RTX), 3786

Resistance strength training, 177

Resistance to thyroid hormone (RTH), 2930–2931,

2930t, 3649

Reslizumab, 2708t

Resminostat, 652f

Respiration

in hypothermia, 3632t

in shock, 2217t, 2218t

signaling pathways in, 263, 264f

Respiratory acidosis, 367

acid-base nomogram, 359f

clinical features of, 367

compensatory responses in, 359t, 367

drug-induced, 367

etiology of, 367, 367t

hyperkalemia in, 353

in mixed acid-base disorders, 360, 360t

treatment of, 367–368

Respiratory alkalosis, 368

acid-base nomogram, 359f

compensatory responses in, 359t

diagnosis of, 368

etiology of, 367t, 368

in hypoxia, 273

in mixed acid-base disorders, 360, 360t

treatment of, 368

Respiratory bronchiolitis–associated ILD, 2134–

2195, 2190t

Respiratory disorders. See also Lung disease;

Respiratory tract infections

approach to the patient, 2131

aspirin-exacerbated, 2159

categories of, 2131, 2131t

chest pain in, 2131

INDEX

clinical features of, 2131–2132 I-191

clubbing in, 2132

cough in, 2131

diagnosis of, 2132, 2140

allergy testing, 2147

arterial blood gases, 2139

artificial intelligence/deep learning in, 2145,

2145f

bronchoscopy. See Bronchoscopy

chest radiography, 2133, 2143, 2143f

CT, 2133, 2143–2145, 2144f

exhaled breath condensate, 2147

gas exchange measurement, 2139

mediastinoscopy, 2140

mediastinotomy, 2140

MRI, 2145, 2145f

PET, 2145

pleural biopsy, 2140

pulmonary function testing, 2132–2133

sputum analysis. See Sputum analysis

sweat testing, 2147

thoracentesis, 2140

thoracoscopy, 2140

thoracotomy, 2140

transthoracic needle aspiration, 2145–2146

ventilatory function measurement, 2138–2139

dyspnea in, 265t, 266, 2131

hemoptysis in, 2131

history in, 2131–2132

inhaled agents associated with, 2132

obesity and, 3086

obstructive patterns, 2138

pathophysiology of, 2133

physical examination in, 2132

pulmonary function values in, 2137–2138, 2138f

restrictive patterns, 2137–2138, 2138f

risk factors for, 2132

smoking and, 2132, 3563t, 3564

Respiratory effort–related arousal (RESA), 2206,

2207f, 2207t

Respiratory failure

in ARDS. See Acute respiratory distress

syndrome (ARDS)

in botulism, 1217

in critically ill patient, 2220–2221

hypercapneic, 2221, 2230

in hyponatremia, 343

hypoxemic, 272–273, 2220–2221, 2230

pathophysiology of, 2220–2221

perioperative, 2221

in shock, 4–5

Respiratory function

disturbances of. See Respiratory disorders

flow-related properties of, 2134–2135, 2135f,

2222, 2223f

gas exchange, 2136–2137

during sleep, 207

ventilation-perfusion heterogeneity, 2136–2137,

2137f

ventilatory adequacy, 2136

volume-related properties of, 2133–2134, 2134f,

2222

work of breathing, 2135–2136

Respiratory muscles

assessment of strength of, 2139

fatigue/weakness of, 2138, 2220

hypoperfusion of, 2221

Respiratory quotient, 2136

Respiratory sinus arrhythmia, A8

Respiratory syncytial virus (RSV) infections

antigenic variability in, 1505

in cancer patient, 561

clinical features of, 1505–1506

epidemiology of, 1505

epigenetics of, 3796

otitis media, 249

prophylaxis for, 1464, 1513

in transplant recipient, 1140

treatment of, 1463t, 1464, 1512

Respiratory syncytial virus (RSV) vaccine, 1513

Respiratory tract infections, 1504

ambulatory antibiotic prescribing for, 248

Aspergillus. See Aspergillus infections, respiratory

tract

in asthma, 2152, 2153

chronic P. aeruginosa, 977–1288

COPD exacerbations and. See Chronic

obstructive pulmonary disease (COPD),

exacerbations of

C. pneumoniae, 1452

in cystic fibrosis, 2176

hemoptysis in, 270

lymphadenopathy in, 458

mastoiditis, 1101

in mitral stenosis, 1992

M. pneumoniae, 1442, 1442t

mucormycosis, 1683

Nocardia, 1337, 1337f, 1339t

nontuberculous mycobacterial, 1394

olfactory dysfunction in, 235

pathogen entry mechanisms, 948

pneumonia. See Pneumonia

S. aureus, 1182

sporotrichosis, 1687, 1687t

upper

antibiotic prescribing for, 248

epiglottitis, 255, 1242, 1243

nonspecific, 248–249

pharyngitis. See Pharyngitis

red flags for, 249

sinusitis. See Sinusitis

viral

adenovirus. See Adenovirus infections

anatomic sites of, 1504

approach to the patient, 1512

in asthma, 2153

clinical features of, 1512

complications of, 1513

coronavirus. See Coronavirus infections

diagnosis of, 1512

epidemiology of, 1511

global considerations in, 1514

hantavirus. See Hantavirus infections

human metapneumovirus, 248, 249, 1506,

1506t

in immunocompetent hosts, 1504–1505

in immunocompromised hosts, 1505

influenza virus. See Influenza

measles. See Measles (rubeola)

