PAMELA DUKE e aoe wv pera Heath vith HeCONTENTS Preface vil 28, Primary hypercoagulable states 65 Acknowledgments ix 29, Thrombocytopenia 167 General Maps 1 Hematopoietic Disorders 69 1, Complement cascade 3 30, Alpha thalassemia 2. Coagulation cascade we eveee coud 31. Beta thalassemia 3. Cell-mediated immunity a7 32. Anemia of chronic disease 4. Humoral immunity, . . om) 33. Iron deficiency anemia 5. Acute inflammation dL 34. Vitamin B12 deficiency 6. Chronic inflammation ......2..+-seesee0 1335, Hemochromatosis 7. Renin-angiotensin-aldosterone system 36. Myeloid lymphomas and leukemias - 8. Hemostasis 37. Lymphoid lymphomas and leukemias vascular Disorders 19 testinal Disorders 87 9. Congestive heart failure vee 38. Gastroesophageal reflux disease oe BD 10, Right-sided heart fatlure 23 39. Ulcerative colitis 91 11, Left-sided heart failure 25 40, Crohn's disease . 93 12. Valvular stenosis 27 AL, Pancreatitis 02... sseeere ve 95 13, Valvular regurgitation 29 42. Cholelithiasis 97 14. Myocardial ischemia and infarction 31 15. Atherosclerosis v.33 Liver Disorders 99 16. Cor pulmonale 235 43. Cirrhosis 101 a 44. Hepatitis B 103 Pulmonary Disorders Ts epntisC 105 17. Chronic obstructive pulmonary disease 46. Alcoholic hepatitis 107 18, Asthma 19, Deep ven thrombosis and pulmonary embolism ....43 Renal Disorders 109 20. Acute respiratory distress syndrome .. oo on ee 48, Acute renal failure 3 ar 49. Chronic renal fallure.......- a0 Genetic Disorders - 50, Glomerulonephritis/nephritic 7 22, Siekle cell anemia S151. Nephrotic syndrome 19 23, Cystic Mbrosis ......-. 5352. Nephrolithiasis 21 24. Gout 55 Fluid and Electrolyte 123 Hemostasis Disorders 57 OS 53. Hyponatremia . 125 25, Hemophilias A&B. 54. Hypernatremia 127 26. Disseminated intravascular coagulation 55. Hypokalemi: 129 27. Platelet disorders 56. Hyperkalem 131@® oovrinss 57. Metabolic acidosis ........4. . 133 58. Anion gap vs non-anion gap metabolic 135 59. Metabolic alkalosis .. 137 60. Respiratory acidosis. incor 1S) 61. Respiratory alkalosis . add Immune Mediated Disorders 143 62. Hypersensitivity reaction type 1 63. Hypersensitivity reaction type 64. Hypersensitivity reaction type 3 . 65. Hypersensitivity reaction type 4 66, Humoral immunodeficiencies 67. Cellular immunodeficiencies 68. Sarcoidosis 69. Systemic lupus erythematosus 161 70, Human immunodeficiency virus 163 71, Endocardit 165 73, 4, Meningitis... corer roma alee Urinary tract infection ........eseceeeee 169) Sepsis syndromes a71 5. ‘Tuberculosis 173 Endocrine Disorders 175 76, Diabetes mellitus type 1 verano 77 sbetes mellitus type 2 179 78. Hyperthyroidism SS 181 79. Hypothyroidism . 183 80. Hypercalcemia 185 81, Hypocaleemia ........... 187 82. Hyperparathyroidism . 83. Adrenal insufficiency (Addison's disease) . S84, Cushing's disease and syndrome 85. Diabetes insipidus 86. Syndrome of inappropriate antidiuretic hormone secretion Rheumatologic and Bone Disorders 87. Rheumatold arthriti 88. Osteoarthritis 89. Osteoporosis : 90. Osteomalacia and rickets ...... Disorders 91. Absheimer’s disease 92. Parkinson’s disease 93. Huntington's disease 94. Myasthenia gravis 95. Multiple sclerosis 96. Seizures and epilepsy 97. Intracranial hemorrhage 98, Ischemic stroke Female Reproductive System Disorders 99, Amenorrhea 100. Menopause : 101. Polycystic ovary syndrome 102. Preeclampsia/eclampsia Appendix A: Normal Blood (B), Plasma (P), or Serum (S) Values 237 References 241 Index 253 191 193 195 197 199 201 203 207 209 211 213 215 27 219 221 223 225compuement cascane > ates ioadsbody | complement cascade Sctrondaspatatte ne estes nari ‘pager nan by terol ten ‘ise psbogensceciy cascade conpose of seumeselenet ese edad testes | — | oe ‘ ‘oi of asp oar hatin hap oS = Eman apes — T T tao pe pont _ conpenrtpen cig ‘mannan nding web 5) Seren ae a Seema e ann ecocincea tam a cotenanes vest | mace oo — (Wal associated serine protease (MASP) Seren ™ ptaynse.sise cnt ci snserd nee Tacit me oi — ‘ =o | Ce a am gin tio einen aw = & = atin —— | (Cabs factor 8 Cb and Cb jin to frm: nites Bom. chemo | 1 caer cunchoce vcenetinbero rm oa Seas _ ieee anaphylatoxin ‘Cb bees se produces many molecules of s {aoamer antes ne conelenrtescate — atts fans cass bats tom : one costs patagn reece et uaa ees ns a cx win _— wie oie se (S) —~ binds 05 —~ CRE nds CF —> CRE nds — CHLTE nds 8 Toler CSc8 tofemeses? 