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Obstentrics_Williams	Any hypertension during pregnancy is a risk marker for morbidity and mortality in later life (American College of Obstetricians and Gynecologists, 2013; Bellamy, 2007). In a case-control study from Iceland, Arnadottir and associates (2005) reported TABLE 40-16. Some Long-Term Consequences in Women with Preeclampsia Syn...	Obstentrics_Williams. Any hypertension during pregnancy is a risk marker for morbidity and mortality in later life (American College of Obstetricians and Gynecologists, 2013; Bellamy, 2007). In a case-control study from Iceland, Arnadottir and associates (2005) reported TABLE 40-16. Some Long-Term Consequences in Women...
InternalMed_Harrison	or inflammatory process. Progressing symptoms associated with the systemic manifestations of fever, stiff neck, and altered level of consciousness imply an infectious process. Relapsing and remitting symptoms involving different levels of the nervous system suggest MS or other inflammatory processes. Slowly progressive...	InternalMed_Harrison. or inflammatory process. Progressing symptoms associated with the systemic manifestations of fever, stiff neck, and altered level of consciousness imply an infectious process. Relapsing and remitting symptoms involving different levels of the nervous system suggest MS or other inflammatory process...
Obstentrics_Williams	Another scenario is that the postterm fetus may continue to gain weight and thus be unusually large at birth. This at least suggests that placental function is not severely compromised. Indeed, continued fetal growth is the norm-albeit at a slower rate beginning at 37 completed weeks (Fig. 43-3). Nahum and colleagues (...	Obstentrics_Williams. Another scenario is that the postterm fetus may continue to gain weight and thus be unusually large at birth. This at least suggests that placental function is not severely compromised. Indeed, continued fetal growth is the norm-albeit at a slower rate beginning at 37 completed weeks (Fig. 43-3). ...
Pediatrics_Nelson	Pediculosis differs from scabies infestation in that the louse resides on the hair or clothing and intermittently feeds on the host by piercing the skin. The bite causes small urticarial papules and itching. Head lice live close to the skin and may live for 30 days, depositing 100 to 400 eggs as nits on hair shafts, us...	Pediatrics_Nelson. Pediculosis differs from scabies infestation in that the louse resides on the hair or clothing and intermittently feeds on the host by piercing the skin. The bite causes small urticarial papules and itching. Head lice live close to the skin and may live for 30 days, depositing 100 to 400 eggs as nits...
Physiology_Levy	Disordersofmenstruationarerelativelycommonandincludemenorrhagia (heavymenstrualflowleadingtolossofmorethan80mLofblood),metrorrhagia irregularandsometimesprolongedmenstrualflowbetweennormalperiods),anddysmenorrhea (painfulperiods).Theexistenceofafewirregularperiods,calledoligomenorrhea, andtheabsenceofperiods,calledamen...	Physiology_Levy. Disordersofmenstruationarerelativelycommonandincludemenorrhagia (heavymenstrualflowleadingtolossofmorethan80mLofblood),metrorrhagia irregularandsometimesprolongedmenstrualflowbetweennormalperiods),anddysmenorrhea (painfulperiods).Theexistenceofafewirregularperiods,calledoligomenorrhea, andtheabsenceofp...
InternalMed_Harrison	mecHanism of action As a synthetic analogue of the antithrombinbinding pentasaccharide sequence found in heparin and LMWH, fondaparinux has a molecular weight of 1728. Fondaparinux binds only to antithrombin (Fig. 143-5) and is too short to bridge thrombin to antithrombin. Consequently, fondaparinux catalyzes factor Xa...	InternalMed_Harrison. mecHanism of action As a synthetic analogue of the antithrombinbinding pentasaccharide sequence found in heparin and LMWH, fondaparinux has a molecular weight of 1728. Fondaparinux binds only to antithrombin (Fig. 143-5) and is too short to bridge thrombin to antithrombin. Consequently, fondaparin...