parainfluenza virus. See Parainfluenza virus

infections

paramyxovirus. See Paramyxovirus

infections

picornaviruses. See Picornaviruses

polyomavirus. See Polyomavirus(es)

prevention of, 1513–1514

rhinovirus, 248–249, 1141, 1506–1507,

1513

risk factors for, 1511

RSV. See Respiratory syncytial virus (RSV)

infections

syndromes, 1504

transmission of, 1511

treatment of, 1512–1513

Respite care, 84

Response Evaluation Criteria in Solid Tumors

(RECIST), 487, 533

Responsive neurostimulation, 3321

REST, 3795

Restan virus, 1627t

Restenosis, 2044, 2067, 2067f

Resting energy expenditure (REE), 2517, 2539

Restitution, 2435

Restless legs syndrome, 3408

in CKD, 2317

clinical features of, 208t, 212, 3408–3409

diagnosis of, 208t, 212

in older adults, 3755

in pregnancy, 3767

treatment of, 208t, 212, 3409

Reston virus, 1646

Restrictive cardiomyopathy, 1967

in amyloidosis, 1967–1968, 1968f, 1969f

clinical features of, 1955t, 2022t

diagnosis of, 1955t, 1968f, 2022t

differential diagnosis of, 1861, 1863t, 2022t, 2024

endomyocardial, 1969

etiology of, 1967, 1968t

fibrotic, 1968–1969

genetic considerations in, 1956t

in metabolic disorders, 1967

overlap with other cardiomyopathies, 1968t

pathogenesis of, 1967

radiation-related, 1968–1969

in systemic sclerosis, 1969

Resveratrol, 3734, 3738, 3738f

Reteplase

actions of, 938

for acute limb ischemia, 2111

contraindications to, 2060

domain structure of, 938, 938f

indications for, 938

for STEMI, 2060

RET gene mutations

actions of, 2976

as drug target, 507

genetic testing for, 2990

in lung cancer, 596, 596f, 607

in MEN 2, 503t, 504, 2881, 2951, 2953, 2980,

2984t, 2990, 3175, 3655

in pheochromocytoma/paraganglioma, 2976,

2981t, 2982f, 2983, 2990

prophylactic thyroidectomy in, 2989–2990, 2989t

screening tests in, 2989t, 2990

in thyroid cancer, 2950–2951, 2989

Reticular activating system (RAS), 184

Reticular dysgenesis, 2714, S8

Reticulate body, 1444, 1444f

Reticulin stain, 429f

Reticulocyte(s), 435f

Reticulocyte count, 426f

in anemia, 435

correction of, 435t, 436

in hemolytic anemia, 776t, 777

Reticulocyte production index, 435t, 436, 436t

Reticuloendothelial system, 748

Reticulohistiocytosis, multicentric, 395

Reticulospinal pathway, 166f

Reticulotype, 33, 35f

Reticulum cell sarcoma (interdigitating dendritic

cell sarcoma), 865

Retina

detached, 218, 225, 225f

early degeneration of, 3275t

functions of, 215

gyrate atrophy of, 3270t

INDEX

I-192 Retina (Cont.):

hemorrhages in

in high-altitude illness, 3617

in infective endocarditis, 221, 221f

in malaria, 1724, 1725f

lesions of, 218

radiation-induced damage to, 532

Retinal artery occlusion, 222, 222f, 1816

Retinaldehyde, 2529

Retinal pigment epithelium, 3304

Retinal vein occlusion, 222, 222f

Retinitis

CMV, 1461, 1462, 1489, 1489f, 1491, 1580

differential diagnosis of, 1761t

T. gondii, 1761, 1761t

Retinitis pigmentosa, 227, 227f, 2355, 3275t, 3645t

Retinoblastoma

bladder cancer and, 677

hereditary (familial), 502, 502f, 503t, 3655

sarcomas and, 712

sporadic, 3655

Retinoblastoma (Rb) protein, 509, 552, 579

Retinoic acid, 382, 2529, 2530. See also All-transretinoic acid (ATRA)

