L
Tierney, Lawrence M., McPhee, Stephen J., Papadakis, Maxine A.
Current Medical Diagnosis & Treatment, 45th Edition
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P
P53 gene mutations
in cancer etiology 1641
breast cancer 706
gene therapy for cancer and 1700–1701
pancreatic and periampullary carcinoma 700
smoking and 5 1646
thyroid cancer 1123 1124
fecal DNA assay for 642
in hepatocellular carcinoma 682
P-450 aromatase deficiency, amenorrhea in 1183
P450 system/cytochrome P450
in acetaminophen hepatotoxicity 1616
in autoimmune hepatitis 663
erythromycin affecting 1569
H2-receptor antagonists affecting 589
nefazodone affecting 1070
in nonalcoholic fatty liver disease 667
protease inhibitors affecting 1340
St. John's wort affecting 1714
P450c11 deficiency 1170 1173 1183
P450c17 deficiency 1173 1183
P450c21 deficiency 1165 1170 1171 1183
P-glycoprotein, in chemotherapy drug resistance 1660
P wave, in differentiation of aberrantly conducted supraventricular beats from ventricular beats 372
PABA (p-aminobenzoic acid), sulfonamide mechanism of action and 1575
Pacemaker
permanent 383–384
biventricular (resynchronization), for cardiac failure 396
for cardiomyopathy 403
for refractory atrial fibrillation 377
for sick sinus syndrome 382
temporary, for infarct-associated conduction disturbances 362
Pacemaker syndrome 384
Packed red cells, transfusion of 533
autologous 533
Paclitaxel 719 723 1662 1674
neuropathy caused by 1683–1684
with trastuzumab 1667
PaCO2 See also PCO2
in asthma 228
exacerbation severity and 229
in near drowning 1602 1603
Paecilomyces, opportunistic infections caused by 1547
Paget-Schroetter syndrome 468
Paget's carcinoma of breast 713–715
nipple involvement and 107–108 713
Paget's disease, of bone 1161–1162
Pain 72–80
assessment scales for 72 72
cancer, evaluation of control of 1688
chronic 1049–1052 1051
acupuncture for 1724–1727 1725
drug therapy for See Pain management, pharmacologic
immobility in elderly and 60
neuropathic 79–80 79 1024
nonpharmacologic interventions in 80
ocular See Ocular pain
otic See Earache
psychologic factors and (somatoform pain disorder) 1048
in reflex sympathetic dystrophy 467 822
response to, in coma or stupor 1017
P.1841
rest
in lower extremity occlusive disease 453
in thromboangiitis obliterans (Buerger's disease) 462
in sickle cell anemia 493
in terminally ill/dying patient 72–80 72
Pain disorders See also Pain
chronic 1049–1052 1051
with psychologic factors (somatoform pain disorder) 1048
Pain management 72–80 72 73 75–76 77–78 79
acupuncture for 1723 1724–1728 1725 1726
assessment scales and 72 72
for back pain 818–819
barriers to good care and 72–73
in cancer patients 1688
for chronic pain disorders 1050–1052
in elderly 65
nonpharmacologic 80
pharmacologic 74–80
acetaminophen/NSAIDs/COX-2 inhibitors 74 75–76
adjuvant 80
in elderly 65
for neuropathic pain 79–80 79
opioids 74–79 77–78
principles of 73 73
in terminally ill/dying patient 72–80 72 73 75–76 77–78 79
double effect and 69
Pain syndromes 815–826
acupuncture for 1723 1724–1727 1725
psychologic factors and 1048
Painful diabetic neuropathy 1223–1224
Painful intercourse See Dyspareunia
Painful subacute thyroiditis 1144
Palifermin, for chemotherapy-induced toxicity 1677 1688
Palilalia, in Tourette's syndrome 1013
Palindromic rheumatism 863
Palivizumab, for respiratory syncytial virus infection 1353 1382
Palladone See Hydromorphone
Palliative care institutions 71
Pallidotomy, for parkinsonism 1010
Pallor, in Raynaud's disease/phenomenon 464 465
Palmar erythema, in cirrhosis 669
Palmar fasciitis
cancer and 863
in Dupuytren's contracture 822
Palmaz stents, for lower extremity occlusive disease 454
Palms
tinea of 103–104
ulnar lesions at 1029
vesiculobullous dermatitis of (pompholyx) 111–112
Palonosetron 1682
Palpitations
in heart disease 313
in pheochromocytoma 1174
in pulmonary embolism 282
Palsies See specific type and Paralysis/palsies
Paludrine See Proguanil
2-PAM See Pralidoxime
Pamelor See Nortriptyline
Pamidronate See also Bisphosphonates
adverse ocular effects of 179
antitumor/antiangiogenic effects of 1671
for chemotherapy-induced toxicity/bone pain 1678 1688
for osteoporosis 1157
for Paget's disease of bone 1162
Panaeolus (hallucinogenic) mushroom poisoning 1629 1630
Panax
ginseng 1712 1717
quinquefolius 1717
Panbronchiolitis, diffuse 247
Pancreas
cancer of 699–701 1664
chronic pancreatitis and 698
gastrointestinal bleeding and 552
incidence/mortality of 1640
diseases of 693–701
dyspepsia and 536
vomiting and 539
divisum 694
functioning/neuroendocrine tumors of 1178–1179
hypoglycemia caused by 1178 1234–1237 1234
in multiple endocrine neoplasia 1150 1191
pseudocysts of 694 696
transplantation of, for diabetes mellitus 1216
Pancreatectomy 699
hyperglycemia and 1201
Pancreatic abscess 696 697
Pancreatic ascites 563 696
Pancreatic cholera 1692
Pancreatic duct, calculus formation in (pancreaticolithiasis), in chronic pancreatitis 698
Pancreatic enzyme supplements 698 699
Pancreatic insufficiency 601 698
Pancreatic islet cell tumors 1178–1179
hypoglycemia caused by 1178 1234–1237 1234
in multiple endocrine neoplasia 1150 1178 1179 1191 1234 1237
Pancreatic islets 1178
hyperplasia of, persistent (noninsulinoma pancreatogenous hypoglycemic syndrome) 1237
transplantation of, for diabetes 1216
Pancreatic polypeptide, F cells secreting 1178
Pancreatic pseudocysts 694 696
Pancreatic secretory trypsin inhibitory (PSTI)
gene, in chronic pancreatitis 698
Pancreaticocholangitis, sclerosing 691
Pancreaticoduodenal resection, for pancreatic and periampullary carcinoma 701
Pancreaticojejunostomy, for chronic pancreatitis 699
Pancreaticolithiasis, in chronic pancreatitis 698
Pancreatitis
acute 693–697 695
ascites in 563 696
autoimmune 697 699
biliary 694
in burn injury 1596
chronic 697–699
didanosine therapy and 1339
hereditary 697
hypercalcemia/hyperparathyroidism and 1151
hyperglycemia in 1201
hypertriglyceridemia and 695 1252
hypocalcemia in 694–695 696 878
in mumps 1365 1366
pleural effusion in 301
sclerosing cholangitis and 691
tropical 697
Pancytopenia 497–498 498
in acute leukemia 508
in aplastic anemia 497
in hairy cell leukemia 512
Panencephalitis, subacute sclerosing 1363
myoclonus in 1012
Panhypergammaglobulinemia See Hypergammaglobulinemia
Panhypogammaglobulinemia See Hypogammaglobulinemia
Panhypopituitarism 1105
Panic disorders/panic attacks 1043–1044 1046
dyspnea in 218 1043
seizures differentiated from 982 1043
sleep 1043
suicide risk and 1043
Panniculitis
lupus 137
sclerosing 125
septal, in erythema nodosum 137
Pannus
in rheumatoid arthritis 827
in trachoma 156
Pantoprazole 588
Pantothenic acid, dietary reference intakes (DRIs) for 1254
Panuveitis 162
PaO2 See also PO2
altitude affecting 224 224
in ARDS 310
in asthma, exacerbation severity and 229 237
home oxygen therapy and 240
in near drowning 1602
relationship of to oxygen saturation 223–224 224
in smoke inhalation 293
Papanicolaou smear (Pap smear) 15 16 734–735 734 1655
anal, in HIV infection/AIDS 1329
in cancer screening 15 16 1655
in cervical intraepithelial neoplasia 734–735 734 1655
in endometrial carcinoma 738
for HPV screening 1655
for rape victim 759
Papaverine, in erectile dysfunction 951 1224
Papillary muscle dysfunction/rupture, in myocardial infarction 364
mitral valve regurgitation and 331
Papillary stenosis, in HIV infection/AIDS 1326
Papilledema 169
in pseudotumor cerebri 1005
Papillitis, in optic neuritis 169
Papillomas
eyelid 154
inverted 200
laryngeal 209–210
Papillomaviruses See Human papillomavirus
PAPP-A See Pregnancy-associated plasma protein-A
Papular urticaria 121
bedbugs causing 136
Papules 92 127–131
violaceous to purple 131–132
Paracentesis See also Ascitic fluid analysis/examination
in ascites 559–560
in cirrhosis 670 670–671
P.1842
Paracetamol See also Acetaminophen
in analgesic nephropathy 926
Parachute mitral valve 325
Paracoccidioides brasiliensis (paracoccidioidomycosis/South American blastomycosis) 1546
Paradoxic aciduria, in saline-responsive metabolic alkalosis 891
Paradoxic embolism
in atrial septal defect/patent foramen ovale 321
in transient ischemic attacks 988
Paradoxic pulse See Pulsus paradoxus
Paradoxic sleep 1078
Paradoxic splitting, of second heart sound 315
Paragangliomas 1174 1175 1177
Paraganglionomas (carotid body tumors) 458
Paragonimus skrjabini/szechuanensis/westermani (paragonimiasis) 1506–1508
Parainfluenzaviruses 1382
Paralysis agitans (idiopathic Parkinson's disease) 1007
Paralysis/palsies 988
acute flaccid
enterovirus 71 causing 1390–1391
poliomyelitis causing 1367
in conversion disorder 1048
in motor neuron diseases 988 1022
ocular motor 170
in myasthenia gravis 1034
periodic See Periodic paralysis
in poliomyelitis 1366 1367
in porphyria 1703
progressive supranuclear, parkinsonism differentiated from 1008
in rabies 1370
sleep, in narcolepsy 1080
spinal cord infarction causing 999
spinal trauma causing 1021
stroke causing 991 993 995 996
in tick-borne encephalitis 1380
Paralytic (adynamic) ileus 607–608
vincristine therapy and 1684
Paralytic shellfish poisoning 1635 1635
Paramalignant pleural effusion 302
Paramyxovirus respiratory infections 1381–1382
Paranasal sinuses 194–202
granulomatous disease of 201
in HIV infection/AIDS 217 1323–1324
infections of 194–197
malignant tumors of 201
sinusitis and 196
Paraneoplastic cerebellar degeneration 1005 1696
Paraneoplastic pemphigus 126
Paraneoplastic syndromes 1695–1698 1696–1697
hypercalcemia and 879 1696
in lung cancer 267–268 1696–1697
neurologic disorders and 1004–1005 1695–1698
in renal cell carcinoma 970 1696–1697
Paranoid personality disorder 1055
Paranoid schizophrenia 1057
delusions and 1057 1057–1058
Paraparesis, tropical spastic (HTLV-associated myelopathy) 1016 1375–1376
Paraphilias 1052–1053 1053–1054
Paraphimosis 933
Paraplegia See also Paralysis
spinal cord infarction causing 999
spinal trauma causing 1021
Parapneumonic pleural effusion 301 301 302
in pneumococcal pneumonia 1403 1404
Paraproteins
in chronic lymphocytic leukemia 510
in myeloma 515 516
neuropathy associated with 1025
in Waldenstr m's macroglobulinemia 517 518
Paraquat poisoning 1631
Parasitic infections
diarrhea in 549
stool analysis for 546 550
dyspepsia in 536
sulfonamides for 1575–1576
Parasomnias 1080–1081
Parasternal lift 315
in pulmonary stenosis 318
Parathar See Teriparatide
Parathion poisoning 1631–1632
Parathyroid gland
disorders of 1146–1155
adenoma/hyperplasia 1149–1150 1151 1153 1154