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lcd sow entseons; an Bsa oh “ype 4 (509 map) ‘release of FN gamma alpha by activated macrophages ‘usually asymetometc “+ HIV/AIDS patents ee ata seme —_ S Meret = ea soma Sethe Serato, a — inorder to contain baclt ‘consequent immune suppression Reardon Emre erence potency sored panties rue win nsens cme ee sean Siee | Scaaeer sma ot cine Seen —- Sat lg a aon (frost common) “lymph nodes (mast commen} can for seratula cram oe a alam Zhan sao Ee, set eee tect om ented x ' rit ae wham == = shemales +R can be normal oF show lower and zen “Caer oe ieteemsmiwee “sm Ste = Seki DD 65544801puseres meuniere ED stooge: ‘pete evans aes) + srrce aac “enn presostor ‘Borat eles = a ‘ure ‘iene reapers swspnce pee) (9) Beal costars oot } 2 dh _.. carpet tore oe ‘luoose nto cabs Ieprromis = pn iy sa = etn mae i ‘Sonesta expe cy Fortean vowed gutta ev a — “sae chim” “ppg chyast tenis at 2 ake: a a eae | | va “ten see eric ag seimgre Seman = ' = sche ame | fates, Bomm! omiey mses —> 2 ‘cam edo rs (_________“ ‘Sheweoein iets sing eam Magen | igh serum toes vedi | tae eats —~ 90. * | The — NX sein oe 7 typovolemis detyration 4 | ype ssetes i onte ve ometekeneg sitcom eed | peinviaweres wewiirus Te? 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(agin. | yogsscme ———- oed\eu al ease ‘sab. amaeamege 08 Senge wet +909 se wu 409 sa eee Bos Ayre. mca racers fez ait ‘ape wntosreoanrans 2a anger ct tral catnge ‘nd nn te rotogheans = sro carl wh ites ‘erst damage Fehon ‘cas tegen components cous toe 2macanal ners ters nals iso honor one tr Sreehy bret to | pes wih verso ones eon ean cose at | contents (A) = roe re mae los age asta ‘mar eeepc O& (nest common) «zona Okt he opel edo tol or vunetasd toes / \ esenetstes mh ema wean | _— ema el fom fens Semper sad oF s vem ake — cone : "ue ba etlopetinase TMP) oii! ‘Sowers Pa 1 pongpant rt |___. sera maton ‘Sees Steeeeiwene dete pes enteia fester pena ‘oss of carlage eventualy {ollowed by remodeling in eepemon dora “affects other tssues of |=» and hypertrophy of bone = ray ns es moat onpeurd tcrr08 sic par dons eae ve cma, == stein one “ore aapattecn Saati soe Soong hts rs ae rere “Semaine = a) eon | et tte ‘isan ve Hebert’ nos, PP snshove Bouchard nodes, "suru ast “pe: org show atepyss any piosreoroRosis > ett iy own bone fomaton ‘alge pe ener _| towed 8 mu Sloe rerarlaon pase obec oat cere eared wears nr tae Isrevedaned so couingtewreble eaten core symptomatic rovee tow rss —> tat ch ia Sasa Tae ©-25 and ik tent res “lariat Shp tase et ype secay L__, topros: ‘nena a Sop pete 5) “Rederiet, Ip ets fot gee nok “are “acerca se) stn este -hpetao eo) Seren gen ‘hymen ‘ers ctr nearsosreomatacta ano wicKers vivuataon eshytetleto ' q aie ~ she cr sore ih eta ‘dacs marion | on Sree eno | Me 7 sara wo “Farner -onneeenee OM i “ioc by sine a ‘eee refer | meet rug serene eo ci i we 3 smn, “lth | i nt, ek E sr 00 seam pen i eta t i | hetero EST tamoowtn ceo et me Slate teetey ur miata. 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urine oy mont “en wane o une eee soni : ede a on cenietre uae tei ain ingame ctneyy potent he dora ae _mosty comveried to “esrone converted voarasenun cose ee oreo \ verti | eaten enn 6 Sipopreten, vere rome sonny cn soesine tae Pret ome soya tcc eeteclononen sae | 2 ket edo canceorecctauesivecianesis — __. sete ore in cone = ed vei os “soo a pe eee eee es oh ole. ia San a) — me = a a secre seven — | a = ones, smtconet ama ean vupeha noma Me yar tt et sevens shrew signa! — ga ——— 4 | anope to eccesen cmsan “ galyrrmne So —— ee sate Te, | | / systemic rotate > 24s stots sarge an ata i ee } 1 1 ‘ester smi hues shoe moni ae vote —_ 4 t recaineres ——svambocyooenis hoe hover oe Soren a cps | ote 1 cee wy many comegessite (ome) fell ayaa’ aes iat al actaiecs “slow platelet count — toons eclampsia“APPENDIX A Normal blood (B), plasma (P), or serum (5) values ‘System International Fluid Reference Range Reference Range ‘Alanine aminotransferase (ALT) Ss 8200 (0.13-0.33 kat/L Aldosterone, with normal sodium S Supine: <16 ng/at <444 pmol/l. intake of 100-200 mBa/day Upright: 4-31 ng/dl. 111-860 pmol/L, Arginine