Retinoic acid-inducible gene-1-like receptors

(RLRs), 2674, 2674t, 2676

Retinoic acid receptors, 2529, 2889

Retinoid acid X receptors (RXRs), 2930, 2930f

Retinoids, 237, 378, 410, 2529

Retinol, 492

Retinol activity equivalent, 2529

Retinol-binding protein, 2538t

Retinopathy

cancer-associated, 2697t

CMV, 1489, 1489f

diabetic. See Diabetic retinopathy

hypertensive, 222, 222f

paraneoplastic, 736

in sickle cell disease, 759t

Retrobulbar tumor, of optic nerve, 227

Retrocalcaneal bursitis, 2878

Retrocollis, 3402

Retrograde amnesia, 202

Retrograde ejaculation, 3057, 3125

Retromer complex, 3298

Retroperitoneal adenopathy, 459

Retroperitoneal fibrosis, 2837, 2838t

Retroperitoneal hemorrhage, 912

Retroperitoneal lymph node dissection, 691

Retropharyngeal abscess, 255, 1351

Retropharyngeal mass, A16

Retropharyngeal space infections, 1351

Retrovirus(es), 1521

cancer development and, 499, 505

classification of, 1521–1522, 1522t

gene expression and replication in, 1523–1524,

1523f

for gene therapy delivery, 1524, 3685t

HIV. See HIV

HLTV-1. See Human T-cell lymphotropic virus

(HTLV-1)

life cycle of, 1522–1523, 1522f

myopathies associated with, 3453

replication strategies of, 1456

structure of, 1454t, 1455f, 1522, 1523f

Rett syndrome, 3301, 3535, 3645, 3795

Revaprazan, 2445

Reverse cholesterol transport, 3136–3137

Reverse isolation, 564

Reverse straight-leg raising sign, 119

Reverse T3

(rT3

), 2926f

Reverse transcriptase enzyme, HIV, 1528, 1529

Reverse transcriptase inhibitors. See Combination

antiretroviral therapy (cART)

