GLOSSARY

Absolute polycythemia excessive red blood significant dilation of the cecum and absence of Acute orthostatic hypotension an abnor-
cell production; a physiologic response result- mechanical obstruction, and is related to exces- mal decrease in blood pressure when a person
ing from increased erythropoietin secretion in sive sympathetic motor input or decreased para- stands. This may lead to fainting.
response to chronic hypoxia or as a symptom of sympathetic motor input. Acute pancreatitis inflammation of the pan-
polycythemia vera. Acute confusional state (ACS) a form of delir- creas resulting from obstruction to the outflow
Absorption atelectasis see Atelectasis. ium caused by interference with the metabolic or of pancreatic digestive enzymes caused by bile
Acid maltase deficiency (glycogen storage other biochemical processes essential for normal duct or pancreatic duct obstruction (e.g., gall-
disease type II or Pompe disease) an auto- brain functioning. Symptoms may include distur- stones). Usually a mild disease and resolves
somal recessive metabolic disorder that dam- bances in cognition and levels of awareness, short- spontaneously.
ages muscle and nerve cells throughout the body term memory deficit, retrograde and anterograde Acute poststreptococcal glomerulonephritis
by an accumulation of glycogen in the lysosome amnesia, and disturbances in orientation, accom- (PSGN) see Glomerulonephritis.
attributable to deficiency of the lysosomal acid panied by restlessness, apprehension, irritability, Acute pyelonephritis acute inflammation of
α-glucosidase enzyme. The buildup of glycogen and apathy. The condition may be associated with the renal parenchyma and pelvis characterized
causes progressive muscle weakness (myopathy) an acute physiologic state, delirium, toxic psycho- by small cortical abscesses and yellowish streaks
throughout the body and affects various body sis, or acute brain syndrome. in the medulla resulting from the accumulation
tissues, particularly in the heart, skeletal mus- Acute coronary syndrome a classification of pus in the collecting tubules and interstitial
cles, liver, and nervous system. encompassing clinical presentations ranging tissue.
Acne a common skin disease characterized by from unstable angina through infarction. Acute renal failure (acute renal injury)
pimples on the face, chest, and back. It occurs Acute cystitis an inflammation of the bladder, a sudden decline in kidney function with a
when the pores of the skin become clogged with which is the most common site of urinary tract decrease in glomerular filtration and accumula-
oil, dead skin cells, and bacteria. infection. tion of nitrogenous waste products in the blood
Acne conglobata severe cystic acne charac- Acute epiglottitis an infection that causes as demonstrated by an elevation in plasma cre-
terized by cystic lesions, abscesses, communi- inflammation of the epiglottis and surrounding atinine and blood urea nitrogen levels.
cating sinuses, and thickened, nodular scars; tissues and may lead to upper airway blockage. Acute respiratory distress syndrome (ARDS)
usually does not affect the face. Acute gastritis an inflammatory disorder of the capillaries or alveoli of the lungs are damaged
Acne rosacea a chronic form of dermatitis of gastric mucosa, usually caused by injury of the as a result of infection, injury, blood loss, or
the face in which the middle portion of the protective mucosal barrier by drugs, chemicals, inhalation injury causing fluid to leak from the
face appears red with small red lines caused or Helicobacter pylori infection. capillaries into the alveoli, resulting in pulmo-
by dilation of capillaries. Acute glomerulonephritis see Glomerulone- nary edema and collapse of some alveoli.
Acne vulgaris an inflammatory eruption of phritis. Acute tubular necrosis (ATN) the kidney
the sebaceous follicles usually occurring on Acute gouty arthritis an abrupt pain of a joint, undergoes ischemic or nephrotoxic injury
the face, upper back, and chest that consists most often the great toe, which is swollen, hot, because of severe hypotension, aminoglyco-
of blackheads, cysts, papules, and pustules. and shiny secondary to an attack of gout. sides, or radiocontrast agents and produces
Noninflammatory acne open comedones Acute idiopathic thrombotic thrombocytope- granular and epithelial cell casts in urine.
caused by the enlargement and dilation of a nic purpura (TTP) see Thrombocytopenia. Acute urethral syndrome the bladder is irri-
plug resulting from the accumulation of oil Acute leukemia see Leukemia. tated and the typical symptoms of a urinary
and dead skin cells inside the hair follicle and Acute liver failure (fulminant liver failure) a tract infection are present in the absence of an
by closed comedones that form if the hair rare clinical syndrome resulting from severe infection.
follicle pore remains closed; they appear as a impairment or necrosis of liver cells without Adenocarcinoma tumor arising from epithelial
tiny, sometimes pink bump in the skin. pre-existing liver disease or cirrhosis. Acetamin- cells with a glandular or glandlike pattern.
Acquired immunodeficiency syndrome ophen overdose is the leading cause. Adenocystic tumor (cylindroma) rare bron-
(AIDS) see Immune deficiency. Acute lung injury (ALI)/acute respiratory dis- chial gland tumors that arise predominantly
Acquired sideroblastic anemia see Anemia. tress syndrome (ARDS) a spectrum of acute in the trachea or large airways and cause
ACTH deficiency a condition characterized by lung inflammations and diffuse alveolocapillary obstruction.
decreased or absent production of adrenocor- injury. Adenomyosis the presence of islands of endo-
ticotropic hormone (ACTH) by the pituitary Acute lymphoblastic leukemia (ALL) see metrial glands surrounded by benign endome-
gland, resulting in a reduction in the secretion Leukemia. trial stroma within the uterine myometrium.
of adrenal hormones and subsequent weight Acute mesenteric ischemia caused by acute Adenosine deaminase (ADA) deficiency see
loss, lack of appetite, weakness, nausea, vomit- occlusion of the mesenteric artery that results in Immune deficiency.
ing, and low blood pressure. a significant reduction in mucosal blood flow to Adrenarche growth of axillary and pubic hair
Actinic keratosis a condition in which a pre- the large and small intestines. Aortic aneurysms, and other physiologic changes induced by
malignant small, reddish, rough spot appears on arterial thrombi, or emboli can be causes. hyperactivity of the suprarenal cortex and adre-
skin chronically exposed to the sun. Acute mountain sickness (AMS) the pres- nocortical secretion of androgenic hormones in
Acute chest syndrome a syndrome occurring ence of a combination of nonspecific symp- early puberty.
in association with sickle cell disease defined by toms that appear within a few hours after ascent Agammaglobulinemia see Immune deficiency.
a new infiltrate on chest radiograph; associated to altitude, and may include headache, loss of Ageusia loss of the sense of taste.
with one or more new symptoms: fever, cough, appetite, nausea, vomiting, weakness, lassitude, Agoraphobia a mental disorder characterized
sputum production, dyspnea, or hypoxia. It dizziness, and difficulty sleeping. by an irrational fear of leaving the familiar
occurs most commonly in the 2- to 4-year-old Acute myelogenous leukemia (AML) see setting of home, or venturing into the open,
age group and declines in incidence with age. Leukemia. so pervasive that a large number of external
Acute colonic pseudo-obstruction (Ogil- Acute otitis media (AOM) an infection of the life situations are entered into reluctantly
vie syndrome) a massive dilation of the large middle ear space, behind the eardrum (tym- or are avoided; often associated with panic
bowel that occurs in critically ill patients and panic membrane); characterized by pain, dizzi- attacks.
immobilized older adults. It is characterized by ness, and partial loss of hearing. Agranulocytosis see Immune deficiency.

1728
 GLOSSARY 1729

Akinesia slowness or loss of normal motor func- Anaphylactoid purpura (allergic purpura, Thalassemia a potentially fatal genetic
tion resulting in impaired muscle movement. Henoch-Schönlein purpura) nonthrom- disorder in which hemoglobin molecules
Akinetic mutism (AM) a syndrome character- bocytopenic purpura attributable to immune are abnormal, resulting in severe anemia;
ized by the inability to speak, loss of voluntary hypersensitivity to foods, drugs, and insect bites. enlarged heart, liver, and spleen; and skel-
movement, and apparent loss of emotional Anemia hemoglobin concentration is less than etal deformation.
feeling. It is related to lesions of the upper normal because of a deficiency in red blood Macrocytic anemia (megaloblastic anemia)
brainstem. cells, a low level of hemoglobin in cells, or both; a condition characterized by erythrocytes
Albright syndrome (Albright-McCune-Stern- it manifests as pallor of the skin and mucous that are larger than normal; associated
berg syndrome) polyostotic fibrous dyspla- membranes, weakness, dizziness, easy fatigabil- with deficiency of vitamin B12 or folic acid
sia, patchy dermal pigmentation, and endocrine ity, and drowsiness caused by oxygen deficiency. caused by inadequate intake or insufficient
dysfunction. Congenital hemolytic anemias absorption secondary to alcoholism or drugs
Alcoholic cirrhosis see Cirrhosis. Alpha-thalassemia major thalassemia in that inhibit DNA replication.
Alcoholic fatty liver (steatosis) the mildest which all four α-chains of hemoglobin Pernicious anemia an autoimmune dis-
form of alcoholic liver disease; can be caused by are defective, resulting in a fatal condition order that causes a deficiency in intrinsic
chronic ingestion of relatively small amounts of because oxygen cannot be released to the factor, resulting in the inability to absorb
alcohol, may be asymptomatic, and is reversible tissues. vitamin B12 and a subsequent increase in
with cessation of drinking. Alpha-thalassemia minor thalassemia in the production of abnormal erythrocytes.
Alcoholic hepatitis (steatohepatitis) a pre- which two α-chains of hemoglobin are Microcytic-hypochromic anemia a condi-
cursor of cirrhosis characterized by inflamma- defective. tion in which red blood cells are smaller than
tion; degeneration and necrosis of hepatocytes; Beta-thalassemia major (Cooley ane- normal as a result of iron deficiency.
infiltration of neutrophils, macrophages, and mia) thalassemia in which α-chain Acquired sideroblastic anemia a hetero-
lymphocytes; immunologic alterations; and synthesis and β-chain synthesis are uncou- geneous group of disorders characterized
lipid peroxidation. pled; β-chain production is depressed by anemia of varying severity caused by
Algor mortis postmortem reduction of body moderately in the heterozygous form, a defect in mitochondrial heme synthe-
temperature. beta-thalassemia minor, and severely in sis; occurs as a primary disorder with no
Alkaline reflux gastritis inflammation of the the homozygous form, beta-thalassemia known cause (idiopathic) or is associated
stomach caused by reflux of bile and alkaline major, resulting in erythrocytes that have with other myeloproliferative or myelo-
pancreatic secretions that contain proteolytic a reduced amount of hemoglobin and plastic disorders.
enzymes and disrupt the mucosal barrier in the accumulations of free α-chains. Hereditary sideroblastic anemia het-
remnant stomach. Beta-thalassemia minor see above. erogeneous group of rare disorders char-
Allergic contact dermatitis contact dermatitis Glucose-6-phosphate dehydrogenase acterized by anemia of varying severity
attributable to allergic sensitization. (G6PD) deficiency an inherited condi- caused by a defect in mitochondrial heme
Allodynia a condition in which pain arises from tion that is asymptomatic in the absence synthesis; occurs almost exclusively in
a stimulus that would not normally be experi- of exposure to particular substances such males, suggesting a predominant recessive
enced as painful. as certain medicines, mothballs, or severe X-linked transmission.
Allostasis long-term or chronic exaggerated infections; with exposure the red blood Hypoplastic anemia a condition in which
responses to stress. cells undergo destruction, producing anemia results from greatly depressed,
Alogia inability to speak because of mental defi- excessive bilirubin that overloads the liver inadequately functioning bone marrow
ciency, mental confusion, or aphasia. and causes jaundice. and smaller-than-normal erythrocytes.
Alopecia loss of hair. Hemoglobin H disease a form of alpha- Iron deficiency anemia (IDA) an insuffi-
Alopecia areata an autoimmune T-cell–medi- thalassemia in which a hemoglobin H gene cient dietary intake or absorption of iron,
ated chronic inflammatory disease directed at is expressed but cannot bind oxygen. resulting in decreased incorporation of
hair follicles that results in baldness, usually in Hereditary spherocytosis (congenital hemoglobin into red blood cells and sub-
round patches. hemolytic anemia, congenital achol- sequent feelings of fatigue, weakness, and
Alpha-thalassemia major see Anemia. uric jaundice) a defect in the cell shortness of breath as well as pale earlobes,
Alpha-thalassemia minor see Anemia. membrane of red blood cells that causes palms, and conjunctivae.
Alzheimer disease (dementia of Alzheimer thickened, fragile red blood cells that are Reversible sideroblastic anemia associ-
type [DAT], senile disease complex) a susceptible to spontaneous hemolysis and ated with alcoholism; results from nutri-
degenerative disease characterized by amyloid results in chronic anemia, jaundice, fever, tional deficiencies of folate.
plaques and fibrillary tangles in the cortex and and abdominal pain. Sideroblastic anemia (SA) refractory
atrophy and widened sulci in the frontal and Sickle cell anemia (sickle cell disease anemia of varying severity that is caused
temporal lobes. [SCD]) an inherited autosomal recessive by altered mitochondrial metabolism
Amblyopia poor vision caused by abnormal disorder of the blood caused by abnor- and is marked by sideroblasts in the bone
development of visual areas of the brain in mal hemoglobin that distorts red blood marrow.
response to abnormal visual stimulation during cells and makes them fragile and prone to Normocytic-normochromic anemia (NNA)
early development. rupture and can cause anemia, joint pain, erythrocytes are of normal size and
Amyotrophic lateral sclerosis (ALS) (spo- fever, leg ulcers, and jaundice. hemoglobin content but of insufficient
radic motor system disease, sporadic Sickle cell–Hb C disease a heterozy- number; usually caused by hereditary
motor neuron disease, motor neuron dis- gous form in which the child simultane- spherocytosis, drug-induced anemia, and
ease, Lou Gehrig disease) a disease that ously inherits a hemoglobin C gene from anemia secondary to malignancies.
breaks down tissues in the nervous system (a another parent. Anemia of chronic disease (ACD) a
neurodegenerative disease); it is of unknown Sickle cell–thalassemia disease a het- mild to moderate anemia resulting from
cause and affects the nerves responsible for erozygous form in which the child simul- decreased erythropoiesis in individuals
movement. taneously inherits a thalassemia gene from with conditions of chronic systemic dis-
Anaphylactic shock a state of shock caused by another parent. ease or inflammation.
a severe allergic reaction that lowers blood pres- Sickle cell trait an inherited condition in Aplastic anemia decreased bone mar-
sure and results in urticaria, breathing difficul- which an individual carries only one gene for row production of adequate amounts
ties, and possibly death. sickle cell disease and is without symptoms. of new red blood cells; results from an
1730 GLOSSARY

autoimmune disorder or exposure to volume and accelerate the formation and rarely, sinovenous thrombosis and leading to a
radiation or substances such as benzene or development of blood cells. decreased flow of blood and oxygen to areas of
certain drugs. Warm autoimmune hemolytic anemia the brain.
Aplastic crisis temporary loss of bone the most common form of autoimmune Asbestosis pulmonary inflammation and fibro-
marrow causes erythropoiesis, resulting hemolytic anemia; caused by IgG that sis resulting from inhalation of hydrous silicates
in an acute fall in hemoglobin levels and binds to erythrocytes at normal body of various metals in fibrous form.
subsequent anemia. temperature; often secondary to other Aseptic meningitis a form of inflammation
Autoimmune hemolytic anemia (AIHA) diseases, especially lymphomas, chronic of the meninges and subarachnoid space sur-
a form of hemolytic anemia involving auto- lymphocytic leukemia, other neoplastic rounding the brain and spinal cord without
antibodies against red blood cell antigens. disorders, or systemic lupus erythemato- evidence of bacterial infection; may be associ-
Cold agglutinin autoimmune hemolytic sus (SLE). ated with viral infection, systemic disease, or
anemia acquired disorder caused by Anencephaly anomaly in which the soft, bony drugs.
autoantibodies against antigens normally component of the skull and much of the brain Aspiration pneumonitis a condition caused by
on the surface of erythrocytes; mediated are missing. the abnormal entry of fluids, particulate mat-
by immunoglobulin M (IgM) antibod- Angelman syndrome (happy puppet syn- ter, or secretions into the lower airways that
ies that optimally bind to and agglutinate drome) an inherited syndrome of jerky pup- can lead to chemical pneumonitis from entry of
erythrocytes in colder portions of the body petlike movements, frequent laughter, mental toxic material such as gastric acid, from bacte-
(e.g., fingers, toes), and occurs less often and motor retardation, peculiar open-mouthed rial infection, or by mechanical obstruction of
than warm antibody hemolysis, affecting facies, and seizures. the lower airways.
mostly middle-aged and older adults. Angina pectoris chest pain caused by reduced Asthma a chronic inflammatory disorder of the
Cold hemolysin autoimmune hemolytic cardiac blood flow and myocardial ischemia. airways involving bronchial hyperresponsive-
anemia (paroxysmal cold hemoglo- Anhedonia absence of pleasure from the per- ness and airway obstruction marked by periodic
binuria) a disorder in which exposure to formance of acts that would ordinarily be attacks of wheezing, shortness of breath, a tight
cold initiates acute and severe intravascu- pleasurable. feeling in the chest, and a cough that produces
lar hemolysis that, unlike cold agglutinin Ankylosing spondylitis (AS, spondyloarthri- mucus because of an allergic reaction triggered
anemia, results in hemoglobinuria. The tis) chronic inflammation of the spine and by certain drugs, irritants, viral infection, exer-
chronic form of this anemia is extremely sacroiliac joints with gradual fusion of the ver- cise, or emotional stress.
rare, but an acute form of paroxysmal cold tebrae that immobilizes the spine. Asymptomatic bacteriuria the presence of bac-
hemoglobinuria is frequently observed Anorexia nervosa (AN) a disorder with both teria in the urine without evidence of infection.
in autoimmune hemolytic anemia of psychologic and physiologic components that Ataxia-telangiectasia (AT) see Immune
childhood. begins with dieting to lose weight and manifests deficiency.
Drug-induced hemolytic anemia a form into an inappropriate self-control behavior; Ataxic cerebral palsy a form of cerebral palsy
of immune hemolytic anemia usually continued restrictive eating may lead to starva- associated with damage to the cerebellum and
resulting from an allergic reaction against tion and eventually death. resulting in gait disturbances and instability;
foreign antigens (e.g., antibiotics) that Anorgasmia (orgasmic dysfunction) the at birth the infant may have hypotonia, but
have attached to the surface of red blood inability of the woman to reach or achieve develops stiffness of the trunk muscles later in
cells. orgasm. infancy.
Fanconi anemia a genetic disease affect- Anuria urine output less than 50 ml/day. Atelectasis a part of or an entire lung collapses
ing bone marrow that is characterized Anxiety disorder a group of disorders involv- and the alveoli deflate as a result of surgery,
by pancytopenia, hypoplasia of the bone ing various manifestations of anxiety that are smoking, or blockage of a bronchiole.
marrow, congenital anomalies, and grouped together and include panic disorder, Absorption atelectasis collapse of lung
pigment changes of the skin and that specific phobia, social phobia, obsessive-com- tissue resulting from gradual absorption of
predisposes the individual to myelodys- pulsive disorder (OCD), posttraumatic stress air from obstructed or hypoventilated alveoli
plasia and to acute myeloid leukemia or disorder (PTSD), acute stress disorder, gen- or from inhalation of concentrated oxygen or
cancers of the mouth, esophagus, intesti- eralized anxiety disorder (GAD), and anxiety anesthetic agents.
nal and urinary tracts, and reproductive disorders secondary to medical conditions or Compression atelectasis air pressure in
organs. substance-induced or not otherwise specified. the pleural space pushes against the already
Hemolytic anemia a condition in which Aplastic anemia see Anemia. recoiled lung, causing compression atelectasis,
red blood cells are destroyed in response Aplastic crisis see Anemia. and against the mediastinum, compressing
to certain toxic or infectious agents or in Appendicitis inflammation of the appendix as and displacing the heart and great vessels.
certain inherited blood disorders and the a result of blockage of the opening from the Surfactant impairment decreased produc-
rate of breakdown exceeds the body’s abil- appendix into the cecum; the appendix wall tion or inactivation of surfactant, which is
ity to compensate. becomes infected and ruptures, allowing the necessary to reduce surface tension in the
Hemolytic disease of the newborn (HDN) infection to spread throughout the abdomen alveoli and causes lung collapse during expi-
(erythroblastosis fetalis) a condition and cause pain, anorexia, fever, nausea, vomit- ration; can occur because of premature birth,
that affects a fetus or newborn in which ing, and diarrhea. acute respiratory distress syndrome, anesthe-
red blood cells break down because of Apraxia a disorder of voluntary movement con- sia, or mechanical ventilation.
antibodies made by the mother that are sisting of impairment of the performance of Atherosclerosis a type of arteriosclerosis in
directed against the infant’s red cells, skilled or purposeful movements; results from which the inflammatory changes of thicken-
potentially resulting in anemia, heart fail- acquired cerebral disease. ing and hardening of the walls of large- and
ure, jaundice, and brain damage. Arcus senilis a gray to white ring at the periph- medium-sized arteries are caused by an ath-
Posthemorrhagic anemia a type of nor- ery of the cornea; caused by deposits of choles- eroma or plaque of lipids, cells, and connective
mocytic-normochromic anemia that is terol in the cornea or hyaline degeneration and tissue in the tunica intima.
caused by sudden blood loss in an indi- occurs primarily in older persons. Atopic dermatitis (AD) (allergic dermatitis) a
vidual with normal iron stores and triggers Areflexia absence of reflexes. chronic hereditary skin disease character-
a compensatory response in which water Arterial ischemic stroke (pediatric arterial ized by intense itching and inflamed skin that
and electrolytes from tissues and inter- ischemic stroke) a rare disorder in children causes redness, swelling, cracking, crusting, and
stitial spaces are used to expand plasma resulting from embolism, arteriopathy, or, scaling.
 GLOSSARY 1731

Atrial septal defect (ASD) a congenital heart Bare lymphocyte syndrome see Immune Bronchiolitis obliterans partial or complete
disease involving the interatrial septum of the deficiency. obliteration of bronchioles and some bronchi
heart that separates the right and left atria, Barrett esophagus chronic peptic ulcer- by granulation and fibrotic tissue masses.
which results in misdirected blood flow between ation of the esophagus; formation of precan- Bronchiolitis obliterans with organizing
the two sides of the heart. cerous lesions with possible progression to pneumonia (BOOP) obstruction of the bron-
Atrioventricular canal (AVC) defect a large adenocarcinoma. chioles and alveolar ducts by fibrous granula-
hole is present in the center of the heart where Bartholinitis (Bartholin cyst) inflammation tion tissue that is further complicated by the
the wall between the atria joins the wall between of one or both of the ducts that lead from the development of pneumonia.
the ventricles, and the tricuspid and mitral introitus (vaginal opening) to the Bartholin/ Bronchopulmonary dysplasia (BPD) a condi-
valves are formed into a single large valve that greater vestibular glands. tion most often found in premature infants in
crosses the defect. Basal cell carcinoma a surface epithelial tumor which chronic pulmonary insufficiency occurs
Atypical ductal hyperplasia (ADH) abnormal of the skin originating from undifferentiated because of long-term artificial pulmonary
proliferating cells in breast ducts. basal or germinative cells. ventilation.
Atypical hyperplasia increased number of cells B-cell neoplasm see Lymphoma. Bruton’s agammaglobulinemia see Immune
with some variation in cellular structure but Becker muscular dystrophy a general term for deficiency.
without sufficient qualitative or quantitative a number of late-onset X-linked recessive heredi- Bulbar palsy a form of palsy resulting from
features of carcinoma. tary, progressive degenerative disorders affecting impaired function of the cranial nerves from
Atypical lobular hyperplasia (ALH) abnormal skeletal muscles, and often other organ systems. degeneration of the motor neurons of primar-
proliferating cells in breast lobules. Beckwith-Wiedemann syndrome an inher- ily the brainstem; manifested as weakness and
Autoimmune hemolytic anemia (AIHA) see ited disorder characterized by exomphalos, wasting of the various bulbar muscles, resulting
Anemia. macroglossia, and gigantism; often associated in difficulty articulating words (dysarthria) and
Autoimmune neonatal thrombocytopenia with visceromegaly, adrenocortical cytomegaly, difficulty swallowing (dysphagia); fluid regurgita-
see Thrombocytopenia. and dysplasia of the renal medulla. tion is a major symptom and can cause aspiration.
Autoimmune vascular purpura (allergic pur- Benign breast disease (BBD) a spectrum of Bullous pemphigoid (BP) a more benign auto-
pura) purpura caused by antibody-mediated noncancerous changes in ducts and lobules of immune disease than pemphigus vulgaris, with
injury of blood vessel walls, typically arterioles the breast, including irregular lumps, cysts, sen- blistering of the subepidermal skin layer.
and capillaries. The reaction is directed to for- sitive nipples, and itching. Burkitt lymphoma see Lymphoma.
eign proteins or chemicals in the blood (micro- Benign prostatic hyperplasia (BPH) enlarge- Burn shock a phenomenon consisting of both a
organisms, drugs, or other chemicals) that ment of the prostate gland, which may press hypovolemic cardiovascular component and a
deposit on the vessel walls. against the urethra and bladder, interfering with cellular component; results from massive fluid
Autonomic hyperreflexia (dysreflexia) a syn- urine flow. losses from the circulating blood volume.
drome resulting from afferent stimuli that cause Beta-thalassemia major (Cooley anemia) see C1 deficiency see Immune deficiency.
intense sympathetic discharge originating with Anemia. C2 deficiency see Immune deficiency.
spinal cord injury above the major splanch- Beta-thalassemia minor see Anemia. C3 deficiency see Immune deficiency.
nic outflow; characterized by hypertension, Biliary atresia a condition in newborn children C3 receptor deficiency see Immune deficiency.
bradycardia, sweating of the forehead, severe in which the biliary tract is blocked or absent, C4 deficiency see Immune deficiency.
headache, and piloerection on distention of the causing bile accumulation and progressive liver C9 deficiency see Immune deficiency.
bladder and rectum. failure. Cachexia illness and malnutrition seen in indi-
Autosomal agammaglobulinemia see Im- Biliary cirrhosis see Cirrhosis. viduals with cancer that results in wasting and
mune deficiency. Bipolar disorder psychiatric disorder charac- eventual death.
Autosomal dominant polycystic kidney disease terized by alternating mania or hypomania and Calculi or urinary stone (urolithiasis) masses
(ADPKD) a progressive disease characterized by depression, often with periods of normal mood of crystals, protein, or other substances that are
formation of multiple cysts of varying size scat- in between, and changes in energy and behavior a common cause of urinary tract obstruction in
tered diffusely throughout both kidneys, resulting according to mood. adults.
in compression and destruction of renal paren- Blast injury tissue damage from compressive Candidiasis a fungal infection caused by an
chyma, usually with hypertension, gross hematu- waves of air against the body followed by waves overgrowth of normal Candida albicans found
ria, and uremia leading to progressive renal failure. of decreased pressure. in the skin and mucous membranes of the
Autosomal hyper-IgM syndrome see Immune Blepharitis inflammation of the eyelids. mouth, respiratory tract, or vagina.
deficiency. B-lymphocyte deficiency see Immune de- Caplan syndrome formation in coal workers
Azotemia kidney dysfunction characterized by ficiency. of intrapulmonary nodules in pneumoconiosis
increased serum urea levels and frequently asso- Bradykinesia decreased spontaneity and move- that are histologically similar to subcutaneous
ciated with increased creatinine levels. ment; a feature of extrapyramidal disorders, rheumatoid nodules associated with rheuma-
Bacterial pneumonia an acute or chronic such as Parkinson disease. toid arthritis.
disease marked by inflammation of the lungs Brainstem gliomas a group of tumors located Carbuncles a condition in which a bacterial
caused by bacterial infection. in the brainstem that are usually classified as infection of the hair follicle or sebaceous gland
Bacterial tracheitis a condition in which the high grade and result in the sudden onset of ducts becomes painful and discharges pus
larynx, trachea, and bronchi are inflamed and symptoms including headaches, vomiting, and through various openings.
present with signs similar to those of epiglotti- visual disturbances. Carcinoma epithelial cell tumor.
tis and croup; may result in airway obstruction Bronchial carcinoid tumor an obstructing Carcinoma in situ (CIS) preinvasive epithelial
secondary to subglottic edema or sloughing of tumor of the trachea or large bronchi that may malignant tumors of glandular or squamous cell
the epithelial lining or the mucopurulent mem- cause paraneoplastic symptoms. origin.
brane within the trachea. Bronchiectasis dilation of the bronchi in Cardiogenic shock a condition resulting from
Bacterial vaginosis (BV) a condition caused by response to obstruction, necrotizing pneumo- decreased cardiac output caused by heart dis-
an overgrowth of normal vaginal bacteria, caus- nias, cystic fibrosis, or Kartagener syndrome (a ease in which the heart is unable to pump blood
ing vaginal discharge with a foul odor. hereditary syndrome consisting of dextrocardia, through the body, usually because of myocardial
Balanitis inflammation of the glans penis caused bronchiectasis, and sinusitis). infarction.
by irritation by environmental substances, phys- Bronchiolitis inflammation of the bronchioles Cardiomyopathy(ies) a diverse group of dis-
ical trauma, or infection. usually caused by viral infection. eases primarily affecting the myocardium and
1732 GLOSSARY

resulting from tissue remodeling caused by that causes right upper quadrant pain and pos- alcohol metabolism, immunologic processes,
myocardial and neurohumoral responses to sibly a rupture and abscess in the gallbladder. oxidative stress from lipid peroxidation, and
ischemic and hypertensive alterations. Cholelithiasis the presence or formation of gall- malnutrition.
Cavernous (congenital) hemangioma a stones in the gallbladder or bile ducts. Biliary cirrhosis a form of alcoholic cirrhosis
birthmark that is similar to the strawberry hem- Chondrosarcoma a cancer of the cartilage that in which damage and inflammation leading to
angioma but is more deeply rooted and may usually occurs in the pelvic bones, shoulder cirrhosis begin in bile canaliculi and bile ducts,
appear as a red-blue spongy mass of tissue filled bones, and the upper part of the arms and legs. rather than in the hepatocytes.
with blood. Chronic active hepatitis the persistence of clin- Primary biliary cirrhosis a T-lymphocyte-
Central core disease (CCD) an autosomal ical manifestations and liver inflammation after and antibody-mediated destruction of the
dominant congenital myopathy characterized the acute stages with consistently abnormal liver small intrahepatic bile ducts.
by hypotonia, delay of motor development in function tests and persistent HBsAg creating a Cloacal exstrophy family of congenital anoma-
infancy, and nonprogressive or slowly progres- predisposition to cirrhosis and primary hepato- lies with two exstrophied bladder units sepa-
sive muscle weakness; on biopsy the central cellular carcinoma. rated by an exstrophied segment of intestine,
core of muscle fibers stains abnormally, myo- Chronic bronchitis chronic bronchitis, particu- which is usually cecum, receiving ileum supe-
fibrils are abnormally compact, and there is larly as a cause of chronic cough in smokers. riorly and continuing distally to blind ending
virtual absence of mitochondria and sarcoplas- Chronic gastritis tends to occur in older adults microcolon.
mic reticulum; histochemically, the cores are with chronic inflammation, mucosal atrophy, Coal worker pneumoconiosis (coal miner
devoid of oxidative enzyme, phosphorylase, and and epithelial metaplasia; may be immune (fun- lung, black lung) mild to severe pneumoco-
ATPase activity. dal) or nonimmune (antral), depending on the niosis (pulmonary fibrosis) caused by coal dust
Central precocious puberty condition in pathogenesis and location of the lesions. (coal, silica, quartz) deposits in the lung; symp-
which puberty begins prematurely with normal Chronic glomerulonephritis see Glomeru- toms initially present as a productive cough and
changes in the hypothalamopituitary (HPG) lonephritis. wheezing, but may advance to chronic bronchi-
axis with premature development of secondary Chronic granulomatous disease (CGD) see tis and emphysema.
sexual characteristics and premature closure of Immune deficiency. Coarctation of the aorta (COA) a condition
the epiphysis of long bones, resulting in lifelong Chronic kidney disease (CKD) progressive loss in which the aorta narrows in the area where
short stature. of renal function associated with systemic dis- the ductus arteriosus inserts; narrowing usually
Centriacinar emphysema see Emphysema. eases such as hypertension, diabetes mellitus, occurs preductal in children and postductal in
Cerebellar astrocytoma brain tumor of the systemic lupus erythematosus, or intrinsic kid- adults.
right or left cerebellar hemisphere that causes ney disease, including kidney stones, acute kid- Cold agglutinin autoimmune hemolytic ane-
motor symptoms on the same side as the tumor. ney injury, chronic glomerulonephritis, chronic mia see Anemia.
Cerebral palsy (CP) a developmental brain pyelonephritis, obstructive uropathies, or vas- Cold hemolysin autoimmune hemolytic
injury that occurs before or shortly after birth cular disorders. anemia (paroxysmal cold hemoglobin-
and causes muscular impairment affecting Chronic leukemia see Leukemia. uria) see Anemia.
motor function and also may alter speech and Chronic lymphocytic leukemia (CLL) see Combined T- and B-lymphocyte deficiency
learning abilities. Leukemia. see Immune deficiency.
Cervical dysplasia (cervical intraepithelial Chronic mesenteric ischemia development of Common variable immune deficiency see
neoplasia [CIN]) a condition characterized regions of compromised blood flow in the mes- Immune deficiency.
by the appearance of abnormal cervical cells that enterium secondary to atherosclerosis (most Communicating (extraventricular) hydro-
are considered precancerous. common), congestive heart failure, dysrhyth- cephalus a disorder in which the cerebrospi-
Cervicitis inflammation of the mucous mem- mias, hemorrhage, thrombus formation, aortic nal fluid pathways are intact but cerebrospinal
brane of the uterine cervix caused by infec- aneurysm, or any condition that decreases arterial fluid absorption is impaired.
tion, typically by chlamydia, genital herpes, or blood flow. Chronic occlusion is often accompa- Complement deficiency see Immune de-
gonorrhea. nied by formation of collateral circulation that ficiency.
Chediak-Higashi syndrome see Immune may be able to nourish the resting intestine. Complete precocious puberty refers to the
deficiency. Chronic mucocutaneous candidiasis see early onset and progression of all pubertal fea-
Cheyne-Stokes respiration an abnormal pat- Immune deficiency. tures (i.e., thelarche, pubarche, and menarche).
tern of breathing in which tidal volume gradu- Chronic myelogenous leukemia (CML) see Complex febrile seizure seizures with charac-
ally increases followed by a gradual decrease and Leukemia. teristic features similar to those of simple febrile
a period of apnea before returning to a normal Chronic obstructive pulmonary disease seizure with a longer duration and focal char-
respiratory pattern. (COPD) any of a group of irreversible respira- acteristics; occur more than once in a 24-hour
Chickenpox an infectious viral disease that is tory diseases (chronic bronchitis, emphysema, period.
spread by direct contact or through the air by α1-antitrypsin deficiency) that are characterized Complex regional pain syndrome (CRPS) dif-
coughing or sneezing; it causes a blister-like by airflow obstruction or limitation. fuse persistent pain usually in an extremity often
rash that first affects the face and trunk and then Chronic pancreatitis inflammation of the pan- associated with vasomotor disturbances, trophic
can spread over the rest of the body; symptoms creas resulting from repeated exacerbations of changes, and limitation or immobility of joints;
include severe itching, fatigue, and fever. acute pancreatitis that lead to chronic changes; frequently follows a local injury.
Childhood absence epilepsy (petit mal sei- associated with obstruction from gallstones, Compression atelectasis see Atelectasis.
zures, nonconvulsive epilepsy) a type of autoimmune disease, gene mutations, smoking, Compressive syndrome (sensorimotor syn-
generalized epilepsy; age of onset is 4 to 10 years. occupational chemical exposure, and obesity. drome; crush syndrome) a shocklike state
Chlamydia a sexually transmitted bacterial Chronic pyelonephritis persistent or recurrent that follows release of a limb or limbs or the
infection that can cause infertility and blindness. infection of the kidney leading to scarring. trunk and pelvis after a prolonged period of
Choking asphyxiation obstruction of the inter- Chronic relapsing thrombotic thrombocyto- compression, such as by a heavy weight; charac-
nal airways. penic purpura (TTP) see Thrombocytopenia. terized by suppression of renal function, prob-
Cholangiocellular carcinoma (cholangiocarci- Cirrhosis degeneration of liver tissue resulting ably the result of damage to the renal tubules by
noma) primary carcinomas of the liver that in fibrosis with nodule and scar formation that myoglobin from the damaged muscles.
develop in the bile ducts. compromises liver function. Congenital adrenal hyperplasia a group of
Cholecystitis inflammation of the gallbladder Alcoholic cirrhosis destructive inflamma- autosomal recessively inherited disorders asso-
commonly caused by impaction of a gallstone tion of the liver caused by the toxic effects of ciated with a deficiency of one of the enzymes
 GLOSSARY 1733

involved in cortisol biosynthesis, resulting in Crohn disease (CD) an autoimmune condi- Deep venous thrombosis (DVT) a blood clot
elevation of ACTH levels and overproduction tion in which the intestines and possibly other or thrombus in a deep vein, usually of the leg.
and accumulation of cortisol precursors proxi- regions of the digestive system are chronically Degenerative disk disease (DDD) interverte-
mal to the block; androgens are produced in inflamed and ulcerated, causing chronic diar- bral disk tissue is replaced by fibrocartilage dur-
excess, causing virilization. The most common rhea, disrupted digestion, and subsequent dif- ing aging; functional capacity is rarely altered.
disorder is the 21-hydroxylase deficiency, caused ficulty eating and digesting food. Demyelinating polyneuropathy a type of
by mutation in the cytochrome P450 21-hydrox- Croup a viral infection that involves the larynx, polyneuropathy in which the peripheral nerve
ylase gene (CYP21) on chromosome 6p. trachea, and the airways leading to the lungs myelin is primarily affected; can be famil-
Congenital aganglionic megacolon and that can result in serious breathing diffi- ial (Charcot-Marie-Tooth disease, type 1) or
(Hirschsprung disease) a congenital defect culties, hoarseness, sore throat, and a hacking acquired (Guillain-Barré syndrome); motor
in which the nerves that innervate the anus cough. nerve conduction is slowed or blocked.
through the wall of the bowel are absent, result- Cryptorchidism the scrotum of one or both Dermatitis herpetiformis pruritic chronic
ing in enlargement of the bowel superior to the testes is absent because of failure of the testis to dermatitis with successive groups of symmetri-
point where the nerves are missing and a sub- descend from the abdominal position during cal, erythematous, papular, vesicular, eczema-
sequent decrease in peristalsis that results in fetal development. tous, or bullous lesions, usually associated with
chronic constipation. Curling ulcer ischemic ulcers of the stomach asymptomatic gluten-sensitive enteropathy.
Congenital hydrocephalus excessive accumu- and duodenal mucosa that develop within hours Detrusor areflexia a lower motor neuron disor-
lation of cerebrospinal fluid present at birth and after an event, such as hemorrhage, multisystem der that results in an underactive, hypotonic, or
characterized by increased intracranial pressure trauma, severe burns, heart failure, or sepsis. atonic bladder function with retention of urine
(ICP). This increase may be caused by a blockage Cushing disease adrenal hyperplasia caused by and distention.
within the ventricular system in which the CSF an ACTH-secreting basophil adenoma of the Detrusor hyperreflexia (uninhibited or reflex
flows, an imbalance in the production of CSF, pituitary. bladder) upper motor neuron disorders in
or a reduced reabsorption of CSF that results in Cushing syndrome increased synthesis and which the bladder empties automatically when
ventricular enlargement and increased ICP. secretion of cortisol from a tumor of the adre- it becomes full and the external sphincter func-
Congenital hypothyroidism lack of secretion nal cortex; caused by administration of glu- tions normally.
of thyroid hormone. cocorticoid drugs or by the presence of an Developmental dysplasia of the hip (DDH) a
Congenital (infantile) nephrotic syndrome ACTH-secreting tumor of the anterior lobe of condition in which the hip joint of babies or
(Finnish type) a very rare form of nephrotic the pituitary gland (Cushing disease), resulting young children is malformed, with the ball
syndrome caused by a defect in a kidney pro- in weight gain, glucose intolerance, and muscle being completely out of the socket or the socket
tein resulting in excessive amounts of protein wasting. being too shallow to support the ball.
excreted in the urine. Cushing ulcer a stress ulcer associated with Diabetes diseases having in common the triad of
Congestive splenomegaly enlargement of the severe head trauma or brain surgery. symptoms of polyuria, weight loss, and signifi-
spleen accompanied by ascites, portal hyperten- Cyclic neutropenia see Immune deficiency. cant glucosuria.
sion, and esophageal varices; most commonly Cylindrical bronchiectasis reversible bronchial Diabetes insipidus a disease caused by a
seen in those with hepatic cirrhosis. dilation with symmetrically dilated airways, as deficiency in or resistance to antidiuretic
Consumptive thrombohemorrhagic disor- can be seen after pneumonia. hormone that is characterized by excretion
ders heterogeneous group of conditions that Cystic fibrosis (CF) a genetic disorder of the of large amounts of dilute urine because of a
demonstrate the entire range of hemorrhagic exocrine glands caused by a mutation in the decrease in water reabsorption in the kidney.
and thrombotic pathologic conditions. CF transmembrane regulator gene, resulting Gestational diabetes mellitus (GDM)
Contact dermatitis an allergic response to an in impairment in chloride transfer across cell carbohydrate intolerance of variable severity
environmental antigen binding to specific car- membranes and subsequent chloride and water with onset during pregnancy.
rier proteins contained in an individual’s skin. accumulation in organs and in thickened secre- Type 1 diabetes mellitus a disorder of
Contrecoup injury brain injury resulting from tions that block ducts and form cysts. carbohydrate metabolism characterized by a
the brain hitting the inside of the skull on the Cystitis a condition characterized by acute or decrease in insulin production, resulting in
side opposite the site of blunt force trauma. chronic inflammation of the urinary bladder, hyperglycemia, ketoacidosis, and eventually
Cor pulmonale right-sided heart failure caused usually caused by bacterial infection of the ure- renal failure and coronary artery disease.
by prolonged pulmonary hypertension. thra; symptoms include frequent burning urina- Type 2 diabetes mellitus a condition of
Coronary artery disease (CAD) narrowing tion, blood in the urine, pain in the pubic area, glucose intolerance that normally appears
of the lumen of one or more of the coronary chills and fever, back pain, and nausea. See Pain- first in adulthood and is exacerbated by
arteries, usually attributable to atherosclerosis, ful bladder syndrome/interstitial cystitis (PBS/ obesity and an inactive lifestyle.
leading to myocardial ischemia; can cause con- IC) for further information. Diabetic nephropathy a progressive kidney dis-
gestive heart failure, angina pectoris, or myocar- Dandy-Walker malformation congenital defect ease caused by diabetes-induced angiopathy of
dial infarction. of midline cerebellar structures and the fourth capillaries in the glomeruli that causes nodular
Craniopharyngioma a brain tumor that devel- ventricle in which hydrocephalus is caused by glomerulosclerosis.
ops in the pituitary gland and most often affects atresia of the foramina of Luschka or Magendie, Diabetic neuropathy combined sensory and
children, causing headache, seizure, diabetes which normally allow the fourth ventricle to motor disorder often seen in older diabetic
insipidus, early onset of puberty, and delayed empty into the areas surrounding the brain, patients as a result of microvascular injury
growth. leading the ventricular flow of CSF into a “blind involving small blood vessels that supply
Craniosynostosis (craniostenosis) (see Syn- pouch.” nerves.
dromic craniosynostosis) premature ossi- Dawn phenomenon abrupt increases in fasting Diabetic retinopathy damage to the retina
fication of the skull and closure of the sutures, levels of plasma glucose between 5 and 9 am, in caused by an overaccumulation of glucose or
resulting in abnormal skull expansion and the absence of antecedent hypoglycemia; occurs fructose that damages the blood vessels in the
asymmetric skull growth. in diabetic patients receiving insulin therapy. retina; in advanced stages, lack of oxygen in the
Cri du chat syndrome a hereditary congeni- Decompression sickness (DCS) (Caisson dis- retina causes fragile blood vessels to grow along
tal syndrome characterized by hypertelorism, ease) gas embolism created when a person the retina and in the vitreous fluid of the eye that
microcephaly, severe mental deficiency, and a under water returns to the surface too quickly, may bleed and cause blurred vision.
plaintive catlike cry; caused by deletion of the resulting in cellular hypoxia, joint and muscle Diaper dermatitis a type of dermatitis charac-
short arm of chromosome 5. pain, and tissue necrosis. terized by inflammation of the skin in the diaper
1734 GLOSSARY

area in infants caused by exposure of the skin to Dysphoric mood mood of general dissatisfac- result of a secondary bacterial infection that is
feces and urine. tion, restlessness, depression, and anxiety; a feel- triggered by a variety of underlying conditions
Diastolic heart failure a condition in which ing of unpleasantness or discomfort. such as urinary tract or sexually transmitted
heart contractions are normal but the ventricle Dysplasia (atypical hyperplasia) abnormal infections.
does not relax completely; therefore, less blood changes in the size, shape, and organization Epilepsy a group of chronic neurologic disor-
enters the heart. of mature cells; considered a form of atypical ders with paroxysmal brain dysfunction from
Diffuse brain injury (diffuse axonal injury) hyperplasia. excessive neuronal discharge; symptoms vary
injury to neuronal axons in many areas of the Dyssynergia development of lesions in the widely from complex behavioral abnormalities
brain caused by stretching and shearing forces upper motor neurons of the brain and spinal to focal convulsions, to momentary spells of
received during brain injury. cord; results in loss of coordinated neuromus- impaired consciousness.
DiGeorge syndrome see Immune deficiency. cular contraction and overactive or hyperreflex- Epispadias a birth defect in which the urethra
Dilated cardiomyopathy (congestive cardio- ive bladder function. opens on the upper penile surface.
myopathy) a condition in which all four Eczema most common inflammatory disorder Erysipelas a highly contagious bacterial infec-
chambers of the heart are enlarged and weak- of the skin; generally characterized by pruritus, tion that produces shiny, red swollen areas
ened, resulting in progressive congestive heart lesions with indistinct borders, and epidermal and fever and can lead to blood poisoning and
failure and the need for heart transplantation. changes. pneumonia.
Discoid (cutaneous) lupus erythematosus Eisenmenger syndrome a progressively devel- Erythema multiforme a skin disease that is
(DLE) see Lupus erythematosus. oping condition in which a congenital heart caused by allergies, seasonal changes, or drug
Disorders of desire (hypoactive sexual desire, defect such as ventricular septal defect is left sensitivities, resulting in the formation of red
decreased libido) the most common sexual untreated and causes a reversed right-to-left macules, papules, or subdermal vesicles on the
dysfunction in women; prevalence increases shunt secondary to increased pressures on the skin and mucous membranes.
with age and may be a biologic manifestation right side of the heart because of pulmonary Erythema toxicum neonatorum a temporary
of depression, alcohol or other substance abuse, hypertension. eruption of redness of the skin, small papules,
prolactin-secreting pituitary tumors, or testos- Embryonic tumor a tumor originating in the and occasionally pustules in newborns that is
terone deficiency. gestational period that contains predominantly associated with contact dermatitis or hypersen-
Distal intestinal obstruction syndrome immature blast cells that cannot differentiate sitivity to milk or other allergens.
(DIOS) a syndrome seen in cystic fibrosis sec- into mature functional cells. Erythrodermic (exfoliative) psoriasis see
ondary to impaction with feces and inspissated Emphysema pulmonary inflammation result- Psoriasis.
mucus. ing in increased work of breathing or physi- Erythromyalgia chronic disorder characterized
Diverticulitis inflammation of the herniations ologic dead space and abnormal permanent by warmth, pain, and redness, occurring pri-
or saclike outpouchings of mucosa through the enlargement of gas-exchange airways (acini) marily in the feet and lower legs.
muscle layers of the colon wall. accompanied by destruction of alveolar walls Essential (primary) thrombocythemia
Diverticulosis presence of multiple bulging without obvious fibrosis. (ET) excessive production of platelets (plate-
sacs pushing outward from the wall of the large Centriacinar emphysema diminished pul- let count greater than 400,000/mm3 of blood);
intestine that may become infected and rupture, monary function resulting from septal may be primary or secondary (reactive) and is
causing abdominal pain, tenderness, and fever. destruction in the respiratory bronchioles usually asymptomatic until the count exceeds 1
Down syndrome trisomy or translocation of and alveolar ducts, usually in the upper lobes million/mm3 of blood when intravascular clot
chromosome 21, resulting in mental retardation; of the lung. formation (thrombosis), hemorrhage, or other
distinctive facial appearance with a low nasal Panacinar emphysema involves destruction abnormalities can occur.
bridge, epicanthal folds, protruding tongue, and of the entire acinus, with damage more Ewing sarcoma a malignant neoplasm of bone,
flat, low-set ears; poor muscle tone (hypoto- randomly distributed and involving the primarily those of the extremities, including
nia); and short stature. Congenital heart defects, lower lobes of the lung. It tends to occur in the shoulder girdle, with a predilection for the
reduced ability to resist respiratory tract infections, older adults and in those with α1-antitrypsin metaphysis; histologically presents as conspicu-
and increased risk for leukemia are common. deficiency. ous foci of necrosis in association with irregular
Drug-induced hemolytic anemia see Anemia. Empyema (infected pleural effusion) a con- masses of small, regular, rounded, or ovoid cells.
Duchenne muscular dystrophy an X-linked dition in which purulent fluid is persistently Exstrophy of the bladder a congenital defect in
genetic disorder in which fat and fibrous tis- discharged into the pleural space as a result of which the lower abdominal wall is malformed
sue infiltrate and weaken muscle tissues such as complications of bacterial infections. and ruptures.
in the legs and pelvis, lungs, and heart; usually Encephalitis inflammation of the brain usually Extrapyramidal/nonspecific cerebral palsy
results in death before adulthood. caused by a virus. any of a group of clinical disorders considered
Dumping syndrome rapid emptying of hyper- Endometriosis a condition that is common in to be due to malfunction in the extrapyramidal
tonic chyme from a surgically created residual women of reproductive age in which the tissue system and marked by abnormal involuntary
stomach causing nausea, vomiting, bleeding, lining the uterus is found outside of the uterus, movements; included are parkinsonism, atheto-
and diarrhea about 20 minutes after a meal. resulting in pain and infertility. sis, and chorea.
Duodenal ulcer most common type of peptic End-stage kidney disease (ESKD) significant Facioscapulohumeral muscular dystrophy
ulcers; usually associated with altered mucosal loss of renal function; usually less than 10% of (FSHD) an autosomal dominant genetic dis-
defenses, rapid gastric emptying, elevated serum renal function remains. order that begins in childhood and causes mus-
gastrin levels, or acid production stimulated by Eosinophilic esophagitis rare, idiopathic cle wasting and weakness, primarily in the face,
smoking. inflammatory disease of the esophagus charac- shoulder, and arms.
Dysfunctional uterine bleeding (DUB) heavy terized by infiltration of eosinophils associated Factor H deficiency see Immune deficiency.
or irregular bleeding in the absence of organic with atopic disease, including asthma and food Factor I deficiency see Immune deficiency.
disease, such as submucous fibroids, endome- allergies. Fanconi anemia see Anemia.
trial polyps, blood dyscrasias, pregnancy, infec- Ependymoma intracranial tumor that is most Fetal alcohol syndrome (FAS) a syndrome
tion, or systemic disease. commonly found in children and typically arises of altered prenatal growth and morphogen-
Dyskinetic cerebral palsy extreme difficulty in from the inner lining of the fourth ventricle and esis that occurs in infants born to women who
fine motor coordination and purposeful move- the spinal canal. were chronically alcoholic during pregnancy;
ments resulting from injury to the basal ganglia Epididymitis a painful condition in which the it includes maxillary hypoplasia, prominence
or thalamus. epididymis becomes inflamed, usually as a of the forehead and mandible, short palpebral
 GLOSSARY 1735

fissures, microphthalmia, epicanthal folds, Generalized neuropathy a functional distur- mesangium with mesangial cell proliferation
severe growth retardation, mental retardation, bance or pathologic change in the cell body of and expansion reducing blood flow and
and microcephaly. one type of peripheral neuron. altering filtration membrane permeability
Fibromyalgia muscles, tendons, and joints are Genital herpes a sexually transmitted viral with development of hematuria,
painful, stiff, and tender; often accompanied by infection that is caused primarily by herpes sim- proteinuria, hypertension, and uremia
restless sleep, fatigue, anxiety, depression, and plex virus type 2 and is characterized by painful (nephritic syndrome); associated with IgA
disturbances in bowel function. lesions in the genital and anal regions. nephropathy, lupus nephritis, or early
Fibrosarcoma a malignant tumor of fibrous Gestational diabetes mellitus (GDM) see diabetic nephropathy.
connective tissue that usually is derived from Diabetes. Rapidly progressive (crescentic) glo-
immature proliferating fibroblasts. GH deficiency a condition characterized by merulonephritis (RPGN) (subacute or
Fibrous dysplasia (FD) a genetic disorder in decreased or absent production of growth hor- extracapillary glomerulonephritis)
which tumor-like growths or lesions form in mone (GH), resulting in a decline in insulin-like develops over days to weeks, primarily affects
one or more bones and replace the medullary growth factor 1 and dwarfism if the deficiency adults in their fifties and sixties, and may be
bone with fibrous tissue, resulting in expansion is prepubertal. idiopathic or associated with a proliferative
and weakening of the bone. Glaucoma a disease of the eye characterized by glomerular disease (diffuse proliferation
Florid hyperplasia rapid and unexpected cell increased intraocular pressure, excavation, and of extracapillary cells), such as lupus or
growth in the lining of the breast ducts. atrophy of the optic nerve; produces defects in poststreptococcal glomerulonephritis.
Focal segmental glomerulosclerosis (FSGS) the field of vision and eventual blindness. Glucose-6-phosphate dehydrogenase (G6PD)
a condition in which glomerular capillaries with Glomerulonephritis inflammation of the renal deficiency see Anemia.
thickened basement membranes and increased glomeruli that may not produce symptoms or Gluten-sensitive enteropathy (celiac sprue)
mesangial matrix collapse in segments. Usually may present with hematuria and proteinuria. a condition characterized by mucosal inflamma-
presents as nephrotic syndrome. Acute glomerulonephritis an inflammatory tion and villous atrophy in the gastrointestinal
Frontotemporal dementia (FTD) (Pick dis- disease of both kidneys predominantly tract formed in response to a genetic predispo-
ease) progressive circumscribed cerebral affecting children from ages 2 to 12. sition for an immune response to gluten and
atrophy; a rare type of cerebrodegenerative Acute poststreptococcal glomerulonephritis similar proteins.
disorder manifested primarily as dementia, in (PSGN) kidney disease secondary to Gonorrhea a sexually transmitted disease
which there is striking atrophy of portions of infection with Streptococci in which bacterial caused by the bacteria gonococci that invade
the frontal and temporal lobes. antigens complex with antibodies in the the mucous membranes of the genitals and uri-
FSH deficiency a condition characterized by blood, deposit in the kidneys, and initiate an nary tract and in women the cervix, fallopian
decreased or absent production of follicle-stim- immune complex–mediated hypersensitivity tubes, and ovaries, causing chronic pelvic pain
ulating hormone (FSH), resulting in a decline reaction. or infertility.
in spermatogenesis/oogenesis and associated Chronic glomerulonephritis a slowly pro- Gout a disorder of uric acid metabolism that
infertility. gressive glomerulonephritis most often causes painful inflammation of the joints, com-
Furuncles staphylococcal infection produces pain- associated with other systemic disease, monly the big toe, and arthritic attacks resulting
ful pus-filled inflamed hair follicles and involves including diabetes, malaria, hepatitis, or from elevated levels of uric acid in the blood and
surrounding skin and subcutaneous tissue. systemic lupus erythematosus, that generally the deposition of negatively birefringent urate
Fusiform aneurysm (giant aneurysm) large leads to irreversible renal failure. crystals around the joints.
aneurysm that stretches to affect the entire cir- Membranoproliferative glomerulonephritis Gouty arthritis inflammation of the joints in
cumference of the arterial wall. (MPGN) a chronic, slowly progressive gout.
Galactorrhea (inappropriate lactation) a con- glomerulonephritis in which the glomeruli Graft rejection immunologic rejection of trans-
dition in which milk-like fluid is secreted from are enlarged as a result of proliferation of planted tissue or organs based on antigen differ-
the breast because of hormonal alterations that mesangial cells and irregular thickening ences between the donor and recipient.
are not associated with childbirth or nursing. of the capillary walls, which narrows the Acute graft rejection cell-mediated immune
Ganglioneuroblastoma an embryonal aggres- capillary lumina. rejection that occurs within days to months
sive tumor of intermediate cellular differen- Membranous glomerulonephritis a slowly after transplantation; immune response is
tiation that originates outside the CNS in the progressive disease of unknown origin or that usually against unmatched HLA antigens and
developing sympathetic nervous system. occurs secondary to autoimmune conditions, develops after transplantation.
Ganglioneuroma a benign neoplasm composed infections, specific drugs, or malignant Chronic graft rejection slow, progressive
of mature ganglionic neurons scattered within tumors that is caused by immune complexes organ failure after a period of months or
a stroma of neurofibrils and collagenous fibers. formed from the binding of antibodies years of normal function by a developing
Gangliosidosis any disease characterized by to antigens of the glomerular basement weak cell-mediated immune response against
abnormal accumulation of specific ganglio- membrane (GBM) or antigens transported minor histocompatibility antigens on the
sides within the nervous system (e.g., Tay-Sachs from the systemic circulation and implanted endothelial cells lining the blood vessels of
disease). in the GBM. the grafted tissue.
Gastroesophageal reflux disease (GERD) the Membranous nephropathy (membra- Hyperacute graft rejection immediate
reflux of acid and pepsin from the stomach to nous glomerulonephritis) membranous rejection of a graft because of pre-existing
the esophagus that causes esophagitis. nephropathy is caused by subepithelial depo- antibodies against antigens expressed on the
General adaptation syndrome (GAS) the sum sition of antibodies (IgG4 subclass) to antigens grafted tissue or organ.
of all nonspecific reactions of the body to pro- (M-type phospholipase A2 receptor [PLA2R] Graft-versus-host disease (GVHD) condition
longed systemic stress, comprising alarm, resis- protein) located on glomerular podocytes and in which mature T cells in a transplanted graft
tance, and exhaustion. activation of complement-mediated inflam- (e.g., transfused blood) are capable of a destruc-
Generalized anxiety disorder (GAD) an anxi- mation with injury and release of inflamma- tive cell-mediated reaction against unmatched
ety disorder characterized by an excessively tory mediators by mesangial and epithelial histocompatibility antigens on the tissues in the
anxious mood lasting at least 1 month that cells, resulting in increased membrane perme- graft recipient.
interferes with daily functioning and may be ability, thickening of the glomerular mem- Granuloma inguinale a bacterial-induced dis-
accompanied by jitteriness, sweating, feelings of brane, and ultimately glomerular sclerosis. ease, also called donovanosis, that is thought
catastrophe concerning one’s family or self, and Mesangial proliferative glomerulonephritis to be transmitted primarily by anal rather than
irritability. deposition of immune complexes in the vaginal intercourse and causes painless genital
1736 GLOSSARY

ulcers like syphilis but progresses to destroy the Hemophilia A (classic hemophilia) a genetic the diaphragm and up into the esophagus or
internal and external genital tissue. disorder in which a mutation in factor VIII chest.
Graves disease autoimmune hyperthyroidism causes prolonged clotting time, decreased for- High altitude cerebral edema (HACE) an
caused by antibodies that continuously activate mation of thromboplastin, and diminished con- increase in severity of symptoms or signs of
TSH receptors, resulting in uncontrolled pro- version of prothrombin. neurologic dysfunction, such as ataxia or altered
duction of thyroxine and characterized by an Hemophilia B (Christmas disease) a genetic consciousness, related to high altitude.
enlarged thyroid gland, protrusion of eyeballs, a disorder similar to hemophilia A in terms of High altitude pulmonary edema (HAPE) a
rapid heartbeat, and nervous excitability. symptoms but with a mutation in the factor IX noncardiogenic pulmonary edema associated
Guillain-Barré syndrome (GBS) (Landry-Guil- gene. with pulmonary hypertension and elevated cap-
lain-Barré syndrome, idiopathic polyneuri- Hemophilia C (factor XI deficiency) a genetic illary pressure related to high altitude illness.
tis, acute inflammatory polyradiculopathy, disorder characterized by a deficiency in factor Hirsutism abnormal growth and distribution
acute autoimmune neuropathy) an acute, XI, resulting in a mild form of hemophilia. of androgen-sensitive hair growth on the face,
immune-mediated disorder of peripheral Hemorrhagic stroke (spontaneous intracra- body, and pubic area in a male pattern that
nerves, spinal roots, and cranial nerves that com- nial hemorrhage) stroke usually caused occurs in women.
monly presents as a rapidly progressive, areflex- by hypertension that results in bleeding in the Hodgkin lymphoma (HL) see Lymphoma.
ive, relatively symmetrical ascending weakness brain and typically increases intracranial pres- Hormonal hyperplasia growth of cellular lay-
of the limb, truncal, respiratory, pharyngeal, sure and may lead to death. ers chiefly in estrogen-dependent organs, such
and facial musculature, with variable sensory Henoch-Schönlein purpura nephritis inflam- as the uterus and breast. After ovulation, for
and autonomic dysfunction; typically reaches its mation of the blood vessels causing bleeding example, estrogen stimulates the endometrium
peak activity within 2 to 3 weeks, followed by a into the skin, mucous membranes, internal to grow and thicken for reception of the fertil-
plateau period of similar duration, and gradual organs, and other tissues; pain and inflamma- ized ovum.
but complete recovery in most cases; often pre- tion in the joints; abdominal pain; gastroin- Huntington disease (HD) an autosomal domi-
ceded by a respiratory tract or gastrointestinal testinal bleeding; inflammation of the kidneys; nant disease causing a progressive increase in
tract infection and is associated with albumino- subcutaneous edema; encephalopathy; and involuntary, jerky, dyskinetic movements; men-
cytologic dissociation of the cerebrospinal fluid. inflammation of the testis. tal deterioration; and premature death.
Guttate psoriasis see Psoriasis. Heparin-induced thrombocytopenia (HIT) see Hyaline membrane disease (HMD) a type of
Gynecomastia abnormal breast tissue develop- Thrombocytopenia. respiratory distress syndrome of the newborn
ment on adolescent boys or men as a result of an Hepatic encephalopathy a condition that in which there is formation of a hyaline-like
imbalance in hormones. is usually caused by liver cirrhosis and portal membrane lining the terminal respiratory pas-
Heat exhaustion occurs when sufficient salt hypertension in which toxins produced by the sages; extensive atelectasis is attributed to lack
and water loss results in hemoconcentration gut pass into the systemic circulation and dam- of surfactant.
with hypotension occurring secondary to fluid age brain cells, resulting in impaired cognition, Hydrocephalus ex vacuo hydrocephalus
loss (hypovolemia), and the individual feels tremor, and a decreased level of consciousness. attributable to loss or atrophy of brain tissue;
weak, is nauseated, and can suddenly collapse. Hepatocellular carcinoma (hepatocarcinoma; less commonly associated with raised intra-
Heat stroke a life-threatening condition associ- HCC) primary carcinoma of the liver develop- cranial pressure and dilation of the cerebral
ated with high environmental temperatures and ing in hepatocytes. ventricles.
humidity causing core body temperature to rise Hepatopulmonary syndrome intrapulmo- Hydrops fetalis edema formation in the fetal
as a result of thermoregulatory failure. nary vasodilation, intrapulmonary shunt- subcutaneous tissue because of an enzyme defi-
Hematemesis accumulation of blood in the gas- ing, and hypoxia and portopulmonary ciency or any one of several other disorders.
trointestinal tract causing irritation, increased hypertension (pulmonary vasoconstriction and Hyperosmolar hyperglycemic nonketotic
peristalsis, and vomiting. vascular remodeling) are common respiratory syndrome (HHNKS) a complication seen in
Hematochezia rapid bleeding from the upper complications of advanced liver disease and diabetes mellitus in which very marked hyper-
GI tract producing bright red stools. portal hypertension. glycemia occurs, causing osmotic shifts in water
Hemochromatosis disorder of iron metabo- Hepatorenal syndrome (HRS) acute renal fail- in brain cells, and resulting in coma. It can be
lism characterized by excessive absorption of ure occurs because of a decrease in renal blood fatal or lead to permanent neurologic damage.
ingested iron, saturation of iron-binding pro- flow secondary to liver disease. Hypersensitive pneumonitis (extrinsic allergic
tein, and deposition of hemosiderin in tissue, Hereditary angioedema an inherited, auto- alveolitis) an allergic, inflammatory disease
particularly in the liver, pancreas, and skin; cir- somal dominant disease characterized by epi- of the lungs caused by inhalation of organic par-
rhosis of the liver, diabetes (bronze diabetes), sodic appearance of nonpitting edema, most ticles or fumes.
bronze pigmentation of the skin, and eventually often affecting the limbs, but capable of involv- Hypertrophic cardiomyopathy a genetic dis-
heart failure may occur; also can result from ing other parts of the body, including mucosal order caused by various mutations that thicken
administration of large amounts of iron orally, surfaces such as those of the intestine (causing the heart muscle, possibly leading to obstruc-
by injection, or in forms of blood transfusion abdominal pain) or respiratory tract (causing tion of blood flow and heart dysfunction; this
therapy. asphyxia); associated with deficiency of inhibi- is a common cause of sudden death in young
Hemoglobin H disease see Anemia. tor of the first component of complement path- athletes.
Hemolytic anemia see Anemia. way (C1 esterase inhibitor). Hypogammaglobulinemia see Immune defi-
Hemolytic disease of the newborn (HDN) Hereditary hemochromatosis (HH) autoso- ciency.
(erythroblastosis fetalis) see Anemia. mal recessive chronic liver disease caused by Hypoplastic anemia see Anemia.
Hemolytic jaundice (prehepatic jaundice, excessive intestinal absorption of elemental Hypoplastic left heart syndrome (HLHS) a
nonobstructive jaundice) jaundice resulting iron; characterized by elevated serum iron satu- condition in which the left side of the heart,
from excessive hemolysis of red blood cells. ration, transferrin, and ferritin levels; improves including the aorta, aortic valve, left ventri-
Hemolytic-uremic syndrome (HUS) a condi- with phlebotomy; increased risk of developing cle, and mitral valve, is underdeveloped and
tion in which platelets aggregate within the kid- cirrhosis, liver cancer, and liver failure. blood returning from the lungs flows through
ney’s small blood vessels, resulting in reduced Hereditary sideroblastic anemia see Anemia. an opening in the atrial septum and the right
blood flow to the kidney and subsequent kidney Hereditary spherocytosis see Anemia. ventricle pumps the blood into the pulmonary
failure and destruction of the red blood cells; Hiatal hernia an anatomic abnormality in which artery and then into the aorta.
occurs usually after exposure to Shiga-like toxin the esophageal hiatus is larger than normal, Hypospadias a birth defect in which the ure-
from a strain of E. coli. causing part of the stomach to protrude through thral opening is abnormally placed, opening
 GLOSSARY 1737

anywhere from the tip of the glans penis, to the IgG subclass deficiency deficiencies in complement system are absent or suboptimal,
shaft, or to the junction of the penis and scro- certain subclasses of antibody. resulting in diminished complement activity.
tum or perineum in males; usually opens in the Selective IgA deficiency failure to pro- These include:
vagina in females. duce IgA, with or without diminished pro- C1 deficiency a deficiency of the first com-
Iatrogenic pneumothorax see Pneumothorax. duction of other classes of antibody. ponent of the classical pathway.
Icterus neonatorum (neonatal jaundice) X-linked hyper-IgM syndrome inability C2 deficiency a deficiency with an
jaundice in newborn infants caused by func- to class-switch resulting from a defect in increased risk for recurrent respiratory
tional immaturity of the liver; usually subsides activation-induced cytidine deaminase tract infections with encapsulated bacteria
within the first few days of life. (AICD). and a systemic lupus erythematosus–like
Idiopathic pulmonary fibrosis (IPF) an exces- Combined T- and B-lymphocyte deficiency syndrome that may be complicated by kid-
sive amount of fibrous or connective tissue in a group of immune deficiencies in which ney disease (glomerulonephritis).
the lung. both T and B lymphocytes are defective. C3 deficiency the most severe comple-
Idiopathic thrombocytopenic purpura (ITP) The most severe of these deficiencies is ment defect; an associated deficit of C3b,
(autoimmune or primary thrombocytope- called severe combined immune deficiency which is a major opsonin, results in a risk
nic purpura) see Thrombocytopenia. (SCID). These include: for recurrent life-threatening infections
IgA nephropathy (Berger disease) the most Adenosine deaminase (ADA) deficiency with encapsulated bacteria.
common form of idiopathic acute glomerulone- a form of SCID caused by an autosomal C3 receptor deficiency deficiencies in
phritis in developed countries, especially Asia; recessive mutation in the enzyme ADA, the complement receptor for C3 result in
cause is unknown. leading to death of rapidly dividing cells, recurrent bacterial infections, particularly
IgA pemphigus the most benign form of pem- particularly lymphocytes. of the skin.
phigus characterized by tissue-bound and circu- Ataxia-telangiectasia (AT) an autosomal C4 deficiency results in an increased risk
lating IgA antibodies targeting desmosomal or recessive disorder resulting from a large for recurrent respiratory tract infections
nondesmosomal cell surface components in the variety of sporadic mutations in the ATM with encapsulated bacteria and a systemic
basement membrane of the epidermis. gene; often associated with ataxia (unsteady lupus erythematosus–like syndrome that
IgG subclass deficiency see Immune defi- gait), telangiectasia (dilation of capillaries), may be complicated by kidney disease
ciency. and variable effects on both B and T cells. (glomerulonephritis).
IL-7 receptor deficiency see Immune deficiency. Bare lymphocyte syndrome forms of C9 deficiency the most common ter-
Immune deficiency a group of disorders in SCID characterized by an inability of minal pathway defect and generally
which one or more components of the immune lymphocytes and macrophages to present asymptomatic.
or inflammatory response is impaired, resulting antigen because of defects in class I (MHC Factor H deficiency a deficiency of comple-
in increased susceptibility to infections. Pri- class I deficiency) or class II (MHC class II ment factor H resulting in increased destruc-
mary (congenital) immune deficiencies result deficiency) MHC antigen expression. tion of C3 and a secondary C3 deficiency.
from genetic defects, and secondary immune IL-7 receptor deficiency a form of SCID Factor I deficiency a deficiency of comple-
deficiencies result from nongenetic factors, such resulting from mutations in the IL-7 ment factor I resulting in increased destruc-
as infections and other physiologic or patho- receptor, which is necessary for matura- tion of C3 and a secondary C3 deficiency.
physiologic conditions. Primary immune defi- tion of T cells. Mannose-binding lectin (MBL) defi-
ciencies include: JAK3 deficiency a form of SCID result- ciency a defect of the lectin pathway
B-lymphocyte deficiency a group of ing from mutations in JAK3, which is an of complement activation resulting in an
disorders in which B-cell development enzyme (a tyrosine kinase) associated with increased risk of infection with microor-
is defective, resulting in lower levels of their receptor for IL-2. ganisms that have polysaccharide capsules
circulating immunoglobulins and increased Purine nucleoside phosphorylase (PNP) rich in mannose.
susceptibility to infections in which deficiency a form of SCID resulting Properdin deficiency an X-linked defect
antibodies are the primary protective from a mutation in the enzyme PNP. in the alternative pathway of complement
mechanism. These include: RAG-1 and RAG-2 deficiencies auto- activation resulting in recurrent meningo-
Agammaglobulinemia a condition in somal recessive mutations in RAG-1 or coccal infections.
which no antibodies are produced. RAG-2 enzyme that are necessary for Phagocytic deficiency a group of conditions
Autosomal agammaglobulinemia an genetic rearrangement of antibody and in which phagocytosis is diminished,
autosomal recessive form of agammaglob- T-cell receptor variable regions. resulting in increased bacterial infections.
ulinemia resulting from mutations in the Reticular dysgenesis the most severe These include:
B-cell receptor. form of SCID in which a common stem Chediak-Higashi syndrome a lethal, pro-
Autosomal hyper-IgM syndrome inabil- cell for all white blood cells is absent; gressive, autosomal recessive, systemic
ity to class-switch resulting from muta- therefore T cells, B cells, and phagocytic disorder associated with oculocutaneous
tions in CD40 on B cells. cells never develop. albinism, massive leukocyte inclusions
Bruton’s agammaglobulinemia a defect Wiskott-Aldrich syndrome (WAS) an (giant lysosomes), histiocytic infiltration
in B-cell development results in lower lev- X-linked recessive trait resulting in of multiple body organs, development of
els of circulating immunoglobulins and chronic eczema with chronic suppurative pancytopenia, hepatosplenomegaly, and
increased susceptibility to infections in otitis media, anemia, thrombocytopenic recurrent or persistent bacterial infections.
which antibodies are the primary protec- purpura, poor antibody response to poly- Chronic granulomatous disease (CGD)
tive mechanism. saccharide antigens, and dysfunctions of both X-linked and autosomal forms of
Common variable immune deficiency cell-mediated immunity. mutations of the NADPH oxidase com-
the most commonly diagnosed immune X-linked SCID a form of SCID with arrest- plex, resulting in diminished production
deficiency; hypogammaglobulinemia of ed maturation of T and NK cells and the of hydrogen peroxide and other oxygen
IgG and other antibody classes; normal production of immature B cells as a result products necessary for the bactericidal
numbers of B cells, with or without associ- of a defect in the IL-2 receptor gamma (γ)- activity of myeloperoxidase.
ated T-cell defects. chain (IL-2Rγ), which is shared with many Cyclic neutropenia an autosomal domi-
Hypogammaglobulinemia a condition other cytokine receptors. nant mutation in the ELA2 gene resulting
in which immunoglobulin levels are much Complement deficiency a group of con- in periods of neutropenia lasting a few
lower than normal. ditions in which specific proteins of the days to weeks.
1738 GLOSSARY