vasopressin P1.0-13.3 pa/ml. 1.0-13.3 ng/L Aspartate aminotransferase (AST) S__9-40U/, (0.15-0.67 kav Bicarbonate, arterial P 22-26 mba/l 22-26 mmol/l. Bilirubin, total S__0.1-1.0 mest, 217 mol/L Calcium: S 8410.2 mg/dl, 2.1-2.6 mmol/L Carbon dioxide (PCO,), arterial B 35-45 mmulg 4.76.0 kPa Chloride BS 95-105 meq/t 95-105 mmol/L Cholesterol, recommended S$ <200 mg/dl, <5.2 mmol/l Cortisol S080 h: 5-23 g/dl 138-635 nmol/L. 1600 h: 3-15 g/dl. 2000 h: <50% of 0800 h value 82-413 nmol/L <0.50 of 0800 h value Creatine kinase Female: 10-70 U/L. 0.47-1.17 kat/L Male: 25-90 U/L, 0.42-1.50 kat/l, Creatinine S__0.6-1.2 mg/dl. 53-106 mol/I. 1,25-Dihydroxyvitamin D 16-42 pg/mL. 38-101 pmol/L. 25-Hydroxyvitamin D 8-80 ng/ml 20-200 nmolél. Estradiol BS Female Prepubertal: <20 pg/ml. <73 pmol/L Premenopausal adult: 23-361 pg/ml, 84-1325 pmol/L. Postmenopausal adult <30 pg/ml, <110 pmol/L Male: <50 pg/ml, <184 pmolil. Ferritin S Male: 15-200 ng/ml. 15-200 gil, Female: 12-150 ng/ml. 12-150 gil Follicle-stimulating hormone S Male: 4-25 mit/ml, 4250 Female: Premenopause: 4~30 IU/ml. 430 U/L Mideycle peak: 10-90 mil/ml. 10-90 iL Postmenopause: 40-250 miU/ml. 40-250 U/L. Glucagon, P 50-200 pg/ml 50-200 ng/L. Glucose ‘S- Pasting: 70-110 mg/dl. 3.9-6.1 mmol/L. 2-h postprandial: <140 mg/dl, <7.8 mmolll.E@® rin Growth hormone Fluid Reference Range 2.0-6.0 ng/ml System International Reference Range 2.0-6.0 g/L HDI cholesterol, as major risk factor S__<35mgidl. <0.91 mmolil. Insulin 80-29 U/mt (0-208 pmol/l Iron S__ 50-170 g/dL 9-30 mol/l, Lactate dehydrogenase S$ 100-1900/, 1.73.2 kati LDL cholesterol, desirable S_<130 mg/dl <3.36 mmol/L Luteinizing hormone S Male: 6-23 miUi/ml, 6-23 U/L. Female Follicular phase: 5-30 mll/ml. 30 UL. Mildeycle: 75-150 mlU/mt. Postmenopause: 30-200 miU/ml. 150 U/L. 30-200 UL. Magnesium 1.5-2.0 mg/L. 0.75-1.0 mmol/L Osmolality PS 275-295 mosm/ke H,0 275-295 mosm/kg Hy ‘Oxygen content, B 17-21 mbidl 017-0211 Oxygen saturation, arterial B_ 96-10% 10.96-1.00 mol/mol Oxygen tension (PO,), arterial B__75-100mm Hg 10,0-13.3 kPa Parathyroid hormone P___10-60pg/mi 10-60 nail. pit arteria Bo 735-745 [17] 35-45 nmol/L Phosphatase, alkaline S___20-70U/L 0,331.17 kat/l Phosphorus, inorganic S 30-45 mg/at 1.0-1.5 mmol/L Potassium S__35-5.0 mBq/t 3,5-5.0 mmol/L, Prolactin S Female Nonpregnant: 3-30 ng/ml. 3-30 g/l Pregnant: 10-209 ng/ml, 10-209 g/t. Postmenopausal: 2-20 ng/ml -20 g/L _ Male: 2-18 ng/mL, DAR g/L Proteins Total S 6.0-7.8 g/dl 60-78 gi Albumin S 35-55 g/dl. 35-55 gil. Globulin, S_23-3.5 e/dL 23-35 g/L Sodium, S_ 136-145 mbq/h 136-145 mmol/l Testosterone, tofal, morning, P Male: 300-1100 ng/dl 10.4-38.1 nmol/L, Female: 20-90 ng/d 0.73.1 nmol/L ‘Thyroid-stimulating hormone S$ 05-5.0 U/mL, O mui ‘Thyroxine (T,), total 5-12 gill. 64:15 nmol/l, ‘Triglycerides, fasting S 35-160 mg/dl. 0.4-1.8 mmol/L, ‘Trilodothyronine (T,) S 115-190 ng/al. 1.8-2.9 nmol/L. Urea nitrogen (BUN) S_ 7-18mgidt 2.5-6.4 mmol urea/l Urie acid 3.0-8.2 mgd. 0.18-0.49 mmol/l,Hematologic values aroenoxs D> Blood volume Plasma volume Male: averages 69 mL/kg body weight Female: averages 65 ml/kg body weight Male: 25-43 mL/kg body weight Female: 28-45 mL/kg body weight 0,025-0.043 Likg body weight 0.028-0.045 Likg body weight Erythrocyte count Male: 4.3-5.9 H10°/mm? 43-5.9 1027, Female: 3.5-5.5 H 10°/mm?> 3.55.5 H102/L Male: 0-15 mm/h (0-15 mm/h Female: 0-20 mm/h (0-20 mmdh. Hematocrit Male: 41-53% 041-053 le: 36-46% 0.36-0.46 Hemoglobin. blood Male: 13,5-17.5 g/dL 2.09-2.71 mmol/l, Female: 12.0-16.0 g/dl. 1,.86-2.48 mmol/L Hemoglobin A, #6% of total Hb 40,06 of total Hb Leukoeyte count and differential Leukocyte count 4£500-11.000/mm? 45-11.0H 10%, ‘Segmented neutrophils 45-74% 0.45-0.74 Bands 04% 0.00-0.04 Eosinophils O-7% 6.00-0.07 Basophils 0.2% 0.00-0.02 Lymphocytes 16-45% 0.16-045 Monocytes 410% 0.04-0.10 Mean corpuscular hemoglobin 25.4-34.6 pa/cell 0,39-0.54 fmol/cell Mean corpuscular hemoglobin conc. 31-36 gia. 4.87-5.58 mmol bil, Mean corpuscular volume 80-100 m* 80-100 Partial thromboplastin time, activated 25-40 seconds 25-40 seconds Platelet count 150,000-400.000/mm? 150-400 8 10° Prothrombin time 11-15 seconds 11-15 seconds Red cel distribution width 1 5-14.5% 0115-0185 Reticuloeyte count 0.5-1.5% of red eels 0.005-0.0015Abscess 47 Acetyaldehyde, 107 ACh receptor antibodies. 