Reverse transcriptase polymerase chain reaction

(RT-PCR), 962, 1560, 1560t

Reverse vaccinology, 968

Reversible cerebral vasoconstriction syndrome,

3343

Reversible posterior leukoencephalopathy, 571, 3350

Revesz syndrome, 3682

Revised Cardiac Risk Index (RCRI), 3769, 3771f

Rev/rev, 1523, 1523f, 1531f

Rewarming

for frostbite, 3634, 3634t

for hypothermia, 3632–3633, 3633t

Reye’s syndrome, 133, 1480, 1482, 1519

Rh0

(D) immune globulin, 910

Rhabdomyolysis

AKI in, 2301, 2303t, 2304, 2307

in heatstroke, 3637

hyperkalemia in, 353

hypernatremic, 346

hypocalcemia in, 358

hypokalemia and, 350

hypophosphatemia-induced, 3162

skin infections and, 1038

treatment of, 2307

Rhabdomyoma, cardiac, 2027, 2027f

Rhabdomyosarcoma, 500t, 712, 713, 714, 3712f. See

also Soft tissue sarcomas

Rhabdoviruses, 1454t, 1455f, 1618, 1623

Rhabdovirus infections

Chandipura virus infection, 1630t, 1638

clinical syndromes of, 1634t

geographic distribution of, 1632–1633t

rabies. See Rabies

vesicular stomatitis virus infection, 1619, 1623

RHAG gene mutations, 779t, 781

RHBDF2 gene mutations, 627

RHC (red hair color) phenotype, 579

Rheumatic fever

cardiovascular complications of

antithrombotic prophylaxis for, 3341t

aortic valve disease, 1979, 1986–1987

diagnosis of, 2767, 2767f, 2768t

echocardiography in, 2767, 2767f, 2768t,

2770–2771v

global considerations in, 1189, 1189f, 1933,

2766, 3711

heart failure, 2769

mitral stenosis, 283, 1991, 2767, 2771v. See

also Mitral stenosis

pathogenesis of, 2766f, 2767

pericarditis, 2023

clinical features of, 135t, 2767–2768

chorea, 2768, 2769

erythema marginatum, 135t, 141, 385, 2768

fever, 2768

joint involvement, 1045, 2767–2768

nodules, 2768

diagnosis of, 2768, 2769t

epidemiology of, 2766, 2766f

etiology of, 135t

genetic considerations in, 2767

global considerations in, 1978, 1978f, 2766

group A streptococcal infection and,

2768

immunopathology of, 2696t, 2732, 2767

inflammasome mutations in, 2678t

pathogenesis of, 2766f, 2767

prevention of, 2770, 2770t

prognosis of, 2770

treatment of, 2768–2769

Rheumatic heart disease. See Rheumatic fever,

cardiovascular complications of

Rheumatoid arthritis (RA), 2751

approach to the patient, 2764–2765

clinical features of, 2751–2753

cardiovascular, 2753

aortic aneurysm, 2102

AV conduction block, 1882

pericarditis, 2023

constitutional, 2752

cutaneous, 395, 2753, A5

extraarticular, 2752, 2752f

hematologic, 432, 753, 753f, 2753

lymphoma, 2753

neck pain, 128

neuropathy, 3489

oral pain, 257

pulmonary, 2196, 2753

Raynaud’s phenomenon, 2113

Sjögren’s syndrome, 2753

spine, 2752

T-cell large granular lymphocytic leukemia,

2753

vasculitis, 2753

wrists and fingers, 2751–2752, 2751f

conditions associated with, 2752f, 2753–2754

diagnosis of, 2758–2760, 2759t, 2760f

differential diagnosis of, 2759

disability in, 2760

EBV and, 2755

environmental factors in, 2755

epidemiology of, 2754, 2754f

genetic considerations in, 480, 2754–2755, 3796

global considerations in, 2754, 2754f, 2765

KIRs with, 2687t

microbiome and, 3697

natural history of, 2760

pathogenesis of, 2694, 2696t, 2699t, 2756–2758,

2757f

pathology of, 2755–2756

prognosis of, 2760

vs. relapsing polychondritis, 2829

remission in, 2764, 2764t

research progress in, 2751

treatment of, 2760

approach to, 2760–2761, 2764

assistive devices, 2764

biologic agents, 2701, 2761, 2762–2763t,

2763

complementary and integrative therapies,

3786

DMARDs, 2761, 2762–2763t, 2763–2764

global considerations in, 2765

glucocorticoids, 2761

NSAIDs, 2761

in older adults, 2765

physical therapy, 2764

in pregnancy, 2765

surgery, 2765

timing of, 3811

Rheumatoid nodules, 395

Rheumatoid vasculitis, 2687t, 2753

Rheumatologic diseases. See Musculoskeletal

disorders

Rhinitis, 1271, 2724, 2726f

Rhinophyma, 383

Rhinoscleroma, 1271

Rhinosinusitis, 251, 1506, 2154. See also Sinusitis

Rhinoviruses, 1506–1507

Rhinovirus infections, 248–249, 1141, 1506–1507,

1513

Rhizobium radiobacter, 1248t, 1249

INDEX

Rhizopus spp., 564, 1143, 1683f. See also I-193

Mucormycosis

Rhodococcus spp. infections, 1208, 1567

Rho kinase, 3056f

Rhonchi, 1937, 2132

Rh RBC blood cell group system, 887–888,

887t

Ri antibodies, 728t, 734

Ribavirin

actions of, 1464, 1512

adverse effects of, 1098, 1464, 2580, 2605

for chronic HCV infection, 1464, 1468t,

2605–2606, 2605f, 2609

drug interactions of, 2591

for fulminant hepatitis, 2580

genetic variations in response to, 477t

in pregnancy, 2605

for RSV infection, 1140, 1463t, 1464, 1512

for viral encephalitis, 1098

for viral hemorrhagic fevers, 978, 1642–1643, S3

Ribociclib

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

adverse effects of, 549t

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

for hepatocellular carcinoma, 652f

Riboflavin (vitamin B2

), 237, 2519t, 2525f, 2526

Riboflavin (vitamin B2

) deficiency, 2524t, 2526

Ribosomal RNA (rRNA), 963

Rice water stool, 1307, 1307f

Richardson syndrome. See Progressive supranuclear

palsy syndrome

Richter’s transformation, in CLL, 838

Rickets

clinical features of, 2524t

diagnosis of, 3168–3169

hereditary vitamin D–resistant, 3168

in hypophosphatasia, 3214

hypophosphatemic, 2292t, 3161, 3163

pathogenesis of, 2524t, 3168

vitamin D–dependent type I (pseudo-vitamin

D–resistant), 3168, 3188

vitamin D–dependent type II, 3188

Rickettsia spp., 134t, 953, 1434

Rickettsia akari. See Rickettsialpox

Rickettsia conorii, 977. See also Mediterranean

spotted (boutonneuse) fever

Rickettsial diseases, 1431

clinical features of, 134t, 141, 393, 1431, 1432t

diagnosis of, S11

ehrlichioses, 1437–1438, 1437f

endemic typhus. See Endemic (murine) typhus

epidemic typhus. See Epidemic (louse-borne)

typhus

epidemiology of, 1431, 1432t

etiology of, 1431, 1432t

global considerations in, 977

human granulocytic anaplasmosis, 1429, 1432t,

1437f, 1438, 1739

Mediterranean spotted (boutonneuse) fever,

134t, 977, 1434–1435

Q fever. See Q fever

rickettsialpox. See Rickettsialpox

Rocky Mountain spotted fever. See Rocky

Mountain spotted fever (RMSF)

scrub typhus. See Scrub typhus

tick-borne spotted fevers, 1434–1435

Rickettsialpox, 1433

clinical features of, 138t, 143, 1432t,

1435

diagnosis of, 1435, 1481

epidemiology of, 138t, 1035, 1432t, 1435

etiology of, 138t

rash in

eschar, 144, A1

evolution of, 138t, 1035, 1435, 1435f

papules and plaques, 133, 138t, 393, 1035, A1

vesicles/pustules, 143

transmission of, 1432t, 3609

treatment of, 1435

vs. varicella, 133, 1481

Rickettsia prowazekii, 977, 1431, 1435. See also

Epidemic (louse-borne) typhus

Rickettsia rickettsii, 977. See also Rocky Mountain

spotted fever (RMSF)

