, a LANGE medical book
2023
CURRENT
Medical Diagnosis
& Treatment
SIXT Y-SECOND EDITION
Edited by
Maxine A. Papadakis, MD
Professor of Medicine, Emeritus
Department of Medicine
University of California, San Francisco
Stephen J. McPhee, MD
Professor of Medicine, Emeritus
Division of General Internal Medicine
Department of Medicine
University of California, San Francisco
Michael W. Rabow, MD
Professor of Medicine and Urology
Division of Palliative Medicine
Department of Medicine
University of California, San Francisco
Associate Editor
Kenneth R. McQuaid, MD
Professor of Medicine
Department of Medicine
University of California, San Francisco
With Contributing Authors
New York Chicago San Francisco Athens London Madrid Mexico City
Milan New Delhi Singapore Sydney Toronto
CMDT2023_FM_pi-xx.indd 1 30/06/22 2:57 PM
,Copyright © 2023 by McGraw Hill. All rights reserved. Except as permitted under the United States Copyright Act of 1976,
no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval
system, without the prior written permission of the publisher.
ISBN: 978-1-26-468774-9
MHID: 1-26-468774-5
The material in this eBook also appears in the print version of this title: ISBN: 978-1-26-468734-3,
MHID: 1-26-468734-6.
eBook conversion by codeMantra
Version 1.0
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a
trademarked name, we use names in an editorial fashion only, and to the benet of the trademark owner, with no intention of
infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps.
McGraw Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corpo-
rate training programs. To contact a representative, please visit the Contact Us pages at www.mhprofessional.com.
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment
and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in
their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publica-
tion. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher
nor any other party who has been involved in the preparation or publication of this work warrants that the information con-
tained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for
the results obtained from use of the information contained in this work. Readers are encouraged to conrm the information
contained herein with other sources. For example and in particular, readers are advised to check the product information sheet
included in the package of each medication they plan to administer to be certain that the information contained in this work is
accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This
recommendation is of particular importance in connection with new or infrequently used medications.
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work
is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy
of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon,
transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill Education’s prior
consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited.
Your right to use the work may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARAN-
TEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE
OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH
THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR
IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE. McGraw-Hill Education and its licensors do not warrant or guarantee that the functions
contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-
Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause,
in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for the content of any
information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable
for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use
the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to
any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.
, Contents
Authors v 13. Blood Disorders 500
Preface xiii
Dedication xvii Lloyd E. Damon, MD, &
Charalambos Babis Andreadis, MD, MSCE
Year in Review: Key Clinical Updates in
CMDT 2023 14. Disorders of Hemostasis, Thrombosis,
& Antithrombotic Therapy 546
1. Disease Prevention & Health Promotion 1
Andrew D. Leavitt, MD, &
Michael Pignone, MD, MPH, & René Salazar, MD Erika Leemann Price, MD, MPH
2. Common Symptoms 15
15. Gastrointestinal Disorders 579
Paul L. Nadler, MD, & Ralph Gonzales, MD, MSPH
Kenneth R. McQuaid, MD
3. Preoperative Evaluation &
Perioperative Management 42 16. Liver, Biliary Tract, & Pancreas