in multiple endocrine neoplasia 1150 1150 1191 1192
carcinoma 1150 1153 1154
thyroid surgery affecting 1125 1126 1140 1147
transplantation of tissue from, for hypoparathyroidism/tetany 1148
Parathyroid hormone 1146
calcium balance/imbalance and 877 1146
deficiency of See Hypoparathyroidism
hypersecretion of See Hyperparathyroidism
laboratory reference range for 1741
magnesium imbalances and 883
phosphate balance/imbalances and 880 882 1146
renal resistance to, in pseudohypoparathyroidism 1147
in uremic encephalopathy 910
in urinary stone disease 944 944 1149
Parathyroid hormone analog, for osteoporosis 1157–1158
Parathyroid hormone-related protein
in cancer-related hypercalcemia 879 1152 1690
in hypophosphatemia 882
Parathyroidectomy 1153
Paravaccinia 1388
Parenchymal cysts, in cysticercosis 1510 1512
Parenchymal lung disease
diffuse 275–280 275
mechanical ventilation causing 308
respiratory failure caused by 307
Parenteral fluids See Fluid management/hydration
Parenteral nutritional support 1281
acidosis and 887 890 1284
in burn injury 1598
complications of 1284–1285 1284
for Crohn's disease 625
electrolyte/mineral requirements and 1282
in HIV infection/AIDS 1322
patient monitoring during 1285
solutions for 1283–1284 1284
Paresis (general) See also Weakness
in syphilis 1444 1451
Paresthesias 988
in diabetes mellitus 1198
malabsorption and 600
in thoracic outlet syndrome 467 816
Paricalcitol, for hyperparathyroidism 1154
Parietal lobe lesions 1001
Parkinsonism 1004 1007–1010
drug-induced 1007 1013 1064
Parkinson's disease, idiopathic (paralysis agitans) See also Parkinsonism
Parkland formula, for fluid resuscitation in burns 1596 1597
Parnate See Tranylcypromine
Paromomycin (aminosidine) 1572 1573–1574
adverse effects of 1472
for amebiasis 1470 1471
for giardiasis 1480
for leishmaniasis 1482
Paronychia 138 139
Parotid glands 207
cysts of, in HIV infection/AIDS 217
in mumps 1365
sialadenitis affecting 208
tumors of 208
Parotitis, in mumps 1365
Paroxetine 1070 1072
adverse ocular effects of 178
overdose toxicity of, seizures/serotonin syndrome caused by 1637
Paroxysmal atrial fibrillation 377
Paroxysmal nocturnal dyspnea, in heart disease 313
Paroxysmal nocturnal hemoglobinuria 491–492
Paroxysmal supraventricular tachycardia 372–374
pregnancy and 416
Pars planitis (intermediate uveitis) 162
Partial mole 773
Partial pressure of carbon dioxide See PCO2
Partial pressure of oxygen See PaO2; PO2
Partial (focal) seizures 980–981 981 982 984
intracranial mass lesions causing 980
schizophrenia differentiated from 1058
transient ischemic attack differentiated from 982 989–990
Partial status epilepticus 986
Partial-thickness burn 1595
Partial thromboplastin time/activated partial thromboplastin time (PTT/aPTT)
in heparin therapy monitoring 287
laboratory reference range for 1741
prolonged 524 529
acquired factor VIII antibodies causing 527
in factor XI deficiency 528
in hemophilia A 526
in hemophilia B 528
lupus anticoagulant causing 532
in vitamin K deficiency 529
in von Willebrand's disease 524
Particle agglutination test (TPPA), for syphilis 1445
Partner abuse (domestic violence) 1081 1082
prevention of 16–17
Parvovirus B19 infection 1387
arthritis in 858 1387
rheumatoid arthritis differentiated from 829
erythema infectiosum and 1355 1387
during pregnancy 1387
PAS See Aminosalicylic acid
P.1843
Passive smoking (environmental tobacco smoke)
COPD and 238
health hazards of 5
asthma 227
cancer 5 267
during pregnancy 765
Pasteurella multocida, in bite infections 1296
Patanol See Olopatadine
Patch testing, in allergic contact dermatitis 114
Patellar tendinitis 825
Patellofemoral syndrome 824–825
Patent ductus arteriosus 324–325
Patent foramen ovale 320–322
Paternal age See Age/aging, paternal
Pathologic fractures
endocrine causes of 1102
in hypercalcemia/hyperparathyroidism 1151
malabsorption and 600
in osteoporosis 1155 1156
in renal osteodystrophy 911
Patient approach 1–19
Patient compliance/noncompliance See Compliance/noncompliance
Patient–doctor relationship See Doctor–patient relationship
Patient education
acne and 116
asthma management and 230
compliance and 1–2
cystic fibrosis management and 245
diabetes and 1217
HIV infection/AIDS prevention and 4 1319 1331
rheumatoid arthritis management and 829
Patient Health Questionnaire 1040
Patient surrogate, Durable Power of Attorney for Health Care designating 70
Pattern baldness 144
in women 144 1170 1172
Patulous auditory tube 183
Pauci-immune (ANCA-associated) glomerulonephritis 799 905 905–906 916 918
Pavor nocturnus (sleep terror) 1080
PAX-4 (Arg133Trp) mutation, in idiopathic type 1 diabetes mellitus 1196
Paxil See Paroxetine
Pb See Lead
PBG See Porphobilinogen
PBI See Penile-brachial index
PC-SPES, for prostate cancer 1702
PCEC (purified chick embryo cell culture) rabies vaccine 1314
PCI See Percutaneous coronary intervention
PCO2 885
in acid-base disorders 885 886
laboratory reference range for 1736
in metabolic acidosis 886
in metabolic alkalosis 886 892
in respiratory acidosis 886 893
in respiratory alkalosis 886 893 894
in respiratory failure 307
PCOS See Polycystic ovary syndrome
PCP See Phencyclidine
PCR See Polymerase chain reaction
PCV (pneumococcal conjugate vaccine) See Pneumococcal vaccine
PCWP See Pulmonary capillary wedge pressure
PDGF See Platelet-derived growth factor
PDT See Photodynamic therapy
Pea soup diarrhea, in enteric (typhoid) fever 1425
Peace pill 1088
Peak expiratory flow (PEF), in asthma 227 228
exacerbation management and 236 237
exacerbation severity and 229
Pediculosis 135–136
Pediculus humanus
var capitis 135
var corporis 135
Pedophilia 1052
intrafamilial (incest) 1052
PEEP See Positive end-expiratory pressure
Peer support groups See Support groups
PEF See Peak expiratory flow
PEG See Polyethylene glycol
Pegasys See Peginterferon
Pegfilgrastim
for chemotherapy-induced toxicity 1671 1678 1680
for infection in cancer/immunocompromised host 1694
Peginterferon, for hepatitis 660 661–662 1588
Pegintron See Peginterferon
Pegvisomant, for acromegaly/gigantism 1112
Pelger-Huet cells 507
Peliosis hepatis 1434
drugs/toxins causing 666
Pellagra 1274
Pelvic abscess
anaerobic 1435
in appendicitis 613
Pelvic appendicitis 613
Pelvic examination 934
in prenatal care 764 765
in rape victim 759
Pelvic floor disorders
constipation and 542
urinary incontinence and 948
uterine prolapse 741
Pelvic inflammatory disease (PID)/pelvic infection 741–743 1557
actinomycetes causing 1436
anaerobes causing 1435 1557
chlamydial 741 742 1441 1554 1557
gonococcal 741 742 1432 1433 1557
in HIV infection/AIDS 1329
IUDs and 742 755
painful intercourse and 747 748
Pelvic muscle (Kegel) exercises
for fecal incontinence 646 647
for urinary incontinence 63
Pelvic pain
in dysmenorrhea 731
in ectopic pregnancy 770
in endometriosis 740
in pelvic inflammatory disease 742
Pemberton's sign 1120
Pemetrexed 1666 1672
Pemphigoid, bullous 127
Pemphigoid (herpes) gestationis 127
Pemphigus 125–126
foliaceus/erythematosus 126
paraneoplastic 126
vulgaris/vegetans 126
HLA in 801
Pen injectors, for insulin administration 1216
Penbutolol 432
Penciclovir, for herpes simplex infections 109 1351 1353
Penetration, ulcer 587 594
back pain and 817
Penicillamine
adverse ocular effects of 179
for Wilson's disease 678
Penicillin 1560–1565
adverse effects of 1564–1565
allergy to 1564–1565
cross-reactivity and 1315–1316
with cephalosporins 1316
testing/desensitization treatment for 793 1315–1316 1564–1565
for anthrax prophylaxis/treatment 1412 1412
with b-lactamase inhibitors 1564
cost of 1561 1563
for endocarditis prophylaxis 1417–1418 1418 1418
extended-spectrum 1563–1564
for group B streptococcal infection prophylaxis in pregnancy 766
for Lyme disease 1461 1461
natural forms of 1560–1563
nutrients affected by 1260
penicillinase-resistant 1564
for pharyngitis 205–206 1401
for pneumonia 256
resistance to 1560
in pneumococcal infections 252 1404 1405
for rheumatic fever prophylaxis/treatment 406 1401
for syphilis 1446 1447 1448 1449 1451 1452 1563
therapy adjustments in renal or hepatic failure and 1559
toxicity of 1565
Penicillin-binding proteins 1560
Penicillinases (β-lactamases) 1560
penicillins combined with inhibitors of 1564
penicillins resistant to 1564
staphylococcal 1552
Penicillium marneffei infections 1546–1547
Penile-brachial index 453
Penile discharge See Urethral discharge
Penile pain 931
in epididymitis 933
Penile prostheses 952
Penile tumescence testing, nocturnal 951
Penis, examination of 933
Penlac See Ciclopirox
Pentamidine 1581–1582
for African trypanosomiasis 1464 1465
hypoglycemia caused by 1239 1542
for leishmaniasis 1481 1482 1483 1484
for Pneumocystis jiroveci infection chemoprophylaxis/treatment 1290 1335 1346 1347 1542
pneumothorax and 303
prophylactic 1290
therapy adjustments in renal or hepatic failure and 1559
Pentasa See Mesalamine
Pentazocine 74
Pentostam See Stibogluconate
Pentoxifylline, for alcoholic liver disease 665
PEP See Positive expiratory pressure (PEP) therapy
Peptic stricture of esophagus 567
dysphagia in 564 567
Peptic ulcer disease 586–591
back pain and 817
complications of 592–595
prevention of 590–591
dyspepsia in 536 587
gastric cancer and 591 598
gastric outlet obstruction and 594
gastrointestinal bleeding in 551 592–593
P.1844
Helicobacter pylori-associated 584 586 588 589
NSAID-induced 586–587 589–591 590 830
pharmacologic/medical management of 588–591 590
refractory 591
gastric cancer and 591 598
Zollinger-Ellison syndrome (gastrinoma) and 591 595
silent 587
gastrointestinal bleeding and 592
ulcer penetration and 587 594
ulcer perforation and 587 593–594
Zollinger-Ellison syndrome (gastrinoma) and 591 595 1178
Peptide hormone inhibitors, for cancer chemotherapy 1674
Peptide T-20 (enfuvirtide) 1338 1342
Peptidoglycans, penicillin action/resistance and 1560
Pepto-Bismol See Bismuth compounds
Peptostreptococci 1434
pneumonia caused by 255 1434
Perception of light (visual acuity) 151
Perceptual distortions
in delirium 1092
in schizophrenia/psychotic disorders 1058
Percocet See Oxycodone
Percodan See Oxycodone
Percussion See Chest percussion
Percutaneous coronary intervention (PCI) 330–331
for acute coronary syndromes 354 354
for angina 330–331
for myocardial infarction 360
prophylactic/preoperative 38 39 415
Percutaneous dilation tracheotomy 213
Percutaneous transhepatic cholangiography (PTC), in liver disease/jaundice 652
Percutaneous transluminal coronary angioplasty (PTCA)/stenting See also Percutaneous coronary intervention; Stents/stent grafts (“covered stents”), intracoronary