Rickettsia typhi, 1431. See also Endemic (murine)

typhus

Ridley-Jopling classification, leprosy, 1384–1385

Riedel’s thyroiditis, 2944

Rifabutin

actions of, 1149, 1164t, 1402

adverse effects of, 1402

drug interactions of, 1703t

for HIV-associated TB, 1378

in H. pylori eradication, 2446, 2448t

for MAC infection, 1404

for MAC infection prophylaxis, 1396, 1563t

pharmacology of, 1402

resistance to, 1164t, 1167

for TB, 1402

for TB prophylaxis, 1563t

Rifampin

for A. baumannii infections, 1277t

actions of, 1149, 1164t, 1165f, 1400

adverse effects of, 1401

allergic interstitial nephritis, 2358

gastrointestinal, 1160

hepatotoxicity, 1154t, 1160, 1378

hyperbilirubinemia, 317

in leprosy, 1389

nephritis, 2281, 2301

thrombocytopenia, 905t, 1374

for anthrax, S3

for asymptomatic GAS carriage, 1191

for Brucella infections, 1313

for Carrión’s disease, 1331t

for cat-scratch disease, 1331t

dosage of, 1401

drug interactions of, 471t, 1155t, 1378, 1380,

1401, 2637

antiretroviral therapy, 1401

atovaquone, 1703t

dapsone, 1704t

quinidine, 1706t

genetic variations in response to, 476t

indications for, 1157t, 1160

for infective endocarditis, 1029t, 1030, 1187

for leprosy, 1389, 1389t

for MAC infections, 1404

for meningitis, 1105, 1176

metabolism of, 1160

for NTM infections, 1396, 1405, 2175

for osteomyelitis, 1049, 1049t, 1050t

pharmacology of, 1400–1401

prophylactic

for leprosy, 1392

for meningitis, 1105, 1162t

for TB, 1563t

for prosthetic joint infections, 1045, 1051,

1187

for Q fever, 1440

for reactive arthritis, 2798

resistance to

detection of, 972

mechanisms of, 1164t, 1167

in M. leprae, 1390

in mycobacteria, 966, 972, 1375–1377, 1375f,

1401

prevalence of, 1157t

for TB

active infection, 1372–1373, 1372t, 1373t,

1398t, 1401

isoniazid-resistant, 1376

monitoring and management of, 1398t

for TB prophylaxis, 1380–1381, 1380t, 1397,

1397t, 1398t

for tuberculous meningitis, 1109

Rifamycins, 1149, 1160, 1164t

Rifapentine

actions of, 1149, 1164t

adverse effects of, 1402

drug interactions of, 1380

pharmacology of, 1402

resistance to, 1164t, 1402

for TB, 1373, 1402

for TB prophylaxis, 1380–1381, 1380t, 1397,

1397t

Rifaximin

for diverticular disease, 2499

for hepatic encephalopathy, 2633

for IBS, 306, 2495, 2496t

for peritonitis prophylaxis, 1055

for travelers’ diarrhea, 302, 997, 1065t

for travelers’ diarrhea prophylaxis, 1066

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

Rift Valley fever virus, 1629t

Right atrial overload, ECG in, 1827f

Right atrial pressure, in shock, 2219,

2220f

Right atrium, 1891f

Right bundle branch, 1880

Right bundle branch block

in Chagas disease, 1751

conditions associated with, 1828

ECG in, 1751f, 1827f, 1828, A7, A8

heart sounds in, 284t, 1821f

Right heart dilation, congenital, 2010,

2011t

Right-left confusion, 198

Right-to-left shunt

intracardiac, 1863–1864

intrapulmonary, 273, 274

Right ventricular dysfunction

after atrial switch procedure, 2014, 2015t

cardiogenic shock in, 2254–2255

diagnosis of, 1838, 1859v, A7

etiology of, 1838

in pulmonary embolism pathophysiology, 2094,

2094f

Right ventricular failure/infarction, 2022t, 2062

Rigidity, 165

Riley-Day syndrome, 3434

Rilonacept, 2708t, 2842

Rilpivirine, 1586, 1588t, 1589, 1590f

Riluzole, 3414, 3426

Rimantadine, 1463t, 1464, 1512, 1564t

Rimegepant, 3362t, 3363–3364, 3363t,

3365t

Ring(s), esophageal, 2424, 2425f

Ringworm. See Dermatophytosis

Rinne test, 242, 3280

Riociguat, 2128, 2129t, 2786

Rio Mamoré virus, 1629t

Ripretinib, 513t, 714

Ri protein, 2697t

Ri protein antibodies, 728t, 734

Risankizumab, 379t, 2800, 2802

INDEX

I-194 Risedronate

adverse effects of, 3205

for fracture prevention, 3204f

for osteoporosis management/prevention, 3045,

3203–3205, 3204f, 3209

for Paget’s disease of bone, 3212, 3212t

Risperidone

adverse effects of, 3087, 3555t

for bipolar disorder, 3551

for delirium, 83t

overdosage/poisoning with, 3591t

for psychosis in Huntington’s disease, 3405

for schizophrenia, 3554, 3555, 3555t

Ritodrine, 348

Ritonavir, 1592t

actions of, 1589

adverse effects of, 1588t, 2591

drug interactions of, 467t, 1703t, 2637

for HIV infection, 1588t, 1589

metabolism of, 467t

molecular structure of, 1590f

Rituximab

actions and targets of, 514t, 536, 536f, 2707t,

2763

adverse effects of, 2744t

common, 2762t, 2763

cutaneous, 408

cytokine release syndrome, 574