217 Achloehydia, 79 ‘cid base balance, 133, 135, 137, 139, 141 ‘eid fast bail, 173 ‘Aci oad, 133,135, 137 ‘Acidosis, Se Diabetic ketoacidass: Metabolic acidosis: Respiratory acidosis Acquired immune defclency syndrome. ‘Sve AIDS ACTH (adrenocorticotropic hormone). 191, 193 Activated partial thromboplastin time. See APT Activated protein C. 65 Acute lace, 35 Acute myeloblastic leukemia, See AN ‘ute reval fallre. See ARE Acute respiratory distress syndrome. See ARDS ‘Adalsonan evs 191 ‘Addisons disease. Ser Adrenal insulcieney ‘Adenoma parathyroid, 189 cutary 193 ADH (entduretc hormone}. 195, 197 Adronal gland. 191, 193 Arenal insufficiency, 191 Adeenal neoplasms, 193 ‘Adrenocorticotopic hormone. See ACTH. Adult call eke, 85 AEB positive sputum, 173 AIDS (acquired immune deflency syndrome), 163, AIDS-defining illness, 163 ‘Airway inflammation, 1 Airway obstruction. 41 Alanine aminotransferase, 237 Alcoholic hepatis.107 Aldosterone. 191, 237 Alkaline phosphatase, 207, 238 alkalis chloride resttant, 137 chloride responsive, 137 metabolic, 137 respiratory 41.181 Allergic init 145, ‘Ap symuckin, 273, ‘Alpha thalassemia, 71 ‘Aluminum incxication, 185 Alveolae damage, se, 43 Alveolar dend space, 43 Alveolar hypoventiiion. 137 Alveolar macrophages. 173 ‘Alveolar walls, 39 Aldelmersdivease, 211 “Amenorebea, 229, 233 AML (acute myeoblasti leukemia). 83 Amylase, 95 “Amyloid anglopathy, 221 Aunyiokd precursor protein, 211 Anaphatoxin 3 Anuphylants. 3 ‘Androgen. 191.229) Anemia, 31,91. 119 aplastic, 83 of chronic disease hemolytic 51, 64.71 from deficiency 77, ‘megaloblaste, 51,67 microangiopathic hemolytic. 61 rmiroeyte mil, 73 rnormoeyte noemochromie, 115. pernicious, 79 siete cel, 51 Angina, 27, 31.33 “Anlon gap metabolic acids, 177 ‘non anion gap %, 133,135, Anorexia, 23,35 ‘Anovulation, 233 AND (atl nateiaretic peptide}, 21 “Anterior descending artery let. 31 ‘Anterior pltltary. 181, 193 ‘nibodies ACh receptor, 217 humoral immunodefciencis eating to, 153 PANCA, 91 Antibody dependent cellar cytotoxicity. 147 ‘Anliaretie hormone. See ADE ‘Antigen presenting el See APC Anilgens endogenous, 149 exogenous, 149) immune modiated dlsorders relating to, 145, 147, 149,131, 1 fhyrnus dependent 8 thymus independent. 9 Antithrombin I deficieney. 65 Aortic regurgitation, 29 Aortic stenosis, 27, APC (antigen presenting cell) 7.41, 65,93, 163 ‘Aplastic anemia. 83. Apoptosis, 7.171, 225 PTT (activated partial thromboplastin time), 5,159 Aguaporin, 195,197 ARDS (acute respiratory distress syndrome), 35 45.47 ARE (acute rena allure) Intrarenal or intrinsic, 113 poscrensl, 113, prerenal, 113 Arwinine vasopeesi, 237 ‘Arterial pressure, 21 pulmonary. 43 Arteries. Se specific entries Arthritis 35. Seeaso Mon or olgoartrs, Ostooarthets rheumatoid 149, 201 symmetric, 201 Arthus reaction, 149 ‘Articulee cartilage. 203 Ascites.23,33, 101 ‘Aspartate aminotransferase, 237, Asters, 115 Asthma, 41, 145 Asymptomatic heart lure, 21 Asymptomatic hyperuricemia, 55 Ataxla-telangiectasia, 155 Atelectasis 43,45, Atheroma, 33 ‘Atherosclerosis, 31, 33,115, 179,225 Athetosis.215 Atrial iat, 29 ‘Atrial natrarctic peptide. See ANP Atciom, 23. 35 Atcophie thyrokis, 183 ‘Aver ods, 83 ‘Autoantibodies, 159 ‘Avtoantigens. 159 ‘Autoimmune disease, 219 ‘Autosplenectomy. 51 ‘Axonal injury 219) ‘Azote, 115, 171 Beals, 9, 41,201 Bacteria Urtreatingt. 169 Bacteria ests ‘acute uncomplicated, 169 complicated, 169, Bacteria meningitis, 167 Barret’ epithelium, 89 Barts hemeglbin, 71 Bernard-Soulie syndrome. 63 Beta thalassemia, 73, Bicarbonate arterial, 237 Bile, 97 Ble duct. common, 97 Biliary elle, 97 Iiliubin, total, 237, Blood, Seals REC (ced blood cells) hemoglobin, 239 BNP (brain aateturetlc peptide), 21 Bone disorders See Rheumatooglc and bone disorders Bone formation, 205, Bone marrow, 51, 67.75, 153,155, Bone marrow expansion. 73 Bone marrow hyperplasia, 71 Bone resorption or turnover. 205 Bony ankylosis, 201 Bouchani’snodes, 203, 7.85,@ ww Bradykinin, 5 Brain natriuretic pepe. See BNP Bronchitis chronic, 39 DBronchoconstiton, 41 (CB convertase,3 CS convertase, 3 Calcio, 185, 187,217,237 Calotum homeostasis. 185, 187 Cancer endometrial. 