for angina 350–351
CABG compared with 351
for myocardial infarction 360 366
prophylactic/preoperative 38 39 415
Percutaneous valvuloplasty See Valvuloplasty
Perennial rhinitis 197
Perforation
in appendicitis 613
of colonic diverticula (diverticulitis) 632–633
ulcer 587 593–594
Performance anxiety 1044 1046
Performance status, cancer treatment response evaluated by 1688–1689
Perfusion scans
lung See Ventilation/perfusion scans
myocardial, in angina 345
Pergolide, for parkinsonism 1009
Pergonal See Menotropins
Periampullary carcinoma 699–701
Perianal cellophane tape test
for enterobiasis/pinworm infection diagnosis 1521
for T saginata diagnosis 1509
Perianal disease See also Anorectal disorders
abscesses and fistulas 647
in Crohn's disease 623 624
hematoma, thrombosed hemorrhoid causing 645
Perianal pruritus 133–134 648
in enterobiasis/pinworm infection 1521
Pericardial effusions 409
in Kawasaki syndrome 1399
malignant 408 1692–1694
in pneumococcal pneumonia 1404
Pericardial friction rub
in myocardial infarction 364
in pericardial effusion 409
in pericarditis 407
Pericardial tamponade See Tamponade
Pericardiectomy/pericardial window
for malignant effusions/neoplastic pericarditis 408 1694
for pneumococcal pericardial effusion 1404
for uremic pericarditis 408
Pericardiocentesis, for pericardial effusion/tamponade 409 414
Pericarditis
acute 407
bacterial 408
in chronic renal failure 408 909–910
constrictive 409–410
restrictive cardiomyopathy differentiated from 404 410
coxsackieviruses causing 407 1390
inflammatory 407–409
in myocardial infarction 364
neoplastic 408
pneumococcal 1403 1404
postmyocardial infarction/postcardiotomy (Dressler's syndrome) 364 408
radiation 408 1600
in systemic lupus erythematosus 413 834
tuberculous 407–408
uremic 408 909–910
viral 407
Pericardium, diseases of 407–410
in systemic lupus erythematosus 413 834
Perichondritis 181
Perihepatitis, pelvic inflammatory disease and (Fitz-Hugh and Curtis syndrome) 742
Peri-infectious glomerulonephritis 915 916
Perilymphatic fistula 184 191
Perindopril 434
Periocular pain See Ocular pain
Periodic breathing See Cheyne-Stokes respiration
Periodic leg movements of sleep 1013
Periodic paralysis 1037
hyperkalemic 874 1037
hypokalemic 874 1037
in hyperthyroidism 1137 1138 1142–1143
normokalemic 1037
Periodontal disease
anaerobic 1434
pneumonia and 255 1434
in HIV infection/AIDS 1326
Perioral dermatitis 115 118
Peripartum cardiomyopathy 417 778
Peripheral artery aneurysms 449–450
Peripheral nerve tumors, mononeuropathy caused by 1028
Peripheral neuropathies See also specific type and Neuropathies
Peripheral pulses See Pulses
Peripheral stem cells, for transplantation 802
Peripheral vascular disease See Vascular disorders
Peripheral vein nutritional support 1281
solutions for 1283
Peristalsis, disorders of See Motility disorders
Peritoneal carcinomatosis 562
Peritoneal cystadenocarcinoma, after prophylactic oophorectomy 1656
Peritoneal dialysis 912–913
for hyperkalemia 876 877
in older adult 930
for poisoning/drug overdose 1613
for renal failure 912–913
coagulopathy and 910
for rewarming in hypothermia 1591
Peritoneal effusions, malignant 1692–1694
Peritoneovenous shunts, for cirrhotic ascites 671
Peritoneum
diseases of 558–563 559
mesothelioma arising in 273 563
Peritonitis 1555
ascitic fluid analysis in 561
dialysis and 912–913
diverticulitis and 632
in familial Mediterranean fever 563
peptic ulcer perforation and 593
perforated appendicitis and 613
secondary bacterial 561
spontaneous bacterial 559 560–562
in cirrhosis 560 671
tuberculous 562
Peritonsillar abscess/cellulitis 206
anaerobic 1434
Permanent pacing See Pacemaker, permanent
Permethrin
for pediculosis 135
for scabies 134 135
Permissive hypercapnia 308
for asthma 237
Permitil See Fluphenazine
Pernicious anemia 487 488
carcinoid tumors and 585 599
gastritis and 487 585
subacute combined degeneration of spinal cord and 1016 1017
Pernicious vomiting of pregnancy 767
Peroneal nerve, common, injury to 1029
Peroxisome proliferator-activated receptor gamma (PPAR-g), thiazolidinediones affecting 1210
Perphenazine 1059 1060 1060
Persistent anovulation See Polycystic ovary syndrome
Persistent islet hyperplasia (noninsulinoma pancreatogenous hypoglycemic syndrome) 1237
Persistent vegetative state 1019
Personal relationships, social issues for terminally ill/dying patient and 83 83
Personality assessment, MMPI-2 in 1040
Personality changes
due to general medical condition (organic personality syndrome) 1092
in syphilis 1451
Personality disorders 1054–1056 1055
Pertussis (whooping cough) 1420
prevention of 1420
Pertussis vaccine, with diphtheria and tetanus toxoids (DTP/DTaP) 1304 1305–1306 1409 1414 1420
Pessary
for genital prolapse 741
for uterine prolapse 741
Pesticide poisoning
chlorinated agents 1622
cholinesterase inhibitors (anticholinesterases) 1631–1632
paraquat 1631
PET See Positron emission tomography
P.1845
Petit mal (absence) seizures 981 981 985
Petit mal (absence) status epilepticus 986
Petroleum products, toxicity/abuse of 1090 1632–1633 1633
aspiration and 294 1632 1633
Petrous apicitis 186
Peutz-Jeghers syndrome 636
gynecomastia in 1100
pigmentation disorders in 1100
Peyer's patches, in enteric (typhoid) fever 1425
Peyronie's disease 822
penile pain in 931
PF4 See Platelet factor 4
PFO See Patent foramen ovale
PGA See Polyglandular autoimmune syndrome
PGI2 See Prostacyclin
pH 885
in acid-base disorders 885 889
in alcoholic ketoacidosis 888
arterial blood 885
in diabetic ketoacidosis 887 1228
esophageal
monitoring 565
in chronic aspiration of gastric contents 294
in gastroesophageal/laryngopharyngeal reflux 210
gastric
nosocomial pneumonia and 253
in Zollinger-Ellison syndrome/gastrinoma 595
laboratory reference range (normal values) for 885 1741
in lactic acidosis 1233
in metabolic alkalosis 891 892
in near drowning 1602
pharyngeal, monitoring, in gastroesophageal/laryngopharyngeal reflux 210
pleural fluid, in parapneumonic effusion 301
in renal failure 909
in respiratory acidosis 893
in respiratory alkalosis 893 894
urine 934
cystine calculi and 946
in hyperchloremic metabolic acidosis 889 890
in renal tubular acidosis 889
stone disease and 944–945
struvite calculi and 946
uric acid calculi and 930 945 946
vaginal 731
venous blood 885
Phaeohyphomycosis 1550
Phalen's sign 821
Pharmaceuticals See under Drug
Pharmacotherapy See also under Drug
in elderly 49 64–66
Pharyngeal dysphagia 564
Pharyngeal pH monitoring, in gastroesophageal/laryngopharyngeal reflux 210
Pharyngitis 204–206 1556
antibiotics for 205–206
in diphtheria 205 1413
in epiglottitis 209
gonococcal 1432
in mononucleosis 205 1358 1359
nonstreptococcal exudative (adenovirus) 1386
in peritonsillar abscess and cellulitis 206
streptococcal 204–206 1400–1401 1556
glomerulonephritis and 915 1400
rheumatic fever after 405 1400 1401
Pharyngoconjunctival fever 156 1386
Pharynx 202–207
in HIV infection/AIDS 216–217
radiation affecting 1600
Phenacetin, in analgesic nephropathy 926
Phenazopyridine, for cystitis 34
Phencyclidine 1088 1627
aggressive/violent/psychotic behavior caused by 1058 1081 1088
Phenelzine 1072
overdose/toxicity of 1629
Phenindione, breast feeding and 785
Phenmetrazine, overdose/abuse of 1089
Phenobarbital 984 1045
for anxiety 1045 1046
breast feeding and 786
monitoring concentrations of 1734
nutrients affected by 1260
overdose/toxicity of 1624
hemodialysis for 1613
for seizures 983 984
during pregnancy 780
status epilepticus and 986
Phenolphthalein
for constipation, removal of from market 544
nutrients affected by 1260
Phenothiazines 1059 1059 1060 1060
adverse ocular effects of 178
lupus anticoagulant associated with 532
overdose/toxicity of 1060 1633
Phenotypic resistance testing, in antiretroviral therapy 1344–1345 1344 1345
Phenoxybenzamine, for benign prostatic hyperplasia 958 959
Phentermine, for obesity 1269
D-Phenylalanine derivative, for diabetes mellitus 1207 1209
Phenylbutazone
adverse ocular effects of 179
lithium interactions and 1077
Phenylephrine 789
Phenylethanolamine N-methyltransferase (PNMT), epinephrine deficiency and 1105
Phenylpropanolamine
in OTC medications, abuse of 1090
removal of from market 1618
Phenytoin 984
adverse ocular effects of 178
antidepressant drug interactions and 1074
for arrhythmias 369
monitoring concentrations of 1734
nutrients affected by 1260
overdose/toxicity of 1619
for seizures 983 984
status epilepticus and 986
Pheochromocytoma 1174–1178
headache in 32 1174
hypertension in 423–424 425 1174 1176 1177
mental status changes caused by 1103
in multiple endocrine neoplasia 1150 1174 1175 1192
orthostatic changes in blood pressure and 424
PHEX endopeptidase mutation, in osteomalacia/rickets 1159
Philadelphia chromosome 504
Phimosis 933
in chancroid 1433
Phlebitis See Thrombophlebitis
Phlebotomus, leishmaniasis transmitted by 1480
Phlebotomy
for hemochromatosis 677
for polycythemia 501
for polycythemia-related pulmonary hypertension 292
Phlegmasia cerulea dolens/phlegmasia alba dolens 471
Phlegmonous (necrotizing) gastritis 585
Phobic disorder 1044 1046–1047
Phonic tics, in Tourette's syndrome 1013
Phoria (latent deviation) 152
Phosphate See Phosphorus/phosphate
Phosphate crystals, in urine 935
Phosphate enema 543
Phosphatidylinositol class A (PICA) gene defect, in paroxysmal nocturnal hemoglobinuria 491
Phosphatonin (fibroblast growth factor 23/FGF-23) 880 881 882
in oncogenic osteomalacia 1159
in X-linked hypophosphatemic rickets 874 1159
Phosphaturia, osteomalacia and 1159
Phosphodiesterase inhibitors
for asthma 231–234 236
for erectile dysfunction 952 1054 1224
Phosphofructokinase, muscle, deficiency of 1102
Phosphoglycerate kinase deficiency 1102
Phosphorus/phosphate 880 1259
in calcium nephrolithiasis/hypercalciuria 943 944 945
deficiency of 1259
in osteomalacia/rickets 874 1159–1160
dietary/supplementary 1259
for diabetic ketoacidosis 1230–1231
for hyperglycemic hyperosmolar state 1232
for hypophosphatemia 882 1161
for osteomalacia 1161
requirements for
dietary reference intakes (DRIs) for 1256
in nutritional support 1282
restriction of in renal failure 912
disorders of concentration/metabolism of 880–883
genetic disorders associated with 874
in renal failure 911 1150
in hypocalcemia 878
laboratory reference range (normal values) for 866 1741
parathyroid hormone affecting 880 1151
urinary excretion of 881
Photoallergy 139–140
Photocoagulation, for diabetic retinopathy 167 1221