Severe congenital neutropenia inade- Infertility the inability to conceive after 1 year of Kaposi sarcoma (KS) a rare cancer of connec-
quate numbers of neutrophils resulting in unprotected intercourse with the same, oppo- tive tissue caused by herpesvirus 8 (HHV8) in
a variety of recurrent and severe bacterial site-sex partner. which many bluish red nodules appear on the
infections beginning early in life. Intracerebral hematoma (intraparenchymal skin, especially skin of the lower extremities;
Secondary immune deficiencies hemorrhage) blood accumulation that par- occurs in a particularly virulent form in indi-
Acquired immunodeficiency syndrome tially clots inside the brain, usually in the frontal viduals with AIDS.
(AIDS) an epidemic, transmissible retro- and temporal lobes. Kawasaki disease a vascular disease character-
viral disease caused by infection with the Intraductal papilloma array of papillary cells ized by an inflamed heart and vessels; a coronary
human immunodeficiency virus (HIV), that grow from the wall of a cyst into the lumen artery aneurysm, thickening, and stenosis; a
resulting in destruction of T-helper cells, of the duct; growth occurs within a dilated duct fever that lasts at least 5 days; and at least four of
suppression of both antibody and cellular often near or beside the nipple causing benign the following: inflammation with reddening of
immune responses, and development of nipple discharge. the whites of the eyes; red, swollen hands or feet
life-threatening infections with opportu- Intrarenal (intrinsic) acute kidney injury (AKI) or peeling skin; rash; swollen lymph glands in
nistic organisms. a sudden decline in kidney function with a the neck; inflamed lips or throat; or red “straw-
Agranulocytosis complete absence of decrease in glomerular filtration and an accu- berry” tongue.
granulocytes in the blood is usually sec- mulation of nitrogenous waste products in Klinefelter syndrome smallness of testes with
ondary to arrested hematopoiesis in the the blood (elevation in plasma creatinine and fibrosis and hyalinization of seminiferous
bone marrow or massive cell destruction blood urea nitrogen levels); may result from tubules, variable degrees of masculinization,
in the circulation. ischemic acute tubular necrosis (ATN), neph- azoospermia, infertility, and increased levels of
Qualitative leukocyte disorder a group rotoxic ATN (i.e., exposure to radiocontrast urinary gonadotropins; associated typically with
of conditions with various disruptions of media or antibiotics), acute glomerulonephri- an XXY chromosome complement although
leukocyte function. tis, vascular disease (malignant hypertension, variants include XXYY, XXXY, and XXXXY.
Quantitative leukocyte disorder a group disseminated intravascular coagulation, and Kwashiorkor a condition in which children do
of conditions, frequently associated with renal vasculitis), allograft rejection, or inter- not receive enough protein in their diet, result-
infections and leukemias, with decreased stitial disease (drug allergy, infection, tumor ing in a swollen and severely bloated abdomen
production of leukocytes in the bone mar- growth). secondary to decreased albumin levels in the
row or accelerated destruction of leuko- Invasive breast carcinoma a malignant inva- blood, skin changes resulting in a reddish dis-
cytes in the circulation. sive epithelial lesion derived from the terminal coloration of the hair and skin in dark-skinned
Transient hypogammaglobulinemia of duct lobular area. children, severe diarrhea, fatty liver, muscle
infancy a period at 6 to 8 months when Invasive carcinoma of the cervix invasion of atrophy, and restricted development.
the newborn may not have produced cervical carcinoma into adjacent tissues, such Lactase deficiency a condition in which insuf-
adequate amounts of antibody to replace as ureters and structures of the lateral pelvic ficient lactase is present in the small intestine to
maternal antibody; in some infants this wall, the vaginal stroma and epithelium, and the digest lactose, resulting in lactose intolerance
may lead to a period of increased suscepti- lower uterine segment and myometrium. characterized by diarrhea, bloating, and gas in
bility to infections. Inverse psoriasis see Psoriasis. response to exposure to lactose.
T-lymphocyte deficiency a group of Iron deficiency anemia (IDA) see Anemia. Lactose intolerance a condition caused
disorders in which T-cell development Irritable bowel syndrome (IBS) a chronic by lactase deficiency in which lactose is not
is defective, resulting in lower levels of noninflammatory disease with a psychophysi- metabolized, making it impossible for the small
cellular immunity. Diminished T helper cell ologic basis; characterized by abdominal pain, intestine to absorb it and causing excessive gas
function may also decrease the production of diarrhea or constipation, or both; no detectable production and diarrhea when exposed to lac-
antibody. These include: pathologic change. tose-containing foods.
Chronic mucocutaneous candidiasis a Irritative syndrome (radicular syndrome) a Lambert-Eaton myasthenic syndrome a gen-
primary defect of T-lymphocyte response combination of changes usually seen with com- eralized disorder of neuromuscular transmission
to a specific infectious agent, the yeast C. promise of a spinal root within the intraspinal caused by a defect in the release of acetylcholine
albicans. canal; these include neck or back pain and, in from the presynaptic nerve terminals; often
DiGeorge syndrome a genetic disorder the affected root distribution, dermatomal pain, associated with small cell carcinoma of the lung,
caused by deletion of a piece of chromo- paresthesias, or both; decreased deep tendon particularly in elderly men with a long history of
some 22 that results in cardiac defects, reflexes; and occasionally myotomal weakness. cigarette smoking; weakness tends to affect solely
abnormal facies, thymic aplasia, cleft pal- Isolated systolic hypertension loss of elastic- axial muscles, girdle muscles, and less often the
ate, and hypocalcemia. ity of the arteries resulting in an increase in car- limb muscles; autonomic disturbances, dry
Immune thrombocytopenic purpura (ITP) see diac output or stroke volume, a systolic blood mouth, and impotence are common; the deep
Thrombocytopenia. pressure consistently greater than 160 mmHg, tendon reflexes are unelicitable; caused by loss
Imperforate anus a congenital defect in which and a diastolic pressure less than 90 mmHg. of voltage-sensitive calcium channels located on
the anal opening is absent because of the pres- JAK3 deficiency see Immune deficiency. the presynaptic motor nerve terminal.
ence of a membranous septum or complete Jaundice (icterus) yellowish brown staining Laryngomalacia a congenital anomaly caused
absence of the anal canal. of the skin and the conjunctivae caused by high by a developmental delay in the laryngeal car-
Impetigo a contagious bacterial infection that bilirubin levels in blood secondary to exces- tilage and supporting structures of the larynx
produces superficial red blisters that rupture sive erythrocyte breakdown, obstruction in or that causes the cartilage to be floppy and fold
and produce thick yellow crusts that commonly around the liver, or liver disease. in on itself during inspiration, producing high-
occur on the face but can spread to other regions Juvenile idiopathic arthritis (JIA) chronic pitched, coarse, and low-pitched sounds.
of the body easily. pauciarticular arthritis and destruction of joints Left heart failure (congestive heart fail-
Infectious mononucleosis (IM) a disease beginning in childhood and often going into ure) inability of the left ventricle to maintain
caused by the Epstein-Barr virus or the cyto- remission at puberty. its circulatory load, with a corresponding rise
megalovirus that is transmitted by exchanging Juvenile myoclonic epilepsy a type of epilepsy in pressure in the pulmonary circulation usu-
saliva or blood or by coughing and sneezing that occurs in adolescents and young adults, ally with pulmonary congestion and ultimately
and acts by infecting the B cells and atypi- usually on awakening, and is characterized by pulmonary edema.
cal T cells, resulting in fever, sore throat, and jerks of the neck, shoulders, and arms and by Legg-Calvé-Perthes disease blood supply
fatigue. clonic-tonic seizures. to the head of the femur near the hip joint is
 GLOSSARY 1739

interrupted, resulting in osteonecrosis of the Discoid (cutaneous) lupus erythematosus of differentiation; previously part of non-
corresponding epiphysis. (DLE) lupus erythematosus limited to Hodgkin lymphoma.
Lennox-Gastaut syndrome a generalized myo- the skin; can progress to systemic lupus Waldenström macroglobulinemia a rare
clonic epilepsy that occurs in children between 1 erythematosus (SLE). type of slow-growing plasma cell tumor that
and 5 years of age as a result of various cerebral Systematic lupus erythematosus (SLE) a secretes a monoclonal IgM molecule; also
afflictions such as perinatal hypoxia, hemorrhage, chronic, multisystem, inflammatory disease; called lymphoplasmocytic lymphoma.
encephalitis, and metabolic disorders of the brain; is one of the most common, complex, and Lymphoplasmocytic lymphoma see
it is characterized by mental retardation, person- serious of the autoimmune disorders. Lymphoma.
ality disorders, and generalized tonic seizures. Lyme disease (borreliosis) tick-borne spi- Lysosomal storage diseases a group of more
Leukemia an acute or chronic malignant dis- rochete bacterial infection that is character- than 30 disorders that result from impaired
ease of the bone marrow and blood-forming ized by a rash in the area of the bite, headache, lysosomal function, leading to mucopolysac-
organs; excessive proliferation of white blood neck stiffness, chills, fever, myalgia, arthralgia, charidoses, lipid storage disorders, mucolipido-
cells occurs and is usually accompanied by dys- malaise, fatigue, and possible development of ses, leukodystrophies, and glycoprotein storage
functional blood cells, anemia, impaired blood arthritis in large joints. disorders.
clotting, and enlargement of the lymph nodes, Lymphoblastic lymphoma (LL) see Macrocytic anemia (megaloblastic anemia)
liver, and spleen. Lymphoma. see Anemia.
Acute leukemia characterized by undifferen- Lymphogranuloma venereum (LGV) a sexu- Major (unipolar) depression severely de-
tiated or immature cells, usually a blast cell, ally transmitted bacterial infection that enters pressed mood and loss of pleasure that may
and the onset of disease is abrupt and rapid the body through breaks in the skin or across begin suddenly or slowly; it persists for at least 2
with a short survival time. the epithelial cell layer of mucous membranes weeks and may recur throughout life.
Acute lymphoblastic/lymphocytic leu- and primarily targets the lymphatics and lymph Malignant hyperthermia an inherited life-
kemia (ALL) excessive production and nodes. threatening disorder that causes muscle rigid-
continuous multiplication of malignant Lymphoma cancer arising from cell prolifera- ity, a hypermetabolic state, tachycardia, and
and immature white blood cells (lympho- tion in lymphoid tissue. increased body temperature in response to
blasts) in the bone marrow that progresses B-cell neoplasm a group of lymphomas administration of general anesthesics.
rapidly if left untreated. including myelomas that originate from Malnutrition lack of nourishment from inade-
Acute myelogenous leukemia (AML) B cells at various stages of differentiation; quate amounts of calories, protein, vitamins, or
excessive number of immature myeloid previously part of non-Hodgkin lym- minerals; caused by improper diet, alterations
cells (myeloblasts) in the blood and bone phoma. in digestion or absorption, chronic disease, or a
marrow crowding out the marrow and Burkitt lymphoma an aggressive malignancy combination of these factors.
decreasing the function of other cells. of the B lymphocytes characterized by a Mannose-binding lectin (MBL) deficiency see
Chronic leukemia the predominant cell is large osteolytic lesion in the facial bones and Immune deficiency.
more differentiated but does not function associated with Epstein-Barr virus infection. Marasmus a childhood disorder characterized
normally, with a relatively slow progression Hodgkin lymphoma (HL) a cancer of by protein and energy malnutrition, resulting
of the malignancy. lymphoid tissue in which the lymph nodes, in dry skin, loss of adipose tissue from normal
Chronic lymphocytic leukemia (CLL) spleen, and liver become enlarged with areas of fat deposits such as buttocks and thighs,
malignant transformation and progressive the presence of Reed-Sternberg cells and is and behavior that is fretful and irritable.
accumulation in the marrow of monoclo- often accompanied by anemia, fever, and Maturity-onset diabetes of youth (MODY) see
nal B lymphocytes; rarely are CLL malig- eventually death if not treated at an early Diabetes mellitis.
nancies of T-cell origin. stage; also referred to as Hodgkin disease. McArdle disease a metabolic disorder involv-
Chronic myelogenous leukemia (CML) Lymphoblastic lymphoma (LL) a progres- ing an enzyme defect that causes deficiency of
production of heterogeneous myeloid cells sive neoplasm arising in the thymus; most are muscle phosphorylase, which helps break down
in the bone marrow, the majority of which of T-cell origin; a variant of acute lympho- glycogen, and consequently this disorder causes
express the Philadelphia chromosome; blastic leukemia; common cause of NHL in an energy deficit in the muscles, resulting in
CML is considered a myeloproliferative children. muscle pain and cramping.
disorder. Lymphoplasmocytic lymphoma also called Meconium ileus obstruction with thickened
LH deficiency a condition characterized by Waldenström macroglobulinemia. meconium in the intestine of a newborn child as
decreased or absent production of luteinizing Mucosa-associated lymphoid tissue a result of a lack of trypsin and associated with
hormone (LH), resulting in a decline in sex ste- (MALT) lymphoma a low-grade B-cell cystic fibrosis of the pancreas.
roid production in testes/ovaries and associated lymphoma linked to infection with H. pylori. Medulloblastoma a malignant cerebellar tumor
infertility. Mycosis fungoides most common cutane- near the fourth ventricle that is most often
Lichen planus a recurrent rash of small, flat- ous T-cell lymphoma; present as focal or found in children and consists of neoplastic cells
topped bumps and rough scaly patches appear- widespread erythematous patches or plaques, that resemble the undifferentiated cells of the
ing on the skin, in the lining of the mouth, and follicular papules, comedone-like lesions, neural tube.
in the vagina in response to inflammation or an and tumors. Membranoproliferative glomerulonephritis
allergy to a specific medication. NK-cell neoplasm a group of lymphomas (MPGN) see Glomerulonephritis.
Localized scleroderma (morphea) rare and that originate from NK cells at various stages Membranous glomerulonephritis see Glo-
idiopathic sclerosis of the skin, usually with of differentiation; previously part of non- merulonephritis.
childhood onset. Hodgkin lymphoma. Membranous nephropathy (membranous glo-
Locked-in syndrome quadriplegia and mut- Non-Hodgkin lymphoma (NHL) a group merulonephritis) see Glomerulonephritis.
ism with intact consciousness and preservation of malignancies of lymphoid tissue classified Ménière disease (endolymphatic hydrops)
of some eye movements; usually results from a as B-cell, T-cell, and NK-cell lymphomas dilation of the membranous labyrinth of the
vascular lesion of the anterior pons. that mimic Hodgkin lymphoma but do not inner ear that is thought to be due to impaired
Lupus erythematosus any of a group of produce the cells characteristic of Hodgkin absorption of endolymph in the endolym-
autoimmune connective tissue disorders that lymphoma; have been reclassified as B-cell, phatic sac; the pathologic finding in Ménière
commonly produce red scaly lesions and are T-cell, or NK-cell neoplasms. disease.
accompanied by fever, malaise, myalgias, T-cell neoplasm a variety of lymphomas Ménière syndrome an affliction characterized
fatigue, and weight loss. that originate from T cells at various stages clinically by vertigo, nausea, vomiting, tinnitus,
1740 GLOSSARY

and fluctuating and progressive sensory hearing opposite sex (virilization of a girl or feminiza- disorders affecting skeletal muscles, and often
loss associated with endolymphatic hydrops. tion of a boy); usually evident at birth and rare other organ systems.
Meningioma a slow-growing mass of the in older children. Myasthenia gravis neuromuscular disorder
meninges that is usually benign but increases Molluscum contagiosum a viral infection of caused by an autoimmune response in which
intracranial pressure the skin occurring in young children that affects antibodies to acetylcholine receptors impair
Meningocele neural tube defect in the skull or the body, arms, and legs; it is spread through neuromuscular transmission.
spinal column that forms a cyst filled with cere- direct contact, saliva, or shared articles of cloth- Mycosis fungoides see Lymphoma.
brospinal fluid through which the meninges of ing and is considered a sexually transmitted Myelodysplastic syndrome (MDS) a group of
the brain protrude. disease in adults, affecting the genitals, lower hematologic conditions characterized by inef-
Mesangial proliferative glomerulonephritis abdomen, buttocks, and inner thighs. fective production of blood cells, resulting in
see Glomerulonephritis. Monoclonal gammopathy of undetermined anemia that requires chronic blood transfusion.
Mesenteric venous thrombosis a condition in significance (MGUS) production of mono- Myoadenylate deaminase deficiency
which a blood clot obstructs one of the mesen- clonal antibodies by noncancerous plasma cells (MDD) a genetic disorder in which an enzyme
teric veins and compromises the intestinal blood that accumulate in the blood. deficiency prevents the conversion of adenosine
supply; can result in intestinal gangrene and tis- Motility diarrhea diarrhea caused by excessive monophosphate (AMP) to inosine monophos-
sue death. motility decreases transit time, mucosal sur- phate, resulting in increased AMP loss and the
Mesothelioma a type of cancer that is usually face contact, and fluid absorption secondary inability to synthesize adenosine triphosphate
associated with previous exposure to asbes- to resection of the small intestine (short bowel for energy.
tos, which affects the pleura, the lining of the syndrome), surgical bypass of an area of the Myocardial infarction a heart condition of sud-
abdominal cavity, the pericardium, and most intestine, fistula formation between loops of den onset in which muscle tissue dies because of
internal organ coverings. intestine, irritable bowel syndrome–diarrhea a lack of blood flow, resulting in varying degrees
Metabolic syndrome a condition of unknown predominant, diabetic neuropathy, hyperthy- of chest pain or discomfort, weakness, sweat-
cause that presents with symptoms of insulin roidism, and laxative abuse. ing, nausea and vomiting, and possibly loss of
resistance, obesity, hypertension, dyslipidemia, Moyamoya disease an abnormality of the consciousness.
and systemic inflammation. blood vessels that supply the frontal region of Myositis inflammation of a muscle, usually a
Metatarsus adductus a foot deformity in which the brain in which vessels constrict or become voluntary muscle, resulting in pain, tenderness,
the front half of the foot bends inward, possibly completely occluded, resulting in diminished and sometimes spasm in the affected area.
because of the infant’s position in the uterus. blood flow. The body attempts to compensate Myositis ossificans a condition in which bone
MHC class I deficiency see Immune deficiency. by growing new vessels at the base of the brain, is deposited in muscle tissue, causing pain and
MHC class II deficiency see Immune deficiency. which appear as a puff of smoke on angiography. swelling.
Microcephaly defect in which failure of normal Mucoepidermoid carcinoma a tumor of the Myxedema cutaneous edema caused by deposi-
brain growth causes delayed skull growth and main or lobar bronchi lumen that may extend tion of connective tissue (e.g., glycosaminogly-
production of a small head. into the peribronchial tissue. cans and hyaluronic acid) and associated with
Microcytic-hypochromic anemia see Anemia. Mucolipidosis (ML) accumulations of both car- hypothyroidism and Graves disease; character-
Microscopic colitis a relatively common cause bohydrates and lipids. ized by dry skin, pretibial myxedema, swelling
of diarrhea; occurs primarily in females and Mucopolysaccharidosis carbohydrate excess around the lips and nose, mental deterioration,
older adults. disorders. and a decrease in basal metabolic rate.
Migraine headache headache that usually Mucopurulent cervicitis (MPC) inflammation Necrotizing enterocolitis (NEC) a condition of
begins in the temporal region unilaterally after of the cervix with purulent endocervical exudate extensive ulceration and necrosis of the ileum
vascular changes of cranial arteries and may that may be asymptomatic or cause abnormal and colon in premature infants during the neo-
cause irritability, nausea, vomiting, constipation vaginal discharge and vaginal bleeding. natal period.
or diarrhea, and photophobia. Mucosa-associated lymphoid tissue (MALT) Necrotizing fasciitis a rare, rapidly spreading
Mild concussion (mild traumatic brain lymphoma see Lymphoma. inflammation starting in the fascia, muscles,
injury) temporary axonal disturbances with- Multiple myeloma (MM) most common and and subcutaneous fat with subsequent necrosis
out the loss of consciousness in response to a most aggressive plasma cell tumor; a clonal of the overlying skin; it is initiated by bacterial
violent blow, jarring, shaking, or other closed- plasma cell cancer characterized by the slow infection and treated with antibiotics; often
head injury. proliferation of malignant cells as tumor cell requires surgical débridement.
Miliaria a skin disease caused by partially masses in the bone marrow that usually results Neonatal alloimmune thrombocytopenic pur-
obstructed sweat glands that results in small and in destruction of the bone; most secrete large pura (NATP) see Thrombocytopenia.
itchy rashes usually located in skinfolds and on amounts of monoclonal proteins that resemble Neonatal purpura fulminans a fatal syndrome
areas of the body that may rub against clothing, intact immunoglobulins. found in neonates who are homozygous or
such as the back, chest, and stomach. Multiple organ dysfunction syndrome double heterozygous for types I and II protein
Minimal change nephropathy (MCN) the (MODS) progressive disease often involving deficiency.
foot processes of the renal capillary basement the ultimate failure of two or more organ sys- Nephritic syndrome a disorder of the glo-
membrane are fused and deformed because of tems after a severe illness or injury; disease pro- merular filtration membrane in which plasma
a T-cell disorder that reduces the anion com- cess is initiated and perpetuated by uncontrolled proteins and red blood cells pass into the urine,
ponent of the basement membrane and allows systemic inflammatory and stress responses and resulting in mild proteinuria, hematuria, and
proteins to leak into the renal tubule. is characterized by a hypermetabolic and hyper- mild hypertension.
Minimally conscious state (MCS) a condition dynamic state that persists as organ dysfunction Nephroblastoma (Wilms tumor) a malignant
in which a severely brain-damaged patient is develops. renal tumor of young children that compresses
capable of deliberate behavior distinguishable Multiple papilloma (diffuse papillomato- the normal kidney parenchyma, causing an
from unconscious reflexive actions. sis) a minimum of five papillomas within a abdominal mass, blood in the urine, and fever
Mitral valve prolapse syndrome the mitral localized segment of breast tissue. and may be associated with anorexia, vomiting,
valve cannot close properly because of one or Multiple sclerosis (MS) chronic demyelinating and malaise; often inherited as an autosomal
both flaps being too large, possibly resulting in disease of the central nervous system that causes dominant trait.
mitral valve regurgitation. inflammation and scarring of myelin sheaths. Nephrotic syndrome a disorder of the glomer-
Mixed precocious puberty development of Muscular dystrophy a general term for a num- ular filtration membrane that permits proteins
some secondary sex characteristics of the ber of hereditary, progressive degenerative to pass into the urine, resulting in proteinuria,
 GLOSSARY 1741

hypoalbuminemia, hyperlipidemia, and sys- Nonsyndromic craniosynostosis (see Cranio- causing pain just below the knee, irritation and
temic edema. synostosis) the premature closure of one or swelling, and possibly abnormal bone growth.
Neural tube defect (NTD) lack of closure of the more of the cranial sutures during the first 18 Osteogenesis imperfecta (brittle bone disease)
neural groove caused by an arrest of the normal to 20 months of an infant’s life, but an isolated a genetic disease in which collagen production is
development of the brain and spinal cord dur- defect unrelated to syndrome. deficient, making the bones abnormally fragile
ing the first month of embryonic development. Normocytic-normochromic anemia (NNA) and causing recurring fractures with only mini-
Neuroblastoma a malignant tumor containing see Anemia. mal trauma, deformity of long bones, a bluish
neuroblast cells that originate in the autonomic Obesity hypoventilation syndrome (pickwick- coloration of the sclerae, and often the develop-
nervous system or the adrenal medulla; is most ian syndrome) a condition of severely over- ment of otosclerosis.
common in infants and young children. weight individuals related to the inability to Osteoid osteoma a benign tumor in one of the
Neurogenic shock (vasogenic shock) a type breathe rapidly or deeply enough to maintain bones of the lower extremities that is painful
of shock caused by the sudden loss of the sym- adequate blood oxygen levels; characterized by and is characterized by vascularized connective
pathetic nervous system signals to the smooth obstructive sleep apnea, somnolence, hypoven- tissue and osteoid material that is surrounded
muscle in vessel walls, causing the vessels to tilation, erythrocytosis, and heart failure. by a large zone of thickened bone.
relax and a decrease in peripheral vascular resis- Obsessive-compulsive disorder (OCD) an Osteomalacia a disease in which vitamin D or
tance and blood pressure. anxiety disorder characterized by obsessive calcium deficiency or excessive renal phosphate
Neuroleptic malignant syndrome hyperther- thoughts and repetitive compulsive actions, loss causes a softening of the bones with accom-
mia with autonomic and extrapyramidal side such as cleaning, checking, or counting. panying pain and weakness.
effects caused by the administration of neuro- Obstructive jaundice jaundice related to extra- Osteomyelitis a bacterial infection of the bone
leptic drugs. hepatic or intrahepatic obstruction. and bone marrow that occurs through open
NK-cell neoplasm see Lymphoma. Obstructive pulmonary disease airway fractures, penetrating wounds, surgical opera-
Nonalcoholic fatty liver disease (NAFLD) obstruction that is worse with expiration so that tions, or by infiltration of the bloodstream;
accumulation of fat in hepatocytes, primarily more force or more time is required to expire a causes pain, high fever, and formation of an
in the form of triglycerides, occurring in the given volume of air and emptying of the lungs abscess at the site of infection.
absence of or with little alcohol intake; causes is slowed; characterized by shortness of breath Osteoporosis a disease in which the bones
progressive inflammation and scarring that is (dyspnea) and wheezing. become porous and weakened, making them
usually asymptomatic for years. Obstructive sleep apnea syndrome (OSAS) a easily fracture and slow to heal.
Nonalcoholic steatohepatitis (NASH) a more disorder of sleep characterized by airway Overactive bladder syndrome (OAB) a
serious form of nonalcoholic fatty liver disease obstruction and episodes of apnea accompanied chronic syndrome of overactivity of the detru-
resulting from hepatocellular injury, inflamma- by snoring. sor muscle; characterized by urgency with invol-
tion, and fibrosis; this condition is difficult to dis- Obstructive uropathy the blockage of urine untary detrusor contractions during the bladder
tinguish from alcohol-induced liver fibrosis; may flow, often by ureteral or kidney stones, result- filling phase.
progress to cirrhosis, end-stage liver disease, and ing in the reflux of urine and subsequent injury Oxygen toxicity an iatrogenic inflammatory
an increased risk for hepatocellular carcinoma. to kidneys. condition caused by prolonged exposure to
Nonbacterial infectious cystitis see Painful Onychomycosis a fungal infection of the fin- high concentrations of supplemental oxygen
bladder syndrome/interstitial cystitis (PBS/IC). gernails or toenails that causes thickening, resulting from damage to alveolocapillary mem-
Nonbacterial prostatitis prostatitis causes roughness, and splitting of the nails. branes, disruption of surfactant production,
chronic pain that disappears and returns with- Oophoritis inflammation of the ovaries. and interstitial and alveolar edema; caused by
out warning but shows no signs of bacterial Open pneumothorax (communicating pneu- oxygen free radicals.
infection in the prostatic fluid even though the mothorax) see Pneumothorax. Paget disease (osteitis deformans) a bone
semen and other fluids from the prostate con- Optic glioma tumor originating from glial cells disorder in which excessive bone remodel-
tain immune cells that the body produces in in the brain that affects the optic nerve; com- ing causes enlarged, deformed bones that can
response to infection. monly seen in children with neurofibromatosis. weaken the bone integrity and result in bone
Non-Hodgkin lymphoma (NHL) see Organic brain syndrome a constellation of pain, arthritis, deformities, or fractures.
Lymphoma. physical brain disorders with psychologic or Painful bladder syndrome/interstitial cys-
Noninfectious cystitis see Painful bladder syn- behavioral signs and symptoms and grouped titis (PBS/IC) (see Cystitis) a condition
drome/interstitial cystitis (PBS/IC). according to symptoms rather than etiology. occurring in women ages 20 to 40 years who
Noninflammatory acne see Acne. Orthopnea shortness of breath (dyspnea) that have symptoms of cystitis, such as frequency,
Noninflammatory joint disease a disease in occurs when an individual lies flat and is com- urgency, dysuria, and nocturia, for more than
which alterations in the structure or mechanics mon in individuals with heart failure. 6 weeks duration; usually related to bacterial
of the joint result in pain during motion. Orthostatic (postural) hypotension a sudden infection.
Nonoliguric renal failure excretion of more drop in blood pressure when a person assumes Nonbacterial infectious cystitis cystitis
than 500 ml/day of urine concurrent with renal a standing position, resulting in dizziness, light- with negative urine cultures and no
failure; although adequate volume of urine is headedness, blurred vision, and temporary loss other known etiology; most common in
excreted, renal tubules have impaired reabsorp- of consciousness. immunocompromised individuals and
tion and concentration and dilution function so Osmotic diarrhea nonabsorbable substance related to viral, mycobacterial, chlamydial, or
that filtration is defective, resulting in accumu- in the intestine draws water into the lumen by fungal infection.
lation of uremic toxins in the blood. osmosis, resulting in large-volume diarrhea; Noninfectious cystitis cystitis without
Nonossifying fibroma (fibrous cortical defi- caused by drinking solutions with excessive sug- evidence of infection; usually autoimmune
cit) a benign fibrous tissue tumor forms in the ars, salt, or vitamin C; maldigestion syndromes. or related to exposure to radiation or
metaphysis of any of the long bones but usually Osteoarthritis (OA) inflammatory degenerative chemotherapy treatment for pelvic or
occurs in the thigh and shin bones in children joint disease in which synthesis and degradation urogenital cancers.
and adolescents. of the articular cartilage in the movable joints Panacinar emphysema see Emphysema.
Nonpuerperal hyperprolactinemia the pres- are altered, resulting in wearing and destruction Pancreatic insufficiency a condition in which
ence of excessive amounts of prolactin (the of cartilage. the pancreas does not secrete enough hormones
pituitary hormone that stimulates milk produc- Osteochondrosis (Osgood-Schlatter disease) and digestive enzymes for normal digestion to
tion) in the blood not related to pregnancy or a condition in children that results from the occur, resulting in malabsorption, malnutrition,
childbirth; most common cause of galactorrhea. tendons pulling on the epiphysis of long bones, vitamin deficiencies, and weight loss.
1742 GLOSSARY

Pancreatitis inflammation of the pancreas, usu- Paraneoplastic pemphigus the most Plaque psoriasis see Psoriasis.
ally resulting in abdominal pain. severe form of pemphigus; is associated with Pneumoconiosis a chronic disease of the
Panhypopituitarism a condition in which the lymphoproliferative neoplasms and affects lungs typically seen in miners, sandblasters,
secretion of all anterior pituitary hormones internal organs, including lungs, thyroid, and metal grinders that is caused by repeated
is inadequate or absent; caused by a variety of kidney, smooth muscle, and gastrointestinal inhalation of dust particles, including iron
disorders that result in destruction or loss of tract. oxides, silicates, and carbonates, that collect in
function of all or most of the anterior pituitary Pemphigus foliaceus a milder form of the lungs and become sites for the formation
gland. pemphigus involving loss of cell-to-cell of fibrous nodules that eventually replace lung
Panic disorder a psychologic disorder that is adhesion (acantholysis) at the subcorneal level tissue.
characterized by recurrent attacks of anxiety or with blistering, erosions, scaling, crusting, and Pneumonia an infection of one or both lungs
terror and usually results in the development of erythema usually of the face and chest. caused by a bacterium, virus, fungus, or other
one or more phobias. Pemphigus vulgaris the most common organism that enters the body through respira-
Papulosquamous disorder collective refer- form of pemphigus with acantholysis at tory passages and causes high fever, chills, chest
ence to inflammatory disorders characterized by the suprabasal level and initiated by IgG pain, difficulty breathing, cough with sputum,
papules, scales, plaques, and erythema, includ- autoantibodies against the desmoglein and possibly bluish skin from insufficiently oxy-
ing psoriasis, pityriasis rosea, and lichen planus. adhesion molecules, resulting in acantholysis genated blood.
Paraesophageal hiatal hernia herniation of in the epidermis with fluid accumulation and Pneumothorax the collapse of a lung and
the greater curvature of the stomach through a blister formation; oral lesions precede the subsequent escape of air into the pleural cav-
secondary opening in the diaphragm. onset of skin blistering. ity between the lung and the chest wall that is
Paraneoplastic pemphigus see Pemphigus. Pericarditis the pericardium is infected by a caused by trauma, environmental factors, or
Paraphimosis a condition in which the foreskin virus, bacteria, parasite, or fungus and becomes spontaneous occurrence and results in a sudden
becomes trapped behind the glans penis and inflamed, resulting in pain and fluid and blood pain in the chest.
cannot return to its normal flaccid position cov- components entering into the pericardial space. Iatrogenic pneumothorax the presence
ering the glans penis. Perihepatitis (Fitz-Hugh–Curtis syndrome) a of air or gas in the pleural space caused
Parkinson disease degeneration of the basal complication of pelvic inflammatory disease by a rupture in the visceral pleura (which
ganglia dopaminergic nigrostriatal pathway secondary to gonococci bacteria traveling up the surrounds the lungs) or the parietal pleura
that causes hypokinesia, tremor, and muscular peritoneum to the upper abdomen and causing and chest wall; is most commonly caused by
rigidity. inflammation. transthoracic needle aspiration.
Parkinsonism (Parkinson syndrome, par- Periodic paralysis one of a group of diseases in Open pneumothorax (communicating
kinsonian syndrome) a neurologic con- which muscular weakness or flaccid paralysis pneumothorax) spontaneous and trau-
dition characterized by tremors, rigidity, occurs without loss of consciousness, speech, or matic pneumothorax in which air pressure
hypokinesia, and postural instability as a result sensation. in the pleural space equals barometric
of degeneration of the corpus striatum or sub- Peripheral artery disease (PAD) any of a group pressure because air that is drawn into the
stantia nigra caused by Parkinson disease and of diseases caused by the obstruction of large pleural space during inspiration (through
other conditions related to toxins or metabolic peripheral arteries secondary to atherosclerosis, the damaged chest wall and parietal
conditions. inflammatory processes, embolism, or throm- pleura or through the lungs and damaged
Paroxysmal nocturnal dyspnea (PND) attacks bus formation that causes ischemia. visceral pleura) is forced out during
of breathing discomfort, shortness of breath, Pernicious anemia see Anemia. expiration.
and coughing that occur at night with varying Pes planus (flatfoot) a condition in which the Primary (spontaneous) pneumothorax
intensity so that individuals must sit up or stand arch of the foot never develops or it collapses occurs unexpectedly in healthy individuals
to relieve dyspnea; may occur in individuals and contacts the ground. (usually men) between ages 20 and 40 years;
with heart failure or lung disease. Peyronie disease (bent nail syndrome) a con- is most often caused by the spontaneous
Partial obstruction of the bladder outlet or dition in which fibrous plaques grow in the soft rupture of blebs on the visceral pleura.
urethra partial obstruction related to deposi- tissue of the penis because of injury of the inter- Secondary (traumatic) pneumothorax
tion of collagen within the smooth muscle bun- nal cavity of the penis that is accompanied by spontaneous or secondary pneumothorax
dles of the detrusor muscle; causes an increase in bleeding and scar tissue formation at the tunica beginning with sudden pleural pain,
the force of detrusor contraction. albuginea of the corpora cavernosa. tachypnea, and possibly mild dyspnea.
Partial precocious puberty the partial devel- Phagocytic deficiency see Immune deficiency. Tension pneumothorax the site of pleural
opment of appropriate secondary sex character- Phenylketonuria (PKU) a genetic disorder in rupture acts as a one-way valve, permitting
istics alone or in combination. which the body lacks the enzyme necessary to air to enter on inspiration, but preventing
Pediculosis pubis a contagious condition, also metabolize the amino acid phenylalanine to its escape by closing during expiration and
known as crabs or crab lice, that is an infesta- tyrosine, resulting in accumulation of phenyl- leading to air pressure in the pneumothorax
tion of the pubic hair in which the louse feeds on alanine and subsequent brain damage and pro- exceeding barometric pressure.
human blood and multiplies rapidly. gressive mental retardation. Polycystic ovary syndrome (PCOS) a hor-
Pelvic inflammatory disease (PID) inflamma- Pheochromocytoma a tumor of the adrenal monal condition in which multiple ovarian
tion of the female genital tract caused by micro- medulla that causes the chromaffin cells to cysts form because of elevated levels of andro-
organisms, typically those that are sexually secrete increased amounts of epinephrine or gens, resulting in hirsutism, obesity, men-
transmitted such as chlamydia and gonococci; norepinephrine. strual abnormalities, infertility, and enlarged
characterized by severe abdominal pain, high Phimosis the foreskin of the penis of an uncir- ovaries.
fever, vaginal discharge, and possibly infertility. cumcised male cannot be fully retracted. Polycythemia vera a chronic, progressive dis-
Pelvic organ prolapse (POP) bladder outlet Pick disease progressive atrophy of the cere- ease that is characterized by overgrowth of the
obstruction in women caused most commonly bral convolutions in a limited area (lobe) of the bone marrow, excessive red blood cell produc-
by a cystocele (the downward protrusion of the brain, with clinical manifestations and course tion, and an enlarged spleen and causes head-
bladder into the vagina) that descends below the similar to those of Alzheimer disease. ache, inability to concentrate, and pain in the
level of the urethral outlet. Pityriasis rosea a skin disorder, thought to be fingers and toes.
Pemphigus a group of autoimmune skin dis- caused by a virus, in which patches of ovular Pompe disease see Acid maltase disease.
eases marked by groups of itching blisters and pink rash appear primarily on the trunk and Port-wine (nevus flammeus) stain a birth-
raw sores on the skin and mucous membranes. extremities. mark caused by superficial and deep dilated
 GLOSSARY 1743

capillaries in the skin that produce a reddish to Prerenal acute kidney injury rapid develop- Primary syphilis a stage of syphilis infection
purplish discoloration of the skin, usually on the ment of renal hypoperfusion with elevation of that occurs after an incubation period of 10 to
face, but can occur anywhere on the body. serum creatinine and urea levels. 90 days and is characterized by a primary sore
Postconcussive syndrome physical and per- Presbyopia a form of farsightedness usually or chancre that develops at the point of initial
sonality changes that may occur after concus- accompanying advanced age in which the lens exposure and lasts 4 to 6 weeks.
sion of the brain, including amnesia, headache, loses elasticity and becomes unable to accom- Prinzmetal angina a form of angina pectoris
dizziness, tinnitus, irritability, fatigability, modate and focus light for near vision. characterized by pain that is not precipitated by
sweating, heart palpitations, insomnia, and dif- Priapism a painful condition in which the erect cardiac work; it is of longer duration and usu-
ficulty concentrating. penis maintains an erection in the absence of ally more severe, and is associated with unusual
Posthemorrhagic anemia see Anemia. physical and psychologic stimulation. electrocardiographic results including elevated
Postobstructive pulmonary edema (POPE) Primary accidental hypothermia uninten- ST segments.
(negative pressure pulmonary edema) a tional drop in core body temperature below Progressive bulbar palsy (see Bulbar palsy) a
rare life-threatening complication that can 35° C (95° F) of a previously healthy person slowly progressive neurodegenerative disorder
occur after relief of upper airway obstruction attributable to the changes that occur with cold of the motor neurons of the cerebral cortex, spi-
(e.g., postextubation laryngospasm after anes- temperatures. nal cord, and brainstem, resulting in progressive
thesia induction, epiglottitis, laryngeal tumor, Primary adrenal insufficiency (Addison dis- symptoms of bulbar palsy that may advance to
or obstructive tonsils). ease) adrenal hypofunction resulting in loss of ability to manipulate food in the mouth,
Postrenal acute kidney injury rare complica- bronzelike pigmentation of the skin, severe inability to swallow, choking, and emotional
tion of urinary tract obstruction that affects prostration, progressive anemia, low blood changes; may lead to aspiration of food and
the kidneys bilaterally (e.g., bilateral ureteral pressure, diarrhea, and digestive disturbance. fluid and death from pneumonia.
obstruction, bladder outlet obstruction–pros- Primary amenorrhea continued absence of Progressive spinal muscular atrophy a pro-
tatic hypertrophy, tumors or neurogenic blad- menarche and menstrual function by 14 years of gressive degenerative disorder of the motor
der, and urethral obstruction); obstruction age without the development of secondary sex neurons of the spinal cord causing muscular
causes an increase in intraluminal pressure characteristics or by age 16 years if these changes weakness and wasting, typically beginning in
upstream from the site of obstruction. have occurred. the distal portions of the limbs and spreading
Post-thrombotic syndrome (PTS) a syndrome Primary biliary cirrhosis see Cirrhosis. proximally.
that follows a vascular thrombosis, such as per- Primary (congenital) immune deficiency see Prolactinoma the most common type of ante-
sistent edema. Immune deficiency. rior pituitary tumor; produces visual distur-
Posttraumatic stress disorder (PTSD) a psy- Primary dysmenorrhea painful menstruation bances and prolactin excess that results in
chologic disorder that may develop in indi- because of a functional disturbance rather than infertility and changes in menstruation in
viduals who have experienced or witnessed because of inflammation, growths, or anatomic females and impotence, loss of libido, and infer-
traumatic events; is characterized by recurrent factors. tility in males.
flashbacks of the traumatic event, nightmares, Primary gout acute episodes of urate crystal– Properdin deficiency see Immune deficiency.
irritability, anxiety, fatigue, forgetfulness, and induced synovitis resulting from abnormality of Prostatitis inflammation of the prostate gland
social withdrawal. purine metabolism; lower-than-normal urinary caused by urinary tract infection.
Potter syndrome a syndrome of renal agenesis excretion of urate leads to hyperuricemia and Protein C deficiency a disorder character-
with hypoplastic lungs and associated neonatal acute episodes of joint inflammation. ized by a lack of anticoagulant activity and an
respiratory distress, hemodynamic instability, Primary hyperaldosteronism (Conn disease, increased tendency to form blood clots because
acidosis, cyanosis, edema, and characteristic primary aldosteronism) an adrenocortical of decreased degradation of factor Va and fac-
(Potter) facies; death usually occurs from respi- disorder caused by excessive secretion of aldo- tor VIIIa secondary to thrombosis, deep vein
ratory insufficiency, which develops before sterone and characterized by headaches, noctu- thrombosis, pulmonary embolism, thrombo-
uremia. ria, polyuria, fatigue, hypertension, potassium phlebitis, neonatal purpura fulminans, and dis-
Poverty of content a disorder, also called pov- depletion, hypokalemic alkalosis, hypervolemia, seminated intravascular coagulation.
erty of speech content, that is characterized by and decreased plasma renin activity; may be Protein S deficiency a disorder character-
disorganized speech that conveys little informa- associated with small benign adrenocortical ized by a lack of anticoagulant activity and an
tion and may be vague or contain repetitive or adenomas. increased tendency to form blood clots because
obscure phrases. Primary hyperparathyroidism usually the of decreased degradation of factor Va and fac-
Prader-Willi syndrome a rare genetic disorder result of a benign parathyroid tumor that tor VIIIa.
caused by gene deletions on paternal chromo- secretes parathyroid hormone and increases cir- Pseudothrombocytopenia see Thrombocyto-
some 15 that result in short stature, hypotonia, culating calcium levels; this condition is accom- penia.
small hands and feet, obesity, mild to moderate panied by hypercalcemia, nausea, vomiting, Psoriasis a noncontagious autoimmune skin
mental retardation, and hypogonadism. lethargy, depression, muscular weakness, and disorder in which the skin becomes scaly and
Precocious puberty a condition in which a an altered mental state. inflamed when cells in the outer layer of skin
boy or girl undergoes the changes associated Primary hypertension (essential hyperten- reproduce faster than normal and accumulate as
with puberty at an unexpectedly early age; often sion, idiopathic hypertension) elevated plaques on the skin surface.
caused by a pathologic process that increases the blood pressure of unknown etiology accom- Erythrodermic (exfoliative) psoriasis wide-
secretion of estrogens or androgens. panied by increased total peripheral vascular spread red, scaling lesions that cover a large
Premenstrual dysphoric disorder (PMDD) resistance by vasoconstriction, increased cardiac body surface area; often accompanied by
recurrence in the luteal phase of the menstrual output, or both. itching or pain associated with constitutional
cycle of distressing physical, psychologic, or Primary multiple organ dysfunction syndrome symptoms (fever, chills, fatigue) and skin
behavioral changes that impair interpersonal (MODS) multiple organ injury directly associ- infections.
relationships or interfere with usual activities. ated with a specific insult, most often ischemia Guttate psoriasis sudden appearance of
Premenstrual syndrome (PMS) a group of or impaired perfusion from an episode of shock small papules on the trunk and extremities,
symptoms that occur in many women from 2 to or trauma, thermal injury, soft tissue necrosis, occasionally after a streptococcal respiratory
14 days before menstruation begins, including or invasive infection with decreased local perfu- tract infection in children.
abdominal bloating, breast tenderness, head- sion in the injured organs. Inverse psoriasis rare development of large,
ache, fatigue, irritability, depression, and emo- Primary (spontaneous) pneumothorax see smooth, dry, and deep red lesions in skinfolds
tional distress. Pneumothorax. (i.e., axilla or groin).
1744 GLOSSARY

Plaque psoriasis most common form of Refeeding syndrome metabolic disturbances Roseola a viral disease in infants and young
psoriasis; begins with well-demarcated, thick, that occur upon initiating parenteral or enteral children that causes fever and a spotty rash that
silvery, scaly erythematosus inflammatory nutritional therapy to individuals who are appears shortly after the fever has subsided.
lesions with epidermal hyperproliferation severely malnourished; starvation results in Rotavirus a viral infection seen in young chil-
and the presence of activated T lymphocytes movement of phosphate, magnesium, and dren that causes diarrhea by attacking the lining
that may become mild, moderate, or severe, potassium ions out of the cells and into the of the small intestine, resulting in the inability to
depending on the size, distribution, and plasma and refeeding increases insulin levels absorb fluid and electrolytes.
inflammation of the lesions. and stimulates movement of glucose and these Rubella an infectious viral disease of children
Pustular psoriasis blisters of noninfectious ions back into the cells, resulting in dangerously and young adults that is spread by a droplet
pus that develop over areas of plaque low levels in the plasma (hypophosphatemia, spray from the respiratory tract of an infected
psoriasis. hypomagnesemia, hypokalemia, hyponatremia, individual; the disease causes a rash that lasts
Pulmonary artery hypertension (PAH) in- hypocalcemia, and vitamin deficiency) and about 3 days with tender and swollen lymph
creased blood pressure in the pulmonary artery other potentially fatal metabolic complications. nodes behind the ears.
attributable to vasoconstriction that may even- Relative polycythemia a relative increase in the Rubeola an infectious viral disease of young
tually lead to fibrosis, increased workload, number of red blood cells caused by loss of the children, also known as measles, that is spread
hypertrophy of the right ventricle, and right fluid portion of the blood. by a droplet spray from the nose, mouth, and
heart failure; etiology may be idiopathic, famil- Renal agenesis only one functional kidney is throat of individuals in the infective stage and
ial, or associated with other diseases. present at birth. causes a rash, white spots in the mouth, a rash
Pulmonary embolism (PE) dislodgement of a Renal dysplasia abnormal tissue development on the face that spreads to the rest of the body,
blood clot from its site of origin and emboliza- in one or both kidneys. and fever.
tion to the arterial blood supply of one of the Respiratory distress syndrome (RDS) of the Russell-Silver syndrome (Russell-Silver
lungs, resulting in shortness of breath and dif- newborn a condition, also known as hyaline dwarfism) a growth disorder manifesting
ficulty breathing, rapid breathing that is painful, membrane disease (HMD), that is a type of as retardation, proportionate short stature, leg
cough, and (in severe cases) hypotension, shock, respiratory distress in newborns, most often in length discrepancy, and a small, triangular-
loss of consciousness, and death. prematurely born infants, those born by cesar- shaped face.
Pulmonary stenosis a condition in which the ean section, or those having a diabetic mother; Saccular aneurysm (berry aneurysm) a local-
opening into the pulmonary artery from the the immature lungs do not produce enough ized, progressively growing sac that affects only
right ventricle narrows. surfactant to retain air so the air spaces empty a portion of the circumference of the arterial
Pure red cell aplasia (PRCA) an acquired or completely and collapse after exhalation. wall and may be the result of congenital anoma-
congenital condition in which the bone mar- Reticular dysgenesis see Immune deficiency. lies or degeneration.
row lacks red blood cell precursors even though Retinoblastoma an autosomal dominant or Saccular bronchiectasis (see Bronchiecta-
megakaryocytes and white blood cell precursors sporadic disorder in which a malignant tumor sis) bronchiectasis resulting in dilated bron-
are usually present at normal levels. forms in the retina of one or both eyes; typically chi that become balloon-like.
Purine nucleoside phosphorylase (PNP) defi- found in infants. Salmon patches (nevus simplex) patches,
ciency see Immune deficiency. Reversible sideroblastic anemia see Anemia. also known as stork bites, of small, pink, flat
Pustular psoriasis see Psoriasis. Rhabdomyolysis a potentially fatal condition spots that are small dilated blood vessels visible
Pyloric stenosis a congenital abnormality in in which skeletal muscle breaks down as a result through the skin and are usually found on the
which the pylorus is narrow, resulting in poor of injury such as physical damage to the muscle, forehead, eyelids, and upper lip; between the
feeding, weight loss, and progressively worsen- high fever, metabolic disorders, excessive exer- eyebrows; and on the back of the neck.
ing vomiting. tion, convulsions, or anoxia of the muscle for Salpingitis inflammation of one of the two fal-
Pyramidal/spastic cerebral palsy palsy result- several hours; large amounts of myoglobin are lopian tubes caused by infection spreading from
ing from damage or defects in the brain’s cor- usually excreted. the vagina or uterus.
ticospinal pathways (upper motor neuron) in Rheumatic fever an inflammatory disease that Sarcoma tumor of the connective tissue cells.
either one or both hemispheres. is associated with recent streptococcal infection Scabies skin infestation with the itch mite, Sar-
Qualitative leukocyte disorder see Immune and causes inflammation of the joints, fever, coptes scabiei, acquired through close contact
deficiency. jerky movements, nodules under the skin, and with an infected person or contaminated cloth-
Quantitative leukocyte disorder see Immune skin rash and often is followed by serious heart ing that produces intense itching.
deficiency. damage or disease secondary to antibodies that Schizophrenia a psychotic disorder character-
RAG-1/RAG-2 deficiencies see Immune react both with streptococcal antigens and with ized by delusions, hallucinations, loosening of
deficiency. those of the heart valve. associations, disturbances in mood and sense of
Rapidly progressive (crescentic) glomerulo- Rheumatic heart disease (RHD) sequela to self and relationship to the external world, and
nephritis (RPGN) see Glomerulonephritis. rheumatic fever in which heart valves are repeat- bizarre, purposeless behavior.
Raynaud disease a condition in which the edly inflamed, developing fibrosis and thicken- Sclerosing adenosis a condition in which the
blood vessels spasm because of inadequate ing that can result in valve deformities, stenosis, number of acini per terminal duct is more than
blood supply, resulting in discoloration of the or regurgitation. twice the number of normal terminal ducts and
fingers and/or toes after exposure to changes in Rheumatoid arthritis an autoimmune disease is associated with a significantly increased risk of
temperature or emotional events. that causes chronic inflammation of the joints subsequent breast carcinoma.
Rectocele a condition caused by childbirth or and the tissue around the joints and other Scoliosis a condition in which the spine is
hysterectomy in which the region between the organs. curved sideways to varying degrees; occurs
rectum and vagina bulges toward the vagina, Rickets a bone disease that is caused by a defi- because of either physiologic curvature or func-
resulting in a sense of pressure or protrusion ciency of vitamin D or calcium and manifests in tional curvature in which contraction of the
within the vagina, the feeling of incomplete children as softening of bones, abnormal growth paraspinal muscles of the back creates a verte-
emptying of the rectum, difficulty passing stool, of bones, and enlargement of cartilage at the bral curve.
discomfort or pain during evacuation or inter- ends of long bones. Seborrheic dermatitis scaly, flaky, itchy, and
course, constipation, vaginal bleeding, fecal Ringed sideroblast an erythroblast in which red skin on the scalp, face, and trunk because of
incontinence, prolapse of the bulge through one third or more of the nucleus is encircled by a yeast infection.
the opening of the vagina, or rectal prolapse 10 or more siderotic granules that may be caused Seborrheic keratosis a benign proliferation of
through the anus. by antituberculous drugs and alcohol abuse. cutaneous basal cells that produces smooth or
 GLOSSARY 1745

warty elevated lesions; seen primarily in older Short bowel syndrome a group of malabsorp- Stevens-Johnson syndrome an inflammatory
people and presents as multiple lesions on the tion conditions resulting from massive resec- eruption of circular lesions that can cover the
chest, back, and face. tion of the small bowel, the degree and kind of majority of the skin and mucous membranes
Secondary (acquired) immune deficiency see malabsorption depending on the site and extent and usually occurs after a respiratory tract infec-
Immune deficiency. of the resection; it is characterized by diarrhea, tion or as an allergic reaction to drugs or other
Secondary amenorrhea menstruation begins steatorrhea, and malnutrition. substances.
at puberty but then is subsequently suppressed Sickle cell anemia see Anemia. Strawberry hemangioma a red birthmark
for three or more cycles or for 6 months in Sickle cell disease (SCD) see Anemia. caused by densely packed blood vessels that usu-
women who previously menstruated. Sickle cell–Hb C disease see Anemia. ally appears on the face, scalp, back, and chest
Secondary dysmenorrhea altered menstrua- Sickle cell–thalassemia disease see Anemia. and disappears during childhood.
tion because of inflammation, infection, tumor, Sickle cell trait see Anemia. Stress ulcer acute peptic ulcer that occurs in
or anatomic factors. Sideroblastic anemia (SA) see Anemia. association with various other pathologic con-
Secondary generalization the process by Silicosis inflammation of the lung resulting ditions, including burns, cor pulmonale, intra-
which a simple partial seizure involving one from the inhalation of free silica (silicon diox- cranial lesions, and surgical operations.
hemisphere becomes a generalized seizure ide) and silica-containing compounds, which Structural scoliosis a side-to-side curvature of
involving the second hemisphere. occurs in mining and related industries. the spine.
Secondary hyperparathyroidism a condi- Simple febrile seizure benign and most com- Subacute thyroiditis (subacute granuloma-
tion of elevated levels of parathyroid hormone mon form of childhood seizure. tous thyroiditis, de Quervian thyroiditis) a
resulting from disease such as renal failure in Simple fibroadenoma benign solid tumors painful inflammation of the thyroid that devel-
which parathyroid hormone concentration is composed of both fibrous and glandular tissue. ops suddenly in a patient who has had a viral
elevated in response to vitamin D deficiency. Sliding hiatal hernia the most common type infection, such as mumps or an upper respira-
Secondary hypertension a condition of ele- of hernia, occurring when the proximal portion tory tract illness. Pain radiates throughout the
vated blood pressure that is associated with of the stomach moves into the thoracic cavity neck and patients feel ill and feverish.
other conditions, primarily with renal disease through the esophageal hiatus, an opening in the Subglottic stenosis narrowing of the airway
by a renin-dependent mechanism or a fluid diaphragm for the esophagus and vagus nerves. below the larynx caused by a congenital anom-
volume–dependent mechanism. Small cell lung carcinoma (SCLS) the most aly or acquired narrowing secondary to injury,
Secondary hypothermia depressed body tem- common type of neuroendocrine lung tumors possibly resulting in respiratory distress, cya-
perature as a consequence of a serious systemic and mostly arise from the central part of the notic episodes, or recurrent lung infections.
disorder, for example, endocrine disorders. lung. Sudden infant death syndrome (SIDS) a
Secondary MODS the result of an excessive Smallpox (variola) an infectious viral disease syndrome, also known as crib death, that is
inflammatory reaction, after a latent period fol- that is caused by a poxvirus and result in high characterized by the sudden, unexpected, and
lowing the initial injury, in organs distant from fever, aches, and widespread eruption of large unexplained death of an apparently healthy
the site of the original injury. It is postulated sores that leave scars. infant less than 1 year of age.
that the resulting organ trauma is caused by Smoldering myeloma a condition in which Superior vena cava syndrome (SVCS) restric-
the host response to a second insult rather than abnormal plasma cells produce a monoclonal tion of the blood flow through the superior vena
being a direct result of the primary injury. protein, but no symptoms or complications of cava secondary to compression by malignancies
Secondary (traumatic) pneumothorax see myeloma are present and may not be present for or lymphadenopathy.
Pneumothorax. several years. Sydenham chorea (St. Vitus dance) a postin-
Secondary septic arthritis a bacterial infection Solitary plasmacytoma a solitary tumor of fectious chorea appearing several months after
in the joints, causing them to become inflamed malignant plasma cells that may result in a a streptococcal infection with subsequent rheu-
and the bacteria to proliferate. single lytic bone lesion or may be in the tissues matic fever. The chorea typically involves the
Secondary syphilis the most contagious stage (extramedullary plasmacytoma). distal limbs and is associated with hypotonia
of syphilis infection; characterized by a skin rash Spina bifida occulta the mildest form of and emotional lability.
that appears on the trunk and extremities 1 to congenital disorder of incomplete closure of Symphysis fibrocartilaginous joint; a type of
6 months after the primary infection and pos- the embryonic neural tube; the outer part of joint in which the apposed bony surfaces are
sibly mucous patches on the genitals or inside some vertebrae may not be completely closed, firmly united by a plate of fibrocartilage.
the mouth. but the defect is not apparent to the unaided Synchondrosis a cartilaginous joint creating a
Selective IgA deficiency see Immune deficiency. eye and usually causes no serious neurologic union between two immovable bones, such as
Septic shock a condition caused by systemic dysfunctions. the synchondroses of the cranium, the pubic
infection that results in decreased tissue perfu- Spinal stenosis narrowing of the spinal canal as symphysis, the sternum, and the manubrium.
sion and oxygenation and can lead to multiple a result of congenital anomaly or spinal degen- Syndesmosis a fibrous union in which two
organ dysfunction syndrome and death. eration, resulting in pain, paresthesias, and neu- bones are connected by interosseous ligaments,
Serum sickness a form of hypersensitivity rogenic claudication. such as the anterior and the posterior ligaments
caused by injection of soluble antigen such as Spondylolisthesis forward displacement of one in the radioulnar and tibiofibular articulations;
antiserum, which activates a type III hypersensi- of the lower lumbar vertebrae over the vertebra is usually converted into bone before adult
tivity response (formation of soluble circulating below it or over the sacrum. life.
antigen-antibody [IgG or IgM] complexes) that Squamous cell carcinoma (SCC) a tumor of Syndrome of inappropriate antidiuretic hor-
activates the complement system. the epidermis and the second most common mone (ADH) secretion (SIADH) a condition
Severe combined immune deficiency human cancer. in which the release of ADH from the posterior
(SCID) see Immune deficiency. Stable angina a condition in which ischemic pituitary is elevated relative to serum sodium
Severe congenital neutropenia see Immune attacks occur at predictable frequencies and levels, resulting in increased water reabsorption
deficiency. duration after activities that increase myocardial by the kidneys and fluid overload.
Shock a condition in which the circulatory sys- oxygen demands such as exercise and stress. Syndromic craniosynostosis (see Craniosyn-
tem is unable to provide adequate circulation to Staphylococcal scalded-skin syndrome (SSSS) ostosis) synostosis that occurs as part of a
the body tissues because of inadequate pumping a disease in infants that is caused by a staphy- genetic syndrome; usually associated with vari-
by the heart, a reduction in blood volume, or a lococcal infection with release of an exfoliative ous dysmorphisms involving the face, skeleton,
reduction in blood pressure; it results in slowing toxin that results in peeling of large areas of and nervous system and usually accompanied
of vital functions and possibly death. skin. by developmental delay.
1746 GLOSSARY

Syphilis a chronic infectious disease that is microcirculation, leading to increased plate- Tinea infection one of a group of fungal skin
transmitted by direct contact, usually in sexual let consumption and organ ischemia. infections that include athlete’s foot, folliculitis,
intercourse, or passed from mother to child in Autoimmune neonatal thrombocytopenia jock itch, ringworm, and pityriasis versicolor.
utero, and progresses through three stages char- destruction of platelets in a fetus/neonate Tinea pedis chronic, superficial fungal infection
acterized by chancres, ulcerous skin eruptions, by antiplatelet antibodies produced in the of the skin of the foot common in adults.
and systemic infection that leads to damage to mother against her own platelet antigens Tinea unguium a fungal infection of the nails.
the cardiovascular and nervous systems. (autoimmune) that are shared with the Tinnitus hearing ringing, buzzing, or other
Systemic inflammatory response syndrome child, and the antibodies are transported sounds without an external cause.
(SIRS) a generalized inflammatory response across the placenta and destroy the child’s T-lymphocyte deficiency see Immune de-
that may lead to depressed cardiac function and platelets. ficiency.
decreased organ perfusion. Chronic relapsing thrombotic thrombocy- Tophaceous gout a form of purine metabolism
Systemic lupus erythematosus (SLE) (see topenic purpura a rare familial form of disorder characterized by formation of chalky
Lupus erythematosus) a chronic, multisys- TTP characterized by recurring episodes of deposits of sodium biurate under the skin and
tem, inflammatory disease and one of the most thrombocytopenia; usually seen in children. in the joints.
common, complex, and serious of the autoim- Heparin-induced thrombocytopenia (HIT) Toxic epidermal necrolysis (TEN) a rare
mune disorders. a form of drug-induced thrombocytopenia adverse reaction to certain drugs in which a
Systolic heart failure a condition in which the caused by IgG antibodies against the large portion of the skin becomes intensely red,
heart muscle contracts so weakly that insuffi- heparin–platelet factor 4 complex leading to may develop blisters, and peels off.
cient oxygenated blood is pumped throughout platelet activation and thrombocytopenia. Tracheomalacia (tracheobronchomalacia) a
the body. Idiopathic thrombocytopenic purpura (ITP) congenital or acquired condition characterized
Tay-Sachs disease (GM2 gangliosidosis) a (autoimmune or primary thrombocyto- by weakness of the tracheal support cartilage,
fatal autosomal recessive lysosomal storage penic purpura) the most common cause resulting in tracheal collapse when increased
disorder in which the lysosomal enzyme hex- of thrombocytopenia, secondary to increased airflow is needed.
osaminidase A (HexA) is deficient, leading to immune-mediated platelet destruction; can Trachoma (granular conjunctivitis or Egyptian
accumulation of gangliosides in the brain and be acute or chronic. ophthalmia) a contagious, chronic inflam-
nerve tissue, mental retardation, convulsions, Immune thrombocytopenic purpura (ITP) mation of the mucous membranes of the eyes,
blindness, and premature death. a condition in which the number of platelets caused by Chlamydia trachomatis.
T-cell neoplasm see Lymphoma. in the blood is reduced by the production Transcortical dysphasia (transcortical sensory
Tension pneumothorax see Pneumothorax. of antibodies against platelets, resulting in dysphasia, mixed transcortical dysphasia,
Tertiary syphilis the most severe stage of syphi- ecchymoses and hemorrhages from mucous isolated speech center) a type of aphasia
lis, which can begin as early as 1 year after the membranes, anemia, and extreme weakness. with poor comprehension, but fluent grammat-
initial infection but can take up to 10 years to Neonatal alloimmune thrombocytopenic ically correct speech. Patients can communicate
manifest and is characterized by gummas— purpura (NATP) a condition in which well and are capable of good repetition.
soft, tumor-like growths found in the skin and fetal platelets have an antigen from the father Transient hypogammaglobulinemia of infancy
mucous membranes and often in the skeleton— that is absent in the mother, and the mother see Immune deficiency.
joint deformity, neurosyphilis, and cardiovascu- forms antibodies that cross the placenta and Transient ischemic attach (TIA) brief episode
lar syphilis. destroy the fetal platelets. in which the brain receives insufficient blood sup-
Tethered cord syndrome a group of neurologic Pseudothrombocytopenia an artificially ply; symptoms depend on the site of the blockage.
disorders related to malformation of the spinal low platelet count in anticoagulated Transposition of the great arteries (TGAs) the
cord in which the cord becomes abnormally blood caused by cooling of the blood and aorta arises from the right ventricle and the pul-
attached or tethered as a result of scar tissue autoagglutination of platelets. monary artery arises from the left ventricle.
that develops as the cord transcends the verte- Thrombotic thrombocytopenic purpura Traumatic (dissecting) aneurysm aneurysm
bral canal with growth; tethering may decrease (TTP) altered blood coagulation caused by caused by weakening of arterial walls, by a pen-
blood flow. an enzymatic deficiency that is characterized etrating missile, or after neurosurgery or neuro-
Tetralogy of Fallot a congenital condition that by a reduced number of platelets in the imaging following an injury.
is characterized by four malformations includ- blood, the formation of blood clots in tissue Trichomoniasis a sexually transmitted bacterial
ing ventricular septal defect, misplacement of arterioles and capillaries, and neurologic infection of the urethra in males and vagina in
the origin of the aorta, narrowing of the pul- damage. females that can cause urinary tract infection
monary artery, and enlargement of the right Thrombophilia genetic or acquired abnormality and a painful, malodorous vaginitis in women
ventricle. of the coagulation system with an increased risk and urethral and bladder infection in males.
Thalassemia see Anemia. for thrombosis. Tricuspid atresia congenital absence of the tri-
Thromboangiitis obliterans (Buerger dis- Thrombotic thrombocytopenic purpura (TTP) cuspid orifice, circulation being made possible
ease) inflammation of the medium-sized see Thrombocytopenia. by the presence of an atrial septal defect.
arteries and veins because of thrombotic occlu- Thrush a yeast infection of the mouth and throat True aneurysm localized dilation of an artery
sion, resulting in ischemia and gangrene. that presents as creamy white curd-like patches with an expanded lumen lined by stretched rem-
Thrombocythemia a chronic disorder of on the tongue, inside the mouth, and on the nants of the arterial wall.
sustained megakaryocyte proliferation that back of the throat and that is commonly associ- Truncus arteriosus a congenital defect in which
increases the number of circulating platelets and ated with yeast infection of the esophagus. a large great vessel arises from a ventricular sep-
results in megakaryocytic hyperplasia, spleno- Thyrotoxicosis excessive concentrations of thy- tal defect and does not divide into the aorta and
megaly, and complications by hemorrhagic and roid hormones in the body that are marked by pulmonary artery, resulting in one vessel carry-
thrombotic episodes. increased metabolic rate, heat intolerance, goi- ing blood both to the body and to the lungs.
Thrombocytopenia a reduced number of circu- ter, reproductive disorders, excessive sweating, TSH deficiency a condition characterized by
lating platelets. and other alterations in systemic function. decreased or absent production of thyroid-stim-
Acute idiopathic thrombotic thrombocy- Tinea capitis fungal infections of the skin clas- ulating hormone (TSH), resulting in a decline
topenic purpura a form of TTP charac- sified according to their location on the body. in thyroid hormone level and subsequent symp-
terized by thrombotic microangiopathy in Tinea corporis (ringworm) a fungal infection toms such as fatigue, cold intolerance, weak-
which platelets aggregate and cause occlu- of the scalp; much more common in children ness, depression, muscle aches, weight gain, and
sion of arterioles and capillaries within the than adults. constipation.
 GLOSSARY 1747

Tuberculosis (TB) an infectious disease of and weight loss, pruritus, edema, anemia, and Venous stasis ulcer a condition affecting
humans caused by Mycobacterium tuberculosis neurologic, cardiovascular disease, and skeletal the lower leg in which leaky valves, obstruc-
that results in the formation of tubercles on the changes. tions, or regurgitation in veins impairs blood
lungs and other tissues of the body. Ureterohydronephrosis dilation of both the flow back to the heart, resulting in pooling of
Tuberous sclerosis complex (TSC) an inher- ureter and the pelvicaliceal system. blood in the lower leg and subsequent tissue
ited disease caused by mutation of the hamartin Ureteropelvic junction (UPJ) obstruction an damage.
and tuberin genes and resulting in malformation impediment to the drainage of urine from Ventricular septal defect (VSD) a congenital
of the brain, retina, and viscera and develop- the kidney, usually attributable to partial or malformation in which the wall between the
ment of epileptic seizures, mental retardation, intermittent blockage of the renal collecting left and right ventricles has a hole that allows
and skin nodules on the face. system at the junction of the renal pelvis and blood to travel between the left and right ven-
Turner syndrome gonadal dysgenesis with short ureter. tricles, potentially leading to congestive heart
stature, undifferentiated (streak) gonads, and Urethral atresia congenital absence or closure failure.
variable abnormalities such as webbing of the of a normal body opening or tubular structure; Vesicoureteral reflux (VUR) reflux of urine
neck, low posterior hair line, increased carry- congenital imperforation of the urethra. from the bladder into the ureter.
ing angle of elbow, cubitus valgus, and cardiac Urothelial (transitional cell) carcinoma the Vestibular nystagmus involuntary rapid
defects. The genotype is XO (45, X) or X/XX or most common bladder malignancy, appearing movement of the eyeball that is due to distur-
X/XXX mosaic. The phenotype is female. on the inner lining of the bladder. bance of the vestibular system; eye movements
Type 1 diabetes mellitus see Diabetes. Usual ductal hyperplasia (UDH) description are rhythmic, with slow and fast components.
Type 2 diabetes mellitus see Diabetes. of normal hyperplasia of cells that line the ducts Vitiligo an autoimmune-related loss of melano-
Ulcerative colitis chronically inflamed and in the normal breast; additional layers of benign cytes resulting in the depigmentation of patches
ulcerated mucosal and submucosal lining of cells are present, but with normal cellular struc- of skin.
the large intestine, resulting in abdominal pain, ture and arrangement. von Willebrand disease an inherited disease in
diarrhea, and rectal bleeding. Uterine prolapse descent or herniation of the which the von Willebrand factor proteins that
Unclassified epileptic seizure seizure disor- uterus into or beyond the vagina because of are made in the blood vessel walls and func-
ders that do not fit neatly into a classified group- weakness of the pelvic musculature, ligaments, tion to control platelet activity are abnormal or
ing. These seizures characteristically have a wide and fascia or obstetric trauma and lacerations absent, resulting in a tendency to hemorrhage.
variety of abnormal clinical activity. Examples sustained during labor and delivery. Waldenström macroglobulinemia see
of this activity include rhythmic eye move- Vacuolar myelopathy HIV-induced loss of Lymphoma.
ments, chewing, and swimming movements. myelin and spongy degeneration of the spinal Wallerian degeneration the degeneration of
These activities are commonly seen in neonatal cord that may cause spastic paraparesis, sensory a nerve fiber that has been separated from its
seizures. ataxia in lower limbs, and unsteady gait. nutritive center by injury or disease; character-
Undifferentiated large cell anaplastic can- Vaginismus a form of sexual dysfunction that ized by segmentation of the myelin and result-
cer a cancer of epithelial origin that has lost all is caused by a psychologic disorder or vagi- ing in atrophy and destruction of the axon.
evidence of differentiation and may have arisen nal inflammation in which the muscles at the Warm autoimmune hemolytic anemia see
from a stem cell. entrance to vagina contract and prevent sexual Anemia.
Unilateral neglect syndrome hemiapraxia intercourse. Wilms tumor see Nephroblastoma.
with failure to pay attention to bodily groom- Vaginitis infection of the vagina usually caused Wilson disease a genetic disease in which the
ing and stimuli on one side but not the other; by a fungus that may cause itching or burning ability to metabolize copper is impaired, result-
usually caused by a lesion in the central nervous and a discharge. ing in an accumulation of copper deposits in
system. Vaginosis vaginal irritation without white blood organs such as the brain, liver, and kidneys and
Unstable angina a condition in which unpro- cells or other indication of infection. subsequent organ dysfunction and failure.
voked ischemic attacks occur at unpredictable Varicocele a painful condition in which the Wiskott-Aldrich syndrome (WAS) see
frequencies and may increase in severity. veins in the scrotum that develop in the sper- Immune deficiency.
Uremia syndrome of renal failure resulting in matic cord enlarge, and if the valves that Xanthelasma a planar xanthoma involving the
elevated blood urea and creatinine levels. regulate blood flow from these veins become eyelid(s).
Uremic syndrome a complex of symptoms dysfunctional, blood does not leave the testis, X-linked hyper-IgM syndrome see Immune
resulting from the accumulation of urea and thereby causing swelling in the veins above and deficiency.
other nitrogenous compounds and toxins in the behind the testis. X-linked SCID see Immune deficiency.
blood, leading to alterations in levels of fluid and Varicose bronchiectasis the bronchi become Zollinger-Ellison syndrome the association
electrolytes, metabolic acidosis, anemia, hyper- large and balloon-like. of atypical, intractable, sometimes fulminating
phosphatemia, and hypocalcemia; symptoms Venous angioma abnormal veins, usually near peptic ulcers with extreme gastric hyperacid-
include hypertension, anorexia, nausea, vom- the ventricular wall, that form as a congenital ity and benign or malignant gastrinomas in the
iting, diarrhea or constipation, malnutrition anomaly. pancreas.
INDEX

A Acetaminophen Acquired immunodeficiency Acute cough, 1249

A band, 1098–1099 child poisoning from, 63–65 syndrome (Continued) Acute cystitis, 1350–1351
A-beta fiber, 486–487 overdose of, liver failure caused as pandemic, 302t Acute epiglottitis, 1296–1297
A-delta fiber, 485–486, 486f by, 1451, 1452b pediatric, 327–329 Acute fulminating hepatitis,
A peptide, proinsulin and, 704 Acetylcholine prevention of, 327 1459
A wave, 1089–1090 action of, in digestive system, statistics on, 322 Acute gastritis, 1434
AA. See Aplastic anemia (AA) 1397t transmission of, 322–324 Acute glomerulonephritis,
ABC. See Aneurysmal bone cyst as neurotransmitter, 452, 453t, treatment of, 327 1353–1357
(ABC) 473–474 Acquired sideroblastic anemia, clinical manifestations of, 1357
Abdominal aneurysm, 1142 sleep affected by, 503 991–992 evaluation and treatment of,
Abdominal angina, 1446 stomach acid secretion and, 1399 Acral-lentiginous melanoma, 1643, 1357
Abdominal aortic aneurysm, Acetylcholine receptor (AchR), 1644t histopathology of, 1356t
1142 624–625 Acrocephaly, 667f pathophysiology of, 1353–1357
Abdominal compartment Achalasia, 1428 Acromegaly, 722–724 pediatric, 1381
syndrome (ACS), 1466b Achilles tendon, rupture of, 1545 clinical manifestations of, Acute gouty arthritis, 1576, 1577f
Abdominal pain, 1426, 1443 Achondroplasia, 152, 153f 723–724 Acute hydrocephalus, 558
Abducens nerve, 472t, 509 AchR. See Acetylcholine receptor evaluation and treatment of, 724 Acute idiopathic
Aberrant conduction, (AchR) example of, 723f thrombocytopenic purpura,
pathophysiology and treatment Acid-base balance, 122–134 pathophysiology of, 723 1040
of, 1184t–1186t alterations in, 126–134 ACS. See Abdominal compartment Acute infectious diarrhea, 1500
Abilify. See Aripiprazole chronic kidney disease and, syndrome (ACS). See Acute Acute inflammatory demyelinating
Abnormal involuntary movement, 1366t, 1367, 1368t confusional state (ACS) polyradiculopathy, 622,
561–562 of urine, 1331 ACTH. See Adrenocorticotropic 623t
ABO alloimmunization, maternal Acid maltase deficiency, 1583 hormone (ACTH) Acute kidney injury (AKI),
hypersensitivity and, 277 Acidemia, 126 ACTH deficiency, 721 1360–1364
ABO blood incompatibility, compensation for, 127f Actin biomarkers and, 1363b
1501 pulmonary artery constriction muscle contraction and, 1532t classification of, 1360t
ABO blood types, 279f caused by, 1231 sarcomere and, 1530 clinical manifestations of,
ABO incompatibility, 1059–1060 Acidosis, 126 Actin filament, 10–11, 1098–1099 1361–1362
ABO system, 278 Acid(s), 49–102 Actinic keratosis, 1641, 1641f, evaluation and treatment of,
ABP. See Acute bacterial prostatitis body, 123 1643 1362–1364
(ABP) formation of, 126f Action potential, 36, 36f pathophysiology of, 1360–1364
ABPM. See Ambulatory blood nonvolatile, 123 cardiac, 1092, 1094–1095, 1095f pediatric, 1385
pressure monitoring (ABPM) renal excretion of, 126f hypokalemia effects on, 116 phases of, 1361
Abscess stomach, 1398–1399, 1399f seizure initiation and, 552–553 urine characteristics of, 1363t
description of, 613 volatile, 123 sinoatrial node and, 1093 Acute leukemia, 1013, 1015–1020
exudate associated with, 213 Acinus Activated partial thromboplastin clinical manifestations of,
formation of, 1274 emphysema and, 1268 time (aPTT), hemophilia 1017–1019
Absolute neutrophil count (ANC), gas exchange and, 1229 diagnosis and, 1071–1072 disseminated intravascular
1009 Acne Activated protein C, pediatric shock coagulation and, 1043–1044
Absolute polycythemia, 1003 causes of, 1654 and, 1707 evaluation and treatment of,
Absolute refractory period, 37 cystic, 1654f Active acquired immunity, 227 1019–1020
Absorption example of, 1620t–1622t Active mediated transport, 32 pathophysiology of, 1016–1020
intestinal, 1401–1402 Acne rosacea, 1631–1632 Active transport, 28, 31–33 Acute liver failure, 1451–1452
pediatric, impairment of, Acne vulgaris, 1631, 1653–1654 Activin, 781 acetaminophen overdose as cause
1494–1499 Acoustic neuroma, 632f Acute angle-closure glaucoma, of, 1451, 1452b
Absorption atelectasis, 1256 Acoustic trauma, 83 types of, 511t Acute lung injury (ALI), 1262f,
Abuse. See Child abuse ACP. See American College of Acute antibody-mediated 1310
Acanthosis nigricans, cancers Physicians (ACP) rejection, 280–281 Acute lung injury/acute respiratory
associated with, 395t Acquired hypercoagulability, Acute asthmatic response, 1265f distress syndrome (ALI/
Accessory nerve, 471f, 472t 1050–1053 Acute autoimmune neuropathy, ARDS), 1261–1263, 1310
Accidental hyperthermia, 500 Acquired immunity, 191, 192t 622 Acute lymphocytic leukemia (ALL),
Accidental hypothermia, 501 Acquired immunodeficiency Acute bacterial conjunctivitis 443, 1015–1016
Accommodation syndrome (AIDS), 322–329 (pinkeye), 507 chromosomal translocations in,
alterations in, 511 Candida infection associated Acute bacterial meningitis, 1018f
eye focus and, 508 with, 313–314 675–676 immunophenotype of, 1018t
Accumulation cardiac complications in, 1175 Acute bacterial prostatitis (ABP), morphologic aspects of cells in,
cellular injury and, 83–88 central nervous system 899 1022f
intracellular, 83f involvement in, 327–329 Acute blood loss, 996, 996t pediatric, 1074–1075, 1077t
ACD. See Anemia of chronic childhood cancer and, 445 Acute bronchitis, 1274–1275 statistics on, 1015t
disease (ACD) clinical manifestations of, Acute chest syndrome, 1066–1068 Acute mesenteric ischemia, 1446
ACE inhibitor. See Angiotensin- 326–327, 328f Acute colonic pseudo-obstruction Acute migratory polyarthritis,
converting enzyme (ACE) drug therapy for, 327 (Ogilvie syndrome), 1432 rheumatic fever associated
inhibitor human immunodeficiency virus Acute confusional state (ACS), with, 1172
Acetabular dysplasia, 1594 progression to, 326f 542–545 Acute motor axonal neuropathy,
Acetaldehyde, alcohol transformed neurologic complications of, Acute coronary syndrome, 1148, 623t
to, 1460–1461 614–617 1156–1163, 1157f Acute mountain sickness, 78

Page numbers followed by f, t, or b indicate figures, tables, or boxes respectively. Syndromes and disorders appear in boldface.