233 (Carbon david, arterial, 237 CCariae eyes 31 Cariae output ‘congestive heart fallure relating fo, 21, 27.115 eep vein thrombosis and pulmonsy embolism, relating to, 43 Ie sided art ale eating to, 23.2 ‘ight sided heart alurereetng to, 23.27, 39.43 Cardiogenic embolus, 225, ‘Cardiomyopathy, lated. 25 ‘Cardiovascular disorders satherosleros's. 33 congestive hear failure, 21,27. 115 cor pulmonale, 35.43 let sided heart are, 23, 25, rnyocardl ischemia and infarction, 31 right sdod heat failure, 23,27, 39.43, valvular regurgitation, 27,29 valvular tenons, 27.29, CCariage metabolism, 203 Cavitation. 173 CERS chemokine receptor 163 (Cod T eal. 9, 41,95, 163,201 Celt mediated estos. 151 Celbmedated immune esponse. 177, Cellet immnity: pases of sfetor,7 ell-medited inflammatory response 79 Calls See pei entries Cellular immunodeicencies, 155 Calla rections, to ace inflammation, 11 Conta dates insipid, 195 Central neryoos system, See CNS Centroblais.9 Cerebral chemi, 225, CTR (ys ibeossansmembrane conductance regulon protein, 53 lachains, 71,73 Bebains 71.73 Charcot’ triad. 97 (Chloride ebarne, 33 CChorie resistant alos, 137 CChioride responsi alkalosis. 137 Cholangitis. 97 Choledocholthiass, 97 hoelthiasis, 97 Cholesterol. 97.237, 238 Cholesterol erysials. 97 Chorea, 215 (Chromosome 4,215 (Chronic obstruct pulmonary disease. See COPD (Chronic produetive cough. 39 (Circulating immune complex, 149 iumfex artery. 31 eros BIOL ONS (central nervous sytem), 33,127, 171,219 Cougulaton caseade 43,171 Tactors eating to, 5 pathways of ‘common, 5.65 cstrinsie. 5.61 nttnse 5.59. 63, 65 ‘Coagulation, lsominated intravascular. 61 67.171 Collagen. 203 Colon, 91 Colonie mucosa immune system. 91 Common ble det. 97 Common variable immunodeiceney syndrome, 153, Community acquired pneumoni. 47, Community acquired (7, 169 Compensated oscoarthitis, 203, Complement cascade, 147, 201 ‘apart of mmiane sistem. 3 paths of ‘alternative, 3 Concentric hypertrophy. 25,27 ‘Congestive hea fale, 21. 27.125 (Contact dermatitis, 151 COPD (chronic obstructive pulmonary dea 35,39 (Cor pulmonale, 35.43 ‘Coronary arteries 31, 33 Coronary vasoconsrct Cortcotropin. Ser RH Cords, 237 Creatine kinase, 237 Crescent shaped hematoma, 223 RH (corticotropin). 191, 193 Crab’ disease, 93 Cevoglobinemia, 105 Cashing’ disease and syndrome, 19 (ystieduet, 97 Cystic ross. 53, atc fibossiansmembrane coductaace regulator protein. SeeCETR protein (Cytokines 7,41, 75,91, 145, 167.201 Cytotoxic edema, 167, Cytotoxicity antibnly dependent cea, 147 coll mediated, 151 (Cytotoxins.7 Deep vein chrombess and palonary ‘embolism, 4 Delayed type hypersenstvity 151,173, Demyelinaton and plague fermation. 219 Diabetes sestational, 233, Insipdus, 195 smelt, 81, 11S type 1.177, type 2.177.179 Diabetic hetocidoss. 177 Diabetic neuropathy. 119 Diapodests. 11 Dhastole volume, 21,29 Diluse alveolar damage. 43 DiGeorge vynrome, 155 1,25.Dihydroxyvamin D237 Dilated cardomsopathy 25 Disseminated intevascolar coagulation. 61 67,171 DDoparninerge neuroma oss, 213, Dysfunctional ant-ehax barr 89) Dysfunctional dssuc resistance. 89 Dyspnea, 39,45, ‘om exertion, 27 paroxywmal nootuenal, 25, 27.29 Recent hypertrophy, 25. 29 Elampsa, 235, badema, 41,119,197 cytotoxic. 167 Intestta, 167 periorbital. 183, peripberal 23. 35 pralmonars 25.2 ‘vasogenic. 167 Lector Tels, 7 ectrulte disorders Se Fluid abd electultes disorders Hevated liver erases, 23 nboli cardhogenk. 225 rnon-cardiogenie,225 pulmonary. 35.43, 165, septic 165, thrombotl, 33 ‘bli scheme stoke, 225, Emphysems, 39 Empyera. 47 Prdocardts. 29 ‘acter relating to, 165 classificatons of, 165 infetve, 165 Endocardivm, 35 Endocrine ats, ping, 231 Endocrine disorders ‘adrenal insifcieney, 191 Cushing’ lsease and syndrome, 193. iabetes insipidus, 195, iabotes melitos 117 type 2,177,179 Iaypecalcemi, 185, 187 Iayperpaathyroidism, 185, 189.207 Inyperthyroidsm, 181 Inypocaleemia. 187 Fnypotalanns eating to, 181, 183, 191, 193. 195 ‘nypothyroiism, 119, 183 SIADIL, 197 Endogenous antigens, 149 “Endometeial cancer. 253 ndometium proliferative phase of 229 secretory phase of, 229 ‘indothetial cel 201, [ndothelialdysfemction, 33,235 “Endodhelia injury. acute iftammation relating, 11 29.43dotheium actvation of vascular injury to, 63 Pribstag liver falar 105 End-stage renal disease. 