Photodermatitis/photosensitivity 92 139–140
drugs causing 140 147
tetracyclines 1571
in lupus erythematosus 105 140 835 835
Photodynamic therapy
for age-related macular degeneration 165
for esophageal cancer palliation 578
Photophobia 150
in ultraviolet keratitis 172
Photopsia (flashing lights) 151
in migraine headache 975
Photorefractive keratectomy (PRK) 153
Photoresection See Nd:YAG laser photoresection
Photosensitivity See Photodermatitis/photosensitivity
Phototherapy
for major depression with seasonal onset 1074
for psoriasis 98
P.1846
Phototoxicity 139–140
Berloque hyperpigmentation caused by 143
Phthirus pubis 135
Phycomycosis (mucormycosis) 1545
rhinocerebral 197
Phyllodes tumor of breast 703
Physical abuse See Abuse
Physical activity See Exercise/activity
Physical agents, disorders caused by 1589–1606
burn injury 1595–1599 1595
cold causing 1589–1592
drowning 1601–1603
electric shock causing 1599
heat (hot environment) causing 1592–1595
radiation causing 1599–1601
Physical examination See also specific disorder
in poisoning/drug overdose 1613–1614
Physical inactivity, prevention of 12–13
Physical instability See Falls; Gait/gait disorders
Physical therapy
for complex regional pain syndrome (reflex sympathetic dystrophy) 467 822
for rheumatoid arthritis 829
for spasticity 1016
for stroke patient 994
Physician
homeopathic 1730
relationship of with patient See Doctor–patient relationship
role of
in end-of-life care 68 68
in smoking cessation 7 8
Physician-assisted suicide 69
Physiologic drug dependence 1082
Physostigmine
for anticholinergic-type mushroom poisoning 1630
for atropine/anticholinergic overdose 1611 1620 1627
Phytanic acid metabolism, in Refsum's disease 1024
Phytoestrogens 1189
cancer prevention and 1647
Phytonadione
for anticoagulant overdose 1619
for hypoprothrombinemia, n cirrhosis 673
Phytotherapy, for benign prostatic hyperplasia 960
Pica, in iron deficiency anemia 482
PICA gene defect, in paroxysmal nocturnal hemoglobinuria 491
Pick's disease 56 1092
Pickwickian syndrome (obesity-hypoventilation syndrome) 305
PID See Pelvic inflammatory disease (PID)/pelvic infection
Piebaldism 143
PIF See Dopamine; Prolactin inhibitory factor
Pigeon-breeder's disease (bird-fancier's lung) 296
Pigmentary skin disorders 142–144
drugs causing 143 148–149
endocrine causes of 1100
Pigmented skin lesions 92–94 92 143
Pill-induced esophagitis 571
Pilocarpine
for chemotherapy/radiation-induced toxicity 1677 1683
for glaucoma/intraocular hypertension 161 173
Pilocarpine iontophoresis sweat test, in cystic fibrosis 245
Pilopine See Pilocarpine
Pimecrolimus 88
T-cell lymphoma and 96
Pimozide, for Tourette's syndrome 1014
Pindolol 432
Pineal tumor 1000
Pinguecula 157–158
Pingueculitis 158
Pink puffers 238 239
Pinta 1453–1454
Pinworm infection (enterobiasis/oxyuriasis) 1521–1522
Pioglitazone 1208 1210–1211
Piper methysticum (kava) 1712 1716–1717
Piperacillin 1563 1564
cost of 1561
therapy adjustments in renal or hepatic failure and 1559
Piperacillin-tazobactam 1564
cost of 1561
therapy adjustments in renal or hepatic failure and 1559
Piperazine, for ascariasis 1519
Pipracil See Piperacillin
Pirbuterol, for asthma 235
Piroxicam 76
Pit viper envenomation 1635–1636
Pitting (nail) 145
in psoriasis 97 145
Pituitary adenoma 999 1104
ACTH-secreting 1167 1168–1169
growth hormone-secreting 1110 1111
hypopituitarism caused by 1104
in multiple endocrine neoplasia 1104 1110 1113 1150 1191
prolactin-secreting 1113 1114 1114–1115
surgical resection/removal of 1106 1107 1111 1112 1115 1169
thyroid-stimulating hormone secreting 1135–1136 1138
Pituitary gland
disorders of 1103–1115
amenorrhea caused by 1183 1184
hormones produced by 1103
deficiency of
anterior hypopituitarism 1104–1108
posterior hypopituitarism 1108–1110
thyroid hormones affecting 1115
hyperplasia of, thyroid-stimulating hormone secretion and 1136
hypothalamic regulation and 1103–1104
tumors of 1104
Pityriasis
alba, in atopic dermatitis 95
rosea 99–100
drugs causing eruptions similar to 149
rubra pilaris 107
versicolor (tinea versicolor) 104
“Pizza-pie” retinopathy, in cytomegalovirus infection 1360
PKD1/PKD2 gene mutations 928
Placental disorders, third-trimester bleeding caused by 774 775
Plague 1430–1431 1553
Plague vaccine 1314 1431
Plakoglobin, in pemphigus vulgaris 125
Plan B, for emergency contraception 757
Plantar fasciitis 826
Plantar fibromatosis, Dupuytren's contracture and 822
Plantar hyperkeratosis of heels 129
Plantar warts 127 128 128–129
Plasma (effective circulating volume) 865
Plasma cell leukemia 515
Plasma cells, in myeloma 515 516
Plasma expanders, for shock 479
Plasma fractions/components See also Fresh frozen plasma
transfusion of 535
Plasma mixing test
in acquired factor VIII antibodies 527
in hemophilia A 526
for lupus anticoagulant detection 532
Plasma renin activity
in Addison's disease 1166
in hyperaldosteronism 1173
in hypertension 422 423
laboratory reference range for 1742
Plasmacytomas 515
Plasmapheresis
for hemolytic-uremic syndrome 522
for thrombotic thrombocytopenic purpura 521
for Waldenstr m's macroglobulinemia 518
Plasmodium
falciparum 1486–1498
follow-up for infection caused by 1497
resistant strains of 1489 1490 1491–1492 1496 1497
severe infection caused by 1497
malariae 1486–1498
ovale 1486–1498
vivax 1486–1498
resistant strains of 1490 1492 1496
Platelet-associated IgG 526
laboratory reference range for 1741
Platelet count
chemotherapy drug dosage adjustments and 1681 1681
in essential thrombocytosis 500 502
in idiopathic (autoimmune) thrombocytopenic purpura 518
laboratory reference range for 1741
in polycythemia 500 501
in preeclampsia-eclampsia 771 772
Platelet-derived growth factor, in myelofibrosis 503
Platelet factor 4, in heparin-induced thrombocytopenia 520
Platelet glycoprotein IIb/IIIa receptors See Glycoprotein IIb/IIIa receptors
Platelet-inhibiting agents See Antiplatelet therapy
Platelet transfusion 534–535
for disseminated intravascular coagulation 531
for gastrointestinal bleeding/variceal hemorrhage 553 573
for idiopathic (autoimmune) thrombocytopenic purpura 520
Platelets
acquired qualitative disorders of 525–526
aspirin/NSAIDs affecting function of 526 830–831
autoantibodies against 526
in idiopathic (autoimmune) thrombocytopenic purpura 518
congenital qualitative disorders of 523–526 523
drugs inhibiting See Antiplatelet therapy
in essential thrombocytosis 502
in myelofibrosis 503
in myeloproliferative disorders 526
in renal failure/uremia 526 910
in von Willebrand's disease 523 524
P.1847
Platinum-based chemotherapy, secondary malignancies and 1645
Platypnea 218
PLCO (Prostate, Lung, Colorectal, & Ovarian) Cancer Screening Trial 1656
Pleistophora species 1477
Plendil See Felodipine
Plethysmography, impedance, in venous thrombosis/pulmonary embolism 283
Pleural biopsy, in tuberculosis 258
Pleural diseases 299–304
occupational 297
respiratory failure caused by 307
Pleural effusions 299–303 300 301
drug-induced 298
in heart disease/failure 300 315 390
malignant 267 301 301 302 1692–1694
paramalignant 302
parapneumonic 301 301 302
in pneumococcal pneumonia 1403 1404
rheumatoid 310
tuberculous 258 301
Pleural fluid analysis 300–301 301
in anthrax 1412
in malignant effusion 301 301 1693
in pneumonia 251
Pleural friction rub
in pleural effusion 300
in pulmonary embolism 282
Pleural mesothelioma 273–274 1664
Pleuritis/pleuritic chest pain 299
in thoracic actinomycosis 1436
Pleurodesis, for malignant pleural effusion 302
Pleurodynia, epidemic (Bornholm disease) 1389
Plicamycin (mithramycin) 1675
for hypercalcemia, in cancer patients 1691
Plummer-Vinson syndrome 482 572
Plummer's disease (toxic adenoma of thyroid) 1135
PML See Progressive multifocal leukoencephalopathy
PML-RARa fusion gene 508
PMS See Premenstrual syndrome/tension
Pneumatic compression devices
for lymphedema 477
for venous thrombosis/pulmonary embolism prevention 284 286 471
Pneumaturia 932
Pneumocandins 1585
Pneumococcal (Streptococcus pneumoniae) infections 1403–1405 1552
drug resistance and 252 1404 1405
endocarditis 1403 1404 1418
immunization against See Pneumococcal vaccine
keratitis 158
meningitis 1295 1404–1405
pneumonia 248 251 252 1403–1404 1556
in HIV infection/AIDS 1323
Pneumococcal vaccine 3 252–253 1305–1306 1307–1309 1310–1311
for elderly 55 1310
in HIV infection/AIDS 4 1308 1310 1332
pregnancy and 1308
Pneumoconioses 295–296 295
Pneumocystis carinii See Pneumocystis jiroveci infection; Pneumocystis jiroveci pneumonia
Pneumocystis jiroveci infection
otitis 194
pentamidine-induced hypoglycemia and 1239 1542
pneumonia See Pneumocystis jiroveci pneumonia
prevention of 1290 1346–1347 1346
Pneumocystis jiroveci pneumonia (pneumocystosis) 249 253 256 1322–1323 1334 1335 1540–1542
CD4 T cell count and 1321 1321 1323 1346 1541
DLCO in 223 1323 1541
pentamidine-induced hypoglycemia and 1239 1542
pentamidine treatment/chemoprophylaxis and 1335 1346 1347 1542
pneumothorax and 303 304
prophylaxis of 1290 1542
Pneumocystosis See Pneumocystis jiroveci pneumonia
Pneumomediastinum 304
Pneumonia 247–256 248–249 1556
anaerobic 248 252 254 255 255–256 1434
in aspergillosis 1544
aspiration 294 295 1556
in anaerobic infections 255 1434
in community-acquired disease 252
drug use and 1298
in hospital-acquired disease 253
hydrocarbon toxicity and 294 1632 1633
bronchiolitis obliterans and (BOOP/cryptogenic organizing pneumonitis/COP) 246–247 276–278 278
chlamydial
C pneumoniae causing 249 251 252 1442 1556
in psittacosis 1441
community-acquired 247–253 1555
cough and 21 21
cytomegalovirus 1361
desquamative interstitial (DIP) 276–278
eosinophilic See also L ffler's syndrome
group A streptococci causing 1402
Haemophilus influenzae causing 248 251 254 1323 1422 1553
in HIV infection/AIDS/immunocompromised host 256 1322–1323 1334 1541 1542
aspergillosis causing 1544
CD4 T cell count and 1321 1321 1323 1346 1541
DLCO (diffusing capacity for carbon monoxide) in 223 1323
hospital-acquired (nosocomial) 253–255 1555
idiopathic fibrosing interstitial 276–278 277–278
in influenza 1383 1384
Legionnaire's 249 251 252 254 255 1423 1553 1556
in leptospirosis 1456
lipoid 294
in measles 1363
mercury vapor 1627
Moraxella catarrhalis causing 249 251 1422
nonspecific interstitial (NSIP) 276–278 277
in HIV infection/AIDS 1323
plague 1431
pleural effusion in (parapneumonic pleural effusion) 301 301 302
pneumococcal 1403 1404
pneumococcal 248 251 1403–1404
immunization against See Pneumococcal vaccine