Hugo Q. Cheng, MD
Disorders 674
Lawrence S. Friedman, MD
4. Geriatric Disorders 52
Leah J. Witt, MD, Rossana Lau-Ng, MD, & 17. Breast Disorders 737
G. Michael Harper, MD Armando E. Giuliano, MD, FACS, FRCSEd, &
Sara A. Hurvitz, MD, FACP
5. Palliative Care & Pain Management 69
Michael W. Rabow, MD, Steven Z. Pantilat, MD, 18. Gynecologic Disorders 763
Ann Cai Shah, MD, Lawrence Poree, MD, MPH, PhD,
& Raj Mitra, MD Jill Brown, MD, MPH, MHS, FACOG, &
Katerina Shvartsman, MD, FACOG
6. Dermatologic Disorders 101
19. Obstetrics & Obstetric Disorders 794
Kanade Shinkai, MD, PhD, & Lindy P. Fox, MD
Vanessa L. Rogers, MD, & Scott W. Roberts, MD
7. Disorders of the Eyes & Lids 168
Jacque L. Duncan, MD, Neeti B. Parikh, MD, & 20. Rheumatologic, Immunologic,
Gerami D. Seitzman, MD & Allergic Disorders 819
Rebecca L. Manno, MD, MHS, Jinoos Yazdany, MD,
8. Otolaryngology Disorders 204 MPH, Teresa K. Tarrant, MD, & Mildred Kwan, MD, PhD
Elliott D. Kozin, MD, & Lawrence R. Lustig, MD
21. Electrolyte & AcidBase Disorders 875
9. Pulmonary Disorders 244
Nayan Arora, MD, & J. Ashley Jefferson, MD, FRCP
Meghan E. Fitzpatrick, MD, Niall T. Prendergast,
MD, & Belinda Rivera-Lebron, MD, MS, FCCP 22. Kidney Disease 903
10. Heart Disease 323 Tonja C. Dirkx, MD, & Tyler B. Woodell, MD, MCR
Todd Kiefer, MD, Christopher B. Granger, MD, &
Kevin P. Jackson, MD 23. Urologic Disorders 943
Mathew Sorensen, MD, MS, FACS,
11. Systemic Hypertension 442 Thomas J. Walsh, MD, MS, & Brian J. Jordan, MD
Michael Sutters, MD, MRCP (UK)
24. Nervous System Disorders 970
12. Blood Vessel & Lymphatic Disorders 473
Vanja C. Douglas, MD, &
Warren J. Gasper, MD, James C. Iannuzzi, MD, MPH, Michael J. Aminoff, MD, DSc, FRCP
& Meshell D. Johnson, MD
iii
CMDT2023_FM_pi-xx.indd 3 30/06/22 2:57 PM
2023
CURRENT
Medical Diagnosis
& Treatment
SIXT Y-SECOND EDITION
Edited by
Maxine A. Papadakis, MD
Professor of Medicine, Emeritus
Department of Medicine
University of California, San Francisco
Stephen J. McPhee, MD
Professor of Medicine, Emeritus
Division of General Internal Medicine
Department of Medicine
University of California, San Francisco
Michael W. Rabow, MD
Professor of Medicine and Urology
Division of Palliative Medicine
Department of Medicine
University of California, San Francisco
Associate Editor
Kenneth R. McQuaid, MD
Professor of Medicine
Department of Medicine
University of California, San Francisco
With Contributing Authors
New York Chicago San Francisco Athens London Madrid Mexico City
Milan New Delhi Singapore Sydney Toronto
CMDT2023_FM_pi-xx.indd 1 30/06/22 2:57 PM
,Copyright © 2023 by McGraw Hill. All rights reserved. Except as permitted under the United States Copyright Act of 1976,
no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval
system, without the prior written permission of the publisher.
ISBN: 978-1-26-468774-9
MHID: 1-26-468774-5
The material in this eBook also appears in the print version of this title: ISBN: 978-1-26-468734-3,
MHID: 1-26-468734-6.
eBook conversion by codeMantra
Version 1.0
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a
trademarked name, we use names in an editorial fashion only, and to the benet of the trademark owner, with no intention of
infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps.
McGraw Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corpo-
rate training programs. To contact a representative, please visit the Contact Us pages at www.mhprofessional.com.
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment
and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in
their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publica-
tion. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher
nor any other party who has been involved in the preparation or publication of this work warrants that the information con-
tained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for
the results obtained from use of the information contained in this work. Readers are encouraged to conrm the information
contained herein with other sources. For example and in particular, readers are advised to check the product information sheet
included in the package of each medication they plan to administer to be certain that the information contained in this work is
accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This
recommendation is of particular importance in connection with new or infrequently used medications.