1748
 INDEX 1749

Acute myelogenous leukemia Adaptive immunity, 191, 224–261 Adjuvant chemotherapy, 397 Affective-motivational system, 487
(AML), 1015–1016 overview of, 192t Adolescent Affective states, 647
classification of, 1019b stress response and, 348, 349f antidepressant drugs for, 651 Afferent lymphatic vessel, 1119
morphologic aspects of cells in, ADCC. See Antibody-dependent blood volume of, 1705t Afferent (sensory) neuron, 462
1022f cell-mediated cytotoxicity cancer incidence in, 442 Afferent pathway (ascending
pediatric, 1074–1075, 1078 Adderall, attention-deficit/ depression in, 647 pathway), 447–448, 485
statistics on, 1015t hyperactivity disorder treated epilepsy in, 678 Affinity maturation, 249
Acute nonlymphocytic leukemia with, 653–654 hematologic system in, 975 African sleeping sickness, 314–315,
(ANLL), 1074–1075 Addison disease, 86, 757–758 obese, 1222 314t
Acute orthostatic hypotension, clinical manifestations of, 757, osteomyelitis in, 1602b, 1603 Afterload
1140 758t overweight, 1222 cardiac output and, 1101
Acute otitis media, 517 evaluation and treatment of, seizures in, 554t description of, 1103
Acute pain, 491–492, 493t 757–758 sexually transmitted infection in, elevated, 1177f
Acute pancreatitis, 1464–1466 pathophysiology of, 757 918–919 heart failure and, 1177
clinical manifestations of, Adenine, 136, 138f–139f, 141, 142f Adoption study, genetic diseases in older adult, 1123t
1464–1465 Adenocarcinoma and, 170–171 pediatric, 1703t
evaluation and treatment of, characteristics of, 1281t ADP. See Adenosine diphosphate Agammaglobulinemia, 283f, 284
1465–1466 definition of, 364 (ADP) acute leukemia associated with,
example of, 1465f endometrial cancer and, 830 ADPKD. See Autosomal dominant 1017
pathophysiology of, 1464–1466, esophageal, 1466 polycystic kidney disease childhood cancer associated with,
1465f gastric, 1467 (ADPKD) 443t
Acute pericarditis, 1163–1164 lung cancer and, 1280 Adrenal androgen, hypersecretion AGE. See Advanced glycation end
Acute-phase reactant, inflammation prostatic, 904–905 of, 756–757 product (AGE)
and, 214 Adenoma Adrenal cortex, 706–710, 752–758 Age, maternal, Down syndrome
Acute-phase response, fever and, colon, inheritance of, 379–380 Adrenal estrogen, secretion of, and, 147, 147f
499f renal, 1347 709–710 Age-dependent penetrance, 154
Acute Physiology and Chronic Adenomatous polyp, 1470, 1470f Adrenal function, alterations in, 752 Age-related bone loss, 1553–1555
Health Evaluation II and III Adenomyosis, 823 Adrenal gland, 706–710 Age-related macular degeneration,
(APACHE II and APACHE Adenosarcoma, uterine sarcoma aging and, 712 511
III), 1684 and, 830–831 location of, 690f Agglutination, immune response by,
Acute poststreptococcal Adenosine, renal blood flow affected stress response and, 344–345 251–252
glomerulonephritis (PSGN), by, 1328t structure of, 707f Aggrecan, 1573
1381–1382 Adenosine deaminase (ADA) Adrenal medulla, 710 Aging
Acute pyelonephritis, 1351–1352 deficiency, 286 disorders of, 758 adrenal gland affected by, 712
clinical manifestations of, 1352 Adenosine diphosphate (ADP), innervation of, 470–473 benign prostatic hyperplasia and,
evaluation and treatment of, 25–26 stress response and, 344–345 898
1352 adenosine triphosphate Adrenarche, 771 body fluids affected by, 104–105
pathophysiology of, 1351–1352 conversion to, 1099 Adrenergic receptor bone affected by, 1536
pediatric, 1387 Adenosine triphosphate (ATP), action of, 475t–476t cancer associated with, 372–373,
Acute rejection, 280, 280f 25–26 cardiac function and, 1097 372f
Acute renal failure, 1360 cardiac muscle and, 1097 types of, 1097 cardiovascular system affected by,
Acute respiratory distress conversion of, to adenosine α-adrenergic receptor 1123–1127
syndrome (ARDS), 348, diphosphate, 1099 classification of, 474 cell biology and, 93–96
1261–1263 heart failure and, 1178b stress response and, 345–346, cellular, 95–96
alveoli in, 1263f muscle metabolism and, 1534 345t definition of, 93
clinical manifestations of, 1263 myocardial metabolism and, β-adrenergic receptor degenerative extracellular changes
evaluation and treatment of, 1099 classification of, 474 associated with, 95
1263 shock and, 1669–1670 stress response and, 345–346, endocrine system affected by, 711
exudative phase of, 1261 Adenosinetriphosphatase, 32–33 345t eye affected by, 510t
fibrotic phase of, 1262–1263 Adenovirus, description of, 318t Adrenergic receptor blocker drugs, gastrointestinal system affected
multiple organ dysfunction Adenylyl cyclase, 694 myocardial ischemia treated by, 1417–1421
syndrome and, 1683 ADH. See Alcohol dehydrogenase; with, 1156 hearing affected by, 515–518
pathogenesis of, 1262f Antidiuretic hormone (ADH) Adrenergic thermogenesis, 496–497 hematologic system affected by,
pathophysiology of, 1261 ADHD. See Attention-deficit/ Adrenergic transmission, 473–474 975
pediatric, 1310 hyperactivity disorder Adrenocortical hyperfunction, hormone function affected by,
phases of, 1261 (ADHD) 753–755 711
proliferative phase of, 1261 Adhesion Adrenocortical hypofunction, immune system affected by, 290
Acute respiratory failure, intestinal obstruction caused by, 757–758 joints affected by, 1536
1252–1253 1437t Adrenocorticotropic hormone male reproductive system affected
Acute rheumatic fever, 1171–1173 wound healing and, 218 (ACTH), 339, 699t by, 795
Acute tracheitis, description of, Adhesion molecule, 209 aging and, 712 musculoskeletal system affected
1296t Adipokine, 420 deficiency of, 721 by, 1536
Acute tubular necrosis (ATN), coronary artery disease and, ectopic secretion of, 753 nervous system affected by, 477,
1360–1361 1152–1153 effects of, 708b 478b
Acute ulcerative colitis, 1442f secretion of, 1447b loss of, 719f olfaction affected by, 518
Acute urethral syndrome, 931 type 2 diabetes mellitus and, 739 secretion of, 708 pain perception affected by, 495
Acyclovir, herpes simplex virus Adiponectin as tumor marker, 369t pancreas affected by, 711
infection treated with, 934 coronary artery disease and, Adrenomedullin, blood pressure parathyroid gland affected by,
AD. See Alzheimer disease (AD) 1152–1153 affected by, 1117 711–712
ADAMTS13 plasma obesity and, 1448 Advanced glycation end product prostate cancer risk and, 909
metalloprotease, 1040, 1043 secretion of, 1447b (AGE), 746–747 pulmonary system affected by,
Adapin. See Doxepin Adipose tissue Adventitia, arterial, 1108b 1244–1247
Adaptation heat production and, 496–497 Affective disorder, concordance renal function affected by, 1336
cell injury and, 49 hormones secreted by, 1447b rates for twins for, 170t reproductive system affected by,
cellular, 50–54 hyperglycemia effects on, 740f Affective flattening, schizophrenia 791
potassium, 115 Adjuvant, immunogenicity and, 229 and, 645b, 646 skin affected by, 1619–1627
1750 INDEX

Aging (Continued) Alcohol (Continued) Allergic dermatitis, 1628 Alzheimer disease (AD), 545–550
sleep patterns affected by, congenital heart defects Allergic purpura, 1074 brain volume in, 549f
504–506 associated with, 1199t Allergic reaction, anaphylactic cerebral blood flow in, 548f
stress and, 358–360 consumption of shock caused by, 1674–1675 clinical differentiation of, 547t
systemic, 96 cancer associated with, 420–422 Allergy clinical manifestations of, 549
taste affected by, 518 cancer risk and, 422t angioedema associated with, 1298 diet and, 549b
temperature regulation affected Alcohol dehydrogenase, 179 bee sting, 272 evaluation and treatment of,
by, 498–502 Alcohol-induced liver disease, 68 clinical manifestations of, 272t 549–550
thyroid gland affected by, 711 Alcoholic cirrhosis, 1460–1461 definition of, 262 genetic factors associated with,
tissue biology and, 93–96 Alcoholic fatty liver, 1460–1461 description of, 270–271 178–179
vision affected by, 509–515 Alcoholic hepatitis, 1460 genetic predisposition for, 271 histopathologic changes in, 549f
Agnosia, 539, 542t Alcoholic liver disease, 1460–1461 IgE-mediated, 272–273 molecular basis for, 547t
Agonal rhythm, pathophysiology Alcoholism, 67–69 immunoglobulin E associated pathogenesis of, 548f
and treatment of, 1183t–1184t cirrhosis caused by, 1460 with, 254 pathophysiology of, 546–549
Agonist, muscle movement as, concordance rates for twins for, tests for, 272–273 prevalence of, 172t
1534–1535 170t type I, symptoms of, 271–272 progression of, 550t
Agoraphobia, 654 genetic factors associated with, type II, 273 risk factors for, 548f
Agranulocyte, 948, 950 179 type III, 273 AM. See Akinetic mutism (AM)
Agranulocytosis, 647, 1009 liver affected by, 85 Allodynia, 490 Amblyopia, 509–510
AH. See Atypical hyperplasia (AH) prevalence of, 172t Alloimmune disease, 276–281 Ambrisentan, pulmonary artery
AIHA. See Autoimmune hemolytic sideroblastic anemia associated Alloimmune neutropenia, maternal hypertension treated with,
anemia (AIHA) with, 991–992 hypersensitivity and, 277 1278
Air embolism, 1143 toxic myopathy associated with, Alloimmunity, 276–277 Ambulatory blood pressure
Air pollution 1585 definition of, 263 monitoring (ABPM), 1221b
cancer risk from, 433 ALD. See Alcohol-induced liver neonatal, 276–277 Amebiasis, 314t
coronary artery disease and, disease Allostasis, stress response and, 344 Amenorrhea, 805
1153 Aldactone, nephrotic syndrome Allostatic load, stress response and, diagnosis of, 806f
Air trapping, emphysema and, 1269 treated with, 1359 344 evaluation and treatment of,
Airway Aldehyde dehydrogenase, 179 Allostatic overload, stress response 805–806
conducting, 1233–1234 ALDH. See Aldehyde dehydrogenase and, 344 pathophysiology of, 805
emphysema and, 1268 Aldose reductase, 746 Alogia, schizophrenia and, 645b, secondary, 806–808
gas-exchange, 1229 Aldosterone, 708–709 646 causes of, 807f
lower, 1233–1234 blood pressure affected by, 1117 Alopecia, 396b, 1646–1647 evaluation and treatment of,
disorders of, 1301–1313 heart failure and, 1177–1178 Alopecia areata, 1646–1647 807–808
pediatric, 1290–1292 hypertension and, 1134 Alpers disease, 673t pathophysiology of, 807–808
pediatric burn injury and, 1718 potassium balance affected by, 114 Alpha cell, islets of Langerhans and, American College of Physicians
pediatric shock treatment and, secretion of, 709f, 755t 703–704 (ACP), 910b
1711 sodium balance and, 108–109 Alpha fetoprotein, 365–366, 369t Amines, example of, 690t
small, inflammation of, 1258 Aldosteronism, metabolic Alpha (α) globulin, 946 Amino acid
structures of, 1228f syndrome and, 756b Alpha-thalassemia, 1069–1070 defects in metabolism of,
systemic disorders effect on, 1260 Alexander disease, 673t types of, 1069 673–674
upper, 1233–1234 Algor mortis, 97 Alpha-thalassemia major, polypeptides composed of, 137
congenital malformations of, ALH. See Atypical lobular 1069–1070 transport of, 33t
1299–1300 hyperplasia (ALH) Alpha-thalassemia minor, Amitriptyline, depression treated
croup and, 1296f ALI. See Acute lung injury (ALI) 1069–1070 with, 652b
infection of, 1294–1298, 1296t ALI/ARDS. See Acute lung injury/ Alpha trait thalassemia, 1069–1070 AML. See Acute myelogenous
pediatric, 1290 acute respiratory distress Alprazolam, panic disorder treated leukemia (AML)
structures of, 1227f syndrome (ALI/ARDS) with, 655 Ammonia
Airway obstruction Alimentary canal, 1393–1409 ALS. See Amyotrophic lateral production of, shock associated
asthma and, 1264 Alkalemia, 126, 127f sclerosis (ALS) with, 1670
pediatric, 1294f Alkaline phosphatase, 1413 ALT. See Alanine aminotransferase renal buffering and, 126
respiratory acidosis caused by, Alkaline reflux gastritis, 1435 (ALT) Ammonium, formation of, 126f
129 Alkaline urine, Alternative pathway, 197–198, 198f Amnesia, concussion and, 588
sites of, 1294f hyperparathyroidism and, 733 Alveolar dead space, 1252 Amnesic dysphasia, 543t–544t
upper, 1293–1301, 1294b Alkalosis, 126. See also Respiratory Alveolar duct Amniocentesis, 136b
Airway resistance, 1236 alkalosis gas exchange and, 1229 Amniotic fluid embolism,
AIS. See Androgen insensitivity acid base balance regulation and, illustration of, 1229f 1143–1144
syndrome (AIS) 125–126 Alveolar pressure, gravity and, 1240f Amoxapine, depression treated
Akathisia, description of, 563t hypokalemia associated with, Alveolar septa, 1229, 1231f with, 652b
AKI. See Acute kidney injury (AKI) 115–117 Alveolar surface tension, 1235–1236 AMPA receptor, 490
Akinesia, 561–562, 564 ALL. See Acute lymphocytic Alveolar ventilation, 1232 Amphiarthrosis (slightly movable
Akinetic mutism (AM), 535, 535t, leukemia (ALL) Alveolocapillary barrier, 1252 joint), 1520
538 All-or-none response, 451 Alveolocapillary injury, acute Amphipathic molecule, 12–13
Alanine aminotransferase (ALT), Allele, 151, 159 respiratory distress syndrome Amphiregulin (AREG), 844–845
1413 Allergen associated with, 1261 Ampulla of Vater, 1411, 1413
Alar plate, 661 allergic reaction against, 270, Alveolocapillary membrane, 1230, Amputation, diabetes mellitus and,
Albers-Schönberg disease, 1582 1309 1240, 1252 752, 753f
Albinism, 86 anaphylactic shock caused by, Alveolus AMS. See Acute mountain sickness
Albright syndrome, 1610 1674–1675 conducting airway structure and, Amsel's criteria, 929
Albumin, 946, 1512t definition of, 229 1228f Amygdala, 457
Alcohol, 67–69 dermatitis caused by, 1627–1628 epithelial cells in, 1229 memory and, 536
abuse of. See Alcoholism desensitization to, 273 gas exchange and, 1229 mood disorders effect on, 650
breast cancer and, 860 Allergic alveolitis, 1259 illustration of, 1229f Amylase
cancer associated with, 403f, Allergic conjunctivitis, 507 oxygen diffusion from, 1252 deficiency of, 1439
415–423 Allergic contact dermatitis, oxygen in, 1251–1252 as digestive enzyme, 1402b
cellular injury caused by, 63–65 1627–1628, 1628b prenatal development of, 1291f Amylin, 706, 741
 INDEX 1751

Amyloid precursor protein gene, Anemia (Continued) Anhedonia-asociality, Antibody-dependent cell-mediated

546–549 macrocytic-normochromic, schizophrenia and, 645b cytotoxicity, 256, 267
Amyotrophic lateral sclerosis 987–989 Anion, definition of, 29 Antibody-mediated hemorrhagic
(ALS), 571–573 manifestations of, 985–987, 985f Anion gap, 127–128 disease, 1073–1074
clinical manifestations of, 573 microcytic-hypochromic, Aniridia, childhood cancer Antibody titer, 252
pathophysiology of, 573 989–993 associated with, 443t Anticipatory response, 339–341
Anabolism, 25 morphologic classification of, Anisotropic band, 1098–1099 Anticoagulant therapy, 1048
Anaerobic glycolysis, 28 983t Ankylosing spondylitis (AS), Anticodon, 142
Anaerobic metabolism, shock and, normocytic-normochromic, 1572–1574 Antidepressant drugs
1669–1670 993–1002 clinical manifestations of, 1574 action of, 649f
Anafranil. See Clomipramine pernicious, 987–989 evaluation and treatment of, 1574 classes of, 648
Anal carcinoma, 1472 posthemorrhagic, 996 pathophysiology of, 1573–1574 depression treated with, 651
Anamnestic immune response, 247 progression of, 985f posture in, 1574f panic disorder treated with,
Anaphase, cell reproduction and, 37 as secondary to drug effects, 994t Anlage, cartilage, 1591–1592 654–655
Anaphylactic shock, 1674–1675, sideroblastic, 991–993 ANLL. See Acute nonlymphocytic Antidiuretic hormone (ADH), 109,
1674f Anemia of chronic disease (ACD), leukemia (ANLL) 109f, 696–699
clinical manifestations of, 1675 983t, 1001–1002 Ann Arbor staging system, 1028, aging and, 712
treatment of, 1671 evaluation and treatment of, 1002 1028t, 1080 diabetes insipidus and, 719
Anaphylactoid purpura, 1382 laboratory findings for, 986t Annulus fibrosis, intervertebral ectopic secretion of, 718–719
Anaphylactoid reaction, 1674–1675 pathophysiology of, 1001–1002 disk herniation and, 597 hypovolemic shock and, 1672
Anaphylatoxin, 198–199, 198f Anencephaly, 169f, 663–664 Anoikis, cancer cell spread and, kidney function affected by, 1327
Anaphylaxis Anesthesia, malignant hyperthermia 389 urine concentration and,
anaphylactic shock and, and, 500–501 Anomia, 545t 1332–1333
1674–1675 Aneuploidy, 144–148, 146f Anomic dysphasia, 543t–544t Antigen
symptoms of, 263 autosomal, 145–147 Anorectal malformation (ARM), binding of, 232
Anaplasia, 364, 368–369 sex chromosome, 147–148 1492 blood group, 278
Anastomosis, complications of, Aneurysm, 1140–1142 Anorectal stenosis, 1492f capture of, 243f
1439 examples of, 1142f Anorexia, 1019, 1423–1424 clinical use of, 225t
ANC. See Absolute neutrophil count intracranial, 603–604 Anorexia nervosa, 1450–1451, definition of, 225
(ANC) types of, 604f, 1141f 1450b description of, 228–229
Anchorage independence, cancer ventricular, 1163 Anorexin, 1448, 1448b endogenous, 244–245
cell development and, 368 Aneurysmal bone cyst (ABC), 1610 Anorgasmia, 834 exogenous, 244
Androcentric alopecia, 1646 Angelman syndrome, 187–188, Anosmia, 517–518 molecular recognition of,
Androgen 187f–188f, 671t Anovulation, secondary 229–235
aging and, 712 Angiitis, 1638–1639 amenorrhea and, 807 presentation of, 242–245, 243f
benign prostatic hyperplasia and, Angina Anoxia, 56–57 processing of, 242–245
898 Prinzmetal, 1153–1154 ANP. See Atrial natriuretic peptide recognition of, 227–236
breast cancer risk and, 848–850 unstable, 1156–1157, 1158b Antagonist, muscle movement as, route of, 229
description of, 776–778 Angina pectoris, 1154 1534–1535 sequestered, 274–275
hypersecretion of, 756–757 Angioedema, 1298 Anterior cerebral artery, 467, 468t T-independent, 249
male growth and development Angiogenesis, 381, 381f, 387, Anterior chamber, effects of aging tissue-specific, 265
affected by, 789 1091–1092, 1106–1108 on, 510t Antigen-antibody binding, 232f, 253
polycystic ovary syndrome and, Angiogenesis factor, 216, 381 Anterior column (ventral column), Antigen-antibody complex, 197
811 Angiography, 1122 462 Antigen binding, 232
prostate cancer and, 901–904 cerebral, 480 Anterior fossa, 464 Antigen-binding fragment, 230–231
in prostate gland, 906 coronary artery disease diagnosed Anterior horn (ventral horn), Antigen-binding molecule, 230f,
prostate gland signaling and, 903f with, 1155 460–461 239f
puberty and, 777–778 magnetic resonance, 478 Anterior pituitary, 697 Antigen-binding site, 228
secretion of, 709–710 Angioma, characteristics of, 627t diseases of, 720–724 Antigen presentation, 233, 243f
sensitivity to, 800–801 Angiotensin-converting enzyme hormones of, 699–700, 699t Antigen-presenting cell (APC),
Androgen-excess theory, breast (ACE) inhibitor Anterior plagiocephaly, 667f 226, 233
cancer and, 848–849 heart failure treated with, 1202 Anterior spinal artery, 469 function of, 242–243
Androgen insensitivity syndrome nephrotic syndrome treated with, Anterior spinothalamic tract, 464 stress response and, 348
(AIS), 805 1384–1385 Anthracycline, 396 Th cell and, 245
Androgen receptor signaling, Angiotensin I, 108–109, 176f Anthrax, 304t–305t Antigen-presenting molecule, 234f
906–907 organs affected by, 1135f Anti-Rh antibody, 1060 Antigen processing, 244–245, 244f
Anemia, 982–1002 ventricular remodeling and, 1176f Antibiotic drugs, 330 Antigenic determinant, 228, 228f
aplastic. See Aplastic anemia Angiotensin II, 108–109, 176f emphysema treated with, Antigenic drift, viral infection and,
(AA) action of, 1111b 1270–1271 320
cancer associated with, 395t, 396b chronic kidney disease and, overuse of, 331–332 Antigenic mimicry, 276
childhood, 1058t 1364–1366 resistance to, 310 Antigenic shift
chronic kidney disease and, 1369 heart failure and, 1177 Antibiotic resistance, 310 in influenza virus, 321f
classification of, 982–987, 983b hypertension and, 1134 Antibody viral infection and, 320–322
clinical manifestations of, kidney function affected by, 1327 adaptive immune response and, Antigenic variation
982–987 myocardial ischemia and, 1159 225 bacterial, 308–309
cognitive function and, 661b organs affected by, 1135f blocking, 273 fungal, 313
folate deficiency, 989 renal blood flow affected by, cellular interactions for, 248 parasitic, 315
hemolytic, 996–1001 1328t classes of, 229–230 viral, 319
hereditary spherocytosis vasoconstriction and, 1117 clinical use of, 225t Antigravity posture, 574–575
associated with, 1063 ventricular remodeling and, 1176f cross-reactive, 275 Antihemophilic factor, disorders
high-output failure and, 1182 Angiotensin III, organs affected by, cytotropic, 263–265 associated with, 1070t
infectious disease as cause of, in 1135f description of, 229–232 Antimetabolite drugs, 396
child, 1062 Angiotensin IV, organs affected by, direct effects of, 252 Antimicrobial drugs, 330–332
iron deficiency, 989–991 1135f function of, 251–255, 251f Antimicrobial lectin, 194
laboratory findings for, 986t Angiotensinogen, 176f indirect effects of, 252 Antimicrobial peptide, 193
lead toxicity associated with, 66 Anhedonia, schizophrenia and, 646 level of, in neonate, 257f Antimicrobials, epithelial, 194
1752 INDEX

Antiphospholipid syndrome, 1050 Apolipoprotein A-I, 1151 Arterial thrombosis, 1041, Ascorbic acid, intestinal absorption
Antiport, 31 Apolipoprotein E gene-allele 4, 1142–1143 of, 1406t
Antiproliferative factor, 1351 546–549 example of, 1050f ASD. See Atrial septal defect (ASD)
Antipsychotic drugs Apoptosis, 21, 91–92 risk for, 1049b Asendin. See Amoxapine
obsessive-compulsive disorder cancer and, 380–381 Arterial thrombus, definition of, Aseptic meningitis, 609, 675
treated with, 657 characteristics of, 88 1048 Aspartate, as neurotransmitter,
schizophrenia treated with, 646b features of, 90t–95t Arterial vessel, 1108 453t, 490
Antipyretic, cytokine as, 498 reactive oxygen species and, 60b Arteriogenesis, 1091–1092, Aspartate aminotransferase (AST),
Antiretroviral therapy, 327 schematic illustration of, 89f 1106–1108 1413
Antithrombin III (AT-III), 970 urinary tract obstruction and, Arteriography, 1122–1123 Aspergillosis, 312t
defects of, 1049 1341–1342 Arteriole meningitis caused by, 611
disseminated intravascular Apotransferrin, iron cycle and, 963 composition of, 1108 Aspergillus fumigatus, 312t
coagulation and, 1044 Appendiceal torsion, 889f hypertension and changes in, Aspergillus spp., 310–311
replacement of, 1048 Appendicitis, 1445–1446, 1472t 1138f Asphyxial injury, 74–75
Antithrombin III (AT-III) Appendicular skeleton, 1517 inflammatory response and, Aspiration
deficiency, 1073 Appetite, hormonal influence on, 196f description of, 1255–1256
Antithymocyte globulin (ATG), 996 1448 systemic circulation and, 1106 foreign body, in infant or child,
Antitoxin, 252, 306 Apraxia, 575, 576t Arteriosclerosis, ischemic injury 1298
α1-antitrypsin, 211 Aprosody, 575 associated with, 56–57 Aspiration pneumonia, 1256,
α1-antitrypsin deficiency, 171b, APS. See Antiphospholipid Arteriovenous malformation 1493–1494
1268–1269 syndrome (AVM), 604–605 Aspiration pneumonitis, 1308
Antrum, stomach, 1396 Apudoma, 1474 Artery. See also specific arteries (i.e., Aspirin
Anuria, acute kidney injury and, Aquaporin, 105 Aorta, Carotid artery) gastritis associated with, 1434
1362 Aqueduct of Sylvius, 459 brain, 468t Kawasaki disease treated with,
Anus, cancer of, carcinogenic agents Aqueous humor, 508 calcification of, 1567f 1218
associated with, 404t–407t Arachidonic acid, 207, 690t cardiac, evaluation of, 1119–1122 stroke treated with, 599–601
Anvil bone, 515 Arachnoid mater, 465f collateral, 1091–1092 thrombocytopenia treated with,
Anxiety, muscle tension caused by, Arachnoid membrane, 464 coronary, 1090–1091, 1119–1122 1041
1578 Arachnoid villi, 466 description of, 1085 Assisted reproductive technology
Anxiety disorder, 652b, 654 ARC. See Arcuate nucleus (ARC) diagram of, 1091f (ART), 836
AOM. See Acute otitis media Arcuate artery, 1325 diseases of, 1132–1163 Associated pulmonary artery
Aorta Arcuate nucleus (ARC), 1447–1448 elastic, 1108 hypertension (APAH),
branches of, 470 Arcus senilis, 1154 fetal development of, 1196 1276–1277
description of, 1088 ARDS. See Acute respiratory of head and neck, 467f Association fiber, 457
fetal development of, 1196 distress syndrome (ARDS) hepatic, 1410f Association neuron (interneuron),
Aortic aneurysm, 1142 AREG. See Amphiregulin (AREG) muscular, 1108 449
Aortic dissection, 1142 Arenavirus, description of, 318t occlusion of, brain affected by, AST. See Aspartate aminotransferase
Aortic regurgitation, 1168t, Areola, breast, 783 468f (AST)
1169–1170 Arginine-vasopressin, 109, 498, 698 principle, diagram of, Asterixis, description of, 563t
Aortic semilunar valve, 1086–1087 heart failure and, 1178 1104f–1105f Asthenia, 561
Aortic stenosis (AS), 1168–1169, Aripiprazole, schizophrenia treated pulmonary, 1088, 1229 Asthma
1169f with, 646b renal, 1325 antigen response in, 1265f
clinical manifestations of, 1168t ARM. See Anorectal malformation structure of, 1107f bronchial, illustration of, 1264f
diagram of, 1212f (ARM) systemic circulation and, 1106 clinical manifestations of,
in infant and child, 1212–1213 Aromatase, 852–853, 903f thrombus formation in, 1264–1266
Aortic valve, calcification of, 88f Arousal, definition of, 528 1142–1143 description of, 1263
APACHE II and APACHE III, 1684 Arousal disorder, 505, 528–535 Arthritis, 1568–1578. See also evaluation and treatment of, 1266
APAH. See Associated pulmonary clinical manifestations of, Rheumatoid arthritis (RA) genetics of, 1308
artery hypertension (APAH) 528–529, 535t, 549b infectious, 1569t pathophysiology of, 1265f
APC. See Antigen-presenting cell outcomes of, 533–535 prevalence of, 172t pediatric, 1308–1310
(APC) pathophysiology of, 528 Arthrography, joint function clinical manifestations of,
Apelin, secretion of, 1447b Arrested cell cycle, 39 evaluated with, 1535 1309
Aphasia, 539 Arrhythmia Arthroscopy, joint function evaluation and treatment of,
API. See Asthma predictive index description of, 1182 evaluated with, 1535 1309–1310
(API) myocardial infarction associated Arthus reaction, 270 pathophysiology of, 1309–1310
Aplastic anemia (AA), 983t, with, 1162 Articular cartilage, 1522–1526 phenotypes of, 1309b
993–996, 993f Arsenic cysts in, 1572 prevalence of, 172t
childhood cancer associated with, inorganic, cancer risk from, 433 long bone growth and, 1592 stress and, 342t
443t prostate cancer caused by, 906 osteoarthritis and, 1565–1566 Asthma predictive index (API),
clinical manifestations of, 995 ART. See Antiretroviral therapy; rebuilding of, 1525b 1309
evaluation and treatment of, Assisted reproductive Articulation, definition of, 1520 Astigmatism, 512
995–996 technology (ART) AS. See Ankylosing spondylitis Astrocyte, 449–450, 450b, 451t
laboratory findings for, 986t Arterial adventitia, 1108b (AS); Aortic stenosis (AS) Astrocytoma, 629–630
pathophysiology of, 995–996 Arterial blood gas analysis, Asbestos characteristics of, 627t
as secondary to drug effects, 994t 1243–1244 cancer risk from, 433 pediatric, 681t–682t, 682
Aplastic crisis, sickle cell disease Arterial circle (circle of Willis), 467 exposure to, 1259 pilocytic, 628
and, 1066 Arterial CO2 pressure, management Asbestosis, 1259 Asymmetric division, cell
Apnea Hypopnea Index, 504 of, 556t Ascariasis, 314t reproduction and, 39
Apneusis, description of, 530t Arterial embolism, sources of, Ascaris lumbricoides, 314t, 316 Asymptomatic bacteriuria, 1350
Apneustic respiration, 532 1143 Ascending colon, 1407 Asymptomatic hyperuricemia,
Apocrine sweat gland, 1618 Arterial ischemic stroke, 677–678 cancer in, 1471f 1576
ApoE4, 546–549 Arterial pressure Ascending pathway, 447–448 Asystole, pathophysiology and
Apoferritin regulation of, 1114–1117 Aschoff body, 1172 treatment of, 1183t–1184t
anemia of chronic disease and, septic shock and, 1675–1676 Ascites, 1453–1454 AT. See Ataxia-telangiectasia
1001 Arterial pressure pulse waveform cirrhosis as cause of, 1453, 1454f AT-III. See Antithrombin III
iron cycle and, 963 analysis, 1122 pediatric, 1503 (AT-III)
 INDEX 1753

Ataxia-telangiectasia, 287, 425 Atrophy, 50–51 Autolysosome, 8 Axon hillock, in central nervous
acute leukemia associated with, brain, 51f Automatic cell, 1095 system, 448
1017 illustration of, 50f Automaticity, cardiac action Axonal injury
childhood cancer associated with, skin, 1620t–1622t potentials and, 1095 mild diffuse, 588
443t Atropine, diarrhea treated with, Autonomic hyperreflexia moderate diffuse, 588
childhood leukemia associated 1426 (dysreflexia), 593, 594f–595f severe diffuse, 588
with, 1075–1076 Attapulgite, diarrhea treated with, Autonomic nervous system (ANS), Axonal injury, 587
Ataxic breathing, description of, 1426 448, 470–476. See also Nervous Azathioprine
530t Attention deficit, 538–539 system myasthenia gravis treated with,
Ataxic cerebral palsy, 672 description of, 541t division of, 473f 626
Ataxic respiration, 532 schizophrenia and, 645b lung innervation by, 1234 rheumatoid arthritis treated with,
Atelectasis, 1256 Attention-deficit/hyperactivity neuroreceptors in, 475t–476t 1572
of neonatal lung, 1302f disorder (ADHD), 653–654 neurotransmitters and, 475f ulcerative colitis treated with,
respiratory distress syndrome Attenuated virus, 332 parasympathetic division of, 1442
associated with, 1301 Atypia, breast lesions and, 839 474f Azidothymidine, 330–331
ATG. See Antithymocyte globulin Atypical ductal hyperplasia, 841, Parkinson disease effects on, Azithromycin
(ATG) 841f 567–568 chlamydia treated with, 931
Atheromatous plaque, ischemic Atypical hyperplasia (AH), 53–54, stress response and, 353–354 cystic fibrosis treated with, 1312
stroke and, 598 841 Autonomic neuropathy, 621–622, Azotemia, 1359, 1363
Atherosclerosis, 51f, 171–172, Atypical lobular hyperplasia 751t AZT. See Azidothymidine
1145–1148 (ALH), 841, 841f Autonomy, cancer cell development
aneurysm and, 1141–1142 Atypical pneumonia, pediatric, and, 368 B
clinical manifestations of, 1147 1306 Autophagic vacuole, 50–51 B cell neoplasm, 1024b, 1027
concentric coronary plaque and, Auditory dysfunction, 517 Autophagosome, 8 B-cell receptor, 229
1148f Auerbach plexus, 1394, 1401 Autophagy, 8, 92–93 genetics of, 242f
diabetes mellitus and, 752, 752f AUL. See Undifferentiated cell atrophy and, 50–51 production of, 239f, 240–241
evaluation and treatment of, leukemia (AUL) illustration of, 92f B-cell receptor complex, 230f,
1147–1148 Aura Autoregulation 232–233
ischemic injury associated with, migraine headache associated blood flow and, 1117–1118 B cell tumor, Burkitt lymphoma
56–57 with, 607–608 acute kidney injury associated and, 1029
pathophysiology of, 1145–1148 seizure associated with, 553–555 with alterations in, 1361 B lymphocyte (B cell), 202, 954
progression of, 1146f terminology for, 555t of intracranial pressure, 556 activation of, 247–249, 249f
Athetosis, description of, 563t Autism of renal blood flow, 1326 acute leukemia and, 1016–1017
Atmospheric pressure, 1237 concordance rates for twins for, Autosomal agammaglobulinemia, aging effects on, 258
cellular injury associated with, 170t 284 antigen presentation by, 243
77–78 genetic factors associated with, Autosomal dominant inheritance, chronic leukemia and, 1021
ATN. See Acute tubular necrosis 167 152–154 defects of, 282t
(ATN) Autoantibody, definition of, pedigree characteristics in, 152 deficiency of, 284–285
Atopic allergy, 271 262–263 penetrance and expressivity in, description of, 225
Atopic dermatitis (AD), 273, 1628 Autocrine signaling, 20 154 differentiation of, 240, 249
example of, 1655f Autocrine stimulation, 380 recurrence risk in, 152–154 immunocompetent, 248–249
pediatric, 1654–1655 Autodigestion, 8, 88–90 Autosomal dominant polycystic maturation of, 240–241
Atopic eczema, pediatric, Autograft, burn injury treated with, kidney disease (ADPKD), primary cutaneous lymphoma
1654–1655 1693–1694, 1694f, 1722f 1381 and, 1645
ATP. See Adenosine triphosphate Autoimmune disease, 262–263, Autosomal hyper-IgM syndrome, rheumatoid arthritis and, 1570
(ATP) 277–281 284 stress response and, 354–355
ATPase. See causes of, 275–276 Autosomal recessive inheritance, B lymphocyte (B cell) deficiencies,
Adenosinetriphosphatase human leukocyte antigen and, 154–156 284–285
ATP7B gene, 1504 276, 276t pedigree characteristics in, B peptide, proinsulin and, 704
Atrial fibrillation, pathophysiology maternal microchimerism and, 154–155 Bacillus anthracis, 304t–305t, 307
and treatment of, 1183t–1184t 275b recurrence risk in, 155–156 Bacillus cereus, 304t–305t
Atrial flutter, pathophysiology and stress and, 342t Autosome, 142 Back pain. See also Low back pain
treatment of, 1183t–1184t Autoimmune hemolytic anemia AV valve. See Atrioventricular (AV) ankylosing spondylitis as cause
Atrial kick, 1088 (AIHA), 280, 998 valve of, 1574
Atrial natriuretic peptide, 109, Autoimmune hepatitis, 1457 AVC. See Atrioventricular canal description of, 492
1134 Autoimmune neonatal defect (AVC) Backache, stress and, 342t
Atrial natriuretic peptide (ANP) thrombocytopenia, 1074 Aventyl. See Nortriptyline Baclofen, cluster headache treated
kidney function affected by, Autoimmune pancreatitis, 1474 Avian influenza, 321b with, 609
1327 Autoimmune polyendocrine Avian influenza A (H5N1) virus, Baclofen pump, 672
renal blood flow affected by, syndrome, 757 pneumonia associated with, Bacteremia, 306
1328t Autoimmune polyendocrinopathy, 1273 as septic shock component, 1676t
Atrial septal defect (ASD), 988 AVM. See Arteriovenous Bacteria
1204–1205, 1204f Autoimmune thrombocytopenic malformation (AVM) chemicals derived from, 194–195
Atrial tachycardia, pathophysiology purpura, 1073 Avolition, schizophrenia and, 646 description of, 302
and treatment of, 1183t–1184t Autoimmune thyroiditis, 729 Avolition-apathy, schizophrenia division of, 306
Atrioventricular bundle, 1093 Autoimmune vascular purpura, and, 645b gram-negative, 303, 303f
Atrioventricular canal defect 1074 Avulsion, definition of, 1545 gram-positive, 303, 303f
(AVC), 1206–1207, 1207f Autoimmunity, 273–276 Awareness immune response suppressed
Atrioventricular dissociation, definition of, 262–263, 273–274 alterations in, 535–539 by, 309
pathophysiology and treatment disorders associated with, pathophysiology of, 538 infection from. See Bacterial
of, 1184t–1186t 264t–265t definition of, 528, 535 infection
Atrioventricular (AV) node, genetic factors contributing to, Axial skeleton, 1517 infective endocarditis caused by,
1092–1093 276 Axon 1173
Atrioventricular (AV) valve, Autolysis in central nervous system, 448 innate immunity provided by,
1086–1088, 1195 cell death and, 88–90 cytoskeleton and, 10f 194
Atrium, description of, 1086 postmortem, 97 injury to, 621 intestinal, 1408–1409
1754 INDEX

Bacteria (Continued) Barr body, 156 Benign breast disease (BBD), Biliverdin, 1411
intracellular, 306–307 Barrett esophagus, 1429, 1466 837–842, 839f Binding protein, 692t
invasion and evasion of, 306–309 Barrier Benign breast tumor, 838t Binge eating disorder, 1450, 1450b
mechanisms of, to defend biochemical, 192–195 Benign prostatic hyperplasia Bioassay, 710–711
against inflammation and closed, 193f (BPH), 897–899 Biofeedback, muscle tension treated
immunity, 308t human defense through, clinical manifestations of, 899 with, 1578
pathogenesis of, 310 192–195, 192t evaluation and treatment of, 899 Biofilm, 305–306
pyrogenic, 306 mechanical, 192 pathogenesis of, 898–899 Biologic membrane, 14f–15f
sexually transmitted infection natural, 192 Benign tumor. See Tumor, benign Biology
caused by, 919t physical, 192 Bent nail syndrome, 889–890 altered cell and tissue, 49–102
tissue damaged by, 309–310 Bartholin cyst, 817 Benzathine penicillin G, syphilis cellular. See Cellular biology
true, 302 chlamydia as cause of, 931 treated with, 925 Biopsy, cancer diagnosis with,
Bacterial embolism, 1144 Bartholin gland, 772, 817f Benzodiazepine receptor system, 394t
Bacterial infection, 252, 302–310, Bartholinitis, 817, 921 654 Bioterrorism, 300
303t. See also Infection Basal body temperature, menstrual Benzoyl peroxide, acne treated with, Biotin, intestinal absorption of,
acquired immunodeficiency cycle effect on, 782 1654 1406t
syndrome and, 327b Basal cell carcinoma, 1641–1642 Beraprost, pulmonary artery Biotransformation, 1413
colonization of, 303–306 types of, 1642f hypertension treated with, 2,3-Biphosphoglycerate (2,3-BPG),
cutaneous, 1634–1635 ultraviolet radiation as cause of, 1278 1242–1243
examples of, 304t–305t 431 Berger disease, 1353, 1356t Bipolar disorder, 647–654
skin disorders associated with, Basal ganglia, 456–457, 463–464 Beriberi, high-output failure and, definition of, 647
1656–1657 Parkinson disease and, 564–565 1182 etiology and pathophysiology of,
transmission of, 303–306 structure of, 656f Bernard-Soulier syndrome, 967, 647–650
urogenital, 919–929 Basal ganglia motor syndrome, 573 1042 genetic factors associated with,
Bacterial meningitis, 609, 675–676 Basal ganglia system, 456 Berry aneurysm, 604, 604f 180
causes of, 676t Basal ganglion gait, 575 Beta agonist drugs, emphysema mania and, 651
clinical manifestations of, 676 Basal ganglion posture, 575 treated with, 1270–1271 prevalence of, 172t
evaluation and treatment of, Basal lamina, 17 Beta antagonist drugs, asthma treatment of, 652–654
612–613, 676 Basal layer (stratum basale), treated with, 1266, 1266b Bipolar neuron, 448–449, 450f
pathophysiology of, 676 1616–1617 Beta blocker drugs Bisoprolol, heart failure treated
Bacterial pneumonia, pediatric, Basal metabolic rate, pediatric, 1292 heart failure treated with, with, 1179–1180
1306, 1307t Basal plate, 661, 661f 1179–1180, 1202 Bisphosphonate, osteoporosis and,
Bacterial prostatitis, 899–900 Base pair substitution, 137–140, myocardial ischemia treated with, 1556
Bacterial superantigen, 310 140f 1156 Bizarre behavior, schizophrenia
Bacterial tracheitis, 1297–1298 Basement membrane, 17, 18f Beta cell and, 645b
Bacterial vaginosis (BV), 929 breast cancer metastasis and, 870 immunologically mediated Black Death, 298–299
clinical manifestations of, invasive breast cancer and, 871f destruction of, 737 Black lung, 1259
930–931 of muscle cell, 1530 islets of Langerhans and, 703–704 Black mold disease, 312t
pathophysiology of, 930–931 Basement membrane nephritis, Beta-cell dysfunction, 741 Bladder, 1325–1326
pelvic inflammatory disease 1357f Beta (β) globulin, 946 aging effects on, 1336
associated with, 814 Base(s), 49–102 Beta-thalassemia, 1069 cancer of. See Bladder cancer
Bactericidal antibiotic drugs, 330 Basic fibroblast growth factor, 381 Beta-thalassemia major, 1069–1070 defense mechanisms of, 1350
Bactericidal/permeability-inducing Basilar artery, 467 Beta-thalassemia minor, 1069 development of, 1377
protein, 194 Basis pedunculi, 459 Bevacizumab, 381 disorders of, pediatric, 1386–1388
Bacteriocin, 194 Basopenia, description of, 1010t, BFGF. See Basic fibroblast growth exstrophy of, 1379–1380
Bacteriostatic antibiotic drugs, 330 1011 factor inflammation of, 1350
Bacteriuria Basophil, 209, 949 Bicarbonate neurogenic, 1344–1345
asymptomatic, 1350 characteristics of, 948t buffering of, 124–125 obstruction of, 1346
clinical manifestations of, 1351 conditions associated with, 1010t carbonic acid concentration and, pediatric, 1380
Bacteroides granulocytosis and, 1009 124f outflow obstruction of, 899
abscess caused by, 613 illustration of, 949f distribution of, in body fluids, 108t tumors of, 1348–1349
pelvic inflammatory disease Basophilia glomerular filtration and, Bladder cancer, 1348
associated with, 814 in chronic myeloid leukemia, 1330–1331 carcinogenic agents associated
Baden-Walker halfway scoring 1077f Bilateral acoustic with, 404t–407t
system, 818b description of, 1010t, 1011 neurofibromatosis, 671t carcinoma and, 1348f
Bainbridge reflex, 1106 Batten disease, 671t, 673t Bilateral renal agenesis, 1380–1381 clinical manifestations of, 1349
Balanitis, 890, 890f BBB. See Blood-brain barrier Bile evaluation and treatment of,
Balantidiasis, 314t BBD. See Benign breast disease in gallbladder, 1413 1349
Balantidium coli, 314t (BBD) secretion of, 1411 pathogenesis of, 1348–1349
Ballism, description of, 563t BCR. See B-cell receptor Bile acid, 1405f, 1411 staging of, 1349t
Bare lymphocyte syndrome, 286 BD. See Bowen disease Bile acid-dependent fraction, 1411 Bladder outlet obstruction, 899,
Bariatric surgery BDNF. See Brain-derived Bile acid-independent fraction, 1411 1380
cardiovascular risk reduction neurotrophic factor (BDNF) Bile acid pool, 1411 Blalock-Taussig shunt, 1209–1210
with, 1152b Becker muscular dystrophy, Bile canaliculi, 1411 Blast cell
obesity treated with, 1450 1608–1609 Bile duct, cancer of, carcinogenic childhood cancer and, 443
type 2 diabetes mellitus treatment Beckwith-Wiedemann syndrome, agents associated with, 404t–407t childhood leukemia and, 1077
with, 742, 742b 188, 443t Bile salt, 1411, 1411f Blast injury, 77
Barlow maneuver, 1595, 1595f Bedbug, skin lesions from, 1662 Bile salt deficiency, 1440 Blastocyst, formation of, 775
Barometric pressure, 1237 Bee sting allergy, 272 Biliary atresia, 1501–1502 Blastomyces dermatitidis, 312t
Baroreceptor Behavior, cancer risk and, 402 Biliary cirrhosis, 1462–1463 Blastomycosis, 312t
blood pressure affected by, 1115 Behavioral variant frontotemporal Bilirubin, 86–87 Bleb, emphysema and, 1269
water balance and, 109 dementia, 547t, 550 erythrocyte destruction and, Bleeding disorders, hereditary,
Baroreceptor reflex, 1106, 1116f, Bell palsy, 572b 962–963 1072
1326–1327 Belt desmosome, 19f excessive production of, 1455 Blepharitis, 507
Barotrauma, pediatric burn injury Bence Jones protein, 1032–1034 metabolism of, 963f, 1411–1412, Blindness, glaucoma and, 510–511
and, 1718 Bends, 77–78 1412f Blocking antibody, 273
 INDEX 1755

Blood Blood pressure (Continued) Body mass index (Continued) Bone fracture. See Fracture
carbon dioxide in, 1243 concordance rates for twins for, obesity defined with, 178, 417, Bone lesion, multiple myeloma
cellular components of, 947–951, 170t 1446 associated with, 1032
948t gastrointestinal bleeding and, overweight defined with, 417 Bone loss
composition of, 945–951, 946f 1427–1428 World Health Organization age-related, 1536, 1553–1555
gases in, normal ranges of, 1245t high, 1452 classification of, 418t mechanism of, 1555f
oxygen content in, 1241 hydrostatic pressure and, 29–30 Body movement, synovial joints osteoporosis and, 1550
oxygen diffusion into, 1252 hypertension and, 1132 and, 1527f Bone marrow, 955–956
postnatal changes in, 1056–1057 as multifactorial trait, 166 Body temperature aspiration of, 973
reduction in number of blood pediatric, 1701b, 1702t aging and, 498–502 B cell development in, 241f
cells in, 985 pediatric shock and, 1702 blood flow affected by, 1114–1115 B cell maturation and, 240
viscosity of, in sickle cell disease, regulation of, 172, 1114–1117 disorders of regulation of, biopsy of, anemia diagnosed
1066 venous, 1117 500–502 with, 995
whole, composition of, 946f Blood supply hypothalamic control of, 496–498 cell differentiation and, 227f
Blood-brain barrier, 469b to nervous system, 467–469 management of, cerebral depression of, acute leukemia
Blood cell to skin, 1619 hemodynamics alterations and, 1017–1019
count of, in child, 1056 to spinal cord, 469 and, 556t differential cell counts in, 974t
development of, 954–965 Blood test, 975, 976t–977t mediation of, 488f images of, 974f
differentiation of, 956–959 renal function evaluated with, menstrual cycle effect on, 782 neutrophils in, 949
normal, 1065f 1335 multiple sclerosis and, 621 samples of, 974f
production of, 954, 1056, 1510 Blood transfusion, pediatric shock normal range of, 495–496 stem cells produced in, 1510
reduction in number of, 985 treatment with, 1712–1713 oxyhemoglobin curve affected by, structure and vascularization of,
sickle-shaped, 1065f Blood type 1242–1243 955f
Blood circulation, cancer cell spread ABO, 279f pediatric, 498 suppression of, 993
and, 389–392 O, 278–279 regulation of, 495–498 as target of human
Blood clot transfusion reaction and, 278 trauma effects on regulation of, immunodeficiency virus, 325
dissolution of, 968f Blood urea nitrogen (BUN), 1335 501–502 test of function of, 973–975
formation of, 968f, 969 acute kidney injury and, 1363t Bohr effect, 1242 Bone marrow transplant (BMT)
lysis of, 971–973 acute kidney injury diagnosis Boil, 1634–1635 acute leukemia treated with, 1019
Blood flow with, 1362–1363 Bombesin, action of, in digestive anemia treated with, 995
autoregulation of, 1117–1118 Blood velocity, 1112 system, 1397t childhood acute myelogenous
in cardiac cycle, 1088–1089 Blood vessel, 1088 Bone leukemia treated with, 1078
cardiogenic shock and, 1700 arterial, 1108 avascular diseases of, 1604–1606 chronic leukemia treated with,
diagram of, 1084f congenital anomalies of, 1663 characteristics of, 1517–1519 1023
distributive shock and, 1700 damage to, 968f childhood leukemia and, multiple myeloma treated with,
factors affecting, 1109–1114, function of, 965–966 1076–1077 1034
1115f hepatic, 1410f cross section of, 1517f Bone matrix, 1515–1516
heart defects and, 1202–1210 inflammation of, 1638 deformity of, osteoporosis bone growth and, 1592
heart structures and, 1086f inflammatory response and, associated with, 1555 function of, 1512t
laminar, 1113 195–197 density of, osteoporosis and, Bone mineral density (BMD), 1552
maldistribution of, 1682–1683 in nephron unit, 1323f 1550 Bone morphogenic protein (BMP),
obstruction to, 1210 pressure-tension and wall effects of aging on, 1536 1512
obstructive shock and, 1710 thickness in, 1141f elements of, 1511–1516, 1512t description of, 1516
pressure and resistance and, renal, 1325 formation of, 1511–1512, function of, 1512t–1513t
1111–1112 structure of, 1106–1109, 1107f 1513t–1514t Bone-remodeling unit, 1519
pulmonary, 1239f Blood vessel tumor, characteristics endochondral, 1591–1592 Bone tissue
renal, 1326–1327 of, 627t in infant and child, 1591–1592 elements of, 1511–1516
acute kidney injury associated Blood volume, pediatric, 1705t fracture of. See Fracture types of, 1517
with alterations in, 1361 Bloom syndrome, 379 growth of, in infant and child, Bone tumor, 1560–1565
autoregulation of, 1326 acute leukemia associated with, 1592–1593 benign, pediatric, 1609–1610
clearance and, 1334–1335 1017 healing stages of, 1520 classification of, 1561b
hormones and, 1328t childhood cancer associated with, infection of. See Infectious bone derivation of, 1561f
neural regulation of, 443t, 444 disease diagnosis of, 1562
1326–1327 childhood leukemia associated integrity of, 1519–1520 epidemiology of, 1560–1561
turbulent, 1113 with, 1075–1076 long, 1517–1518 giant cell, 1564–1565, 1564f
vascular compliance and, BMD. See Bone mineral density metabolism of, chronic kidney patterns of bone destruction in,
1113–1114 (BMD) disease and, 1368–1372 1561–1562, 1562t
vessel cross-sectional area and, BMP. See Bone morphogenic minerals in, 1516 pediatric, 1609–1611
1113f protein (BMP) osteoporosis in, 1555f types of, 1562–1565
viscosity and, 1112 BMT. See Bone marrow transplant remodeling of, 1521f BOOP. See Bronchiolitis obliterans
Blood gas, normal ranges for, (BMT) repair of, 1520 organizing pneumonia
1245t BNP. See Brain natriuretic peptide structure and function of, (BOOP)
Blood gas analysis, hypoventilation BO. See Bronchiolitis obliterans 1510–1520, 1518f Bordetella pertussis, 303, 304t–305t,
diagnosed with, 1250 (BO) tests of function of, 1535 305, 307
Blood group, Rh, 279 Body Bone albumin, 1516 Borrelia burgdorferi, 302, 304t–305t
Blood group antigen, 278 perception and awareness of, Bone cancer, 1560–1565 Lyme disease caused by, 617, 1640
Blood lead level, 66 506 carcinogenic agents associated Borrelia miyamotoi, 1640
Blood loss skeletal muscles of, 1528f with, 404t–407t Borrelia recurrentis, 302, 308–309
acute, 996 stomach, 1396 diagnosis of, 1562 Bosentan, pulmonary artery
hypovolemic shock associated Body cell, reproduction of, 37 ionizing radiation as cause of, hypertension treated with,
with, 1672 Body fluid. See Fluid(s), body 424t 1278
Blood pressure Body mass index (BMI) Bone cell, 1512–1515 Botulinum toxin
baroreceptor and chemoreceptor childhood obesity measured with, example of, 1514f cerebral palsy treated with, 672
reflex control of, 1116f 1221 function of, 1512t dystonia treated with, 574b
child, 1219f concordance rates for twins for, Bone disorders, 1550–1565 Bowel, necrosis of, 1499
classification of, 1132t 170t Bone fluid, 1516 Bowen disease, 1642f
1756 INDEX

Bowing fracture, 1541 Brain herniation syndrome, 557b, Breast cancer (Continued) Broca speech area, 456–457
Bowleg, 1593 557f branching morphogenesis Brodie abscess, 1560
Bowman glomerular capsule Brain injury, 582t compared to, 867t Broken heart syndrome, 1162,
(Bowman space), 1320–1321, coup and contrecoup, 584f breast biopsy and risk of, 838b 1162b
1324f, 1329 diffuse, 587–588 carcinogenic agents associated Bromocriptine
Bowman (urinary) space, 1322, focal, 582–587 with, 404t–407t mastalgia treated with, 842t
1329, 1355–1356 genetics of, 589 chemical agents and, 861t–862t prolactinoma treated with, 724
BP. See Bullous pemphigoid (BP) pathophysiology of, 583f cigarette smoking associated Bronchial capillary, 1230
BPD. See Bronchopulmonary primary, 582–588 with, 413 Bronchial circulation, 1229–1231
dysplasia (BPD) recovery spectrum after, 534 clinical manifestations of, 873, Bronchial tree, congenital
BPH. See Benign prostatic secondary, 588–589 873t malformations of, 1300
hyperplasia (BPH) Brain metastases, 631–632 death rate of, 843 Bronchiectasis, 1256–1258, 1257f
BPI. See Bactericidal/permeability- Brain natriuretic peptide (BNP), 109 driver mutations and copy Bronchiole
inducing protein blood pressure affected by, 1117 number changes in, 863f conducting airway structure and,
Brachial plexus, 469 heart failure and, 1179b environment factors affecting, 1228f
Brachytherapy, 397–398, 857 hypertension and, 1134 855–863 description of, 1228
Braden scale, 1625 kidney function affected by, 1327 evaluation and treatment of, 873 gas exchange and, 1229
Bradycardia renal blood flow affected by, genetic factors associated with, illustration of, 1229f
pathophysiology and treatment 1328t 172–174 inflammation of, 1258
of, 1183t–1184t Brain scan, 478–480 hormones and, 845–855 Bronchiolitis, 1258, 1305–1306
pediatric shock and, 1701–1702 Brain tumor inflammatory stroma in, 868–870 Bronchiolitis obliterans (BO),
Bradycardic effect, 1103–1104 characteristics of, 627t inheritance of, 379–380 1258, 1308
Bradykinesia, 561–562, 564, 567 pediatric, 681, 681t–682t inherited syndromes and, Bronchiolitis obliterans organizing
Bradykinin, 201 clinical manifestations of, 863–866 pneumonia (BOOP), 1258
multiple organ dysfunction 682–683 invasive, 870, 871f Bronchitis
syndrome and, 1680–1682 evaluation and treatment of, invasive carcinoma, 870 acute, 1274–1275
renal blood flow affected by, 683–684 ionizing radiation as cause of, chronic, 1267–1268, 1267f
1328t location of, 682f 424t clinical manifestations of, 1269t
Bradyphrenia, 568 types of, 682–684 male, 914–916 Bronchoalveolar cell carcinoma,
Brain primary, 626, 628–631 mammary gland development 1280
abnormalities of, schizophrenia Brainstem, 454 and, 848f Bronchoconstriction, airway
associated with, 642 arousal alterations and, 528 mammography screening for, resistance affected by, 1236
areas of, attention deficit and, cognitive functions and, 535f 393b Bronchodilation, airway resistance
539f–540f respiration controlled by, 1233 metastasis of, 869f, 872b affected by, 1236
arteries of, 468f, 468t Brainstem dysfunction normal breast tissue compared Bronchopulmonary dysplasia
atrophy of, 51f oculomotor responses associated to, 865f (BPD), 1303–1305
blood supply to, 467–469. See also with, 532 physical activity and prevention clinical manifestations of, 1305
Cerebral hemodynamics pupillary changes associated with, of, 422 evaluation and treatment of, 1305
cardiovascular control center in, 532 progression of, 872f pathophysiology of, 1304–1305,
1104–1106 Brainstem glioma, in child, radiation as cause of, 856–858 1304f
cerebral hemisphere of, 537f 681t–682t, 682–683 risk factors for, 844t Bronchospasm, asthma as cause
cognitive functions and, 535f Branched-chain ketoaciduria, risk of, 843t of, 1266
contusion of, 583 671t sarcoma and, 866t Bronchus
coverings of, 465f Branching morphogenesis, 843 screening for, 858, 858b abnormal dilation of, 1256–1258
description of, 454–460 BRCA1 gene, 863, 864b staging of, 394f conducting airway structure and,
development of, 661–663 ductal carcinoma in situ and, stress and, 356–357 1228f
hydrocephalic, magnetic 867–868 subclasses of, 364–365 description of, 1228
resonance image of, 559f ovarian cancer and, 831 subtypes of, 843 dysplasia in, 54f
hyperglycemia effects on, 740f prostate cancer and, 904 tumorigenesis in, 869f epithelium of, 1229
injury to (See Brain injury) BRCA2 gene, 863, 864b types of, 866t foreign body aspiration in, 1298
left hemisphere of, cortical areas ductal carcinoma in situ and, Breast cancer receptor gene, 174, inflammation of, 1256–1258
of, 536f 867–868 831 metaplasia in, 54f
liquefactive necrosis of, 90f ovarian cancer and, 831 Breast carcinogenesis, 867f reversible changes in, 54f
normal prostate cancer and, 904 Breast milk, 253, 784 wall of, 1229
Chiari malformation compared Breast Breast pain, treatment of, 842t Brucella abortus, 304t–305t
to, 665f benign conditions of, 842t Breastfeeding, breast cancer and, Brucella spp., 306–307
magnetic resonance image of, biopsy of, breast cancer risk and, 846b–847b Brudzinski sign, 606, 676
559f 838b Breathing Brugia malayi, 316
occlusion of arteries of, 468f cyst in, 838–839 abnormal patterns of, 1249–1250 Brush border, 1401
protective structures for, density of, 855, 855f altered, asthma indicated by, 1309 Brush border enzyme, 1402
464–467 disorders of, 836 bronchiolitis effect on, 1305 Bruton’s agammaglobulinemia,
venous drainage of, 467–469 female, 782–784 diaphragmatic, 1292 284
Brain abscess, 613–614 development of, 783, 783b labored, 1249–1250 Buboes, inguinal, 927
Brain cancer lymphatic drainage of, 783f mechanics of, 1234–1237 Bubonic/pneumonic plague,
carcinogenic agents associated menopause and, 795 muscles associated with, 298–299, 302t
with, 404t–407t schematic diagram of, 782f 1234–1235 Buerger disease, 1144
ionizing radiation as cause of, variation in, 783b neurochemical control of, 1233 Buffer, acid-base balance and, 123,
424t male, 784, 913–916 paradoxic, 1292 126
Brain death, 533 normal, breast cancer compared patterns of, 529–532, 530t Buffer systems, 123–126, 123t
Brain-derived neurotrophic factor to, 865f restricted, 1250 Buffering
(BDNF), 648 structure and function of, work of, 1236–1237 acid-base balance and, 123
Brain dysfunction 782–784 Breech presentation, renal, 125–126
motor response affected by, Breast cancer, 843 developmental hip dysplasia respiratory, 125–126
532–533 benign breast disease and, associated with, 1594 Bulbar palsy, 572
oculomotor responses associated 837–838 Brittle bone disease, 1597–1599 Bulbocavernosus, 772
with, 532 brain metastases and, 631–632 Broca dysphasia, 543t–544t Bulbourethral gland, 789
 INDEX 1757

Bulbus cordis, 1196 Burns. See Burn injury Calcium (Continued) Cancer (Continued)
Bulimia nervosa, 1450, 1450b Burrow, clinical manifestations of, metabolism of, 703f clinical manifestations of, 392,
Bulla 1625t osteoporosis and, 1552, 1556 396b
emphysema and, 1269 Bursa, description of, 1546 Calcium channel antagonist drugs, colon. See Colorectal cancer
example of, 1620t–1622t Bursitis, 1545–1547 cluster headache treated with, development of, 408f
Bullous impetigo, 1656 clinical manifestations of, 609 diagnosis of, 392–396
Bullous pemphigoid (BP), 1633, 1546–1547 Calcium channel blocker drugs, diet and, 414–423
1634f evaluation and treatment of, 1547 1099–1101, 1156 of digestive system, 1466–1478
BUN. See Blood urea nitrogen pathophysiology of, 1546–1547 Calcium ion disseminated intravascular
(BUN) sites and causes of, 1547t cardiac muscle contraction and, coagulation and, 1043–1044
Bundle branch, 1093 Buspirone, anxiety disorder treated 1100f DNA methylation and, 186, 415f
Bundle of HIS, 1093–1094 with, 655 cellular communication and, 23 early life conditions and, 410–413
Bunyavirus, description of, 318t BV. See Bacterial vaginosis (BV) concentration of, in myocardium, endometrial, 830–831
Bupropion, depression treated with, Bystander effects of ionizing 1094t environment factors associated
652b radiation, 78–80, 428–429 as second messenger, 23–25, 24f, with, 413
Burkholderia cepacia, cystic fibrosis 694 epidemiology of, 402–441
associated with, 1312 C sickle cell disease and, 1065 epigenetic basis of, 186, 403–409
Burkitt lymphoma, 375–376, C cell, thyroid function and, 702 transport of, 33t of esophagus (See Esophageal
1029–1030 C1 deficiency, 287 Calcium oxalate, kidney stone cancer)
childhood, 1078–1079 C2 deficiency, 287 composed of, 1343 of female reproductive system,
Epstein-Barr virus associated C3 deficiency, 287 Calcium salts, 87 825–834
with, 383 C4 deficiency, 287 Calcium stone, 1343 gallbladder (See Gallbladder
example of, 1029f C9 deficiency, 288 Calcium transport, heart failure cancer)
Burn injury, 1685–1696 C1 esterase inhibitor, 201 and, 1178 of gastrointestinal tract,
cardiovascular system response C fiber, 485–486, 486f Calcium-troponin complex, 1101 1466–1472
to, 1689–1690 C-myb gene, rhabdomyosarcoma Calculus gene misregulation and, 380–382
cellular injury caused by, 77 associated with, 1612 description of, 1343 gene types of, 374t
cellular response to, 1690–1693 C peptide, proinsulin and, 704 urinary, classification of, 1343 genetic basis of, 372–387,
clinical manifestations of, C protein, muscle contraction and, Calicivirus, description of, 318t 403–409
1687–1689 1532t California encephalitis virus, genetic changes in, 375–379
deep partial-thickness, 1686 C3 receptor deficiency, 289 central nervous system diseases genetic factors associated with,
depth of, 1686t, 1716 C-type natriuretic peptide (CNP), caused by, 610t 172–174
diagram for, 1688f 1117, 1327 Callus, 53 genetic lesions in, 375b
edema associated with, 1690, action of, 1111b bone healing and, 1520 global patterns of, 409b
1690f hypertension and, 1134 formation of, following fracture, glucose utilization in, 369
epidemiology and etiology of, C wave, 1089–1090 1542f hallmarks of, 380f
1685 Ca. See Calcium osteosarcoma and, 1563 human papillomavirus vaccine
evaluation and treatment of, Ca++. See Calcium ion Caloric ice-water test, 533f and prevention of, 775b
1693–1696 Cabergoline Calymmatobacterium granulomatis, immune system affected by,
first-degree, 1685–1686 elevated growth hormone treated 928 382–383
fluid replacement after, 1690, with, 724 CAM. See Cell adhesion molecule immunity and, 382–387
1690b prolactinoma treated with, 724 (CAM) incidence trends of, 409–410
immune function altered by, CAC. See Coronary artery cAMP. See Cyclic adenosine infection associated with, 423,
1720f calcification (CAC) monophosphate (cAMP) 397t
immunologic response to, Cachectin, 310 Campylobacter jejuni, 304t–305t inflammation and, 382–387
1692–1693 Cachexia, 396b, 1451 CA-MRSA. See Community- inflammation as cause of,
metabolic response to, 1691– CAD. See Coronary artery disease acquired methicillin-resistant 383–384
1692, 1721t (CAD) Staphylococcus aureus invasion of, 387–392
nonthermal, 1685 Cadherin, 18 (CA-MRSA) infection ionizing radiation as cause of,
nutritional support following, Caisson disease, 77–78 Cancellous bone, 1517, 1518f 424–431
1721–1722 Calcification, 1512 Cancer, 1. See also Malignancy laryngeal, 1278–1279
pain management for, 1723 dystrophic, 87 aging and, 372–373, 372f lifestyle factors associated with,
partial-thickness, 1685–1686 metastatic, 87–88 bladder. See Bladder cancer 413
pathophysiology of, 1687–1689 Calcitonin, 120, 701t, 702 body weight and, 418f liver (See Liver cancer)
pediatric, 1715–1725 Calcitonin gene-related peptide, bone. See Bone cancer lung (See Lung cancer)
physiologic alterations associated stress response influenced by, breast. See Breast cancer metabolism of, 369, 370f
with, 1692f 351t Candida infection associated metastasis of, 387–392, 391f
recovery from, 1723–1725 Calcitriol, 1334 with, 313–314 micro-ribonucleic acid and, 186
second-degree, 1686 Calcium, 119–122 causes of, 403f microRNA and, 378–379
severity of, 1687, 1716–1725 accumulation of, 87–88 cervical. See Cervical cancer molecular characterization of,
superficial partial-thickness, 1686 alteration in balance of, 114–122 characteristics of, 363–372 364–365
systemic response to, 1689–1690 alteration in level of, 121t childhood, 442–446, 681, 1074 mortality trends of, 409–410
temperature regulation affected balance of, chronic kidney disease congenital factors associated obesity as risk factor and,
by, 502 and, 1366t with, 443t 417–420
thermal, 1685 bone matrix and, 1515 drugs associated with, 445t obesity pathways linking to, 421f
third-degree, 1686–1687 chronic kidney disease and, environmental factors for, ovarian, 831–834
wound care following, 1722, 1722b 1368–1372, 1368t 444–445 pain associated with, 494
Burn shock, 1687–1690, 1691f, crystallization of, 1517t etiology of, 443–445 pancreatic (See Pancreatic
1718–1719 deficiency of, 732 genetic factors associated with, cancer)
Burn unit, referral criteria for, 1689b digestion and absorption of, 1405 444 penile (See Penile cancer)
Burn wound depth, 1685–1696 distribution of, in body fluids, incidence and types of, prevalence of, 172t
Burning mouth syndrome 108t 442–443 prevention of, 411, 412b
folate deficiency anemia excitation-contraction coupling prognosis for, 445 progression of, 384–387
associated with, 989 and, 1099–1101 classification of, molecular prostate (See Prostate cancer)
iron deficiency anemia associated fracture risk and, 1556b markers for, 368f radiation-induced, 80–81
with, 990–991 function of, 1512t classification of sites of, 404t–407t radiation therapy for, 397–398
1758 INDEX

Cancer (Continued) Capsule Cardiac cycle, 1088–1089 Carditis

risk factors for, 414f antiphagocytic, 307–308 phases of, 1088, 1089f rheumatic fever associated with,
skin (See Skin cancer) bacterial, 309f speed of, 1092 1172
staging of, 392–394 Caput medusae, 1452–1453 Cardiac excitation, 1094 rheumatic heart disease and, 1172
stress and, 355–356 Carbohydrate Cardiac index (CI) Caretaker gene, 379
summary of convincing and cellular accumulation of, 84–85 definition of, 1120t Carina, description of, 1228
probable judgments related chronic kidney disease and, in older adult, 1123t Carnitine palmitoyltransferase
to, 414f 1368–1369 Cardiac muscle, 1097 (CPT), 1583
surgery for, 398 digestion of, 1402, 1403f Cardiac orifice, 1396 Carotid artery, 467
survival rates for, 394t metabolism of, 1413 Cardiac output (CO), 1101–1106, Carotid artery wall thickness
terminology for, 363–372 plasma membrane protein and, 1102f (CAWT), 1153
testicular (See Testicular cancer) 14f–15f, 15–16 cardiogenic shock and, 1671 Carrier
tissue differentiation during, Carbon dioxide (CO2) definition of, 1120t definition of, 151
366f airway gas exchange of, 1229 effects of, 1114 immunogen and, 229
treatment of, 392, 395 cellular metabolism and, 25–26 hypertension and, 1132 obligate, 154
uterine, 830 removal of, 1238 Cardiac plexus, 1096 Carrier detection test, 156
in utero, 410–413 transport of, 1243 Cardiac septation, 1195–1196, Carrier screening, 136b
vaginal (See Vaginal cancer) ventilation and, 1232 1195f Cartilage
viral-associated, 382–383 Carbon dioxide partial pressure Cardiac sphincter, 1395 ankylosing spondylitis effects on,
vulvar, 829–830 (Pco2), 124 Cardiac troponin I, myocardial 1573–1574
Cancer biology, 1 Carbon monoxide (CO), 67 infarction diagnosis and, articular, 1522–1526
Cancer cell asphyxiation from, 74 1161 calcification of, 1567f
adherence of, 389–390 cellular injury caused by, 63–65 Cardioexcitatory center, 1105–1106 collagen fibers in, 1524–1525
biology of, 368–372 Carbon tetrachloride (CCl4), 62–65, Cardiogenesis, 1194 destruction of, osteoarthritis and,
detachment of, 388–389 64f Cardiogenic shock, 1162, 1671– 1567
growth of, 369f Carbonic acid 1672, 1705–1706 effects of aging on, 1536
immortality of, 382, 382f bicarbonate concentration and, causes of, 1671 rebuilding of, 1525b
invasion of, 388–389 124f clinical manifestations of, 1672, tissue engineering for, 1568b
metabolism of, 369 buffering of, 124–125 1706 Cartilage anlage, 1591–1592
metastasis of, 388 description of, 123 definition of, 1700 Cartilaginous joint, 1520, 1523f
microenvironment of, 386f formation of, 1243 diagram of, 1672f Caseation necrosis, 1273–1274
spread of, 389 ventilation and, 1232 pediatric, evaluation and Caseous necrosis, 90, 91f
survival of, 389 Carboxyhemoglobin, 67 treatment of, 1710–1715 Cast, bone fracture treated with,
Candida albicans, 310–311, 312t, Carboxypeptidase, 199 treatment of, 1671–1672 1543
313, 313f as digestive enzyme, 1402b Cardioinhibitory center, 1105–1106 Casts, urinary, 1336
candidiasis infection caused by, protein digestion and, 1402 Cardiomyopathy, 1165–1167 Catabolic (flow) phase of
1638 Carbuncle, 1634–1635 diabetes mellitus and, 751 metabolism, 1720
dermatitis caused by, 1655 Carcinoembryonic antigen, 369t, pathophysiology of, 1166t Catabolism, 25, 26f
immune system suppressed by, 1471 types of, 1165f Catalase, 8, 61–62
314 Carcinogen Cardiopulmonary system Cataract, 510
thrush caused by, 1658 alcohol as, 420 chronic kidney disease effects on, Catecholamine. See also
Candidiasis, 310–311, 312t, 314, exposure to, 402 1365t Epinephrine; Norepinephrine
1638 Carcinogenesis postnatal development of, 1198 action of, 474
chronic mucocutaneous, 285 alcohol-related, 422 Cardiovascular autonomic effects of, 345t
meningitis caused by, 611 breast, 867f neuropathy, 750 glucocorticoids and, 707
sites of, 1638t chemical, 432–433 Cardiovascular control center, heart failure and, 1177
Cannon, Walter B., 338–339 of cigarette smoke, 413f 1104–1106 multiple organ dysfunction
CAP. See Community-acquired ionizing radiation induced, Cardiovascular disease syndrome and, 1683
pneumonia (CAP) 427–428 alcohol consumption and, 67–68 secretion of, 758–759
Capillary radiation, 424–425 medications for prevention of, stress response and, 343
bronchial, 1230 Carcinoid syndrome, cancers 1151b synthesis of, 710f
composition of, 1108 associated with, 395t prevalence of, 172t as tumor marker, 369t
coronary, 1092 Carcinoma. See also Cancer renin-angiotensin-aldosterone urine concentration affected by,
description of, 1085 anal, 1472 system and, 1134b 1332
flow through, 1114t breast, types of, 866t vascular endothelial dysfunction Cathelicidin, 193
inflammatory response and, 196f bronchoalveolar cell, 1280 and, 95, 95f Catheter, urinary tract infection
lymphatic, 1119f bronchogenic, 1279–1280 Cardiovascular disorders, acquired, associated with, 1349b
permeability of, 107, 107f cervical, 365f, 827 1218 Cation, definition of, 29
phagocytosis and, 210f definition of, 364 Cardiovascular function Cat’s-eye reflex, 513
pulmonary, 1229–1230 invasive, 385f alterations in, 1129–1193 Cauda equina, 460, 461f
pulmonary lymphatic, 1230 origination of, 389 tests of, 1119–1123 Cauda equina syndrome, 1345
systemic circulation and, 1106 ovarian, 833t Cardiovascular system Causalgia, 494–495
wall of, 1109f pancreatic, 1474f aging and, 1123–1127 CAVC. See Complete
water movement and, 105, 106f of prostate, 908f alterations in, 1129–1193 atrioventricular septal defect
Capillary filtration forces, 106f rectal, 1471 anatomy of, 1194–1196 (CAVC)
Capillary hydrostatic pressure, renal cell, 1347 autonomic innervation of, 1093f Caveolae, 12, 35
104–105, 107f Carcinoma in situ, 364 burn injury and, 1717 Caveolae-mediated endocytosis, 35
Capillary injury, pulmonary edema CARD15/NOD2 gene, 1442 chronic kidney disease effects on, Caveolin-independent endocytosis,
associated with, 1260 Cardiac action potential, 1092, 1365t, 1369 35
Capillary malformation, example 1094–1095, 1095f development of, 1194–1198 Cavernous angioma
of, 1664f Cardiac catheterization, 1122 hemorrhagic shock and, 1706t (malformation), 604–605
Capillary (plasma) oncotic pressure, Cardiac cell hyperthyroidism effects on, 727t Cavernous (congenital)
105–107, 107f death of, myocardial ischemia as hypothyroidism effects on, 730t hemangioma, 1663, 1663f
Capillary seal, 1690 cause of, 1159 organ dysfunction and, 1684b Cavernous sinus, 467
Capillary telangiectasis, 604–605 myocardial infarction and, pediatric, 1194–1224, 1703t Cavins, 35
Caplan syndrome, 1572 1158–1159 structure and function of, 1 Cavitation, 1274
 INDEX 1759

CAWT. See Carotid artery wall Cell (Continued) Central cyanosis, 1250 Cerebellar gait, 575
thickness (CAWT) diploid, 142 Central herniation, 557b Cerebellar memory, 536
CBC. See Complete blood count division of, 37–38, 38f Central (secondary) Cerebellar motor syndrome, 574,
(CBC) energy production in, 26–27 hyperthyroidism, 725 574t
CBP. See Chronic bacterial environment of, 49–102 Central hypothyroidism, 728 Cerebellar multiple sclerosis,
prostatitis (CBP) epithelial, 11f, 40 Central lymphoid organ, 236–237, 620–621
CBT. See Cognitive-behavioral euploid, 143–144 240 Cerebellomedullary cistern, 465
therapy (CBT) function of, 2 Central nervous system (CNS) Cerebellum
CCL4. See Carbon tetrachloride giant, 214 abnormal breathing patterns and, function of, 459
(CCl4) haploid, 142, 144f 530f structure of, 459
CD4, Treg cells and, 386–387 hyperplasia of, 51–53 acquired immunodeficiency Cerebral aqueduct (aqueduct of
CD25, Treg cells and, 386–387 hypertrophy of, 51 syndrome and, 327–329 Sylvius), 459
CD (cluster of differentiation), illustration of, 3f acute leukemia effects on, 1019 Cerebral artery, 467, 468t
227–228 injury to (See Cellular injury) alcohol effect on, 68 Cerebral blood flow, 555, 555b
CD molecule, function of, 228t insulin action on, 705f cancer of Cerebral blood volume, 555b
CD1 molecule, 234f, 235 intake and output of, 28–37 carcinogenic agents associated Cerebral cortex, 455f, 456
antigen processing and, 244f intercalated, 114 with, 404t–407t sensory and motor areas of, 456f
function of, 228t membrane system of, 7f pediatric, 443 Cerebral death, 534
CD2 molecule, 238f metabolic waste in, shock and, childhood lymphoma and, 1079 Cerebral edema, 557–558
function of, 228t 1670 description of, 454–469 Cerebral hemisphere, areas of, 537f
T cell differentiation and, metabolism of, 25–28 development of, 660 Cerebral hemodynamics
239–240 nucleus of, 2–4 disorders of (See Central nervous alterations in, 555–559
CD3 molecule, 238f, 239–240 polarity of, 11–12, 11f system [CNS] disorders) description of, 555b
antigen presentation and, 245 polyploid, 143–144 divisions of, 454t management of, 556t
function of, 228t principal, 114 hemorrhagic shock and, 1706t Cerebral infarction, 599
CD4 molecule, 239–240 programmed death of, 21 human immunodeficiency virus Cerebral nuclei, 457
antigen presentation and, 245 reproduction of, 37–39 and, 616b Cerebral oxygen saturation, 555b
function of, 228t response of, to burn injury, infection of, 609–618, 675–677 Cerebral palsy (CP), 670–672,
T cell development and, 240 1690–1693 inflammation of, 609–618 1606
CD8 molecule, 239–240 signaling, 21 intoxications of, 674–675 causes of, 672t
function of, 228t somatic, 142 multiple sclerosis lesions in, 620 clinical manifestations of, 672
T cell and, 249–250 structure and function of, 2–17 neoplasms of, human evaluation and treatment of, 672
T cell development and, 240 swelling of, 84 immunodeficiency virus pathophysiology of, 670–672
CD19 molecule, function of, 228t transformation of, cancer and, and, 617 risk factors for, 672t
CD20 molecule, function of, 228t 428 organ dysfunction and, 1684b sexual function impacted by,
CD21 molecule, 228t, 241 transport systems in, 33t overview of, 447–448 834t
CD25 molecule viral infection of, 319f pain and, 485, 488f Cerebral perfusion pressure, 555b
function of, 228t Cell adhesion molecule (CAM), spread of viral pathogens in, 611f Cerebral thrombosis, 598
Treg cell and, 257 13–15, 18 stress response and, 340f Cerebral vasospasm, 606
CD28 molecule, function of, 228t Cell cycle, 37–39, 38f trauma to, temperature Cerebrospinal fluid (CSF), 465–466
CD40 molecule, 228t, 241 Cell death, 55, 55t, 88–93 regulation affected by, 502 analysis of, 479t, 480
CD48 molecule, function of, 228t Cell junction, 3f, 18–20 tumors of, 626–637 composition of, 465t
CD58 molecule, function of, 228t Cell lysis, 198, 198f viral infection in, 611f flow of, 466f
CD80 molecule, function of, 228t Cell-to-cell adhesion, 17–20 Central nervous system (CNS) hydrocephalus and, 669f
CD154 molecule, function of, 228t Cellular adhesion molecule, 211t disorders, 581–621 obstruction of flow of, 558
CDR. See Complementary- Cellular biology, 1 childhood leukemia associated Cerebrovascular accident (stroke
determining region Cellular communication, 1, 20–25 with, 1076 syndrome), 598–604, 834t
CD45R molecule, 240 Cellular crosstalk, 1 indications of, 533 Cerebrovascular disease, 598,
CEA. See Carcinoembryonic antigen Cellular function, 2 inherited metabolic, 673–674, 677–678
(CEA) Cellular immunity, 226–227 673t Cerebrovascular disorder, 598–607
Cecum, 1407 Cellular injury, 49–50, 54–83 virus as cause of, 610t Cerebrum, 456
Ceftriaxone chemical, 62–70 Central neurogenic hemispheres of, 455f
gonorrhea treated with, 922 genetic factors and, 75 hyperventilation, 532 structure of, 456–457
pelvic inflammatory disease illustration of, 55f Central neuropathic pain, 494 Cervical cancer, 825–828
treated with, 816b immunologic, 75 Central perfusion pressure, carcinogenic agents associated
Celexa. See Citalopram infectious, 75 management of, 556t with, 404t–407t
Celiac artery, 1396, 1446 intentional, 70–71 Central precocious puberty, clinical manifestations of, 826
Celiac branch of aorta, 470 manifestations of, 83–88 803–804, 887 clinical staging for, 829t
Celiac disease, 1494 mechanisms of, 55 Central reflex hyperpnea, evaluation and treatment of,
Celiac plexus, 1396 nutritional imbalance and, 75 description of, 530t 826–828
Celiac sprue, 1494 physical agents as cause of, 75–83 Central sensitization, 490 human papillomavirus as cause
Cell radiation as cause of, 78–81 Central sulcus, 456 of, 423
abnormal, killing of, 255–256 systemic manifestations of, 88, 89t Central tolerance, 240, 273–274 human papillomavirus vaccine
adaptation of, 50–54 themes in, 55t B-cell receptor development and, and prevention of, 775b
adaptive alterations in, 50f types of, 55t 241 pathogenesis of, 825–828
aging and, 93–96 unintentional, 70–71 immune response and, 229 screening for, 826b
altered, 49–102 Cellular receptor, 16–17, 202–203 Central venous pressure (CVP), 1702 viral infection as cause of,
atrophy of, 50–51 Cellular swelling, 84 Centriacinar emphysema, 382–383
biology of, 1 Cellulitis, 1635 1269–1270, 1270f Cervical carcinoma in situ (CIS),
cancer, biology of, 368–372 Centers for Disease Control and Centriole, 3f, 10 825–827, 826f
communication of, 20–25 Prevention (CDC), sexually Centromere, 37 Cervical disk, herniation of,
components of, 2–17 transmitted infection statistics Cephalic phase of secretion, 1400 597–598
connections of, 19f from, 919b Cephalosporin, gonorrhea treated Cervical dysplasia, 827
cytoskeleton of, 9–11 Central canal, 460–461 with, 922 Cervical intraepithelial carcinoma
death of (See Cell death) Central core disease (CCD), 1578, Cerebellar astrocytoma, in child, (CIN), 825, 827, 828f
differentiation of, 956–959 1582 683 Cervical spondylolisthesis, 596
1760 INDEX