pneumocystis See Pneumocystis jiroveci pneumonia
postoperative, risk factors for 41–42 41
prevention of 252–253
in Q fever 1398
respiratory syncytial virus causing 1381–1382
SARS 1385
treatment of
for hospitalized patients 252 254–255
for outpatients 252
usual interstitial (UIP) 276–278 277
varicella zoster virus 1356
during pregnancy 781 1356
ventilator-associated 253 254 308
viral 251
Pneumonia Patient Outcomes Research Team (PORT), pneumonia risks/mortality and 247–249 250
Pneumonitis See also Pneumonia
acute gastric aspiration causing 295
acute interstitial (AIP) 277
cryptogenic organizing (COP/idiopathic bronchiolitis obliterans with organizing pneumonia/BOOP) 246–247 276–278 278
cytomegalovirus 1361
hydrocarbon/petroleum distillates/solvents causing 294 1632 1633
hypersensitivity 296–297 296
mercury vapor 1627
nonspecific interstitial (NSIP) 276–278 277
in HIV infection/AIDS 1323
radiation 298–299 1600
usual interstitial (UIP) 276–278 277
Pneumoplasty, reduction, for COPD 242–243
Pneumothorax
acupuncture causing 1724
catamenial 303
Pneumocystis jiroveci pneumonia/pentamidine prophylaxis and 303 304 1347
spontaneous 303–304
chest pain in 303 344
dyspnea in 22–23
tension 303 304
traumatic 303
PNMT See Phenylethanolamine N-methyltransferase
PO2 See also PaO2
altitude affecting 224 224
laboratory reference range for 1741
in pulmonary embolism 281
relationship of to oxygen saturation 223–224 224
in respiratory failure 307 308
Podagra 811
Podophyllum resin (podophyllin/podofilox)
fetotoxicity of 91 128
for wart removal 128
for perianal warts 128 646
for vulvar warts 733
POEMS syndrome, hyperpigmentation in 1100
Poikilocytosis
in beta thalassemia major 486
in iron deficiency anemia 483
in myelofibrosis 503
Poisindex 1607
Poison control centers 1607
P.1848
Poison ivy/oak/sumac 113–115
Poisoning/drug overdose 1607–1638
abdominal x-rays in 1615
anion gap in 888 1614
antidotes for 1610 1611
arrhythmias in 1609 1609
coma caused by 1019 1607–1608 1608
eye decontamination in 172 1611 1617 1618
gastrointestinal decontamination in 1607 1611–1613
hypertension in 1609
hyperthermia in 1610
hypotension in 1608–1609
hypothermia in 1608
initial evaluation in 1607
laboratory tests in 1614–1615 1614 1615
osmolar gap in 872 1614 1614
patient observation and 1607
physical examination in 1613–1614
preventable deaths caused by 2
seizures in 1609–1610 1610
skin decontamination in 1610–1611 1617 1618 1632
toxicology screen in 1614–1615 1615
Poisonous mushrooms 1629–1631 1630
Poisonous snakes 1635–1636
Poliomyelitis 1366–1368
immunization against 4 1305–1306 1314 1367
Poliovirus vaccine 4 1305–1306 1314
Pollens, avoidance therapy for allergies caused by 788
Polyangiitis, microscopic See Microscopic polyangiitis
Polyarteritis See also Arteritis
neuropathy associated with 845 1026
nodosa 137 844–846
Polyarthralgia See Arthritis/arthralgia
Polyarthritis See Arthritis/arthralgia
Polycarbophil See Fiber, dietary
Polychondritis, relapsing 181 850–851
Polyclonal gammopathy 796
Polycystic kidney disease
autosomal dominant 927 928
intracranial aneurysms and 928
Polycystic ovary syndrome (persistent anovulation) 746–747
amenorrhea in 746 1184
hirsutism in 746 1170 1171
infertility and 746
obesity in 746 747 1099
Polycythemia 500–502 500 501
in chronic mountain sickness (Monge's disease) 1605
in cor pulmonale 412
hypertension and 422
pulmonary hypertension and 291 292
relative (“spurious”) 500 500 501 501
vera 500–502 500 501 1664
hepatic vein obstruction (Budd-Chiari syndrome) and 679
Polydipsia/thirst
in diabetes insipidus 1108 1109
in diabetes mellitus 1198 1198
in hypercalcemia/hyperparathyroidism 1150
hyponatremia caused by 869 1058
lithium causing 1076
psychogenic 869 1058
Polyendocrinopathy-candidiasis-ectodermal dystrophy, autoimmune 1147 1164–1165
Polyethylene glycol/PEG 3350
for constipation/preoperative bowel cleansing 543 544
for whole bowel irrigation 1612
Polyglandular autoimmune syndrome
Addison's disease in 1147 1164–1165
Hashimoto's thyroiditis in 1144
pigmentary disorders in 1100
type 1 1147 1164–1165
autoimmune hepatitis in 663
type 2 1165
Polyglandular failure (Schmidt's) syndrome 1144 1165 1201
Polymerase chain reaction (PCR) testing
in Lyme disease 1460
in viral infections 1349–1350
in Whipple's disease 604
Polymorphic reticulosis 201
Polymorphonuclear neutrophil count, joint fluid 807 808
Polymorphous light eruption 140
Polymyalgia rheumatica 820 846–847
immobility in elderly and 60
rheumatoid arthritis differentiated from 829
Polymyositis 840–842
autoantibodies in 836 841
cancer-related 840 841 1696
Polymyxins 1574
for ophthalmic disorders 175
Polyneuropathies 1023 1023–1028
acute idiopathic See Guillain-Barr syndrome
cancer-related 1005 1026
in diabetes mellitus 1223
in HIV infection/AIDS 1026 1325
in Lyme disease 1026 1459
in polyarteritis 845 1026
in sarcoidosis 1026
toxic 1026
Polypectomy, colonoscopic 634
Polyphagia with weight loss, in diabetes mellitus 1198 1198
Polypharmacy
in elderly 49 64–66 1094 1095
iatrogenic problems for hospitalized patient and 1096
Polyprenoic acid, in cancer prevention 1649
Polyps/polyposis 614
adenomatous 614
familial 635–636
nonfamilial 633–636
cervical 733
of colon 633–637
lower gastrointestinal bleeding and 555
colorectal cancer and 633 635–637 1643
gastric 596
hamartomatous 636
hyperplastic 614
juvenile familial 636
nasal 200
in allergic rhinitis 197 200
in schistosomiasis 1502
of small intestine 610 633
submucosal 614
vocal cord 210
Polyradiculoneuropathy
in cytomegalovirus infection 1361
in Guillain-Barr syndrome 1027
in HIV infection/AIDS 1026 1325
in Lyme disease 1026
Polyradiculopathy, in HIV infection/AIDS 1026 1325
Polysomnography 305 306
Polystyrene sulfonate, for hyperkalemia 876 877
Polysurgery (surgery proneness) 1096 1097
somatization disorder and 1048
Polyuria
in Cushing's syndrome 1168
in diabetes insipidus 1108 1109
in diabetes mellitus 1198 1198
in hypercalcemia/hyperparathyroidism 879 1150
lithium causing 1076
in tubulointerstitial disease 926
Pomeroy tubal resection 758
Pompholyx (vesiculobullous hand eczema/dyshidrosis/dyshidrotic eczema) 111–112
Ponstel See Mefenamic acid
Popliteal adventitial disease 456
Popliteal arteries
aneurysms of 449–450
abdominal aortic aneurysms and 447
thrombosis of 449
occlusion of 455–456
Popliteal entrapment syndrome 455–456
Popliteal pulse, in lower extremity occlusive disease 453
Popliteal tendinitis 825
Porcelain gallbladder 685 687
Porfimer, for photodynamic therapy in esophageal cancer 578
Pork, trichinosis transmitted by 1532
Pork insulin 1212
Pork tapeworm (Taenia solium) 1508 1509 1510
PORN See Progressive outer retinal necrosis
Porphobilinogen, urinary
laboratory reference range for 1741
in porphyria 1703
Porphobilinogen deaminase, deficiency of in porphyria 1703
Porphyria
acute intermittent 1024–1025 1703–1704 1704
cutanea tarda 112
photodermatitis and 139 140
mental status changes in 1103 1703
peripheral nerve involvement in 1024–1025 1703
variegate 1024–1025
Porphyrins, urine, in porphyria cutanea tarda 112
PORT (Pneumonia Patient Outcomes Research Team), pneumonia risks/mortality and 247–249 250
Portal decompression, for esophageal varices 575
Portal hypertension
ascites in 558 559 559
cirrhosis and 670
malignant 562
esophageal varices in 551–552 573 574
gastrointestinal bleeding in 551–552
noncirrhotic 680
in schistosomiasis 1502
Portal hypertensive gastropathy 583
gastrointestinal bleeding in 552 583
Portal vein thrombosis, noncirrhotic portal hypertension caused by 680
Portosystemic shunts
emergency/surgical, for esophageal varices 575
rebleeding prevention and 576
transvenous (transjugular) See Transvenous (transjugular) intrahepatic portosystemic shunts
P.1849
Posaconazole 1548 1550
Positioning vertigo 191
Positive end-expiratory pressure (PEEP)
for ARDS 310
for near drowning victim 1602
Positive expiratory pressure (PEP) therapy, in cystic fibrosis 245
Positive inotropic agents See also Digitalis/digitalis glycosides
for cardiac failure 394–395
Positive-pressure breathing
for COPD 242
intermittent (IPPB), prevention of postoperative pulmonary complications and 42
Positive-pressure ventilation
noninvasive (NPPV)
for COPD 242
for respiratory failure 308
for respiratory failure 308
Positron emission tomography (PET)
in angina 345
in cancer staging 1658
lung cancer and 268–270 270
thyroid cancer and 1125 1128
in solitary pulmonary nodule 266
in tumor size evaluation 1686
Postcapillary pulmonary hypertension 290
Postcardiotomy/postmyocardial infarction pericarditis (Dressler's syndrome) 364 408
Postcholecystectomy syndrome 685 688
Postcoital/emergency contraception 757
IUD for 755 757
Postcoital test, in infertility workup 748–749
Postdysenteric colitis 1472
Postepileptic automatism 982
Posterior synechiae, in uveitis 162
Posterior uveitis 162
Postgastrectomy alimentary hypoglycemia 1234 1234 1238
Postgonococcal urethritis/cervicitis 1432 1441
Postherpetic neuralgia 110 979 1357 1358
Posthypercapnia alkalosis 892 893
Posthypocapnia acidosis 890 894
Postinfarction angina/ischemia 361
Postinfectious bronchiolitis obliterans 246
Postinfectious glomerulonephritis 915 916 917 1400
Postinfectious irritable bowel syndrome 615–616
Postinflammatory hyperpigmentation 143
Post-kala azar dermal leishmaniasis 1483
“Post-Lyme disease syndrome” 1461 1462
Postmenopausal depression (involutional melancholia) 760 1187
Postmenopausal vaginal bleeding 730
endometrial carcinoma and 738
Postmicturition syncope 384
Postmyocardial infarction/postcardiotomy pericarditis (Dressler's syndrome) 364 408
Postnasal drip, cough caused by 21 22 219
Postpartum depression 1066 1103
Postpartum infection
anaerobic 1435
mastitis 787
streptococcal 780
Postpartum psychosis 1066
Postpartum thyroiditis 1136 1144 1146
HLA in 801
Postpoliomyelitis syndrome 1367
Postprandial (reactive) hypoglycemia 1234 1234 1238
after ethanol ingestion 1238
Postrenal azotemia 901 902
Posttransplant lymphoproliferative disorder 1359
Posttraumatic epilepsy/seizure disorder 980
Posttraumatic headache 977
Posttraumatic stress disorder 1042 1082
Posttraumatic syringomyelia 1021
Posttraumatic vertigo 191
Postural drainage
in bronchiectasis 244
in COPD 242
in cystic fibrosis 245
Postural hypotension See Orthostatic (postural) hypotension
Postural instability See Falls; Gait/gait disorders
Postvoid dribbling 932
Potassium 1259
dietary/replacement 1259 1279
for diabetic ketoacidosis 1230
diuretic use and 1279
in fluid management 894 895
for hyperglycemic hyperosmolar state 1232