fetal, 2747

hypersensitivity reaction, 577

IgM flare, 877

infections, 557, 560, 562, 2763, 2805, 2825t

infusion reaction, 574, 575

paraneoplastic pemphigus, 402

progressive multifocal leukoencephalopathy,

742, 2763, 2825t, 3470

pulmonary, 2192

serious, 2762t, 2805t

tumor lysis syndrome, 573

for ALL, 833, 833t

for antiphospholipid antibody syndrome, 2367,

2751

for autoimmune hemolytic anemia, 787, 838

for autoimmune pancreatitis, 2666

for B-cell prolymphocytic leukemia, 856

for bullous pemphigoid, 403

for Burkitt’s lymphoma, 846

for cardiac transplant rejection, 1974

for CLL, 839

for coagulation factor inhibitor eradication, 913

for cold agglutinin disease, 787–788

for dermatomyositis, 405

for diffuse large B-cell lymphoma, 512, 847

for EGPA, 2810

for epidermolysis bullosa acquisita, 404

for follicular lymphoma, 848

for gamma heavy chain disease, 877

for gastric lymphoma, 634

for granulomatosis with polyangiitis, 2808

for hairy cell leukemia, 856

for hemolytic-uremic syndrome, 575

for hepatitis C–associated cryoglobulinemic

vasculitis, 2814

for IgG4-related disease, 2840

for immune thrombocytopenic purpura, 907

for inflammatory myopathies, 2825, 2825t

for insulin autoimmune syndrome, 2996

for kidney transplant rejection, 2330

for lymphoplasmacytic lymphoma, 849

for mantle cell lymphoma, 849

for marginal zone lymphoma, 850, 856

for membranous glomerulonephritis, 2344

monitoring during treatment with, 2762t

for monoclonal gammopathy of undetermined

significance, 873

for MS, 3470

for mucous membrane pemphigoid, 404

for myasthenia gravis, 3515

for neuromyelitis optica, 3478

for pemphigus vulgaris, 402

for primary central nervous system lymphoma,

706

for rheumatoid arthritis, 2762t, 2763

for Sjögren’s syndrome, 2789, S1

for SLE, 2744t, 2747

for systemic sclerosis, 2784

for thrombotic thrombocytopenic purpura, 908

for vasculitic neuropathy, 3508

for vasculitis, 2805

for Waldenström’s macroglobulinemia, 876–877

Rivaroxaban

adverse effects of, 936, 1906

dosage of, 935–936

for DVT/PE, 2098, 2099t

indications for, 935

management before endoscopic procedures,

2904t

management before lumbar puncture, S9

monitoring treatment with, 936

for NSTE-ACS, 2050t, 2052

pharmacology of, 935t

in pregnancy, 937

reversal of, 3351

for stroke prevention, 1906, 1907t, 3346

for VTE prophylaxis, 2100t, 3773

Rivastigmine, 175, 195, 3374, 3386, 3398

River blindness. See Onchocerca volvulus/

onchocerciasis

Rizatriptan, 3362t, 3363, 3363t

RLRs (retinoic acid-inducible gene-1-like

receptors), 2674, 2674t, 2676

Rmp protein, 1236

RMRP gene mutations, 444, 2715, S8

RMSF. See Rocky Mountain spotted fever (RMSF)

RNA polymerase (RNP), 2696t, 2776t

RNA viruses, 1454t, 1455–1456, 1455f. See also

specific viruses

RNF216 gene mutations, 3015t

Ro (reproduction number), 972, 3717

Robotic bronchoscopy, 2142

Robotics, for neurologic rehabilitation, 3819–3820,

3820f

ROC (receiver operative characteristic curve), 25,

25f

Rocio virus, 1626t

“Rocker foot,” 2874

Rocky Mountain spotted fever (RMSF), 1431

clinical features of, 1432t, 1433

cutaneous

characteristics of, 136t, 142f, 1103

evolution of, 141, 977, 1103–1104, 1433

petechial rash, 977, 1433, 1433f, A1, A5

purpura, 399

myocarditis, 1962

vascular damage, 910

diagnosis of, 1434

differential diagnosis of, 144, 1103–1104, 1434

epidemiology of, 1431–1433, 1432t

etiology of, 975t, 977

fulminant, 1433–1434

pathogenesis of, 1433

prevention of, 1434

treatment of, 975t, 977, 1434

Rocuronium, 2276, 3576

Rod(s), 215

Rodent(s)

bite-wounds, 1125, 1127t

in plague, 1321, S3

Rodent-borne viruses, 1624. See also specific viruses

diagnosis of, 1631

disease syndromes of, 1625–1630t, 1631. See also

specific diseases

arthritis and rash, 1631, 1633–1635, 1634t

encephalitis, 1634t, 1635–1638

fever and myalgia, 1634t, 1638–1640

hemorrhagic fevers. See Viral hemorrhagic

fevers

pulmonary disease, 1634t

epidemiology of, 1624

geographic distribution of, 1632–1633t

transmission of, 1624

Roflumilast, 2188

Roll Back Malaria campaign, 3709

Romaña sign, 1750t

Romberg maneuver, 3281

Romberg sign, 161, 169, 176

Rombo’s syndrome, 586

Romidepsin, 513t, 517, 549t, 552, 850, 857

Romiplostim, 907

Romosozumab, 3208

Root canal therapy, 256, 262

Root cavity, A3

Ropinirole, 208t, 212, 3395, 3396t, 3409

ROS. See Reactive oxygen species (ROS)