Cervicitis, 816 Chest wall, 1231 Child (Continued) Child (Continued)

chlamydial, 931f disorders of, 1253–1254 encephalopathy in, 674–675 tumors in, 681, 1612t
gonococcal, 921f dynamics of, in infant and child, endocarditis in, 1198b type 1 diabetes mellitus in, 738
Cervix, 774–775 1292 epilepsy in, 678–681 urinary system in, 1376–1378
abnormalities of, 801 elastic properties of, 1236 Epstein-Barr virus in, 1011 urinary tract alterations in,
cancer of. See Cervical cancer pain in, 1251 fever response in, 500 1376–1392
dysplasia of, 53f restrictions of, 1253–1254 fluid balance in, 1377–1378 urinary tract infection in,
inflammation of, 816 Cheyne-Stokes respiration, gastroesophageal reflux disease 1386–1387
invasive carcinoma of, 827 529–532, 530t, 1250 in, 1493–1494 Child abuse
neoplasm in, 365f Chiari malformation, 665, 665f glomerular disorders in, burn injury associated with, 1715
CF. See Cystic fibrosis (CF) Chickenpox (varicella), 1659t, 1381–1385 pediatric trauma from,
CFS. See Chronic fatigue syndrome 1660–1661 heart failure in, 1200–1202 1612–1613
(CFS) Chief cell, gastric secretion and, hematologic system in, 975 Childhood absence epilepsy,
CGD. See Chronic granulomatous 1398 hematologic values for, 978t, 678–679
disease Chilblains, 1646 1057t Chlamydia, 929–932
cGMP. See Cyclic guanosine Child hemorrhagic stroke in, 678 evaluation and treatment of, 931
monophosphate (cGMP) acquired cardiovascular disorders hepatitis in, 1502 pelvic inflammatory disease
Chagas disease, 314–315, 314t in, 1218 human immunodeficiency virus associated with, 814
Chalazion, 507 acquired hematologic disorders infection in, 328, 329b transmission of, 303
Chancre in, 1058–1062 hypertension in, 1218–1221 Chlamydia pneumoniae, 304t–305t
penile, 924f acquired immunodeficiency infectious mononucleosis in, Chlamydia spp., infection from,
syphilis as cause of, 923 syndrome in, 327–329 1011 303t
vulval, 924f alterations in digestive function inflammatory response in, 220 Chlamydia trachomatis, 303,
Chancroid, 925–927 in, 1486–1509 inherited hematologic disorders 304t–305t, 929–930
clinical manifestations of, 927 alterations in hematologic in, 1062 conjunctivitis caused by, 508
evaluation and treatment of, function in, 1055–1082 integumentary system alterations Neisseria gonorrhoeae syndromes
927 anemia in, 1058t in, 1653–1667 compared to, 930t
pathophysiology of, 927 antidepressant drugs for, 651 iron deficiency anemia in, 1058 Chlamydial cervicitis, 931f
penile, 928f asthma in, 1308–1310 ischemic stroke in, 677–678 Chlamydial conjunctivitis, 508
vulvar, 928f basal metabolic rate of, 1292 kidney injury in, 1385 Chlamydial epididymitis, 930
Channel regulation, cellular bipolar disorder in, 653–654 kidney stones in, 1387b Chlamydial ophthalmia, 931f
communication and, 22, 23f bladder function alterations in, lead exposure for, 65b Chlamydial urethritis, 930
Charcot neuropathy, 750–751 1378–1391 leukemia in, 1074–1078 Chlamydophilia pneumoniae,
CHD. See Coronary heart disease blood pressure in, 1219f, 1220t, lower airway disorders in, pediatric pneumonia caused
(CHD) 1701b 1301–1313 by, 1306
Chédiak-Higashi syndrome, 289, blood volume in, 975 lymphoma in, 443, 1078–1081 Chlorambucil, chronic leukemia
1042 blood volume of, 1705t metabolic characteristics of, 1292 treated with, 1023
Chemical agent body fluids in, 104 multiple organ dysfunction Chloride
aplastic anemia caused by, 993 body temperature regulation syndrome in, 1699–1715 accumulation of, shock as cause
breast cancer and, 861, 861t–862t in, 498 muscle growth in, 1593 of, 1669–1670
as carcinogen, 432–433 bone growth in, 1592–1593 musculoskeletal development in, alterations in balance of, 109–114
cardiac effects of, 1106 brain tumor in, 628, 681, 1591–1593 balance of, 108–109
cellular injury caused by, 63–70 681t–682t musculoskeletal function description of, 109
Chemical asphyxiant, 74 burn injury to, 1715–1725 alterations in, 1591–1615 distribution of, in body fluids,
Chemical burn, 1716 cancer in, 442–446 musculoskeletal tumors in, 108t
Chemical injury, cellular, 62–70 etiology of, 443–445 1609–1612 sodium balance with, 108–109
Chemical signaling, 21f genetic factors associated with, nervous system structure and urine concentration and, 1332
Chemical synapse, cellular 444 function in, 660–663 Chloride ion, concentration of, in
communication and, 20 incidence and types of, neurologic disorders in, 660 myocardium, 1094t
Chemical thermogenesis, 496–497 442–443 neurologic function alterations Chlorpromazine, schizophrenia
Chemokine, 203, 205 prognosis for, 445 in, 660–688 treated with, 646, 646b
Chemokine ligand 2, 385–386 cancer incidence rates for, 409 obese, 1221 Choking asphyxiation, 74
Chemoreceptor, 1234 cardiovascular function obstructive sleep apnea syndrome Cholangiocarcinoma, 1473
blood pressure affected by, alterations in, 1194–1224 and, 1300 Cholangiocellular carcinoma, 1473
1115–1116 cardiovascular performance in, osteomyelitis in, 1602b, 1603 Cholangitis, 1463
respiration control and, 1233 1703t pain perception of, 495 Cholecalciferol, 119–120, 1334
Chemoreceptor trigger zone, 1424 central nervous system infections platelet disorders in, 1070–1074 Cholecystitis, 1067–1068, 1464
Chemotactic factor, 198–199, 198f in, 675–677 pneumonia in, 1306–1308, 1307t Cholecystokinin, 1415
Chemotaxis, 39, 207 central nervous system tumor poisoning of, from medication, action of, in digestive system,
Chemotherapy in, 443 63b 1397t
acute leukemia treated with, 1019 cerebrovascular disease in, pulmonary function alterations secretion of, 1397–1398
adjuvant, 397 677–678 in, 1290–1318 Cholelithiasis (gallstones),
childhood leukemia treated with, chest wall dynamics in, 1292 pulmonary system in, 1290–1293 1463–1464
1077 coagulation disorders in, radiation exposure of, 445 clinical manifestations of, 1464
Hodgkin lymphoma treated with, 1070–1074 renal system alterations in, evaluation and treatment of, 1464
1026 coarctation of the aorta in, 1376–1392 pathophysiology of, 1463–1464
induction, 397 1210–1212 respiratory tract infection in, risk factors for, 1463
multiple myeloma treated with, congenital heart defects in, 1305–1308 Cholera, as pandemic, 302t
1034 1198–1218 scoliosis in, 1600f Choleresis, 1411
neoadjuvant, 397 congenital musculoskeletal seizures in, 554t Choleretic agent, 1411
non-Hodgkin lymphoma treated defects in, 1593–1597 shock in, 1699–1715, 1700b Cholesterol
with, 1028 connective tissue disease in, 1604t skeletal development in, 1593 absorption of, 173b
Chest depression in, 647 skin infections in, 1656–1661 accumulation of, 85
muscle retraction in, 1292f diarrhea in, 1499–1500 sleep patterns in, 503–504 action of, 1149
radiograph of, pulmonary dysrhythmia in, 1711b stroke in, 677–678, 677b plasma membrane protein and,
function and, 1244 electrolyte balance in, 1377–1378 thalassemia in, 1069–1070 14f–15f
 INDEX 1761

Cholesterol esterase, fat Chronic conjunctivitis, 507 Chronic pulmonary aspiration CIS. See Cervical carcinoma in situ
emulsification and, 1402–1404 Chronic cough, 1249 (CPA), 1308 (CIS)
Cholinergic crisis, 626 Chronic diarrhea, pediatric, 1500 Chronic pyelonephritis, 1352, 1387 Cisterna magna, 465
Cholinergic transmission, 473–474 Chronic fatigue syndrome (CFS), Chronic rejection, 281 Cisternae, 5f, 6–7
Chondrocyte, 1522–1523 1580–1581 Chronic renal failure Citalopram
Chondrogenic (cartilage-forming) clinical manifestations of, 1581 anemia associated with, 1001 depression treated with, 652b
tumor, 1563–1564 evaluation and treatment of, 1581 sexual function impacted by, 834t obsessive-compulsive disorder
Chondroid, 1563 pathophysiology of, 1580–1581 Chronic venous insufficiency treated with, 657
Chondrosarcoma, 633b, 1563–1564 Chronic fundal gastritis, (CVT), 1129–1130 Citric acid cycle, 26–27, 28f
Chordae tendineae, 1087–1088 1434–1435 Chronologic aging, 93 CKD. See Chronic kidney disease
Chordee, 1378, 1379f Chronic gastritis, 1434 Chvostek sign, 120, 733–734 (CKD)
Chordoma, 633b Chronic glomerulonephritis, Chyle, pleural effusion and, Class-switch
Chorea, 563t, 1172 1357–1358 1254–1255 defective, 284
Chorionic villus sampling (CVS), pediatric, 1381 Chylomicron, 1149, 1405 genetics of, 249f
136b Chronic granulomatous disease, Chylothorax, pleural effusion and, immunoglobulin class and,
Choroid, description of, 508 289 1254–1255 248–249
Choroid plexus, 465 Chronic hepatitis, pediatric, 1502 Chyme, 1396, 1424 Classic cerebral concussion (Grade
Choroid plexus tumor, Chronic hypertension, 1136–1140 Chymotrypsin IV), 588
characteristics of, 627t Chronic kidney disease (CKD), deficiency of, 1439 Classic hemophilia, 1071
Christmas disease, 1071 1364–1372 as digestive enzyme, 1402b Classical pathway, 197, 198f
Christmas factor, disorders calcium metabolism in, 1368t protein digestion and, 1402 Clathrin, 6–7
associated with, 1070t clinical manifestations of, 1366 CI. See Cardiac index (CI) Clathrin-independent endocytosis,
Chromaffin cell, 710 evaluation and treatment of, Cigar smoking, cancer associated 35
Chromatid, 37 1370–1372 with, 413 Clathrin-mediated endocytosis,
chromosome structure and, 145f pathophysiology of, 1364–1366 Cigarette smoking 35
homologous chromosomes and, phosphate metabolism in, 1368t atherosclerosis associated with, Clawlike prolongation, keloids
145f progression of, 1366f, 1366t 1145 and, 1626
Chromatin, 4f, 37 signs and symptoms of, 1367f cancer associated with, 413 Clear cell tumor, 1347
alterations in, 183–184 stages of, 1364t carcinogenesis of, 413f Clearance
epigenetic modification and, 185f systemic effects of, 1365t coronary artery disease and, 1151 glomerular filtration rate and,
epigenetic modulation and, 408f Chronic left heart failure, emphysema associated with, 1269 1334
modification of, 377f 1179–1180 lung cancer risk associated with, renal function and, 1334–1335
Chromophil, 699 Chronic leukemia, 1013, 1020–1023 165 Cleft lip (harelip), 1486–1487
Chromophobe, 699 clinical manifestations of, 1021 maternal, fetal lung development Cleft lip and/or palate
Chromosomal aberration evaluation and treatment of, affected by, 1293b concordance rates for twins for,
cancer and, 428 1021–1023 Cilia, 3f, 40 170t
childhood cancer and, 444 pathophysiology of, 1020–1023 Ciliary muscle, effects of aging on, prevalence rate of, 171t
Chromosomal instability (CIN), Chronic lung disease of 510t recurrence risk for, 169t
379, 1470 prematurity, 1303–1304 CIN. See Cervical intraepithelial Cleft palate (CLP), 1486–1487
Chromosomal mosaic, 145–146 Chronic lymphocytic leukemia carcinoma (CIN); Climate, adaptation to, 497
Chromosome, 142–151 (CLL), 1015t, 1020, 1022f Chromosomal instability Climate change, cellular injury
aberrations of, 143–151 Chronic lymphocytic thyroiditis, (CIN) caused by, 75–77
abnormalities of structure of, 729 Cingulate gyrus, 457 Clindamycin, bacterial vaginosis
148–151 Chronic mesenteric ischemia, 1446 Cingulate gyrus herniation, 557b treated with, 929
cell reproduction and, 37 Chronic migraine, 607 Circadian rhythm sleep disorder, Clitoris, 772
copy number variation in, 375–376 Chronic mucocutaneous 505 CLL. See Chronic lymphocytic
deletion of, 148–149 candidiasis, 285 Circadian rhythms, 420, 495–496 leukemia (CLL)
diseases associated with Chronic myelogenous leukemia Circle of Willis, 467, 468f Cloaca, 1376
aberrations of, 143–151 (CML), 1020 Circulation Cloacal exstrophy, 1380
epigenetic modulation and, 408f morphologic aspects of cells in, bronchial, 1229–1231 Clomipramine, depression treated
gene identification on, 159–163 1022f collateral, 1091–1092 with, 652b
homologous, 142 statistics on, 1015t coronary, 1090, 1091f, 1117–1118 Clonal deletion, 240
karyotype of, 145f Chronic myeloproliferative enterohepatic, 1411 Clonal expansion, 373
linkage analysis of, 159–163 disorder (CMPD), 1003 fetal, 1196–1198, 1197f Clonal proliferation, 373, 373f
locus assignment to, 160–163 Chronic obstructive pulmonary heart structure and, 1085–1090 Clonal selection, 226, 226f, 236–237,
mutation of, 149f disease (COPD), 1263, maternal, DNA analysis of, 136b 237t, 241–251
structure of, 145f 1266–1271 postnatal, 1198 B-cell, 248f
translocation of, 375–376 air trapping in, 1269f pulmonary, 1229–1243 cancer and, 373
X, 156 nutrition and, 1269b systemic, 1083–1085, 1106–1118 Tc cell, 250f
Y, 157 pathogenesis of, 1268f transitional, 1196–1198 Clonazepam
Chromosome 18, depression and, respiratory acidosis caused by, Circulatory system, 1083–1085 obsessive-compulsive disorder
647–648 129 diagram of, 1084f, 1104f–1105f treated with, 657
Chromosome 22, depression and, sleep disorders associated with, Circumcision, penile disorders and, panic disorder treated with, 655
647–648 506 889 Clonic phase
Chromosome band, 142–143 Chronic orthostatic hypotension, Circumflex artery, 1090–1091 definition of, 555t
Chromosome breakage, 148 1140 Cirrhosis, 68, 85, 1460–1463 seizures and, 553
Chromosome theory of inheritance, Chronic otitis media, 517 ascites caused by, 1453, 1454f Clonorchis sinensis, cancer associated
152 Chronic pain, 492–494, 493t causes of, 1460b with, 423t
Chronic active hepatitis, 1459–1460 Chronic pain syndrome, 492–494 clinical manifestations of, 1461, Clopidogrel, stroke treated with,
Chronic angle-closure glaucoma, Chronic pancreatitis, 1466 1462f 599–601
types of, 511t Chronic paroxysmal hemicrania evaluation and treatment of, 1461 Closed fracture, 1541
Chronic bacterial prostatitis (CPH), 609 example of, 1461f Closed (blunt) trauma, 582
(CBP), 900 Chronic pericarditis, 1164 hepatorenal syndrome associated Clostridium botulinum, 304t–305t,
Chronic bronchitis, 1267–1268 Chronic postoperative pain, 493 with, 1456–1457 309–310
clinical manifestations of, 1269t Chronic prostatitis/chronic pelvic pathophysiology of, 1460–1461 Clostridium difficile, 304t–305t,
pathogenesis of, 1268f pain syndrome (CPPS), 900 pediatric, 1502 309–310, 1500
1762 INDEX

Clostridium perfringens, 304t–305t, Coccidioides immitis, 312t Colon, 1407 Compensated shock, pediatric,
309–310 Coccidioidomycosis, meningitis bacteria in, 194 1699
Clostridium tetani, 303, 304t–305t caused by, 611 diverticular disease of, 1444–1445 Compensation
Clotting cascade Cochlea, 515 neoplastic lesions in, 373 for acid-base changes, 127f
arterial thrombosis and, Cochlear nerve, 515 Colonization carbonic acid-bicarbonate
1142–1143 Codominance, genetic, 151 bacterial infection and, 303–306 buffering and, 124–125
shock and, 1670 Codon fungal, 311–312 for metabolic acidosis, 128f
Clotting factor description of, 137 of microorganisms, 300–301 for metabolic alkalosis, 129f
blood tests for, 976t–977t termination, 137 viral, 317–319 for respiratory acidosis, 131f
coagulation and, 946–947 Cognitive-behavioral therapy (CBT) Colony-stimulating factor, 958 for respiratory alkalosis, 131f
defects of, 1042 obsessive-compulsive disorder clinical uses of, 959 Compensatory growth, urinary tract
description of, 1070t treated with, 657 effects of, 959f obstruction and, 1342
function of, 969–970 panic disorder treated with, Colony-stimulating factor-1, Compensatory hyperplasia, 52–53,
Clotting factor disorders, 1070t 654–655 385–386 218
Clotting system, 199–201, 200f, 969 schizophrenia treated with, 647 Color blindness, 512 Compensatory hypertrophy, 1342
description of, 970 Cognitive-evaluative system, 487 Color vision, alterations in, 512 Competitive inhibitor, 31
disseminated intravascular Cognitive function Colorectal cancer, 1467t, Complement
coagulation and, 1044 areas of brain and, 535f 1468–1472 bacterial evasion of, 309
illustration of, 971f iron and, 661b carcinogenic agents associated burn injury and, 1693
Clozapine, schizophrenia treated Cognitive network deficit with, 404t–407t defects of, immune deficiency
with, 646–647, 646b description of, 539f–540f clinical manifestations of, 1471 and, 282t
Clozaril. See Clozapine manifestations of, 541t conditions confused with, 1472t glomerulonephritis and, 1381
CLP. See Cleft lip and/or palate; Cognitive system development of, 1470f hypersensitivity reaction effect
Cleft palate (CLP) alterations in, 527–555 DNA methylation and, 186 on, 269–270
Clubbing deficits of, 538, 539f–540f genetic factors associated with, multiple organ dysfunction
cystic fibrosis and, 1312 Cogwheel rigidity, 567 174 syndrome and, 1680–1682
description of, 1250 Colchicine, gout treated with, hereditary nonpolyposis, 174 parasitic evasion of, 315
example of, 1251f 1578 inheritance of, 379–380 viral evasion of, 320
Clubfoot, 1596–1597 Cold, skin injury from, 1646 pathogenesis of, 1469–1472 Complement cascade, 197
bilateral, 1596f Cold agglutinin autoimmune pedigree of, 379f activation of, 198f
concordance rates for twins for, hemolytic anemia, 998 physical activity and prevention complement defects and, 287f
170t Cold autoimmune hemolytic of, 422 Complement deficiency, 284,
idiopathic, 1596f anemia, 280 risk factors for, 1468b 287–288, 287f
prevalence rate of, 171t Cold hemolysin autoimmune signs and symptoms of, 1471f Complement protein C1, 197
recurrence risk for, 169t hemolytic anemia, 998–999 staging of, 1471 Complement protein C2, 197
Cluster breathing, 530t, 532 Cold shock, 76b, 1709 survival rates for, 394t Complement protein C3, 197, 1381
Cluster headache, 607t, 608–609 Colipase, fat emulsification and, ulcerative colitis and, 384 Complement protein C4, 197
Cluster of differentiation, 227–228 1402–1404 Columnar cell, 40, 41t–42t Complement protein C5, 197
CML. See Chronic myelogenous Colitis Coma Complement protein C1 esterase
leukemia (CML) diarrhea cause by, 1426 arousal and awareness in, 535t inhibitor, 201
CMPD. See Chronic ulcerative, 1440–1442 definition of, 529t Complement receptor, 202
myeloproliferative disorder Collagen irreversible, 534 Complement system, 197–199,
(CMPD) articular cartilage and, 1522–1523 neurologic death and, 533 200f
CMV. See Cytomegalovirus bone, 1523 Combination therapy, chronic Complementary base pairing, 137
CNP. See C-type natriuretic peptide bone matrix and, 1515 leukemia treated with, 1023 Complementary-determining
(CNP) bone tissue and, 1511 Combined T- and B-cell defect, region, 231–232
CNS. See Central nervous system cartilage, 1523 immune deficiency and, 282t Complete atrioventricular septal
(CNS) effects of aging on, 1536 Combined T- and B-lymphocyte defect (CAVC), 1206–1207
CO. See Carbon monoxide (CO); extracellular matrix and, 17 deficiency, 284–287 Complete blood count (CBC), 292
Cardiac output (CO) function of, 1512t Comedone Complete fracture, 1541, 1542t
CO2. See Carbon dioxide (CO2) scleroderma and, 1639 clinical manifestations of, 1625t Complete precocious puberty, 803b,
COA. See Coarctation of the aorta synthesis, osteogenesis imperfecta description of, 1653–1654 804, 887
(COA) and, 1598 Comminuted fracture, 1541 Complex febrile seizure, 679
Coagulation cascade, 199–201, 199f, synthesis of, scar formation and, Commissural fiber, 457 Complex motor performance,
1142–1143 1722 Common bile duct, 1411 alterations in, 574
Coagulation disorders, 1037–1053 types of, 1516t Common bundle, 1093 Complex regional pain syndrome
pediatric, 1070–1074 wound healing and, 216–219 Common variable immune (CRPS), 494–495
Coagulation factor, 970t, 1070t Collagen fiber, 40–41, 1516 deficiency, 285 Compliance, lung distention and,
Coagulation system, 969 in articular cartilage, 1523 Communicability, pathogenic, 302 1236
Coagulative necrosis, 90 in cartilage matrix, 1524–1525 Communicating hydrocephalus Complicated hypertension,
Coal miner lung, 1259 heterotypic, 1525f (nonobstructive), 558 1136–1140
Coal worker pneumoconiosis, 1259 Collagen matrix, impaired, 219 Communicating pneumothorax, Complicated plaque, 1147
Coanal atresia, 1300 Collagen zone, 1524f 1254 Complicated urinary tract
Coarctation of the aorta (COA), Collagenic (collagen-forming) Community-acquired methicillin- infection, 1349–1350
1210–1212, 1211f tumor, 1564 resistant Staphylococcus Compound fracture, brain injury
clinical manifestations of, 1212 Collateral artery, 1091–1092 aureus (CA-MRSA) infection, from, 586
evaluation and treatment of, 1212 Collateral ganglion, 470 1634, 1635b Compression, injury caused by, 82
hemodynamics of, 1211f Collectin, 194 Community-acquired pneumonia Compression atelectasis, 1256
with patent ductus arteriosus, Collecting duct, kidney, 1323 (CAP), 1306 Compressive syndrome, 633–634
1211f Colliculi, 459 Compact bone, 1517, 1518f Computed tomography (CT)
pathophysiology of, 1210–1212 Colloid, pediatric fluid therapy Compartment disorder, bone function evaluated with,
Coated pits, 35 with, 1711 amenorrhea and, 805 1535
Cobalamin replacement therapy, Colloid osmotic pressure, 30–31 Compartment syndrome breast cancer associated with, 856
988–989 Colloid replacement, pediatric pathogenesis of, 1549f cardiac function evaluated with,
Cocaine (crack), description and burn injury treatment with, symptoms of, 1550 1121
effects of, 72t–73t 1718–1719 Compazine. See Prochlorperazine childhood cancer and, 445b
 INDEX 1763

Computed tomography (Continued) Conivaptan, 719 Copy number variation Corticosteroids (Continued)
gastrointestinal tract evaluated Conjugated bilirubin, 1411–1412 chromosomal, 375–376 epiglottitis treated with, 1297
with, 1415 Conjunctiva, 507 schizophrenia and, 642b glomerulonephritis treated with,
issues associated with, 426b–427b Conjunctivitis, 304t–305t, 507–508 Cor pulmonale, 1181, 1181f, 1277f, 1357
osteoporosis evaluated with, Conn disease, 755 1278 hemolytic anemia treated with,
1555–1556 Connective tissue, 40–41 Cornea 1000
radiation exposure from, 425, autoimmune disorders of, description of, 508 nephrotic syndrome treated with,
426b–427b, 427f 264t–265t effects of aging on, 510t 1359, 1385t
of skull and spine, 478 cardiac, 1086 Corner metaphyseal fracture, 1613 respiratory distress syndrome
spinal, 478 diseases of, pediatric, 1604t Cornification, 781 treated with, 1301–1302
systemic circulation evaluated extracellular matrix and, 17–18 Coronary angiography, 1122 septic shock treated with,
with, 1122 phagocytosis and, 210f Coronary artery, 1090–1091 1678–1679
Concentration gradient, 29 types of, 42t–44t Coronary artery calcification Corticotropin-releasing hormone
Concept disorder, 542t Connexin, 1092 (CAC), 1153 (CRH), 696–697
Concordant trait, 169–170 Connexon, 18–20, 19f Coronary artery disease (CAD), effects of, 353t
Concussion Consanguinity, 154–156 1148–1153 female reproductive system and,
classic cerebral, 588 Consciousness diabetes mellitus and, 751 352f
mild, 587 altered, 529t lipoprotein genes contributing fever and, 498
Conditional response, stress definition of, 527 to, 176t immune system affected by,
response and, 341 eye movement and, 531t prevalence of, 172t 348–349
Conducting artery, 467 level of, 529 risk factors for, 1149, 1152–1153 loss of, 719f
Conduction, heat loss by, 497 hypovolemic shock and, 1705 sleep disorders associated with, stress response and, 343
Conduction dysphasia, 543t–544t pediatric shock and, 1700–1701 506 Cortisol
Conduction system, 1092–1095 pupil appearance and, 531f stress and, 342t aging and, 712
Conductive hearing loss, 517 loss of (See Loss of Coronary capillary, 1092 Cushing disease and, 754
Condylomata, 890 consciousness) Coronary circulation, 1091f, effects of, 346t
Condylomata acuminata, Consolidation, abscess formation 1117–1118 immune system and, 348–350
935f–936f, 936, 1637 and, 1274 Coronary heart disease (CHD) multiple organ dysfunction
Condylomata lata, 924–925, 925f Constipation, 1424–1425 genetic factors associated with, syndrome and, 1683
Cones, description of, 508 clinical manifestations of, 1425 171–172 osteoporosis and, 1552
Confusion, definition of, 529t evaluation and treatment of, 1425 ischemia-reperfusion injury and, secretion of, 707–708
Congenital acholuric jaundice, 1062 intestinal obstruction as cause of, 58b sleep affected by, 503
Congenital adrenal hyperplasia, 1433–1434 psychosocial stress and, 354b stress response and, 340f, 346–349
752 pathophysiology of, 1424–1425 Coronary ostia, 1090 Corynebacterium diphtheriae,
Congenital aganglionic megacolon, Constrictive pericarditis, 1164, 1165f Coronary perfusion pressure, 1117 304t–305t, 309
1491–1492 Consumptive Coronary sinus, 1090 Costal cartilage, 1520
Congenital foot deformity, thrombohemorrhagic Coronary sulcus, 1090–1091 Cotswold staging classification
1595–1596 disorder, 1043–1048 Coronary vein, 1092 system, 1025–1026, 1026t
Congenital glaucoma, types of, 511t Contact burn, 1715 Coronavirus, description of, 318t Cough, 1249
Congenital heart defect Contact-dependent signaling, 20 Corpora cavernosa, 787 acute, 1249
classification of, 1199–1202, 1201t Contact dermatitis, 273, 274f Corpora quadrigemina, 459 asthma indicated by, 1309
disorders coexistent with, 1200t Contact guidance, 39 Corpus, uterine, 774–775 chronic, 1249
environmental factors associated Contact inhibition, cancer cell Corpus callosum (commissural foreign body aspiration as cause
with, 1199t development and, 368 fibers), 457 of, 1298
genetic factors associated with, Content of thought, 535 Corpus luteum, 776 upper airway obstruction
1200t Continuous positive airway pressure abnormal uterine bleeding and, associated with, 1294
in infant and child, 1198–1218 (CPAP), 1302–1303 808 Cough reflex, 1249
mixing defects in, 1214–1218 Continuous renal replacement cysts of, 821 Countercurrent exchange system,
obstructive, 1210–1214 therapy (CRRT), 1363–1364 Corpus spongiosum, 787 1331–1332, 1332f
prevalence rate of, 171t Contractility, pediatric, 1703t Corpus striatum, 457 Coup injury, 583, 584f
Congenital heart disease. See also Contraction Correction Coupling, muscle contraction and,
Heart disease impaired, 220 carbonic acid-bicarbonate 1533
classification of, 1199–1202 muscle, 1533–1534 buffering and, 124–125 Cowper gland, 789
heart failure associated with, wound healing and, 216, 218 for metabolic acidosis, 128f COX-1. See Cyclooxygenase
1201t Contracture, 1578 for metabolic alkalosis, 129f (COX-1)
pediatric, 1198–1218 burn injury and, 1693 for respiratory acidosis, 131f Coxsackievirus, 318t, 610t
Congenital hemolytic anemia, wound healing and, 220 for respiratory alkalosis, 131f CP. See Cerebral palsy (CP)
1062, 1068b Contralateral control, 456–457 Corrigan pulse, 1169–1170 CPA. See Chronic pulmonary
Congenital hip dislocation, Contrecoup injury, 583, 584f Cortex, kidney, 1320 aspiration (CPA)
recurrence risk for, 169t Contusion Cortical association area, attention CPAP. See Continuous positive
Congenital hydrocephalus, brain, 583 deficit and, 539f–540f airway pressure (CPAP)
668–670 cerebral, 584f Cortical bone, 1517, 1555f CPH. See Chronic paroxysmal
Congenital hypothyroidism, 731 clinical manifestations of, 584 Cortical development, hemicrania (CPH)
Congenital malformation, 171 description of, 79t malformations of, 667–670 CPPS. See Chronic prostatitis/
Congenital nephrotic syndrome Conus, description of, 1215 Cortical dysplasia, 668 chronic pelvic pain syndrome
(Finnish type), 1384 Conus medullaris, 460, 461f Corticobulbar pathway, 463–464 (CPPS)
Congenital nipple inversion, 842t Convection, heat loss by, 497 Corticospinal tract, 456–457 CPT. See Carnitine
Congenital syphilis (CS), 924–925 Convergence, nervous system Corticosteroid-binding globulin, 346 palmitoyltransferase (CPT)
Congenital varicella syndrome, processing and, 448 Corticosteroids Crab louse, 939f
1660 Convertase, 197 asthma treated with, 1266 Cradle cap, 1629
Congestive heart failure (CHF), Cooley anemia, 1069 croup treated with, 1296 Cranial meningocele, 664
1175–1181. See also Heart Coombs test, 1060–1061 cystic fibrosis treated with, 1312 Cranial nerve, 447–448, 469, 471f,
failure (HF) Coping Duchenne muscular dystrophy 472t
pediatric, 1200–1202 definition of, 357 treated with, 1607–1608 description of, 472t
prevalence of, 172t stress response influenced by, emphysema treated with, meningitis as cause of damage
Congestive splenomegaly, 1036 355–358 1270–1271 to, 612
1764 INDEX

Cranial nerve palsy, 572, 572t Cryptococcus neoformans, 312t Cyst (Continued) Cytoplasm, 2, 3f, 83
Cranial suture, in infant, 663f Cryptogenic epilepsy, 553 corpus luteum, 821 Cytoplasmic matrix, 4
Cranial tumor, 626–632 Cryptorchidism, 443t, 892–894 dermoid, 821 Cytosine, 136, 138f–139f, 141, 142f
Craniopharyngioma, in child, Cryptosporidium parvum, 314t, 1500 example of, 1620t–1622t Cytoskeleton, 9–11
681t–682t, 683 Crypts of Lieberkühn, 1401 exudate associated with, 213 Cytosol, 4, 8–9
Craniosacral division, Crystalline fragment, 230–231 follicular, 820–821 Cytotoxic (metabolic) edema, 558
parasympathetic nervous Crystallization, kidney stone ovarian, 820–821, 820f Cytotropic antibody, 263–265
system and, 473 formation and, 1343 Cystatin C, 1335, 1362–1363
Craniostenosis, 667f Crystalloid, pediatric fluid therapy Cystic acne, 1620t–1622t, 1654f D
Craniosynostosis, 666–667, 667f with, 1711 Cystic duct, 1413 D cell, gastric secretions and, 1398
Cranium, 464 Crystals, urinary, 1336 Cystic fibrosis (CF), 155f, 1310– D-dimer, 973
Creatine kinase CS. See Congenital syphilis (CS) 1313, 1494 deep venous thrombosis and, 1131
muscle contraction and, 1532t CSF. See Cerebrospinal fluid (CSF) clinical manifestations of, 1312, disseminated intravascular
muscle mass measured with, 1532 CSF1 response, 870 1495t coagulation diagnosis and,
Creatinine, muscle mass measured Cuboidal bone, 1518 complications of, 1495t 1047
with, 1532 Cuboidal cell, 40, 41t–42t evaluation and treatment of, DAG. See Diacylglycerol (DAG)
Creatinine clearance, 1334, Cul-de-sac, female genitalia and, 1312–1313 Damage-associated molecular
1366–1367, 1366t 773 lung pathology in, 1311f pattern (DAMP), 202
Creatinine concentration Curling ulcer, 1439 meconium ileus associated with, Danazol
acute kidney injury diagnosis Cushing disease, 753–755, 754f 1490 endometriosis treated with,
with, 1362–1363 Cushing syndrome, 347–348, 347b, nutritional problems in, 1312, 824–825
glomerular filtration rate and, 395t, 753–755, 754f 1313b mastalgia treated with, 842t
1367f Cushing ulcer, 1439 pathogenesis of, 1311f Dandy-Walker malformation, 669
Cretinism, 731, 731f Cutaneous melanoma, 1643–1644, pathophysiology of, 1310–1313, Dantrolene, malignant
Creutzfeldt-Jakob disease 1644t 1495t hyperthermia treated with,
clinical differentiation of, 547t Cutaneous systemic vasculitis, screening for, 1312 1549
molecular basis for, 547t 1638 Cystic fibrosis gene, 1310 Dark adaptation, 510
CRH. See Corticotropin-releasing Cutaneous vascular malformation, Cystic fibrosis transmembrane DASH diet, hypertension treated
hormone (CRH) 1662–1664 conductance regulator with, 1139–1140
Cri du chat syndrome, 148–149, Cutaneous vasculitis, 1638–1639 (CFTCR) protein, 1310–1311 DAT. See Dementia of Alzheimer
149f CVA. See Cerebrovascular accident Cystinuric stone, 1344 type (DAT)
congenital heart defect associated (stroke syndrome) Cystitis Data processing deficit, 539–550
with, 1200t CVP. See Central venous pressure acute, 1350–1351 Daughter cell, 37
pathophysiology of, 671t (CVP) nonbacterial infectious, 1351 Dawn phenomenon, 746
Crick, Francis, 136 CVS. See Cerebral vasospasm; noninfectious, 1351 DCI. See Delayed cerebral ischemia
Cricopharyngeal muscle, 1395 Chorionic villus sampling pediatric, 1387 (DCI)
Crista ampullaris, 515 (CVS) urinary tract infection and, DCIS. See Ductal carcinoma in situ
Crista supraventricularis, 1089 CVT. See Chronic venous 1349–1350 (DCIS)
Cristae, 8, 9f insufficiency (CVT) Cystocele, 818–819, 819f DDD. See Degenerative disk
Crohn disease (CD), 1442–1444 CXCL12-abundant reticular cell, Cystometric test, 1346 disease (DDD)
clinical manifestations of, 1443 956 Cytochrome, 28 DDH. See Developmental dysplasia
colorectal cancer confused with, Cyanide, asphyxiation from, 74 Cytochrome P-450, selective of the hip (DDH)
1472t Cyanosis serotonin reuptake inhibitors DDR. See DNA damage response
diarrhea cause by, 1426 description of, 1250 and, 652 (DDR)
distribution patterns of, 1441f heart defects associated with, Cytokine, 203–205, 212–213 De Quervain thyroiditis, 729
evaluation and treatment of, 1444 1202 bone fracture and, 1541–1542 Deafferentation pain syndrome,
example of, 1443f Cyclic adenosine monophosphate bronchopulmonary dysplasia 494
features of, 1443t (cAMP), 23, 694 and, 1304 Deamination, 1412–1413
pathophysiology of, 1442–1444 cell responses mediated by, 25t burn injury and, 1692 Death
Cross-bridge cycle of muscle as second messenger, 24f, 694t cell reproduction and, 38–39 causes of, in United States, 1130t
contraction, 1099, 1101f Cyclic guanosine monophosphate cystic fibrosis and, 1311–1312 chronic obstructive pulmonary
Cross-bridge theory, 1533 (cGMP), 23–25, 694, 694t effects of, on skeletal tissues, 1515t disease as cause of,
Cross-reactive antibody, 275 Cyclic neutropenia, 289 function of, 236t 1266–1267
Crossing over, genetic results of, Cyclooxygenase (COX-1), 969 heart failure and, 1178 injury as cause of, 70
159, 159f Cyclophosphamide, 396 multiple organ dysfunction myocardial infarction as cause
Croup, 1294–1296 chronic leukemia treated with, syndrome and, 1680 of, 1163
clinical manifestations of, 1295 1023 pediatric septic shock and, 1707 sepsis as cause of, 1675
description of, 1296t glomerulonephritis treated with, proinflammatory, septic shock somatic, 97–100
evaluation and treatment of, 1357 and, 1675 Death rate, statistics on, 71f
1295–1296 nephrotic syndrome treated with, psoriasis and, 1629 Débridement, 216
pathophysiology of, 1295–1296 1359 receptors for, 235–236 Decerebrate posture, 534f, 534t, 575
upper airway obstruction and, Cyclosporine rheumatoid arthritis and, Declarative memory, 536
1296f aplastic anemia treated with, 996 1569–1570 Decompression sickness, 77–78
Crouzon syndrome, 1486 myasthenia gravis treated with, stress response and, 348 Decornification, 781
CRPS. See Complex regional pain 626 superantigen and, 251 Decorticate posture, 534f, 534t,
syndrome (CRPS) rheumatoid arthritis treated with, type 2 diabetes mellitus and, 574–575
CRRT. See Continuous renal 1572 739–741 Decreased libido, 834
replacement therapy (CRRT) ulcerative colitis treated with, Cytokinesis Decreased urine formation, 113–114
Crush injury, brain injury from, 1442 cell reproduction and, 37 Decubitus ulcer, 1625, 1626f
586–587 Cylindrical bronchiectasis, phases of, 37 Deep brain stimulation, 652, 657
Crush syndrome, pathogenesis of, 1256–1258, 1257f Cytomegalovirus infection, 318t, Deep partial-thickness burn, 1686,
1549f Cymbalta. See Duloxetine 320, 617 1687f
Cryoglobulin, 270 Cyst central nervous system diseases Deep venous thrombosis (DVT),
Cryoprecipitate, hemophilia treated benign ovary, 820–821 caused by, 610t 1041, 1130–1131
with, 1072 bone, pediatric, 1609–1610 Cytomegalovirus retinitis, example pulmonary embolism caused by,
Cryptococcosis, 312t, 611 breast, 838–839 of, 328f 1275
 INDEX 1765

Defecation reflex, 1408 Deoxyribonucleic acid (DNA). See Developmental dysplasia of the hip Diabetes mellitus (Continued)
Defective class-switch, 284 DNA (deoxyribonucleic acid) (DDH), 1594–1595 genetic factors associated with,
Defensin, 193 Depolarization clinical manifestations of, 1595 177–178
Degenerative disk disease (DDD), cardiac action potential and, evaluation and treatment of, 1595 glucocorticoids and, 347b
594–596 1094 pathophysiology of, 1594–1595 pathophysiology of, 739–741,
Degranulation, 206–207, 206f cellular transport and, 36 Developmental plasticity, 410 740f
Dehiscence, 220 myocardial cell, 1094 Devic disease, 620 type 1 compared to, 177t
Dehydration, 112 Depomedroxyprogesterone acetate, Dexamethasone, multiple myeloma types of, 735–743
diarrhea as cause of, 1499 endometriosis treated with, treated with, 1034 Diabetic ketoacidosis (DKA), 738,
hypovolemia and, 1704t 824–825 Dextran, iron deficiency anemia 744–745, 745f
hypovolemic shock associated Depression, 647–654 treated with, 991 Diabetic nephropathy, 747–749,
with, 1704–1705 clinical manifestations of, DGI. See Disseminated gonococcal 1357–1358
intestinal obstruction as cause of, 650–651 infection (DGI) Diabetic neuropathy, 749–751
1431–1432 dementia associated with, 568 DHT. See Dihydrotestosterone classification of, 751t
severity of, 1705t etiology and pathophysiology of, (DHT) pathogenesis of, 750f
water balance and, 109 647–650 DI. See Diabetes insipidus (DI) Diabetic retinopathy, 747
Delayed cerebral ischemia (DCI), medications for, 652b Diabetes example of, 749f
606 neuroanatomic and functional atherosclerosis associated with, findings in, 749t
Delayed hypersensitivity reaction, abnormalities associated 1145 pathophysiology of, 748f
263 with, 650 sexual function impacted by, Diacylglycerol (DAG), 694, 694t
Delayed hypersensitivity skin test, prevalence of, 172t 834t Diagnosis
270 risk factors for, 653b Diabetes insipidus (DI), 719–720 prenatal, genetic testing and, 136b
Delayed union, following bone symptoms of, 647b clinical manifestations of, 720 presymptomatic, genetic testing
fracture, 1543 treatment of, 651–652, 653b evaluation and treatment of, 720 for, 136b
Deletion, chromosomal, 148–149, Depth of injury, burn assessment pathophysiology of, 720 Diagnostic and Statistical
149f and, 1716 Diabetes mellitus (DM), 734–752 Manual of Mental Disorders
Delirium, 542 Dermal appendage, 1618 acute complications of, 743–746 (DSM-IV-TR)
autonomic nervous system and, Dermal ischemia, burn injury characteristics of, 734t–735t anxiety disorders in, 654
545 associated with, 1717 chronic complications of, schizophrenia and, 644
dementia compared to, 545t Dermatitis, 1627 746–752 Diamond-Blackfan anemia,
Delta cell, islets of Langerhans and, allergic contact, 1627–1628 classification of, 734t–735t childhood leukemia associated
703–704 atopic, 273, 1628 concordance rates for twins for, with, 1075–1076
Delta-storage pool disease, 1042 contact, 273, 274f 170t Diapedesis, 209
Delusion, schizophrenia and, 645b, example of, 1620t–1622t coronary artery disease and, 1151 Diaper dermatitis, 1655, 1655f
646 pediatric, 1654–1655 diabetic ketoacidosis associated Diaphragm
Demeclocycline, syndrome of seborrheic, 1629 with, 744t breathing and, 1231
inappropriate antidiuretic stasis, 1628 diagnosis of, 735b description of, 1225
hormone secretion treated substances causing, 1628b epidemiology and etiology of, Diaphyseal fracture, 1541
with, 719 Dermatitis herpetiformis, 1497 736t Diaphysis, long bones and,
Dementia, 545–546 Dermatome, spinal nerves and, 469 foot lesions caused by, 753f 1517–1518
causes of, 546b Dermatomyositis, 1584–1585 genetic factors associated with, Diarrhea, 1425–1426, 1499–1500
cognitive-affective symptoms cancers associated with, 395t 174–178 bacterial causes of, 1500
and, 568 pediatric incidence of, 1604t hypoglycemia associated with, clinical manifestations of, 1426
degenerative Dermatophyte, 311, 1637, 1657 744t Crohn disease as cause of, 1443
clinical differentiation of, 547t Dermis, 1617–1618, 1618t incretin-based therapy for, 741b evaluation and treatment of, 1426
molecular basis for, 547t Dermoid cyst, 821 kidney affected by, 748 gastrointestinal bleeding and,
delirium compared to, 545t DES. See Diethylstilbestrol (DES) prevalence of, 172t 1428
evaluation and treatment of, 546 Descending colon, 1407, 1471f recurrence risk of, 174–177 gluten-sensitive enteropathy and,
human immunodeficiency virus- Descending modulation of pain, type 1, 734–739 1497
related, 616t 489 clinical manifestations of, intestinal obstruction as cause of,
pathophysiology of, 546 Descending pathway, 447–448, 490f 737–738 1433–1434
Dementia of Alzheimer type Desensitization, mechanism of, 273 concordance rates for twins pathophysiology of, 1425–1426
(DAT), 546–550 Desipramine, depression treated for, 170t Diarthrosis (freely movable joint),
Dementia with Lewy bodies with, 652b environmental factors and, 1520
clinical differentiation of, 547t Desmin, muscle contraction and, 735–737 Diastole
molecular basis for, 547t 1532t epidemiology and etiology of, cardiac action potentials and,
Demyelinating disorder, 618–621 Desmoid-type fibromatosis (DTF), 736t 1092
Demyelinating polyneuropathy, 870 evaluation and treatment of, definition of, 1088
621–622 Desmoplastic stroma, 870 738–739 Diastolic depolarization, 1095
Dendrite, in central nervous system, Desmosome, 3f, 18–20, 19f genetic factors associated with, Diastolic heart failure, 1180–1181,
448 Desvenlafaxine, depression treated 174–177 1180t
Dendritic cell, 201–202 with, 652b genetic susceptibility to, 735 DIC. See Disseminated
antigen presentation by, 243, 243f Desyrel. See Trazodone pathophysiology of, 735, 740f intravascular coagulation
monocyte and, 950 Detection, awareness alterations type 2 compared to, 177t Diencephalon, 457–459
as target of human and, 538 viruses and, 736b Diet
immunodeficiency virus, Detection deficit, 538, 541t type 2, 734, 739–742 Alzheimer disease and, 549b
325 Detrusor areflexia, 1345 chronic hyperglycemia and, breast cancer and, 858–860
Dendritic zone, in central nervous Detrusor hyperreflexia, 1345 740f cancer caused by, 403f, 414–423
system, 448 Detrusor hyperreflexia with clinical manifestations of, 741, cancer prevention and, 414f
Dengue virus, 318t vesicosphincter (detrusor 742t diverticular disease and, 1444b
Denosumab, osteoporosis treated sphincter) dyssynergia, 1345 concordance rates for twins immune system affected by,
with, 1556 Detrusor muscle, 1325 for, 170t 290–291
Dent disease, 1582 Detrusor sphincter dyssynergia, epidemiology and etiology of, in pregnancy, cancer
Dental amalgam, mercury in, 69 1346–1347 736t development and, 410
Denticulate ligament, 465 Developing fetus, formation of, evaluation and treatment of, premenstrual syndrome and,
Deoxyhemoglobin, 961 768 741–742 813b
1766 INDEX

Diet (Continued) Diplegia, 568–569 Distal internal obstruction Dopamine (Continued)

prostate cancer and, 901, 902b Diploid cell, 142 syndrome (DIOS), 1490 restless leg syndrome and,
type 2 diabetes mellitus treatment Diplopia, 509–510 Distal symmetric polyneuropathy, 505
and, 742 Dipsogenic diabetes insipidus, 720 750 septic shock treated with,
Dietary Approaches to Stop Dipyridamole, stroke treated with, Distal tubule, urinary tract 1678–1679
Hypertension, 1139–1140 599–601 obstruction as cause of damage shock treated with, 1714t
Dietary fat, breast cancer and, Direct effects of hormones, 695 to, 1342 synthesis of, 459, 710f
858–859 Discoid (cutaneous) lupus Distributive shock, definition of, Dopamine D2-receptor blocking
Diethylstilbestrol (DES) erythematosus (DLE), 1632, 1700 drugs, 646–647
cancer associated with, 410, 854t 1633t Disuse atrophy, 50, 1581 Dopamine hypothesis,
childhood cancer associated with, Discordant trait, 169–170 Diuretics schizophrenia and, 643
445 Disease action of, 1333t Dopamine system, 644f
uterine abnormalities associated autoimmune, 275b description of, 1333 Dopaminergic nigrostriatal
with, 801 chromosome aberrations and, Diver disease, 77–78 pathway, 564–566
Differentiation, cell function and, 143–151 Divergence, nervous system Doppler ultrasonography, 1122
2 congenital, 171 processing and, 448 Dormancy, metastasis and,
Diffuse axonal injury (DAI), 582t, epigenetic, treatment of, 186 Diverticular disease, 1444–1445 390–392
587–588, 587f epigenetics and, 183–190 Diverticulitis, 1444–1445, 1472t Dorsal column, 462
Diffuse brain injury, 587–588 factors influencing incidence of, Diverticulosis, 1431t, 1444–1445 Dorsal horn, 460–461
Diffuse noxious inhibitory controls 164–165 Diving response, 76b Dorsal root ganglion, 460–461,
(DNIC), 489 genes and environment and, Dizygotic twin, 169 461f
Diffuse papillomatosis, 839–840 164–182 DKA. See Diabetic ketoacidosis Dorsolateral prefrontal cortex
Diffusing capacity, 1243 genetic (See Genetic disease) (DKA) (DLPFC), 643
Diffusion genetics of, 171–182 DLE. See Discoid (cutaneous) lupus Dosage compensation, 156
across alveolocapillary incidence of, 164–165 erythematosus (DLE) Double-helix
membrane, 1240 infectious (See Infectious DLPFC. See Dorsolateral prefrontal DNA composition and, 136
facilitated, 31–32 disease) cortex (DLPFC) example of, 138f
passive transport and, 29, 29f multifactorial DMARD. See Disease-modifying Double-strand break, 428, 856
Diffusion coefficient, 29 recurrence risks of, 167–168 anti-rheumatic drugs Down-regulation, hormone
DiGeorge syndrome, 281, 285, transmission patterns of, (DMARD) receptors and, 691–692
285f, 733 167–168 DMD. See Duchenne muscular Down syndrome, 146–147, 146f,
Digestion prevalence of, 164–165 dystrophy (DMD) 149–151
accessory organs of, 1409–1415 risk factors for, 165 DNA (deoxyribonucleic acid), acute leukemia associated with,
cell energy production and, 26 sexual dysfunction caused by, 136–142 1017
disorders of organs of, 1451–1466 834t antigen-binding molecule atrioventricular canal defect
intestinal, 1401–1402 stress and, 338–362 production and, 239f associated with, 1206–1207
pediatric, impairment of, stress-related, 342t in cell nucleus, 2 childhood cancer associated with,
1494–1499 telomeres and, 355b composition and structure of, 136 443t, 444
Digestive system virus as cause of, 318t genes composed of, 135 childhood leukemia associated
alterations of function of, Disease-modifying anti-rheumatic genetic code and, 137 with, 1075–1076
1423–1485 drugs (DMARD), 1572 immunoglobulin class-switch congenital heart defect associated
cancer of, 1466–1478 Disk and, 249 with, 1200t
hormones of, 1397t intervertebral, 466–467 ionizing radiation effect on, 80 maternal age as factor in, 147,
hyperglycemia effects on, 740f spinal, herniation of, 597–598, lymphocyte development and, 147f
neurotransmitters of, 1397t 597f 237 Doxepin, depression treated with,
structure and function of, 1 Dislocatable hip, 1594 mitochondrial, 61–62 652b
structures of, 1394f Dislocation mutation of, 137–141 Doxorubicin, multiple myeloma
tests of, 1415–1416 bone, 1544–1545 replication of, 137, 139f treated with, 1034
Digestive tract clinical manifestations of, 1544 structure of, 138f Doxycycline
cancer of, carcinogenic agents evaluation and treatment DNA acetylation, cancer and, 415 chlamydia treated with, 931
associated with, 404t–407t of, 1545 DNA damage response (DDR), 428 pelvic inflammatory disease
as closed barrier, 193f pathophysiology of, 1544–1545 DNA methylation, 183 treated with, 816b
Digital rectal examination, 899 Disorders of desire, sexual cancer and, 186, 403, 415, 415f DPT. See Diphtheria-pertussis-
Digoxin, heart failure treated with, dysfunction and, 834 gene silencing and, 378 tetanus vaccine (DPT)
1179–1180 Disorganized behavior, DNA polymerase, 137, 139f Dreaming, REM sleep and, 503
Dihydroergotamine, migraine schizophrenia and, 646 Dobutamine Dressler postinfarction syndrome,
headache treated with, 608 Disorganized speech, schizophrenia heart failure treated with, 1179 1162
Dihydrotestosterone (DHT), 791 and, 646 septic shock treated with, Driver mutation, cancer genetics
in prostate tissue, 906 Disorientation, definition of, 529t 1678–1679 and, 373
testosterone conversion to, 906f Displaced fracture, 1544f shock treated with, 1714t Drowning, 74–75
Dilated cardiomyopathy, 1165– Disruptive mood dysregulation Dolichocephaly, 667f Drug addiction, dopamine and,
1166, 1165f–1166f, 1166t disorder, 653–654 Dolichoscaphocephaly, 668f 460b
Diltiazem, action of, 1099–1101 Disse space, 1409–1410 Doll’s eyes phenomenon, 532f Drug efficacy, genetic testing for,
Dilutional hyponatremia, 113 Disseminated gonococcal infection Dominance, genetic, 151 136b
Dimorphic, 310–311 (DGI), 921–922 Donath-Landsteiner antibody, 999 Drug-induced hemolytic anemia,
Dimorphism, sideroblastic anemia Disseminated intravascular Donovan body, 928 999, 999f
and, 992 coagulation (DIC), 1043–1044 Donovanosis, 928–929 Drug-induced hyperthermia, 77
DIOS. See Distal internal antecedents to, 1044b Dopa, synthesis of, 710f Drug(s)
obstruction syndrome (DIOS) laboratory tests for diagnosis of, Dopamine anemia secondary to, 994t
Dipeptidyl peptidase IV, type 2 1047b action of, 474, 698t cellular injury caused by, 63–70
diabetes mellitus and, 741 pathophysiology of, 1044–1048, drug addiction and, 460b childhood cancer associated with,
Diphtheria 1045f movement alterations and, 561 445t
tissue damage in, 309 Distal axonal polyneuropathy, as neurotransmitter, 452, 453t, congenital heart defects
vaccination and reduction of, 330t 621–622 474–476 associated with, 1199t
Diphtheria-pertussis-tetanus Distal convoluted tubule, 1323, renal blood flow affected by, efficacy of, genetic testing for,
vaccine (DPT), 332–333 1331 1328t 136b
 INDEX 1767

Drug (s) (Continued) Dyspnea Edema (Continued) Electromyogram (EMG), 1535

prenatal exposure to, cancer and, description of, 1248–1249 nephrotic syndrome associated Electron-transport chain, 28
445 emphysema associated with, 1270 with, 1384 Electrophysiology studies, cardiac
social, 69–70 signs of, 1249 pathophysiology of, 105–107 function evaluated with, 1121
street, 69–70 Dyspnea on exertion, 1249 pitting, 107, 107f Elephantiasis, 314t
vasoactive, 1714t Dyspraxia, 575, 576t plasma leakage and, 195–196 ELISA. See Enzyme-linked
Dry gangrene, 91 Dysreflexia, 593 spinal cord injury and, 591 immunosorbent assay (ELISA)
DTF. See Desmoid-type Dysregulated apoptosis, 92 EEG. See Electroencephalograph Ellis-van Creveld syndrome,
fibromatosis (DTF) Dysrhythmia (EEG) congenital heart defects
Dual-photon absorptiometry description of, 1182 Effective osmolality, 30 associated with, 1200t
(DXA) myocardial infarction associated Effective renal blood flow (ERBF), Eltrombopag, immune
bone density measured with, 1535 with, 1162 1334–1335 thrombocytopenic purpura
osteoporosis evaluated with, pediatric, 1711b Effective renal plasma flow (ERPF), treated with, 1039
1555–1556 stress and, 342b 1334–1335 Embolic stroke, 599
DUB. See Dysfunctional uterine Dyssomnia, 504–505 Effector mechanism, immune Embolism, 1143–1144
bleeding (DUB) Dyssynergia, neurogenic bladder response and, 251–257 Embolus
Duchenne muscular dystrophy and, 1344–1345 Effector organ, innervation of, definition of, 1048, 1143
(DMD), 158, 1606t, 1607– Dystonia, 560–561, 560t, 574–575 447–448 gas, 77
1608. See also Muscular botulinum toxin for, 574b Efferent lymphatic vessel, 1119 ischemic injury associated with,
dystrophy (MD) Dystonic movement, 574–575 Efferent (motor) neuron, 462 56–57
clinical manifestations of, Dystonic posture, 574–575 Efferent pathway (descending stroke associated with, 599
1607–1608 Dystrophic calcification, 87 pathway), 447–448, 485 Embryo
evaluation and treatment of, Dystrophin, 158, 1607–1608 Efferent tubule, 785 disorders associated with stages
1608, 1609f Dysuria, urine flow obstruction Effexor. See Venlafaxine of, 662f
Ductal adenocarcinoma, 1474 and, 1346 Ehlers-Danlos syndrome, mitral external genitalia development
Ductal carcinoma in situ (DCIS), DZ. See Dizygotic twin valve prolapse associated with, in, 770f
364, 866–868 1170 formation of, 768
Ductal hyperplasia, 841 E Eisenmenger syndrome, 1202, 1205 internal genitalia development
Ductus arteriosus, 1196–1198 Ear Ejaculation, 787 in, 769f
Ductus deferens, 786 anatomy of, 514–515 Ejaculatory duct, 788 tumor in, 684
Dukes’ C colon cancer, 1472 infection of, 516–517 Ejection fraction Embryology, cardiovascular
Dukes’ D colon cancer, 1472 inner, 515, 516f cardiac output and, 1101 development and, 1194
Duloxetine, depression treated with, middle, 515 diastolic heart failure and, 1180 Embryonic hemoglobin, 1056
652b structure of, 515f heart failure and, 1175, Embryonic stem cell, 184, 958
Dumping syndrome, 1440 Eardrum, 514–515 1179–1180 Embryonic tumor, 443
Duncan disease, 1013 Early asthmatic response, 1264 in older adult, 1123t EMG. See Electromyogram (EMG)
Duodenal ulcer, 1435–1437, 1436f, Early dumping syndrome, 1440 Elastase, as digestive enzyme, 1402b Emission, of seminal fluid, 787
1437t Early stage disease, 327 Elastic artery, 1108 Emotional memory, 536
Duodenum, 1400 Eastern equine encephalitis virus, Elastic fiber, 40–41 Emphysema, 1268–1271
arterial supply to, 1401 encephalitis caused by, 615t Elastic recoil, 1236 alveoli affected by, 1270f
gastrinoma of, 1438 Eating behavior, hormonal Elastin, 17, 18f clinical manifestations of, 1269t,
obstruction of, pediatric, 1490 influence on, 1448b Elavil. See Amitriptyline 1270
peptic ulcer in, 1435 Eating disorder, classification of, Elbow evaluation and treatment of,
Duplication, chromosomal, 149, 149f 1450b bursitis of, 1547t 1270–1271
Dura mater, 464, 465f Ebb phase of metabolism, 1720 dislocation or subluxation of, micrographs of, 1270f
Dust, inhalation of, 1259 Ebola virus, 318t 1544–1545 pathogenesis of, 1268f
DVT. See Deep venous thrombosis EBV. See Epstein-Barr virus Elderly. See Older adult pathophysiology of, 1269–1271
(DVT) Eccrine sweat gland, 1618 Electrical burn, 1716 Empirical risk, multifactorial disease
Dwarfism, 721f, 731 ECF. See Extracellular fluid (ECF) Electrocardiogram (ECG), 1120, and, 167
Dynorphin, 491 ECF-A. See Eosinophil chemotactic 1154–1155 Empyema, 613, 1254–1255
Dysfunctional uterine bleeding factor of anaphylaxis normal values for, 1095, 1096f EMS. See Eosinophilia-myalgia
(DUB), 808 Echocardiography, 1120 potassium imbalance and, 117f syndrome (EMS)
Dyskinesia, 561–562 Echoencephalography, 480 Electroconvulsive therapy (ECT), Emsam. See Selegiline
Dyskinetic cerebral palsy, 672 Echolalia, 540 652 EMT. See Epithelial-mesenchymal
Dyslipidemia, 1149–1151 Echovirus, central nervous system Electroencephalogram, sleep cycles transition (EMT)
chronic kidney disease and, diseases caused by, 610t and, 502f Emulsification, 1402–1404
1366t, 1368–1369 ECM. See Extracellular matrix Electroencephalograph (EEG), Encephalitis, 614, 615t, 675
criteria for, 1149t (ECM) 480 Encephalocele, 664
Dyslipoproteinemia, 1149, 1150t ECT. See Electroconvulsive therapy Electroencephalography, 480 Encephalopathy, 670–677
Dysmenorrhea (ECT) Electrolyte balance acute, 674–677
clinical manifestations of, 805 Ectoparasite, sexually transmitted chronic kidney disease and, drug-induced, 674
evaluation and treatment of, 805 infection caused by, 919t 1367–1368, 1368t hypertension associated with, 1138
pathophysiology of, 804 Ectopic pregnancy, chlamydial pediatric, 1377–1378 End-diastolic volume, 1101–1102
primary, 804–834 infection as cause of, 929–930 Electrolyte(s), 49–102 End-stage kidney disease (ESKD),
secondary, 804 Ectopic testis, 892–894 body fluids and, 29 747–748, 1359
Dysmnesia, 536–537 Eculizumab, hemolytic anemia concentration of, in transcellular Endemic, definition of, 302
Dyspareunia (painful intercourse), treated with, 1000–1001 fluids, 104t Endemic goiter, 729
834–835 Eczema, 1627 distribution of, in body Endocannabinoid, 1449
Dysphagia, 1428–1429 Edema, 105–108 compartments, 108t Endocardial cushion, 1195
Dysphasia, 539–540 burn injury associated with, 1690, measurement of, 29 Endocarditis
transcortical, 540 1690f, 1717 protein function and, 13–15 bacterial, 1144
types of, 543t–544t cerebral (See Cerebral edema) small intestine transport of, cancers associated with, 395t
Dysphoric mood, 650–651 clinical manifestations of, 1401–1402 in infant and child, 1198b
Dysplasia, 53–54, 54f 107–108 Electromagnetic field, 431–432 infective, 1173–1175
cervical, 827, 828f evaluation and treatment of, 108 Electromagnetic radiation, 81–82, Staphylococcus aureus associated
illustration of, 50f formation of, 107f 431–432 with, 311f
1768 INDEX

Endocardium Endosteum, 1518 Enzyme(s) Epileptic syndrome, 553

description of, 1085–1086 Endothelial cell, 209 digestive, 1402b Epileptogenesis, 553
disorders of, 1167–1175 leukocyte interaction with, 211t pancreatic, 1415 Epileptogenic focus, 553
infection and inflammation of, mechanism of, 973t phase I activation, 416–417 Epimysium, muscle, 1527
1173 Endothelin phase II detoxification, 416–417 Epinephrine
Endocervical canal, 774–775 action of, 1111b Eosinopenia, description of, 1010t, action of, 474
Endochondral formation of bone, heart failure and, 1178 1011 cardiac effects of, 1106
1591–1592, 1592f renal blood flow affected by, Eosinophil, 209–210, 949 croup treated with, 1296
Endochondral ossification, 1328t characteristics of, 948t effects of, 345
1511–1512 Endothelium, 207–208, 1108–1109, conditions associated with, 1010t myocardial contractility affected
Endocrine disorders, 1137t, 1582 1109f count of, 1057 by, 1103
Endocrine gland, structure and cancer of, carcinogenic agents granulocytosis and, 1009 septic shock treated with,
function of, 696–711 associated with, 404t–407t illustration of, 949f 1678–1679
Endocrine pancreas, 703–706, function of, 1111b parasitic infection and, 254–255 shock treated with, 1714t
734–752 glomerular, 1321–1322 values for, 978t stress response and, 339f–340f,
Endocrine system injury to for infant and child, 1057t 343
aging and, 711 atherosclerosis and, 1145 Eosinophil chemotactic factor of synthesis of, 710f
autoimmune disorders of, pulmonary embolism and, anaphylaxis, 206, 254–255 urine concentration affected by,
264t–265t 1275 Eosinophilia, description of, 1332
chronic kidney disease effects on, multiple organ dysfunction 1010–1011, 1010t vasoconstriction and, 1117
1365t, 1369 syndrome and, 1680 Eosinophilia-myalgia syndrome Epiphyseal plate, 1518, 1592
feedback loops in, 691f vasomotion regulated by, 1110f (EMS), 1010–1011 Epiphysis, long bone and,
functions of, 689 Endothelium-derived relaxing Eosinophilic cellulitis, 1010–1011 1517–1518
glands in, 690f factor, action of, 1111b Eosinophilic esophagitis, 1429 Episodic memory, 536
hyperthyroidism effects on, Endotoxic shock, 310 Eosinophilic fasciitis, 1010–1011 Epispadias, 1379
727t Endotoxin, 306, 1680 EP. See Evoked potentials Epithalamus, 457–459
hypothyroidism effects on, 730t Endotracheal intubation, subglottic Ependymal cell, 449–450, 451t Epithelial antimicrobials, 194
stress effects on, 353, 710 stenosis caused by, 1299–1300 Ependymoma, 630–631, 630f Epithelial cell, 11f, 19f
tests of function of, 710–711 Energy balance, 418–420 characteristics of, 627t as physical barrier, 192
Endocytosis, 33–35, 34f, 211 Energy metabolism disease, in child, 681t–682t, 682–683 secretions from, 193
caveolae-mediated, 35 1582–1583 Epicardium, 1085 Epithelial-mesenchymal transition
caveolin-independent, 35 Enhancer, gene transcription and, Epicondylitis, 1546, 1546f (EMT), 389, 390f, 864, 907
clathrin-independent, 35 141 Epicritic, definition of, 464 Epithelial ovarian tumor,
clathrin-mediated, 35 Enkephalin, 350, 453t, 491 Epidemic 831–832
receptor-mediated, 35f, 175f Enneking Staging System for Bone definition of, 302 Epithelial tissue, 39–40
Endodontics, 5–6 Tumors, 1562, 1562t sexually transmitted infections tumors associated with, 367t
Endogenous opioids, 490 Entamoeba histolytica, 314t as, 918 types of, 41t–42t
Endogenous pyrogen, 213, Enteric nervous system, 1394 Epidermal growth factor, 39t Epithelialization, 216, 219
301–302, 498 Enteric (intramural) plexus, Epidermis, 39–40, 1616–1617, 1618t Epithelioid cell, 214
Endolarynx, description of, 1394 Epididymal cyst, 892 Epithelium
1226–1228 Entero-oxyntin, action of, in digestive Epididymis, 785–786, 889f bronchial
Endolymphatic hydrops, 507 system, 1397t Epididymitis, 897 description of, 1229
Endometrial cancer, 422, 830–831, Enterobius vermicularis, 314t chlamydial, 930 hyperplasia of, 53f
830f Enterocele, 820 gonorrhea and, 921 chemicals secreted by, 193–194
Endometrial cycle, 779f Enterochromaffin-like cell, 1398 Epidural hematoma, 465, 584 infection resistance by, 191
Endometrial implantation, sites of, Enterococcus faecalis, 304t–305t Epidural space, 465 parietal, 1322
824f Enterococcus faecium, 304t–305t Epigenetic change pseudostratified, 40
Endometrial polyp, 821 Enteroglucagon, action of, in digestive cancer and, 372 simple, 40
Endometrial stromal sarcoma, system, 1397t cancer development and, 408f stratified, 40
830–831 Enterohepatic circulation, 1411 Epigenetic modulation, cancer transitional, 1325
Endometriosis, 823–825 Enterokinase, 1402b, 1415 development and, 408f Epitope, 228, 228f
classification system for, 825t Enterovirus, type 1 diabetes mellitus Epigenetic silencing, 378–380 Epoprostenol, pulmonary artery
clinical manifestations of, 824 and, 736b Epigenetic transgenerational hypertension treated with,
evaluation and treatment of, Entropion, 507 inheritance, 184–185 1278
824–825 Enuresis, 1388 Epigenetics, 183–190 EPSP. See Excitatory postsynaptic
pathophysiology of, 824–825 Environment cancer and, 186, 372, 403–409 potential
Endometrium, 775 cancer development and, 413 definition of, 183 Epstein-Barr virus (EBV), 318t
ectopic, 823 diseases and, 164–182 human development and, Burkitt lymphoma associated
hyperplasia of, 53 fetus affected by, 412f 184–185 with, 1029
Endomitosis, 965 genetic factors and, 169–171 modification in, 185f cancer associated with, 382, 383t,
Endomorphin, 491 Environmental factors types of processes in, 184f 423, 423t
Endomysium, muscle, 1527 asthma caused by, 1308 Epiglottis, laryngomalacia and, 1299 central nervous system diseases
Endoneurium, 448 breast cancer and, 855–863 Epiglottitis caused by, 610t
Endoplasmic reticulum, 3f, 5f childhood cancer and, 444–445 acute, 1296–1297 childhood cancer and, 445
antigen processing and, 244f congenital heart defects description of, 1296t childhood Hodgkin lymphoma
cytoskeleton and, 10f associated with, 1199t Epilepsy, 553, 678–681 associated with, 1079
Endoplasmic reticulum stress, immune system affected classification of, 554b infectious mononucleosis
6b, 91 by, 291 clinical manifestations of, associated with, 1011
Endorphin, 350, 491, 699t lung cancer associated with, 678–679 lymphocytosis associated with,
descending pathway and, 490f 1279–1280 concordance rates for twins for, 1011
as neurotransmitter, 453t schizophrenia and, 642 170t lymphoma associated with,
stress response influenced by, Environmental tobacco smoke, definition of, 550 1078–1079
351t cancer and, 413 evaluation and treatment of, Equatorial plate, 37
β-endorphin, 699t Enzyme-linked immunosorbent 680–681 Equilibrium, Parkinson disease
Endoscopy, gastrointestinal tract assay (ELISA), 710–711, pathophysiology of, 678 effects on, 567
evaluated with, 1416 1032–1034, 1047 prevalence of, 172t Equilibrium receptor, 515
 INDEX 1769

Equine encephalitis virus, central Escherichia coli (Continued) Estrone, 776 External auditory canal, 514
nervous system diseases caused osteomyelitis caused by, 1602 ET. See Essential (primary) External elastic lamina, 1106
by, 610t pelvic inflammatory disease thrombocythemia (ET) External intercostal muscle,
Equinovarus deformity, 1596–1597 associated with, 814 Ethambutol, tuberculosis treated 1234–1235
ERBF. See Effective renal blood flow tissue damage caused by, 309 with, 1274 External urethral sphincter,
(ERBF) urinary tract infection caused Ethanol, 67–69, 420–422 1325–1326
Erectile reflex, 787 by, 1350 Ethanol metabolism pathway, 68f Extinction, awareness alteration
Erection, male, 787 Escitalopram Etiology, multifactorial, childhood and, 535–536
Ergotamine, migraine headache anxiety disorder treated with, 655 cancer and, 443 Extracellular fluid (ECF)
treated with, 608 depression treated with, 652b ETS. See Environmental tobacco amount of, 103–104
ERK. See Extracellular signal ESKD. See End-stage kidney disease smoke content of, 1690t
regulated kinase (ERK) (ESKD) ETV6 oncogene, acute leukemia electrolyte balance in, 108t
Erlotinib, 381 Esophageal atresia, 1487, 1488f and, 1017 hypotonic alterations and, 112t
Erosion, skin, example of, Esophageal cancer, 1466–1467, Eukaryote, 2 in infant, 1378
1620t–1622t 1467t Euploid cell, 143–144 osmolality of, 30
ERPF. See Effective renal plasma carcinogenic agents associated Eustachian (pharyngotympanic) polarity of, 29
flow (ERPF) with, 404t–407t tube, 515 water movement and, 105
ERR. See Excess relative risk (ERR) ionizing radiation as cause of, Euthyroid sick syndrome, 1369 Extracellular matrix (ECM), 17–18,
ERT. See Estrogen replacement 424t Evaporation, heat loss by, 497 18f
therapy (ERT) Esophageal phase of swallowing, Evaporative fluid loss, burn injury aging and, 95
Eryptosis, anemia and, 987 1395–1396 and, 1719 injury to, 54–55
Erysipelas, 1635 Esophageal varices, 1453 Evaporative water loss (EWL), 1693 lactation and, 845, 845f
Erythema marginatum, 1172–1173 Esophagitis, 1429, 1429f Evening primrose oil, mastalgia Extracellular messenger, cellular
Erythema migrans, 1640 Esophagus, 1395–1396 treated with, 842t communication and, 22, 23f
Erythema multiforme, 1633–1634, aging effects on, 1417–1418 Evoked potentials, 480 Extracellular signal regulated kinase
1634f description of, 1395 Ewing sarcoma, 633b (ERK), 1553
Erythema toxicum neonatorum, malformations of, 1487–1492 example of, 1611f Extradural brain abscess, 613
1664 obstruction of, 1428 pediatric, 1610–1611 Extradural hematoma, 584
Erythroblast, 959 peptic ulcer in, 1435 EWL. See Evaporative water loss Extradural tumor, 633
Erythroblastosis fetalis, 1058, 1060, Essential (primary) (EWL) Extrafusal muscle, 1527
1501 thrombocythemia (ET), Exanthema subitum, 1659t, 1660 Extrahepatic (prehepatic)
Erythrocyte, 947–948 1040–1042 Excess relative risk (ERR), 424–425 portal venous obstruction,
alterations in function of, Estradiol, 776 Excitation, muscle contraction and, 1502–1503
982–1007 breast cancer risk and, 850–852 1533 Extramedullary plasmacytoma,
antigenic properties of, 1059 HPA axis affected by, 350 Excitation-contraction coupling, 1032
appearance of, in various reproductive maturation and, 771 calcium and, 1099–1101 Extramedullary tumor, 633
disorders, 984f Estriol, 776 Excitatory interneuron, 487 Extrapyramidal motor syndrome,
blood tests for, 976t–977t Estrogen Excitatory neurotransmitter, 490 573–574, 574t
carbon dioxide in, 1243 action of, 1111b Excitatory postsynaptic potential, Extrapyramidal/nonspastic
characteristics of, 948t benign prostatic hyperplasia and, 452–453 cerebral palsy, 672
destruction of, 962–963 898 Excited delirium syndrome, 542 Extrapyramidal system, 456–457,
development of, 959–964 biosynthesis of, 850f Excitotoxicity, 589 458f
disorders of, in child, 1058–1070 breast cancer risk and, 849–850 Excoriation, example of, Extrinsic allergic alveolitis, 1259
inflammation mediation and, breast development and, 783 1620t–1622t Exudate, inflammation associated
201–202 in breast tumor, 852 Excretion, urinary, 1328 with, 213
normal, 1064f description of, 776–778 ExDS. See Excited delirium Exudative effusion, 1254–1255
premature death of, 987 effects of, 778t syndrome Eye, 508–509
production of, 960 endometrial cancer and, 830 Executive attention function, 538 autoimmune disorders of,
in child, 1057 female gonadal development Executive attentional network 264t–265t
in fetus, 1055–1057 and, 769 deficit, description of, 541t cancer of, carcinogenic agents
sickled, 1064f–1065f, 1065 gynecomastia and, 913 Exercise associated with, 404t–407t
terms used in assessment of, 983t HPA axis affected by, 350 muscle metabolism and, 1534 effects of aging on, 510t
in urine, 1335–1336 hypersecretion of, 756–757 obesity treated with, 1450 external, 507
Erythrocyte disorders, 982–1007 mammary gland development osteoporosis and, 1556 infection of, bacteria associated
pediatric, 1058–1070 and, 847, 848f type 2 diabetes mellitus treatment with, 304t–305t
Erythrodermic (exfoliative) menstrual cycle affected by level and, 742 muscles of, 509f
psoriasis, 1629–1630 of, 794t Exercise testing, cardiac function structure of, 508f
Erythroid hyperplasia, 1000 migraine headache and, 608 measured with, 1120–1121
Erythromelalgia, 608 osteoporosis and, 1552–1553 Exocrine pancreas, 1413–1416, F
Erythropoiesis, 959–960 production of, in breast cancer 1418t F cell, islets of Langerhans and,
fetal, 975 cell, 853f Exocytosis, 34f, 35–36 703–704
nutritional requirements for, prostate cancer and, 906 Exogenous pyrogen, 301–302, 498 Fab. See Antigen-binding fragment
962, 962t prostate gland signaling and, 903f Exon, 142 Fabry disease, 673t
regulation of, 960–961, 960f secretion of, 709–710 Exophthalmos, 726 Facial nerve, 471f, 472t, 473
Erythropoietin, 959, 960f, 1334 stress response influenced by, Exostosis, pediatric, 1609 Facilitated diffusion, 31–32
chronic kidney disease and, 1369 351t Exotoxin, 306 Facilitation, neuron function and,
levels of, 1057 Estrogen-alone hypothesis, breast Expectancy-related cortical 453
sideroblastic anemia treated with, cancer risk and, 850–852 activation, 489 Facioscapulohumeral dystrophy,
993 Estrogen receptor α, prostate cancer Expiration, interaction of forces 1606t
Escharotomy, 1686–1687 and, 906 during, 1237f Facioscapulohumeral muscular
Escherichia coli, 304t–305t, 305–307 Estrogen receptor β, prostate cancer Expressive disorders, 575 dystrophy (FSHD), 1609
attachment of, 306f and, 906 Expressive dysphasia, 543t–544t Factor H deficiency, 288
diarrhea caused by, 1500 Estrogen replacement therapy Expressivity, genetic, 154 Factor I deficiency, 288
hemolytic uremic syndrome (ERT) Exstrophy of the bladder, 1379– Factor IX deficiency, 1070–1071
associated with, 1383 breast cancer risk and, 853–855 1380, 1379f Factor V Leiden, 1049
meningitis caused by, 676 cancer associated with, 854t External anal sphincter, 1407 Factor VII, 201
1770 INDEX