Pathology_Robbins	http://ebooksmedicine.net Fig. 7.36 Wilmstumorinthelowerpoleofthekidneywiththecharacteristictantograycolorandwell-circumscribedmargins. Patients typically present with a palpable abdominal mass, which may extend across the midline and down into the pelvis. Less often, the presenting features are fever and abdominal pai...	Pathology_Robbins. http://ebooksmedicine.net Fig. 7.36 Wilmstumorinthelowerpoleofthekidneywiththecharacteristictantograycolorandwell-circumscribedmargins. Patients typically present with a palpable abdominal mass, which may extend across the midline and down into the pelvis. Less often, the presenting features are feve...
Pathology_Robbins	Immune hydrops results from an antibody-induced hemolytic disease in the newborn that is caused by blood group incompatibility between mother and fetus. Such an incompatibility occurs when the fetus inherits red cell antigenic determinants from the father that are foreign to the mother. The most common antigens to resu...	Pathology_Robbins. Immune hydrops results from an antibody-induced hemolytic disease in the newborn that is caused by blood group incompatibility between mother and fetus. Such an incompatibility occurs when the fetus inherits red cell antigenic determinants from the father that are foreign to the mother. The most comm...
Surgery_Schwartz	for localizing pheo-chromocytomas (Fig. 38-46B), especially those in ectopic posi-tions. This test has a reported sensitivity of 77% to 89% and a specificity ranging from 88% to 100%.Treatment The medical management of pheochromocytomas is aimed chiefly at blood pressure control and volume repletion. Irreversible, long...	Surgery_Schwartz. for localizing pheo-chromocytomas (Fig. 38-46B), especially those in ectopic posi-tions. This test has a reported sensitivity of 77% to 89% and a specificity ranging from 88% to 100%.Treatment The medical management of pheochromocytomas is aimed chiefly at blood pressure control and volume repletion. ...
Neurology_Adams	The patient with catatonia appears unresponsive, in a state that simulates stupor, light coma, or akinetic mutism. There are no signs of structural brain disease, such as pupillary or reflex abnormalities. As in the normal awake state, oculocephalic responses are muted—that is, the eyes move concurrently with the head ...	Neurology_Adams. The patient with catatonia appears unresponsive, in a state that simulates stupor, light coma, or akinetic mutism. There are no signs of structural brain disease, such as pupillary or reflex abnormalities. As in the normal awake state, oculocephalic responses are muted—that is, the eyes move concurrent...
InternalMed_Harrison	Diluting agents decrease the absorption of the radionuclide; for example, water may be used as a diluting agent in the treatment for tritium (3H) contamination. The recommended amount is 3–4 L/d for at least 3 weeks. Mobilizing agents are most effective when given immediately; however, they may be effective for up to 2...	InternalMed_Harrison. Diluting agents decrease the absorption of the radionuclide; for example, water may be used as a diluting agent in the treatment for tritium (3H) contamination. The recommended amount is 3–4 L/d for at least 3 weeks. Mobilizing agents are most effective when given immediately; however, they may be...
InternalMed_Harrison	tool in settings where measurements of anti-HIV antibodies may be misleading, such as in acute infection and neonatal infection. Four assays are predominantly used for this purpose. They are reverse transcriptase PCR (RT-PCR; Amplicor); branched DNA (bDNA; VERSANT); transcription-mediated amplification (TMA; APTIMA); a...	InternalMed_Harrison. tool in settings where measurements of anti-HIV antibodies may be misleading, such as in acute infection and neonatal infection. Four assays are predominantly used for this purpose. They are reverse transcriptase PCR (RT-PCR; Amplicor); branched DNA (bDNA; VERSANT); transcription-mediated amplific...
Surgery_Schwartz	needs of muscle cells. Therefore, in the fasting state, hepatic glycogen stores are rapidly and preferentially depleted, which results in a fall of serum glucose concentration within hours (<16 hours).During fasting, a healthy 70-kg adult will utilize 180 g of glucose per day to support the metabolism of obligate glyco...	Surgery_Schwartz. needs of muscle cells. Therefore, in the fasting state, hepatic glycogen stores are rapidly and preferentially depleted, which results in a fall of serum glucose concentration within hours (<16 hours).During fasting, a healthy 70-kg adult will utilize 180 g of glucose per day to support the metabolism...