115,117 Eosinophils 41 piduralbematoma, 225 pileps 21 plepic syndromes, 221 Fpieptogeness, 221 Epithelial cll dystunetion, 91.173 rosie efx disease, 89 Brythroblatos fetal, 147 Brytheocyte count, 229 Biythrooyte sedimentation rats, Exythropoies's, 71.73.75, 7.81 rythropoietin, 75,77 sophagastic junction, 89 Bxophageal adenocarcinoma, 89 Essential thrombocytosis, 83 radio 229,237 steogen, 232 uvolemic hypernatremia, 1 volemic hyponatremia, 125 Excitotoricty. 225 xucrine panereatc function, defective, 79 Exogenous antigens, 149 Exteeclllarbufering, 133 Extracellular uid compartment. 125, 127 Extracellolar uid. 133,135,137, 139, 142 Extrahepati manifestations, 103, 105 Fxtra-pulmonary disease, 17 actors. Soe also ANP: BNP; Intrinsic factor receptors ‘coagulation cascade eelating to. 5 hhemophifias A.& Belang to, $9 primary hypercoagulabe states eating, 10,65 at necrosis. 95 Female reproductive system dsorders amenorrhea, 229 menopause, 231 poleystc ovary syndrome, 233, reeclampsla/eclampria, 235, Femoral veins 43 Ferritin, 75.77.81, 237 etal hemoglobin, 73 Fri. 5.59, 61, 165, Flrinogen, 3.59.61 ibinobss. 5, 61 ibroatheroma, 32 Fibrosis, 13.39, 101,107,157 cystic, 33 pulmonary. 45 Fibro plague. 22 Fistulas, 95 Fluid and electrolytes dsorders ‘anion gp ¥.non anion gap metabole cides. 133, 135 lnyperkalemia. 231 Ihypernatremia, 127 hypokalemia, 129 hyponatremia, 125 Kidneysrelating to, 133, 135, 137, 159,14 metabolic acidosis, 113, 133,135, metabo alkalosis, 137 respiratory acidoss 41, 43. 139, respiratory alkalosis 4, L4 Foam cll, 33 Focal chemi, 225 olck-stimulating hoemone Se FSR SH (flee stating hoemone), 231,237 Fulminant hepatitis. 103, Gall blader 97 Gastroesophageal reflux disease See GERD Gastrointestinal dsonders cholelithiasis, 97 ‘Crohn's disease, 93 GERD, 89 pancreatitis. 95 tlceratve colitis, 91 Gastroinestioal trict, 53, Genetic disorders vsti ts. 53 out sickle cell anemia, 51 Genitouriacy system, 53 ‘GERD gastroesophageal reflux disease), 89 Germinal cater, 9 Cestitlonal diabetes, 253 ‘GPR igomerularilteation rate), 113 GGianzmann's dheombasthena, 63 ‘agiobin chains, 71,75 Balobin chains. 71.73 ‘eglobin genes, 71, 73 Belobin genes, 71,73 Glomerular disease secondary. 117 (Glomerular Hilteation rate. Soe GER. Glomerulonephries. 115, 117 Glomerulonepbrits. 117, 149 ‘Glomeruloscleroi, 115 lucagon, 237 hucocorticoi levels 191 (Glucose, 177.179, 237 ‘Glutathione supply, 107 Gout, 35 Gouty sephropathy, $5 Graft ejections. 151 Gamulom forms, 7,157,173 Granalomatous reaction, 151, 185 (Growth hormone, 238 Hay celleukemia, 85 Barts. 71 LHD (hepatitis B virus. 103, HCV hepatitis C virus, 105 HCV RNA. 105, HL cholesterol, 238 Hear disease, rheuma Hear failure asymptomat, 21 ‘congestive. 21.27 let side, 23 2 right sided, 25 Sans and sympoms of 21 Heart marmurs. 29 Heherden’s nodes, 203 Heinx bales, 71 [HELP syndrome, 235 Heemarthrosis, 59 Hematocrit, 239 nex > Hematoma recent shaped, 223 epidural 225, subdural 229 Hematopoetle disorders apa thalassemia, 71 emia of ehronic disease, 75 beta thalassemia, 73 Ihemoeheomatoss, 73,81 ‘ton deficiency anemia, 77 lympbod ymphomas aed leukemias, 85 ‘macrophages relating to, 75, 77.81 ‘myeloid lymphomas and leukemias, a ‘itamtn B12 deficiency 79 Heematuria, asymptomatic, 117 Hemechroaiatosi, 73, 81 Hemochromatosis gene mutation, 81 Hemoglobin, 77 ATS Ag. 239 Baris, 71 lod, 259 fetal, 73 Hedsease, 71 mean corpuscular, 239, FHemoglobinopathy. 51 Hemolyis intravascular St Hemolytic anemia. 51,61, 71, 73, microanglopathic. 61 Hemopbilis A&B factors relating to, $9 pathways relating to, 59 Hemoptysis, 27 Hemorrhage Intracranial, 223 subarachnoid, 223 Hemorthagie pancreatitis, 95, Hemosiderin, 81 Hemostasis sabnormal. 115 peimary. 17 secondary, 5 Hemostasis disorders Mitochondtal dysfunction, 212 Mitral egurgiation, 25,29 Mitral stenosis.27 Mitral valve prolapse, 29 Mixed acid bse disorder, 132, [Mobs (multiple organ dvsfcton syndrom) 45,61, 171 [MOE itp organ ature. 61 Mono or oligoarthrtis 53 Monoeytes. 33 Monosodiam urate, 5 Mucous secretion, 41,53 ulhipl chron ver escases. 101 Multiple myeloma. 85 ‘Multiple organ dysfunction syndrome, Sie MODS Multiple organ ature. See MO Multiple seerosis 219) Murmur ‘cule of tricuspld regurgitation, 43 sorte 27. heart. 