Factor VIIa, 972f Fat necrosis tumor, description Fever Fight-or-flight response,
Factor VIII concentrate, hemophilia of, 838t benefits of, 498–500 1095–1096
treated with, 1072 Fatigue, cancer associated with, definition of, 498 hypovolemic shock and, 1704
Factor VIII deficiency, 1070 396b infection as cause of, 301–302 FIGO. See International Federation
Factor X, 201 Fatigue fracture, 1541 inflammation associated with, of Gynecologists and
Factor XI deficiency, 1070–1071 Fatty acids, inflammation and, 194b 213 Obstetricians (FIGO)
Factor XIa, 972 Fatty liver, 84–85, 85f pathogenesis of, 498, 499f Filaggrin protein, 1654
Factor XII, 201 Fatty streak, 1145–1147 pediatric septic shock associated Filamentous bacteria, 302
Factor XIIa, 972, 1045 Fc. See Crystalline fragment with, 1708 Filamin, muscle contraction and,
FAD. See Familial Alzheimer FD. See Fibrous dysplasia (FD) Fever of unknown origin (FUO), 1532t
disease (FAD) FDP. See Fibrin degradation 500 Filariasis, 314t
Failure to thrive (FTT), 1498–1499 product (FDP) FFA. See Free fatty acid (FFA) Filovirus, description of, 318t
clinical manifestations of, 1498 Febrile response, fever and, 499f FFM. See Fat-free mass Filtration, passive transport and,
congenital heart defects and, Febrile seizure, 679 FGF-23. See Fibroblast growth 29–30
1201–1202 Fecal impaction, 1425 factor-23 (FGF-23) Filtration fraction, 1326
evaluation and treatment of, Fecal mass, 1408 FHH. See Familial hypocalciuric Filtration slit, 1321–1322, 1324f
1498–1499 Feces, 1408 hypercalcemia (FHH) Filum terminale, 460
pathophysiology of, 1498–1499 Feedback loop, hormone regulation Fiber, dietary, breast cancer and, Fimbriae, 305, 775
Fallopian tube, 775–776 and, 691f 859 Finasteride
abnormalities of, 801 Feedback system, hormonal Fiberoptic endoscopy, alopecia treated with, 1646
cross-section of, 774f alterations and, 718t gastrointestinal tract evaluated prostate cancer treated with,
inflammation of, 813–814 Female with, 1416 901–904
False aneurysm, 1140 cancer incidence rates for, Fibril, collagen fiber and, 1516 Finger
False joint, 1543 409–410 Fibrin, 199–201 dislocation or subluxation of,
Falx cerebri, 464, 465f corticotropin-releasing hormone Fibrin clot, 216 1544
Famciclovir, herpes simplex virus effects on, 353t Fibrin degradation product (FDP), webbing of, 1593–1594
infection treated with, 934 external genitalia of, 771–772, 973, 1044 Fingernail, iron deficiency anemia
Familial adenomatous polyposis 772f Fibrin-stabilizing factor, disorders effect on, 990–991
(FAP), 1470 infertility caused by, 835–836 associated with, 1070t Firearms, injury caused by, 70
Familial Alzheimer disease (FAD), internal genitalia of, 772–776, Fibrinogen First-degree block, pathophysiology
546–549, 547t 773f blood clotting and, 946–947 and treatment of, 1184t–1186t
Familial essential sex hormones in, 776–778 disorders associated with, First-degree burn, 1685–1686
thrombocythemia (FET), 1040 Female-pattern alopecia, 1646 1070t First messenger
Familial hypercholesterolemia, Female reproductive system. See Fibrinolysis, 967, 1044 cellular communication and,
172, 173b Reproductive system; female Fibrinolytic system, 971–972 22
Familial hypocalciuric Feminization, 756, 888b defects in, 972 hormones as, 692, 693f
hypercalcemia (FHH), Fenestration, capillaries and, 1108 illustration of, 973f Fish, mercury in, 69
732–733 Ferritin, 86 Fibrinous exudate, inflammation Fisher syndrome, 623t
Familial hypokalemic periodic iron absorption and, 1406 associated with, 213 Fissure
paralysis, 115 iron cycle and, 963 Fibroadenoma, 838t, 840–841 example of, 1620t–1622t
Familial pulmonary artery iron deficiency anemia diagnosis Fibroblast, 18f, 216–218 in forebrain, 456
hypertension (FPAH), and, 991 characteristics of, 1618t Fissure of Rolando, 456
1276–1277 Ferroportin, iron cycle and, 964 extracellular matrix and, 17–18 Fitz-Hugh-Curtis syndrome,
Family, cancer-prone, 379–380 Fertility prostate cancer and, 907 921–922
Fanconi anemia, 379 impaired, 835–836 Fibroblast growth factor, 39t, 386, Fixation, external, bone fracture
acute leukemia associated with, male, 913 1515t treated with, 1543
1017 tests of, 792t, 836 Fibroblast growth factor-23 (FGF- Flaccid paralysis, 571
childhood cancer associated with, Festinating gait, 567 23), 1557 Flaccid paresis, 571
443t, 444 FET. See Familial essential Fibrocystic change, breast lesions Flaccidity, 560t
childhood leukemia associated thrombocythemia (FET) and, 838–839 Flail chest, 1253, 1253f
with, 1075–1076 Fetal alcohol syndrome, 68–69 Fibromyalgia (FM), 1579–1580 Flame burn, 1715–1716
description of, 995 Fetal hemoglobin (HbF), 961, 1056 classification of, 1579f Flash freeze, 1646
FAP. See Familial adenomatous Fetal shunt, closure of, 1197–1198 clinical manifestations of, 1580 Flashback, posttraumatic stress
polyposis (FAP) Fetus concomitant conditions with, disorder and, 655
Farsightedness, 512 alcohol effect on, 68–69 1580t Flat bone, 1518
FAS. See Fetal alcohol syndrome alloimmunity and, 276 differential diagnosis of, 1580t Flatfoot, 1597
Fas ligand, 255–256 circulation in, 1196–1198, 1197f education for individuals with, Flavin adenine dinucleotide, 25–26,
Fascia, muscle, 1527 developing, 768 1581b 28
Fascicle environmental effects on, 412f evaluation and treatment of, Flavivirus, description of, 318t
in central nervous system, 448 external genitalia development 1580 Flea bite, 1662
muscle, 1527 in, 770f myofascial pain compared to, Florid hyperplasia, 839
Fasciola hepatica, 314t gonorrhea transmitted to, 920 1579t Fluconazole, tinea capitis treated
Fat hematologic system in, 975 pathophysiology of, 1579–1580 with, 1657
breast cancer and, 858–859 hematopoiesis in, 1055–1056 Fibronectin, 17, 305 Fludarabine, chronic leukemia
chronic kidney disease and, immune function in, 257 Fibrosarcoma, 1564, 1612t treated with, 1023
1368–1369 internal genitalia development Fibrosis Fluid balance
dietary, 1405b in, 769f cirrhosis and, 1460 chronic kidney disease and,
digestion of, 1402–1406, 1403f ionizing radiation effect on, 80 pulmonary, 1258–1260 1367–1368
emulsified, 1402–1404 lung development in, maternal scleroderma and, 1639 lymphatic system role in, 1118f
malabsorption of, gluten-sensitive smoking and, 1293b Fibrous dysplasia (FD), 1610 pediatric, 1377–1378
enteropathy associated with, maternal chickenpox and, 1660 Fibrous joint, 1520 Fluid mosaic model, 12b
1496–1497 muscle growth in, 1593 Fibrous plaque, 1145–1147 Fluid resuscitation
metabolism of, 1412 oxygenation in, 1196 Field effect, breast cancer and, burn injury treated with,
Fat embolism, 1144 polycystic ovary syndrome and, 864–866 1689–1690, 1719
Fat-free mass, 96 811b Fifth disease, sickle cell disease and, pediatric burn injury treatment
Fat necrosis, 91, 91f syphilis transmitted to, 923 1066 with, 1718–1719
 INDEX 1771

Fluid resuscitation (Continued) Fontanel Free cytosolic calcium, 87f G-protein-coupled receptor
pediatric septic shock treated development of, 661–662 Free fatty acid (FFA), 739 (GPR54), 802, 886
with, 1709 in infant, 663f Free radicals, 59–62 GABA. See Gamma-aminobutyric
pediatric shock treatment with, Food biologically relevant, 62t acid (GABA)
1711 cancer prevention and, 414f–415f chromosomal aberrations and, Gabapentin, cluster headache
Fluid therapy cellular energy production and, 428, 428f treated with, 609
burn injury treated with, 1689 26–27 diseases and disorders linked GABHS. See Group A beta-
multiple organ dysfunction digestion and absorption of, to, 62t hemolytic Streptococci
syndrome treated with, 1685 1403f oxygen, aging and, 95 (GABHS)
pediatric shock treatment with, pro- and anti-cancer effects of, termination of, 70t GAD. See Generalized anxiety
1711 411f Freezing, movement alterations disorder (GAD)
Fluid(s), 49–102 Food allergy, tests for, 272–273 and, 564 Gait, disorders of, 575
aging and, 104–105 Food particles, aspiration of, 1256 Frontal lobe, 456, 539f–540f Galactorrhea, 836–837
body, 103–104 Food poisoning Frontotemporal dementia (FTD), clinical manifestations of, 837
composition of, 29 bacteria as cause of, 304t–305t 546, 550 evaluation and treatment of, 837
distribution of, 104–105 Clostridium botulinum as cause clinical differentiation of, 547t pathophysiology of, 836–837
loss of, 109 of, 309–310 molecular basis for, 547t Galactosemia, 1503t
pediatric, 1378 Staphylococcus aureus associated Frostbite, 1646 Galea aponeurotica, 464
pH of, 123t with, 311f Frostnip, 1646 Gallbladder, 1413
transcellular, electrolytes in, 104t superantigen and, 251 Fructose, transport of, 33t inflammation of, sickle cell
Fluke, 314, 314t Foot Fructosemia, 1503t disease and, 1067–1068
Fluoxetine, depression treated with, abnormalities of, 1596t FSGS. See Focal segmental location of, 1409f
652b deformities of, 1595–1597 glomerulosclerosis (FSGS) organ dysfunction and, 1684b
Fluphenazine, schizophrenia treated dystonic posturing of, 561f FSH. See Follicle-stimulating structure of, 1414f
with, 646b Foramen of Magendie, 466 hormone (FSH) tests of, 1416, 1417t
Fluvoxamine Foramen of Monro, 466 FTD. See Frontotemporal dementia Gallbladder cancer, 404t–407t,
depression treated with, 652b Foramen ovale, 1195–1197 (FTD) 1473–1474
obsessive-compulsive disorder Foramina of Luschka, 466 FTT. See Failure to thrive (FTT) Gallbladder disorders, 1463–1464
treated with, 657 Forbidden clone, 275 Full thickness burn injury, Gallstones, 1463–1464
Foam cell, 1145–1147 Forebrain, 454, 454t, 456–459 1686–1687, 1687f example of, 1463f
Focal brain injury, 582–587, 582t Foreign body aspiration, 1298, Fulminant liver failure, 1451 sickle cell disease and, 1067–1068
Focal neuropathy, 622, 751t 1298f Functional cyst, 820 Gamete
Focal segmental glomerulosclerosis Foreign matter, embolism from, Functional dysphagia, 1428 description of, 142
(FSGS), 1384 1144 Functional hearing loss, 517 haploid, 144f
Focal seizure, 551–552 Foreskin, of penis, 786–787 Functional incontinence, 1344t, 1388 Gamma-aminobutyric acid
Folate Formal thought disorder, Functional magnetic resonance (GABA), 179
deficiency of, 989 schizophrenia and, 645b, 646 imaging (fMRI), of skull and Huntington disease and, 564
description of, 989 Formoterol, asthma treated with, spine, 478 as neurotransmitter, 452, 453t,
erythropoiesis requirements for, 1266b Functional reserve capacity (FRC), 490
962 Fornix, 457, 773 1243, 1292 schizophrenia and, 643
Folate deficiency anemia, 983t, Forward theory, ascites and, 1453 Fundus, stomach, 774–775, 1396 sleep affected by, 503
986t, 989 Fossa, in cranium, 464 Fungal infection, 310–314 Gamma (γ) globulin, 946
Folic acid Founder cell, 39 acquired immunodeficiency Gamma-glutamyltransferase, 1413
description of, 989 Fovea centralis, description of, 508 syndrome and, 327b Gamma neuropathy, 571
intestinal absorption of, 1406t FPAH. See Familial pulmonary cutaneous, 1637–1638 Ganglia, in central nervous system,
Folic acid deficiency, 67 artery hypertension (FPAH) immune response suppression 448
Follicle FR. See Framework region by, 313 Ganglioneuroblastoma, 684
formation of, 808 Fracture, 1540–1543 skin disorders associated with, Ganglioneuroma, 684
of thyroid gland, 700 classification of, 1541–1543 1657–1658 Gangliosidosis, 674
Follicle-stimulating hormone clinical manifestations of, tissue damage from, 313 Gangrene, 91
(FSH), 696f, 699t 1542–1543 transmission and colonization of, Gangrenous necrosis, 91, 91f
deficiency of, 721 corner, 1613, 1613f 311–312 Gap junction, 3f, 18–20, 19f–20f
delayed puberty in male and, definition of, 1540–1541 Fungal meningitis, 611 Gardnerella vaginalis, 814, 929
886 evaluation and treatment of, 1543 Fungus Gas
fetal production of, 769–770 hip, osteoporosis associated with, diagnosis of, 311 description of, 1237–1238
function of, 776–777 1551 infection from, 303t toxic, 1258–1259
loss of, 719f osteoporosis associated with, mechanisms of, to defend Gas diffusion, respiration and, 1228
male sex hormone production 1555 against inflammation and Gas embolus, 77
and, 789–791 pathophysiology of, 1541–1542 immunity, 308t Gas-exchange airway, 1229
menopause and, 793–794 types of, 1541f, 1542t pathogenesis of, 313–314 Gas-exchange membrane, 1231f
menstrual cycle and, 780 Fracture Risk Assessment (FRAX), pathogenic, 312t Gas gangrene, 91
ovarian cyst and, 820–821 1556 sexually transmitted infection Gas pressure
polycystic ovary syndrome and, Fragile site, chromosomal, 151 caused by, 919t gas molecules and, 1238f
811 Fragile X syndrome, 151 transmission and colonization of, measurement of, 1237–1238
Follicle-stimulating hormone Fragility fracture, 1541 311–312 Gas transport, 1238–1243
(FSH) deficiency, 721 Frailty, 96 FUO. See Fever of unknown origin Gasping breathing pattern,
Follicular cyst, 820–821 Frameshift mutation, 140, 140f (FUO) description of, 530t
Follicular/proliferative phase of Framework region, 231–232 Furuncle, 311f, 1634–1635 Gastrectomy, complications of, 1439
menstrual cycle, 780 Francisella tularensis, 304t–305t Fusidic acid, impetigo treated with, Gastric banding, obesity treated
Folliculitis, 311f, 1634 Frank-Starling law of the heart, 1656 with, 1450
Follistatin, 781 1101–1102, 1102f Fusiform aneurysm, 604 Gastric bypass surgery, type 2
Fomite, gonorrhea transmission Fraternal twin, 169 Fusiform muscle, 1527 diabetes mellitus treatment
and, 920 FRAX. See Fracture Risk Assessment with, 742b
Fondaparinux, stroke treated with, (FRAX) G Gastric cancer, 1467–1468
599–601 FRC. See Functional reserve capacity G cell, gastric secretion and, 1398 Gastric emptying, 1397–1398
Fontan procedure, 1210, 1214 (FRC) G protein, 23 Gastric fluid, 1398
1772 INDEX

Gastric gland, 1398, 1398f GCT. See Gate control theory of Genetics (Continued) Gibbs-Donnan equilibrium, 30–31
Gastric hydrochloric acid, 1398 pain cancer and, 379–380, 403–409 Giemsa stain, 142–143
Gastric inhibitory peptide, action of, GDM. See Gestational diabetes childhood cancer and, 444 Gilbert disease, 1456
in digestive system, 1397t mellitus (GDM) chronic leukemia and, 1020–1021 Gilbert syndrome, cholelithiasis
Gastric lipase, as digestive enzyme, GDP. See Guanosine diphosphate congenital heart defect and, 1200t associated with, 1463
1402b Gegenhalten (paratonia), 560–561, depression and, 647–648 GIP. See Glucose-dependent
Gastric motility, 1397–1398 560t elements of, 151 insulinotropic polypeptide
Gastric outlet obstruction, Gender, pain and, 496b hemophilia and, 1071 (GIP)
1430–1431 Gene amplification, 376 immune system affected by, 291 Glands of Montgomery, 783
Gastric phase of secretion, 1400 Gene-environment interaction, 171 leukemia and, 1014–1015 Glans, 786–787
Gastric pit, 1398f Gene silencing, cancer and, 403 lung cancer treatment and, 1280b Glans penis, squamous cell
Gastric secretion, 1398–1400 Gene switching neurologic disorders and, 671t carcinoma of, 891f
electrolyte composition of, 1398f antigenic variation by, 308 panic disorder and, 654 Glanzmann thrombasthenia, 969,
phases of, 1399–1400 parasitic, 315 schizophrenia and, 642 1042
Gastric surgery, obesity treated with, Gene therapy, 137b type 1 diabetes mellitus and, 735 Glasgow Coma Scale
1450 for heart failure, 1180b Genital herpes, 932–934 brain injury classification with,
Gastric ulcer, 1437–1439 immune deficiency treated with, Genital tract infection, 813–817 582, 584
benign, 1437f 294–296 Genital tubercle, 769 concussion evaluated with, 587
characteristics of, 1437t General adaptive syndrome, Genital ulceration, 926f Glaucoma, 510–511
clinical manifestations of, 338–339 Genital warts, 890, 935–936 illustration of, 511f
1438–1439 Generalized AchR myasthenia, 625 Genitalia types of, 511t
pathophysiology of, 1438–1439, Generalized anxiety disorder external Gleason score, 905b
1438f (GAD), 655 development of, 770f Glenn procedure, 1214
Gastrin, 706, 1397 Generalized neuropathy, 622 female, 771–772, 772f Glenohumeral joint, dislocation or
action of, 1397t Generalized seizure, 551–552, 679 male, 784–787 subluxation of, 1544
secretion of, 1438 Generalized symmetric female, abnormal bleeding of, Glioblastoma multiforme, 627t,
stomach acid secretion and, 1399 polyneuropathy, 621–622 808t 629, 630f
Gastrinoma, 1438 Generation of clonal diversity, 225, internal Glioma
Gastritis, 304t–305t, 988, 226f, 236–241, 237t development of, 769f characteristics of, 627t
1434–1435 Gene(s), 1 female, 772–776, 773f in child, 681t–682t, 682
Gastrocolic reflex, 1408 BRCA1 (See BRCA1 gene) male, 787–789 classification of, 629t
Gastroduodenal artery, 1401 BRCA2 (See BRCA2 gene) ulceration of, 926f description of, 628
Gastroesophageal reflux disease cancer-causing mutations in, viral infections of, 932–937 Gliotoxin, 313
(GERD), 1429 372–373 Genitourinary tract, as closed Glisson capsule, 1409
clinical manifestations of, 1493 caretaker, 379 barrier, 193f Global dysphasia, 543t–544t
evaluation and treatment of, 1494 definition of, 135 Genome Globin, 961, 1411
pathophysiology of, 1493–1494 diseases and, 164–182 human, 160 Globulin, 946
pediatric, 1493–1494 Duchenne muscular dystrophy, protection of, 379–380 Glomerular basement membrane
Gastroileal reflex, 1407 158 Genomic imprinting, 187–188 (GBM), 1321, 1324f,
Gastrointestinal (GI) bleeding, environmental factors and, Genomic instability, 78–80, 428–429 1358–1359
1426–1428 169–171 Genotype, 135, 151 Glomerular capillary, 1324f, 1325,
pathophysiology of, 1427f heterozygous, 151 Genu valgum (knock knee), 1593 1353
pediatric, 1503 homozygous, 151 Genu varum (bowleg), 1593 Glomerular disease, 1067, 1357
presentations of, 1428t housekeeping, 184 Geodon. See Ziprasidone Glomerular endothelium,
Gastrointestinal system identification of, 159–163 GERD. See Gastroesophageal reflux 1321–1322
aging effects on, 1417–1421 Ig, 375–376 disease (GERD) Glomerular filtration, 1329–1331
autoimmune disorders of, insulin, 177 Germ cell creatinine clearance and,
264t–265t leptin, 178 somatic cell compared to, 412t 1366–1367
burn injury and, 1719 misregulation of, 380–382 testicular tumor and, 896t pressures in, 1330f
chronic kidney disease effects on, mutation of, into oncogenes, Germ cell tumor Glomerular filtration membrane,
1365t, 1369 375–376 characteristics of, 627t 1321
hyperthyroidism effects on, 727t myc, 375–376, 376f ovarian cancer and, 832 Glomerular filtration rate (GFR),
hypothyroidism effects on, 730t number of, in human body, 135 German measles, 1658–1659, 1659t 1326, 1329
organ dysfunction in, 1684b presenilin, 178 Germinative layer of skin (stratum clearance and, 1334
tests for, 1415t protein formation and, 141–142 germinativum), 1616–1617 in infant, 1377
Gastrointestinal tract, 1393–1409 ras, 375 Germline mosaicism, 154 plasma creatinine concentration
cancer of, 1466–1472 schematic of, 141f Gestational diabetes mellitus and, 1335, 1367f
disorders of (See Gastrointestinal silencing of, 378 (GDM), 743 urinary tract obstruction and,
tract disorders) SRY, 157, 157f Gestrinone, endometriosis treated 1342
tests of, 1415–1416, 1416t tumor-suppressor, 154, 373–374 with, 824–825 Glomerular injury, mechanisms
wall of, 1394f X-linked recessive, 158 GFR. See Glomerular filtration rate of, 1354f
Gastrointestinal tract disorders, Genetic counseling, muscular (GFR) Glomerular lesion, classification
1423–1451 dystrophy and, 1608 GH. See Growth hormone (GH) of, 1355t
clinical manifestations of, Genetic disease, 1, 171–182 Ghrelin, 706 Glomerulonephritis, 1352–1358
1423–1428 continuum of, 169f obesity and, 1449 acute, 1353–1357
pediatric, 1486–1500 principles of, 180–182 type 2 diabetes mellitus and, 741 chronic, 1357–1358
Gastrointestinal tract infection, recurrence risk of, 152–154 Giant aneurysm, 604 histopathology of, 1356t
bacteria as cause of, 304t–305t transmission of, 151–159 Giant cell, 214 pathogenesis of, 1355t
Gastrointestinal trauma, cancer Genetic heterogeneity, 863 Giant cell tumor, 633b, 1564–1565, pediatric, 1381–1382, 1381t,
effects on, 396b Genetic testing, 136b 1564f 1382f
Gate control theory of pain, 485 Genetics Giantism, 722, 723f Glomerulosclerosis, 1364
Gating, cell defense and, 20 allergy and, 271 Giardia intestinalis, diarrhea caused Glomerulotubular balance, 1331
Gaucher disease, 673t of asthma, 1308 by, 1500 Glomerulus
GBM. See Glomerular basement asthma and, 1263 Giardia lamblia, 314t anatomy of, 1324f
membrane (GBM) autoimmunity and, 276 Giardia spp., 316 blood vessels in, 1325
GCS. See Glasgow Coma Scale breast cancer and, 863–866 Giardiasis, 314t description of, 1320–1321
 INDEX 1773

Glomerulus (Continued) Glycation, hyperglycemia and, Gouty arthritis, 1574–1575 GST. See Glutathione-S-transferase
development of, 1376 746–747 Gower 1 hemoglobin, 1056 (GST)
diabetes mellitus effects on, 748 Glycine, as neurotransmitter, 453t, Gower 2 hemoglobin, 1056 GTP. See Guanosine triphosphate
disorders of, 1352–1359, 490 G6PD. See Glucose-6-phosphate GU. See Gonococcal urethritis (GU)
1381–1385 Glycogen dehydrogenase deficiency Guanine, 136, 138f–139f, 141, 142f
fluid filtered in, 1329 abnormality in metabolism of, GPIIb/IIIa complex, 969 Guanosine diphosphate, 23
inflammation of, 1352–1353 1583 GPR54. See G-protein-coupled Guanosine triphosphate, 23
upper urinary tract obstruction accumulation of, 85 receptor (GPR54) Guanylyl cyclase, 694
effect on, 1341–1342 Glycogen storage disease, 85 Graft rejection, 280–281 Guide, DNA replication and, 137
Glossopharyngeal nerve, 471f, 472t, Glycogenolysis, 1451 chronic, 281 Guillain-Barré syndrome, 622–624
473 Glycolysis hyperacute, 280 classification of, 623t
Glottis, 1226–1228 aerobic, 420 Graft-versus-host disease, 292 clinical manifestations of,
carcinoma of, 1278 anaerobic, 28, 370f Gram-negative bacteria, 303, 303f 623–624
laryngomalacia and, 1299 cancer cell metabolism and, 369 Gram-positive bacteria, 303, 303f evaluation and treatment of, 624
GLP-1. See Glucagon-like peptide-1 cell energy production and, 26 Granulation tissue, 216 pathophysiology of, 622–623
(GLP-1) illustration of, 27f Granulocyte, 201–202, 948–950 Gunshot wound, description of, 79t
Glucagon, 706 muscle metabolism and, 1534 description of, 1009–1011 Gut, cancer of, 1467t
diabetes mellitus and, 737–739 Glycoprotein, 13–15 leukocyte development and, Gut hypothesis, multiple organ
swallowing and, 1396 description of, 1516 964–965 dysfunction syndrome and,
type 2 diabetes mellitus and, 741 example of, 690t Granulocyte colony-stimulating 1682
Glucagon-like peptide-1 (GLP-1), function of, 1512t factor, 954t Guttate psoriasis, 1629–1630, 1630f
706 immune response and, 235–236 Granulocytopenia, 1009 GVHD. See Graft-versus-host
type 2 diabetes mellitus and, 741 Glycosaminoglycan, in articular Granulocytosis, 1009 disease
Glucocorticoid, 706–708 cartilage, 1525 description of, 1010t Gynecomastia, 148, 913
inflammation and obesity and, Glycosuria, 745 Granuloma, 214, 215f, 310 Gyrus, 456–457
347b GM2 gangliosidosis, 674 Granuloma inguinale, 928–929
respiratory distress syndrome GnRH. See Gonadotropin-releasing Granulomatous colitis, 1442 H
treated with, 1301–1302 hormone (GnRH) Granulosa cell, 776 HACE. See High altitude cerebral
stress response and, 343, 346–348 GnRH pulse generator, 887 Granzyme, 255–256 edema
synthesis and secretion of, 708f Goblet cell, 1229 Grasp reflex, 533, 533f HAE. See Hereditary angioneurotic
Glucocorticoid-induced Golfer’s elbow, 1546 Graves dermopathy, 726 edema (HAE)
osteoporosis, 1553 Golgi apparatus, 3f, 6–7 Graves disease, 726–728 Haemophilus aegyptus, 304t–305t
Glucocorticosteroids, nephrotic Golgi complex, 6–7, 6f, 10f example of, 727f Haemophilus ducreyi, chancroid
syndrome treated with, Golgi tendon organ, 1528–1529 hypersensitivity reaction and, caused by, 925–927
1384–1385 Gomphosis, fibrous joint and, 1520 267–269 Haemophilus infection,
Gluconeogenesis, 346, 1320b, 1451 Gonad, 768, 771f maternal hypersensitivity and, 277 conjunctivitis caused by, 507
Glucose Gonadal dysgenesis, childhood Gravity Haemophilus influenzae, 303,
cancer utilization of, 369, 370f cancer associated with, 443t alveolar pressure and, 1240f 304t–305t
deficiency of, cellular injury Gonadarche, 771 pulmonary blood flow affected bacterial tracheitis caused by,
associated with, 75 Gonadostat, 770, 803–804, 887 by, 1239f 1297–1298
impairment of delivery of, shock Gonadotropin-releasing hormone Gray matter, 456–457, 461f epiglottitis caused by, 1296–1297
associated with, 1670 (GnRH), 696–697 multiple sclerosis lesions in, 620 meningitis caused by, 676
metabolism of, shock and, 1670 action of, 698t schizophrenia effect on, 643f osteomyelitis caused by, 1602
regulation of, kidney and, 1320b delayed puberty in male and, 886 Great cardiac vein, 1092 otitis media caused by, 516–517
transport of, 33t fetal production of, 769–770 Greater vestibular gland, 772 pelvic inflammatory disease
uptake of, 704–705 menstrual cycle and, 780 Greenstick fracture, 1541 associated with, 814
Glucose-6-phosphate ovarian cyst and, 820–821 GRF. See Growth hormone- Hageman factor, 201, 1070t
dehydrogenase deficiency polycystic ovary syndrome and, releasing factor (GRF) Hagen-Poiseuille equation, 1111
(G6PD), 1058, 1062, 1501 811 Griseofulvin, tinea capitis treated Hair cell, ear structure and, 515
Glucose-dependent insulinotropic puberty and, 802 with, 1657 Hair disorders, 1646–1647
polypeptide (GIP), 706, 741 Gonadotropin-releasing hormone Groove sign, 932 Hair follicle, 1618
Glucose intolerance pulse generator, 770, 803–804 Ground substance, 40–41, 1511 infection of, 1634
chronic kidney disease and, Gonococcal cervicitis, 921f Group A beta-hemolytic Streptococci inflammation of, 1634–1635
1368 Gonococcal pharyngitis, 921 (GABHS), 1297–1298 Hair loss, cancer associated with,
polycystic ovary syndrome and, Gonococcal urethritis (GU), 888 Growth factor 396b
810 Gonococcus breast cancer and, 380 Haldol. See Haloperidol
Glucose-like peptide 1, 1449 electron microscopy of, 920f cell reproduction and, 38–39 Hallervorden-Spatz disease, 673t
Glucose transporter deficiency, gonorrhea caused by, 919 description of, 954t Hallucination, schizophrenia and,
672 Gonorrhea, 919–922 examples of, 39t 644–646, 645b
Glutamate clinical manifestations of, Growth hormone (GH), 350–352, Haloperidol
as neurotransmitter, 453t, 490 921–922 696–697, 699t, 700 obsessive-compulsive disorder
schizophrenia and, 644 evaluation and treatment of, 922 aging and, 711, 712b treated with, 657
sleep affected by, 503 outpatient treatment for, 923b breast cancer and, 855 schizophrenia treated with, 646,
Glutamate hypothesis, pathophysiology of, 920–922 deficiency of, 721 646b
schizophrenia and, 644 pelvic inflammatory disease hypersecretion of, 722–724 Hamartoma, childhood cancer
Glutathione peroxidase, 61–62 associated with, 814 osteoporosis and, 1552 associated with, 443t
Glutathione-S-transferase (GST), Gorlin syndrome, childhood cancer sleep affected by, 503 Hammer bone, 515
417 associated with, 443t stress response influenced by, 351t HAND. See Human
Glutathione-S-transferase gene, Gout, 7, 1574–1578 Growth hormone (GH) deficiency, immunodeficiency virus-
prostate cancer and, 904 clinical manifestations of, 721 associated neurocognitive
Gluten-sensitive enteropathy, 1576–1578 Growth hormone-releasing factor disorder (HAND)
1494–1497 evaluation and treatment of, (GRF), 696–697, 700 Hand
clinical manifestations of, 1497 1578 Growth hormone-releasing dislocation or subluxation of,
evaluation and treatment of, 1497 pathophysiology of, 1575–1578 hormone 1544
pathophysiology of, 1494–1497, stages of, 1576 action of, 698t dystonic posturing of, 561f
1496f urate and, 88 loss of, 719f rheumatoid arthritis of, 1569f
1774 INDEX

Hanging strangulation, 74 Heart failure (HF) Helicobacter pylori (Continued) Hemoglobin (Hb) (Continued)
HAP. See Hydroxyapatite (HAP) brain natriuretic peptide and, pathogenesis of disease related in erythrocyte, 947–948
HAPE. See High altitude 1179b to, 1434b fetal, 961, 1056
pulmonary edema clinical manifestations of, 1202b pernicious anemia associated iron in form of, 990
Haploid cell, 142, 144f congenital heart disease and, with, 988 molecular structure of, 961f, 961t
Haplotype, 233–235 1199–1200, 1201t Helminth, 314 normal ranges of, 1245t
Hapten, 229 definition of, 1175 acquired immunodeficiency oxygen binding with, 1240–1241
Hapten model, 999, 999f evaluation of, 1179–1180 syndrome and, 327b oxygen transport and, 1240
Hashimoto disease, 729 gene therapy for, 1180b description of, 314t sickle cell, 1064f
Haustra, 1407 high-output, 1181–1182 infection from, 303t synthesis of, 961–962
Haversian canal, 1517 metabolic changes associated Hemagglutinin, 320 values for, 978t, 1057t
Haversian system, 1517 with, 1178b Hemangioblastoma, characteristics Hemoglobin H disease, 1069
Hay fever, stress and, 342t multiple organ dysfunction of, 627t Hemoglobin S (HbS), 1063, 1066
Hb. See Hemoglobin (Hb) syndrome associated with, Hemangioma, 633b, 1662–1663 Hemolysis, hemolytic anemia
HbF. See Fetal hemoglobin (HbF) 1683 Hemangiopericytoma, pediatric, associated with, 997t
HbS. See Hemoglobin S (HbS) pediatric, 1200–1202 1612t Hemolytic anemia, 983t, 996–1001
HCAP. See Pneumonia; clinical manifestations of, 1201 Hematemesis, 1249, 1428, 1428t causes of, 997t
healthcare-associated evaluation and treatment of, Hematochezia, 1428, 1428t clinical manifestations of, 1000
HD. See Huntington disease (HD) 1201–1202 Hematocrit evaluation and treatment of,
HDI. See Human Development pathophysiology of, 1200–1202 chronic kidney disease and, 1366t 1000–1001
Index types of, 1175–1182 definition of, 1112 laboratory findings for, 986t
HDL. See High-density lipoprotein Heart failure with preserved values for, for infant and child, as secondary to drug effects, 994t
(HDL) ejection fraction (HFpEF), 1057t Hemolytic disease of the newborn
HDN. See Hemolytic disease of the 1180–1181 Hematologic system, 1 (HDN), 1058–1062, 1061f, 1501
newborn (HDN) Heart failure with reduced ejection aging and, 975 clinical manifestations of, 1060
Head fraction (HFrEF), 1175 alterations in, in child, 1055–1082 evaluation and treatment of,
arteries of, 467f Heart function autoimmune disorders of, 1060–1062
veins of, 469f chart of, 1089f 264t–265t pathophysiology of, 1059–1062
Head injury, genetics of, 589 indicators of, 1120t blood tests for disorders of, Hemolytic jaundice, 1456
Headache, 607–609 structures controlling, 1092–1101 976t–977t Hemolytic uremic syndrome
brain tumor as cause of, 683 tests of, 1119–1123 chronic kidney disease effects on, (HUS), 1382–1383
characteristics of, 607t Heart rate (HR), 1092, 1102f, 1365t, 1369 clinical manifestations of, 1383
stress and, 342t 1103–1106 clinical evaluation of, 973–975 evaluation and treatment of, 1383
Healing, wound, 216 cardiac output and, 1101 components of, 945–954 pathophysiology of, 1383
Health care, injury from errors in, definition of, 1120t hypothyroidism effects on, 730t Hemophilia, 1070–1072
71–75 gastrointestinal bleeding and, organ dysfunction and, 1684b clinical manifestations of, 1071
Hearing, 514–515 1427–1428 pediatric, 975 evaluation and treatment of,
aging and, 515–518 hypovolemic shock and, 1672 Hematoma 1071–1072
dysfunction of, 517 in infant, 1198 epidural, 584 pathophysiology of, 1071–1072
Hearing loss, 83, 517 mean arterial pressure and, 1114t extradural, 584 types of, 1071–1072
Heart, 1085–1106 in older adult, 1123t intracerebral, 586 Hemophilia A, 1071
arteries of, diagram of, 1091f pediatric, 1702t–1703t subdural, 585f Hemophilia B, 1071
chambers of, 1086, 1087f, 1141f pediatric shock and, 1701 Hematopoiesis, 954–959 Hemophilia C, 1071
conduction system of, 1093f Heart valve, 1086–1088, 1087f fetal, 1055–1056 Hemoprotein, 86–87
development of, 1194 disorders of, 1167 illustration of, 958f Hemoptysis, 1249
diagram of, 1084f stenosis of, 1167 neonatal, 1055–1056 Hemorrhage
electrical activity in, 1096f venous, damage to, 1129–1130 sites of, 1056f disseminated intravascular
embryologic development of, Heat, inflammation associated with, Hematopoietic cell, differentiation coagulation and, 1044–1045
1195f 213 of, 957f, 1511f hypertensive, 602f
enlargement of, 51 Heat conservation, mechanisms of, Hematopoietic cell growth factor, hypovolemic shock associated
fetal, development of, 1194 497–498 39t with, 1705
fibrous skeleton of, 1086 Heat cramps, 77, 500 Hematopoietic growth factor, intracerebral, 603f
innervation of, 1095–1097 Heat exhaustion, 77, 500 958 microscopic, 591
intracardiac pressure in, Heat loss, mechanism of, 497 Hematopoietic stem cell (HSC), wound healing and, 218
1089–1090 Heat production, body temperature 955–956, 958, 1510 Hemorrhagic exudate, 213
rupture of, 1163 and, 496 Hematuria, 1335–1336 Hemorrhagic shock
septal development of, 1196f Heat stroke, 77, 500 Heme pediatric, 1706t
stress effects on, 341, 342b Heat production, mechanisms of, description of, 961 temperature regulation affected
structure of, 1083–1090, 1086f, 496–497 hemoglobin separated into, 1411 by, 502
1092–1101 Heel, bursitis of, 1547t iron cycle and, 963 Hemorrhagic stroke, 602–603,
valves in. See Heart valve Height, distribution of, 165–166, Hemiagnosia pain, 494 677b, 678
veins of, diagram of, 1091f 166f Hemianopia, 512 Hemosiderin, 86, 963
wall of, 1085–1086, 1085f, Heinz body, 1062 Hemifacial spasm, 561f Hemosiderosis, 86
1163–1175 Helicobacter pylori, 304t–305t Hemiparesis, 568–569 Hemostasis
Heart attack, 1148 cancer associated with, 423, 423t Hemiparetic cerebral palsy, 672 control of, 970–971
Heart disease. See also Congenital gastric cancer associated with, Hemiplegia, 568–569, 677 illustration of, 966f
heart disease; Coronary heart 384, 1467 Hemiplegic posture, 574–575 impaired, 1042–1043
disease gastric ulcer associated with, Hemizygous chromosome, 156 mechanism of, 965–973
acquired, 1218 1437t, 1438 Hemochromatosis, 992 Hemostatic plug, 969
manifestations of, 1175 gastritis associated with, 1434 Hemoconcentration, burn injury Hemothorax, pleural effusion and,
pediatric, 1198–1218 immune response suppressed associated with, 1717 1254–1255
psychosocial stress and, 354b by, 309 Hemodialysis, 1363–1364 Henderson-Hasselbalch equation,
pulmonary edema associated infection caused by, 1435 Hemodynamics, postnatal, 1198 123
with, 1260 mucosa-associated lymphoid Hemoglobin (Hb) Henoch-Schönlein purpura, 1353
radiation exposure and, 81 lymphoma associated with, blood tests for, 976t–977t Henoch-Schönlein purpura
stress and, 356 1467 carbon monoxide effect on, 67 nephritis, 1382
 INDEX 1775

Hepadnavirus, description of, 318t Hereditary nonpolyposis colorectal Hindbrain, 454, 454t, 459–460 Homeostasis
Heparin cancer, 379 Hinge region, 231 bone formation and, 1513t–1514t
deep venous thrombosis treated Hereditary sideroblastic anemia, Hip cell injury and, 49
with, 1131 992 bursitis of, 1547t cellular communication and,
disseminated intravascular Hereditary spherocytosis (HS), degeneration of, 1566f 20
coagulation treated with, 1062–1063 developmental dysplasia of, immunologic, 263
1047 Hermansky-Pudlak syndrome, 1594–1595 stress response and, 339–341
osteoporosis and, 1552 1042 dislocation or subluxation of, Homocystinuria, congenital heart
stroke treated with, 599–601 Herniation, intestinal obstruction 1544–1545, 1594, 1594f defects associated with, 1200t
thromboembolism treated with, caused by, 1431t, 1437t dysplasia of, 1594–1595, 1594f Homologous chromosome, 142,
1048 Herniation syndrome, 557, 557b, fracture of, osteoporosis 145f
thrombosis treated with, 1072 585 associated with, 1551 Homonymous hemianopsia, 512
Heparin-induced Heroin, description and effects of, Hippocampus, 457 Homovanillic acid/vanillylmandelic
thrombocytopenia (HIT), 72t–73t attention deficit and, 539f–540f acid, as tumor marker, 369t
1038 Herpes simplex encephalitis, 614f dysmnesia and, 536–537 Hookworm disease, 314t
Hepatic artery, 1409 Herpes simplex virus (HSV), 320, glucocorticoid receptors in, Hordeolum, 507
Hepatic encephalopathy, 1636 649b Hormonal hyperplasia, 53
1454–1455, 1503 central nervous system diseases Hirschsprung disease, 1491–1492 Hormonal regulation
Hepatic portal vein, 1409 caused by, 610t Hirsutism, 807, 1647 alterations in, 717–767
Hepatic vein, 1409–1410 genital infection caused by, 932 Histamine mechanism of, 1, 717–718
Hepatitis type 1, description of, 318t action of, in digestive system, 1397t Hormonal signaling, 20
alcoholic, 69f, 1460 type 2, description of, 318t biologic effects of, 271 Hormone insensitivity, 717–718
autoimmune, 1457 type B, description of, 318t gastric secretions and, 1398 Hormone receptor, 691–692
pediatric, 1502 Herpes simplex virus (HSV) hypersensitivity reaction and, lipid-soluble, 694–695, 695f
viral, 1457–1460 infection 265 steroid, 694–695
Hepatitis A virus (HAV), 318t, clinical manifestations of, inflammation and, 206–207 Hormone replacement therapy
1457–1458 933–934 mast cell and, 348–349, 349f (HRT), 853–855
course of infection with, 1458f evaluation and treatment of, 934 as neurotransmitter, 452, 453t Hormone(s)
pediatric, 1502 neonatal, 933 renal blood flow affected by, alterations in regulation of,
Hepatitis B surface antigen pathophysiology of, 933–934 1328t 717–767, 804–834
(HBsAg), 1502 Herpes varicella, 1636 stomach acid secretion and, 1399 binding proteins and, 692t
Hepatitis B virus (HBV), 318t, Herpes zoster, 1636, 1660–1661 Histamine cephalgia, 608 blood flow affected by,
1457–1459 Herpesvirus Histiocyte, characteristics of, 1618t 1116–1117
cancer associated with, 382–383, cancer associated with, 383t, 423 Histone, 2, 185f breast cancer and, 845–855
383t, 423, 423t description of, 318t Histone modification, 183–184 cancer associated with, 403f
course of infection with, 1458f Herpesvirus type B, cancer Histoplasma capsulatum, 310–311, cardiac effects of, 1106
mother-infant transmission of, associated with, 423t 312t characteristics of, 689
1458 Heterophagosome, 8 Histoplasmosis, 310–311, 312t, 611 eating behavior influenced by,
pediatric, 1502 Heterophile antibody, 1012–1013 HIT. See Heparin-induced 1448b
sexually transmitted infection Heterotopic ossification (HO), thrombocytopenia (HIT) effects of, 695
and, 940–941 1547 HIV. See Human female reproductive system and,
Hepatitis C virus (HCV), 1457–1459 Heterozygote, 151 immunodeficiency virus 350
cancer associated with, 382–383, HEV. See High endothelial venule (HIV) infection as first messenger, 692
383t, 423, 423t Hexosamine pathway, Hives, 272, 1639 hypothalamic, 698t
pediatric, 1502 hyperglycemia and, 747 HL. See Hodgkin lymphoma (HL) inadequate synthesis of, 718t
sexually transmitted infection HFpEF. See Heart failure with HLA. See Human leukocyte antigen incretin, 706
and, 940 preserved ejection fraction HLHS. See Hypoplastic left heart lipid-soluble, 690t, 691
Hepatitis D virus (HDV), (HFpEF) syndrome (HLHS) osteoporosis and, 1552
1457–1459 HFrEF. See Heart failure with HMD. See Hyaline membrane prostate cancer and, 901–904
Hepatitis delta agent, 941 reduced ejection fraction disease (HMD) regulation of, 1
Hepatitis E virus (HEV), 1457–1459 (HFrEF) HME. See Hereditary multiple release of, 690–691
Hepatoblastoma, Beckwith- HGF. See Hepatocyte growth factor exostoses (HME) renal, 1333–1334
Wiedemann syndrome and, HH. See Hereditary HO. See Heterotopic ossification renal function affected by, 1327
188 hemochromatosis (HH) (HO) as second messenger, 694, 694t
Hepatocarcinoma, 1472 Hiatal hernia, 1429–1430, 1430f H2O2. See Hydrogen peroxide secretion of, 1447b
Hepatocellular carcinoma, 1472 Hibernating myocardium, 1160 (H2O2) sex (See Sex hormone)
Hepatocyte, 1409–1410 Hiccups, brain dysfunction Hodgkin lymphoma (HL), stress response influenced by,
Hepatocyte growth factor, 52–53 associated with, 533 1023–1027 350–353, 351t
Hepatomegaly, polycythemia vera Hidradenitis suppurativa, 1631b childhood, 1079–1081 structural categories of, 690t
associated with, 1003 High altitude cerebral edema, 78 clinical manifestations of, transport of, 691
Hepatopulmonary syndrome, High altitude illness, 78 1025–1026 in utero production of, 768–770
1453 High altitude pulmonary edema, evaluation and treatment of, vasoconstrictor, 1117
Hepatorenal syndrome (HRS), 78 1026–1027 water-soluble, 690t, 691
1456–1457, 1461 High-density lipoprotein (HDL), example of, 1027f Horner syndrome, 684
Hepcidin 1149 lymph nodes sites of, 1026f Horseshoe kidney, 1378
iron absorption and, 1406 atherosclerosis and, 1145, 1151 non-Hodgkin lymphoma Horton syndrome, 608
iron cycle and, 964 optimization of, 1149–1151 compared to, 1028t Housekeeping gene, 184
Herald patch, 1630, 1630f High endothelial venule, 242 pathophysiology of, 1024–1027 Howell-Jolly body, 984f
Herd immunity, 333 High-flow vascular malformation, statistics on, 1015t Howship lacunae, 1515
Hereditary angioedema, 201 1663 subtypes of, 1025t HPA. See Hyperphenylalaninemia
Hereditary angioneurotic edema High-output failure, 1181–1182, survival rates for, 394t (HPA); Hypothalamic-
(HAE), 1298 1182f Holding contraction, muscle, 1534 pituitary-adrenal (HPA) axis
Hereditary hemochromatosis Highly sensitive C-reactive protein, Hole zone, 1516 HPG. See Hypothalamic-pituitary-
(HH), 1004 1152 Holt-Oram syndrome, congenital gonadal (HPG) axis
Hereditary multiple exostoses Hila, description of, 1228 heart defects associated with, HPO4. See Phosphate
(HME), 1609 Hilum, of kidney, 1320 1200t HR. See Heart rate (HR)
1776 INDEX

HRS. See Hepatorenal syndrome Human papillomavirus (Continued) Hygiene hypothesis, asthma and, Hyperkalemia, 117–119
(HRS) cervical cancer associated with, 1264, 1309 acute kidney injury and, 1363
HRT. See Hormone replacement 825–826 Hymen, 772 causes of, 118t
therapy (HRT) vaccine for, 775b, 935, 935b Hyperactivity, description of, 563t chronic kidney disease and, 1367
HS. See Hereditary spherocytosis vulvar cancer and, 829–830 Hyperacute rejection, 280, 280f clinical manifestations of,
(HS) warts associated with, 1636–1637 Hyperaldosteronism, 755–756 117–118
HSC. See Hematopoietic stem cell Human papillomavirus infection, clinical manifestations of, 756 electrocardiogram affected by,
(HSC) 934–936 evaluation and treatment of, 756 117f
HSV. See Herpes simplex virus clinical manifestations of, Hyperalgesia, 489 evaluation and treatment of, 119
(HSV) 921–922 Hyperbaric oxygen therapy, bone pediatric shock associated with,
Human chorionic gonadotropin, evaluation and treatment of, infection treated with, 1560 1713
369t, 855 936 Hyperbilirubinemia, 86–87, 1060, Hyperkalemic periodic paralysis,
Human defenses, 192, 192t pathophysiology of, 935–936 1455 1582
inflammatory response as, Human T-cell lymphotropic virus cholelithiasis associated with, Hyperketonemia, 737–739, 744
195–213 type 1, 383 1463 Hyperkinesia, 561–562, 563t
Human Development Index, cancer cancer associated with, 423t neonatal, 1500–1501 Hyperleptinemia, 1448
incidence rates and, 409b central nervous system diseases pediatric, 1061–1062 Hyperlipidemia, 1384
Human DNA sequence, 160 caused by, 610t Hypercalcemia, 119f, 120–121, cellular injury caused by, 75
Human genome, 160 Human T-cell lymphotropic virus 731–732 nephrotic syndrome associated
Human immunodeficiency virus- type 2, central nervous system cancers associated with, 395t with, 1359t
associated neurocognitive diseases caused by, 610t multiple myeloma associated Hypermagnesemia, 122
disorder (HAND), 615–617 Human-to-human transmission, with, 1032 Hypermenorrhea, 808t
Human immunodeficiency infection and, 301 pediatric shock associated with, Hypermetabolism
virus-associated peripheral Humoral immune response, 1713 burn injury associated with,
neuropathy, 617 247–249 Hypercalciuria, 1720–1721
Human immunodeficiency virus Hunter syndrome, congenital heart hyperparathyroidism and, 733 multiple organ dysfunction
encephalopathy, 677 defects associated with, 1200t Hypercapnia, 129, 529–532, 1251 syndrome and, 1683
Human immunodeficiency virus Huntington disease (HD), 154, hypoventilation and, 1250 Hypermimesis, 575
(HIV) infection 562–564 obstructive sleep apnea syndrome Hypernatremia, diabetes insipidus
acquired immunodeficiency clinical differentiation of, 547t and, 1300 associated with, 720
syndrome and, 322, 326f molecular basis for, 547t respiratory failure and, Hyperopia, 512
Candida infection associated Hurler syndrome, congenital heart 1252–1253 Hyperosmolar hyperglycemic
with, 313–314 defects associated with, 1200t Hyperchloremia, 112 nonketotic syndrome
central nervous system HUS. See Hemolytic uremic Hyperchloremic metabolic (HHNKS), 745–746, 745f
complications caused by, syndrome (HUS) acidosis, 128 Hyperparathyroidism, 731–733
616b Hyaline membrane disease (HMD), Hypercoagulability, 1048–1053 chronic kidney disease and, 1368
central nervous system diseases 1301 congenital, 1072–1073 clinical manifestations of, 733
caused by, 610t Hyaluronate, 1522 pulmonary embolism and, 1275 evaluation and treatment of, 733
clinical manifestations of, Hydrocele, 892, 893f Hypercoagulation, nephrotic low back pain caused by, 596–597
326–327 Hydrocephalus, 558–559, 668–670 syndrome associated with, Hyperphenylalaninemia (HPA),
dementia associated with, 616t clinical manifestations of, 1384 673–674
genetic map of, 323f 669–670 Hypercyanotic spell, 1209 Hyperphosphatemia, 734
immune system affected by, evaluation and treatment of, 670 Hyperemia, blood pressure affected Hyperphosphaturia,
291–292 magnetic resonance image of, by, 1116 hyperparathyroidism and, 733
opportunistic infections 559f Hyperfunction, urinary tract Hyperpituitarism, 722
and, 617 pathophysiology of, 669 obstruction and, 1342 Hyperplasia, 51–53
pathogenesis of, 324–326 types of, 558–559 Hyperglycemia illustration of, 50f
pediatric, 329b Hydrocephalus ex vacuo, 558 cellular injury associated with, 75 proliferative breast lesions and,
peripheral nervous system Hydrocephaly, prevalence rate of, chronic, 740f 841
complications in, 616b 171t chronic kidney disease and, 1369 Hyperpnea, 1249
prevention of, 327 Hydrochloric acid, secretion of, diabetes mellitus and, 737–739 Hyperpolarization
sites of therapeutic intervention 1399f glycation and, 746–747 cardiac action potentials and,
of, 324f Hydrogen ion, 122–123, 1330 hexosamine pathway and, 747 1094
statistics on, 322 Hydrogen peroxide (H2O2), 8 hypovolemic shock associated hypokalemia and, 116
structure of, 323f Hydrogen sulfide, asphyxiation with, 1704 Hyperprolactinemia
tissues infected by, 325f from, 74 microvascular disease and, causes of, 837b
transmission of, 318t, 322 Hydrolase, 7 747–751 nonpuerperal, 837
treatment of, 327 Hydronephrosis, 1341–1342, 1380 multiple organ dysfunction secondary amenorrhea and, 807
tuberculosis associated with, 1274 Hydrophilic pole, molecular, 12–13 syndrome and, 1683 Hypersensitivity, 262–281
viral meningitis caused by, 617 Hydrophobic pole, molecular, pediatric shock associated with, anaphylactic shock and, 1675
Human immunodeficiency virus 12–13 1703, 1713 definition of, 262
myelopathy, 617 Hydrops fetalis, 1060 polyol pathway and, 746 mechanism of, 263–270
Human immunodeficiency virus Hydrostatic pressure protein kinase C and, 746 Hypersensitivity pneumonitis,
neuropathy, 617 passive transport and, 29–30 type 2 diabetes mellitus and, 739 1259–1260
Human leukocyte antigen (HLA), in plasma, 30f Hyperglycemic hyperosmolar Hypersensitivity reaction
174, 177, 233, 234f Hydroureter, 1341–1342 state, 745 antigenic targets of, 270–277
autoimmune disease and, 276, Hydroxyapatite (HAP), 119, 1516 Hyperglycemic neuropathy, 751t classification of, 262
276t Hydroxychloroquine, rheumatoid Hyperhemolytic crisis, sickle cell clinical manifestations of, 272t
graft rejection and, 280 arthritis treated with, 1572 disease and, 1066 delayed, 263
inheritance of, 235f Hydroxydaunomycin, chronic Hyperhomocysteinemia, 1049, examples of, 263t
psoriasis and, 1629 leukemia treated with, 1023 1152 immediate, 263
Human leukocyte antigen-death Hydroxyurea Hyperinsulinemia incidence of, 263t
receptor 4 (HLA-DR4), 1569 polycythemia vera treated with, cancer and, 419 type I: IgE-mediated, 263–265,
Human papillomavirus (HPV) 1004 chronic kidney disease and, 1368 266f–267f, 273
cancer associated with, 382, thrombocytopenia treated with, polycystic ovary syndrome and, allergic reactions associated
423–424, 423t 1041 810 with, 271f
 INDEX 1777

Hypersensitivity reaction Hypertrophic obstructive Hypoparathyroidism, 733–734 Hypovolemia

(Continued) cardiomyopathy, 1166 Hypophosphatemia, 121–122, 732 burn injury associated with, 1689
symptoms of, 271–272 Hypertrophic scar, 219, Hypophyseal portal system, 697f dehydration and, 1704t
tests for, 272–273 1620t–1622t, 1626–1627, Hypophysiotropic hormone, 698t hypovolemic shock associated
type II: tissue-specific, 263, 1722 Hypopituitarism, 720–722 with, 1672, 1703
265–269, 273 Hypertrophy, 51 clinical manifestations of, 721 inflammation and, 218–219
mechanism of, 268f cardiac, 51 evaluation and treatment of, 722 pediatric burn injury associated
type III: immune-complex illustration of, 50f Hypopituitary dwarfism, 721f with, 1718
mediated, 263, 269–270 myocardial, 52b Hypoplastic anemia, 992, 995 pediatric septic shock associated
mechanism of, 269, 269f Hyperuricemia, 88, 1574–1575 Hypoplastic kidney, 1380 with, 1709
type IV: cell-mediated, 263, 270, Hyperventilation, 1250 Hypoplastic left heart syndrome shock caused by, 1671
273 asthma and, 1264 (HLHS), 1214, 1214f Hypovolemic shock, 1672–1673,
mechanism of, 270f central neurogenic, 532 Hypopolarization, potassium 1703–1705
Hypersomnia, 505 respiratory alkalosis associated imbalance associated with, 118 burn injury associated with, 1690
Hypersplenism, 1036 with, 130 Hypoproteinemia, 218–219 clinical manifestations of,
Hypersynchronization, seizure Hyphae, fungal infections and, Hyposmia, 517–518 1704–1705
initiation and, 552–553 1637–1638 Hypospadias, 1378, 1379f definition of, 1700
Hypertension, 1132–1140 Hypoactive sexual desire, 834 Hypotension diagram of, 1673f
atherosclerosis associated with, Hypoalbuminemia, nephrotic hypovolemic shock associated intestinal obstruction as cause of,
1145 syndrome associated with, with, 1703 1431–1432
cardiovascular disorders 1359t orthostatic (postural), 1140 pediatric, evaluation and
associated with, 1138 Hypocalcemia, 119f, 120 Hypotensive shock, pediatric, treatment of, 1710–1715
chronic, 1136–1140 chronic kidney disease and, 1368 1699 Hypoxemia, 985, 1251–1252
chronic kidney disease and, 1369 hypoparathyroidism and, Hypothalamic-pituitary-adrenal acute respiratory distress
clinical manifestations of, 733–734 (HPA) axis, 339, 341f, 696–700 syndrome and, 1263
1138–1139 treatment of, 734 female reproductive system and, causes of, 1252t
complicated, 1136–1140 Hypocapnia, 130, 1250 350, 352f congenital heart disease and,
coronary artery disease and, 1151 Hypochloremia, 113 Hypothalamic-pituitary-adrenal 1199–1200
evaluation and treatment of, Hypochloremic metabolic acidosis, (HPA) system, alterations in, heart defects associated with,
1139–1140 130f 718–724 1202
genetic factors associated with, Hypochloremic metabolic Hypothalamic-pituitary-adrenal obstructive sleep apnea syndrome
172, 1132 alkalosis, 128 system dysregulation, stress and, 1300
hyperaldosteronism and, 756 Hypochlorhydria, 1418 and, 648 respiratory failure and,
intracranial, 556, 556f Hypocomplementemia, 1355 Hypothalamic-pituitary-gonadal 1252–1253
laboratory tests for, 1221t Hypocomplementemic, definition (HPG) axis, 771, 771f, 886 upper airway obstruction
obesity associated with, 1136b of, 269–270 Hypothalamic-pituitary system associated with, 1293
pathogenesis of, 1133f Hypocortisolism, 757 alterations in, 718–724 Hypoxia, 56–59
pathophysiology of, 1132, 1133f Hypocretin, 503 menstrual cycle and, 779f cerebral, 74
pediatric, 1218–1221 Hypodermis, 1616, 1618–1619, Hypothalamic-pituitary-testicular diabetes mellitus and, 752
clinical manifestations of, 1220 1618t axis, 791, 791f inflammation and, 57f
evaluation and treatment of, Hypoferremia, 990 Hypothalamic-pituitary-thyroid shock as cause of, 1699
1220–1221 Hypogammaglobulinemia, 284 system dysregulation, 648–650 Hypoxic pulmonary
pathophysiology of, 1220–1221 Hypogeusia, 518 Hypothalamus, 457–459 vasoconstriction, 1230–1231,
pheochromocytoma associated Hypoglossal nerve, 472t body temperature regulated by, 1232b
with, 759 Hypoglycemia, 743 496
portal, 1452–1453 cancers associated with, 395t cortisol secretion regulated by, I
prevalence of, 172t hypovolemic shock associated 708 I band, 1098–1099
primary, 1132–1140 with, 1704 functions of, 459b IABP. See Intraaortic balloon
pulmonary artery, 1276–1278 pediatric shock associated with, hormones secreted by, 339 counterpulsation (IABP)
secondary, 1136–1140 1703, 1713 location of, 690f IARC. See International Agency for
stress and, 342t symptoms of, 743 nerve tracts from, 698f Research on Cancer (IARC)
stroke associated with, 598 Hypoglycemic drugs, 743t obesity and, 1447–1448 Iatrogenic hypothyroidism, 729
treatment for, 1139f Hypogonadism, 802t sleep affected by, 503 Iatrogenic pneumothorax, 1254
Hypertensive hemorrhage, 602, Hypokalemia, 115–117 structure and function of, IBD. See Inflammatory bowel
602f causes of, 118t 696–697 disease (IBD)
Hyperthermia, 76–77, 500–501, clinical manifestations of, Hypothermia, 501 IBS. See Irritable bowel syndrome
1708 116–117 cellular injury caused by, 75–76 (IBS)
Hyperthermic injury, 76–77 electrocardiogram affected by, pediatric septic shock associated Ibuprofen
Hyperthyroidism, 725–728 117f with, 1708 abnormal uterine bleeding treated
causes of, 725f evaluation and treatment of, 117 therapeutic, 1715 with, 809
clinical manifestations of, 725, hyperaldosteronism and, 756 Hypothermic injury, 75–76 cystic fibrosis treated with, 1312
726f intestinal obstruction as cause Hypothyroidism, 728–731 gastritis associated with, 1434
evaluation of, 727f of, 1432 clinical manifestations of, 726f infectious mononucleosis treated
hypersensitivity reaction and, pediatric shock associated with, nephrotic syndrome associated with, 1013
267–269 1713 with, 1359t ICF. See Intracellular fluid (ICF)
systemic manifestations of, 727t Hypokalemic periodic paralysis, systemic manifestations of, 730t ICH. See Intracranial hemorrhage
Hypertonia, 560–561, 560t 1582 Hypotonia, 559–560, 560t (ICH)
Hypertonic, definition of, 110–111 Hypokinesia, 561–562, 564 Hypotonic alteration ICOU. See Idiopathic calcium
Hypertonic alteration Hypokinetic confusional state, 542 causes of, 112t oxalate urolithiasis (ICOU)
sodium-chloride-water balance Hypolipidemia, cellular injury sodium-chloride-water balance ICP. See Intracranial pressure (ICP)
and, 110–112 caused by, 75 and, 112–114 Icteric phase of hepatitis, 1459
sodium concentration and, 110f Hypomagnesemia, 122 sodium concentration and, 110f Icterus, 1000, 1455–1456
Hypertonic solution, 31 Hypomimesis, 575 Hypotonic fluid imbalance, 112 Icterus gravis neonatorum, 1060
Hypertrophic cardiomyopathy, Hyponatremia, 112–113, 113b Hypotonic hyponatremia, 113 Icterus neonatorum, 1060
1165f, 1166–1167, 1166t, 1167f dilutional, 113 Hypotonic solution, 31 IDA. See Iron deficiency anemia
Hypertrophic lichen planus, 1631f hypotonic, 113 Hypoventilation, 1250–1252 (IDA)
1778 INDEX

Identical twin, 169 Immune deficiency (Continued) Immunity (Continued) Immunoglobulin M, 229–230
Idiojunctional rhythm, evaluation and care of, 292–293 humoral, 226–227 biologic properties of, 232t
pathophysiology and treatment gene therapy for, 294–296 innate, 1 hemolytic anemia and, 998
of, 1183t–1184t primary, 281–289, 282t natural, 191 hemolytic disease of the newborn
Idiopathic Addison disease, 757 secondary, 289–292 passive, 227 and, 1060
Idiopathic calcium oxalate Immune function stress response and, 348, 349f immune response and, 247
urolithiasis (ICOU), 1343 burn injury and, 1719–1720, surfactant and, 1236b immune thrombocytopenic
Idiopathic (type 1B) diabetes, 735 1720f Immunization purpura and, 1039
Idiopathic epilepsy, 553 surfactant and, 1236b active, 332–333 in infant, 1292–1293
Idiopathic equinovarus, 1597 Immune response, 224–225. See also passive, 333–336 physicochemical properties of,
Idiopathic inflammatory myopathy Immunity Immunocompetent, lymphocytes 231t
(IIM), 1584 adaptive, 224–225 and, 225 Immunoglobulin superfamily cell
Idiopathic polyneuritis, 622 aging effects on, 257–260 Immunocyte, 948 adhesion molecule, 18
Idiopathic pulmonary fibrosis bacterial suppression of, 309 Immunogen, description of, Immunologic homeostasis, 263
(IPF), 1258 to burn injury, 1692–1693 228–229 Immunologic incompetence,
Idiopathic scoliosis, 1600 cellular, 249–251 Immunogenicity, pathogenic, 302 pediatric, 1292–1293
Idiopathic thrombocytopenic cytokines and, 235–236 Immunoglobulin (Ig), 333 Immunologically privileged site,
purpura (ITP), 1073–1074 diabetes mellitus and, 752 adaptive immune response and, 274–275
Idioventricular rhythm, edema and, 107 225 Immunology, lung cancer treatment
pathophysiology and treatment fetal, 257 biologic properties of, 232t and, 1280b
of, 1183t–1184t fungal suppression of, 313 in breast milk, 253 Immunomodulation, type 1
IF. See Intrinsic factor (IF) humoral, 247–249 class-switch and, 248–249 diabetes mellitus treated with,
IFG. See Impaired fasting glucose induction of, 241–251 classes of, 229–230 738b
(IFG) infection and, 291–292 definition of, 229 Immunotherapy, passive, 333–336
Ig. See Immunoglobulin (Ig) malignancy and, 291 Kawasaki disease treated with, Impaired fasting glucose (IFG), 735
IgA. See Immunoglobulin A medical treatment and, 291 1218 Impaired glucose tolerance (IGT),
IgD. See Immunoglobulin D neonatal, 257 molecular structure of, 230–232 735
IgE. See Immunoglobulin E overview of, 226f in neonate, 257 Impaired hemostasis, 1042–1043
IGF. See Insulin-like growth factor to parasitic infection, 315 physicochemical properties of, Imperforate anus, 1492, 1492f
(IGF) primary, 247–248 231t Impetigo, 1635, 1656, 1656f
IGF-2. See Insulin-like growth products of, 225 secretory, 252 Staphylococcus aureus associated
factor 2 secondary, 247–248 structure of, 231f with, 311f
IGF-1. See Insulin-like growth factor secretory, 252–253 Immunoglobulin A, 229 Imprinting, genomic, 187–188
1 (IGF-1) viral neutralization of, 319–320 biologic properties of, 232t Impulse formation, disorders of,
IgG. See Immunoglobulin G viral suppression of, 320 immune thrombocytopenic 1183t–1184t
IgM. See Immunoglobulin M Immune system purpura and, 1039 Inadequate intake of dietary
IgSF CAM. See Immunoglobulin aging and, 257–260, 290 in infant, 1292–1293 sodium, 113
superfamily cell adhesion bacterial neutralization of, 309 physicochemical properties of, Inamrinone, shock treated with,
molecule burn injury and, 1719–1720 231t 1714t
IGT. See Impaired glucose tolerance cancer and, 382–383 secretory immune response and, Inborn errors of metabolism,
(IGT) chronic kidney disease effects on, 253 congenital heart defects
IIM. See Idiopathic inflammatory 1365t, 1369 Immunoglobulin A deficiency, 285 associated with, 1200t
myopathy (IIM) corticotropin-releasing hormone Immunoglobulin A nephropathy, Inbreeding, 156
IL. See Interleukin influence on, 348–349 1353, 1356t Incidence, disease, 164–165
Ileal atresia, 1490 cortisol and, 348–350 Immunoglobulin A pemphigus, Incidence rate, 164
Ileocecal valve (sphincter), 1400, dietary insufficiency and, 290–291 1633 Incise wound, description of, 79t
1407 fetal, 257 Immunoglobulin A protease, 309 Inclusion-body myositis,
Ileocolitis, 1442 fungal suppression of, 313 Immunoglobulin D, 230 1584–1585
Ileogastric reflex, 1407 maternal, 276 biologic properties of, 232t Incomplete fracture, 1541, 1542t
Ileum, 1400, 1490 neonate, 257 physicochemical properties of, Incontinence
Ileus, intestinal, 1431 organ dysfunction and, 1684b 231t types of, 1344t, 1389t
Iloprost, pulmonary artery parasitic neutralization of, 315 Immunoglobulin E, 230, 254–255 urinary, 1388–1391
hypertension treated with, parasitic suppression of, 315–316 asthma and, 1264 Increased intracranial pressure
1278 pregnancy effects on, 290 biologic properties of, 232t (IICP), 555–557
IM. See Infectious mononucleosis secretory, 252 function of, 254f hydrocephalus as cause of,
(IM) stress effects on, 290, 342, physicochemical properties of, 668–669
Image processing deficit, 353–355, 648 231t Incretin, 706, 741
description of, 541t systemic, 252 type I hypersensitivity reaction Incubation phase of hepatitis,
Imatinib, 376, 396–397 viral neutralization of, 319–320 and, 263–265 1459
Imatinib mesylate, chronic leukemia viral suppression of, 320 Immunoglobulin G, 229 Incus bone, 515
treated with, 1023 Immune thrombocytopenic biologic properties of, 232t Indomethacin, gastritis associated
Imipramine, depression treated purpura (ITP), 277, 1038–1039 deposition of, in kidney and skin, with, 1434
with, 652b Immunity. See also Immune 277f Induced ischemia, 1154–1156
Immediate hypersensitivity response glomerulonephritis and, 1381 Induction chemotherapy, 397
reaction, 263 acquired, 224–225 hemolytic anemia and, 998 Infant. See also Child; Neonate
Immobilization, following bone active versus passive, 227 hemolytic disease of the newborn acquired cardiovascular disorders
fracture, 1543 adaptive, 224–261 and, 1059–1060 in, 1218
Immortal, cancer cells as, 368 alterations in, 262–297 immune response and, 247, alterations in digestive function
Immune cell, 1510 cancer and, 382–387 1292–1293 in, 1486–1509
Immune complex, 197 cancer progression and, 384–387 immune thrombocytopenic asthma in, 1308–1310
Immune complex disease, 269–270 cell-mediated, 226–227 purpura and, 1039 bladder function alterations in,
Immune corticotropin-releasing cellular, 226–227 in neonate, 257 1378–1391
hormone site, 343 characteristics of, 225–227 physicochemical properties of, blood pressure in, 1220t
Immune deficiency deficiencies in, 281–296 231t blood volume in, 975, 1056–1057,
clinical presentation of, 281 fetal, 1292–1293 Immunoglobulin G subclass 1705t
definition of, 281 herd, 333 deficiency, 284–285 body fluids in, 104
 INDEX 1779

Infant (Continued) Infection, 298–337. See also Infectious viral encephalitides, 614 Influenza
body temperature regulation Infectious disease Infective endocarditis, 1173–1175 avian, 321b
in, 498 AIDS-defining, 327b clinical manifestations of, 1175 death from, 298–299
burn injury recovery in, 1723 anemia associated with, 1062 evaluation and treatment of, 1175 as pandemic, 302t
burn injury to, 1715–1725 bacterial (See Bacterial infection) pathogenesis of, 1174f pathogenesis of, 320–322
cardiopulmonary development bone, 1558–1559, 1601–1603 pathophysiology of, 1173–1175 vaccination and reduction of,
in, 1198 burn injury associated with, 1720 risk factors for, 1173b 330t
circulation in, 1198 cancer associated with, 396b, Infectivity, pathogenic, 302 viral antigenic variation and,
coarctation of the aorta in, 397t, 403f, 423–424, 423t Inferior colliculi, 459 319
1210–1212 cellular injury from, 75 Inferior mesenteric branch of aorta, Influenza virus, 318t
congenital heart defects in, chlamydial, 929–932 470 antigenic shift in, 321f
1198–1218 congenital heart defects Inferior vena cava, 1088 pneumonia associated with, 1273
cranial sutures and fontanels in, associated with, 1199t Infertility, 835–836 Infratentorial disorder, 528
663f coronary artery disease and, 1153 chlamydial infection as cause of, Infratentorial herniation, 557b,
cryptorchidism in, 892–893 countermeasures against, 929–931 557f
diarrhea in, 1499–1500 329–336 male, 913b Infratentorial tumor, in child, 683
epilepsy in, 678 cutaneous, 1634–1638 maternal age and, 836f Infundibulum, 775
glomerular disorders in, diabetes mellitus and, 752 Infiltrating carcinoma, 866t Inguinal canal, 784, 785f
1381–1385 ear, 516–517 Infiltrating glioma, 681t–682t Inhalation injury, toxic gas as cause
heart failure in, 1200–1202 emergent, 299–300, 299t Infiltration, cellular injury and, 83 of, 1258–1259
heart rate of, 1198 fever and, 498 Infiltrative splenomegaly, 1036 Inheritance
hematologic system in, 975 fungal (See Fungal infection) Inflammasome, 202 autosomal dominant, 152–154
hematologic values for, 978t, genital tract, 813–817 Inflammation, 1 autosomal recessive, 154–156
1057t herpes simplex virus, 932–934 acute, 213–214, 217f epigenetic transgenerational,
hematopoiesis in, 1055–1056 human papillomavirus, 934–936 alterations in, 262–297 184–185
hemodynamics in, 1198 human-to-human transmission cancer and, 382–387, 403, 419f multifactorial, 165–168
hepatitis in, 1502 of, 301 cancer progression and, 384–387 X-linked, 156–158
human immunodeficiency virus immune deficiency associated cellular mediators of, 201–213 Inherited hemorrhagic disease,
infection in, 328 with, 281 cellular products associated with, 1070–1073
hypertension in, 1218–1221 immune response against, 203–205 Inherited (congenital) myasthenic
immune function in, 257 251–252 chronic, 214–215 syndrome, 624
integumentary system alterations immune system affected by, description of, 195 Inhibin, 781
in, 1653–1667 291–292 edema and, 107 Inhibitory interneuron, 487
iron deficiency anemia in, 1058 microorganisms and, 300–322 fatty acids and, 194b Inhibitory neurotransmitter,
jaundice in, 1500–1501 myositis, 1583 genital tract, 813–817 490–491
lower airway disorders in, neoplasms associated with, 384t glucocorticoids and, 347b Inhibitory postsynaptic potential,
1301–1313 nosocomial, bacteria associated hypoxia and, 57f 452–453
metabolic characteristics of, 1292 with, 304t–305t levels of reactants during, 214t Injury
multiple organ dysfunction parasitic, 254–255, 314–317 local manifestation of, 213 asphyxial, 74–75
syndrome in, 1699–1715 pediatric, septic shock and, markers of, 1152 blunt-force, 79t
muscle growth in, 1593 1706–1707 mediators of, 204f burn (See Burn injury)
musculoskeletal development in, process of, 300–301 mobilization of, 191 genetic factors and, 75
1591–1593 as septic shock component, phases of, 197f health care error as cause of,
musculoskeletal function 1676t prostatic, 905f 71–75
alterations in, 1591–1615 sexually transmitted (See Sexually prostate cancer associated hypoxic, 56–59
osteomyelitis in, 1602–1603, transmitted infection (STI)) with, 904 immunologic, 75
1602b stages of, 301 Inflammation injury, pediatric, infectious, 75
pain perception of, 495 streptococcal, rheumatic fever 1710 inflammatory, 75
pneumonia in, 1306–1308, 1307t caused by, 1172–1173 Inflammatory acne, 1653–1654 intentional, 70–71
premature tissue damage from, 316 Inflammatory bowel disease (IBD), irreversible, 54–55
bronchopulmonary dysplasia tumors associated with, 384t 1440–1446, 1500b musculoskeletal, 1540–1550
in, 1303–1304 upper airway, 1294–1298, 1296t Inflammatory joint disease, occupational, 89t
respiration in, 1293 urogenital, 919–940 1568–1578 reversible, 54–55
respiratory distress syndrome viral (See Viral infection) Inflammatory muscle disease, sharp-force, 79t
in, 1301 zoonotic, 301 1583–1585 smoke inhalation, 1668
pulmonary system in, 1290–1293 bacteria associated with, Inflammatory response, 195–213 statistics on, 71f
reflex development in, 663t 304t–305t acute, 195f temperature regulation affected
renal system alterations in, viral, 317 characteristics of, 196–197 by, 502
1376–1392 Infectious arthritis, 1569t sequence of events in, 196f unintentional, 70–71
renal system in, 1378 Infectious bone disease, 1558–1560 to bone fracture, 1541–1542 Innate immunity, 191
respiratory distress syndrome in, clinical manifestations of, to burn injury, 1692f overview of, 192t
1302b 1559–1560 chronic, 215f stress response and, 348, 349f
respiratory tract infection in, evaluation and treatment of, 1560 definition of, 192 Inner dura, dura mater and, 464
1305–1308 pathophysiology of, 1559–1560 dysfunction during, 218–219 Inositol triphosphate, 694, 694t
seizures in, 554t pediatric, 1601–1603 in multiple organ dysfunction Inotropic agent, 1103
shock in, 1699–1715, 1700b Infectious disease, 275. See also syndrome, 1682 Insect bite, skin disorders caused
skin infections in, 1656–1661 Infection in older adult, 220–223 by, 1661–1662
sleep patterns in, 503–504 cellular injury associated with, overview of, 192t Insomnia, 504
sudden infant death syndrome in, 75–76 pediatric, 220 Inspiration
1313–1315 clinical process of, 301–302 phases of, 197f interaction of forces during,
urinary tract alterations in, death caused by, 298–299 vascular, 195–197 1237f
1376–1392 mortality and morbidity of, 299 Inflammatory stroma, breast cancer muscles associated with,
Infant diarrhea, 1499–1500 stages of, 301 and, 868–870 1234–1235
Infantile spasm, 679–680 Infectious mononucleosis (IM), Infliximab, ulcerative colitis treated INSTI. See Integrase strand transfer
Infarction, heart attack and, 1148 1011–1013, 1012f with, 1442 inhibitor drugs
Infected pleural effusion, 1255 Infectious organism, classes of, 303t Inflow tract, 1086 Insufficiency fracture, 1541
1780 INDEX