hypertension and 422 1279
for hypokalemia 874–875
for renal tubular acidosis 891
requirements for in nutritional support 1282
restriction of, in chronic renal failure 912
disorders of concentration of 873–876
genetic disorders associated with 874 874
in renal tubular acidosis 889 889
laboratory reference range (normal values) for 866 873 1741
Potassium channel blocking drugs, for arrhythmias 368 370
Potassium chloride See Potassium, dietary/replacement
Potassium concentration gradient, transtubular (TTKG) 874
Potassium iodide, in table salt, goiter prevention/treatment and 1131
Potassium-sparing diuretics
for cardiac failure 391
lithium interactions and 1077 1077
Potentization, in homeopathy 1729
Potomania, beer 869
Pott's disease 860
POU1F1 gene mutation, in pituitary hormone deficiency 1104
Pouchitis 630
Poultry, influenza transmission and 1383 1384
Powassan virus 1371
Power of attorney, durable, for health care 70
Poxvirus infections 1387–1389
PPAR-γ See Peroxisome proliferator-activated receptor gamma
PPARg gene, thyroid cancer and 1123
PPD (purified protein derivative) test 258–259 259
PPV (pneumococcal polysaccharide vaccine) See Pneumococcal vaccine
PRA See Plasma renin activity
Prader-Willi syndrome 1098
Pralidoxime, for cholinesterase inhibitor (anticholinesterase) poisoning 1611 1632
nerve agents in chemical warfare and 1622
PrameGel See Pramoxine
Pramipexole, for parkinsonism 1009
Pramosone See Hydrocortisone; Pramoxine
Pramoxine 89
Prandin See Repaglinide
Pravachol See Pravastatin
Pravastatin 1242 1250 1251
Prax See Pramoxine
Prayer, in complementary/alternative medicine 1709
Praziquantel
for clonorchiasis/opisthorchiasis 1506
for cysticercosis 1512
for hydatid cysts 1514 1515
for paragonimiasis 1507
for schistosomiasis 1503–1504
for tapeworm infections 1509
Prazosin
for benign prostatic hyperplasia 958 959
for hypertension 437 438
Pre-Gen Plus See Multitarget DNA tests
Prebreakfast hyperglycemia 1218–1219 1219
Precholecystectomy syndrome 687–688
Precordial pulsations 315
Precose See Acarbose
Prediabetes 1203
PredMild See Prednisolone
Prednicarbate 87
Prednisolone
for asthma 232 235
for ophthalmic disorders 174–175
Prednisone 1192 1193
for allergic contact dermatitis 115
for asthma 232 235 236
for autoimmune hepatitis 663
in cancer chemotherapy 1674
for giant cell arteritis 847
for idiopathic (autoimmune) thrombocytopenic purpura 519
for minimal change disease 921
for pneumocystosis 1542
for polymyalgia rheumatica 847
Preeclampsia-eclampsia 771–773 772 779
antihypertensive therapy in 773 779
in gestational trophoblastic disease 774
headache and 32
late-onset (postpartum) 773
Preexcitation syndromes 374
Pregnancy 763–787
air travel during 767 1606
alcohol use during 764–765 1084
amenorrhea (primary/secondary) caused by 1183 1184 1185
anemia during 775
antidepressant use during 1070
antipsychotic drug use during 1063
appendicitis during 613 782
ascariasis during 1518
asthma during 776
biliary colic during 685
bleeding during
in gestational trophoblastic disease 773–774
third-trimester 774–775
breast cancer and 716 724 726 782
breast cancer risk and 705 706
cardiac disease and 416–417
cardiomyopathy of (peripartum cardiomyopathy) 417 778
cardiovascular changes during 416
cardiovascular complications of 417
Chlamydia trachomatis infection and 780
cholecystectomy and 685 782 783
choledocholithiasis during 782–783
P.1850
cholelithiasis/cholecystitis during 685 782–783
cholestasis/jaundice of 651 782–783
S-adenosylmethionine (SAMe) for 1719
cytomegalovirus infection during 1360
diabetes insipidus and 1108
diabetes mellitus and 776–777 777 1226
screening for 765 777
diagnosis/differential diagnosis of 763
drug/medication use/avoidance during 763 764
topical therapy and 91
ectopic 769–771
hCG levels in 763 770
IUDs and 755
fatty liver of 667 779–780
folic acid deficiency during 489 766–767 775
gallbladder disease/surgery during 685 782–783
glycosuria during 1201
gonorrhea and 780
group B streptococcal infection and 766 780 1402
hCG levels in 763
heart disease and 416–417 777–778 778
hepatitis B and 653
vaccination recommendations and 657 764 1308 1311
hepatitis C and 655
hepatitis E and 655 657
herpes (pemphigoid) gestationis during 127
herpes infection during 778–779
heterotopic 770
HIV infection/AIDS in 776 1333
hypertension and 416–417 424 771–773 772 779
hyperthyroidism during 781 1136 1142
hypothyroidism during 781 1133–1134
immunizations during 767
influenza vaccination during 757 1308
iron deficiency anemia during 481–482 766 775
IUDs and 755
leg cramps during 1102–1103
listeriosis during 1414
lupus anticoagulant-anticardiolipin-antiphospholipid antibody syndrome and 775 776 837
luteoma of 1171
Lyme disease and 1458 1462
malaria chemoprophylaxis during 1496
manifestations of 763
Marfan's syndrome and 416
mask of (chloasma/melasma) 143 1100
oral contraceptive use causing 143 753 1100
maternal virilization during 1171
measles during 1363
medical conditions complicating 775–782
mitral stenosis and 329 330
MMR vaccination and 1304 1306 1308
molar (hydatidiform mole) 773–774
hyperthyroidism in 774 1136
myomectomy during 738
nutrition in 764 766–767 1254 1256 1257
ovarian tumors during 783
parathyroidectomy during 1153
parvovirus B19 infection in 1387
preeclampsia-eclampsia in 771–773 772
prenatal care and 763–766
prolactin levels in 1113
prolactinoma in 1114
radiation exposure during 765 1600 1601
respiratory alkalosis in 893
Rh incompatibility and 783
testing for 765
rubella exposure/rubella vaccination during 1304 1306 1308 1368 1368–1369
scabies during 134
screening tests in 764
seizures and 780
in eclampsia 771 772 773
sexually transmitted disorders and 780
sickle cell anemia and 775
smoking during 765
bupropion therapy for cessation and 11
nicotine therapy for cessation and 9 10
streptococcal infection and 766 780 1402
surgical complications during 782–783
syphilis during 780 1452–1453
termination of
by delivery
in acute fatty liver of pregnancy 779
in diabetic patient 777 1226
in preeclampsia-eclampsia 771 772 773
by elective abortion See Abortion, elective/induced
by recurrent (habitual) abortion 769
by spontaneous abortion 768–769
thyroid disease during 781
hyperthyroidism 781 1136 1142
hypothyroidism 781 1133–1134
thyroid cancer 1127
toxoplasmosis during 1498 1500 1501
travel and 767 1606
traveler's diarrhea during 1301
trophoblastic disease and 773–774
tuberculosis/tuberculosis treatment during 262 781
ultrasonography during 765
ectopic pregnancy and 770
urinary tract infection during 782
varicella (chickenpox)/varicella vaccine during 780–781 1308 1312 1356 1357
vomiting of 538 767
acupuncture for 1728–1729
weight gain in 766
Pregnancy-associated plasma protein-A (PAPP-A), testing for 764
Pregnancy tests 763
in amenorrhea 1185
in ectopic pregnancy 763 770
for rape victim 759
in spontaneous abortion 768
Prehn's sign 933
Prehypertension 419 420
Preleukemia (myelodysplastic syndromes) 506–507
sideroblasts/sideroblastic anemia and 486 506
Premarin cream See Estrogen vaginal creams
Premature beats
atrial (supraventricular/atrial extrasystoles) 372
in myocardial infarction 361
ventricular (ventricular extrasystoles) 379
in myocardial infarction 362
Premature ejaculation 951
Premature (preterm) labor, prevention of 783–784
Premature ovarian failure 1184–1185
Premenopausal bleeding See also Menstruation; Vaginal bleeding
abnormal 728–730
Premenstrual dysphoric disorder 1066 1103
Premenstrual syndrome/tension 730–731
Premphase See Estrogens, with progestins
Prempro See Estrogens, with progestins
Prenatal care 763–766
Prenatal testing/diagnosis 740
for Down's syndrome 765
maternal age and 764 765
for muscular dystrophy 1036
for sickle cell disease 493 775
for toxoplasmosis 1501
Prenatal vitamins 766–767
Preoperative evaluation/perioperative management 35–48
asymptomatic patient and 35–36 36
cardiovascular disease and 36–41 36 37 38 39
endocrine disorders and 44–46 45
hematologic disorders and 43–44
liver disease and 42–43
neurologic disorders and 44 44
physiologic effects of anesthesia and surgery and 35
pulmonary disorders and, for non-lung resection surgery 41–42 41
renal disease and 46 46
surgical site infections and 46–48 47
Prepatellar bursitis 823
Prerenal azotemia 901–902 901
in hyperglycemic hyperosmolar state 1232
Presbyacusis 51 52 180 187–188
Presbyopia 154
Preservatives, in ocular preparations, toxic and hypersensitivity reactions to 177
Pressure sores (decubitus ulcers) 140–141 141
bed rest/immobility and 60 140–141
Preterm (premature) labor, prevention of 683–684
Pretibial fever 1456
Pretibial myxedema (Graves' dermopathy) 1135 1137 1142
Preven, for emergency contraception 757
Preventive care 2–19
in elderly 55–56
recommendations for 3
Prevotella
melaninogenica 1434 1552
pneumonia caused by 255 1434
oropharyngeal strains of 1434 1552
Priapism (prolonged painful erection) 931
trazodone causing 1071 1080
vasoactive therapy for erectile dysfunction causing 952 1224
Primaquine
for malaria chemoprophylaxis/treatment 1489 1490 1493–1494 1496
resistance to 1492
for Pneumocystis jiroveci infection 1335 1542
Primary effusion (body cavity) lymphoma 1362
Primary sclerosing cholangitis 690–692
in HIV infection/AIDS 691 1326
Primaxin See Imipenem
Primidone 984
breast feeding and 786
monitoring concentrations of 1734
nutrients affected by 1260
for seizures 983 984
Primum atrial septal defect 320
P.1851
Prinivil See Lisinopril
Prinzmetal's (variant) angina 347
Prion disease 1374–1375
Pristinamycin 1579
Pritikin Diet 1247
PRK See Photorefractive keratectomy
Probenecid
allopurinol interactions and 814
for gout 813
Problem drinking 1083 1084–1085
differential diagnosis of 1084
Procainamide
antidepressant drug interactions and 1074
for arrhythmias 369
ventricular tachycardia 379
monitoring concentrations of 1734
overdose/toxicity of 1634
Procarbazine 1672
antidepressant drug interactions and 1074
Procardia See Nifedipine
Prochlorperazine 540 1682
overdose/toxicity of 1633
Procidentia 741
Proctitis 645–646
chlamydial infection causing 1440
diarrhea and 545
radiation 555 556 1683
in ulcerative colitis 628
Proctocolectomy, for familial adenomatous polyposis 635
Proctocolitis 645
Proctosigmoidoscopy See also Sigmoidoscopy
Procyclidine 1004
Progesterone
in estrogen replacement therapy 1187 1188 1645
receptors for, in breast cancer 716–717
hormone therapy and 716–717 720 721–722
prognosis and 724
serum levels of, in infertility workup 749
topical 1187