ROS1 gene mutations, 596, 596f, 597t, 607

Rosacea. See Acne rosacea

Rosenbaum card, 216, 216f

Roseola (exanthem subitum), 134t, 141, 1491, A1

Rose spots, 1293f, A1

Rosiglitazone

actions of, 2529, 3112

adverse effects of, 3110t, 3112

contraindications to, 3110t

for NALFD, 2623

for type 2 diabetes mellitus, 3110t, 3112

Ross procedure, 1983

Ross River virus infection (epidemic polyarthritis),

1044, 1625t, 1633–1634

Rosuvastatin, 2049, 3126, 3142t, 3156. See also

Statins

Rotational atherectomy, 2067

Rotator cuff tendinitis, 2849, 2878–2879, 2878f

Rotaviruses, 1456, 1597t, 1598f, 1599

Rotavirus infections

clinical features of, 292, 300t, 1600

diagnosis of, 301, 1597t, 1600

epidemiology of, 1063, 1064t, 1599, 1600f

global considerations in, 1599, 1600f

immunity to, 1600

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

pathogenesis of, 1600

prevention of, 1600–1601

in transplant recipient, 1141

treatment of, 1600

Rotavirus vaccine, 1601, 3699

Roth’s spots, 221, 221f, 979

Rotigotine, 3395, 3396t, 3409

Rotor syndrome, 318, 2561, 2561t

Rouleaux formation, 425, 427f

Round pneumonia, 1174

Roundworms, 1697–1698. See also Nematodes/

nematode infections

Rousettus aegypticus, 1646

Rous sarcoma virus, 499, 1522t

Roux-en-Y gastric bypass, 3093f, 3094, 3133

Rove beetle, 3615

INDEX

Rovsing’s sign, 2514, 2514t I-195

Rowasa enemas, 2483

RPE65 gene mutations, 3686t, 3688

rpoB gene, 1375

RPR (rapid plasma reagin) test, 1411

rRNA (ribosomal RNA), 963

RS3PE syndrome, 2759

RSDL (reactive skin decontamination lotion), S4

RSV604, 1464

RSV infections. See Respiratory syncytial virus

(RSV) infections

rT3

(reverse T3

), 2926f

RTA. See Renal tubular acidosis (RTA)

RTEL1, 3680

RTEL1 gene mutations, 3682, 3682t

RTH (resistance to thyroid hormone), 2930–2931,

2930t, 3649

rtPA (recombinant tissue plasminogen activator).

See Alteplase (rtPA)

RT-PCR (reverse transcriptase polymerase chain

reaction), 1560, 1560t

RTX (resiniferatoxin), 3786

Rubella (German measles), 1612

clinical features of, 134t, 393, 1612–1613

oral, 257

skin, 134t, 141, 393, 1613f, A1

congenital, 981t, 1100, 1613, 1613t, 3767–3768

diagnosis of, 1613

differential diagnosis of, 1486t

epidemiology of, 1612

global considerations in, 1612, 1614, 1614f

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

pathogenesis of, 1612

in pregnancy, 141, 1613–1614, 3767–3768

prevention of, 1614

treatment of, 1614

Rubella vaccine, 1614, 1614f, 3768. See also

Measles-mumps-rubella vaccine (MMR)