Insula, 457 Interleukin (Continued) Interstitial hydrostatic pressure, 105 Intrinsic acute kidney injury, 1385
Insulin, 704–706 rheumatoid arthritis and, Interstitial matrix, 18f Intrinsic factor (IF), 988, 1399
action of, 705t, 1111b 1569–1570 Interstitial oncotic pressure, 105 Introitus, 772
breast cancer and, 855 source and function of, 236t Interstitial space, metabolic waste Intron, 142
cells affected by, 705f Interleukin-1, 203–204 in, shock and, 1670 Intussusception, 1492–1493
defects in secretion of, 734 burn injury and, 1692 Interventricular foramen (foramen ileocolic, 1493f
inflammation and obesity and, function of, 236t of Monro), 466 intestinal obstruction caused by,
347b in multiple organ dysfunction Intervertebral disk, 466–467 1431t, 1437t
potassium balance affected by, syndrome, 1682 herniation of, 597–598, 597f Invariant chain, 245
114 multiple organ dysfunction Intestinal malrotation, 1489–1490 Invasion
Insulin clearance, 1334 syndrome and, 1680, 1683 Intestinal obstruction, 1431 cancer, 387–392
Insulin gene, 177 pediatric septic shock and, 1707 causes of, 1431t infectious agent and, 301
Insulin-like growth factor (IGF), stress response and, 348–349 classification of, 1432t Invasive breast carcinoma, 870
39t, 700 Interleukin-2, 39t clinical manifestations of, Invasive carcinoma of the cervix,
acromegaly and, 724 burn injury and, 1692 1432–1434 827
aging and, 711, 712b function of, 236t evaluation and treatment of, 1434 Invega. See Paliperidone
breast cancer and, 855 production of, 245–247 example of, 1437t Inverse acne, 1631b
deficiency of, 721 Th cell maturation and, 245 pathophysiology of, 1431–1434, Inverse psoriasis, 1629
effects of, on skeletal tissues, Interleukin-4 1433f Inversion, chromosomal, 149, 149f
1515t burn injury and, 1692 Intestinal peristalsis, 1407 Involucrum, osteomyelitis and,
Insulin-like growth factor 1 (IGF-1) function of, 236t Intestinal phase of secretion, 1400 1559, 1559f, 1602
breast cancer and, 855 pediatric septic shock and, 1707 Intestinal vascular insufficiency, Involution
cancer and, 419 Interleukin-5, function of, 236t 1446 delayed, 845
Insulin-like growth factor 2 (IGF-2), Interleukin-6, 203–204 Intestine epithelial cells affected by,
184–185, 188 burn injury and, 1692 bacteria in, 1408–1409 846b–847b
Insulin reaction, 743 function of, 236t large (See Large intestine) lobular, 845
Insulin resistance, 739 heart failure and, 1178 small (See Small intestine) mammary gland, 845
cancer and, 419, 419f multiple organ dysfunction Intestinointestinal reflex, 1407 postlactational, 845
heart failure and, 1178 syndrome and, 1680 Intima, synovial membrane and, Iodinated contrast media, 725b
hypertension associated with, pediatric septic shock and, 1707 1522 Iodine
1136 stress response and, 348–349 Intra-abdominal pressure, burn breast health and, 860
obesity and, 1448 Interleukin-7 injury and, 1717 deficiency of, breast cancer and,
uremia associated with, 1369 B cell maturation and, 240 Intraaortic balloon counterpulsation 860
Insulin resistance syndrome, function of, 236t (IABP), 1671–1672 mastalgia treated with, 842t
419–420 Interleukin-8 Intracardiac pressure, 1089–1090, Iodine deficiency, 729
Insulin shock, 743 burn injury and, 1692 1090f, 1090t Ion
Integral membrane protein, 13 function of, 236t Intracellular fluid (ICF) body fluids and, 29
Integrase, human pediatric septic shock and, 1707 amount of, 103–104 concentration of, in myocardium,
immunodeficiency virus Interleukin-10, 204 electrolyte balance in, 108t 1094t
pathogenesis and, 324 function of, 236t hypotonic alterations and, 112t inorganic, transport of, 33t
Integrase strand transfer inhibitor pediatric septic shock and, 1707 osmolality of, 30 protein function and, 13–15
drugs, 327 Interleukin-11, pediatric septic polarity of, 29 Ion channel, 31
Integrin, 18, 18f, 202, 209, 1515 shock and, 1707 water movement and, 105 Ionizing radiation, 78–81
Integumentary system, 1 Interleukin-12, function of, 236t Intracerebral brain abscess, 613 acute exposure to, 429–430
burn injury and, 1717 Interleukin-13 Intracerebral hematoma, 586 aplastic anemia caused by, 993
chronic kidney disease effects on, function of, 236t Intracerebral hemorrhage, 603f breast cancer and, 856–858
1365t, 1370–1372 pediatric septic shock and, 1707 Intracranial aneurysm, 603–604 cancer associated with, 403f,
hyperthyroidism effects on, 727t Interleukin-17, function of, 236t Intracranial hemorrhage (ICH), 424–431
hypothyroidism effects on, 730t Interleukin-22, function of, 236t 589, 602–603 cellular damage caused by, 80f
Intelligence quotient (IQ), Interleukin-7 receptor deficiency, Intracranial pressure (ICP), childhood exposure to, 445
concordance rates for twins 286 555–557 latent effects of, 429–430
for, 170t Interlobar artery, 1325 increase in low-dose, 430–431, 430b
Intensification phase, childhood Intermediary metabolism, 9 hydrocephalus as cause of, microenvironment effects of,
leukemia treatment and, Intermediolateral gray horn (lateral 668–669 429–430
1077–1078 horn), 460–461 pediatric brain tumor and, sources of exposure to, 425f
Intentional tremor, description Intermittent claudication, 1148 682–683 types of, 82t
of, 563t Internal anal sphincter, 1407 management of, 556t IPF. See Idiopathic pulmonary
Intercalated cell, 114, 1323 Internal capsule, in cerebrum, 457 Intracranial tumor, 628f fibrosis (IPF)
Intercalated disk, 1097 Internal carotid artery, 467 Intraductal papilloma, 838t, Ipilimumab, melanoma treated
Interdigestive myoelectric complex, Internal urethral sphincter, 839–840, 840f with, 1644
1407 1325–1326 Intradural tumor, 633 IPSP. See Inhibitory postsynaptic
Interferon, 204 International Agency for Research Intrahepatic portal hypertension, potential
action of, 205f on Cancer (IARC), 402–403, 1503 IR. See Ionizing radiation
response of, to viral infection, 319 432–433 Intramedullary tumor, 633 Iris, description of, 508
source and function of, 236t International Federation Intramembranous bone formation, Iron
thrombocytopenia treated with, of Gynecologists and 1511–1512, 1591–1592 cognitive function and, 661b
1041 Obstetricians (FIGO), 833, Intraocular pressure, glaucoma and, digestion and absorption of,
Interferon-gamma, production of, 833t 510–511 1405
245–247 Interneuron, 449, 487 Intraosseous cannulation, burn hemoglobin synthesis and, 1059
Interleukin, 203 Interphase, cell reproduction and, injury treatment and, 1719 restless leg syndrome and, 505
asthma and, 1264 37 Intrarenal (intrinsic) acute kidney Iron cycle, 963–964, 964f
effects of, on skeletal tissues, Interstitial edema, 558 injury, 1360–1361 Iron deficiency, in older adult, 975
1515t Interstitial fluid, 103–104 Intravascular fluid, 103–104 Iron deficiency anemia (IDA), 983t,
osteoporosis and, 1553 loss of, hypovolemic shock Intravenous fluid, pediatric shock 984f, 989–991
pediatric septic shock and, 1707 associated with, 1672 treatment with, 1711 in child, 1058–1059
psoriasis and, 1629 water movement and, 105 Intravenous immune globulin, 278 clinical manifestations of, 1059
 INDEX 1781

Iron deficiency anemia (IDA) Isoproterenol, shock treated with, Joint (Continued) Kidney (Continued)
(Continued) 1714t disorders of (See Joint disorders) congenital abnormalities of, 1378
evaluation and treatment of, Isothiocyanate, cancer prevention effects of aging on, 1536 development of, 1376
1059 and, 417 fibrous, 1520 diabetes mellitus effects on, 748
pathophysiology of, 1059 Isotonic, definition of, 109–110 pediatric osteomyelitis and, 1602 dysplastic, 1380
clinical manifestations of, Isotonic alteration structure and function of, embryonic development of, 1377f
990–991 sodium-chloride-water balance 1520–1526 function of, 1327–1334
evaluation and treatment of, 991 and, 109–110 synovial, 1522–1526 glucose regulation and, 1320b
laboratory findings for, 986t sodium concentration and, 110f tests of function of, 1535 hemorrhagic shock and, 1706t
manifestations of, 990f Isotonic contraction, muscle, 1534 tissues of, 1522f hormones and, 1327
occult bleeding as cause of, Isotonic solution, 31 types of, 1523f hyperglycemia effects on, 740f
1426–1427 Isotope cisternography, 480 Joint capsule, 1522 hypoplastic, 1380
pathophysiology of, 990–991 Isotretinoin, acne treated with, 1654 Joint cavity, 1522 infection of, 1352
Iron dextran, iron deficiency anemia Isotropic band, 1098–1099 Joint disorders, 1565–1578 injury to, 1359–1364
treated with, 991 Isotype-switch, immunoglobulin Joint effusion, 1567–1568 innervation of, 1326–1327
Iron overload, 1004 and, 248–249 Joint mice, 1565 polycystic, 1381
Irregular bone, 1519 Isthmus Joint space, 1522 potassium balance regulated by,
Irreversible coma, 534 of thyroid gland, 700 Joint stiffness, 1567–1568 114
Irreversible injury, cellular, 54–55 uterine, 774–775 Junctional bradycardia, sodium concentration and, 108
Irritable bowel syndrome (IBS), Itching, 1627 pathophysiology and treatment structures of, 1319–1325, 1320f
1445–1446 ITP. See Idiopathic of, 1183t–1184t tumors of, 1347–1348
clinical manifestations of, 1445 thrombocytopenic purpura Junctional complex, 18–20 urinary tract obstruction as cause
diagnostic criteria for, 1446b (ITP) Junctional tachycardia, of damage to, 1342
pathophysiology of, 1445–1446 Itraconazole, tinea capitis treated pathophysiology and treatment Kidney disease
Irritant contact dermatitis, 1628 with, 1657 of, 1183t–1184t chronic, 1364–1372
Irritant receptor, 1234, 1248–1249 Ivermectin, pediculosis treated with, Juvenile idiopathic arthritis (JIA), end-stage, 747–748
Irritative syndrome, 634 1662 1603–1604 signs and symptoms of, 1367f
Ischemia IVIG. See Intravenous immune Juvenile myoclonic epilepsy, 678, Kidney stone, 1343–1344
burn injury associated with, 1717 globulin 680 clinical manifestations of, 1344
coronary artery disease associated Juxtaglomerular apparatus (JGA), evaluation and treatment of, 1344
with, 1148 J 1322, 1324f pathophysiology of, 1343–1344
electrocardiogram of, 1155f J chain, 229 Juxtaglomerular cell, 1322, 1324f pediatric, 1387b
hypoxia caused by, 56, 56f J-receptor, 1234, 1248–1249 Juxtamedullary nephron, 1320–1321 pyelonephritis associated with,
myocardial, 1153–1156 Jackknife seizure, 679–680 1352t
peripheral artery disease JAK. See Janus family of tyrosine K Kinin cascade, 199f, 201
associated with, 1148 kinase (JAK) K+. See Potassium ion Kinin system, 200f, 201, 1680–1682
shock as cause of, 1699 JAK3 deficiency, 286 Kallikrein, 201, 972 Kininase, 201
silent, 1154–1156 Janeway lesion, 1175 Kaposi-associated herpesvirus 8, Klebsiella granulomatis, 928, 1500
spinal cord injury and, 591 Jansky-Bielschowsky disease, 673t 1645 Klebsiella pneumoniae, 304t–305t
Ischemia reperfusion injury, 58b, Janus family of tyrosine kinase Kaposi sarcoma (KS), 1645 Klinefelter syndrome, 148, 148f,
1116 (JAK), 692, 694, 694t carcinogenic agents associated 156, 914
Ischemic cardiomyopathy, 1165 Janus kinase 2, 1003, 1041 with, 404t–407t childhood leukemia associated
Ischemic/menstrual phase of Jaundice, 1455–1456 example of, 328f with, 1075–1076
menstrual cycle, 780 bilirubin level and, 86–87 virus associated with, 383 Knee
Ischemic preconditioning, 1158 clinical manifestations of, 1456 Kaposi sarcoma herpesvirus, cancer bursitis of, 1547t
Ischemic stroke, 598–602 evaluation and treatment of, 1456 associated with, 382 dislocation or subluxation of,
clinical manifestations of, 599 hemolytic anemia associated Kartagener syndrome, congenital 1544
evaluation and treatment of, with, 1000 heart defects associated with, osteomyelitis and, 1602
599–602 hereditary spherocytosis 1200t Knee joint, 1524f
pediatric, 677–678, 677b associated with, 1063 Karyolysis, 88–90 Kneecap, Osgood-Schlatter disease
Ischemic ulcer, 1439 in infant, 1061–1062 Karyotype, 142, 145f and, 1605
ISH. See Isolated systolic mechanism of, 1455f Kasai procedure, 1501f Knock knee, 1593
hypertension (ISH) neonatal, 1060, 1500–1501 Kawasaki disease, 1218 Kohler disease, 1604
Islets of Langerhans, 703–704 pathophysiology of, 1455–1456 Keloid, 219, 219f, 1620t–1622t, Koplik spots, 1659–1660
diabetes mellitus and, 737 types of, 1456t 1626–1627 Krabbe disease, 673t
tumors of, 1474 JC virus, central nervous system Keratin, 1616–1617 Krebs cycle, 26–27
Isocarboxazid, depression treated diseases caused by, 610t Keratinocyte, 1616–1617, 1618t KS. See Kaposi sarcoma (KS)
with, 652b Jejunal atresia, 1490 Keratitis, 508 Kupffer cell, 962, 1409–1410, 1412
Isocitrate dehydrogenase 1 (IDH1) Jejunum, 1400, 1490 Keratoacanthoma, 1640–1641, Kussmaul respiration, 1249
gene, 628–629 Jenner, Edward, 247–248 1640f Kwashiorkor, 1451, 1497
Isocitrate dehydrogenase 2 (IDH2) Jerk nystagmus, 509 Keratoconjunctivitis, 507 Kyphoscoliosis, chest well
gene, 628–629 Jet-lag syndrome, 505 Kernicterus, 1060, 1501 restriction associated with,
Isoflavone, breast cancer and, 859 JGA. See Juxtaglomerular apparatus Kernig sign, 606, 676 1253
Isohemagglutinin, 278 (JGA) Ketogenic diet, epilepsy and, 680, Kyphosis
Isoimmunity, definition of, 263 JIA. See Juvenile idiopathic 680b example of, 1555f
Isolated speech center, 540 arthritis (JIA) Ketosis-prone diabetes, 744 pediatric skeletal development
Isolated systolic hypertension Joint Kidney and, 1593
(ISH), 1132 body movement provided by, aging effects on, 1336
Isolated (pure) vigilance deficit, 1527f blood flow in, 1326–1327 L
538 cartilaginous, 1520 blood tests for, 1335 L-asparaginase, 396
Isomaltase, as digestive enzyme, childhood leukemia and, blood vessels in, 1325 La Cross encephalitis virus,
1402b 1076–1077 cancer of, carcinogenic agents encephalitis caused by, 615t
Isometric contraction, muscle, classification of, 1520 associated with, 404t–407t Labia majora, 771
1534 definition of, 1520 classification of dysfunctions of, Labia minora, 771–772
Isoniazid, tuberculosis treated with, dislocation or subluxation of, 1359 Labile factor, disorders associated
1274 1544–1545 clearance and, 1334–1335 with, 1070t
1782 INDEX

Laboratory test Lateral corticospinal pathway, Lens Leukodystrophy, childhood, 662f

for hypertension, 1221t 463–464 changes in thickness of, 511 Leukokoria, 513
for pulmonary function, 1243 Lateral epicondylopathy, 1546 description of, 508 Leukopenia, 396b, 1009
Laceration, description of, 79t Lateral fissure, 456 effects of aging on, 510t Leukotriene, 207
Lacrimal apparatus, 507, 507f Lateral horn, 460–461 Lentiform nucleus, 457 Leukotriene antagonist drugs,
β-lactamase, 310 Lateral spinothalamic tract, 464 Lentigo malignant melanoma asthma treated with, 1266
Lactase, as digestive enzyme, Lateral sulcus, 456 (LMM), 1643, 1644t Levodopa, Parkinson disease treated
1402b Latex allergy, 1627–1628 Leprosy, bacteria associated with, with, 568
Lactase deficiency, 1439–1440 Laurence-Moon-Biedl syndrome, 304t–305t Levonorgestrel intrauterine device
Lactate dehydrogenase (LDH), 1413 congenital heart defects Leptin, 178, 1446–1447 (LNG-IUD), abnormal uterine
Lactated Ringer solution, 1690, associated with, 1200t appetite affected by, 1448 bleeding treated with, 809
1690t Lazy eye, 510 coronary artery disease and, Levosimendan, heart failure treated
Lactation, 784 LBB. See Left bundle branch (LBB) 1152–1153 with, 1179
epithelial cells affected by, LCA. See Left coronary artery (LCA) female reproductive system Lewis phenomenon, 501
846b–847b LCIS. See Lobular carcinoma in affected by, 350 Lewy body dementia, 547t, 568
inappropriate, 836–837 situ (LCIS) inflammation and, 420 Lexapro. See Escitalopram
Lacteal capillary, 1401 LCP. See Legg-Calvé-Perthes menstrual cycle and, 778 Leydig cell, 784–785
Lactic acid, production of, 28 disease (LCP) secretion of, 1447b male sex hormone production
Lactobacillus, as microbiome, 194 LDH. See Lactate dehydrogenase Leptin resistance, 1448 and, 789–791
Lactobacillus acidophilus, 773 (LDH) Leptomeningitis, 612f spermatogenesis and, 912
Lactoferrin, anemia of chronic LDL. See Low-density lipoprotein LES. See Lower esophageal sphincter LGV. See Lymphogranuloma
disease and, 1001 (LDL) (LES) venereum (LGV)
Lactose intolerance, 1497, 1500 Lead, 65–67 Lesch-Nyhan syndrome, 671t, LH. See Luteinizing hormone
Lacuna, bone matrix and, 1514 absorption of, 66 673t (LH)
Lacunar stroke (lacunar infarct), child exposed to, 65 Lesion LH deficiency, 721
599–602 exposure to, 65–66 skin, 1619–1627, 1620t–1622t Lhermitte sign, 621
LAD. See Left anterior descending Lead poisoning, 65–66 urticarial, 1639 Li-Fraumeni syndrome, childhood
artery (LAD) central nervous system disorder Lesser vestibular gland, 772 cancer associated with, 443t,
Ladd’s band, 1489 caused by, 674–675 Let-down reflex, 782 444
Lafora disease, 671t clinical manifestations of, 66 Lethargy, definition of, 529t Liability distribution, multifactorial
Lambert-Eaton myasthenic effects of, 675f Leukemia, 1013–1023 inheritance and, 166, 167f
syndrome, 624, 625t pathophysiology of, 66 acute, 1015–1020 Libido
Lamellae, bone matrix and, 1517 prevention of, 66–67 carcinogenic agents associated aging and, 795
Lamina propria, 1401 treatment of, 66–67 with, 404t–407t decreased, 834
Laminar flow, 1113, 1114f Lectin, antimicrobial, 194 childhood, 443, 1074–1081 testosterone and, 789
Laminin, 305, 1512t, 1516 Lectin pathway, 197–198, 287–288 classification of, 1075 Lice infestation, 1661–1662
Landry-Guillain-Barré syndrome, LED. See Light-emitting diode clinical manifestations of, Lichen planus (LP), 1620t–1622t,
622 Leflunomide, rheumatoid arthritis 1076–1077 1630–1631, 1631f
Langerhans cell treated with, 1572 evaluation and treatment of, Lichenification, example of,
antigen processing by, 1627–1628 Left anterior descending artery 1077–1078 1620t–1622t
characteristics of, 1618t (LAD), 1090 pathogenesis of, 1075–1078 Life expectancy, 94–96, 94b
in epidermis, 1617 Left bundle branch (LBB), 1094 types of, 1075–1078 Life span
immune function of, 1617 Left coronary artery (LCA), 1090 chronic, 1020–1023 definition of, 93
Langhans giant cell, 215f Left heart, 1083–1085 clinical manifestations of, 1020t normal, 94–96
Language disorder, 539–540, 545t Left heart failure, 1175–1181 definition of, 364 Lifestyle
Lanreotide, elevated growth Left pulmonary artery, 1088 Down syndrome and, 444 anti-cancer effects of, 411f
hormone treated with, 724 Left-sided heart disease, pulmonary incidence of, 1013, 1014f breast cancer and, 855–863
Laplace’s law, 1102–1103, 1141f, edema associated with, 1260 ionizing radiation as cause of, cancer development and, 413
1235 Left ventricle, description of, 1086 424t cancer risk and, 402
Large bowel obstruction, 1432 Left ventricular dysfunction, 342b origins of, 1014f pro-cancer effects of, 411f
Large cell carcinoma, lung cancer Left ventricular end-diastolic pathophysiology of, 1014–1015, Ligament
and, 1281–1282 pressure (LVEDP), 1103, 1020t definition of, 1545
Large intestine, 1407–1408, 1408f 1175–1177 risk factors for, 1015 denticulate, 465
Large intestine obstruction, 1434 Left ventricular end-diastolic statistics on, 1015t sprains and strains of, 1545
Laryngeal atresia, 1300 volume (LVEDV), 1103 types of, 1013 Ligamentum venosum, 1197
Laryngeal cancer, 404t–407t, Legg-Calvé-Perthes disease (LCP), Leukemoid reaction, 1009 Ligand
1278–1279 1604–1605 Leukocyte plasma membrane and, 16, 16f
Laryngomalacia, 1299, 1299f Legionella pneumophila, 304t–305t, alterations in function of, receptor-medicated endocytosis
Laryngoscopy, epiglottitis and, 1297 1271 1008–1023 and, 35f
Laryngospasm, epiglottitis and, Leigh disease, 673t blood tests for, 976t–977t signaling, 25t
1297 Leiomyoma, 821–823 characteristics of, 948t Ligature strangulation, 74
Laryngotracheobronchitis, example of, 823f in child, 1057 Light-emitting diode, 81b
1294–1295, 1296t uterine, 822f description of, 948–950 Light therapy, alopecia treated with,
Larynx Leiomyosarcoma development of, 964–965 1646
cancer of, 404t–407t, 1278–1279 pediatric, 1612t endothelial cell interaction with, Limb girdle dystrophy, 1606t
description of, 1226–1228 uterine sarcoma and, 830–831 211t Limbic system, 457, 654f
illustration of, 1227f, 1296f Leishmania donovani, 314t illustration of, 949f Lindane, pediculosis pubis treated
upper airway obstruction and, Leishmania spp., 315 inflammation mediation and, with, 939–940
1294, 1294b Leishmania tropica, 314t 201–202 Linear fracture, 1541
Lassa virus, 318t Leishmaniasis, 314t pediatric values for, 1057t Lingual lipase, as digestive enzyme,
Late asthmatic response, 1264 Lenalidomide, multiple myeloma quantitative alterations of, 1402b
Late dumping syndrome, 1440 treated with, 1034 1009–1011 Link protein, in articular cartilage,
Latent syphilis, 923–924 Lengthening contraction, muscle, in urine, 1336 1525
Lateral aperture (foramina of 1534 values for, 978t Linkage analysis, genetic, 159–163
Luschka), 466 Lennox-Gastaut syndrome, 678, Leukocyte adhesion deficiency, 289 Linoleic acid, mastalgia treated with,
Lateral column, 462 680 Leukocytosis, 213–214, 1009, 1077f 842t
 INDEX 1783

Lip Liver disease, 1043 LP. See Lichen planus (LP) Luteinizing hormone (Continued)
cancer of, carcinogenic agents alcoholic, 1460–1461 LPS. See Lipopolysaccharide ovarian cyst and, 820–821
associated with, 404t–407t aplastic anemia associated with, Lubiprostone, 1425 polycystic ovary syndrome and,
variations in cleft of, 1487f 993 Ludiomil. See Maprotiline 811
Lipase Liver disorders, 1451–1463, Lumbar cistern, 465 progesterone secretion and,
deficiency of, 1439 1500–1506 Lumbar plexus, 469 778
as digestive enzyme, 1402b Liver failure, multiple organ Lumbar puncture, 466 Luvox. See Fluvoxamine
fat emulsification and, 1402–1404 dysfunction syndrome Lumbar spondylosis, 595–596 LVEDP. See Left ventricular end-
Lipase-colipase, as digestive enzyme, associated with, 1683 Lumbosacral disk, herniation of, diastolic pressure (LVEDP)
1402b Liver lobule, 1409–1410, 1410f 597 LVEDV. See Left ventricular end-
Lipid Livor mortis, 97 Lumbosacral disk disease, 595–596 diastolic volume (LVEDV)
cellular accumulation of, 84–85 LL. See Lymphoblastic lymphoma Lumbosacral root disorder, 596f Lyme arthritis, 1569t
metabolism of, 1149 (LL) Lumen, blood vessel, 1108 Lyme disease, 304t–305t, 617–618,
plasma membrane and, 12–13 LMM. See Lentigo malignant Luminance, definition of, 81 1640
Lipid-acceptor protein, 63 melanoma (LMM) Lund and Browder Chart, 1688f Lymph
Lipid bilayer membrane, 14f–15f LN. See Lobular neoplasia (LN) Lung description of, 1118
Lipid metabolism disorders, 1583 Lobular carcinoma in situ (LCIS), aspiration into, 1255–1256 obstruction of, 107
Lipid peroxidation, 60–61 868 cancer of (See Lung cancer) Lymph node, 952–954
Lipid raft, 13, 14f–15f Lobular hyperplasia, 841 carbon dioxide diffusion in, 1243 alterations in function of,
Lipid-soluble hormone receptor, Lobular involution, 845 caseous necrosis of, 91f 1023–1035
694–695 Lobular neoplasia (LN), 868 cystic fibrosis effects on, 1311 architecture of, 953f
Lipiduria, nephrotic syndrome Localized scleroderma, 1639–1640 dynamics of, 1292f enlarged, 1023
associated with, 1359t Locked-in syndrome, 535, 535t elastic properties of, 1236 histology of, 242f
Lipocyte, 1409–1410 Locus fetal development of, 1290–1291, Hodgkin lymphoma effects on,
Lipofuscin, 8 assignment of, to chromosome, 1293b 1025f–1026f
Lipoid nephrosis, 1383–1384 160–163 inflammation in, tuberculosis as infectious mononucleosis effects
Lipolysis, 1402–1404 chromosomal, 151 cause of, 1273–1274 on, 1012
Lipoma, example of, 1620t–1622t heterozygous, 151 innervation of, 1234 secretory immune system and,
Lipopolysaccharide, 306, 307f homozygous, 151 location of, 1232f 253f
Lipoprotein recombination rates and, 160 pediatric, 1290–1292 Lymphadenopathy, 1021, 1021f,
definition of, 1149 Locus ceruleus-norepinephrine prenatal development of, 1291f 1023
high-density, 1149 system, 350, 352f, 650 receptors in, 1234 Lymphangiosarcoma, pediatric,
atherosclerosis and, 1145 LODS. See Logistic organ systemic disorders effect on, 1260 1612t
optimization of, 1149–1151 dysfunction score (LODS) tuberculosis of, 91f Lymphangitis, gonorrhea and,
low-density, 173b Logistic organ dysfunction score water in, 1260 921
heart disease and, 172 (LODS), 1684 zones of, 1239 Lymphatic system, 1118–1119
in plasma, 946–947 Long bone, 1517–1518 Lung cancer, 1279–1286 fluid balance and, 1118f
Lipoprotein (a), 1151 Long-term starvation, 1451 asbestos exposure associated with, obstruction of, pulmonary edema
Lipoprotein gene, 176t Longitudinal fissure, 456–457 1259 associated with, 1260
Liposarcoma, pediatric, 1612t Loop of Henle, 1331 brain metastases and, 631–632 organs of, 1118f
Lipotropin, 699t description of, 1322 carcinogenic agents associated structure and function of, 1
Liquefactive necrosis, 90 urine concentration and, 1332 with, 404t–407t Lymphatic vessel, 1092, 1119b
Lissencephaly, 668f Loperamide, diarrhea treated with, characteristics of, 1281t Lymphedema, 107, 1200t
Listeria monocytogenes, 304t–305t 1426 cigarette smoking associated Lymphoblastic lymphoma (LL),
Listeria spp., 306–307 Lordosis, pediatric skeletal with, 165 1030
Literal paraphrasia, 545t development and, 1593 example of, 1281f Lymphocyte, 213
Lithium, congenital heart defects Loss of consciousness incidence of, 1279b adaptive immune response and,
associated with, 1199, 1199t brain injury associated with, ionizing radiation as cause of, 225
Lithium carbonate 587 424t characteristics of, 948t
bipolar disorder treated with, 652 concussion associated with, 588 mortality rate associated with, conditions associated with,
cluster headache treated with, 609 Loss of heterozygosity, 378–380 1279b 1010t
Liver, 1409–1413 Lou Gehrig disease, 572 risk factors for, 1279b count of, 1057
blood vessels of, 1410f Low back pain, 596–597, 1574 silicosis associated with, 1259 description of, 950, 1011
cancer of (See Liver cancer) Low bladder wall compliance, 1346 staging of, 1283f development defects of, 283f
chemical injury of, 64f Low-density lipoprotein (LDL), tobacco use associated with, 413 illustration of, 949f
fatty, 84–85 1149 treatment of, 1279b leukocyte development and,
hematologic function of, 1412 atherosclerosis and, 1145 trends for, 1279b 964–965
hyperglycemia effects on, 740f heart disease and, 172 warning signs for, 1279b in lymph node, 954
lipid accumulation in, 85 oxidation of, 1147f Lung capacity, 1243, 1244f micrograph of, 209f, 225f
location of, 1409f Low-flow vascular malformation, Lung fluke disease, 314t pediatric values for, 1057t
organ dysfunction and, 1684b 1663 Lung volume, aging effects on, quantitative alteration of, 1011
regeneration of cells in, 52–53 Low-pressure hydrocephalus, 558 1245f T-helper, 245–247
structure of, 1410f Lowe disease, 673t Lupus erythematosus, 1632 tumor-infiltrating, 386–387
tests of, 1416, 1417t Lower esophageal sphincter (LES), Lupus nephritis, 1357–1358 values for, 978t
vascular function of, 1412 1395, 1428 Luteal/secretory phase of menstrual Lymphocytic meningitis, 609
vitamins and minerals stored in, Lower gastrointestinal (GI) cycle, 780 Lymphocytopenia, description of,
1413 bleeding, 1426–1427 Luteinizing hormone (LH), 696f, 1010t, 1011
Liver cancer, 1467t, 1472–1473 Lower motor neuron, 462 699t Lymphocytosis, description of,
carcinogenic agents associated Lower motor neuron syndrome, deficiency of, 721 1010t, 1011
with, 404t–407t 569t, 571 delayed puberty in male and, 886 Lymphogranuloma venereum
clinical manifestations of, 1473 Lown-Ganong-Levine syndrome, fetal production of, 769–770 (LGV), 931–932
description of, 1467t pathophysiology and treatment function of, 776–777 Lymphoid neoplasm, classification
evaluation and treatment of, of, 1184t–1186t male sex hormone production of, 1024b
1473 Loxapine, schizophrenia treated and, 789–791 Lymphoid organs, 951–954
ionizing radiation as cause of, with, 646b menopause and, 793–794 Lymphoid stem cell, 236–237
424t Loxitane. See Loxapine menstrual cycle and, 780 Lymphoid system, 951–954
1784 INDEX

Lymphoid tissue Magnetic field, 431–432 Malnutrition-inflammation Mastalgia, treatment of, 842t
cell differentiation and, 227f Magnetic resonance angiography complex syndrome, 1370b Mastitis, 842t
histology of, 242f (MRA), 478 MALT. See Mucosa-associated Maternal-fetal incompatibility,
primary, 236–237 Magnetic resonance imaging (MRI) lymphoid (MALT) lymphoma 1059
secondary, 236–237 bone function evaluated with, Maltase, as digestive enzyme, 1402b Matrix, kidney stone formation and,
secretory immune system and, 1535 Malunion, following bone fracture, 1343–1344
253f brain, with schizophrenia, 643f 1543 Matrix metalloproteinase, 216,
Lymphoma cardiac function evaluated with, Mammalian target of rapamycin, 388–389
B-cell, 383 1121 93–94 Maturation phase of wound healing,
carcinogenic agents associated gastrointestinal tract evaluated Mammary cell, progesterone 216, 217f, 218
with, 404t–407t with, 1415 regulation of, 851f–852f Maturity-onset diabetes of youth
classification of, 1023 joint function evaluated with, Mammary duct carcinoma, 866t (MODY), 178, 742–743
cutaneous, 1645 1535 Mammary duct ectasia, 838t, 842t MBD. See Mammographic breast
definition of, 364 of skull and spine, 478 Mammary gland density (MBD)
incidence of, 1023 systemic circulation evaluated aging effects on, 845 McArdle disease, 1582–1583, 1583f
ionizing radiation as cause of, with, 1122 development of, 847, 848f MCS. See Minimally conscious state
424t Magnetic resonance spectroscopy, progesterone regulation of, MDD. See Myoadenylate
malignant, 1023–1030 of skull and spine, 478 851f–852f deaminase deficiency (MDD)
origins of, 1014f Maintenance fluid, burn injury Mammary lobule carcinoma, 866t MDS. See Myelodysplastic
pediatric, 443, 1074–1081 treatment and, 1718–1719 Mammographic breast density syndrome (MDS)
statistics on, 1015t Major calyces, kidney, 1320 (MBD), 855 ME. See Myalgic encephalomyelitis
Lymphoplasmacytic lymphoma, Major (unipolar) depression, Mammography (ME)
1035 647 benefits and harms of, 857t Mean arterial pressure (MAP), 1114
Lysosomal storage disease, 84, Major duodenal papilla, 1411 breast cancer associated with, 856 definition of, 1120t
674 Major histocompatibility complex radiation effects from, 858b factors affecting, 1114t
Lysosome, 3f, 7–8, 7f, 211 (MHC), 233–235, 244f screening with, 393b management of, 556t
primary, 8 Malabsorption, 1439, 1497 Mania, 647b, 651 Measles
secondary, 8 Malabsorption syndrome, Manic-depressive disorder, genetic 3-day, 1658–1659
1439–1440 factors associated with, 180 characteristics of, 1659t
M Malaria, 314–315, 314t Manic episode, symptoms of, 647b concordance rates for twins for,
M-CSF. See Macrophage colony example of, 316f Manipulation, following bone 170t
stimulating factor (M-CSF) statistics on, 316 fracture, 1543 eradication of, 298–299
M line, 1098–1099 Malassezia furfur, 312t Mannose-binding lectin (MBL), German, 1658–1659
M protein, 1032–1034, 1033f, Maldigestion, 1439 198 location of rash of, 1659f
1532t Maldistribution of blood flow, Mannose-binding lectin (MBL) red, 1659–1660
Macrocytic anemia, 984f 1682–1683 deficiency, 287–288 vaccination and reduction of,
Macrocytic-normochromic Male Manual strangulation, 74 330t, 333
anemia, 987–989 alterations in reproductive system MAP. See Mean arterial pressure Measles virus, 318t, 610t
Macromolecule, 17 of, 885–917 (MAP) Meat, cancer and, 417
Macrophage, 83–84, 209, 212, 212f cancer incidence rates for, 409 Map unit, 159–160 Mechanical injury, 79t, 82
activation of, 212–213, 256–257, external genitalia in, 784–787 Maple syrup urine disease, 671t, Mechanical stress, injury associated
256f infertility caused by, 835–836 673t with, 82
alveolar, 1229 internal genitalia in, 787–789 Maprotiline, depression treated Mechanonociceptor, 486
antigen presentation by, 243 sex hormones in, 789–791 with, 652b Mechanotransduction, 9–10, 82
bactericidal activity of, 212–213 sexual dysfunction in, 911–912 Marasmus, 1451, 1497 Meckel diverticulum, 1490–1491
characteristics of, 948t Male breast cancer, 914–916 Marburg virus, 318t Meconium, 1308, 1490
lymphatic vessel growth from, Male-pattern alopecia, 1646 Marfan syndrome Meconium ileus (MI), 1490
1119b Male-pattern baldness, 1646 congenital heart defects Medial epicondylopathy, 1546
micrograph of, 209f Male reproductive system. See associated with, 1200t Median aperture (foramen of
monocyte and, 950 Reproductive system, male mitral valve prolapse associated Magendie), 466
mononuclear phagocyte system Malignancy. See also Cancer with, 1170 Median eminence, pituitary gland
and, 950t circadian disruption and, 420 Marginating storage pool, 958–959 and, 697
in multiple organ dysfunction of female reproductive system, Margination, 209 Mediastinum, 1225, 1232f
syndrome, 1682 825–834 Marijuana, description and effects description of, 1085
pneumonia and, 1271–1272 immune system affected by, 291 of, 72t–73t neuroblastoma in, 684
tumor-associated, 385–386 plasma cell, 1030–1035 Marker polymorphism, 160 Mediated transport, 31–33, 32f
Macrophage colony stimulating respiratory tract, 1278–1286 Marplan. See Isocarboxazid Medical error, 71
factor (M-CSF), 385–386, Malignant hypertension, 1138 Marrow neutrophil reserve, 949 Medical radiation, 78
702–703, 954t Malignant hyperthermia (MH), 77, Mass reflex, 593 Medical treatment, immune system
Macropinocytosis, 33–34 500–501, 1549 Mast cell, 205–207 affected by, 291
Macrovascular disease, diabetes Malignant melanoma, 86 asthma and, 1264 Medication
mellitus and, 751–752 Malignant tumor. See Tumor, characteristics of, 1618t cardiovascular disease prevention
Macula, effects of aging on, 510t malignant corticotropin-releasing hormone with, 1151b
Macula densa, 1322 Malleus bone, 515 effect on, 348–349, 349f child poisoning from, 63b
Macular degeneration, 511 Mallory body, 1460 degranulation of, 198–199, 206– errors in, 71
Macular edema, 747 Malnutrition, 1451–1466, 207, 206f, 265, 266f–267f Medulla, kidney, 1320
Macule, example of, 1620t–1622t 1497–1498 eosinophilia and, 1010–1011 Medulla oblongata, 454, 460, 1424
Maculopathy, 747 cellular injury associated with, 75 generation of, 949–950 Medulloblastoma
Maffucci syndrome, 1663 chronic kidney disease associated hypersensitivity reaction and, characteristics of, 627t
Magnesium, 122 with, 1369 263–265 in child, 681t–682t, 682–683
alteration in balance of, 114–122 chronic obstructive pulmonary lipid vasoactive substance Medusa head, 1452–1453
alteration in level of, 121t disease and, 1269b produced by, 208f Megacolon, 1491
digestion and absorption of, 1405 gluten-sensitive enteropathy mediator synthesis by, 207 Megakaryocyte, 950–951, 951f
distribution of, in body fluids, associated with, 1496f in multiple organ dysfunction Megaloblastic anemia, 987
108t immune system affected by, syndrome, 1682 neutropenia caused by, 1009
osteoporosis and, 1556 290–291 parasitic infection and, 254–255 as secondary to drug effects, 994t
 INDEX 1785

Meiosis, 142, 144f Menopause (Continued) Metabolic acidosis (Continued) Metronidazole (Continued)
Meissner plexus, 1394, 1401 skeletal changes associated with, intestinal obstruction as cause pelvic inflammatory disease
Melanin 795 of, 1432 treated with, 816b
accumulation of, 85–86 systemic changes in, 794–795 shock and, 1670 trichomoniasis treated with, 938
in epidermis, 1617 uterine changes in, 794 Metabolic alkalosis, 127f, 128–129 Metrorrhagia, 808t, 809
Melanocortin-4 receptor gene, Menorrhagia, 808t, 809 Metabolic alterations in arousal, Mg. See Magnesium
1446–1447 iron deficiency anemia associated 528 MGUS. See Monoclonal
Melanocyte with, 990 Metabolic bone disease, 1550–1558 gammopathy of undetermined
characteristics of, 1618t Menorrhea, 808t Metabolic detoxification significance (MGUS)
cutaneous melanoma and, 1643 Menstrual cycle, 778–782 (biotransformation), 1413 MH. See Malignant hyperthermia
in epidermis, 1617 alterations in, 804–834 Metabolic disorders (MH)
Melanocyte-stimulating hormone estrogen level and, 794t immune system affected by, 291 MHC (major histocompatibility
(MSH), 498, 699t hormonal control of, 780–781 pediatric, 1503–1506 complex), 233–235
Melanoma hormonal feedback mechanism Metabolic pathway, 25 MHC class I deficiency, 286
carcinogenic agents associated in, 780t Metabolic rate, burn injury and, MHC class I gene, 233, 234f, 240
with, 404t–407t illustration of, 779f 1720 MHC class I molecule, 245
cutaneous, 1643–1644 phases of, 778–780 Metabolic syndrome, 347–348, 739 MHC class II deficiency, 286
TNM staging criteria for, 1644b uterine phases of, 781 aldosteronism and, 756b MHC class II gene, 233, 234f, 240
ultraviolet radiation as cause of, vaginal response in, 781 coronary artery disease and, MHC class II molecule, 245
431 Menstruation, 778 1151–1152 MI. See Meconium ileus (MI)
Melatonin abnormal, 808t diagnosis of, 739b Micelle, 1404–1405, 1405f, 1440
release of, 700 retrograde, 823 Metabolism Microalbuminuria, 748–749
stress response influenced by, Mental disorders, sleep disorders anaerobic, shock and, 1669–1670 Microbiome, normal, 194, 300
351t, 354 associated with, 505–506 burn injury and, 1691–1692, 1720 Microbody, description of, 8
Melena, 1428, 1428t Mental retardation, chromosome cardiac, 1090–1092 Microcephaly, 667–668, 667f
Mellaril. See Thioridazine abnormalities associated with, cellular, 25–28 Microchimerism, maternal, 275b
Melphalan, multiple myeloma 143 impairment of, 1669–1670 Microcirculation, 1109f
treated with, 1034 Mercury, 69 shock and, 1669f Microcytic-hypochromic anemia,
Membrane, biologic, 14f–15f Merkel cell, 1617 chemical reactions of, 496 984f, 989–993
Membrane attack complex, 198, characteristics of, 1618t circadian clock and, 422f Microdomain, 35
198f in epidermis, 1617 intermediary, 9 Microencephaly, 667–668, 668b
Membrane potential, 36–37, 1094 Mesalazine, ulcerative colitis treated muscle, 1533–1534 Microfilament, 3f, 10–11, 10f
Membrane transport, 28–37 with, 1442 organ dysfunction and, 1684b Microglia, 449–450, 451t
Membranoproliferative Mesangial cell, 1320–1321, 1324f oxidative cellular, 26 β2-microglobulin, 233, 234f,
glomerulonephritis (MPGN), Mesangial matrix, 1320–1321, 1324f Metanephros, 1376 1032–1034
1355 Mesangial proliferative Metaphase, cell reproduction and, Microorganism
Membranous bone, 1520 glomerulonephritis, 1355 37 colonization of, 300–301
Membranous glomerulonephritis, Mesencephalon, 454t, 459 Metaphase plate, 37 countermeasures against,
1353 Mesencephalon dysfunction, eye Metaphase spread, 142 329–336
Membranous nephropathy, 1353 movement and, 531t Metaphysis, long bone and, human health and, 300
Memory, 536, 537f Mesenchymal cell, 54 1517–1518 human relationships with, 300b
Memory cell, immune response cancer and, 370–371, 371f Metaplasia, 50f, 54, 54f infection and, 300–322
and, 226–227 differentiation of, 1511f Metarteriole, composition of, mechanisms of, to defend
Memory deficit, 537–538, 541t microenvironment of, 386f 1108 against inflammation and
Men having sex with men (MSM) Mesenchymal-epithelial transition Metastasis immunity, 308t
gonorrhea and, 921 (MET), 907 blood-borne tumor, 391f multiplication of, 301
syphilis and, 922–923 Mesenchymal stem cell (MSC), 294, common sites of, 391t opportunistic, 300
Menarche, 778 955–956, 1510 definition of, 364 penicillin-resistant, 330
Mendel, Gregor, 135, 151 Mesenchymal tissue, tumors description of, 387–392 Micropinocytosis, 33–34
Mendelian trait, 151 associated with, 367t pattern of, 391f–392f MicroRNA, 184
Mendel’s second law, 152 Mesenchyme, 1511–1512, 1591 steps in, 389f cancer and, 186, 416
Ménière disease, 507 Mesenteric artery, 1446 Metastatic calcification, 87–88 genes affected by, 378–379
Meningeal layer, dura mater and, Mesenteric venous thrombosis, 1446 Metastatic cascade, 632 Microsatellite instability (MSI),
464 Mesentery, 1401 Metatarsus adductus, 1595–1596 1470
Meninges, 464–465 Mesoderm, bone tumors and, 1560 developmental hip dysplasia Microscopic colitis, 1441b
Meningioma, 627t, 631, 631f Mesodermal germ layer, 443 associated with, 1594 Microsleep, 505
Meningitis, 304t–305t, 609–613, Mesonephros, 1376 Metencephalon, 459–460 Microspherocyte, 1063f
675 Mesothelioma, asbestos exposure Methamphetamine, description and Microsporum canis, 312t, 1657
bacterial, 675–676 associated with, 1259 effects of, 72t–73t Microtubule, 3f
clinical manifestations of, 612 Mesothelium, cancer of, Methemoglobin, 961 cytoskeleton and, 10f
evaluation and treatment of, carcinogenic agents associated Methicillin-resistant Staphylococcus description of, 10
612–613 with, 404t–407t aureus (MRSA), 310, 331 neuron and, 448
pathogenesis of, 611f Messenger RNA (mRNA), 141–142, bone infection from, 1559 Microvascular disease,
pathophysiology of, 612 237–239 osteomyelitis caused by, 1602 hyperglycemia and, 747–751
Meningocele, 663–666 MET. See Mesenchymal-epithelial tonsillar infection caused by, 1297 Microvillus, 3f, 40, 1401
clinical manifestations of, transition (MET) Methotrexate, 396, 1572 Micturition, 1325
665–666 Metabolic acidosis, 126–128 Methylation, DNA, 183 Micturition center, 1345
evaluation and treatment of, 666 acid base balance regulation and, Methylenetetrahydrofolate Micturition reflex, 1326
example of, 664f 125–126 reductase (MTHFR), 1049 Midbrain, 454, 459
Meningoencephalocele, 664f causes of, 127t Methylnaltrexone, 1425 attention deficit and, 539f–540f
Menometrorrhagia, 808t, 809 chronic kidney disease associated Methylprednisolone, idiopathic periaqueductal gray matter of,
Menopause, 778, 791 with, 1367–1369 thrombocytopenic purpura 487
cardiac changes associated with, compensation and correction for, treated with, 1073 secondary vesicles of, 454t
795 127f–128f Metronidazole Midcortical nephron, 1320–1321
definition of, 795 high-output failure and, 1182 bacterial vaginosis treated with, Middle cerebral artery, 467, 468t
ovarian changes in, 793–794 hyperchloremic, 128 929 Middle fossa (temporal fossa), 464
1786 INDEX

Mifepristone, endometriosis treated Mixed nerve, 469 Mood disorder, 647–654 MTHFR. See
with, 824–825 Mixed precocious puberty, 803b, clinical manifestations of, Methylenetetrahydrofolate
Migraine headache, 607–608 804 650–651 reductase (MTHFR)
characteristics of, 607t causes of, 888b etiology and pathophysiology of, MTOR. See Mammalian target of
clinical phase of, 608 in male, 887 647–650 rapamycin
Migratory testis, 892–893 Mixed transcortical dysphasia, 540 neuroanatomic and functional Mucolipidoses (MLs), 84
Mild diffuse axonal injury, 588 MLs. See Mucolipidoses (MLs) abnormalities associated Mucopolysaccharidoses (MPSs),
Mild traumatic brain injury, 587 MM. See Multiple myeloma (MM) with, 650 84
Miliaria, 1664 MMR. See Mumps and measles treatment of, 651–654 Mucopurulent cervicitis, 816
Miliaria crystallina, 1664 (rubeola) vaccine (MMR) Moraxella catarrhalis, 304t–305t Mucosa-associated lymphoid
Miliaria rubra (prickly heat), 1664 Moban. See Molindone bacterial tracheitis caused by, (MALT) lymphoma, 384, 1467
Milk Mobile telephone, radiation 1297–1298 Mucosal barrier, 1399
composition of, 784 exposure from, 432 otitis media caused by, Mucus, 1399
production of, 782, 784 Mode of inheritance, 151–152 516–517 Mucus plugging, cystic fibrosis and,
Milliequivalent, electrolyte Moderate diffuse axonal injury, Morphea, 1639–1640 1311
measurement with, 29 588 Motilin, 1397, 1397t Müllerian duct, abnormality of, 801
Milrinone MODS. See Multiple organ Motility Multifactorial disease
heart failure treated with, 1179 dysfunction syndrome acquired impairment of, in adult population, 171–182
shock treated with, 1714t (MODS) 1492–1494 principles of, 180–182
Milroy disease, congenital heart MODY. See Maturity-onset congenital impairment of, Multifactorial etiology, childhood
defects associated with, 1200t diabetes of youth (MODY) 1486–1487 cancer and, 443
Mineralocorticoid, 708–709 Mold, 310–311, 312f Motility diarrhea, 1426 Multifactorial inheritance, 165–168
Mineral(s) Mole, 1641 Motility disorders, 1428–1434 basic model of, 165–166
digestion and absorption of, Molecular mimicry, 275 Motor dysphasia, 543t–544t recurrence risk and, 167–168
1405–1406 Molecule Motor memory, 536 threshold model of, 166–167
storage of, 1413 adhesion pairings and, 235b Motor neuron, 462, 571f transmission patterns of, 167–168
Minimal change nephropathy antigen-binding, 230f Motor neuron disease, 571–572 Multifactorial trait, 165
(MCN), 1383–1384 antigen-presenting, 234f Motor neuron syndrome, 568–571, Multifocal neuropathy, 622
Minimally conscious state, 535, antigen recognition by, 229–233 569t Multinucleated giant cell, 320
535t size of, immune response and, Motor neuropathy, 622 Multiple causation, childhood
Minor calyces, kidney, 1320 229 Motor pathway, 463–464 cancer and, 443
Minoxidil, alopecia treated with, Molindone, schizophrenia treated Motor response Multiple endocrine neoplasia
1646 with, 646b abnormal, 534t syndrome, 722, 732
Minute ventilation, 1232 Molluscum body, 937 brain dysfunction and, 532–533 Multiple myeloma (MM),
Minute volume, 1232 Molluscum contagiosum, 937, Motor unit, 462–463 1030–1035
MiR. See MicroRNA 937f, 1658 muscle mechanics and, 1534 clinical manifestations of, 1032
MiRNA. See MicroRNA Monoamine hypothesis of skeletal muscle and, 1528–1532 diagnostic criteria for, 1035b
Mirror focus, seizures and, 553 depression, 648 Motor vehicle accident, injury evaluation and treatment of,
Mirtazapine, depression treated Monoamine oxidase inhibitor caused by, 70 1032–1035
with, 652b drugs, 648 Mouth, 1395–1396 osteolytic lesions associated with,
Miscarriage action of, 649f candidiasis infection in, 1638t 1034f
chromosome abnormalities depression treated with, 652b Movement pathophysiology of, 1030–1035
associated with, 143 side effects of, 651 alterations in, 561–573 staging system for, 1034t
maternal age and, 836f Monoblast, in acute monoblastic dystonic, 574–575 statistics on, 1015t
Mitochondria, 8 leukemia, 1077f Movement disorder, 561 Multiple organ dysfunction
calcium ion accumulation in, 63 Monoclonal gammopathy of Moyamoya disease, 678 syndrome (MODS), 1262,
DNA in, 137 undetermined significance MPC. See Mucopurulent cervicitis 1679–1685
inner membrane of, 8 (MGUS), 1030, 1031f, 1032 MPGN. See Membranoproliferative clinical manifestations of, 1683
outer membrane of, 8 Monocyte, 201–202, 209, 212 glomerulonephritis (MPGN) common triggers of, 1680b
reactive oxygen species and, characteristics of, 948t MPS. See Mononuclear phagocyte description of, 1668
61–62 conditions associated with, system (MPS); Myofascial pain evaluation and treatment of,
Mitochondrial deoxyribonucleic 1010t syndrome (MPS) 1684–1685
acid, 61–62, 96 count of, 1057 MPSs. See Mucopolysaccharidoses pathogenesis of, 1681f
Mitochondrial permeability description of, 950, 1009–1011 (MPSs) pathophysiology of, 1680–1685
transition pore, 58–59 illustration of, 949f MPTP. See Mitochondrial pediatric, 1699–1715
Mitochondrion, 3f leukocyte development and, permeability transition pore septic shock and, 1675
cytoskeleton and, 10f 964–965 MRA. See Magnetic resonance Multiple papilloma, 839–840
illustration of, 9f pediatric values for, 1057t angiography (MRA) Multiple sclerosis (MS), 618–621
Mitophagy, 61–62 values for, 978t MRI. See Magnetic resonance childhood, 662f
Mitosis, 38f Monocyte chemotactic protein-1, imaging (MRI) clinical manifestations of,
cell reproduction and, 37 385–386 MRNA. See Messenger RNA 619–620
microtubule and, 10 Monocytopenia, description of, (mRNA) concordance rates for twins for,
phases of, 37 1010t, 1011 MRSA. See Methicillin-resistant 170t
tissue formation by, 40f Monocytosis, description of, 1010t, Staphylococcus aureus diagnosis of, 621t
Mitral and tricuspid complex, 1011 (MRSA) evaluation and treatment of, 621
1088 Mononeuropathy, 751t MS. See Multiple sclerosis (MS) pathogenesis of, 618f
Mitral regurgitation, 1168t, 1170 Mononuclear phagocyte system MSC. See Mesenchymal stem cell pathophysiology of, 618–619
Mitral stenosis, 1169, 1169f (MPS), 950, 950t (MSC) prevalence of, 172t
clinical manifestations of, 1168t Monosaccharide, sodium transport MSH. See Melanocyte-stimulating sexual function impacted by, 834t
valvular vegetations in, 1172f and, 1404f hormone (MSH) syndromes of, 620b
Mitral valve, 1087–1088 Monosodium urate (MSU), MSI. See Microsatellite instability Multiplication, of infectious agent,
Mitral valve endocarditis, 1174f 1574–1575 (MSI) 301
Mitral valve prolapse syndrome, Monosomy, 144–148 MSU. See Monosodium urate Multipolar neuron, 448–449, 450f
1170–1171, 1170f Monozygotic twin, 169 (MSU) Multipotency
Mixed hearing loss, 517 Mons pubis, 771 MtDNA. See Mitochondrial cancer cells and, 370–371
Mixed incontinence, 1344t Mood, definition of, 647 deoxyribonucleic acid cell reproduction and, 39
 INDEX 1787

Mumps Musculoskeletal system (Continued) Myelomeningocele, 663–666, 664f Myocardium (Continued)

orchitis associated with, 894–895 pediatric alterations in function clinical manifestations of, oxygen supply to, 1099
vaccination and reduction of, of, 1591–1615 665–666 relaxation of, 1101
330t structure and function of, 1 evaluation and treatment of, 666 Myocyte, 41, 52b
Mumps and measles (rubeola) tests of function of, 1535–1536 Myelopathy Myoepithelial cell, invasive breast
vaccine (MMR), 1659 Mustard and Senning operation, degenerative disk disease and, 595 cancer and, 871f
Mumps virus, 318t, 610t 1215–1216 vacuolar, 617 Myofascial pain, fibromyalgia
Mupirocin, impetigo treated with, Mutagen Myeloperoxidase, 211, 1311–1312 compared to, 1579t
1656 cancer-prone family and, 379 Myeloperoxidase deficiency, 289 Myofascial pain syndrome (MPS),
Muscle description of, 140 Myeloproliferative disorder, 1020 492–493
alcohol effects on, 1585 Mutation, 137–141 Myeloproliferative red blood cell Myofibril, muscle, 1529–1532, 1529f
breathing mechanics and, antigenic variation by, 308 disorder, 1002 Myofibroblast, 218, 1626
1234–1235 cancer-causing, 372–373 Myenteric plexus (Auerbach Myogenic mechanism, 1326
cardiac, 44t, 1097 chromosomal, 149f plexus), 1394, 1401 Myoglobin
contraction of, 1100f driver, 373–374 Myoadenylate deaminase coronary blood flow and, 1117
hypertrophy of, 52f frameshift, 140f deficiency (MDD), 1583 iron cycle and, 963
components for function of, missense, 137–140, 140f Myoblast, 1526, 1529 Myoglobinuria, 1547
1533–1535 nonsense, 140f Myocardial cell, 1097–1099 Myography, muscle function
composition of, 1526 passenger, 373 death of, myocardial ischemia as evaluated with, 1535
contraction of, 1100f, 1533–1534 point, 375 cause of, 1159 Myoma, 821–823
contracture of, 1578 viral infection and, 320 ischemic, 1153, 1158 Myometrium, 775, 821
effects of aging on, 1536 Mutation rate, 140–141 Myocardial contractility, 1099, 1103 Myopathy, 1585
energy sources for, 1533t Mutational hot spot, 140–141 Myocardial depressant factor Myopia, 511–512
extraocular, 509–510 MVO2. See Myocardial oxygen (MDF), 1689 Myosin, 1098–1099
eye, 509f consumption (MVO2) Myocardial depression muscle contraction and, 1532t
growth of, pediatric, 1593 Myalgic encephalomyelitis (ME), burn injury associated with, 1689 sarcomere and, 1530
hyperglycemia effects on, 740f 1580 multiple organ dysfunction structure of, 1098f
illustration of, 1528f Myasthenia, cancers associated syndrome and, 1683 Myositis, 1583–1585
mechanics of, 1534 with, 395t Myocardial dysfunction, ventricular Myositis ossificans, 1547
metabolism in, 1533–1534 Myasthenia gravis, 624–626 remodeling and, 1176f Myotonia, 560t, 1581–1582
nerve impulses and stimulation antibodies and, 625f Myocardial infarction (MI), Myotonic channelopathy, 1581
of, 462–463 clinical manifestations of, 626 1156–1163 Myotonic dystrophy, 1606t
nonprotein constituents of, 1532 evaluation and treatment of, clinical manifestations of, 1160 Myxedema, hypothyroidism
proteins of, 1532 626 complications associated with, associated with, 729
skeletal, 44t, 1097, 1526–1535 maternal hypersensitivity and, 1157 Myxedema coma, hypothyroidism
smooth, 44t 277 concordance rates for twins for, associated with, 729
tests of function of, 1535–1536 pathophysiology of, 625–626 170t MZ. See Monozygotic twin
tumors of (See Muscle tumor) Myasthenic crisis, 626 definition of, 1160b
types of, 1527–1532 Myc gene, 375–376, 376f diabetes mellitus and, 751 N
weakness of, amyotrophic lateral MYC protein, 375–376 electrocardiographic alterations NAFLD. See Nonalcoholic fatty
sclerosis associated with, 573 Mycobacterium leprae, 302, associated with, 1161f liver disease (NAFLD)
Muscle cell, 1529, 1529f 304t–305t, 306–307, 309 evaluation and treatment of, Nail, 1618, 1618f
Muscle disorders, 1582–1583 Mycobacterium tuberculosis, 302, 1160–1162 Nail disorders, 1647
Muscle fiber 304t–305t, 306–307 example of, 1159f Naproxen
characteristics of, 1530t immune response suppressed genetic factors associated with, abnormal uterine bleeding treated
contractile proteins of, 1532t by, 309 171–172 with, 809
description of, 1529–1532 osteomyelitis caused by, 1603 ischemic injury associated with, gastritis associated with, 1434
illustration of, 1531f Mycoplasma genitalium, 302, 814 56–57 Narcolepsy, 505
pediatric, 1593 Mycoplasma pneumoniae, 302, pathophysiology of, 1157–1158 Nardil. See Phenelzine
Muscle fiber action potential, 304t–305t plaque disruption and, 1158f Narrow-angle glaucoma, types of,
muscle contraction and, 1533 croup caused by, 1294–1295 sexual function impacted by, 834t 511t
Muscle group, movement of, pediatric pneumonia caused by, site of, 1161f Nasal cavity, cancer of, carcinogenic
1534–1535 1306 tissues changes associated with, agents associated with,
Muscle membrane, 1530, 1581 Mycoplasma spp., infection from, 1159t 404t–407t
Muscle membrane abnormalities, 303t Myocardial ischemia, 1153–1156 Nasal continuous positive airway
1581–1582 Mycosis, 311–312 clinical manifestations of, pressure (NCPAP), respiratory
Muscle pump, 1109, 1112f Mycosis fungoides, 1645, 1645f 1153–1154 distress syndrome treated with,
Muscle strain, 1547, 1548t Mycotic aneurysm, 604 cycle of events in, 1153f 1303
Muscle tissue, 41, 44t Myelencephalon, 460 evaluation and treatment of, Nasal wall, 1227f
Muscle tone Myelin, 448 1154–1156 NASH. See Nonalcoholic
alterations in, 559–561, 560t demyelinating disorders and, stress and, 342b steatohepatitis (NASH)
decrease in, heat loss by, 497 618 Myocardial oxygen consumption Nasopharynx
Muscle tumor, 1585 destruction of, 618–619 (MVO2), 1099 cancer of, carcinogenic agents
pediatric, 1611–1612 development of, 662–663 Myocardial remodeling, 1160 associated with, 404t–407t
Muscle wasting, shock associated Myelin sheath, 448 Myocardial stunning, 1159–1160 description of, 1233–1234
with, 1670 Myelination, brain development Myocardium National Wilms Tumor Study
Muscular artery, 1108 and, 662–663 coagulative necrosis of, 90f Group, 1386
Muscular dystrophy (MD), 1606– Myelodysplasia, 663, 666t contraction and relaxation of, NATP. See Neonatal alloimmune
1609, 1607f. See also Duchenne Myelodysplastic syndrome (MDS), 1099–1101 thrombocytopenic purpura
muscular dystrophy (DMD) 992 description of, 1085–1086 (NATP)
Musculoskeletal injury, 1540–1550 Myelofibrosis, 984f disorders of, 1165–1167 Natriuretic hormone
Musculoskeletal system, 1 Myelogenic tumor, 1564–1565 electrophysiologic mapping of, action of, 1111b
aging effects on, 1536 Myelogram, 480 1121 hypertension and, 1134
alterations in function of, Myelography, 480 ion concentrations in, 1094t Natriuretic peptide, 109
1540–1590 Myeloid tissue, 955 lymphatic capillaries of, 1092 heart failure and, 1178
hypothyroidism effects on, 730t Myeloma cell, 1031f, 1035f metabolism in, 1099 kidney function affected by, 1327
1788 INDEX

Natural immunity, 191 Neonate (Continued) Nervous system (Continued) Neurogenic detrusor overactivity,
Natural killer cell, 213, 255f, 256 osteomyelitis in, 1602b embryonic development of, 661 1342f
catecholamine and, 346 seizures in, 554t enteric, 1394 Neurogenic diabetes insipidus,
description of, 950 shock in, 1700b heart function and, 1095–1097 719–720
stress response and, 354–355 signs of distress in, 1700b hyperthyroidism effects on, 727t Neurogenic sarcoma, pediatric,
Natural killer cell neoplasm, 1024b, sleep patterns of, 503–504 hypothyroidism effects on, 730t 1612t
1027 thrombocytopenia in, 1074 organ dysfunction and, 1684b Neurogenic shock, 1673–1674,
Nature and nurture, 169–171 Neoplasm. See also Tumor organization of, 447–448 1673f
Nausea, 1424 acquired immunodeficiency overview of, 447–448 blood flow affected by, 1700
Navane. See Thiothixene syndrome and, 327b parasympathetic, heart function description of, 592
NcRNA, 184 B cell, 1024b, 1027 and, 1096–1097 signs of, 1705
Nearsightedness, 511–512 benign, 366f pediatric, 660–663 treatment of, 1671
Nebulin, muscle contraction and, cervical, 365f peripheral (See Peripheral nervous Neuroglia, 449–450
1532t childhood, 681 system (PNS)) Neuroglial cell, 448–450, 450f
NEC. See Necrotizing enterocolitis definition of, 364 protective structures for, 464–467 Neuroglycopenia, 743
(NEC) inflammation associated with, 384t somatic, 448 Neurohormonal signaling, 20
Necator americanus, 314t intracranial, 628f stress effects on, 353 Neurolemma, 631
Neck, arteries of, 467f lymphoid, classification of, 1024b stress response and, 340f, Neurolemmocyte, 450
Necroptosis, 88, 90 malignant, 366f 344–345 Neuroleptic malignant syndrome,
Necrosis, 88–91 natural killer cell, 1024b, 1027 structure and function of, 1 77
characteristics of, 88 renal, 1347 support cells of, 451t Neurologic disorders
features of, 90t–95t T cell, 1024b, 1027 sympathetic (See Sympathetic genetic basis for, 671t
reactive oxygen species and, 60b Neostigmine, 1434 nervous system) hypertension and, 1137t
schematic illustration of, 89f Neovascularization, cancer cell, tests of, 477 Neurologic function, pediatric,
Necrotizing enterocolitis (NEC), 389–390 Nesiritide, heart failure treated with, alterations in, 660–688
1499 Nephritic sediment, 1357 1179 Neuroma, 631
Necrotizing fasciitis, 309, 1635 Nephritic syndrome, 1356t, Net filtration, body water Neuromatrix theory of pain, 485
Nefazodone, depression treated 1358–1359 movement and, 105, 106f Neuromodulator, description of,
with, 652b clinical manifestations of, 1359 Net filtration pressure (NFP), 1329 453t
Negative dimension, schizophrenia pathophysiology of, 1358–1359 Neural crest, 660–661, 684 Neuromotor function, alterations
and, 646 Nephritis, basement membrane, Neural fold, 660 in, 559
Negative feedback, hormone 1357f Neural groove, 660 Neuromuscular (myoneural)
regulation and, 690 Nephroblastoma, 1385 Neural lobe, 697 junction, 462–463, 463f,
Negative pressure pulmonary Nephrogenic diabetes insipidus, Neural plate, 660 625t
edema, 1260–1261 720, 1342–1343 Neural tissue, 41–48 Neuromuscular (myoneural)
Negative selection, self-antigen Nephrolithiasis, pediatric, 1386 Neural tube, 660, 661f junction disorder, 624–626
and, 240 Nephron, 1320–1323 Neural tube defect (NTD), 168b, Neuromuscular tissue disorders,
Neglect syndrome, 536 aging effects on, 1336 663–666 264t–265t
Neisseria gonorrhoeae, 303, components of, 1321f genetic factors associated with, Neuromyelitis optica (NO), 620
304t–305t development of, 1376–1377 167 Neuromyotonia, 625t
Chlamydia trachomatis function of, 1327–1331, 1328f normal spine compared to, 664f Neuron, 448–449
syndromes compared to, illustration of, 1323f prevalence rate of, 171t afferent, 462
930t Nephron tubule, 1322, 1322f risk for, 663b bipolar, 448–449
drug-resistant strains of, 922 Nephrotic sediment, 1357 Neuraminidase, 320 description of, 41
gonorrhea caused by, 919 Nephrotic syndrome, 1356t, Neurilemma (Schwann sheath), 448 efferent, 462
immune response suppressed 1358–1359 Neuritic plaque, 546–549 formation of, 662–663
by, 309 cancers associated with, 395t Neuroblastoma lower motor, 462
Neisseria meningitidis, 303, clinical manifestations of, 1359, embryonal, 684 postsynaptic, 451
304t–305t, 609, 676 1359t gene amplification in, 376f presynaptic, 451
Neisseria spp., 305 evaluation and treatment of, 1359 Neurochemical dysregulation, primary-order, 487
complement deficiency and, 288 pathophysiology of, 1358–1359, depression and, 648 pseudounipolar, 448–449
phase shift by, 308–309 1358f Neuroendocrine dysregulation, second-order, 487
Nematode, 314 pediatric, 1383–1385 648–650 seizure initiation and, 552–553
Neoadjuvant chemotherapy, 397 clinical manifestations of, 1384 Neuroendocrine response, stress structural classification
Neoantigen, 275 evaluation and treatment of, and, 710 of, 450f
Neologism, 545t 1384–1385 Neuroendocrine system, 567–568, structure of, 449f
Neonatal alloimmune pathophysiology of, 1383–1385 696 third-order, 487
thrombocytopenic purpura Nerve. See also specific nerves (i.e., Neurofibril, 448 unipolar, 448
(NATP), 1074 Cranial nerve, Spinal nerve) Neurofibrillary tangle, 546–549 upper motor, 462
Neonatal jaundice, 1060 injury to, 450–451 Neurofibroma, 631 Neuronal cell tumor, characteristics
Neonatal myasthenia, 625 peripheral, 471f characteristics of, 627t of, 627t
Neonatal purpura fulminans, 1072 regeneration of, 450–451 example of, 1620t–1622t Neuropathic itch, 1627
Neonate Nerve fiber, repair of, 451f Neurofibromatosis, 154, 155f, 631, Neuropathic pain, 494–495
antibody levels in, 257f Nerve growth factor, 39t 671t Neuropathy
blood volume in, 975, 1056–1057 Nerve impulse, 451–454 childhood cancer associated with, clinical manifestations of, 622
blood volume of, 1705t Nerve sheath tumor, 631 443t description of, 621–624
chlamydial infection in, 931 Nervous system, 1 congenital heart defects evaluation and treatment of, 622
epilepsy in, 678 aging and, 477, 478b associated with, 1200t human immunodeficiency virus,
hematologic system in, 975 autonomic (See Autonomic diagnosis of, 632b 617
hematopoiesis in, 1055–1056 nervous system (ANS)) inheritance of, 379–380 pathophysiology of, 622
herpes simplex virus infection blood supply in, 467–469 Neurofilament, 448 Neuropeptide, eating behavior
of, 934 cells of, 448–451 Neurogenesis, 648, 649b influenced by, 1448b
hydronephrosis in, 1380 central (See Central nervous Neurogenic bladder, 1344–1345 Neuropeptide Y, 350, 351t
immune function in, 257 system (CNS) causes of, 1345f Neuroreceptor, 473–476, 475t–476t
inflammatory response in, 220 chronic kidney disease effects on, pyelonephritis associated with, Neuroregulin (NRG), 1528–1529
jaundice in, 1455 1365t, 1369 1352t Neurotonia, 624
 INDEX 1789

Neurotransmitter, 452–454, Nipah virus, central nervous system Noncommunicating Norepinephrine reuptake inhibitor
473–476 diseases caused by, 610t hydrocephalus (obstructive), drugs, depression treated with,
antidepressant drugs and, 649f Nipple 558 652b
autonomic nervous system and, breast, 783 Nondeclarative memory Norepinephrine system, 650f
475f retraction of, breast cancer and, (nonconscious), 536 Normal anion gap, 128
cellular communication and, 20 873f Nondisjunction, aneuploidy and, Normal-pressure hydrocephalus,
chemical signaling and, 21f Nipple inversion, 842t 145, 146f 558
definition of, 452 Nissl substance, 448 Nondividing support cell, 789 Normoblast, 959
description of, 453t Nitrate drugs, myocardial ischemia Nonerosive reflux disease, 1429 Normocytic-normochromic
excitatory, 490, 589 treated with, 1156 Nongonococcal urethritis (NGU), anemia, 993–1002
inhibitory, 490–491 Nitric oxide (NO) 888, 932 Normokalemia, 117f
nerve impulse and, 451–452 action of, 1111b Noninfectious cystitis, 1351 Norovirus, 318t
neurons and, 41 blood flow and, 966 Noninflammatory acne, 1653–1654 Norpramin. See Desipramine
of pain modulation, 489–491 burn injury and, 1689 Nonnucleoside reverse transcriptase Nortriptyline, depression treated
schizophrenia effect on, 643–644 multiple organ dysfunction inhibitor drugs, human with, 652b
sleep affected by, 503 syndrome and, 1680 immunodeficiency virus Norwood procedure, 1214
Neutralization, immune response pediatric septic shock and, 1707 treated with, 327 Nose, upper airway obstruction and,
by, 251–252 production of, 207–208 Nonobstructive jaundice, 1456 1294b
Neutropenia release of, 209 Nonoliguric renal failure, 1362 Nosocomial infection
cyclic, 289 renal blood flow affected by, Nonorganic failure to thrive, 1498 bacteria associated with,
description of, 1009, 1010t 1328t Nonossifying fibroma, pediatric, 304t–305t
maternal hypersensitivity and, Nitroglycerin, shock treated with, 1609 multiple organ dysfunction
277 1714t Nonproliferative breast lesion, syndrome associated with,
severe congenital, 289 Nitroprusside, shock treated with, 838–839 1684
Neutrophil, 208–210, 212 1714t Nonpuerperal hyperprolactinemia, Staphylococcus aureus as cause
acute respiratory distress NK cell, 255f, 256 837 of, 310
syndrome and, 1261 NMDA receptor, 490 Nonpurulent meningitis, 609 NPC. See Nuclear pore complex
characteristics of, 948t NNRTI. See Nonnucleoside reverse Nonshivering thermogenesis, NREM (slow-wave) sleep, 502
conditions associated with, 1010t transcriptase inhibitor drugs 496–497 NRG. See Neuroregulin (NRG)
count of, 1057 NO. See Nitric oxide (NO) Nonspecific vaginosis, 929 NRTI. See Nucleoside reverse
cystic fibrosis and, 1311–1312 Nocebo effect, 489 Nonsteroidal antiinflammatory transcriptase inhibitor drugs
description of, 949 Nociceptin, 490 drugs (NSAID) NSCLC. See Non-small cell lung
granulocytosis and, 1009 Nociception, 485, 487 abnormal uterine bleeding treated cancer (NSCLC)
illustration of, 949f Nociceptive transmission, pain with, 809 NTD. See Neural tube defect (NTD)
in multiple organ dysfunction and, 485 gastritis associated with, 1434 Nuclear envelope, 2, 4f–5f
syndrome, 1682 Nociceptor, 485–486, 486t, 489b gout treated with, 1578 Nuclear factor-kappa beta ligand,
pneumonia and, 1272 Nocturia, urine flow obstruction migraine headache treated with, 702–703
type II hypersensitivity reaction and, 1346 608 Nuclear membrane, 3f
and, 267 Node, myocardium and, 1092 peptic ulcer associated with, 1435 Nuclear pore complex, 4–5
type III hypersensitivity reaction Nodes of Ranvier, 448 pregnancy-associated breast Nucleolus, 2, 3f–4f
and, 269 Nodule, example of, 1620t–1622t cancer prevention with, Nucleoplasm, 4f
values for, 978t, 1057t Noise, injury caused by, 82–83 846b–847b Nucleoside reverse transcriptase
Neutrophil chemotactic factor, Noise trauma, 82–83 Nonstructural scoliosis, 1600 inhibitor drugs, human
207 Nominal dysphasia, 543t–544t Nonsyndromic craniosynostosis, immunodeficiency virus
Neutrophil elastase, 1311–1312 Non-Hodgkin lymphoma (NHL), 666 treated with, 327
Neutrophil extracellular trap, 1272 383, 1027–1029 Nontargeted effects of ionizing Nucleosome, 185f, 408f
Neutrophilia, 1009, 1010t childhood, 1078–1079 radiation, 78–80, 427–429 Nucleotide, 136
Neutrophilic asthma, 1309b Hodgkin lymphoma compared Nonthermal burn injury, 1685 Nucleus, 3f
Nevus (mole), 1641, 1641f to, 1028t Nonthyroidal illness syndrome, accumulation of substances in, 83
classification of, 1643t statistics on, 1015t 1369 cell, 2–4
description of, 86, 86f Non-inflammatory joint disease, Nonunion, following bone fracture, in central nervous system, 448
Nevus flammeus, 1663–1664 1565 1543 illustration of, 4f
Nevus simplex, 1664 Non-nociceptive stimulation, pain Nonvolatile acid, 123 Nucleus accumbens, 460b
Newborn. See Neonate and, 485 Norepinephrine Nucleus pulposus, 466–467
NFP. See Net filtration pressure Non-rapid eye movement (NREM) action of, 474 herniation of, 594–595
(NFP) sleep, 502 cardiac effects of, 1106 intervertebral disk herniation
NGU. See Nongonococcal Non-small cell lung cancer effects of, 343, 345 and, 597
urethritis (NGU) (NSCLC), 1280 myocardial contractility affected low back pain and, 597
NHL. See Non-Hodgkin lymphoma Non-specific low back pain, 492 by, 1103 Null cell, acute leukemia and, 1016
(NHL) Non-ST-elevation myocardial as neurotransmitter, 452, 453t, Nutrient artery, 467
Niacin, intestinal absorption of, infarction (non-STEMI), 1156 473–474 Nutrient(s)
1406t Non-staghorn calculus, 1343 pain modulation and, 490 absorption of, 1404f
Niche, bone marrow structure and, Non-STEMI. See Non-ST-elevation septic shock treated with, metabolism of, 1412–1413
955–956, 956f myocardial infarction 1678–1679 Nutrigenomics, 414–415, 414f
Nicotinamide adenine dinucleotide, (non-STEMI) shock treated with, 1714t Nutrition
25–28 Nonalcoholic fatty liver disease stress response and, 339f–340f, burn injury and, 1721–1722
Nicotinamide adenine dinucleotide (NAFLD), 1461 343 cancer prevention and, 415–423,
phosphate, 211 Nonalcoholic steatohepatitis synthesis of, 710f 415f
Nicotinic acid, intestinal absorption (NASH), 1461 urine concentration affected by, cell cycle and, 416f
of, 1406t Nonbacterial infectious cystitis, 1332 cellular injury and, 75
Niemann-Pick disease, 673t 1351 vasoconstriction affected by, 1097 chronic kidney disease and, 1370b
Nifedipine, action of, 1099–1101 Nonbacterial prostatitis, 900 vasoconstriction and, 1117 chronic obstructive pulmonary
Night terrors, 505 Nonbullous impetigo, 1656 Norepinephrine-dopamine reuptake disease and, 1269b
Nightmare, 505 Noncardiogenic pulmonary edema, inhibitor drugs, depression cystic fibrosis and, 1312, 1313b
posttraumatic stress disorder 1261 treated with, 652b immune system affected by,
and, 655 Noncoding RNA, 184 Norepinephrine receptor, 650 290–291
1790 INDEX