Progesterone-releasing IUDs 1187
Progestin minipill 752 753–754
abnormal premenopausal bleeding caused by 729 754
Progestins
for abnormal premenopausal bleeding 729
in amenorrhea evaluation 1185
in cancer chemotherapy 1673
in combination oral contraceptives 751 751–752
in estrogen replacement therapy 1186 1187 1188 1645
long-acting (contraceptive injections/implants) 754
oral 1187
for postmenopausal vaginal bleeding 730
Proglottids, tapeworm 1508
Programmed cell death (apoptosis), P53 regulation of, cancer etiology and 1641
Progressive bulbar palsy 1022
Progressive massive pulmonary fibrosis 296
Progressive multifocal leukoencephalopathy 1324–1325 1375
Progressive outer retinal necrosis (PORN), varicella zoster virus causing 1356–1357
Progressive spinal muscular atrophy 1022
Progressive supranuclear palsy, parkinsonism differentiated from 1008
Proguanil 1495
with atovaquone (Malarone) 1488 1489 1490 1493 1495 1496 1497
emergency self-treatment and 1488
resistance to 1492 1493
with chloroquine 1488 1495
with dapsone (Lapdap) 1488
in pregnancy 767
resistance to 1491
Proinsulin, in insulinoma 1235
Projective psychiatric tests 1040
Prolactin (PRL) 1113
serum levels of See also Hyperprolactinemia
in gynecomastia 1100
infertility and 749 1114
laboratory reference range for 1741
in pseudoseizure identification 983 1048
Prolactin (PRL) inhibitory factor (PIF) 1113
Prolactinoma 1113 1114 1114–1115 1191
Prolixin See Fluphenazine
Promazine, overdose/toxicity of 1633
Promethazine 540
Prometrium See Progestins
Pronator teres syndrome 1028
Pronouncement (death) 84–85
PROP1 gene mutation, in pituitary hormone deficiency 1104 1105
Propafenone 369
for atrial fibrillation 377
self-administered, for paroxysmal episodes 377
overdose/toxicity of 1634
Propecia See Finasteride
Prophylactic antibiotics See Antimicrobial chemoprophylaxis
Propine See Dipivefrin
Propionibacterium acnes 115 117
Propionyl-L-carnitine, for lower extremity occlusive disease 454
Propoxyphene
benzodiazepine interactions and 1046
overdose/toxicity of 1631
Propranolol See also Beta-adrenergic blocking drugs
antidepressant drug interactions and 1074
for arrhythmias 369
for Graves' disease/hyperthyroidism 1138
for hypertension 432
for migraine prophylaxis 976
overdose/toxicity of 1620
Proptosis (exophthalmos) 152–153
in dysthyroid eye disease 170 1137 1141
Propylene glycol, lactic acidosis and 887
Propylthiouracil
for Graves' disease/hyperthyroidism 1138–1139 1139
during pregnancy/lactation 781 1139 1142
Prosom See Estazolam
Prosopagnosia, intracranial mass lesions causing 1001
Prostacyclin, for pulmonary hypertension 292
Prostaglandin analogs See also specific agent
for glaucoma/intraocular hypertension 161 173–174
Prostaglandins
for elective abortion 758
in erectile dysfunction 952
vascular evaluation and 951
NSAIDs affecting 74 830
Prostate, Lung, Colorectal, & Ovarian (PLCO) Cancer Screening Trial 1656
Prostate gland
benign hyperplasia of 954–961 956 958 959
biopsy of 962–963
cancer of 961–966 963 964 966 1664
diet and 1647
finasteride in prevention of 1653
HER-2/neu overexpression in 1644
hormone therapy for 966 966 1670–1671
incidence/risk/mortality of 962 1639 1640 1640
paraneoplastic syndromes associated with 1696–1697
PC-SPES for 1702
screening for 14–16 15 963–964 963 1656 1687
in elderly 55
selenium in prevention of 1651
staging of 964 964 1658
testosterone replacement therapy and 1182
tumor markers for 962
vitamin E in prevention of 1650–1651
examination of 956–957
inflammation/infection of See Prostatitis
minimally invasive surgery on, for benign prostatic hyperplasia 960–961
transurethral balloon dilatation of 961
transurethral electrovaporization of 961
transurethral incision of (TUIP) 959 960
transurethral needle ablation of (TUNA) 961
transurethral resection of (TURP) 960
Prostate-specific antigen (PSA)
in benign prostatic hyperplasia 957
laboratory reference range for 1741
in prostate cancer 962
response to chemotherapy evaluated by 1687
screening and 14–16 15 962 963–964 1656
Prostate-specific antigen (PSA) density, in cancer screening 963–964 1687
Prostate-specific antigen (PSA) velocity, in cancer screening 963
Prostatectomy
open, for benign prostatic hyperplasia 959 960
radical, for prostate cancer 965
transurethral laser-induced (TULIP), for benign prostatic hyperplasia 960–961
transurethral (TURP), for benign prostatic hyperplasia 959 960
Prostatic pain 931
in acute bacterial prostatitis 940
Prostatitis
acute bacterial 939 940 942
chronic bacterial 939 940–941 942
gonococcal 1431 1432
nonbacterial 941–942 942
zinc in resistance to 937
Prostatodynia 942 942
Prostep See Nicotine, replacement therapy for smoking cessation
Prostheses
arterial/endovascular See Bypass grafting
for joint replacement
coagulase-negative staphylococcal infection and 1408
septic arthritis and 856
penile 952
P.1852
Prosthetic heart valves 338–339
anticoagulant therapy and 338–339
endocarditis and 1419
pregnancy and 339
endocarditis and 1415 1419
Protease, in pancreatic enzyme supplements 699
Protease inhibitors 1337–1338 1340–1341
antituberculous drug interactions and 261
in combinations 1340 1342 1343
resistance to 1345
Protein
ascitic fluid 560 561
cerebrospinal fluid, in CNS infection 1294
dietary 1253–1257
deficiency of (protein-energy malnutrition) 1264–1267
digestion of 601
requirements for 1253–1257 1257
dietary reference intakes (DRIs) for 1257
in nutritional support 1282
restriction of See Protein-restricted diet
in urinary stone formation 944
total serum
laboratory reference range (normal values) for 1742
in liver disease/jaundice 651
urinary 896
ratio of to urinary creatinine 897
Protein C
activated, in disseminated intravascular coagulation 530
deficiency of, warfarin-induced skin necrosis in 532
laboratory reference range for 1741
recombinant (drotrecogin alfa), for bacteremia/sepsis/shock 480 1424
Protein-calorie undernutrition See Protein-energy malnutrition
Protein:creatinine urinary concentration 897
Protein electrophoresis
laboratory reference range for 1741
urinary, in overload proteinuria 897
Protein-energy malnutrition 1264–1267
Protein-losing enteropathy 601 614–615 614
in measles 1363
Protein malnutrition, in nephrotic syndrome 920–921
Protein-restricted diet 1279
for acute tubular necrosis 904
for chronic renal failure 911–912 1279
in diabetes mellitus 1205 1222
for hepatic encephalopathy 672 1279
for nephrotic syndrome 921
for urinary stone disease 944
Protein S, laboratory reference range for 1742
Proteinosis, pulmonary alveolar 279–280
Proteinuria 896 896–897
Bence Jones (light chain in urine) 897
in myeloma 515 929
renal toxicity and 904
in diabetes mellitus/diabetic nephropathy 923 1222
by dipstick 897 934
in glomerulonephritis 906
in IgA nephropathy 917
in membranous nephropathy 922
in nephrotic syndrome 919–920
in preeclampsia-eclampsia 771 772
in sickle cell disease/glomerulopathy 929 930
in systemic lupus erythematosus 835
in tubulointerstitial disease 926
Proteomics, in cancer study 1642
Proteus
miribilis 1553
vulgaris 1553
Prothrombin, des-gamma-carboxy, in hepatocellular carcinoma 682
Prothrombin time
in alcoholic liver disease 664 665
in anticoagulant overdose/toxicity 1618 1619
laboratory reference range (normal values) for 1742
in liver disease/jaundice 651
prolonged 529
in vitamin K deficiency 529
Proton pump inhibitors 588
for Barrett's esophagus 567
for dyspepsia 536
gastrin levels affected by 595
for gastroesophageal reflux disease/esophagitis 567 568 568–569
in H pylori eradication therapy 589 590
H pylori test results affected by 584 588
for NSAID gastritis 583
for NSAID toxicity mitigation 590 591 830
for peptic stricture 567
for peptic ulcer disease 588 589 590 590 591
bleeding management and 553–554 592
prevention and 590 591 830
refractory ulcers and 591
in scleroderma 839
for stress gastritis 583
for Zollinger-Ellison syndrome/gastrinoma 596 1178
Protopam See Pralidoxime
Protopic See Tacrolimus (FK506), topical
Protoporphyrin, free erythrocyte, laboratory reference range for 1738
Protozoal infections 1463–1501
Protriptyline 1072
Proventil See Albuterol
Provera See Progestins
Providencia 1553
Provocation testing See also specific test
in food and drug allergies 793–794
Proximal renal tubular acidosis 889 889 890
genetic defects associated with 874
Prozac See Fluoxetine
PrPC/PrPSc, in prion disease 1374
PRSS1 gene, in chronic pancreatitis 697
Pruritus (itching) 92 132–137
ani 133 134 648
tinea causing 102
anogenital 133–134 648
in enterobiasis/pinworm infection 1521
in biliary cirrhosis 675
in cutaneous larva migrans 1519
in diabetes 1198 1198
drugs causing 148
drugs for
systemic 91
topical 89 91 134
of ear canal 182
of eye 150
in hookworm disease 1525
in onchocerciasis 1528
in polycythemia 500
in renal failure/uremia 133 907
vulvae 133
PS-341 See Bortezomib
PSA See Prostate-specific antigen
Pseudallescheria boydii, opportunistic infections caused by 1547
Pseudoachalasia 580
Pseudoachromia 143
Pseudo-addiction, pain management in terminally ill/dying patient and 73
Pseudoallergic (anaphylactoid) reactions 791 795
Pseudoaneurysm
femoral 450
gastrointestinal bleeding and 552
myocardial rupture and 364
Pseudobacteremia 1292
Pseudobulbar palsy 1022
Pseudoclaudication, of spinal stenosis 820
Pseudocysts, pancreatic 694 695
Pseudodementia 1092
in elderly 1094
Pseudoephedrine 789
monoamine oxidase inhibitor interactions and 1074
Pseudoepileptic seizures See Pseudoseizures
Pseudofolliculitis 119
Pseudogout 812 814
Pseudohermaphroditism, amenorrhea in 1183
Pseudohypoaldosteronism type I 874
Pseudohypoaldosteronism type II (Gordon syndrome) 874
Pseudohyponatremia 867
Pseudohypoparathyroidism 1147
Pseudomembrane, in diphtheria 205 1414
Pseudomembranous colitis 619
Pseudomonas aeruginosa 1553
burn wound infection caused by 1597–1598
eye medications contaminated by 177
hot tub folliculitis caused by 118 119
keratitis caused by 158
malignant external otitis (skull base osteomyelitis) caused by 182 186
pneumonia caused by 248 252 253 254
Pseudomonic acid See Mupirocin
Pseudo-obstruction, intestinal
acute (Ogilvie's syndrome) 608–609
chronic 609–610
Pseudopapilledema (optic disk drusen) 169
Pseudoporphyria 112
Pseudopseudohypoparathyroidism 1147
Pseudoseizures 983 1048
Pseudotumor
cerebri 1005–1006
lithium use and 1076
of gallbladder 687
pleural effusion and 302
Pseudo-von Willebrand disease 523 525
Psilocybin 1087 1630
hallucinogenic (Psilocybe) mushroom poisoning and 1629 1630 1630