Psichiatry_DSM-5	An important marker of a substance use disorder diagnosis, particularly in milder cases, is continued use despite a clear risk of negative consequences to other valued activities or re- lationships (e.g., school, work, sport activity, partner or parent relationship). Because some cannabis users are motivated to minimiz...	Psichiatry_DSM-5. An important marker of a substance use disorder diagnosis, particularly in milder cases, is continued use despite a clear risk of negative consequences to other valued activities or re- lationships (e.g., school, work, sport activity, partner or parent relationship). Because some cannabis users are mo...
Physiology_Levy	6. Autoregulation of blood flow occurs in most tissues. This process is characterized by a constant blood flow in the presence of a change in perfusion pressure. Autoregulation is mediated by a myogenic mechanism whereby an increase in transmural pressure elicits a contraction of vascular smooth muscle and a decrease i...	Physiology_Levy. 6. Autoregulation of blood flow occurs in most tissues. This process is characterized by a constant blood flow in the presence of a change in perfusion pressure. Autoregulation is mediated by a myogenic mechanism whereby an increase in transmural pressure elicits a contraction of vascular smooth muscle...
Psichiatry_DSM-5	Genetic and physiological. For individuals with gender dysphoria without a disorder of sex development, some genetic contribution is suggested by evidence for (weak) familial- ity of transsexualism among nontwin siblings, increased concordance for transsexualism in monozygotic compared with dizygotic same-sex twins, an...	Psichiatry_DSM-5. Genetic and physiological. For individuals with gender dysphoria without a disorder of sex development, some genetic contribution is suggested by evidence for (weak) familial- ity of transsexualism among nontwin siblings, increased concordance for transsexualism in monozygotic compared with dizygotic ...
Pathoma_Husain	B. Pseudomyxoma peritonei is massive amounts of mucus in the peritoneum. 1. Due to a mucinous tumor of the appendix, usually with metastasis to the ovary I. ECTOPIC PREGNANCY A. Implantation of fertilized ovum at a site other than the uterine wall; most common site is the lumen of the fallopian tube (Fig. 13.17). B. Ke...	Pathoma_Husain. B. Pseudomyxoma peritonei is massive amounts of mucus in the peritoneum. 1. Due to a mucinous tumor of the appendix, usually with metastasis to the ovary I. ECTOPIC PREGNANCY A. Implantation of fertilized ovum at a site other than the uterine wall; most common site is the lumen of the fallopian tube (Fi...
First_Aid_Step2	A randomized controlled trial is an experimental, prospective study in which subjects are randomly assigned to a treatment or control group. Random assignment helps ensure that the two groups are truly comparable. The control group may be treated with a placebo or with the accepted standard of care. The study may be ma...	First_Aid_Step2. A randomized controlled trial is an experimental, prospective study in which subjects are randomly assigned to a treatment or control group. Random assignment helps ensure that the two groups are truly comparable. The control group may be treated with a placebo or with the accepted standard of care. Th...
Pathology_Robbins	Fig. 15.5A ). Histologic examination demonstrates a cystlike space lined by granulation tissue or fibrous connective tissue that is filled with mucin and inflammatory cells, particularly macrophages ( Fig. 15.5B ). Complete excision of the cyst and the minor salivary gland constitutes definitive treatment.	Pathology_Robbins. Fig. 15.5A ). Histologic examination demonstrates a cystlike space lined by granulation tissue or fibrous connective tissue that is filled with mucin and inflammatory cells, particularly macrophages ( Fig. 15.5B ). Complete excision of the cyst and the minor salivary gland constitutes definitive trea...
Pathology_Robbins	The prevention and treatment of senile and postmenopausal osteoporosis includes exercise, appropriate calcium and vitamin D intake, and pharmacologic agents that decrease resorption (bisphosphonates). Bisphosphonates reduce osteoclast activity and induce osteoclast apoptosis. Denosumab, an anti-RANKL antibody that bloc...	Pathology_Robbins. The prevention and treatment of senile and postmenopausal osteoporosis includes exercise, appropriate calcium and vitamin D intake, and pharmacologic agents that decrease resorption (bisphosphonates). Bisphosphonates reduce osteoclast activity and induce osteoclast apoptosis. Denosumab, an anti-RANKL...