Nutrition (Continued) Obstructive uropathy, 1340 Oncogene addiction, 374 Orthomyxovirus, description of,
inflammatory response affected Obtundation, definition of, 529t Oncogenesis 318t
by, 218–219 Occipital lobe, 457 cancer and, 373–374 Orthopnea, 1249
pediatric, impairment of, Occult bleeding, 1426–1427, 1428t epigenomic alterations and, 186f Orthostatic (postural)
1494–1499 Occult hydrocephalus, 558 radiation-induced cancer and, hypotension, 1140
pro- and anti-cancer effects of, Occupational hazard 428 OS. See Oxidative stress (OS)
411f cancer associated with, 403f Oncomir, 184, 378–379 OSAS. See Obstructive sleep apnea
Nutrition disorders, 1446–1451 carcinogens from, 432–433 Oncosis, 84, 84f syndrome (OSAS)
Nystagmus, 509 mechanical injury and, 89t Oncotic pressure, 30–31, 30f Osgood-Schlatter disease,
OCD. See Obsessive-compulsive Onychomycosis, 1647 1604–1606
O disorder (OCD) Oophoritis, 813–814 Osler node, 1175
O2. See Oxygen (O2) Octreotide, elevated growth Open-angle glaucoma, types of, Osler-Weber-Rendu disease,
OA. See Osteoarthritis (OA) hormone treated with, 724 511t congenital heart defects
OAB. See Overactive bladder Ocular movement, alterations in, Open brain trauma, 586 associated with, 1200t
syndrome (OAB) 509–510 Open fracture, 1541 Osmolality
Oat cell carcinoma, 1281t Ocular myasthenia, 625 Open pneumothorax, 1254 of body water, 105
O’Beirne sphincter, 1407 Oculocephalic reflex response, 532f Open (penetrating) trauma, brain definition of, 30
Obesity, 1446–1450 Oculomotor nerve, 471f, 472t, 473, injury from, 582 Osmolarity, definition of, 30
body mass index as criteria for, 509 Ophthalmia neonatorum, 922, 922f Osmoreceptor, 109
417 Oculomotor response Ophthalmopathy, 726 Osmosis, passive transport and,
breast cancer and, 860 brain injury and, 532 Opioid receptor, 490 30–31
cancer associated with, 415–423, consciousness state and, 531t Opioids, 199, 490 Osmotic diarrhea, 1425
415f, 421f Oculovestibular reflex, 533f Opisthorchis viverrini, cancer Osmotic pressure, 30
cancer caused by, 403f Ofatumumab, chronic leukemia associated with, 423t Osteitis deformans, 1557–1558
cancer risk and, 418f treated with, 1023 OPSI. See Overwhelming post- Osteitis fibrosa, chronic kidney
childhood, 1221 Ogilvie syndrome, 1432 splenectomy infection (OPSI) disease and, 1368
clinical manifestations of, 1450 Ohm’s law, 1236 Opsonin, 198f, 211, 252 Osteoarthritis (OA), 1564–1565
coronary artery disease and, OI. See Osteogenesis imperfecta Opsonization, 211, 252 clinical manifestations of,
1151–1152 (OI) Optic chiasm, 512 1567–1568
cortisol and, 347–348 Olanzapine, schizophrenia treated Optic disc, description of, 508 evaluation and treatment of,
definition of, 1446 with, 646b Optic glioma, in child, 683 1568
diabetes mellitus associated with, Older adult Optic nerve, 471f, 472t illustration of, 1566f
177–178 body temperature regulation description of, 508 pain caused by, 1567f
dyspnea associated with, 1253 in, 498 edema of, 512–513 pathophysiology of, 1565–1568
endometrial cancer and, 830 cardiovascular function in, 1123t Optic nerve glioma, pediatric, 682 risk factors for, 1565
energy balance and, 418–420 fever response in, 500 Optic pathway glioma, pediatric, Osteoblast, 1514
evaluation and treatment of, 1450 hearing loss in, 515–516 681t–682t bone repair and, 1520
genetic factors associated with, immune response in, 257–260 Optico-spinal multiple sclerosis description of, 1512
178 immune system in, 290 (OSMS), 620 example of, 1514f
glucocorticoids and, 347b inflammatory response in, 220–223 Oral cavity, cancer of, carcinogenic function of, 1512t
hypertension and, 1134–1136, iron deficiency in, 975 agents associated with, in perichondrium, 1591–1592
1136b pain perception in, 495 404t–407t production of, 955–956
male precocious puberty pulmonary system in, 1244 Oral contraceptives Osteoblastic niche, 956
associated with, 887 renal function of, 1336 abnormal uterine bleeding treated Osteoblastoma, 633b
obstructive sleep apnea syndrome seizures in, 554t with, 809 Osteocalcin, 1512t, 1516
and, 1300 sleep patterns of, 504 breast cancer and, 855 Osteochondroma, pediatric, 1609
pathophysiology of, 1447–1450, Olecranon bursa, 1547f premenstrual syndrome and, Osteochondrosis, pediatric,
1449f Olfaction, 517–518, 518f 813 1604–1606
polycystic ovary syndrome and, aging effects on, 518 Oral phase of swallowing, 1395 Osteoclast, 1515
810 dysfunction of, 517–518 Orap. See Pimozide description of, 1512
prevalence of, 172t Olfactory bulb, 517–518 Orchiectomy, 893–894, 896–897 example of, 1514f
pro- and anti-cancer effects of, Olfactory hallucinations, 517–518 Orchiopexy, 893–894 function of, 1512t
411f Olfactory nerve, 471f, 472t Orchitis, 894–895, 895f Osteocyte, 1514–1515
prostate cancer and, 902b Oligoastrocytoma, characteristics Orexin, 503, 1448, 1448b description of, 1512
sleep disorders associated with, of, 627t Organ dysfunction, 1679–1680. example of, 1514f
504 Oligodendrocyte, 449–450, 451t See also Multiple organ function of, 1512t
type 2 diabetes mellitus associated Oligodendroglioma, 627t, 630 dysfunction syndrome Osteogenesis imperfecta (OI),
with, 739 Oligohydramnios, developmental (MODS) 1597–1599
Obesity gene, 1446–1448 hip dysplasia associated with, clinical manifestations of, 1684b clinical manifestations of, 1598
Obesity hypoventilation syndrome, 1594 Organ of Corti, 515 congenital heart defects
504 Oligomenorrhea, 808t Organ-specific autoimmune associated with, 1200t
Obligate carrier, 154 Oliguria, 1333 adrenalitis, 757 evaluation and treatment of,
Obligatory growth, urinary tract acute kidney injury associated Organ transplantation 1598–1599
obstruction and, 1342 with, 1361 childhood cancer associated with, mitral valve prolapse associated
Oblique fracture, 1541 mechanisms of, 1362f 443t with, 1170
Obsessive-compulsive disorder Omega-3 fatty acids, 194b major histocompatibility complex pathophysiology of, 1598–1599
(OCD), 656 Omega-6 fatty acids, 194b and, 233–235 Sillence classification of, 1598t
Obstructive hydrocephalus, 669 Onchocerca volvulus, 314t rejection of, 280 telescoping medullary rods for
Obstructive jaundice, 1455–1456 Onchocerciasis, 314t Organelle, 2 treatment of, 1599f
Obstructive pulmonary disease, Oncogene cellular function and, 2 Osteogenic (bone-forming) tumor,
1263–1271 activation of, 375f cytoplasmic, 4–11 1562–1563
Obstructive shock, 1710 childhood cancer associated with, Organic brain syndrome, 1163 Osteoid osteoma, 633b, 1514, 1563,
blood flow affected by, 1700 444, 444t Organic failure to thrive, 1498 1610
definition of, 1700 definition of, 373–374 Orgasmic dysfunction, 834 Osteomalacia, 1557
Obstructive sleep apnea syndrome mutation of genes into, 375–376 Oropharynx, description of, chronic kidney disease and, 1368
(OSAS), 503–505, 1300–1301 N-myc, 376 1233–1234 low back pain caused by, 596–597
 INDEX 1791

Osteomyelitis, 1558–1560 Overwhelming post-splenectomy PAD. See Peripheral arterial disease Pancreas disorders, 1464–1466
microorganisms as cause of, infection (OPSI), 1037 (PAD) Pancreatic α-amylase, 1415
1602b Oviduct, 775–776 PAF. See Platelet-activating factor Pancreatic acinar cell, structure of,
pediatric, 1601–1603 Ovulation, 776, 781 (PAF) 1414f
clinical manifestations of, 1603 disruption of, 835–836 PAG. See Periaqueductal gray Pancreatic cancer, 1467t,
evaluation and treatment of, lack of, uterine bleeding matter 1474–1478
1603 associated with, 808 Paget disease of bone (PDB), carcinogenic agents associated
pathophysiology of, 1602–1603 Ovum, zygote formation and, 1557–1558 with, 404t–407t
Osteonectin, 1512t, 1516 768 clinical manifestations of, 1558 survival rates for, 394t
Osteopenia, 1550 Oxidation, cell energy production evaluation and treatment of, Pancreatic duct, 1413
Osteopetrosis, 1582 and, 26 1558 Pancreatic insufficiency, 1439
Osteophyte, 1565 Oxidative cellular metabolism, pathophysiology of, 1558 Pancreatic lipase, 1415
Osteopontin, description of, 1516 26 PAH. See Pulmonary artery Pancreatic polypeptide, 706, 1397t
Osteoporosis, 1550–1557 Oxidative phosphorylation, 27–28, hypertension (PAH) Pancreatitis, 1464–1466
clinical manifestations of, 1555 369, 370f, 420 Pain, 485–495 Pancytopenia, 993, 1015
evaluation and treatment of, Oxidative stress (OS), 59–62, 59f, abdominal, 1426 Pandemic
1555–1557 746, 1553 acute, 491–492, 493t definition of, 302
low back pain caused by, 596–597 OXPHOS. See Oxidative cancer associated with, 396b historic examples of, 302t
pathophysiology of, 1553–1557 phosphorylation categories of, 491b Paneth cell, 1401
risk factors for, 1551b Oxycephaly, 667f chest wall, 1251 Panhypopituitarism, 721
Osteoprotegerin (OPG), 1553, 1554f Oxygen (O2) chronic, 492–494, 493t Panic disorder, 654–655
Osteosarcoma, 633b, 1562–1563, airway gas exchange of, 1229 clinical description of, 491–495 etiology and pathophysiology
1563f blood content of, 1241 definition of, 485 of, 654
pediatric, 1610 delivery of gender and, 496b treatment of, 654–655
Ostium primum, 1195, 1204 to body cells, 1238 inflammation associated with, Panicogen, 654
Ostium secundum, 1195, 1204 pediatric, 1703t 213 Panner disease, 1604
Otitis externa, 516 shock and, 1669–1670 intensity of, 485 Pantothenic acid, intestinal
Otitis media, 516–517 muscle metabolism and, 1534 low back, 596–597 absorption of, 1406t
bacteria as cause of, 304t–305t transport of, 1240–1243 neuroanatomy of, 485–487 PAO2. See Partial pressure of oxygen
treatment of, 333 Oxygen consumption (VO2), 1292 neuropathic, 494–495 in alveolar blood (PAO2)
Otitis media with effusion, 517 Oxygen consumption index, perception of, 487 PaO2. See Partial pressure of oxygen
Otolith, 515 definition of, 1120t aging and, 495 in arterial blood (PaO2)
Outflow tract, 1086 Oxygen debt, muscle metabolism pediatric, 495 PAOP. See Pulmonary artery
Oval window, 515 and, 1534 pulmonary, 1251 occlusion pressure (PAOP)
Ovarian cancer, 831–834 Oxygen-dependent killing pulmonary disorders as cause of, Papanicolaou smear
carcinogenic agents associated mechanism, 211 1250–1251 cervical cancer screening with,
with, 404t–407t Oxygen-independent killing referred, 492, 492f 826–827, 826b
carcinoma as, 833t mechanism, 211 somatic, 492 human papillomavirus screened
clinical manifestations of, Oxygen tension (PO2) theories of, 485 with, 936
832–833 level of, 1066 visceral, 492 sexually transmitted infection
evaluation and treatment of, sickle cell anemia and, 1065 Pain fiber, 486f caused by, 934–936
833–834 Oxygen toxicity, 1259 Pain management, following burn Papanicolaou (Pap) test, 382–383
metastasis of, 833f Oxygenation injury, 1723 Papez circuit, 457
pathogenesis of, 831–834 arterial, determinants of, Pain modulation, 487–491 Papillary muscle, 1087–1088
Ovarian cycle, 776, 778–782, 779f 1240–1241 mechanisms of, 489f Papilledema, 512–513
length of, 780 fetal, 1196 neurotransmitters of, 489–491 Papilloma, characteristics of, 627t
Ovarian follicle, 776, 777f pediatric shock and, 1701f pathways of, 487–489, 488f Papillomavirus, 318t
Ovarian stroma, 832f pediatric shock treatment and, Pain threshold, 491 Papovavirus, description of, 318t
Ovarian tumor, 832f–833f 1711 Pain tolerance, 491 Papule, example of, 1620t–1622t
Ovary, 776 shock treated with, 1671 Pain transduction, 485 Papulosquamous disorders,
benign cyst of, 820–821 Oxyhemoglobin (HbO2), 961, Pain transmission, 486 1629–1632
carcinoma of, 833t 1241–1242 Painful bladder syndrome/ Para-aminohippuric acid,
cross-section of, 774f, 777f Oxyhemoglobin association, interstitial cystitis (PBS/IC), 1334–1335
cyst of, 820f 1241–1243 1351 Paracrine signaling, 20
inflammation of, 813–814 Oxyhemoglobin dissociation, Painful facial expression, 495, 495f Paracusia willisiana, 517
location of, 690f 1241–1243 Painless thyroiditis, 729 Paradoxic sleep, 503
migration of epithelial cells to, Oxyhemoglobin dissociation curve, Palate, variations in cleft of, 1487f Paraesophageal hiatal hernia, 1430
831f 1241–1242, 1242f Paliperidone, schizophrenia treated Parageusia, 518
polycystic, 810, 810f Oxytocin, 696–699 with, 646b Paragonimus westermani, 314t
torsion of, 821 stress response influenced by, Palmomental reflex, 533, 533f Parainfluenza virus, 318t,
Overactive bladder syndrome 351t, 352 PAMP. See Pathogen-associated 1294–1295
(OAB), 1345–1346 Ozone layer, 433 molecular pattern Paralysis, definition of, 568
Overflow incontinence, 1344t Ozone pollution, cancer risk from, Panacinar emphysema, 1269–1270, Paralytic ileus, 1431, 1431t
Overflow theory, ascites and, 1453 433 1270f Paralytic poliomyelitis, 571
Overgrowth syndrome, 1663 Pancolitis, 1441–1442 Paramyxovirus, description of, 318t
Overweight P Pancreas, 703–706, 704f, 1413–1415 Paraneoplastic pemphigus, 1633
adolescent, 1222 P wave, 1095, 1230–1231 aging and, 711 Paraneoplastic syndrome, 365–366,
body mass index as criteria for, PA. See Pernicious anemia blood supply to, 1413 394–395, 395t
417 PABC. See Pregnancy-associated dysfunction of, 734–752 Paraparesis, 568–569
cancer risk and, 418f breast cancer (PABC) gastrinoma of, 1438 Paraphimosis, 888–889, 889f
childhood, 1222 Pacemaker hyperglycemia effects on, 740f Paraphrasia, 545t
definition of, 1450 in myocardium, 1092 innervation of, 1413 Paraplegia, 568–569
genetic factors associated with, sinoatrial node and, 1092–1093 location of, 690f, 1409f spinal cord injury as cause of, 592
178 PaCO2. See Partial pressure of necrosis of, 91f Parasite
obstructive sleep apnea syndrome carbon dioxide in arterial structure of, 1414f immune system neutralized by,
and, 1300 blood (PaCO2) tests of, 1416, 1418t 315–316
1792 INDEX

Parasite (Continued) Paroxysmal nocturnal dyspnea Pathogen-associated molecular Pemphigus foliaceus, 1633
immunoglobulin E and, 254–255 (PND), 1249 pattern, 202 Pemphigus vulgaris, 1633
infection from, 314–317 Paroxysmal nocturnal Pathogenicity, 302 Penciclovir, herpes simplex virus
invasion and evasion of, 315–316 hemoglobinuria, 998 Pathologic atrophy, 50 infection treated with, 934
mechanisms of, to defend Pars distalis, 697 Pathologic fracture, 1541 Pendular nystagmus, 509
against inflammation and Pars interarticularis, 596 Pathologic hyperplasia, 53 Penetrance
immunity, 308t Pars intermedia, 697 Pattern recognition receptor, 202, age-dependent, 154
pathogenesis of, 316–317 Pars nervosa, 697 273 genetic, 154
sexually transmitted infection Pars tuberalis, 697 Pattern theory of pain, 485 Penicillin
caused by, 919t, 937–940 Partial atrioventricular septal PAVC. See Partial atrioventricular allergic reaction to, 273
skin disorders caused by, defect (PAVC), 1206–1207 septal defect (PAVC) resistance to, 330
1661–1662 Partial obstruction of the bladder Pavementing, 209 Penicillin G, syphilis treated with,
Parasomnia, 505 outlet or urethra, 1346 Pavlik harness, 1595, 1595f 925
Parasympathetic nerve, 473 Partial precocious puberty, 803b, PAWP. See Pulmonary artery wedge Penile cancer, 890–891
Parasympathetic nervous system, 804, 887 pressure (PAWP) carcinogenic agents associated
344, 473–476, 474f Partial pressure, definition of, 1237 Paxil. See Paroxetine with, 404t–407t
Paratenonitis, 1546t Partial pressure of carbon dioxide PBC. See Primary biliary cirrhosis Penile torsion, 1378
Parathyroid function, alterations in, (PCO2) (PBC) Penis, 786–787
731–734 chemoreceptor monitoring of, PBI/IC. See Painful bladder candidiasis infection in, 1638t
Parathyroid gland, 700f, 702–703 1234 syndrome/interstitial cystitis cross section of, 787f
aging and, 711–712 normal ranges of, 1245t (PBS/IC) disorders of, 888–891
alterations in function of, Partial pressure of carbon dioxide PCI. See Percutaneous coronary herpes lesions on, 934f
731–734 in alveolar blood (PACO2), intervention (PCI) hypospadias and, 1378
location of, 690f hypoventilation and, PCO2. See Partial pressure of carbon squamous cell carcinoma of,
Parathyroid hormone (PTH), 702 1251–1252 dioxide (PCO2) 891f
alterations in secretion of, 731 Partial pressure of carbon dioxide PCOS. See Polycystic ovary Pennate muscle, 1527
calcium balance and, 119 in arterial blood (PaCO2), 124, syndrome (PCOS) Pepsin
low level of, 733 1232 PD. See Parkinson disease (PD) as digestive enzyme, 1402b
osteoporosis and, 1552 chemoreceptor monitoring of, PDA. See Patent ductus arteriosus gastric secretion and, 1399
Parathyroid hormone-related 1234 (PDA) Pepsinogen, gastric secretion and,
peptide, 703 hypoventilation and, 1250 PDB. See Paget disease of bone 1398
Paratonia, 560–561, 560t increase in, 1251 (PDB) Peptic ulcer disease, 1435–1439
Paratope, 228 Partial pressure of oxygen, 1237 PDGR. See Platelet-derived growth Peptidase, as digestive enzyme,
Paraurethral gland, 772 normal ranges of, 1245t factor 1402b
Parenchyma, 40–41 Partial pressure of oxygen in Peak bone mass, 1550 Peptide, example of, 690t
Paresis (weakness), 568 alveolar blood (PAO2), Pediculosis, 1661–1662 Peptide YY, 1397t, 1449
Parietal cell (oxyntic cell), 1398 1230–1231, 1240 Pediculosis pubis, 939–940 Percent mammographic density
Parietal epithelium, 1322 amount of, 1251–1252 Pediculus capitis, 1661 (PMD), 855
Parietal lobe, 457 hypoventilation and, 1251–1252 Pediculus corporis, 1661 Perceptual dominance, 491
Parietal pericardium, 1085 Partial pressure of oxygen in arterial Pedigree Percutaneous coronary intervention
Parietal peritoneum, 775 blood (PaO2) in autosomal recessive (PCI), 1156
Parkinson disease (PD), 564–568 chemoreceptor monitoring of, inheritance, 154–155 Perforin, 255–256
clinical manifestations of, 1234 characteristics of, 152 Perfusion
566–567 determinants of, 1240–1241 linkage analysis and, 159–160 blood pressure and, 1114
cognitive-affective symptoms reduction in, 1251 mode of inheritance and, 152 gas exchange and, 1238–1240
of, 568 Partial pressure of oxygen in mixed sex-influenced traits and, 159 in pulmonary circulation, 1239
evaluation and treatment of, 568 venous blood (PVO2), 1241 symbols used for, 152f systemic, pediatric shock and,
fluorodopa in, 566f Partial seizure, 551–552, 679 PEEP. See Positive end-expiratory 1701f
influence of symptoms of, 568 Partial-thickness injury, 1685–1686 pressure (PEEP) Pergolide, prolactinoma treated
molecular basis for, 547t Partial thromboplastin time test, Pegvisomant, elevated growth with, 724
pathophysiology of, 565–566, 1047 hormone treated with, 724 Periaqueductal gray matter, 487
566f Partial trisomy, 145–146 Pelizaeus-Merzbacher disease, 673t Pericardial cavity, 1085
posture abnormalities associated Passenger mutation, cancer genetics Pelvic floor dysfunction, 1424 Pericardial effusion, 1164
with, 567 and, 373 Pelvic inflammatory disease (PID), Pericardial fluid, 1085
prevalence of, 172t Passive acquired immunity, 227 813–814 Pericardial sac, 1085
treatment for, 459b Passive mediated transport, 31–32 ascension of, 814f Pericardiocentesis, 1164
Parkinsonian bradykinesia, 567 Passive transport, 28–31 clinical manifestations of, 814 Pericarditis, 1162
Parkinsonian rigidity, 567 Patau syndrome, acute leukemia diagnostic criteria for, 815b acute, 1163–1164
Parkinsonian tremor, 566 associated with, 1017 evaluation and treatment of, constrictive, 1164
Parkinsonism, 564–565, 565b Patch, example of, 1620t–1622t 815–816 Pericardium
Parnate. See Tranylcypromine Patella, Osgood-Schlatter disease gonorrhea and, 921 description of, 1085
Paronychia, 1647 and, 1605 oral treatment for, 816b disorders of, 1163–1164
Parosmia, 517–518 Patent ductus arteriosus (PDA), pathophysiology of, 814–816 inflammation of, 1162–1163
Parotid gland, 1395 1202–1204, 1203f Pelvic nerve, 473 Perichondrium, 1591–1592
Paroxetine clinical manifestations of, Pelvic organ prolapse (POP), Periduodenal band, 1489
anxiety disorder treated with, 1203–1204 817–820, 1346 Perihepatitis, 921–922
655 coarctation of the aorta with, physical examination terms for, Perilymph, 515
depression treated with, 652b 1211f 818b Perimenopausal hormone
obsessive-compulsive disorder evaluation and treatment of, 1204 risk factors for, 818b transition, 793f
treated with, 657 pathophysiology of, 1203–1204 symptoms of, 820b Perimenopause, 791–793
panic disorder treated with, 655 Pathogen treatment of, 820b endocrine events associated with,
posttraumatic stress disorder countermeasures against, Pelvic pain, diagnostic algorithm 793t
treated with, 656 329–336 for, 815f ovarian folliculogenesis during,
Paroxysmal cold hemoglobinuria, disease caused by, 302 PEM. See Protein-energy 793b
998–999 mechanism of action of, 302 malnutrition (PEM) transition timeline for, 794t
Paroxysmal dyskinesia, 562 portal of entry of, 302 Pemphigus, 1632–1633 Perimetrium, 775
 INDEX 1793

Perimysium, muscle, 1527 Pertussis, vaccination and Phimosis, 888–889, 889f Pituitary adenoma, 722
Perinatal stroke, 677 reduction of, 330t Phocomelia, 171 Pituitary gland, 697
Perineal body, 772 Pes planus (flatfoot), 1597 Phosphate, 119–122 location of, 690f, 697f
Perineum, 772 Pessary alteration in balance of, 114–122 structure of, 697f
Periodic paralysis (PP), 1582 pelvic organ prolapse treated alteration in level of, 121t Pituitary hormone, 696f
Periosteal collar, 1591–1592 with, 1347 balance of, chronic kidney disease Pituitary stalk, 697, 718
Periosteum (endosteal layer), 464, uterine prolapse treated with, 818 and, 1366t Pituitary tumor
465f, 1517 PET. See Positron-emission bone matrix and, 1515 characteristics of, 627t
Peripheral arterial disease (PAD), tomography (PET) crystallization of, 1517t growth hormone secretion and,
752, 1148 Petechiae, clinical manifestations deficiency of, 121 722
Peripheral arterial vasodilation of, 1625t dibasic, 126 prolactin secretion affected by,
theory, ascites and, 1453 Peyronie disease, 889–890, 890f digestion and absorption of, 724
Peripheral chemoreceptor, PGD. See Preimplantation genetic 1405 Pityriasis rosea, 1630, 1630f
1233–1234 diagnosis (PGD) distribution of, in body fluids, PK value, 123
Peripheral corticotropin-releasing pH, 122–123 108t PKD gene, 1381
hormone site, 343 bicarbonate level and, 124–125 function of, 1512t PKU. See Phenylketonuria (PKU)
Peripheral cyanosis, 1250 of body fluids, 123t kidney stone composed of, Placebo effect, 489
Peripheral lymphoid tissue, chemoreceptor monitoring of, 1343 Placenta, cancer development and,
236–237 1234 metabolism of, chronic kidney 410
Peripheral membrane protein, 13 control mechanisms of, 125f disease and, 1368–1372, Plagiocephaly, 666–667, 667f
Peripheral nerve, 471f of urine, 1335 1368t Plantar wart, 1636–1637
Peripheral nervous system (PNS), Phagocyte, 208–213, 282t, 288–289, Phosphatidylinositol, 13 Plaque
469–470 288f, 948 Phospholipase atherosclerosis caused by, 1145
development of, 660–661 Phagocyte deficiency, immune as digestive enzyme, 1402b atherosclerotic, 1153
human immunodeficiency virus deficiency and, 284 fat emulsification and, 1402–1404 concentric coronary, 1148f
and, 616b Phagocytosis Phospholipid molecule, 13f disruption of, 1158f
overview of, 447–448 bacterial protection against, Phototherapy, jaundice treated with, example of, 1620t–1622t
pain and, 485 307–308 1061–1062 rupture of, 1147
Peripheral nervous system (PNS) definition of, 208 Phthirus pubis, 1661 unstable, pathogenesis of, 1157f
disorders, 621–624 description of, 33–34 PHVA. See Posthyperventilation Plaque psoriasis, 1629
Peripheral neuropathic pain, 494 fungal protection against, 313 apnea (PHVA) Plasma
Peripheral obesity, 1450 immune response and, 243 Phyllodes tumor, 838t carbon dioxide in, 1243
Peripheral resistance, 1114–1117, microtubule and, 10 Physeal plate, long bone growth description of, 945–947
1114t parasite protection against, 315 and, 1592 inflammatory response and,
Peripheral sensitization, 489 process of, 209–212, 210f, 288 Physical activity 195–196
Peripheral tolerance, 240, 273–274 steps in, 212f breast cancer and, 863 loss of, hypovolemic shock
defective, 275 type II hypersensitivity reaction cancer prevention and, 414f–415f, associated with, 1672
immune response and, 229 and, 266–267, 268f 415–423 organic and inorganic
Peripheral vascular resistance, heart Phagolysosome, 211 cancer risk and, 403f, 422t components of, 947t
failure and, 1177 Phagosome, 211 pro- and anti-cancer effects of, oxygen in, 1240–1241
Peripheral vascular system, 1106 Phantom limb pain, 494 411f water movement and, 105
Peristalsis, 1396 Pharyngeal phase of swallowing, Physiologic atrophy, 50 Plasma cell
intestinal motility and, 1407 1395 Physiologic dead space, 1240 B cell and, 247, 249
rate of, 1397 Pharyngitis, gonococcal, 921 Physiologic jaundice malignancies of, 1030–1035
Peristaltic movement, 1408 Pharynx (hyperbilirubinemia) of the Plasma creatinine concentration,
Peritoneal cavity, 1400–1401 cancer of, carcinogenic agents newborn, 1500–1501 glomerular filtration rate and,
Peritoneum, 1400–1401 associated with, 404t–407t Physiologic reflux, 1429 1335, 1367f
Peritonitis, 1400–1401 description of, 1395 Pia mater, 461f, 465 Plasma kinin cascade, 199f, 201
Peritonsillar abscess, 1296t, 1297, illustration of, 1227f Pica, lead poisoning and, 674–675 Plasma membrane, 2, 11–16
1297f upper airway obstruction and, Pick disease, 550 calcium effects on, 116f
Peritubular capillary, 1325 1294b Picornavirus, description of, 318t carbohydrate in, 15–16
Permeable membrane, passive Phase I activation enzyme, 416–417 PID. See Pelvic inflammatory chemical injury to, 62–63
transport and, 29 Phase II detoxification enzyme, disease (PID) classification of, 13
Permethrin 416–417 Pigment, accumulation of, 85–87 composition of, 12–16
pediculosis pubis treated with, Phases of gastric secretion, Pili cytoskeleton and, 10f
939–940 1399–1400 bacterial colonization and, 305 functions of, 12t
pediculosis treated with, 1662 Phenelzine, depression treated with, example of, 306f illustration of, 3f
scabies treated with, 939 652b Pilocytic astrocytoma, 628, 683 lipids in, 12–13
Permissive effects of hormones, 695 Phenobarbital, epilepsy treated Pimozide, schizophrenia treated potassium effects on, 116f
Pernicious anemia, 983t, 984f, with, 681 with, 646b proteins of, 11f
987–989 Phenotype, 151 PIN. See Prostate epithelial receptors in, 16, 16f
bone marrow aspirate of, 987f definition of, 135 neoplasia (PIN) transport in, 33
laboratory findings for, 986t multigenerational versus Pineal body, 457–459 Plasma membrane receptor, 16, 16f,
Peroxide, 60–61 transgenerational, 412t Pineal gland, 690f, 700 17t, 692–695
Peroxisome, 3f, 8 Phenylalanine, 673, 710f Pink eye, bacteria associated with, Plasma metalloprotease
Perphenazine, schizophrenia treated Phenylephrine, septic shock treated 304t–305t, 507 ADAMTS13, 1040, 1043
with, 646b with, 1678–1679 Pink tets, 1208 Plasma oncotic pressure, 106–107
Persistent vegetative state (VS), Phenylketonuria (PKU), 151, Pinna, 514–515 Plasma protein, 197–201
534, 535t 673–674, 673t, 674f Pinocytosis, 33–34 description of, 945–947
Person-year, disease incidence rate Phenylpyruvic acid, 673 Pinworm infection, 314t interactions among, 201
and, 164 Phenytoin, congenital heart defects Pipe smoking, cancer associated synthesis of, 214
Personality, stress response associated with, 1199, 1199t with, 413 Plasma thromboplastin antecedent,
influenced by, 355–358 Pheochromocyte, 710 PIRO. See Predisposition-infection- disorders associated with,
Personalized medicine, 364–365 Pheochromocytoma, 758, 758f response-organ (PIRO) 1070t
Perthes disease, 1604–1605 Philadelphia chromosome, dysfunction system Plasma transferrin, iron absorption
Pertofrane. See Desipramine 1014–1015, 1016f Pit cell, 1409–1410 and, 1406
1794 INDEX

Plasmalemma, 2 Pneumolysin, 1272 Polydipsia, diabetes insipidus Posterior fossa, 464

Plasmapheresis, multiple myeloma Pneumonia, 1271–1272 associated with, 720 Posterior horn (dorsal horn),
treated with, 1034 abscess formation caused by, Polygenic trait, 165 460–461
Plasmin, 201, 971–972, 1044 1274 Polyhydramnios, 1488 Posterior pituitary, 697
Plasminogen, 972 aspiration, 1256 Polymenorrhea, 808t diseases of, 718–720
Plasminogen-plasmin system, community-acquired, 1271 Polymerization, erythrocyte and, hormones of, 698–699
971–972 death from, 298–299 1066 Posterior spinal artery, 469
Plasmodium falciparum, 316 etiologic microorganisms for, Polymicrobial organism, sexually Posterior vein of left ventricle, 1092
Plasmodium malariae, 316 1271b transmitted infection caused Postganglionic neuron, 470
Plasmodium ovale, 316 gastroesophageal reflux disease as by, 919t Postgastrectomy syndrome, 1439
Plasmodium spp., 314t, 316 cause of, 1493–1494 Polymorphism, 151 Posthemorrhagic anemia, 983t, 996
Plasmodium vivax, 316 healthcare-associated, 1271 Polymorphonuclear neutrophil, clinical manifestations of, 996t
Plastic rigidity, 567 hospital-acquired, 1271 208–209, 949 laboratory findings for, 986t
Plasticity, brain function and, 456 pathophysiologic course of, 1272f Polymyositis, 1584–1585 Posthyperventilation apnea
Platelet pathophysiology of, 1271–1272 Polyol pathway, hyperglycemia (PHVA), 529, 530t
activation of, 968–969 pediatric, 1306–1308 and, 746 Postictal state
adhesion of, 967 evaluation and treatment of, Polyp definition of, 555t
aggregation of, 969 1307–1308 definition of, 1470 seizures and, 553
alterations of, 1037–1053 pathophysiology of, 1306–1308 endometrial, 821 Postmenopausal osteoporosis,
blood tests for, 976t–977t viral, 1306 uterine, 821f 1552–1553
characteristics of, 948t pneumococcal, 1272 Polypeptide Postmortem autolysis, 97
in child, 1057 prevention of, 1273 example of, 690t Postmortem change, 97
description of, 950–951 Staphylococcus aureus associated protein structure and, 13, 137 Postobstructive diuresis, urinary
development of, 965 with, 311f protein synthesis and, 143f tract obstruction and,
disorders of, 1037–1042 ventilator-associated, 1271 Polyploid cell, 143–144 1342–1343
function of, 967–969 viral, 1273–1275 Polyploidy, 155–156 Postobstructive pulmonary edema
inflammation mediation and, Pneumonitis, 1256, 1259–1260 Polyribosome, 9 (POPE), 1260–1261
201–202, 208 Pneumothorax, 1254 Polyuria, 720, 745 Postpartum thyroiditis, 729
pediatric disorders of, 1070–1074 PNI. See Psychoneuroimmunology POMC. See Pro-opiomelanocortin Postrenal acute kidney injury,
values for, 978t PNM. See Primary nodular Pompe disease, 7, 1200t, 1583 1361, 1385
Platelet-activating factor (PAF), melanoma (PNM) Pons, 454, 459–460 Postsynaptic neuron, 451
207, 208f PNS. See Peripheral nervous system Ponseti casting, 1597, 1597b Posttranslational modification, 13
in multiple organ dysfunction (PNS) Pontine dysfunction, eye Posttraumatic hypermetabolic
syndrome, 1682 PO2. See Oxygen tension (PO2) movement and, 531t response, 1691–1692
pediatric septic shock and, 1707 Podocyte, 1321–1322, 1324f Pontine micturition center, 1345 Posttraumatic infarction, 591
Platelet-derived growth factor, 39, Point mutation, 375, 1071 POP. See Pelvic organ prolapse Posttraumatic stress disorder
39t, 381 Poiseuille’s law, 1111 (POP) (PTSD), 341, 356, 655–656
Platelet-release reaction, 968 Poison, common types of, 675b POPE. See Postobstructive Postural tremor, description of,
Plecanatide, 1425 Poison ivy, allergy to, 273, 1627f pulmonary edema (POPE) 563t
Pleomorphic cell, 368–369 Poisoning, central nervous system Pores of Kohn, 1229, 1256, 1257f Posture
Pleura, 1231 disorder caused by, 674 Porphyrin, 962–963 disorders of, 574–575
abnormalities of, 1254–1255 Polarity, of electrolytes, 29 Port-wine stain, 1663–1664 dystonic, 574–575
systemic disorders effect on, 1260 Poliomyelitis, 571 Portal hypertension, 1452–1453 Parkinson disease effects on, 567
Pleural cavity, 1231, 1232f immunization campaign against, clinical manifestations of, 1453, Potassium, 114–119
Pleural disorders, 1253–1255 332 1503 alteration in balance of, 114–122,
Pleural effusion, 1254–1255 as pandemic, 302t evaluation and treatment of, 118t
infected, 1255 vaccination and reduction of, 1453, 1503 deficiency of, 115–117, 745
mechanisms of, 1255t 330t pediatric, 1502–1503 distribution of, in body fluids,
Pleural friction rub, 1250–1251 Poliovirus, 318t, 610t types of, 1502–1503 108t
Pleural pain, 1250–1251 Pollutant, exposure to, 65f Portland hemoglobin, 1056 imbalance of, electrocardiogram
Pleural space, 1231 Pollution, cancer risk from, 433 Positional equinovarus, 1597 affected by, 117f
fluid in, 1254 Polyarteritis, pediatric incidence Positional plagiocephaly, 666–667 pediatric shock treatment and,
gas in, 1254 of, 1604t Positive end-expiratory pressure 1713
Pleurisy, 1250–1251 Polyarthritis, rheumatic fever (PEEP), 1256 secretion of, 756
Pleuritis, 1250–1251 associated with, 1172 Positive formal thought disorder, urinary excretion of, 1367
Plexus, in central nervous system, Polycarbophil, diarrhea treated schizophrenia and, 645b Potassium adaptation, 115
448 with, 1426 Positive selection, T cell Potassium ion
Plexus injury, 624 Polycystic kidney, 1381 development and, 240 active transport of, 32–33
PMD. See Percent mammographic Polycystic ovary syndrome Positron-emission tomography concentration of, in myocardium,
density (PMD) (PCOS), 810–812 (PET), 478 1094t
PMDD. See Premenstrual amenorrhea associated with, bone function evaluated with, transport of, 36
dysphoric disorder (PMDD) 807–808 1535 Potassium ion leak channel, 31
PML. See Progressive multifocal clinical manifestations of, 811, gastrointestinal tract evaluated Potter syndrome, 1380–1381
leukoencephalopathy (PML) 811b with, 1415 Pouchitis, 1442
PMS. See Premenstrual syndrome evaluation and treatment of, 812 Post-thrombotic syndrome (PTS), Poverty of content, schizophrenia
(PMS) insulin resistance in, 810f 1131 and, 646
PND. See Paroxysmal nocturnal pathophysiology of, 810–812 Post-transplant PP. See Periodic paralysis (PP)
dyspnea (PND) Polycythemia lymphoproliferative disorder, PP cell, islets of Langerhans and,
Pneumococcal pneumonia, 1272, cancers associated with, 395t 383 703–704
1306, 1307t description of, 1002–1003 Postcentral gyrus, 457 PR interval, 1095
Pneumococcal vaccine, sickle cell Polycythemia vera (PV), 1003–1004 Postconcussive syndrome, 588 Prader-Willi syndrome, 187–188,
disease treated with, 1068b clinical manifestations of, 1003 Posterior cerebral artery, 467, 468t 187f–188f
Pneumoconiosis, 1259 diagnostic criteria for, 1004b Posterior column (dorsal column), PRCA. See Pure red cell aplasia
Pneumocystis carinii, 312 evaluation and treatment of, 462 (PRCA)
Pneumocystis jiroveci, 312, 312t 1003–1004 Posterior (dorsal) column pathway, Precancerous cervical neoplasia,
Pneumocystis pneumonia, 312t pathophysiology of, 1003–1004 464 827t
 INDEX 1795

Precancerous dysplasia, cervical Presenilin gene, 178, 546–549 Primary voluntary motor area, Prolapse, heart valve function and,
cancer associated with, 825 Pressure, blood flow affected by, 456–457 1087–1088
Precentral gyrus, 456–457 1111–1112 Principal cell, 114, 1323 Proliferation, reactive oxygen
Precipitation, immune response by, Pressure-natriuresis relationship, Principle of independent species and, 60b
251–252 1133, 1136f assortment, 152 Proliferative breast lesion
Precocious puberty, 803–804, 803b Pressure ulcer, 1625–1626 Principle of segregation, 152 with atypia, 841–842
Predisposition-infection-response- example of, 1620t–1622t Prinzmetal angina, 1153–1154 without atypia, 839–841
organ (PIRO) dysfunction risk factors for, 1626b Pristiq. See Desvenlafaxine Prolixin. See Fluphenazine
system, 1679t, 1684 Presymptomatic diagnosis, genetic Pro-opiomelanocortin (POMC), Promoter site, gene transcription
Prednisone testing for, 136b 699–700 and, 141
chronic leukemia treated with, Presynaptic neuron, 451 Proaccelerin, disorders associated Pronephros, 1376
1023 Pretibial myxedema, 726, 728f with, 1070t Pro-opiomelanocortin, female
immune thrombocytopenic Prevalence Procalcitonin, 702 reproductive system affected
purpura treated with, 1039 of congenital malformations, 171t Procalcitonin (PCT) level, 1678– by, 350, 352f
multiple myeloma treated with, of disease, 164–165 1679, 1679b Properdin deficiency, 288
1034 Prevalence rate, 164 Procallus, 1520 Prophase, cell reproduction and, 37
Preexcitation syndrome, PRF. See Prolactin-releasing factor Prochlorperazine, schizophrenia Propionibacterium acnes, 1654
pathophysiology and treatment (PRF) treated with, 646b Proprioception, 506–507
of, 1184t–1186t Priapism, 890, 890f Procollagen, wound healing and, Proprioceptive information, 464
Prefrontal area, 456 Prickly heat, 1664 218 Prosencephalon, secondary vesicles
Prefrontal cortex, 644f PRIFLE criteria, kidney injury Proconvertin, disorders associated of, 454t
Preganglionic neuron, 470 defined with, 1385t with, 1070t Prostacyclin
Pregnancy Primary accidental hypothermia, Proctitis, 1441–1442 action of, 1111b
breast cancer and, 843–845 75–76 Prodroma blood flow and, 966
breast development affected by, Primary adrenal insufficiency, definition of, 555t in multiple organ dysfunction
784 757–758 seizure associated with, 553–555 syndrome, 1682
diet during, cancer development Primary aldosteronism, 755 Prodromal phase of hepatitis, 1459 Prostaglandin
and, 410 Primary bile acid, 1411 Proenzyme, 197 action of, 1111b
disseminated intravascular Primary biliary cirrhosis (PBC), Proerythroblast, 959 dysmenorrhea and, 804
coagulation and, 1043–1044 1462–1463 Progesterone, 778 renal blood flow affected by, 1328t
ectopic, chlamydial infection as Primary brain (intracerebral) breast cancer risk and, 849–850 synthesis of, 207
cause of, 929–930 tumor, 628–631 effects of, 778t Prostate, enlargement of, 1346
immune system affected by, 290 Primary centers of ossification, 1591 mammary gland development Prostate cancer, 900–909
maternal smoking during, 1293b Primary cutaneous lymphoma, and, 847, 848f carcinogenic agents associated
pyelonephritis associated with, 1645 mastalgia treated with, 842t with, 404t–407t, 908f
1352t Primary dysmenorrhea, 804–834 swallowing and, 1396 clinical manifestations of,
Rh-incompatible, 1060 Primary gout, 1575 traumatic brain injury (TBI) 908–909
secondary amenorrhea and, Primary hyperaldosteronism, 755 treated with, 589b dietary factors associated with,
807 Primary hyperparathyroidism, Progesterone progenitor cell, 849f 901, 902b
syphilis during, 923 731–732, 732t Progestin, mastalgia treated with, evaluation and treatment of,
tobacco use during, 413 Primary hypertension, 1132–1140 842t 908–909
Pregnancy-associated breast cancer in infant and child, 1220 Programmed cell death, 91–92 genetic factors associated with,
(PABC), 843–844, 846b–847b pathologic effects of, 1138t Programmed necrosis, 88 904–905
Pregnancy-induced hypertension, risk factors for, 1132 Progressive bulbar palsy, 572 grades of, 905b
1137t Primary hyperthyroidism, 725 Progressive multifocal hormonal factors associated with,
Prehepatic jaundice, 1456 Primary hypothyroidism, 728–729, leukoencephalopathy (PML), 901–904, 905
Prehn sign, 894 729f 617 incidence of, 901f
Preimplantation genetic diagnosis Primary (congenital) immune Progressive myoclonus epilepsy, metastases in, 908f
(PGD), 136b, 1068–1069 deficiency, 281–289, 282t, 283f 671t pathogenesis of, 904
Prekallikrein activator, 201 Primary immune response, 247–248 Progressive nonfluent aphasia, 550 progression of, 907f
Preload Primary incontinence, 1389 Progressive relaxation training, screening for, 909b–911b
cardiac output and, 1101 Primary intention, wound healing 1578–1579 treatment of, 909
description of, 1103 and, 217f Progressive spinal muscular Prostate enlargement, 1346–1347
elevated, 1177f Primary lymphoid organ, 236–237 atrophy, 572 Prostate epithelial neoplasia (PIN),
heart failure and, 1175–1177 Primary lysosomal granule, 211 Progressive systemic sclerosis, 907
Premature atrial contraction, Primary lysosome, 8 pediatric incidence of, 1604t Prostate gland
pathophysiology and treatment Primary motor area, 456–457 Proinflammatory cell, septic shock description of, 788–789
of, 1183t–1184t Primary multiple organ and, 1675 disorders of, 897–909
Premature junctional contraction, dysfunction syndrome, 1680, Proinsulin, 704 hormone signaling in, 903f
pathophysiology and treatment 1681f Projectile vomiting, 1424, 1489 inflammation of, 899, 905f
of, 1183t–1184t Primary (idiopathic) nephrotic Projecting artery, 467 zones of, 788f, 898f
Premature ventricular contraction, syndrome, 1383 Prokaryote, 2 Prostate neoplasm, progression
pathophysiology and treatment Primary nodular melanoma Prolactin, 699t, 700 of, 907f
of, 1183t–1184t (PNM), 1643, 1644t breast cancer and, 855 Prostate-specific antigen (PSA),
Premenstrual disorder, 812–813 Primary order neuron, 486–487 hypersecretion of, 724 365–366
Premenstrual dysphoric disorder Primary peristalsis, 1396 male sex hormone production prostate cancer detection with,
(PMDD), 812 Primary (spontaneous) and, 791 908–909
Premenstrual syndrome (PMS), pneumothorax, 1254 mammary gland development screening with, 911b
812, 813b Primary sclerosing cholangitis and, 847, 848f testing for, 899
Premotor area, 456 (PSC), 1463 stress response influenced by, as tumor marker, 369t
Prepregnancy sickle cell test, Primary spermatocyte, 789 351t, 352 Prostate-specific antigen (PSA)
1068–1069, 1069f Primary spinal cord injury, 590 Prolactin-inhibiting factor (PIF), velocity, 909
Prerenal acute kidney injury, 1360, Primary syphilis, 923, 924f 696–697, 837 Prostatitis, 899–900
1385 Primary thrombocytopenic Prolactin-releasing factor (PRF), bacterial, 899–900
Presbycusis, 515–517 purpura, 1073 698t classification of, 899b
Presbyopia, 511 Primary thyroid disorder, 724–725 Prolactinoma, 724 gonorrhea and, 921
1796 INDEX

Protease Protopathic, definition of, 464 PTSD. See Posttraumatic stress Pulmonary system (Continued)
description of, 15 Protoporphyrin, 961 disorder (PTSD) alterations of function of,
in multiple organ dysfunction Protozoa Puberty 1248–1289
syndrome, 1682 acquired immunodeficiency alterations of, 802–804 burn injury and, 1718
Protein C, 970–971 syndrome and, 327b delayed, 802–803, 802t chronic kidney disease effects
defects of, 1049 description of, 314t causes of, 886b on, 1369
disseminated intravascular infection from, 303t, 314–317 male, 886 defense mechanisms in, 1226t
coagulation and, 1044 mechanisms of, to defend description of, 770–771 diagram of, 1084f
pediatric shock and, 1707 against inflammation and male, alterations in, 885–887 disorders of, 1255–1286
replacement of, 1048 immunity, 308t normal onset of, 802 functions of, 1232–1243
Protein C deficiency, 1072 sexually transmitted infection precocious, 803–804, 803b hyperthyroidism effects on, 727t
Protein-calorie malnutrition, 75 caused by, 919t causes of, 887b hypothyroidism effects on, 730t
Protein core, in articular cartilage, Protriptyline, depression treated forms of, 887b organ dysfunction in, 1684b
1525 with, 652b in male, 886–887 pediatric, structure and function
Protein-energy malnutrition Proximal convoluted tubule, 1322, Pubic louse, 939, 939f of, 1290–1293
(PEM), 1497 1324f, 1330–1331 Public health, disease prevention pediatric alterations of,
Protein-energy wasting, 1370b Prozac. See Fluoxetine and, 330 1290–1318
Protein folding, 6b PRR. See Pattern recognition Pulmonary artery, 1088 structures of, 1225–1231
Protein kinase A, 694 receptor constriction of, 1230–1231 tests of, 1243–1244
Protein kinase C, 694, 746 Prucalopride, 1425 pulmonary circulation and, 1229 Pulmonary vascular disease,
Protein S, 970–971, 1049 Pruritus, 1627 Pulmonary artery hypertension 1275–1278
Protein S deficiency, 1072 PS. See Pulmonary stenosis (PS) (PAH), 1276–1278 Pulmonary vascular resistance
Protein(s) PSA. See Prostate-specific antigen classification of, 1277b (PVR)
accumulation of, 85 (PSA) clinical manifestations of, definition of, 1120t
binding, 692t PsA. See Psoriatic arthritis (PsA) 1277–1278 ventricular septal defect and,
buffering of, 125 Psammoma bodies, 87 evaluation and treatment of, 1205
as cellular receptors, 16–17 PSC. See Primary sclerosing 1278 Pulmonary vein, 1088, 1230
chronic kidney disease and, cholangitis (PSC) pathogenesis of, 1277f Pulmonary ventilation, heat loss
1368–1369 Pseudoarthrosis, 1543 pathophysiology of, 1277–1278 by, 497
deficiency of, cellular injury Pseudoautosomal region, 157 Pulmonary artery occlusion Pulmonic valve, 1086–1087
associated with, 75 Pseudobuboes, 928–929 pressure (PAOP), 1702 Pulse pressure, 1114
depletion of, shock associated Pseudogout, 1575 Pulmonary artery wedge pressure Pulsus paradoxus, 1164,
with, 1670 Pseudohypertrophic, definition of, (PAWP), 1702 1264–1266
description of, 13–15 1607 Pulmonary atresia, 1213 Puncture wound, 79t
digestion of, 1402, 1403f Pseudohypoparathyroidism, Pulmonary capillary, pulmonary Punnett square, 153f
distribution of, in body fluids, 732–733 circulation and, 1229–1230 heterozygous carriers and, 155f
108t Pseudomonas aeruginosa, 194–195, Pulmonary capillary wedge X-linked recessive traits and,
formation of, 141–142 304t–305t, 307 pressure, 556t 158f
heredity and, 136–142 bacterial meningitis and, 676 Pulmonary circulation, 1229–1231 Pupil
lipid-acceptor, 63 cystic fibrosis associated with, control of, 1232–1243 changes in, brainstem
metabolism of, 1412 1312 illustration of, 1230f dysfunction and, 532
muscle, 1532 Pseudomonas spp., immune perfusion distribution in, 1239 description of, 508
plasma membrane, 11f molecule degradation by, 309 thrombus in, 1275 Pure red cell aplasia (PRCA), 995
role of, 1412t Pseudostratified epithelium, 40 Pulmonary disease Pure sodium deficit, 113
synthesis of, 9, 143f Pseudothrombocytopenia, 1037 clinical manifestations of, 1269t Pure water deficit, 112
transmembrane, 13 Pseudounipolar neuron, 448–449, conditions caused by, 1251–1253 Purine nucleoside phosphorylase
transport, 31 450f pain caused by, 1250–1251 (PNP) deficiency, 286
Proteinuria PSGN. See Acute poststreptococcal signs and symptoms of, Purkinje fiber, 1094
chronic kidney disease and, glomerulonephritis (PSGN) 1248–1251 Purpura, clinical manifestations
1364–1366, 1366t, 1368 Psoriasis, 172t, 1629–1630 Pulmonary edema, 1260–1261 of, 1625t
multiple myeloma associated Psoriatic arthritis (PsA), chronic kidney disease and, 1369 Purulent exudate, inflammation
with, 1032 1629–1630 pathogenesis of, 1260f associated with, 213
nephrotic syndrome associated Psoriatic nail disease, 1630 Pulmonary embolism (PE), Pus
with, 1359t Psychiatric disorders, genetic 1275–1276 inflammation associated with,
Proteoglycan, 1626 factors associated with, clinical manifestations of, 213
in articular cartilage, 1525 179–180 1275–1276 pleural effusion and, 1255
description of, 1516 Psychogenic alterations in arousal, evaluation and treatment of, 1276 Pustular psoriasis, 1629–1630
function of, 1512t 528 example of, 1275f Pustule, example of, 1620t–1622t
Proteolytic cascade, 15 Psychogenic itch, 1627 myocardial infarction associated PV. See Polycythemia vera (PV)
Proteome, 13 Psychologic distress, 355 with, 1163 PVO2. See Partial pressure of
Proteomics, 13 Psychoneuroimmunology, 342 pathogenesis of, 1276f oxygen in mixed venous blood
Prothrombin, disorders associated Psychotherapy pathophysiology of, 1275–1276 (PVO2)
with, 1070t bipolar disorder treated sources of, 1143 PVR. See Pulmonary vascular
Prothrombin consumption time, with, 653 Pulmonary fibrosis, 1258–1260 resistance (PVR)
hemophilia diagnosis and, depression treated with, 651 Pulmonary function, alterations of, Pyelonephritis
1071–1072 Psychotic dimension, 644–646 1248–1289 acute, 1351–1352
Prothrombin gene, mutation of, Psychotic episode, 644 clinical manifestations of, causes of, 1352t
1049 PTH. See Parathyroid hormone 1248–1253 chronic, 1352
Prothrombin time (PT), hemophilia (PTH) pediatric, 1290–1318 example of, 1352f
diagnosis and, 1071 PTLD. See Post-transplant Pulmonary lymphatic capillary, pediatric, 1387
Prothrombin time test, 1047 lymphoproliferative disorder 1230 urinary tract infection and,
Prothrombinase complex, 970 PTM. See Posttranslational Pulmonary stenosis (PS), 1213– 1349–1350
Proto-oncogene, 374, 444 modification 1214, 1213f Pyknosis, 88–90
Proton pump inhibitor drugs, Ptosis, 509–510 Pulmonary system Pyloric gland, 1398
gastroesophageal reflux disease PTS. See Post-thrombotic abbreviations used in, 1238t Pyloric obstruction, 1430–1431
treated with, 1429 syndrome (PTS) aging and, 1244–1247 Pyloric sphincter, 1396
 INDEX 1797

Pyloric stenosis Ramsay Hunt syndrome, 572b Recombination activating gene Renal agenesis, 1380–1381
genetic factors associated with, RANK receptor, 1553 (RAG), 237–239, 286 Renal aplasia, 1380
166 RANKL. See Receptor activator Recombination activating gene-1 Renal artery, 1325
pediatric, 1488–1489 of nuclear factor κβ ligand deficiency, 286 Renal capsule, 1319
prevalence rate of, 171t (RANKL) Recombination activating gene-2 Renal cell carcinoma (RCC), 1347,
recurrence risk of, 167t Raphe-serotonin system, 650 deficiency, 286 1348t
Pyramidal motor syndrome, Rapid eye movement (REM) sleep, Recombination rate, 160 Renal clearance, 1334
569–570, 574t 503 Reconstructive phase of wound Renal colic, 1344
Pyramidal/spastic cerebral palsy, Rapidly adapting receptor, 1234 healing, 216–219 Renal column, 1320
672 Rapidly progressive (crescentic) Recovery phase of hepatitis, Renal corpuscle, 1320–1321
Pyramidal system, 570, 570f glomerulonephritis (RPGN), 1459–1460 Renal disorders, hypertension and,
Pyramids, kidney, 1320 1353–1354 Rectal cancer, 1467t, 1468–1472, 1137t
Pyrazinamide, tuberculosis treated Ras gene. See Result of altered 1471f Renal dysplasia, 1380
with, 1274 sequence (ras) gene carcinogenic agents associated Renal failure, 1359
Pyridoxine, sideroblastic anemia RAS protein, 374f, 380 with, 404t–407t anemia associated with, 1001
treated with, 992 Rash, viral diseases as cause of, Rectocele, 818–820, 819f childhood leukemia associated
Pyrogen, 213, 301–302, 498 1659t Rectosigmoid (O’Beirne) sphincter, with, 1076
Pyruvate, 28, 28f Rashkind procedure, 1210 1407 hepatorenal syndrome and,
Pyuria, 1336 Rastelli procedure, 1216, 1218 Rectosphincteric reflex, 1408 1456–1457
PYY. See Peptide YY Raynaud disease, 1144–1145 Rectum, ulcerative colitis and, Renal fascia, 1319
Raynaud phenomenon, 270, 1441 Renal hormone, 1333–1334
Q 1144–1145 Recurrence risk, of genetic diseases, Renal insufficiency, 1359
QRS complex, 1095 Rb. See Retinoblastoma 152–154 Renal neoplasm, 1347
QT interval, 1095 RB gene, 513 Red blood cell. See Erythrocyte Renal papillae, 1325
Quadriparesis, 568–569 RBB. See Right bundle branch Red measles, 1659–1660 Renal pelvis, 1320
Quadriplegia, 568–569, 592 (RBB) Red meat Renal stone, gout associated with,
Qualitative leukocyte disorder, RBC. See Erythrocyte breast cancer and, 859 1578
1008–1011 RCA. See Right coronary artery cancer and, 417 Renal system, 1
Quantitative leukocyte disorder, (RCA) Red muscle, 1529, 1530t aging effects on, 1336
1008 RCC. See Renal cell carcinoma Red nucleus, midbrain structure alterations in function of,
Quantitative trait, 165 (RCC) and, 459 1340–1375
Quetiapine, schizophrenia treated RDS. See Respiratory distress Red stroke, 599 autoimmune disorders of,
with, 646b syndrome of the newborn Redness, inflammation associated 264t–265t
(RDS) with, 213 blood tests for, 1335
R Reactive oxygen species (ROS), Reduction, following bone fracture, burn injury and, 1719
RAAS. See Renin-angiotensin- 58–62 1543 graft rejection in, 280f
aldosterone system (RAAS) cellular effects of, 60b Reed-Sternberg cell, 1024, 1024f hypothyroidism effects on, 730t
Rabies virus, 318t, 610t diabetes mellitus and, 746 Reelin, 643 organ dysfunction and, 1684b
Radial scar (RS), 840, 840f functional effects of, 60f Refeeding syndrome, 1451, 1451b pediatric, alterations in function
Radiation generation of, 61f Referred pain, 492, 492f, 1426 of, 1376–1392
breast cancer and, 856–858 mitochondria and, 61–62 Reflex, development of, in infant, structure of, 1319–1326
congenital heart defects osteoporosis and, 1553 663, 663t tests of, 1334–1336
associated with, 1199t ultraviolet radiation and, 431 Reflex arc, 462, 463f tumors of, 1347–1348
electromagnetic, 81–82 Reactive response, 339–341 Reflex incontinence, 1345f Renal transitional cell carcinoma
heat loss by, 497 Reagin, 263–265 Reflex sympathetic dystrophy, (RTCC), 1347
ionizing (See Ionizing radiation) Receptor 494–495 Renal tubule, substances
low-dose, 78–80, 430–431, 430b B-cell (See B-cell receptor) Reflux esophagitis, 1429 transported by, 1331b
ultraviolet (See Ultraviolet cellular, 16–17, 202–203 Refraction, alterations in, 511–512, Rendu-Osler-Weber disease,
radiation) cellular communication and, 21 512f 604–605
Radiation-induced breast cancer, complement, 202 Regional enteritis, 1442 Renin, 176f
856 cytokine, 235–236, 236t Regional osteoporosis, 1552 kidney function affected by,
Radiation therapy, 397–398 dyspnea and, 1248–1249 Regurgitation, valvular, 1169–1170 1327
Hodgkin lymphoma treated with, histamine, 206–207 Rehabilitation, following burn secretion of, 755t
1026 hormone, 691–692 injury, 1723 Renin-angiotensin-aldosterone
multiple myeloma treated with, inhibitory, 256 Reiter syndrome, 930 system (RAAS), 108f, 176f,
1034 lung, 1234 Relative polycythemia, 1002–1003 709
Radicular pain, 624 pattern recognition, 202 Relative refractory period, 37 cardiovascular disease and,
Radicular paresthesia, 624 plasma membrane, 16, 16f Relative risk, 165 1134b
Radicular syndrome, 634 scavenger, 202–203 Relaxation heart failure and, 1177–1178
Radiculitis (radiculoneuritis), T cell (See T cell receptor) muscle contraction and, 1533 hypertension and, 1132–1133
624 toll-like, 202, 203t techniques for, 358 kidney function affected by, 1327,
Radiculopathy, 595, 624 types of, 25t REM sleep behavior disorder, 1327f
Radiofrequency electromagnetic Receptor activator of nuclear factor 506 sodium balance and, 108–109
radiation (RF-EMR), 431–432 κβ ligand (RANKL), 1553, Remeron. See Mirtazapine ventricular remodeling and, 1176f
Radiograph, chest, 1119, 1244 1554f, 1569 Remodeling Reovirus, description of, 318t
Radiography, gastrointestinal tract Receptor-mediated endocytosis, abnormal, Paget disease and, Reoxygenation injury, 58
evaluated with, 1415 175f 1558 Repair, wound, 215–220
Radioimmunoassay (RIA), 710–711 Recessiveness, genetic, 151 bone integrity and, 1519–1520 Reperfusion (reoxygenation)
Radioimmunotherapy, non- Reciprocal translocation, 149f, 151 hypoxic pulmonary injury, 58, 58b, 1159, 1683
Hodgkin lymphoma treated Recombinant antihemolytic factor vasoconstriction and, 1232b pediatric, 1699, 1710
with, 1028 plasma/albumin-free method, illustration of, 1521f Replacement therapy, disseminated
Radionucleotide imaging, ischemia hemophilia treated with, 1072 pediatric bone growth and, intravascular coagulation
diagnosed with, 1155 Recombination 1592–1593 treated with, 1047–1048
Radon, cancer risk from, 433 allele formation and, 159 pulmonary artery hypertension Replication, deoxyribonucleic acid,
RAG. See Recombination activating antigenic variation by, 308 and, 1277 137
gene (RAG) viral infection and, 320–322 Renal adenoma, 1347 Replicative aging, 93
1798 INDEX

Repolarization Respiratory rate, 1232, 1702t Retropulsion, gastric motility and, Rhythmicity, cardiac action
cardiac action potential and, 1094 Respiratory syncytial virus (RSV), 1397 potential and, 1095
cellular transport and, 36–37 318t Retrovirus, 318–319 RIA. See Radioimmunoassay (RIA)
myocardial cell, 1094 bronchiolitis caused by, 1305 cancer associated with, 383t Rib, fracture of, 1253
Reproductive maturation, croup caused by, 1294–1295 description of, 318t Ribonucleic acid. See RNA
description of, 770–771 pediatric pneumonia caused by, Rett syndrome, 668, 671t (ribonucleic acid)
Reproductive system 1306 Reverse transcriptase, human Ribosomal protein synthesis, 9
aging effects on, 791 Respiratory system immunodeficiency virus Ribosome, 3f, 4–5, 10f, 142
chronic kidney disease effects on, acid base balance regulation by, pathogenesis and, 324 Rickets, 1557, 1599–1600
1365t, 1369 125–126 Reverse Warburg Effect, 420 Rickettsia prowazekii, 302, 304t–305t
development of, 768–771 autoimmune disorders of, Reversible injury, cellular, 54–55 Rickettsia rickettsii, 302
female, 771–782 264t–265t Rewarming, hypothermia and, 501 Rickettsiae spp., infection from, 303t
abnormalities of, 800–802 burn injury and, 1717 Reye syndrome, Epstein-Barr virus Rifampin, tuberculosis treated with,
alterations in, 800–884 functional components of, and, 1013 1274
benign growths and 1232f RF. See Rheumatoid factor (RF) RIFLE criteria
proliferative conditions hemorrhagic shock and, 1706t RF-EMR. See Radiofrequency acute renal failure classification
of, 820–825 neurochemical control of, 1233f electromagnetic radiation with, 1360, 1360t
cancer of, 825–834 structure of, 1226f (RF-EMR) kidney injury defined with, 1385,
disorders of, 804–834 Respiratory tract Rh alloimmunization, maternal 1385t
hormones of, 350 as closed barrier, 193f hypersensitivity and, 277 Right atrium, description of, 1086
stress and, 352f infection of, bacteria as cause of, Rh blood group, 279 Right bundle branch (RBB), 1094
tests of, 791 304t–305t Rh immune globulin (RhoGAM), Right coronary artery (RCA), 1090
hyperthyroidism effects on, 727t malignancies of, 1278–1286 1061 Right heart, 1083–1085
hypothyroidism effects on, 730t Respiratory tract infection, Rh incompatibility, 1059–1060, Right heart failure, 1181, 1181f
male, 784–791 1271–1272 1060f Right lymphatic duct, 1118
aging effects on, 795 bacteria as cause of, 304t–305t Rh-negative erythrocyte, 1059 Right pulmonary artery, 1088
alterations in, 885–917 pediatric, 1305–1308 Rh-positive erythrocyte, 1059 Right ventricle, description of,
disorders of, 888–909 Resting lung volume, pediatric, 1292 Rh system, 279–280 1086
structure of, 785f Resting membrane potential, 36 Rhabdomyolysis, 1547–1550 Rigidity, 560t, 561
tests of, 791 hypokalemia and, 116 causes of, 1548b–1549b brain dysfunction associated
structure and function of, 1 hypokalemia effects on, 116 clinical manifestations of, 1550 with, 533
tests of function of, 791, 792t Restless leg syndrome, 505 evaluation and treatment of, Parkinson disease and, 567
Reproductive tract, female, Restricted breathing, 1250 1550 Rigor mortis, 97
abnormalities of, 800–802 Restrictive cardiomyopathy, 1165f, Rhabdomyosarcoma (RMS), 364 Riluzole, 573
RES. See Reticuloendothelial system 1166t, 1167 description of, 1585–1586 Ringed sideroblast, 991
(RES) Restrictive lung disorder, pediatric, 1611 Ringer lactate solution, 1690t
Reservatrol, 415–416 1255–1263 clinical manifestations of, Ringworm, 1637, 1657–1658
Residual body, autophagy and, 8 Restrictive pericarditis, 1164 1612t Risk factors
Residual volume (RV), 1243 Result of altered sequence (ras) gene, tissue affected by, 1612t for breast cancer, 844t
Resistance, blood flow affected by, 375, 375f, 1612 Rhabdovirus, description of, 318t for disease, 165
1111–1112 Retching, 1424 RHD. See Rheumatic heart disease Risperdal. See Risperidone
Resistin Rete peg, 1617–1618 (RHD) Risperidone
coronary artery disease and, Rete testis, 785 Rhegmatogenous retinal obsessive-compulsive disorder
1152–1153 Reticular activating system, 454, detachment, 511 treated with, 657
secretion of, 1447b 454f, 528 Rheumatic fever, 1171–1173 schizophrenia treated with, 646b,
Resistin-like molecule β, 194 Reticular dysgenesis, 285–286 clinical manifestations of, 1172 647
Resolution, wound, 215–220 Reticular fiber, 40–41 evaluation and treatment of, Ritalin, attention-deficit/
Respiration, 1232 Reticular formation, 454 1172–1173 hyperactivity disorder treated
heart rate and, 1106 Reticulocyte, 959–960 Jones criteria for diagnosis of, with, 653–654
partial pressure of gases in, 1241f pediatric, 1057 1173t Rituximab
physiologic control of, 1293 values for, 978t, 1057t pathophysiology of, 1171–1172 chronic leukemia treated with,
Respiratory acidosis, 129–130 Reticuloendothelial system (RES), rheumatic heart disease 1023
compensation and correction 950 developed from, 1172 hemolytic anemia treated with,
for, 131f Retina Rheumatic heart disease (RHD), 1000
compensation for, 127f description of, 508 1171–1173, 1171f idiopathic thrombocytopenic
Respiratory alkalosis, 130–134 diabetes mellitus and, 747 Rheumatoid arthritis (RA), purpura treated with, 1073
compensation and correction effects of aging on, 510t 1568–1572 myasthenia gravis treated with,
for, 131f structure of, 508f classification criteria for, 1573b 626
compensation for, 127f Retinal detachment, 511 clinical manifestations of, non-Hodgkin lymphoma treated
hypokalemia associated with, 115 Retinoblastoma, 154, 376, 513 1571–1572 with, 1028
Respiratory bronchiole, gas bilateral, 514f evaluation and treatment of, 1572 RLS. See Restless leg syndrome
exchange and, 1229 childhood, 444 juvenile idiopathic arthritis and, RMS. See Rhabdomyosarcoma
Respiratory center, 1233 clinical manifestations of, 513 1603 (RMS)
Respiratory distress syndrome development of, 514f pathogenesis of, 1570f RNA (ribonucleic acid), 136–142
of the newborn (RDS), evaluation and treatment of, 513 pathophysiology of, 1569–1572 in cell nucleus, 2
1301–1303, 1302b gene, 376 pediatric incidence of, 1604t noncoding, 184, 378–379
atelectasis of lung and, 1302f inheritance of, 379–380 schematic view of, 1571f protein formation and, 141
pathogenesis of, 1303f pedigree for, 154f sexual function impacted by, 834t splicing of, 142
Respiratory failure, 1252–1253 Retinoid, acne treated with, 1654 stress and, 342t synthesis of, 141–142
cystic fibrosis as cause of, 1311 Retinopathy Rheumatoid factor (RF), 1569 transcription of, 142f
multiple organ dysfunction diabetic, 747 Rheumatoid nodule, 1572 translation of, 142
syndrome associated with, stages of, 747 Rhodopsin, 510 RNA polymerase, 141, 142f
1683 Retractile testis, 892–893 RhoGAM. See Rh immune globulin Robertsonian translocation,
Respiratory patterns Retrograde menstruation, 823 (RhoGAM) 149–151, 150f
abnormal, 530f Retropharyngeal abscess, 1296t, Rhombencephalon, secondary Rocky Mountain spotted fever,
arousal alternations and, 529 1298 vesicles of, 454t 304t–305t, 1640
 INDEX 1799

Rods, description of, 508 Saltatory conduction, 448 Schwannoma, 627t, 631, 632f Secondary lymphoid organ,
Roentgenogram (x-ray film), of SAM. See Severe acute malnutrition SCI. See Spinal cord injury (SCI) 236–237, 242, 242f
skull and spine, 477–478 (SAM) Sciatica, low back pain and, 597 Secondary lysosome, 8
Rolling hiatal hernia, 1430 Saprophyte, 311 SCID. See Severe combined Secondary multiple organ
Romiplostim, immune Sarcolemma, 1530 immune deficiency dysfunction syndrome, 1680,
thrombocytopenic purpura Sarcoma Scissors gait, 575 1681f
treated with, 1039 breast, 866t Sclera, description of, 508 Secondary nephrotic syndrome,
ROS. See Reactive oxygen species definition of, 364 Scleroderma, 1584, 1639–1640, 1383
(ROS) uterine, 830–831 1639f Secondary neuronal injury,
Rosacea, 1632f Sarcomere, 1097 Sclerosing adenosis, 840 588–589
Roseola, characteristics of, 1659t composition of, 1530 Sclerostin, 1553 Secondary peristalsis, 1396
Roseola (exanthema subitum), 1660 of myofibril, 1530 Scoliosis, 1600–1601 Secondary (traumatic)
Rotationplasty, 1563 in skeletal muscle, 1527 clinical manifestations of, 1601 pneumothorax, 1254
Rotavirus, 318t Sarcopenia, 96 evaluation and treatment of, 1601 Secondary polycythemia, 1003
diarrhea caused by, 1500 Sarcoplasm, 1530 osteogenesis imperfecta Secondary septic arthritis, 1602
vaccine for, 333 Sarcoplasmic reticulum, 1530 associated with, 1598–1599 Secondary spermatocyte, 789
Rough endoplasmic reticulum, 5–6 Sarcoptes scabiei, 938, 938f, 1661 pathophysiology of, 1601 Secondary spinal cord injury, 591
Roundworm, description of, 314t Sarcotubular system, 1530 Scotoma, 510 Secondary syphilis, 923
Roux-en-Y gastric bypass, obesity Sarcotubule, 1530 Scott syndrome, 1042 Secondary ureteropelvic junction
treated with, 1450 SARM. See Selective androgen Scrotum, 786 obstruction, 1380
RPGN. See Rapidly receptor modulator (SARM) acute, conditions responsible Secondhand smoke, cancer and,
progressive (crescentic) SARS. See Severe acute respiratory for, 889f 413
glomerulonephritis (RPGN) syndrome (SARS) disorders of, 891–892 Secretin
RS. See Radial scar (RS) Saturated fatty acid, 1405b SDB. See Sleep disordered action of, in digestive system,
RS cell. See Reed-Sternberg cell SBC. See Simple bone cyst (SBC) breathing (SDB) 1397t
RSV. See Respiratory syncytial virus Scabies, 938–939, 1620t–1622t, Sebaceous cyst, example of, pancreatic function and, 1415
(RSV) 1661 1620t–1622t stomach function and, 1397
RTCC. See Renal transitional cell Scald injury, 1715 Sebaceous follicle, acne and, swallowing and, 1396
carcinoma (RTCC) Scalded skin syndrome, 311f 1653–1654 Secretory diarrhea, 1425
Rubella (German or 3-day Scale, example of, 1620t–1622t Sebaceous gland, 1618 Secretory immune response,
measles), 1658–1659 Scalene muscle, 1235 Seborrheic dermatitis, 1629 252–253
characteristics of, 1659t Scaphocephaly, 667f Seborrheic keratosis, 1640, 1640f Secretory (mucosal) immune
vaccination and reduction of, Scar Second-degree block, system, 252, 253f
330t example of, 1620t–1622t pathophysiology and treatment Secretory immunoglobulin, 252
Rubella virus, 318t, 610t following burn injury, 1687f, of, 1184t–1186t Secretory vesicle, 6–7
Rubeola (red measles), 1659–1660, 1693 Second-degree burn, 1686 Sedentary lifestyle, coronary artery
1659t formation of, 1722 Second messenger disease and, 1151–1152
Ruffled border, 1515 maturation of, 1722–1723 calcium, 24f Segmental inhibition of pain, 487
Rugae, 772–773 Scar tissue, 215–216 cellular communication and, Segmentation, intestinal motility
Rule of nines, burn injury assessed excessive, 218 22–25 and, 1407
with, 1687f, 1716 hypertrophic, 219 cyclic adenosine monophosphate, Seizure
Russell bodies, 85 Scavenger receptor, 202–203 24f causes of, 554t
Russell-Silver syndrome, 188 SCC. See Squamous cell carcinoma hormones as, 693f, 694, 694t clinical manifestations of,
RV. See Residual volume (RV) (SCC) Second-order neuron, 487 551t–552t, 553–555
Ryanodine receptor (RyR), 1533, 1578 SCD. See Sickle cell disease (SCD) Secondary aldosteronism, 755 definition of, 550
Schilder disease, 662f Secondary amenorrhea, 806–808 febrile, 679
S Schistosoma haematobium, cancer Secondary bile acid, 1411 in infant, 678
S cell, 1415 associated with, 423t Secondary biliary cirrhosis, 1463 initiation of, 552–553
SA. See Sideroblastic anemia (SA); Schistosoma mansoni, 314t Secondary brain injury, 588–589 partial, 679
Sinoatrial (SA) node Schistosomiasis, 314t, 316 Secondary centers of ossification, pathophysiology of, 552–553
Saccular aneurysm, 604 Schistosomiasis haematobium, 1592 terminology for, 555t
Saccular bronchiectasis, 1256–1258 urinary tract infection caused Secondary dysmenorrhea, 804 types of, 551–555, 551t–552t
Sacral plexus, 469 by, 1351 Secondary generalization, 551–552 Seizure disorder, 550–555
SAG. See Superantigen Schizophrenia, 642–647 Secondary glaucoma, types of, diseases and conditions associated
SAH. See Subarachnoid brain abnormalities associated 511t with, 550
hemorrhage (SAH) with, 642 Secondary gout, 1575 evaluation and treatment of, 555
Saliva, 1395 clinical manifestations of, Secondary granule, 211 Selectin, 18, 209
Salivary α-amylase (ptyalin), 1395 644–646 Secondary hyperaldosteronism, Selective androgen receptor
Salivary gland, 1395, 1395f concordance rates for twins for, 755 modulator (SARM), 1552,
Salivary gland cancer, 404t–407t 170t Secondary hyperparathyroidism, 1556
Salivation, 1395 etiology and pathophysiology of, 732 Selective attention deficit
Salmeterol, asthma treated with, 642–644 Secondary hypertension, (orientation), 535–536, 541t
1266b genetic factors associated with, 1136–1140 Selective estrogen response modifier
Salmon patch (nevus simplex), 179–180 pathogenesis of, 1137t (SERM), 1553, 1556
1664 genetic predisposition for, 642 pediatric, 1219b, 1220 Selective IgA deficiency, 285
Salmonella spp., 305, 309 medications for, 646b Secondary hypocortisolism, 758 Selective serotonin reuptake
diarrhea caused by, 1500 neuroanatomic alterations Secondary hypothermia, 75–76 inhibitor (SSRI), 648
immune molecule degradation associated with, 642–643 Secondary (central) action of, 649f
by, 309 neurotransmitter alterations hypothyroidism, 728, 729f depression treated with, 652b
products secreted by, 307 associated with, 643–644 Secondary (acquired) immune panic disorder treated with, 655
Salmonella typhi, 304t–305t, 306 prevalence of, 172t deficiency, 281, 289–292 side effects of, 651–652
Salpingitis, 813–814, 813f, 921 recurrence risk for, 179t Secondary immune response, Selegiline, depression treated with,
Salt symptoms of, 645b 247–248 652b
kidney stone formation and, 1343 treatment of, 646–647 Secondary incontinence, 1389 Selenium, prostate cancer and,
level of, chronic kidney disease Schwann cell, 449–450, 451t Secondary intention, 216, 217f 902b
and, 1367 Schwann sheath, 448 Secondary lung malignancy, 857 Self-antigen, 229, 273–274
1800 INDEX