Rubella virus, 1612

Rubeola. See Measles

Rubidium-82, 1834t, 1835

Rubinstein-Taybi syndrome, 3645t, 3795

Rubivirus, 1612. See also Rubella

Rubor, 440f, 2108

Rubrospinal pathway, 166f

Rucaparib, 513t, 551t, 688, 3838

Rufinamide, 3319t

Rumination, 291, 2424

Rumination disorder/syndrome, 292, 3552

RUNX1 gene mutations, 800, 809, 809t, 812, 812t,

820, 864

Runx2, 3157–3158

Russell body gastritis, 2458

Russell’s viper bite, 3596, 3597f, 3601. See also

Snakebites

Russell venom viper test, 2745

Ruxolitinib

actions of, 513t, 544, 545t

adverse effects of, 545t, 805, 807

for atypical chronic myeloid leukemia, 860

for chronic neutrophilic leukemia, 859

for hemophagocytic syndrome, 865

for polycythemia vera, 804–805

for primary myelofibrosis, 807

RV (residual volume), 2134, 2134f, 2135f,

2138f

RV144, 1596

R value, 2584

R wave, 1824, A7

RYR1 gene, 477t, 478

RYR2 gene mutations, 1956t

RYR3 gene, 1552t, 1554

S-100 protein, in carcinoma of unknown primary,

718t

SAAG (serum ascites-albumin gradient), 323

Saaremaa virus, 1628t

Sabiá virus, 1626t

Saccades, 217, 231

Saccadomania, 231

Saccharopinuria, 3270t

Saccular aneurysm, 2101, 2102, 3353–3355. See

also Aortic aneurysm; Subarachnoid

hemorrhage

Sacituzumab, 536f, 542, 613t, 625

Sacral insufficiency fracture, A16

Sacral neuromodulation, 330, 2503

Sacral pain, 125

Sacral spinal lesions, 3446

Sacroiliitis

in axial spondyloarthritis, 2791, 2793

in IBD, 2480, 2481t

in reactive arthritis, 2797, 2798

SACT (sinoatrial conduction time), 1875

Sacubitril-valsartan, 1941, 1945, 1947–1948,

1948t

Saddle nose deformity

in granulomatosis with polyangiitis, 1816,

2806

in relapsing polychondritis, 1816, 2827, 2828f

Safety in health care, 50. See also Adverse events

Safety theory, 51

Safinamide, 3395, 3396t

Sagging brain syndrome, 3376

St. John’s wort, 422t, 471t, 473, 3786, 3787

St. Louis encephalitis, 1626t, 1636–1637

St. Vitus’ dance. See Sydenham’s chorea

Salary compensation plan, 24

Salicylates

adverse effects of, 240, 362, 368, 2744t

drug interactions of, 471t, 542

overdosage/poisoning with, 362–363, 3585,

3594t

for rheumatic fever, 2768–2769

for SLE, 2744t

Salicylic acid

for acne vulgaris, 382

for prickly heat, 3636

for scabies, 3608

for tinea versicolor, 381

for warts, 381

Salience network, 203

Saline

half-normal, for hypovolemia, 341

hypertonic, 345, 352, 2270t

hypotonic, 341, 347

isotonic, 341, 347, 366, 3598

normal

for hypercalcemia, 357

for hypercalcemia of malignancy, 723

for hyperkalemia, 355

for hyponatremia, 345

for hypovolemia, 341

for sepsis/septic shock, 2248

for SIADH, 723

for sinusitis, 252

for sore throat, 254

Saline infusion test, 2965

Saliva, 237, 261, 1535

Salivary duct obstruction, 261

Salivary gland(s)

benign tumors of, 590, 594

diseases of, 261–262

enlargement of, 2789, 2789t

IgG-4 related lesions of, 2837, 2838f, 2838t

malignant tumors of, 262, 590, 594

Salivary stone (sialolithiasis), 261, A3

Saliva substitutes, 261

Salmeterol, 1400, 2156, 2186

Salmonella spp.

antibiotic resistance in, 1157t, 1296, 1298

chronic carriage of, 1295

laboratory identification of, S11

S. enteritidis, 1295–1296

S. typhimurium. See Salmonella Typhimurium

subspecies/serotypes, 1291–1292

Salmonella spp. infections, 1295. See also Enteric

(typhoid) fever

antibiotic resistance in, 1296, 1298

aortitis, 2107

bacteremia, 1296–1297

bone, joint, and soft tissue, 1297

in cancer patient, 558t, 561

CNS, 1297

diagnosis of, 1065, 1297, S11

endovascular, 1296–1297

epidemiology of, 1295–1296

etiology of, 1291–1292

food-related, 300

gastroenteritis

clinical features of, 300, 300t, 1064t, 1296

epidemiology of, 1295–1296

vs. IBD, 2479

pathogenesis of, 1292

treatment of, 1065t, 1066, 1297–1298, 1297t

genital, 1297

global considerations in, 1296

in HIV infection, 1564t, 1568

intraabdominal, 1297

prevention and control of, 1298

pulmonary, 1297

reactive arthritis and, 2797

splenic abscess, 1059–1060

in transplant recipient, 1143

treatment of, 1156–1157t, 1297–1298, 1297t

urinary tract, 1297

Salmonella Paratyphi, 1291–1292. See also Enteric

(typhoid) fever

Salmonella Typhi, 1291–1292. See also Enteric

(typhoid) fever

Salmonella Typhimurium

adherence of, 951

antibiotic resistance in, 1296

as bioweapon, S3

cytotoxins, 958

entry into host, 948

immune response inhibition by, 958

inflammasomes of, 957

secretion systems, 952

serotypes, 1292, 1296

Salmonellosis, nontyphoidal. See Salmonella spp.

infections

Salmon River virus, 1625t

Salp15, 1426

Salpingitis

abdominal pain in, 85, 111t, 112, 1087

clinical features of, 1087

C. trachomatis, 1447, 1449t

diagnosis of, 1087

treatment of, 1089

Salpingo-oophorectomy, 695, 698

Salsalate, 2861t

Salt-depletion heat exhaustion, 3636

Salt therapy, 155, 345, 366

Salt-wasting disorders, 338, 342, 2073

Salty taste sensation, 233

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