Gynecology_Novak	360. Cho BY, Kim WB, Chung JH, et al. High prevalence and little change in TSH receptor blocking antibody titres with thyroxine and antithyroid drug therapy in patients with non-goitrous autoimmune thyroiditis. Clin Endocrinol (Oxf) 1995;43:465–471. 361. Tamaki H, Amino N, Kimura M, et al. Low prevalence of thyrotropin...	Gynecology_Novak. 360. Cho BY, Kim WB, Chung JH, et al. High prevalence and little change in TSH receptor blocking antibody titres with thyroxine and antithyroid drug therapy in patients with non-goitrous autoimmune thyroiditis. Clin Endocrinol (Oxf) 1995;43:465–471. 361. Tamaki H, Amino N, Kimura M, et al. Low prevale...
InternalMed_Harrison	The early stages of follicle growth are primarily driven by intraovarian factors and may take up to a year from development of the primary follicle to the dominant follicle stage. Further maturation to the preovulatory state, including the resumption of meiosis in the oocyte, requires the combined stimulus of FSH and l...	InternalMed_Harrison. The early stages of follicle growth are primarily driven by intraovarian factors and may take up to a year from development of the primary follicle to the dominant follicle stage. Further maturation to the preovulatory state, including the resumption of meiosis in the oocyte, requires the combined...
Neurology_Adams	A small proportion of otherwise healthy infants exhibit rhythmic jerking of the hands, arms, and legs or abdomen, both at the onset and in the later stages of sleep (benign neonatal myoclonus). The movements begin in the first days of life and disappear within months. There may be a familial tendency toward these movem...	Neurology_Adams. A small proportion of otherwise healthy infants exhibit rhythmic jerking of the hands, arms, and legs or abdomen, both at the onset and in the later stages of sleep (benign neonatal myoclonus). The movements begin in the first days of life and disappear within months. There may be a familial tendency t...
InternalMed_Harrison	weight gain. Quetiapine is distinct in having a weak D2 effect but potent α1 and histamine blockade. Ziprasidone causes minimal weight gain and is unlikely to increase prolactin but may increase QT prolongation. Aripiprazole also has little risk of weight gain or prolactin increase but may increase anxiety, nausea, and...	InternalMed_Harrison. weight gain. Quetiapine is distinct in having a weak D2 effect but potent α1 and histamine blockade. Ziprasidone causes minimal weight gain and is unlikely to increase prolactin but may increase QT prolongation. Aripiprazole also has little risk of weight gain or prolactin increase but may increas...
Gynecology_Novak	The low-viscosity ﬂuids—1.5% glycine, 3% sorbitol, and 5.0% mannitol—are used commonly because of their low cost, compatibility with standard electrosurgery, and availability in large-volume bags. However, should these electrolyte free and usually hypotonic media be absorbed to excess in the systemic circulation, they ...	Gynecology_Novak. The low-viscosity ﬂuids—1.5% glycine, 3% sorbitol, and 5.0% mannitol—are used commonly because of their low cost, compatibility with standard electrosurgery, and availability in large-volume bags. However, should these electrolyte free and usually hypotonic media be absorbed to excess in the systemic ...
Pathology_Robbins	• PGD2 is the major prostaglandin made by mast cells; Vasodilation Prostaglandins PGI2 (prostacyclin), PGE1, PGE2, PGD2 along with PGE2 (which is more widely distributed), it causes vasodilation and increases the permeability of Vasoconstriction Thromboxane A2, leukotrienes C4, D4, E4 postcapillary venules, thus potent...	Pathology_Robbins. • PGD2 is the major prostaglandin made by mast cells; Vasodilation Prostaglandins PGI2 (prostacyclin), PGE1, PGE2, PGD2 along with PGE2 (which is more widely distributed), it causes vasodilation and increases the permeability of Vasoconstriction Thromboxane A2, leukotrienes C4, D4, E4 postcapillary v...