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work
is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy
of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon,
transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill Education’s prior
consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited.
Your right to use the work may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARAN-
TEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE
OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH
THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR
IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE. McGraw-Hill Education and its licensors do not warrant or guarantee that the functions
contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-
Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause,
in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for the content of any
information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable
for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use
the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to
any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.
, Contents
Authors v 13. Blood Disorders 500
Preface xiii
Dedication xvii Lloyd E. Damon, MD, &
Charalambos Babis Andreadis, MD, MSCE
Year in Review: Key Clinical Updates in
CMDT 2023 14. Disorders of Hemostasis, Thrombosis,
& Antithrombotic Therapy 546
1. Disease Prevention & Health Promotion 1
Andrew D. Leavitt, MD, &
Michael Pignone, MD, MPH, & René Salazar, MD Erika Leemann Price, MD, MPH
2. Common Symptoms 15
15. Gastrointestinal Disorders 579
Paul L. Nadler, MD, & Ralph Gonzales, MD, MSPH
Kenneth R. McQuaid, MD
3. Preoperative Evaluation &
Perioperative Management 42 16. Liver, Biliary Tract, & Pancreas
Hugo Q. Cheng, MD
Disorders 674
Lawrence S. Friedman, MD
4. Geriatric Disorders 52
Leah J. Witt, MD, Rossana Lau-Ng, MD, & 17. Breast Disorders 737
G. Michael Harper, MD Armando E. Giuliano, MD, FACS, FRCSEd, &
Sara A. Hurvitz, MD, FACP
5. Palliative Care & Pain Management 69
Michael W. Rabow, MD, Steven Z. Pantilat, MD, 18. Gynecologic Disorders 763
Ann Cai Shah, MD, Lawrence Poree, MD, MPH, PhD,
& Raj Mitra, MD Jill Brown, MD, MPH, MHS, FACOG, &
Katerina Shvartsman, MD, FACOG
6. Dermatologic Disorders 101
19. Obstetrics & Obstetric Disorders 794
Kanade Shinkai, MD, PhD, & Lindy P. Fox, MD
Vanessa L. Rogers, MD, & Scott W. Roberts, MD
7. Disorders of the Eyes & Lids 168
Jacque L. Duncan, MD, Neeti B. Parikh, MD, & 20. Rheumatologic, Immunologic,
Gerami D. Seitzman, MD & Allergic Disorders 819
Rebecca L. Manno, MD, MHS, Jinoos Yazdany, MD,
8. Otolaryngology Disorders 204 MPH, Teresa K. Tarrant, MD, & Mildred Kwan, MD, PhD
Elliott D. Kozin, MD, & Lawrence R. Lustig, MD
21. Electrolyte & AcidBase Disorders 875
9. Pulmonary Disorders 244
Nayan Arora, MD, & J. Ashley Jefferson, MD, FRCP
Meghan E. Fitzpatrick, MD, Niall T. Prendergast,
MD, & Belinda Rivera-Lebron, MD, MS, FCCP 22. Kidney Disease 903
10. Heart Disease 323 Tonja C. Dirkx, MD, & Tyler B. Woodell, MD, MCR
Todd Kiefer, MD, Christopher B. Granger, MD, &
Kevin P. Jackson, MD 23. Urologic Disorders 943
Mathew Sorensen, MD, MS, FACS,
11. Systemic Hypertension 442 Thomas J. Walsh, MD, MS, & Brian J. Jordan, MD
Michael Sutters, MD, MRCP (UK)
24. Nervous System Disorders 970
12. Blood Vessel & Lymphatic Disorders 473
Vanja C. Douglas, MD, &
Warren J. Gasper, MD, James C. Iannuzzi, MD, MPH, Michael J. Aminoff, MD, DSc, FRCP
& Meshell D. Johnson, MD
iii
CMDT2023_FM_pi-xx.indd 3 30/06/22 2:57 PM