2 sida, 27 titel, 27.29 ie ftique, 217 Mycosis anges, Myelogenous leukemia, cheonic, 83 Myeloid fymphemas and leukemias. 83 Myelold metaplasia with myelosclersis, 83 Myeloid stem cl, 83 Myocardial contraction. 21 Myocardial inaction, 179 Mvoeardi ischemia and infarction, 32, Myocantialremedeling, 21 Myocaniiom, 23.31.35 Myveyte necrosis. 31 Myoestes. 21 yogeni les, 113, Myxedera coma, 183 Naive ell. 7 Necroteing vasculitis, 149 Negative brelringent crystals Neoplasms, adrenal 1915 \Nepiriiesynetome, 117, 119 epbeitis, 159 Nepheogsntedisetes insipidus, 195 Nepbrolthass. $5,121 [Nepbrons, 115 Iephropsthy. 179 Nephrotie syndrome, 117, 119 NERD inonerosive relay disease, 89 eurotiiloy tangles, 217 Neuobunoral mecanisas, 21 Neutolage disorders ‘Aluheimer's disease, 211 Huntington's disease, 215 Snracrial hemorrhage, 223 Ischemicstroke, 225 mullpe sero, 219) asthenia gravis 217 Parkinson's disease 213 seizures aul epilepsy. 221 Neuronal cel death, 167, 215 ‘Neuronal loss, dopaminergic. 213 Neurons, 211 Neuropatly. 179 ‘Neurotransmision. abnormalities with, 221@® Worx ‘Neutrophs 39, 45.147, 167 Noctua, 25 Nodes Bouchard’ 203 eberden's, 203 Iymoh. 5 [Non anion gap anion gap metabolic acidosis. 143,135, [Nom Hodgkin's rmphomas, 85 Nonccardiogeni embolus, 225 [Nonerosie roflax case. See NERD [Normal anon gap metabolic acidosis. 135, [Normochloremic metabolic cio, 135, [Normocytie normochronie anemia, 115 Nosocomial acquired UTI, 169 ‘Nosocomial pneumonia, 47 ‘Nuclestion, 97, 121 Otigomenorthea, 233 Opsontzation. 3.147 Orthopnea, 25.27.29 Osmolality. 238 plasma, 125,127, 177, 197 brine, 113. 195,197 Osteoazthtis. 203 (Onoclasts, 201 COxtoomalaia, 115, 119 rickets and. 207 Osteoporosis. 205 Ovarian cycle folicular phase of, 229 luteal phase of 229 ovarian failure, 229 Ovaries aging, 231 ‘Oxidative and nitrosatie stress, 213 Oxided IML, 33 ‘Oxygen content, arterial, 238 ‘oxygen saturation arterial, 238 P-ANCA antibody, 91 Pancreas, 33 Pancreatitis cute, 45,95 chromic, 95 Fhemoeshagle, 95 Parathyroid adenoma, 188 Parathyroid glands, 185, 189 Parathyroid hormone. See PTH Parathyroid hypecplsia, 189 Parenchymi train, 211, 225, liver, 101 lung. 39.45, renal, 113 Parkinson's disease, 213 Paroxysmal nocturnal dsp 27,29 ial thromboplastin time, activated, 239 Pathogens, 3.9 Pepsin. 79, 39) Perimenopause, 231 Perioebitl edema, 183 Paripheral edema, 23. 35, Periporal immune response. 219 Peripheral insulin resistance 179 Peripheral vasculature, 33 re Perniciows semi, 79 HL arterial 238 Phagoeytoss. 9.11, 147 Phosphatase alaline. 207.238 Phosphate deficiency. 207 Phosphorus homeostasis, 207 Phutary adenoma. 193 Ptutary gland. 181, 191, 193 Placenal chemi, 235 Plague, 31, 33,221, 219 Plasma coli, 9 91 Plasma icon pool, 81 Plasma osmolality, 125, 127,177, 197 Plasma proteins. 1 Plasma volume, 239 Plasmin. 5.51 Platelet agsrezates. 5, 43,59, 63 Platelet count. 239 Plateet disorders, 63 Platelet receptors 63 Platelets. 67 Pluripotent hematopoetic stem eels 153, 153 Pocuimoni, $5 community aegared. 47 nosocomial. 47 Podagra, $5 Polyestl ovary syndrome. 233 Polyeytbemia, 39 Polgethemia vera, $3 Polyps, 177.179, 195 Polyphagla, 17 Polyoria 177,179, 195 Popltal wens. 43 Portal hypertension, 101 Pore system, 35 Pottosystemie shunt, 101, Potassium, 238 abnormal cell fanetion relating to, 129,131 ‘abnormal distribution of 129. 131 Impaited excretion of 131 Intakes of 129) Preeclampsin/ecampia, 235 Pregnancy induced amenoerea, 229 Pretenal aziemia. eveesile. 113 Presynaptic rundown, 217 Pay adaptive immune response 9 Primary hypercoagulabe states, 65 Primary hypertension. 111 Primary iymphovd flee. 9 Primary ovarian furs, 229 Primary renal disease 117 Prolactin, 238 Pros.atits, 169 Protein C decency 65 Protein deficiency. 65 Proteinase ett, 39 Protein, 119, 235 Proteopscans, 203, Protombin, 5, 59 Prochrombin motaiton 65 Prochrombin time. See PT Preudocysts, 95 Pseudobyperkalemia, 131 Pseudobypocalcemia, 187 Pseuohyponatremia. 125 PP proiroanbin time), 5,239) PIE (parathyroid hormone), 185, 187,189 Palmonary arterial pressure, 43 Pulmonary arteries, 33, PPalmonary disease. 173 PPalmonary disorders acute respiratory dlstress syndrome, 45 fasting, 41 coPD. 35.39 ‘or pulmonale, 35,43 ‘deep vein theomboss and pulmonary embolism. 