InternalMed_Harrison	PART 2 Cardinal Manifestations and Presentation of Diseases of the bleeding (e.g., recent inhalation exposures) as well as any previous episodes of hemoptysis should be elicited during history-taking. Monthly hemoptysis in a woman suggests catamenial hemoptysis from pulmonary endometriosis. Moreover, the volume of bloo...	InternalMed_Harrison. PART 2 Cardinal Manifestations and Presentation of Diseases of the bleeding (e.g., recent inhalation exposures) as well as any previous episodes of hemoptysis should be elicited during history-taking. Monthly hemoptysis in a woman suggests catamenial hemoptysis from pulmonary endometriosis. Moreov...
Surgery_Schwartz	in heterodimerization between two different receptor types that are coexpressed; this leads to transphosphorylation and transactiva-tion of both receptors in the complex (transmodulation). In this context, the lack of a specific ligand for the HER2/neu receptor suggests that HER2/neu may function solely as a co-recepto...	Surgery_Schwartz. in heterodimerization between two different receptor types that are coexpressed; this leads to transphosphorylation and transactiva-tion of both receptors in the complex (transmodulation). In this context, the lack of a specific ligand for the HER2/neu receptor suggests that HER2/neu may function sole...
InternalMed_Harrison	A brain abscess typically presents as an expanding intracranial mass lesion rather than as an infectious process. Although the evolution of signs and symptoms is extremely variable, ranging from hours to weeks or even months, most patients present to the hospital 11–12 days following onset of symptoms. The classic clin...	InternalMed_Harrison. A brain abscess typically presents as an expanding intracranial mass lesion rather than as an infectious process. Although the evolution of signs and symptoms is extremely variable, ranging from hours to weeks or even months, most patients present to the hospital 11–12 days following onset of symp...
Immunology_Janeway	of the global incidence, 1 in every 20 adults is infected. Indeed, HIV/AIDS has emerged as the most deadly single infectious agent in the short time since its identification as a new human pathogen. Nevertheless, there is cause for optimism: the incidence of new cases of HIV infections worldwide has declined annually s...	Immunology_Janeway. of the global incidence, 1 in every 20 adults is infected. Indeed, HIV/AIDS has emerged as the most deadly single infectious agent in the short time since its identification as a new human pathogen. Nevertheless, there is cause for optimism: the incidence of new cases of HIV infections worldwide has...
InternalMed_Harrison	of the primary visual cortex give rise to dense, congruous hemianopic field defects. Occlusion of the posterior cerebral artery supplying the occipital lobe is a common cause of total homonymous hemianopia. Some patients with hemianopia after occipital stroke have macular sparing, because the macular representation at ...	InternalMed_Harrison. of the primary visual cortex give rise to dense, congruous hemianopic field defects. Occlusion of the posterior cerebral artery supplying the occipital lobe is a common cause of total homonymous hemianopia. Some patients with hemianopia after occipital stroke have macular sparing, because the macu...
Surgery_Schwartz	is in the diag-nosis of acute cholecystitis, which appears as a nonvisualized gallbladder, with prompt filling of the common bile duct and duodenum. The lack of gallbladder filling is due to inflamma-tory closure of the cystic duct preventing bile backflow into the gallbladder (Fig. 32-8). Evidence of cystic duct obstr...	Surgery_Schwartz. is in the diag-nosis of acute cholecystitis, which appears as a nonvisualized gallbladder, with prompt filling of the common bile duct and duodenum. The lack of gallbladder filling is due to inflamma-tory closure of the cystic duct preventing bile backflow into the gallbladder (Fig. 32-8). Evidence of...
Surgery_Schwartz	2005;11:2456-2461. 359. Di Carlo V, Chiesa R, Pontiroli AE, et al. Pancreatoduodenectomy with occlusion of the residual stump by Neoprene injection. World J Surg. 1989;13:105-110; discussion 110-111. 360. Tran K, Van Eijck C, Di Carlo V, et al. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospecti...	Surgery_Schwartz. 2005;11:2456-2461. 359. Di Carlo V, Chiesa R, Pontiroli AE, et al. Pancreatoduodenectomy with occlusion of the residual stump by Neoprene injection. World J Surg. 1989;13:105-110; discussion 110-111. 360. Tran K, Van Eijck C, Di Carlo V, et al. Occlusion of the pancreatic duct versus pancreaticojejuno...