Psittacosis (ornithosis) 1441–1442
Psoas sign, in appendicitis 612 613
Psoralen plus ultraviolet A (PUVA) therapy, for psoriasis 98
Psoriasiform eruptions, drugs causing 149
Psoriasis 97–99
arthritis and 97–98 853–854
drugs affecting 149
exfoliative dermatitis and (erythrodermic psoriasis) 97 107
in HIV infection/AIDS 857 1328
P.1853
HLA in 801 851 853
tinea infections differentiated from 102 103
Psoriatic arthritis 97–98 853–854
HLA in 851 853
Psoriatic erythroderma 97
PSTI gene, in chronic pancreatitis 698
Psychedelic drug abuse 1087–1088
Psychiatric history/interview 1038
Psychiatric/psychologic disorders 1038–1097
assessment of 1038–1040 1039
chest pain and 581
consultation and 1041
in elderly 1094–1095
urinary incontinence and 62
hospitalization for 1041
hospitalization and medical/surgical disorders and 1095–1097
irritable bowel syndrome and 615 616 618
treatment approaches in 1040–1041
in Wilson's disease 678
Psychodiagnostics, Rorschach 1040
Psychogenic polydipsia 869 1058
Psychologic challenges, for terminally ill/dying patient 82–83
Psychologic disorders See Psychiatric/psychologic disorders
Psychologic drug dependence 1082
Psychologic testing 1040
Psychopathic (antisocial) personality disorder 1054 1055
Psychosexual disorders/dysfunction 1052–1054
Psychosurgery, for obsessive-compulsive disorders 1047
Psychotic disorders (psychoses) 1056–1065
alcohol withdrawal and (delirium tremens) 1084 1093
alcoholic hallucinosis 1084 1085–1086 1092
atypical 1057
brief 1057
delusions and 1057 1057–1058
depression and 1057 1058 1067 1068
differential diagnosis of 1058
drug-induced/toxic 1058
drug therapy for 1059–1064 1059 1060 1063
hospitalization and medical-surgical disorders and 1095
in hypothyroidism (myxedema madness) 1103 1132
intensive care unit 1095
Korsakoff's 1084 1092 1103 1273
late life (in elderly) 1057 1094 1095
mania differentiated from 1058
postpartum 1066
suicide risk and 1067
Psychotropic agents See Antianxiety drugs; Antidepressants; Antipsychotic drugs
Psyllium fiber See also Fiber, dietary
for constipation 543
PT See Prothrombin time
PTC See Percutaneous transhepatic cholangiography
PTCA See Percutaneous transluminal coronary angioplasty
PTEN multiple hamartoma syndrome (Cowden disease) 636
Pteroylmonoglutamic acid See Folic acid
Pterygium 157–158
PTHrP See Parathyroid hormone-related protein
Ptosis 153
in myasthenia gravis 153 1034
in third nerve paralysis 153 170
PTSD See Posttraumatic stress disorder
PTT See Partial thromboplastin time
Puberty
delayed 1180 1189
amenorrhea and 1183
gynecomastia during 1100
Pubic lice 135
Puerperal mastitis 787
Puestow procedure, modified, for chronic pancreatitis 699
Puffer fish poisoning 1635 1635
Pulmicort Turbihaler See Budesonide
Pulmonary alveolar proteinosis 279–280
Pulmonary angiography, in pulmonary embolism 283–284
Pulmonary arteries, as source of hemoptysis 220
Pulmonary aspiration syndromes 294–295
Pulmonary capillary wedge pressure (PCWP)
in myocardial infarction 357
in shock 479
Pulmonary circulation, disorders of 280–293
alveolar hemorrhage syndromes and 293
pulmonary hypertension and 290–292 291 410–411 411
respiratory failure caused by 307
thromboembolism and 280–290 282 285 286 287 288
vasculitis and 292–293
Pulmonary cysts, hydatid 1513 1514 1515
Pulmonary decompression sickness (chokes) 1603
Pulmonary diffusing capacity See Diffusing capacity
Pulmonary disorders See also specific disorder and under Respiratory
acute respiratory distress syndrome (ARDS) 309–311 310
airway disorders 225–247
in anthrax 1411 1411–1412 1413
approach to patient with 220–225
in ascariasis 1518
in aspergillosis 1544
in blastomycosis 1545
bronchoscopy in diagnosis of 225
in burn injury 1598
chronic See specific disorder and Chronic obstructive pulmonary disease
circulatory 280–293
in coccidioidomycosis 1539 1540
cognitive disorders/delirium caused by 1091
common manifestations of 218–220
decompression/dysbaric 1603
drug-induced 298 298
environmental 293–299
eosinophilic 280
exercise stress testing in diagnosis of 224–225
in filariasis 280 1522–1523
hantaviruses causing 1378
in histoplasmosis 1538
in HIV infection/AIDS 256 1322–1323
in hookworm disease 1525
hydatid cysts 1513 1514 1515
infections 247–265
adenovirus 1386 1387
anaerobic 1434
Bordetella bronchiseptica causing 1420
cough in 20–21 21 219
cytomegalovirus 1361
mycobacterial
nontuberculous 263–265 1437–1438
tuberculosis See also Tuberculosis
viral 1381–1386
interstitial (diffuse parenchymal) 275–280 275
in measles 1363
metastatic (secondary lung cancer) 272–273
neoplastic 265–275
in nocardiosis 1436–1437
occupational 295–298
in paragonimiasis 1507
physical examination in 220–222
pleural diseases and 299–304
postoperative, risk factors for 41 41
preoperative evaluation/management of 41–42 41
pulmonary function tests in diagnosis of 222–224 223 224 224
radiation causing 298–299 1600
respiratory failure 306–309 307
scleroderma and 838
in strongyloidiasis 1530
syndrome of inappropriate ADH secretion caused by 868
in syphilis 1450
in systemic lupus erythematosus 834
toxic 297 1617
tropical pulmonary eosinophilia 280 1522–1523
ventilation control disorders and 304–306
in Wegener's granulomatosis 292 847–848
Pulmonary edema 397–398
acute high-altitude 1604–1605
drug-induced 298
in heart disease 312
in atrial myxoma 413
cardiac failure 386 389 397–398
myocardial infarction 356
in near drowning victim 1602
respiratory failure caused by 307
Pulmonary embolectomy 289
Pulmonary embolism See Pulmonary venous thromboembolism
Pulmonary fibrosis
in ankylosing spondylitis 852
bleomycin-induced 1684
busulfan-induced 1684
drug-induced 298
idiopathic See Idiopathic fibrosing interstitial pneumonia
progressive massive 296
radiation causing 299
Pulmonary flow murmur, during pregnancy 416
Pulmonary function tests 222–224 223 224 224
in asthma 227–228 228
assessment/monitoring/prevention and 237
exacerbation management and 236
in COPD 238 239
in cor pulmonale 412
in cystic fibrosis 245
in interstitial (diffuse parenchymal) lung disease 275
in lung cancer 270
preoperative 41–42
Pulmonary heart disease (cor pulmonale) 412
in COPD 242 412
in pulmonary hypertension 292
Pulmonary hemosiderosis, idiopathic 293
P.1854
Pulmonary hypertension 290–292 291
cardiac failure and 390 411
primary (idiopathic) 290 410–411 411
pulmonary valve regurgitation and 338
Pulmonary infarction, pleural effusion in 301
Pulmonary infiltrates See also Pneumonia
drugs causing 298
eosinophilic 280
in immunocompromised host/HIV infection/AIDS 256
Pulmonary nodule
in metastatic disease 272–273
solitary 265–266
in dirofilariasis 1522
in metastatic disease 273
Pulmonary osteoarthropathy, hypertrophic 222 862–863
rheumatoid arthritis differentiated from 829
Pulmonary radiation fibrosis 299
Pulmonary regurgitation See Pulmonic regurgitation
Pulmonary-renal syndromes, microscopic polyangiitis causing 849
Pulmonary stenosis 318–319
in tetralogy of Fallot 323 324
Pulmonary thromboembolism See Pulmonary venous thromboembolism
Pulmonary vasculitis 292–293
Pulmonary veno-occlusive disease 290–291
pulmonary hypertension and 410 411
Pulmonary venous thromboembolism 280–290 282 285
anticoagulation in management of 284–289 288
detection/assessment of 281–284 282 285
dyspnea in 23 281 282
high-altitude pulmonary edema and 1605
prevention of 284 286 287
septic, in drug users 1298
thrombolytic therapy in management of 289
venous thrombosis and 280–281
in Wegener's granulomatosis 848
Pulmonic regurgitation 337–338
Pulsatile tinnitus 189
Pulse deficit, in atrial fibrillation 375
Pulse oximetry See Oximetry
Pulsed Doppler ultrasound 316
Pulseless disease (Takayasu arteritis) 414 463–464
Pulses
in aortic regurgitation 335
in heart disease 314
in hypertension 426
in lower extremity occlusive disease 453
in thromboangiitis obliterans (Buerger's disease) 462
Pulsus alternans, in heart disease 314
Pulsus paradoxus, in heart disease 314
pericardial effusion 409
Punch biopsy, for cervical intraepithelial neoplasia 735
Pupillary reactions
assessment of 152
in coma or stupor 1017–1018
in locked-in-syndrome 1019
in third nerve paralysis 170
Pupils
dilation of
acute angle-closure glaucoma precipitated by 153 159 177
for ophthalmoscopy 153
examination of 152
Pure autonomic failure 987
Pure red cell aplasia 489
cancer-related 1697
Purified chick embryo cell culture (PCEC) rabies vaccine 1314
Purified insulin 1212 1213
Purified protein derivative (PPD) test 258–259 259
Purines
dietary 812 813
in gout 812
in urinary stone formation 944
Purple coneflower See Echinacea
Purpura
cancer-related 863
in cryoglobulinemia 850
drugs causing 147
Henoch-Sch nlein (anaphylactoid) 850 917–918 917
idiopathic (autoimmune) thrombocytopenic 518–520 519
thrombotic thrombocytopenic 520–522 521
Pursed lip breathing, for COPD 242
Push enteroscopy, in gastrointestinal bleeding 556 558
Pustular skin disorders 92 115–121
Puumala viruses 1378
PUVA therapy, for psoriasis 98
pXO1/pXO2 plasmids, anthrax virulence and 1411
Pyelogram, intravenous (IVP) 899
Pyelonephritis 938–940 939 1555 1556
ascending infection and 937 938
dysuria and 33 938
emphysematous 939
during pregnancy 782
Pylephlebitis, ruptured appendicitis and 613
Pyoderma
gangrenosum 141
miliaria and 120
in pediculosis 135
in scabies 134
Pyogenic arthritis See Septic (nongonococcal acute bacterial) arthritis
Pyogenic hepatic abscess 680–681
Pyogenic osteomyelitis 858–859
Pyometra, in endometrial carcinoma 738
Pyrantel pamoate
for ascariasis 1519
for enterobiasis/pinworm infection 1521 1522
for hookworm disease 1526
Pyrazinamide, for tuberculosis 260–261 260 261
in bone and joint disease 861
in latent disease/prophylactic 263
pregnancy and 262
Pyridostigmine, for myasthenia gravis 1034
Pyridoxal/pyridoxal phosphate/pyridoxamine 1274
Pyridoxine (vitamin B6) 1274–1275
dietary reference intakes (DRIs) for 1254
for gyromitrin mushroom poisoning 1630
for homocystinuria 1706
hyperhomocysteinemia associated with deficiency of 1707
for isoniazid overdose/toxicity 1274 1611 1626
mental changes associated with deficiency of 1103
Pyrimethamine 1575
folic acid (leucovorin) rescue with 1575
for malaria
with dapsone (Maloprim) 1488
resistance to 1491
with sulfadoxine (Fansidar) 1488 1494–1495
resistance to 1491
nutrients affected by 1260
for toxoplasmosis chemoprophylaxis/treatment 1335 1347 1500
Pyrosis (heartburn) 536 563–564 566
Pyuria 896 935 936
sterile, in tuberculosis 930
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