Self-protein Septicemia Sexual dysfunction Sialoprotein

bacteria coating with, 308 burn injury associated with, 1720 diagnostic and treatment description of, 1516
parasite coating with, 315 high-output failure and, 1182 algorithm for, 835f function of, 1512t
virus use of, 319 Septum primum, 1195 female, 834–835, 834t Sickle cell anemia, 983t, 984f, 1063,
Self-renewal, cell reproduction Septum secundum, 1195 male, 911–912 1463
and, 39 Sequential organ failure assessment evaluation and treatment of, Sickle cell disease (SCD),
Selye, Hans, 338–339 (SOFA), 1684 912 1063–1069
Semantic dementia, 550 Sequestered antigen, 274–275 pathophysiology of, 911–912 clinical manifestations of, 1067f
Semantic memory, 536 Sequestra, osteomyelitis and, 1602 Sexual maturation crises in, 1066
Semen Sequestration crisis, sickle cell alterations of, 802–804 evaluation and treatment of,
analysis of, 836 disease and, 1066 male, alterations in, 885–887 1068–1069
production of, 787 Sequestrum, osteomyelitis and, Sexual trauma, female, inheritance of, 1065t
Semicircular canal, 515 1559, 1559f pyelonephritis associated with, pathophysiology of, 1065–1069
Semilunar valve, 1086–1087 SERM. See Selective estrogen 1352t pneumococcal vaccine for, 1068b
Seminal vesicle, 788, 788f response modifier (SERM) Sexually transmitted infection Sickle cell-Hb C disease, 1063, 1068
Seminiferous tubule, 784–785, 790f Seroquel. See Quetiapine (STI), 918–944 Sickle cell-thalassemia disease,
Senile disease complex, 546 Serotonin bacteria as cause of, 304t–305t 1063, 1068
Senile gait, 575 as neurotransmitter, 452, 453t causal microorganisms for, 919t Sickle cell trait, 1063
Senile posture, 575 pain modulation and, 490 incidence and prevalence of, Sickling, description of, 1065
Senses, 506–509 vomiting and, 1424 920f Sideroblastic anemia (SA), 983t,
Sensitization, hypersensitivity Serotonin modulator drugs, statistics on, 919b 984f, 991–993
reactions and, 263 depression treated with, 652b transmissibility of, 940t clinical manifestations of, 992
Sensorimotor syndrome, 633–634 Serotonin receptor agonist drugs, Sharpey fiber, 1517 evaluation and treatment of,
Sensorineural hearing loss, 517 migraine headache treated SHBG. See Sex hormone-binding 992–993
Sensory-discriminative system, with, 608 globulin (SHBG) laboratory findings for, 986t
487 Serotonin reuptake inhibitor drugs, Shear forces, injury caused by, 82 as secondary to drug effects, 994t
Sensory ganglion (dorsal root depression treated with, Shear stress, 1091–1092 SIDS. See Sudden infant death
ganglion), 460–461 652b Shift-to-the-left reaction, 1009 syndrome (SIDS)
Sensory inattentiveness, 535–536 Serotonin syndrome, 652 Shiga toxin, 1383 Sigmoid colon, 1407, 1441
Sensory motor pathway, 458f Serotonin system, 650f Shigella sonnei, 304t–305t, 309 Signal transducers and activators
Sensory neuron, 449 Sertoli cell, 789, 912 Shigella spp., 306–307 of transcription (STAT), 692,
Sensory neuropathy, 622 Sertraline diarrhea caused by, 1500 694, 694t
Sensory pathway, 464 depression treated with, 652b products secreted by, 307 Signal transduction, 20–25, 692–695
Sensory receptor obsessive-compulsive disorder Shingles, 1636, 1661 Signal transduction pathway, 22f,
skeletal muscle and, 1528–1529 treated with, 657 Shivering, 501 25t
types of, 450b panic disorder treated with, 655 Shock, 1668–1679. See also Signaling
Sensory speech area, 457 posttraumatic stress disorder individual types of shock (i.e., chemical, 21f
Sensory system, hyperthyroidism treated with, 656 Cargiogenic shock, etc.) contact-dependent, 20
effects on, 727t Serum, description of, 945 arterial thrombosis associated Signaling cell, 21
Sepsis Serum sickness, 270 with, 1143 Silencing, genetic, 378
bacteria associated with, 306 Serum transferrin receptor, 991 cellular metabolism affected by, Silent ischemia, 1153–1156
disseminated intravascular Serzone. See Nefazodone 1669–1670, 1669f Silent thyroiditis, 729
coagulation associated with, Sever disease, 1604 classification of, 1668–1669 Silicosis, 1259
1043–1044 Severe acute malnutrition (SAM), clinical manifestations of, Sillence classification, 1597–1598,
pathology of, 1677f 1497–1498 1671–1679, 1700–1710 1598t
pediatric, 1706 Severe acute respiratory syndrome drugs for treatment of, 1714t Simple bone cyst (SBC), 1609–1610
definition of, 1708b (SARS), 318t, 1273 glucose delivery affected by, Simple epithelium, 40
emerging therapies for, Severe combined immune 1670 Simple fibroadenoma, 840–841
1713–1715 deficiency, 285–286 oxygen delivery affected by, Sinding-Larsen-Johansson
predisposition-infection- Severe congenital neutropenia, 1669–1670 syndrome, 1604
response-organ (PIRO) 289 pediatric, 1699–1715 Sinequan. See Doxepin
dysfunction system for Severe diffuse axonal injury, 588 emerging therapies for, Single-photon absorptiometry
staging of, 1679t Severe sepsis 1713–1715 (SXA), 1555–1556
as septic shock component, 1676t definition of, 1708b evaluation and treatment of, Single-photon emission computed
severe, treatment of, 1676–1678 organ dysfunction associated 1710–1715 tomography (SPECT), 1121,
wound, 218 with, 1709b treatment of, 1671–1679 1155
Septic shock, 1675–1679 pediatric, 1708 types of, 1671–1679, 1700 Sinoatrial (SA) node, 1092–1093
arterial thrombosis associated Sewer gas, asphyxiation from, 74 vasodilation in, 1678f dysrhythmia and, 1182
with, 1143 Sex, determination of, 157 Shock index, 1710, 1715 Sinus, superior sagittal, 466
clinical manifestations of, Sex chromosome, 142, 147–148 Short bone, 1518 Sinus arrhythmia, 1106
1675–1676 Sex-determining region on Y Short bowel syndrome, 1444 Sinus block, pathophysiology and
cold, 1709 chromosome (SRY), 769 Short-term starvation, 1451 treatment of, 1184t–1186t
components of, 1676t Sex hormone, 353 Shortening contraction, muscle, Sinus bradycardia, pathophysiology
endotoxin as cause of, 310 female, 776–778 1534 and treatment of, 1183t–1184t
pediatric, 1706–1710 male, 789–791, 795–796 Shoulder Sinus dysrhythmia,
clinical manifestations of, osteoporosis and, 1552 bursitis of, 1547t pathophysiology and treatment
1707–1710 reproductive system development dislocation or subluxation of, of, 1183t–1184t
definition of, 1708b and, 768 1544–1545 Sinus node, 1092–1093
evaluation and treatment of, Sex hormone-binding globulin Shulman syndrome, 1010–1011 Sinus tachycardia, pathophysiology
1710–1715 (SHBG), 791 Shunting, hypoxemia and, 1252 and treatment of, 1183t–1184t
hemodynamic support in, 1712f Sex-influenced trait, 158 Shwachman-Diamond syndrome, Sinus venosus defect, 1204
organ dysfunction associated Sex-limited trait, 158 childhood leukemia associated Sinusoid, 1409–1410
with, 1709b Sex-linked inheritance, 156 with, 1075–1076 SIRS. See Systemic inflammatory
treatment of, 1709 Sexual behavior, cancer associated SIADH. See Syndrome of response syndrome (SIRS)
treatment of, 1671, 1676–1678 with, 423–424 inappropriate antidiuretic SJS. See Stevens-Johnson syndrome
warm, 1709 Sexual differentiation, 768–770 hormone (SIADH) (SJS)
 INDEX 1801

Skeletal muscle, 1097 SLE. See Systemic lupus Sodium (Continued) Spermatogenesis, 784–785, 789, 912
channelopathy of, 1581–1582 erythematosus (SLE) pediatric shock treatment and, Spermatogonia, 789, 912
contractile proteins of, 1532t Sleep, 502–504 1713 Spermatozoon, 768, 790f
contraction of, 496 cycle of, 503 retention of, hypertension and, Spherocytosis, hereditary,
cross section of, 1528f deprivation of, 505 1134 1062–1063
effects of aging on, 1536 non-rapid eye movement, 502 spherocytosis and, 1062–1063 Sphincter muscle, urinary,
illustration of, 1528f patterns of transport of, 1404f 1325–1326
organization of, 1529f aging and, 504–506 urinary, acute kidney injury and, Sphincter of Oddi, 1411, 1413
proteins of, 1532 pediatrics and, 503–504 1363t Spina bifida, 663–664
structure and function of, rapid eye movement, 503 urine concentration and, 1332 concordance rates for twins for,
1526–1535 Sleep apnea, 505, 1300–1301. See Sodium ion 170t
types of, 1527–1532 also Obstructive sleep apnea active transport of, 32–33 example of, 169f
Skeletal muscle disorders, 1578 syndrome (OSAS) concentration of, in myocardium, Spina bifida occulta, 665–666
Skeletal system, chronic kidney Sleep disorder, 504–505 1094t Spinal accessory nerve, 472t
disease effects on, 1365t Sleep disordered breathing (SDB), glomerular filtration and, 1330 Spinal artery, 469, 470f
Skeleton 1300 transport of, 33t, 36 Spinal column, 466–467, 466f
abnormal density or modeling of, Sleep disturbance, stress and, 357 Sodium-potassium pump, 32f, 36, Spinal cord, 460–463
1597–1601 Sleep-wake transition disorder, 36f, 1669–1670 arteries of, 470f
anterior view of, 1519f 505 SOFA. See Sequential organ failure blood supply to, 469
appendicular, 1517 Sleepwalking, 505 assessment (SOFA) cross section of, 463f
axial, 1517 Sleeve gastrectomy, obesity treated Soft tissue, cancer of, carcinogenic illustration of, 461f
development of, pediatric, with, 1450 agents associated with, neural circuits in, 462
1593 Sliding-filament model, 1098f 404t–407t secondary vesicles of, 454t
menopause and, 795 Sliding filament theory, 1533 Solar plexus, 1396 tracts of, 462f
trauma to, 1540–1545 Sliding hiatal hernia, 1429–1430 Solitary plasmacytoma, 1030, 1032 Spinal cord abscess, 613–614
Skene gland, 772 Small cell carcinoma Solitary toxic adenoma, 728 Spinal cord injury (SCI), 589
Skin characteristics of, 1281t Solutes, cell transport and, 28–33 clinical manifestations of,
aging effects on, 1619–1627 example of, 1281f Somatic cell 592–594, 592t–593t
autoimmune disorders of, Small intestine, 1400–1407 description of, 142 evaluation and treatment of, 594
264t–265t cancer of, 1468 germ cell compared to, 412t sexual function impacted by, 834t
blood supply to, 1619 digestion and absorption in, reproduction of, 37 types of, 591t
as closed barrier, 193f 1401–1402 Somatic cell nuclear transfer, 93 Spinal cord tumor, 633–637
cold injury to, 1646 illustration of, 1400f Somatic cell therapy, 137b characteristics of, 627t
cross section of, 1617f lipid absorption in, 1406f Somatic death, 97–100 distribution of, 633f
diagnostic procedures for, 1619t malrotation of, 1489–1490 Somatic motor pathway, 458f primary, 633b
dysfunction of, 1619–1627 motility of, 1406–1407 Somatic nervous system, 448 Spinal multiple sclerosis, 620
fungal infection of, 1637–1638 muscles of, 1401 Somatic pain, 492 Spinal nerve, 469
hemorrhagic shock and, 1706t obstruction of, 1431 Somatic recombination, 237 location of, 461f
infection of, 1634–1638 water and electrolyte transport Somatosensory system, 506–509 spinal cord coverings and, 461f
bacteria as cause of, by, 1401–1402 Somatostatin, 696–697, 700, 706 Spinal shock, 570, 592, 592t–593t
304t–305t Small intestine carcinoma, 1468 action of, 698t Spinal stenosis, 596
Staphylococcus aureus as cause Small intestine obstruction, in digestive system, 1397t Spinal tract, 462, 462f
of, 310 1431–1432 gastric secretions and, 1398 Spindle, muscle, 1528–1529
innervation of, 1619 Smallpox (variola), 1661 stress response influenced by, 351t Spindle fiber, 37
layers of, 1616–1618, 1618t eradication of, 298–299 Somatotropin, 350–352 Spine
renewal of, 1616–1617 immunization campaign against, Somite, 660–661 compression injury of, 590f
structure and function of, 332 Somogyi effect, 746 degenerative disorders of,
1616–1619 as pandemic, 302t Sorafenib, 381 594–598
tests of function of, 1619 vaccination and reduction of, Sorbitol, excess of, 746 flexion-rotation injury of, 590f
viral infections of, 1636–1637 330t Soy, dietary, breast cancer and, hyperflexion injury of, 590f
Skin cancer, 1641–1645 Smoke inhalation injury, 1668 859–860 Spinothalamic tract, 462
carcinogenic agents associated Smoldering myeloma, 1032 Spanish influenza, 298–299, 302t, Spinous layer of skin (stratum
with, 404t–407t Smooth endoplasmic reticulum, 6 320–322 spinosum), 1616–1617
ionizing radiation as cause of, SMP. See Sympathetically mediated Spasmodic croup, 1294–1295 Spiral fracture, 1541
424t pain (SMP) Spastic gait, 575 Spiral or helical computed
trends for, 1642b Snout reflex, 533, 533f Spastic paresis/paralysis, 568–569 tomography (CT), 478
ultraviolet radiation as cause of, Snow, John, 329–330 Spasticity, 560, 560t Spirochetes, 302
431 SNS. See Sympathetic nervous Spatial summation, neuron function Spirometry, 1243
Skin color, pediatric shock system (SNS) and, 453 asthma diagnosed with,
assessment and, 1701 Social drugs, 69–70 Specific gravity, urinalysis and, 1335 1309–1310
Skin disorders, 1627–1646 Sodium Specific immunity, 191 values measured by, 1244t
clinical manifestations of, accumulation of, shock as cause Specific low back pain, 492 Splanchnic nerve, 470
1619–1627 of, 1669–1670 Specificity theory of pain, 485 Spleen
inflammatory, 1627–1629 balance of, 108–109 SPECT. See Single-photon emission alterations in function of,
pediatric, 1664 alterations in, 109–114 computed tomography (SPECT) 1036–1037
Skin graft, burn injury treated with, chronic kidney disease and, Sperm architecture of, 952f
1722 1366t emission of, 787 description of, 951–952
Skin lesion, 1619–1627, chloride balance with, 108–109 impaired production of, 912–913 enlargement of, 1036, 1452
1620t–1622t, 1625t deficit of, 113 motility of, 913 Splenectomy
Skin tumor, 1640–1641 distribution of, in body fluids, Sperm cell, 768, 790f congenital hemolytic anemia
Skinfold, candidiasis infection in, 108t Spermatic cord, 784 treated with, 1068b
1638t extracellular concentration of, Spermatic vein, varicocele and, description of, 1036–1037
Skip lesion, 1442 110f 891–892 hemolytic anemia treated with,
Skull inadequate intake of, 113 Spermatid, 789 1000
normal, 667f level of, chronic kidney disease Spermatocele, 892, 893f immune thrombocytopenic
Paget disease of, 1558f and, 1367 Spermatocyte, 789 purpura treated with, 1039
1802 INDEX

Splenic pulp, 951 Staphylococcus aureus, 304t–305t Stomach (Continued) Stress (Continued)
Splenic sinus, 953f antibiotic-resistant, 300 illustration of, 1396f interactions of, 343f
Splenomegaly bacterial meningitis and, 676 innervation of, 1396 local response to, 349–350
chronic leukemia associated with, bacterial tracheitis caused by, muscles in, 1396 mental, silent ischemia and,
1021 1297–1298 peptic ulcer in, 1435 1154–1156
description of, 1036, 1452 bone infection from, 1559 ulcers of, 1437 obesity and, 347b
diseases associated with, 1036b cystic fibrosis associated with, Stomach cancer, 1467–1468, 1467t pediatric, 355b
hereditary spherocytosis 1312 carcinogenic agents associated personality and, 355–358
associated with, 1063 erysipelas caused by, 1635 with, 404t–407t psychologic, 341
infectious mononucleosis infection caused by, 311f ionizing radiation as cause of, psychoneuroimmunologic
associated with, 1012 nosocomial infection associated 424t mediators of, 342
pediatric, 1503 with, 310 sites of, 1468f systemic response to, 349–350
polycythemia vera associated osteomyelitis caused by, 1602 Storage disease, 674 Stress-age syndrome, 358–360
with, 1003 products secreted by, 307 Stormorken syndrome, 1042 Stress fracture, 1541
Splint, bone fracture treated with, skin infection from, 1634, 1656 Strabismus, 509, 513 Stress incontinence, 1344t
1543 Staphylococcus epidermidis, Strain Stress-induced muscle tension,
Split-thickness sheet graft, 1722, 304t–305t definition of, 1545 1578–1579
1722f Staphylococcus saprophyticus, injury caused by, 82 Stress radionucleotide imaging,
Spondyloarthropathy, 1572 urinary tract infection caused Strangulation, 74 ischemia diagnosed with, 1155
Spondylolisthesis, 596 by, 1350 Stratified epithelium, 40 Stress-related disorder, 338
Spondylolysis, 596 Staphylococcus spp., immune Stratum basale, 1616–1617 Stress-related mucosal disease,
Spongy bone, 1517, 1558 molecule degradation by, 309 Stratum corneum, 1616–1617 1439
Spontaneous intracranial Starling hypothesis, 105 Stratum germinativum, 1616–1617 Stress response, 343–355
hemorrhage (ICH), 602–603 Starvation, 1450–1451 Stratum spinosum, 1616–1617 behavioral, 344f
Sporadic motor neuron disease, Stasis dermatitis, 1628 Strawberry hemangioma, 1662– hormones affecting, 351t
572 Stasis ulcer, 1628f 1663, 1663f illustration of, 340f
Sporadic motor system disease, 572 STAT. See Signal transducers and Street drugs, 69–70 immune system affected by,
Sporothrix schenckii, 312t activators of transcription Streptococcus agalactiae, 304t–305t 353–354
Sprain, definition of, 1545 (STAT) Streptococcus pneumoniae, 303, neuroendocrine system and, 710
Spread, of infectious agent, 301 Static contraction, muscle, 1534 304t–305t physiologic, 344f
Sputum, abnormal, 1249 Static encephalopathy, 670–672 antigenic variation and, 308–309 Stress testing
Squamous cell, 40, 41t–42t Statin drugs, cardiovascular disease meningitis caused by, 609, 676 cardiac function measured with,
Squamous cell carcinoma (SCC), prevented with, 1151b otitis media caused by, 516–517 1120–1121
1642–1643 Status asthmaticus, 1266 pathophysiologic course of, ischemia diagnosed with, 1155
characteristics of, 1281t Status epilepticus, 553, 681 1272f Stress ulcer, 1439
esophageal, 1466 Steatosis, 1460–1461 pediatric pneumonia caused by, Stressor
example of, 1281f Stelazine. See Trifluoperazine 1306 neural response to, 339f
of glans penis, 891f Stellate cell, 1409–1410 penicillin-resistant, 300 neuroendocrine response to, 710
lung cancer and, 1280 Stem cell Streptococcus pyogenes, 303, Stretch injury, brain injury from,
of penis, 891 cancer, 370–372, 372f, 416 304t–305t 587
renal, 1348–1349 cell reproduction and, 39 antigenic variation and, 308–309 Stretch receptor, 1234, 1248–1249
ultraviolet radiation as cause of, embryonic, 184 bacterial tracheitis caused by, Striated muscle, 1527
431 intestinal, 1401 1297–1298 Stridor
vaginal cancer and, 829 lymphoid, 236–237 erysipelas caused by, 1635 description of, 1249–1250
Squamous-columnar junction, 775 mesenchymal, 370–371, 371f skin infection from, 1656 diagnostic approach to, 1295f
Src gene, rhabdomyosarcoma microenvironment of, 386f Streptococcus spp. foreign body aspiration as cause
associated with, 1612 mononuclear phagocyte system abscess caused by, 613 of, 1298
SRY. See Sex-determining region on and, 950t necrotizing fasciitis caused by, laryngomalacia as cause of, 1299
Y chromosome (SRY) myocardial hypertrophy and, 52b 309 upper airway obstruction
SRY gene, 157, 157f, 769 Stem cell transplant, childhood skin infection from, 1634 associated with, 1293
SSM. See Superficial spreading acute myelogenous leukemia Stress Stroke
melanoma (SSM) treated with, 1078 aging and, 358–360 in child, 677–678, 677b
SSSS. See Staphylococcal scalded- STEMI. See ST-elevation myocardial cardiac events triggered by, clinical manifestations of, 599
skin syndrome (SSSS) infarction (STEMI) 1155f diabetes mellitus and, 751–752
St. Louis encephalitis virus, Stenosis, 1168–1169 concepts of, 339–342 evaluation and treatment of,
encephalitis caused by, 615t definition of, 1091–1092 coping and, 355–358 599–602
St. Vitus dance, 1172 subglottic, 1299–1300 coronary heart disease associated genetic factors associated with,
ST-elevation myocardial infarction Sternocleidomastoid muscle, 1235 with, 354b 171–172
(STEMI), 1156 Sternum, fracture of, 1253 definition of, 339–341 incidence of, 598
ST interval, 1095 Steroid, example of, 690t diabetes and, 347b ischemic, 598–602
Stab wound, 79t Steroid hormone mechanism, 695f disease and, 338–362 ischemic injury associated with,
Stable angina, 1153–1154 Steroid (lipid-soluble) hormone emotional, heart affected by, 56–57
Stable factor, disorders associated receptor, 694–695 342b pain associated with, 494
with, 1070t Steroid-resistant nephrotic female reproductive system perinatal, 677
Stachybotrys chartarum, 312t syndrome, 1384–1385 affected by, 352f prevalence of, 172t
Stage, cancer, 393–394 Steroid-sensitive nephrotic general concepts of, 338–339 radiation exposure and, 81
Staghorn calculus, 1343–1344 syndrome, 1384–1385 health outcomes affected by, 356f risk factors for, 598
Stance, disorders of, 574–575 Stevens-Johnson syndrome (SJS), historical background on, secondary to occlusion or
Stapes bone, 515 1664 338–339 stenosis, 600t–601t
Staphylococcal scalded-skin STI. See Sexually transmitted hypertension and, 1137t stress and, 342t
syndrome (SSSS), 1656–1657, infection (STI) hypothalamic-pituitary-adrenal Stroke syndrome, 598–604,
1657f Stirrup bone, 515 system dysregulation and, 600t–601t
Staphylococci Stomach, 1396–1400 648 Stroke volume (SV), 1102f, 1103
abscess caused by, 613 blood supply to, 1396 illness and, 355–358 cardiac output and, 1101
scalded-skin syndrome caused gastric secretions produced in, immune system affected by, 290, definition of, 1120t
by, 1656 1398 353–355 mean arterial pressure and, 1114t
 INDEX 1803

Stroke volume (Continued) Substrate, enzyme affinity for, 25 Suture, fibrous joint and, 1520 Syphilis (Continued)
in older adult, 1123t Substrate phosphorylation, 28 SV. See Stroke volume (SV) false-positive serologic test for,
pediatric, 1703t Subthalamic nucleus, 459 SVCS. See Superior vena cava 927b
Stroke volume index (SVI), 1120t Subthalamus, 457–459 syndrome (SVCS) incidence of, 922–923
Stroke work index (SWI), 1120t Succussion splash, 1430–1431 SVI. See Stroke volume index (SVI) pathophysiology of, 923–924
Stroma Suck reflex, 533, 533f SVO2. See Venous oxygen saturation progression of, 923b
definition of, 907 Sucrase, as digestive enzyme, 1402b (SVO2) Syringomyelic syndrome, 634
ovarian, 832f Sudden infant death syndrome SVR. See Systemic vascular Systemic circulation, 1083–1085,
prostate cancer and, 907–909 (SIDS), 77, 1313–1315 resistance (SVR) 1106–1118
Stromal cell, breast cancer etiology of, 1313 Swallowing, 1395–1396 Systemic hypertension, in infant
progression and, 872f genetic factors associated with, esophageal phase of, 1395–1396 and child, 1218–1221
Stromal fibroblast, estrogen 1313 oral phase of, 1395 Systemic immune system, 252
produced by, 853f risk factors for, 1313 pharyngeal phase of, 1395 Systemic inflammatory response
Strongyloides stercoralis, 314t Suffocation, 74 Sweat gland, 1618 syndrome (SIRS), 500, 1262
Strongyloides stercoralis, diarrhea Sugar, transport of, 33t Sweating, heat loss by, 497 pediatric, 1707, 1708b
caused by, 1500 Suicide, risk of, depression Swelling, inflammation associated septic shock and, 1675, 1676t
Strongyloidiasis, 314t associated with, 651 with, 213 Systemic lupus erythematosus
Structural alterations in arousal, Sulcus, in forebrain, 456 SWI. See Stroke work index (SWI) (SLE), 277–278, 1632
528 Sulcus limitans, 661, 661f Swine influenza A (H1N1) virus, clinical manifestations of, 278
Structural scoliosis, 1600 Sulfasalazine, rheumatoid arthritis pneumonia associated with, maternal hypersensitivity and,
Struvite, kidney stone composed treated with, 1572 1273 277
of, 1343 Sumatriptan, migraine headache SXA. See Single-photon pediatric incidence of, 1604t
Struvite stone, 1343–1344 treated with, 608 absorptiometry (SXA) Systemic vascular evaluation,
Stuart-Power factor, disorders Summation, neuron function and, Sydenham chorea, 1172 1122–1123
associated with, 1070t 453 Sylvian fissure, 456 Systemic vascular resistance (SVR),
Stupor, definition of, 529t Sunitinib, 381 Sympathetic ganglion, 461f, 470 1114
Sturge-Weber-Dimitri disease, Sunlight, cancer associated with, 431 Sympathetic nervous system (SNS), definition of, 1120t
congenital heart defects Sunsetting eyes, 669 470–473 hypovolemic shock and, 1672
associated with, 1200t Superantigen, 250–251, 310 hypertension and, 1132–1133, in infant, 1198
Sturge-Weber syndrome, Superficial artery, 467 1133f neurogenic shock and,
1663–1664 Superficial cortical nephron, Sympathetically mediated pain 1673–1674
Stye, 507 1320–1321 (SMP), 494–495 septic shock and, 1675–1676
Subacute granulomatous Superficial partial-thickness injury, Sympathogonia, 684 Systole
thyroiditis, 729 1686 Symphysis, cartilaginous joint and, cardiac action potentials and,
Subacute lymphocytic thyroiditis, Superficial spreading melanoma 1520 1092
729 (SSM), 1643, 1644t Symport, 31 definition of, 1088
Subacute thyroiditis, 729 Superior colliculi, 459 Symptomatic epilepsy, 553 Systolic compressive effect, 1117
Subarachnoid hemorrhage (SAH), Superior mesenteric artery, 1401 Synapse Systolic heart failure, 1175
464–465, 605–607, 606f Superior mesenteric branch of description of, 41 cycle of, 1178f
classification of, 607t aorta, 470 nerve impulse and, 451–452 diastolic heart failure compared
clinical manifestations of, 606 Superior sagittal sinus, 466 Synaptic cleft, 451–452, 452f to, 1180t
evaluation and treatment of, Superior vena cava, 1088, 1131 Synaptic knob (bouton), 451–452
606–607 Superior vena cava syndrome Synarthrosis (immovable joint), T
Subarachnoid space, 464–465, 465f (SVCS), 1131–1132 1520 T3. See Triiodothyronine (T3)
Subclinical hyperthyroidism, 725 Superoxide dismutase, 61–62 Synchondrosis, cartilaginous joint T4. See Thyroxine (T4)
Subclinical hypothyroidism, 728 Supersaturation, kidney stone and, 1520 T cell
Subclinical thyroid disease, formation and, 1343 Syncytiotrophoblast, 257f activation of, 249–251
724–725 Supply-dependent oxygen Syncytium, 324–325 acute leukemia and, 1016–1017
Subcutaneous layer of skin, consumption, 1683 Syndactyly, 1593–1594 adhesion molecular pairings for,
1618–1619 Suppurative arthritis, 1569t Syndesmophyte, 1574 235b
Subdural brain abscess, 613 Suprachiasmatic nucleus (SCN), Syndesmosis, fibrous joint aging effects on, 257–258
Subdural hematoma, 464–465, 502 and, 1520 allergic contact dermatitis and,
585, 585f Supraopticohypophysial tract, 696 Syndrome of inappropriate 1628
acute, 585 Supratentorial disorder, 528 antidiuretic hormone asthma and, 1264
chronic, 585–586, 586f Supratentorial herniation, 557b, (SIADH), 395t, 718–719 autoreactive, 240
Subdural space, 464–465, 465f 557f clinical manifestations of, 719 defects of, 282t
Subglottic stenosis, 1299–1300 Supratentorial region, pediatric evaluation and treatment of, description of, 225
Subintima, synovial membrane and, tumor in, 681 719 development of, 238f, 246f
1522 Supratentorial tumor, in child, 683 pathophysiology of, 719 differentiation of, 239–240
Sublingual gland, 1395 Surface tension, alveolar, 1235–1236 Syndromic craniosynostosis, 666 function of, 255–257
Subluxated hip, 1594 Surfactant Synovial fluid, 1522, 1535 immunocompetent, 249–250
Subluxation, 1544–1545 alveolar ventilation and, 1235 Synovial joint, 1522–1526, 1524f macrophage activation by,
clinical manifestations of, 1544 deficiency of body movement provided by, 256–257, 256f
evaluation and treatment of, 1545 in premature infant, 1292 1527f maturation of, 237–240
pathophysiology of, 1544–1545 respiratory distress syndrome movement of, 1526, 1526f primary cutaneous lymphoma
Submandibular gland, 1395 associated with, 1301 rheumatoid arthritis and, 1568 and, 1645
Submucosal plexus (Meissner description of, 1229 Synovial membrane (synovium), regulation of, 177
plexus), 1394, 1401 immunity and, 1236b 1522, 1570–1571 rheumatoid arthritis and,
Subserosal plexus, 1394 Surfactant atelectasis, 1256 Synovial sarcoma, pediatric, 1612t 1569
Substance P, 696–697 Surgery Synovitis, 1571, 1571f stress response and, 354–355
action of, 698t cancer treated with, 398 Synovium, 1524f subsets of, 246f
as neurotransmitter, 453t temperature regulation affected Syphilis, 922–925 T cell lymphoma, 1079f
stress response influenced by, by, 502 bacteria associated with, T cell neoplasm, 1024b, 1027
351t Surmontil. See Trimipramine 304t–305t T cell receptor, 229
Substantia gelatinosa, 460–461, 487 Survivor, hospitalization or death clinical manifestations of, 924 production of, 237–239, 239f
Substantia nigra, 459, 565–566, 565f of, 357b evaluation and treatment of, 925 T cell receptor complex, 230f, 233
1804 INDEX

T-cytotoxic lymphocyte (Tc cell), TCR. See T cell receptor Testicular cancer (Continued) Therapeutic hyperthermia, 500
249 TDF. See Testes-determining factor evaluation and treatment of, Therapeutic hypothermia, 76, 501
clonal selection of, 250f (TDF) 896–897 Thermal burn injury, 1685
function of, 255–256 Tears, eye hydrated with, 507 pathogenesis of, 895–897 Thermogenesis, chemical, 496–497
T helper cell (Th cell), 226, 245 Technetium scanning, cardiac Testicular neoplasm, 895 Thermoregulation, 496, 1721
psoriasis and, 1629 function evaluated with, 1121 Testicular torsion, 889f Thiamine deficiency, high-output
subsets of, 245–247 Tectum, 459 Testicular tumor, 895f, 896t failure and, 1182
T-helper lymphocyte, 245–247 TEF. See Tracheoesophageal fistula Testis, 784–785 Thimerosal, 69, 333
T-independent antigen, 249 (TEF) aging and, 795 Thioridazine, schizophrenia treated
T lymphocyte (T cell), 202, 954 Tegmentum, 459 descent of, 785f with, 646b
deficiency of, 284 Telangiectasia, example of, ectopic, 892–894 Thiothixene, schizophrenia treated
description of, 225 1620t–1622t infection of, 894 with, 646b
function of, 255–257 Telencephalon, 456–457 interior anatomy of, 786f Third-degree block,
maturation of, 237–240 Telephone, radiation exposure location of, 690f pathophysiology and treatment
rheumatoid arthritis and, 1570 from, 432 torsion of, 894, 894f of, 1184t–1186t
type IV hypersensitivity reaction Telescoping medullary rod, Testosterone Third-degree burn, 1686–1687
and, 270 osteogenesis imperfecta treated aging and production of, 795–796 Third-order neuron, 487
T lymphocyte (T cell) deficiency, with, 1599f benign prostatic hyperplasia and, Third spacing, shock and, 1670
285 Telomerase, 382 898 Third spacing of fluids, 1703–1704
T memory cell, 249 Telomeres breast cancer risk and, 848–849 Thirst, 109
T regulatory (Treg) cell, 249, 257 cancer cell immortality and, 382, dihydrotestosterone and, 906 13q syndrome, childhood cancer
asthma and, 1264 382f gynecomastia and, 913 associated with, 443t
microenvironment of, 386f stress response and, 355b male gonadal development and, Thoracic aneurysm, 1142
self-antigen response and, 229 Telophase, cell reproduction and, 37 769 Thoracic cavity, 1231, 1232f
wound healing and, 386–387 Temperature male growth and development Thoracic duct, 1118
T tubule system, 1097–1098 body (See Body temperature) affected by, 789 Thoracolumbar division, 470
Tachycardia extremes of, cellular injury caused osteoporosis and, 1552 Thorazine. See Chlorpromazine
hypovolemic shock associated by, 75–77 prostate cancer and, 901–904 Thought disorders, 642
with, 1705 Template, DNA replication and, 137 reproductive maturation and, 771 Three-day measles, 1658–1659
pediatric shock and, 1701 Temporal extradural hematoma, stress response influenced by, Threshold of liability, multifactorial
septic shock associated with, 1708 585 351t, 352–353 inheritance and, 166
Tacrolimus, ulcerative colitis treated Temporal fossa, 464 Tet spell, 1209 Threshold potential, 36
with, 1442 Temporal lobe, 457 Tetanus Thrombin time, hemophilia
Taenia solium, 314t Temporal summation, neuron muscle contraction and, 1534 diagnosis and, 1071
Tail of Spence, 782 function and, 453 vaccination and reduction of, Thromboangiitis obliterans, 1144
Takotsubo cardiomyopathy, 1162 TEN. See Toxic epidermal 330t Thrombocyte
TAM. See Thyronamine (TAM); necrolysis (TEN) Tetany, hypocalcemia associated description of, 950–951
Tumor-associated macrophage Tenase complex, 970 with, 120 development of, 965
Tamm-Horsfall glycoprotein, 1331, Tendinitis, 1545, 1546f, 1546t, Tethered cord syndrome, 665 Thrombocythemia, 1040–1042
1350 1605 Tethering, injury caused by, 82 Thrombocytopenia, 1037–1040
Tamoxifen Tendinopathy, 1545–1547 Tetraiodothyronine, 702 cancer associated with, 396b
cancer associated with, 854t clinical manifestations of, Tetralogy of Fallot (TOF), 1207– clinical manifestations of, 1041
mastalgia treated with, 842t 1546–1547 1209, 1208f evaluation and treatment of,
Tamponade, 1164 evaluation and treatment of, clinical manifestations of, 1209 1041–1042
Tanning bed, squamous cell 1547 evaluation and treatment of, 1209 pathophysiology of, 1037
carcinoma associated with, pathophysiology of, 1546–1547 pathophysiology of, 1207–1209 Thrombocytosis, 1040–1042
1642–1643 Tendinosis, 1545, 1546t Tetraploidy, 143–144 Thromboembolic disease,
Tapeworm, 314, 314t Tendon TF. See Tissue factor (TF) 1048–1053
TAPVC. See Total anomalous definition of, 1545 TFPI. See Tissue factor pathway Thromboembolism, 1143
pulmonary venous connection joint mobility and, 1527 inhibitor (TFPI) myocardial infarction associated
(TAPVC) sprains and strains of, 1545 TGA. See Transposition of the great with, 1163
Tardive dyskinesia, 562, 646 tissue engineering for, 1568b arteries (TGA) risk for, 1049b
Target cell Tendon disorders, classification TH. See Therapeutic hypothermia Thromboembolization, deep
cellular communication and, 21 of, 1546t Th cell, 245 venous thrombosis and, 1131
hormonal alterations and, 718t Teniae coli, 1407 adhesion molecular pairings for, Thromboembolus, definition of,
hormone binding at, 693f Tennis elbow, 1546 235b 1130–1131
regulation of, 692f Tension, injury caused by, 82 antigen-presenting cell and, 245 Thrombolysis, stroke treated with,
Taste, 517–518 Tension pneumothorax, 1254, subsets of, 245–247 599–601
aging effects on, 518 1254f as target of human Thrombomodulin, 970–971
alterations in, 518 Tension-type headache, 342t, 607t, immunodeficiency virus, Thrombophilia, 1048–1050, 1072
TAVC. See Transitional 609 325–326 Thromboplastin generation test,
atrioventricular septal defect Tentorium cerebelli, 464 Th1 cell, 245–247, 270 1071–1072
(TAVC) Teratologic equinovarus, 1597 Th2 cell, 245–247 Thrombopoietin, 965
Tay-Sachs disease, 7, 671t, 673t, 674 Terbinafine, tinea capitis treated Th17 cell, 245–247, 270 idiopathic thrombocytopenic
TB. See Tuberculosis (TB) with, 1657 Th1 to Th2 shift, 348 purpura treated with, 1073b
TBI. See Traumatic brain injury Teriparatide, osteoporosis treated Thalamus, 457–459 Thrombosis
(TBI) with, 1556–1557 attention deficit and, 539f–540f congenital, 1072–1073
TBSA. See Total body surface area Termination sequence, DNA nociception and, 487 hereditary factors associated with,
(TBSA) transcription and, 141–142 Thalassemia, 983t, 1069–1070 1049–1050
TBW. See Total body water (TBW) Tertiary syphilis, 924 Thalidomide, 171, 381 ischemic injury associated with,
Tc cell, 249 Testes-determining factor (TDF), congenital heart defects 56–57
clonal selection of, 250f 769 associated with, 1199, 1199t markers of, 1152
function of, 255–256 Testicular cancer, 893–897 multiple myeloma treated with, portal hypertension associated
type IV hypersensitivity reaction carcinogenic agents associated 1034 with, 1452
and, 270 with, 404t–407t Theca cell, 776 risk for, 1049b
TCA. See Tricyclic antidepressants clinical manifestations of, 895 Thelarche, 771, 783, 802 thrombocytopenia and, 1041
 INDEX 1805

Thrombotic crisis, sickle cell TIA. See Transient ischemic attack Tobacco use Toxin
disease and, 1066 (TIA) bladder cancer associated with, antibody against, 252
Thrombotic stroke (cerebral Tick bite, 1640 1348–1349 cancer and, 403
thrombosis), 598 Tick-borne disease, 1640 bronchitis associated with, 1267 neutralization of, 251f
Thrombotic thrombocytopenic Tidemark, in cartilage, 1524–1525 cancer associated with, 172, 403f, parasitic, 316
purpura (TTP), 1040 Tight junction, 18–20, 19f 413–414 Staphylococcus and, 310
Thromboxane, action of, 1111b Tinea capitis, 1637, 1657 laryngeal cancer associated with, vaccination against, 332
Thromboxane A2, 969 Tinea corporis (ringworm), 312t, 1278 Toxoid, 252
Thromboxane A2 (TXA2), in 1637, 1657–1658 lung cancer associated with, 1279 vaccination and, 332
multiple organ dysfunction Tinea cruris, 312t TOF. See Tetralogy of Fallot (TOF) Toxoplasma gondii, 314t, 613
syndrome, 1682 Tinea infection, 1637–1638 Tofranil. See Imipramine Toxoplasma spp., 315
Thrombus Tinea pedis, 312t, 1637, 1657 Togavirus, description of, 318t Toxoplasmosis, 314t, 617, 1583
arterial, 1142–1143 Tinea unguium, 1637 Tolerance TP53 gene, 844–845
definition of, 1048, 1130–1131 Tinidazole breakdown of, 273–275 rhabdomyosarcoma associated
example of, 1048f bacterial vaginosis treated with, central, 273–274 with, 1612
formation of, tissue factor and, 929 defective peripheral, 275 squamous cell carcinoma and,
972f trichomoniasis treated with, immune response and, 229 1643
ischemic stroke and, 598 938 peripheral, 273–274 Trabeculae, spongy bone
pathogenesis of, 1157f Tinnitus, noise-induced, 83 Toll-like receptor, 202, 203t and, 1517
Thrush, 1658 Tissue, 39–48 Tonic phase Trabeculae carneae, 1089
Thymine, 136, 138f–139f, 142f aging and, 93–96 definition of, 555t Trabecular bone, osteoporosis in,
Thymus altered, 49–102 seizures and, 552–553 1555f
aging effects on, 257–258 bacterial damage to, 309–310 Tonicity, 31 Trachea
atrophy of, 96 connective, 40–41, 42t–44t Tonsil, cancer of, carcinogenic conducting airway structure and,
cell differentiation and, 227f damage to agents associated with, 1228f
location of, 690f fungal infection as cause of, 404t–407t congenital malformations of,
T cell development in, 237, 238f, 313 Tonsillar infection, 1297 1300
239–240 from parasitic infection, 316 Tonsillectomy and adenoidectomy description of, 1228
as target of human phagocytosis and, 210f (T&A), 1300–1301 illustration of, 1227f, 1296f
immunodeficiency virus, viral infection as cause of, Tonsillitis, 1297 upper airway obstruction and,
325 320 Tophaceous gout, 1576 1294b
Thyrocalcitonin, 702 destruction of, immunologic Tophus, gouty, 1577f, 1578 Tracheal stenosis, 1300
Thyroid cancer mechanisms of, 265t Topiramate, cluster headache Tracheitis, description of, 1296t
carcinogenic agents associated epithelial, 39–40 treated with, 609 Tracheobronchomalacia, 1299
with, 404t–407t formation of, 39 Torsion Tracheoesophageal fistula (TEF),
ionizing radiation as cause of, granulation, 216 injury caused by, 82 1487, 1488f
424t muscle, 41, 44t intestinal obstruction caused by, Tracheomalacia, 1299
Thyroid carcinoma, 731 neural, 41–48 1431t Trachoma, 508
Thyroid disease, 711, 725b regeneration of, 215–216 Torsion of the testis, 889f, 894, 894f Traction, bone fracture treated with,
hyperthyroidism resulting from, resolution and repair of, 215–220 Torticollis 1543
728 types of, 39–48 developmental hip dysplasia Trafficking, protein synthesis
Thyroid gland, 700–702, 700f Tissue factor (TF), 201 associated with, 1594 and, 13
aging and, 711 blood clot formation and, 969 spasmodic, 561f Trait
alterations of, 724–731 disseminated intravascular Torus fracture, 1541 concordant, 169–170
hormones of, 701t coagulation and, 1043–1044 Total anomalous pulmonary discordant, 169–170
location of, 690f thrombus formation and, 972f venous connection (TAPVC), multifactorial, 165
Thyroid hormone (TH), 700–701 Tissue factor pathway inhibitor 1216–1217 polygenic, 165
cardiac effects of, 1106 (TFPI), 970 Total body surface area (TBSA), Transcalvarial herniation,
deficiency of, 728 Tissue hypoxia, anemia and, 985 1687, 1716 557b
osteoporosis and, 1552 Tissue perfusion Total body water (TBW), 104 Transchondral fracture, 1541
regulation of secretion of, definition of, 1668 alterations in movement of, Transcortical dysphasia, 540
700–701 shock and, 1670 105–108 Transcortical motor dysphasia,
synthesis of, 701–702 Tissue plasminogen activator, balance of, 109 543t–544t
Thyroid-stimulating hormone 972 distribution of, 104t Transcortical sensory dysphasia,
(TSH), 699t, 700–701 Tissue-specific antigen, 265 normal gains and losses of, 104t 543t–544t
deficiency of, 721 Tissue thromboplastin, blood clot osmolality of, 105 Transcortin, 346, 708
hypersensitivity reaction effect formation and, 969 in relation to weight, 104t Transcription
on, 267–269 Tissue tropism, 301 Total brain death, 533 protein synthesis and, 143f
regulation of, 690 Titin, 1098–1099 Total lung capacity (TLC), 1243 RNA synthesis and, 141–142
Thyroid-stimulating hormone muscle contraction and, 1532t Total peripheral resistance, Transcription factor, 141, 141f
deficiency, 721 sarcomere and, 1530 1114–1115 Transcription factor binding site,
Thyroid-stimulating hormone- TLC. See Total lung capacity (TLC) Total resistance, blood flow and, 141
releasing hormone (TSH-RH), TLR. See Toll-like receptor 1112 Transfer reaction, 27–28
496 TNF. See Tumor necrosis factor Touch, sensation of, 506 Transfer RNA, 142, 143f
Thyroid-stimulating (TNF) Tourette syndrome, 562b, 656 Transferrin
immunoglobulin, 726 TNM system (tumor spread-node Toxic epidermal necrolysis (TEN), iron absorption and, 1406
Thyroid storm, 728 involvement-metastasis), 1664 iron cycle and, 963
Thyroiditis, 729 393–394 Toxic erythema of the newborn, iron deficiency anemia diagnosis
Thyronamine (TAM), 702b bladder carcinoma staging with, 1664 and, 991
Thyrotoxic crisis, 728 1349t Toxic multinodular goiter, 728 Transformation, cancer cell
Thyrotoxicosis, 725–726, 727f bone tumor staging with, 1562 Toxic myopathy, 1585, 1586b development and, 368
Thyrotropin-releasing hormone lung cancer staging with, Toxic shock syndrome Transforming growth factor, 39t,
(TRH), 690, 696–697, 698t, 700 1282–1283 Staphylococcus aureus associated 204, 216, 236t
Thyroxine (T4), 690t, 701t, 702 melanoma staging with, 1644b with, 311f Transforming growth factor-alpha,
hormone regulation and, 690 renal cell carcinoma staging with, superantigen and, 251 effects of, on skeletal tissues,
thyrotoxic crisis and, 728 1348t Toxigenicity, pathogenic, 302 1515t
1806 INDEX

Transforming growth factor-beta, Trichinosis, 314t TSI. See Thyroid-stimulating Tumor-associated macrophage,
1512 Trichomonad, 937 immunoglobulin 385–386
effects of, on skeletal tissues, Trichomonas vaginalis, 314t TTP. See Thrombotic Tumor capsule, 870
1515t Trichomoniasis, 314t, 937–938 thrombocytopenic purpura Tumor-infiltrating lymphocyte,
osteoporosis and, 1553 Trichophyton mentagrophytes, 312t (TTP) 386–387
Transfusion reaction, 278–280 Trichophyton rubrum, 312t Tube feeding, following burn injury, Tumor invasion, breast cancer and,
Transient Trichophyton tonsurans, 1657 1721–1722 872b
hypogammaglobulinemia of Trichuriasis, 314t Tubercle, 1273–1274 Tumor marker, 365–368, 369t
infancy, 290 Trichuris trichiura, 314t Tubercular meningitis, 611–612 Tumor necrosis factor (TNF), 205
Transient ischemic attack (TIA), Tricuspid atresia, 1209–1210, 1210f Tuberculin skin test, 1274 effects of, on skeletal tissues,
599 Tricuspid regurgitation, 1168t, Tuberculosis (TB), 1273–1274 1515t
Transient receptor potential 1170 clinical manifestations of, 1274 heart failure and, 1178
channel, 485–486 Tricuspid valve, 1087–1088, 1209 drug-resistant, 331b in multiple organ dysfunction
Transitional atrioventricular septal Tricyclic antidepressants, 648 evaluation and treatment of, 1274 syndrome, 1682
defect, 1206–1207 action of, 649f incidence of, 1273 multiple organ dysfunction
Transitional epithelium, 1325 side effects of, 651–652 pathophysiology of, 1273–1274 syndrome and, 1680, 1683
Translation Trifluoperazine, schizophrenia skin test for, 270 source and function of, 236t
protein synthesis and, 143f treated with, 646b Tuberculous arthritis, 1569t Tumor necrosis factor-alpha
RNA, 142 Trigeminal autonomic cephalagia, Tuberous sclerosis, 443t, 671t osteoporosis and, 1553
Translocation 608 Tuberous sclerosis complex (TSC), pediatric septic shock and, 1707
chromosomal, 149–151, 149f, Trigeminal nerve, 471f, 472t 680 stress response and, 348–349
375–376 Trigone, description of, 1325 Tubular reabsorption, 1328 Tumor necrosis factor-beta,
reciprocal, 151 Triiodothyronine (T3), 701t, 702 Tubular secretion, 1328 production of, 245–247
Robertsonian, 149–151, 150f cardiac effects of, 1106 Tubular transport, 1329–1331, 1336 Tumor-suppressor gene, 154,
Translocation of bacteria, 1682, hormone regulation and, 690 Tubule, renal, substances 376–378
1693 thyrotoxic crisis and, 728 transported by, 1331b cancer syndromes associated with
Transmembrane protein, 13 Trilafon. See Perphenazine Tubuloglomerular feedback, 1326 loss of, 376t
Transplantation Trimipramine, depression treated Tubulointerstitial fibrosis, childhood cancer associated with,
major histocompatibility complex with, 652b 1341–1342, 1357 444, 444t
and, 233–235 Triple negative breast cancer, chronic kidney disease associated definition of, 373–374
rejection of, 276 848–849 with, 1364 loss of, 377f
Transport maximum, glomerular Triploidy, 143–144 Tubulus rectus, 785 radiation-induced cancer and,
filtration and, 1329–1330 Trisomy, 144–148 Tumor. See also Neoplasm 428
Transport protein, 31 Trisomy 13 benign, 364, 364t, 366f Tunica adventitia, 1106
Transposition of the great arteries acute leukemia associated with, benign breast, 838t Tunica albuginea, 784–785
(TGA), 1214–1216 1017 benign versus malignant, 364t Tunica dartos, 786
clinical manifestations of, 1215 congenital heart defect associated bladder, 1348–1349 Tunica externa, 1106
evaluation and treatment of, with, 1200t bone, 1560–1565 Tunica intima, 1106
1215–1216 Trisomy 18, 1200t brain and spinal cord, Tunica media, 1106
hemodynamics in, 1215f Trisomy 21, 146–147, 146f, 444 characteristics of, 627t Tunica vaginalis, 784, 785f
pathophysiology of, 1215–1216 Trisomy X, 147 central nervous system, 626–637 Turbulent flow, 1113, 1114f
Transudative effusion, 1254 TRNA. See Transfer RNA characteristics of, 364t Turner syndrome, 147, 147f, 156
Transverse colon, 1407, 1471f Trochlear nerve, 471f, 472t, 509 classification of, 364–368 amenorrhea and, 805
Transverse fracture, 1541 Trophoblast, 257 cranial, 626–632 congenital heart defect associated
Transverse tubule, 1530 Tropomyosin, muscle contraction definition of, 363 with, 1200t
Tranylcypromine, depression and, 1532t embryonic, 443, 684 Twin studies
treated with, 652b Troponin, muscle contraction and, extracerebral, 631–632 epigenetic modification and,
Trauma 1532t female reproductive system, 825 185
immune system affected by, 291 Troponin I inflammation associated with, genetic diseases and, 169–170
nonaccidental, 1612 coronary artery disease and, 1152 384t Twins
skeletal, 1540–1545 myocardial infarction diagnosis intestinal obstruction caused by, concordance rates for disease in,
spinal cord, 589–594 and, 1161 1431t 170t
temperature regulation affected Troponin-tropomyosin complex, intracranial, 628f genetic disease studies with, 169
by, 501–502 1098–1099 malignant, 364, 366f (See also Twitch, muscle, 1534
Traumatic (dissecting) aneurysm, Trousseau phenomenon, cancers Cancer) Tympanic cavity, 515
604 associated with, 395t mechanical stress and, 388b Tympanic membrane, 514–515
Traumatic brain injury (TBI), Trousseau sign, 120, 733–734 metastasis of, common sites of, Type 1 diabetes mellitus. See
581–589, 582t True aneurysm, 1140 391t Diabetes mellitus (DM), type 1
classification of, 582 True bacteria, 302 microenvironment of, 429, 429f Type 2 diabetes mellitus. See
progesterone for, 589b Truncus arteriosus, 1196, 1217– muscle, 1585, 1611–1612 Diabetes mellitus (DM), type 2
Trazodone, depression treated with, 1218, 1217f musculoskeletal, 1609–1612 Type A synovial cell, 1522
652b Trypanosoma brucei, 314t neuroendocrine, 1279–1280 Type B synovial cell, 1522
Treacher Collins syndrome, 1486 Trypanosoma cruzi, 314t nomenclature of, 364–368 Type I fiber, muscle, 1529, 1530t
Treg cell. See T regulatory (Treg) Trypsin origin of, 367t Type I programmed cell death, 92
cell deficiency of, 1439 ovarian, 832f Type II fiber, muscle, 1529, 1530t
Trehalase, as digestive enzyme, as digestive enzyme, 1402b pancreatic, 1474 Type II programmed cell death, 92
1402b protein digestion and, 1402 pathophysiology of, 681–682 Typhoid fever, 304t–305t
Treitz ligament, 1400 Trypsin inhibitor, 1415 pediatric, 681, 1612t Typhus, as pandemic, 302t
Tremor at rest, description of, 563t TSC. See Tuberous sclerosis pituitary, growth hormone Tyrosine, synthesis of, 710f
Treponema pallidum, 302–303, complex (TSC) secretion and, 722 Tyrosine kinase, 694t
304t–305t TSH. See Thyroid-stimulating renal, 1347–1348
TRH. See Thyrotropin-releasing hormone (TSH) skin, 1620t–1622t, 1640–1641 U
hormone (TRH) TSH deficiency, 721 staging of, 394f UAO. See Upper airway
Tricarboxylic acid cycle, 26–27 TSH-RH. See Thyroid-stimulating tissue of origin of, 367t obstruction (UAO)
Trichinella spiralis, 314t hormone-releasing hormone of uncertain origin, 367t Ubiquitine-proteasome pathway, 50
Trichinellosis, 1583 (TSH-RH) wound healing and, 385f UC. See Ulcerative colitis (UC)
 INDEX 1807

UDH. See Usual ductal hyperplasia Upper esophageal sphincter, 1395 Urinary tract Urothelial (transitional cell)
(UDH) Upper gastrointestinal (GI) alterations in function of, carcinoma, 1348–1349
Ulcer bleeding, 1426–1427 1340–1375 Urticaria, 272, 1639, 1639f
characteristics of, 1437t Upper motor neuron, 462 congenital abnormalities of, Urushiol, 273
decubitus, 1625 Upper motor neuron syndrome, 1378 Usual ductal hyperplasia (UDH),
duodenal, 1435–1437 568–571, 569t illustration of, 1341f 839
example of, 1620t–1622t Uracil, 141, 142f pediatric, alterations in function Uterine cancer, 830
peptic, 1435–1439 Urate, 88–93 of, 1376–1392 Uterine fibroid, 821–823
pressure, 1625–1626 concentration of, 1575t Urinary tract infection (UTI), Uterine tube, 775–776
stasis, 1628f pH and, 1575f 1349–1352 Uterus, 773–775
stress, 1439 solubility of, 1575 catheter-associated, 1349b abnormal bleeding of, 808–809
surgical treatment of, 1439 Urate oxidase, 8 clinical manifestations of, 1351 clinical manifestations of,
Ulcerative colitis (UC), 1440–1442 Urea, 1332 evaluation and treatment of, 1351 809
clinical manifestations of, chronic kidney disease and, host defense mechanisms and, evaluation and treatment of,
1441–1442 1366t 1350 809
colon cancer and, 384 clearance of, 1366–1367 pathophysiology of, 1350–1351 pathophysiology of, 808–809
colorectal cancer confused with, production of, shock associated pediatric, 1386–1387 abnormalities of, 801
1472t with, 1670 types of, 1350–1352 bicornuate, 801f
diarrhea cause by, 1426 urinary tract infection defense Urinary tract obstruction, cross-section of, 774f
distribution patterns of, 1441f and, 1350 1340–1349 double, 801f
evaluation and treatment of, 1442 Ureaplasma urealyticum, pelvic calculi as cause of, 1343 leiomyoma in, 822–823, 822f
features of, 1443t inflammatory disease causes of, 1341f malformations of, 801f
pathophysiology of, 1441–1442 associated with, 814 evaluation and treatment of, menopause and, 794
Ultrafiltration, 1327–1328 Uremia, 1359 1346–1347 menstrual cycle and, 781
Ultrasonography shock associated with, 1670 lower, 1344–1347 polyp of, 821f
Doppler, 1122 systemic effects of, 1365t upper, 1340–1344 prolapse of, 817–818
gastrointestinal tract evaluated Uremic syndrome, 1366 Urination, 1325 sarcoma of, 830–831
with, 1415 Ureter, 1325 Urine variations in position of, 774f
Ultrasound, of skull and spine, 480 abnormal configuration of, 1388f in acute kidney injury, 1363t UTI. See Urinary tract infection
Ultraviolet radiation cancer of, carcinogenic agents casts in, 1336 (UTI)
cancer associated with, 403f, 431 associated with, 404t–407t crystals in, 1336
melanin secretion and, 1617 dilation of, 1341–1342 decreased formation of, 113–114 V
skin cancer caused by, 1641 Ureterohydronephrosis, 1341–1342 dilution and concentration of, V wave, 1089–1090
squamous cell carcinoma Ureteropelvic junction (UPJ) 1331–1333, 1332f Vaccination
associated with, 1642–1643 obstruction, 1380 diuretics as factor in flow of, 1333 derivation of, 247–248
Umbilical cord blood, antibody Urethra, 1325–1326 formation of, 1329f diseases prevented by, 330t
levels in, 257f disorders of, 888 obstruction to flow of, 1346–1347 Vaccine
Unclassified epileptic seizure, 679 in male, 787 obstruction to outflow of, 1329, active immunization with,
Uncomplicated urinary tract obstruction of, 1346 1340 332–333
infection, 1349–1350 Urethral atresia, 1380 pH of, kidney stone formation route of, 229
Unconjugated bilirubin, 1411 Urethral polyp, 1380 and, 1343 Vacuolar degeneration, 84
Underactive bladder syndrome, 1345 Urethral stricture, 888, 921, red blood cells in, 1335–1336 Vacuolar myelopathy, 617
Underfill theory, ascites and, 1453 1346–1347 sediment in, 1335–1336 Vacuolation, 57–58
Undifferentiated large cell Urethral valve, 1380 specific gravity of, 1335 Vagina, 772–773
anaplastic cancer, 1281 Urethritis, 888 white blood cells in, 1336 abnormal bleeding of, 808t
Undifferentiated leukemia, chlamydial, 930 Urine color, 1335 bacteria in, 194
1074–1075 Urge incontinence, 1344t Urine pH, 1335 cancer of (See Vaginal cancer)
Unfolded-protein response, 6b Uric acid (UA), 88, 1575 Urine specificity, acute kidney candidiasis infection in, 1638t
Unilateral neglect syndrome, gout and, 1574–1575 injury and, 1363t double, 801f
535–536, 538 kidney stone composed of, 1343 Urine volume, acute kidney injury menstrual cycle and, 781
Unilateral renal agenesis, 1380 pH and, 1575f and, 1363t pH of, 816
Unipolar neuron, 448 production of, 1576f Urobilinogen, 1411–1412 prolapse of, 817, 819f
Uniport, 31 synthesis of, 1576f Urodilantin, 1327, 1328t Vaginal cancer, 404t–407t, 829
United States Uric acid stone, 1344 Urodilatin Vaginal mesh, 819b
causes of death in, 1130t Urinalysis, 1335–1336 blood pressure affected by, 1117 Vaginismus, 835
death rate in, 71f Urinary Bence Jones protein, as hypertension and, 1134 Vaginitis, 816
infant mortality in, 95t tumor marker, 369t Uroepithelium, 1325 Vaginosis, 816
injury statistics for, 71f Urinary bladder, 1325–1326 Uroflowmetry, 1346 Vagus nerve, 471f, 472t, 473
ionizing radiation exposure in, 79f aging effects on, 1336 Urogenital infection, 919–940 Valacyclovir, herpes simplex virus
life expectancy in, 94–95, 95t cancer of, carcinogenic agents Urogenital sinus, 768 infection treated with, 934
maternal mortality in, 95t associated with, 404t–407t Urogenital tract, menopause and, Valence, antigen binding and,
Universal donor, 278–279 structure and location of, 1324f 795 232
Universal recipient, 278–279 Urinary incontinence, Urokinase-like plasminogen Valproic acid, cluster headache
Unmyelinated C fiber, 486 1388–1391 activator (u-PA), 972 treated with, 609
Unresponsiveness, 528 clinical manifestations of, 1389 Urolithiasis, 1343 Valsalva maneuver, 1408
Unsaturated fatty acid, 1405b evaluation and treatment of, Urologic system, 1 Valve, heart. See Heart valve
Unstable angina, 1156–1157, 1158b 1389–1391 aging effects on, 1336 Valve disease, 52f
Unverricht-Lundborg disease, 671t pathogenesis of, 1388–1391 alterations in function of, Valvular dysfunction, 1167–1171
Up-regulation, hormone receptors Urinary meatus, 772 1340–1375 Valvular regurgitation, 1167,
and, 691–692 Urinary stone, 1343 pediatric, alterations in function 1168t
Up-regulation of proteasome, 50 Urinary system of, 1376–1392 Valvular stenosis, 1167, 1168t
UPA. See Urokinase-like development of, 1376–1377 structures in, 1325–1326 Vancomycin, resistance to, 331
plasminogen activator embryonic, 1376 tests of, 1334–1336 VAP. See Pneumonia,
Upper airway obstruction (UAO) organs of, 1320f Uromodulin, 1331 ventilator-associated
causes of, 1294b pediatric, 1376–1378 Uropathogen, virulence of, 1350 Variable surface glycoprotein, 315
pediatric, 1293–1301 structures in, 1325–1326 Urotensin II, action of, 1111b Varicella, 1659t, 1660–1661
1808 INDEX

Varicella-zoster virus (VZV), 318t, Vein (Continued) Ventricular system, cerebrospinal Viral hepatitis (Continued)
610t, 1636 description of, 1085, 1109 fluid and, 465–466 evaluation and treatment of, 1460
Varices, description of, 1452 diagram of, 1091f Ventricular tachycardia, pathophysiology of, 1459
Varicocele, 891, 892f diseases of, 1129–1132 pathophysiology and treatment Viral infection, 317–322
Varicose bronchiectasis, 1256–1258 of head, 469f of, 1183t–1184t acquired immunodeficiency
Varicose vein, 1129–1130 hepatic, 1410f Venule syndrome and, 327b
Vas deferens, 786 lymphatic, 1118 inflammatory response and, 196f cancer and, 382
Vasa recta, 1325, 1332 principle, diagram of, lymphatic, 1118 cutaneous, 1636–1637
Vasa vasorum, 1106 1104f–1105f systemic circulation and, 1106 immune defense against, 319–320
Vascular compliance, 1113–1114 pulmonary, 1088, 1230 Verapamil immune response suppression
Vascular dementia, clinical structure of, 1107f action of, 1099–1101 in, 320
differentiation of, 547t systemic circulation and, 1106 cluster headache treated with, 609 rash produced by, 1659t
Vascular disease, peripheral, Velocardiofacial syndrome, 733 Verbal paraphrasia, 545t skin disorders caused by,
1144–1145 Vemurafenib, melanoma treated Vermiform appendix, 1407 1658–1661
Vascular disorders, 1137t, with, 1644 Vermis, 459 tissue damage caused by, 320
1638–1640 Vena cava, 1088 Verrucae vulgaris, 1636–1637, transmission and colonization of,
Vascular endothelial dysfunction, Venereal disease. See Sexually 1637f 317–319
95, 95f transmitted infection (STI) Vertebra Viral meningitis, 609, 676–677
Vascular endothelial growth factor, Venereal wart, 1637 ankylosing spondylitis effects on, evaluation and treatment of,
381, 385–387, 420 Venezuelan equine encephalitis 1573–1574 612–613
Vascular malformation, 604–605, virus, encephalitis caused by, description of, 466–467, 466f human immunodeficiency virus
605f 615t fracture of, 590–591 associated with, 617
Vascular niche, 956 Venlafaxine lumbar, 467f Viral pneumonia, 1273–1275, 1306,
Vascular smooth muscle, anxiety disorder treated with, osteoporotic, 1551f 1307t
neurogenic shock and, 1674 655 Vertebral artery, 467 Virchow triad, 1048, 1130–1131,
Vasculitis, 1042, 1639f depression treated with, 652b Vertebral canal, 461f 1275
Vasculogenesis, 1106–1108 panic disorder treated with, 655 Vertebral column, 466–467, 466f Virilization, 756, 757f, 888b
Vasectomy, prostate cancer Venography, 1122–1123 Vertebral injury, 590, 591t Virion, 317–319
associated with, 904 Venous angioma, 604–605 Vertigo, 506–507 Virulence, pathogenic, 302, 1350
Vaso-occlusive crisis, sickle cell Venous oxygen saturation (SVO2), Very-low-density lipoprotein Virus
disease and, 1066 1241 (VLDL), 1149 attenuated, 252, 332
Vasoactive intestinal peptide Venous stasis, pulmonary embolism Vesicant, burn injury from, 1685 central nervous system diseases
action of, in digestive system, and, 1275 Vesicle, 3f caused by, 610t
1397t Venous stasis ulcer, 1130 example of, 1620t–1622t childhood cancer and, 445
stress response influenced by, Venous thromboembolism (VTE), secretory, 6–7 classification of, 317
351t 1130–1131 transport by formation of, 33–36 croup caused by, 1294–1295
Vasoconstriction Venous thrombosis, 1041 Vesicosphincter, 1342f, 1345 description of, 317
body heat and, 498 cancers associated with, 395t Vesicoureteral reflux (VUR), diseases caused by, 318t
description of, 1108 risk for, 1049b 1387–1388 electron micrograph of, 317f
hypovolemic shock associated Venous thrombus, 1048 clinical manifestations of, 1388 infection from, 252, 303t
with, 1705 Ventilation, 1232–1238 evaluation and treatment of, 1388 intracellular survival of, 319
pulmonary venous hypoxia as assisted, bronchopulmonary pathophysiology of, 1388 invasion and evasion of,
cause of, 1230–1231 dysplasia treated with, 1305 pyelonephritis associated with, 319–320
Vasoconstrictor hormone, 1117 gas exchange and, 1238–1240 1352t mechanisms of, to defend
Vasodilation, 1110f lung capacity and, 1244f Vesiculobullous skin disorders, against inflammation and
description of, 1108 muscles of, 1235f 1632–1634 immunity, 308t
heat loss by, 497 neurochemical control of, Vestibular nystagmus, 506–507 neutralization of, 251f
mechanics of, in shock, 1678f 1233–1234 Vestibule, 515 pathogenesis of, 320–322
pediatric septic shock associated pediatric shock treatment and, female genitalia and, 772 sexually transmitted infection
with, 1708 1711 in pulmonary system, 1226–1228 caused by, 919t, 932–937
Vasogenic edema, 557–558, 589 Ventilation-perfusion, Vestibulitis, 816–817 type 1 diabetes mellitus and, 736b
Vasomotion, 1108–1109, 1110f abnormalities of, 1252f Vestibulocochlear nerve, 471f, 472t Visceral endothelium, 1321–1322,
Vasomotor flush, 794–795 Ventilation-perfusion ratio (V/Q), Vestibulospinal pathway, 463–464 1324f
Vasopressin 1239–1240, 1252 Vestigial tab, 1593–1594 Visceral obesity, 1450
blood pressure affected by, 1117 Ventral column, 462 Vibrio cholerae, 304t–305t, 306, 309 Visceral pain, 492, 1426
septic shock treated with, Ventral horn, 460–461 Vibrio cholerae, diarrhea caused by, Visceral pericardium, 1085
1678–1679 Ventricle 1500 Viscosity, blood flow and, 1112
shock treated with, 1714t description of, 465, 1086 Vibrio parahaemolyticus, 304t–305t Visfatin, secretion of, 1447b
stress response influenced by, 352 filling of, 1088 Vigilance deficit, description of, Vision, 507–509
vasoconstriction and, 1117 Ventricular aneurysm, 1163 541t aging effects on, 509–515
Vasospasm, Raynaud disease Ventricular block, pathophysiology Vigilance system, 538 dysfunction of, 509–513
associated with, 1145 and treatment of, 1184t–1186t Viibryd. See Vilazodone neurologic disorders and,
Vaspin, secretion of, 1447b Ventricular bradycardia, Vilazodone, depression treated with, 512–513
Vault, 3f, 8, 9f pathophysiology and treatment 652b Visual acuity, alterations in,
VCD. See Vocal cord dysfunction of, 1183t–1184t Villus, intestinal, 1401 510–511
(VCD) Ventricular dysrhythmia, stress Vincristine Visual field, 509f
Vegetables and, 342b chronic leukemia treated with, Visual pathway, 509f
cancer prevention and, 417 Ventricular end-diastolic pressure, 1023 Vital signs
prostate cancer and, 902b pediatric, 1703t multiple myeloma treated with, pediatric, 1702t
Vegetative state (VS), 534 Ventricular fibrillation, 1034 pediatric shock and, 1701
VEGF. See Vascular endothelial pathophysiology and treatment Viral arthritis, 1569t Vitamin A, intestinal absorption
growth factor of, 1183t–1184t Viral conjunctivitis, 507 of, 1406t
Vein. See also specific veins (i.e., Ventricular remodeling, 1175, Viral hepatitis, 1457–1460 Vitamin A deficiency, 1440
Hepatic vein) 1176f characteristics of, 1457t Vitamin B
cerebral, 467–469 Ventricular septal defect (VSD), cirrhosis caused by, 1460 DNA methylation and, 415–416
coronary, 1092 168, 1205–1206, 1206f clinical manifestations of, 1459 intestinal absorption of, 1406t
 INDEX 1809

Vitamin B12 Vomiting (Continued) Water (Continued) Wnt gene, 1512

erythropoiesis requirements for, intestinal obstruction as cause of, submersion in, injury caused by, Wnt signaling, 1376, 1553
962 1433–1434 76, 76b Wolff-Parkinson-White syndrome,
replacement of, for pernicious pyloric obstruction associated transport of, 33t pathophysiology and treatment
anemia, 988–989 with, 1430–1431 urine concentration and, 1332 of, 1184t–1186t
Vitamin B12 deficiency, pernicious von Hippel-Lindau disease Water deficit, 112 Wolff ’s law, 1515
anemia associated with, childhood cancer associated with, Water intoxication, 113–114 Work of breathing, 1236–1237
987–988 443t Water loss, burn injury and, Working memory, 538, 643
Vitamin C, intestinal absorption congenital heart defects 1691–1693 Working memory deficit, 538, 541t
of, 1406t associated with, Water vapor, gas pressure and, World Allergy Organization
Vitamin D 1200t 1237–1238 (WAO), 1675, 1675b
bone and, 1512t von Recklinghausen disease, 154, Watson, James, 136 World Health Organization
burn injury and, 1717 671t, 1200t WBC. See Leukocyte (WHO), smallpox
calcium balance and, 119–120 von Willebrand disease, 967, WBI. See Whole-breast irradiation immunization campaign from,
fracture risk and, 1556b 1071 (WBI) 332
intestinal absorption of, 1406t von Willebrand factor (vWF), Weibel-Palade body, 966 Wound
prostate cancer and, 902b 966–967 Weight gain, breast cancer and, 860 infection of, bacteria as cause of,
renal function affected by, 1334 VS. See Vegetative state (VS) Wellbutrin. See Bupropion 304t–305t
role of, 703, 703b VSD. See Ventricular septal defect Wells syndrome, 1010–1011 resolution and repair of, 215–220,
Vitamin D3, 1334, 1406t (VSD) Wernicke area, 457 217f
Vitamin D deficiency, 703, 732, VTE. See Venous Wernicke dysphasia, 543t–544t sepsis in, 218
1440 thromboembolism (VTE) West Nile virus, 318t Wound contraction, 218
asthma associated with, 1308 Vulva, 771, 934f central nervous system diseases Wound healing, 215–220
chronic kidney disease and, 1368 Vulvar cancer, 829–830 caused by, 610t abnormal, skin lesion associated
nephrotic syndrome associated Vulvitis, 816–817 encephalitis caused by, 615b, 615t with, 1626
with, 1359, 1359t Vulvodynia, 816–817 West syndrome, 679–680 bone, 1520
osteomalacia associated with, Vulvovaginal gland, 772 Western equine encephalitis virus, burn, 1722, 1722b
1557 VUR. See Vesicoureteral reflux encephalitis caused by, 615t diabetes mellitus and, 752
rickets associated with, (VUR) Wet gangrene, 91 disruption of, 220
1599–1600 VWF. See Von Willebrand factor Wheal, example of, 1620t–1622t dysfunctional, 218–220
Vitamin E (vWF) Wheal and flare reaction, 272 Treg cell and, 386–387
intestinal absorption of, 1406t VZV. See Varicella-zoster virus Wheezing tumor growth and, 385f
prostate cancer and, 902b (VZV) asthma indicated by, 1309 Wound infection, Staphylococcus
Vitamin E deficiency, 1440 description of, 1249–1250 aureus associated with, 311f
Vitamin K W foreign body aspiration as cause Wound repair, myocardial
bone and, 1512t Wakefulness, 502f of, 1298 infarction and, 1160
coagulation and, 1042–1043 Waldenström macroglobulinemia, Whiplash, brain injury from, 587 Woven bone, 1520
deficiency of, 1042–1043 1030, 1035 White blood cell. See Leukocyte Wrist, dislocation or subluxation
Vitamin K deficiency, 1440 Wallerian degeneration, 450–451, White coat hypertension, of, 1544
Vitamin(s) 622 1220–1221 Wuchereria bancrofti, 314t, 316
cellular function and, 75 Wandering, description of, 563t White fast-motor fiber, 1529
digestion and absorption of, WAO. See World Allergy White graft, 280 X
1405–1406, 1406t Organization (WAO) White matter, 456–457, 461f X chromosome, 156
erythropoiesis requirements for, Warburg effect, 370f, 420 multiple sclerosis lesions in, 620 X descent, 1089–1090
962 Warfarin White muscle, 1529, 1530t X inactivation, 156–157
storage of, 1413 congenital heart defects White stroke, 599 X-linked agammaglobulinemia,
Vitiligo, 1617, 1620t–1622t associated with, 1199, 1199t Whole-breast irradiation (WBI), 857 284, 1017
Vitreous humor, 508, 510t thrombosis treated with, 1072 Whole-breast radiation therapy, 857 X-linked hyper-IgM syndrome, 284
Vitronectin, 305 Warm autoimmune hemolytic Whooping cough, 304t–305t X-linked inheritance, 156–158
Vivactil. See Protriptyline anemia, 998 Wickham striae, 1630–1631 X-linked lymphoproliferative
VLDL. See Very-low-density Warm shock, 1709 Wilms tumor, 188, 1385–1386 syndrome, 1013
lipoprotein (VLDL) Warts, 1636–1637 childhood cancer associated with, X-linked recessive gene, 158
VO2. See Oxygen consumption Water 444 X-linked severe combined immune
(VO2) accumulation of, shock as cause clinical manifestations of, 1386 deficiency, 286
Vocal cord, 1226–1228 of, 1670 evaluation and treatment of, X-ray
carcinoma of, 1278 balance of 1386 breast cancer associated with, 856
paralysis of, 1299 alterations in, 109–114 inheritance of, 379–380 chest, 1119
Vocal cord dysfunction (VCD), chronic kidney disease and, pathogenesis of, 1385–1386 ionizing radiation from, 78–80
1299 1366t staging of, 1386t of skull and spine, 477–478
Vogt-Spielmeyer disease, 673t body survival rates for, 1386t Xanthelasma, 1154
Volatile acid, 123 alternations in movement of, Wilms tumor 1 (WT1) gene, 1376 Xanthine dehydrogenase, 1683
Volkmann canal, 1517 105–108 Wilson disease, 673t, 1503t, Xanthine oxidase, 1683
Volume/pressure sensitive receptor, balance of, 109 1504–1506 Xanthine stone, 1344
water balance and, 109 distribution of, 104t Windchill factor, 497 Xanthoma, 174f
Voluntary muscle, 1526–1527 excess of, 113–114 Window period, infection and, 327 Xenobiotics, 416–417
Volvulus movement of, 105 Wingless type signaling, urinary Xenoestrogen, breast cancer and,
intestinal malrotation and, 1489 normal gains and losses of, tract development and, 1376 861
intestinal obstruction caused by, 104t Wireless telephone, radiation Xeroderma pigmentosum, 379
1437t solute imbalances and, 110t exposure from, 432
Vomiting, 1424 cell transport and, 28–33 Wirsung duct, 1413 Y
brain dysfunction associated cellular injury caused by, 84 Wiskott-Aldrich syndrome, 281, Y chromosome, 157
with, 533 small intestine transport of, 283f, 286–287 Y descent, 1089–1090
gastroesophageal reflux disease as 1401–1402 acute leukemia associated with, Yawning, brain dysfunction
cause of, 1493–1494 sodium and chloride balance and, 1017 associated with, 533
gastrointestinal bleeding and, 108–109 childhood cancer associated with, Yeast, 310–311, 312f
1428 solute imbalances and, 110t 443t Yellow fever virus, 318t
1810 INDEX

Yellow marrow, 1518 Z Zoloft. See Sertraline Zygote, chromosomal deletion and,
Yersinia pestis, 304t–305t Z line, 1098–1099 Zona fasciculata, 706 148–149
Yersinia spp., 306–307 Zellweger encephalopathy, 673t Zona glomerulosa, 706 Zyprexa. See Olanzapine
Young adult Zinc, immune system affected by Zona reticularis, 706
cancer incidence in, 442 level of, 291 Zoonotic infection
seizures in, 554t Ziprasidone, schizophrenia treated bacteria associated with,
with, 646b, 647 304t–305t
Zollinger-Ellison syndrome, 1438 viral, 317