Surgery_Schwartz	metachronous metastases (metastasis diagnosed after a disease-free interval). The natural history of metastatic disease is so poor for some tumors (e.g., pancreatic cancer) that there is no role at this time for surgical metastasectomy. In cancers with a more favorable outlook, observation for several weeks or months, ...	Surgery_Schwartz. metachronous metastases (metastasis diagnosed after a disease-free interval). The natural history of metastatic disease is so poor for some tumors (e.g., pancreatic cancer) that there is no role at this time for surgical metastasectomy. In cancers with a more favorable outlook, observation for several...
Anatomy_Gray	The longitudinal arch of the foot is formed between the posterior end of the calcaneus and the heads of the metatarsals (Fig. 6.113A). It is highest on the medial side, where it forms the medial part of the longitudinal arch, and lowest on the lateral side, where it forms the lateral part. The transverse arch of the fo...	Anatomy_Gray. The longitudinal arch of the foot is formed between the posterior end of the calcaneus and the heads of the metatarsals (Fig. 6.113A). It is highest on the medial side, where it forms the medial part of the longitudinal arch, and lowest on the lateral side, where it forms the lateral part. The transverse ...
Neurology_Adams	A. Exogenous intoxications: alcohols, barbiturates and other sedative drugs, opiates (Chaps. 41 B. Endogenous metabolic disturbances: anoxia, diabetic acidosis, uremia, hepatic failure, nonketotic hyperosmolar hyperglycemia, hypoand hypernatremia, hypoglycemia, addisonian crisis, profound nutritional deficiency, carbon...	Neurology_Adams. A. Exogenous intoxications: alcohols, barbiturates and other sedative drugs, opiates (Chaps. 41 B. Endogenous metabolic disturbances: anoxia, diabetic acidosis, uremia, hepatic failure, nonketotic hyperosmolar hyperglycemia, hypoand hypernatremia, hypoglycemia, addisonian crisis, profound nutritional d...
Pediatrics_Nelson	Dysmorphology is the recognition of the pattern of congenital malformations (often multiple congenital malformations) and dysmorphic features that characterize a particular syndrome. Syndromes are collections of abnormalities, including malformations, deformations, dysmorphic features, and abnormal behaviors that have ...	Pediatrics_Nelson. Dysmorphology is the recognition of the pattern of congenital malformations (often multiple congenital malformations) and dysmorphic features that characterize a particular syndrome. Syndromes are collections of abnormalities, including malformations, deformations, dysmorphic features, and abnormal b...
Pharmacology_Katzung	At least two additional types of acetylcholine receptors are found within the neuromuscular apparatus. One type is located on the presynaptic motor axon terminal, and activation of these receptors mobilizes additional transmitter for subsequent release by moving more acetylcholine vesicles toward the synaptic membrane....	Pharmacology_Katzung. At least two additional types of acetylcholine receptors are found within the neuromuscular apparatus. One type is located on the presynaptic motor axon terminal, and activation of these receptors mobilizes additional transmitter for subsequent release by moving more acetylcholine vesicles toward ...
InternalMed_Harrison	Urate-lowering drugs are generally not initiated during acute attacks but after the patient is stable and low-dose colchicine has been initiated to decrease the risk of the flares that often occur with urate lowering. Colchicine anti-inflammatory prophylaxis in doses of 0.6 mg one to two times daily should be given alo...	InternalMed_Harrison. Urate-lowering drugs are generally not initiated during acute attacks but after the patient is stable and low-dose colchicine has been initiated to decrease the risk of the flares that often occur with urate lowering. Colchicine anti-inflammatory prophylaxis in doses of 0.6 mg one to two times dai...
Surgery_Schwartz	of improved visualization and articulating instruments may improve out-comes, but the cost-effectiveness of robotic repair is unclear. Overall, more studies are needed to evaluate the role of robotics in ventral hernia surgery.Although still rare, given the increase in laparoscopic procedures, the incidence of laparosc...	Surgery_Schwartz. of improved visualization and articulating instruments may improve out-comes, but the cost-effectiveness of robotic repair is unclear. Overall, more studies are needed to evaluate the role of robotics in ventral hernia surgery.Although still rare, given the increase in laparoscopic procedures, the inc...