43, macrophages relating wo. 39,47 noun, #7 Pulmonary edema, 25.27, 29,43 Paimonary embolism, 35.43, 165 Pulmonary fbrosis. 45 Pulmonary hypertension, 29, 35,45 Pulmonary infection. 43 Pulmonary vale nsufickeney of 23,35 Purine, degradation of 55 Pyelonepheits. 169, [RBC (red blood cells). 75.81. 117 Receptor mediated endocytsis, 105, Red blood cells. Ser RBC Red el dsrbusion width, 239 Reed Slernberg cll. 85 Refractory hypoxemia. 45 Refractory septie sho. 171 Regenerative oodles, 101 Regurgitation ‘sorts, 24 mitral tecuspid, 43 valvular, 27,29 Renal artery stenosis, 33 Renal biopsy: 117 Renal compensation, 139, 141 Renal disease wendstate. 115, 117 pemary 117 Renal disorders slomerulonephrits. 117, 149 hypertension, 111 nephrolithisis, 55,121 ‘nephrotic syadrome, 117, 119 real falare, 111,113,115, eral exertion, 133,137, 139 eral flare ARE ID crank, 11,115 ena functions. lose of 115 Renal osteodystrophy. 115 Renal parenctyma, 113, Renal reasorpson and synthesis, of new HCO, 133.137 Renal vein thrombosis. acute, 119 Reperfusion injury 45 ES (reticuloendothelial system 47,75 171.23 Respiratory actos. 43,43. 138 Respiratory alkalosis, 41, 141 Respcatory compensation. 133 esting cell membrane potential, 129, 131 Retculocyte count, 75,77, 239 Reticuloendotbellal macrophages, 81 Reticuloendothelial system, See RES Retinopathy 179 Reverse transcriptase. 163heumaticheart disease, 29 Bheumatoid arthritis, 149 ‘chronic iflammation relating to, 201 sstemie manifestations of, 201 Rheumatol factor, 201 Rheumatologie and bone disorders stcoarhriis. 203 osteomalacia, 115, 119, 207 ‘osteupoross,205 rheumatoid arthritis, 149, 201 rickets, 207 Ricks. See Osteomalacia Right sided dilatation, 43, Hight sided heat failure, 23, 27.99.43, Right wentricular pressure. 43, Sarcoidosis, 157 Schistocytes 61 Secondary adaptive immune response. 9 Secondary lomerularalease, 117 Secondary hemostasis § Secondary hypertension, 111 Secondary ovarian fallare, 229 Seizures and epilepsy. 221 Sepsis, 45,51. 171 Sepsis cascade, 171 Sepsis syndrome, 171 Septicemboll. 165, Seplic shock, 171 Sequestration, 67, 101 Serology of hepatitis B, 103, Serum sickness, 149 ‘Severe combined immune dlicieney, 155. Seaary syndrome. 83 Shortnes of breath, 35,47 SIADH (syndrome of Inappropriate antdiurede hormone secretion) 197 Sickle cell anemia, St Sickle cell erat St Sikle shape. 51 SIRS systemic inflammatory response syndrome). 95, 171 Sodiuen, 125, 127, 238 Somatic hypermutai Spleen. 67 Splenic sequestration, 51 Splenomegaly 31.71, 73.83 Samana metaplasia, 39 i107 te cals, 107 nite, 27 real artery 33 valvular, 27,29 Stone formation, in kney, 121 Strokes, 27.29, 159, 179, 225 Subarachnoid hemorebages 223 Subdral hematoma, 223 Sweat lands. 53 Symmetric arthritis, 201 9 Syncope, 27 Syndrome of inappropriate antidhretic hormone szcretion, See SIADEL Synovitis. 55 ‘Synovium, 201 Syphilis. 29 Systemic anaphyess, 145 ‘Systemic inflammatory response syndrome See SIRS ‘System lupus erythematosus, 149 causes of 159) Inflammation relating to, 159 nephritis relating to, 159) ‘Systemic manifestations, of rheumatoid arthritis 201 Systemic vasculature 23,35, Systolic dysfunction, 25, 29 Systolic function, 23 Systolie volume, 25, 29 ‘Teel activation or priming, 7,91, 155,157, 217,219 TB cals, 181, 183, THealls, 181, 183 ‘Tubular necrosis, cute, 113 Tachyeandia. 43, 45, Tachypoea, 43,45 Target ells, 7 Testosterone, total, morning, 238 ‘Th cell eytokine profil, 7 ‘Tha cytokines, 41 ‘Tha pathwos, $1 Brhalassemia intermedia, 73 ‘thalassemia major, 71 B thalassemia major. 73 ‘thalassemia minor, 71 Bihalasemia minoe 73, ‘Thrombin, 5,59, 61.65.17) “Theombocytopathia. 67 ‘Thrombocytopenia, 61,67, 172 ‘Theombocytosis, 83 “Theombomodatin, 65 ‘hrombopotetin, 67 Trambosis, 33 deep vein. 43 ‘Thrombetic emboli, 33 Thrombotic phase, 61 “Thrombus, 43 ‘Thymic aplasia, 155 ‘Thymus, $5, 155, ‘Thymus dependent antigens. 9 ‘Thymus independent antigens, 9 ‘Thyroid glands, 181 ‘hyroidstimulating hormones. SerTSH ‘Thyeotoxcoss, 31,181 ‘Thytotcopin-releasing hormones, See TRH ‘Thyroxine, total, 238 "TIA (ransient ischemic attack), 22: "TC (otal ion binding capacity) 77. 81 Msue damage chronic inflammation relating 1d ‘issue necrosis. nlaamation relating to, 11 Toph 55 ‘ota iron binding capacty See TRC Teaaslercin, 75,81 Transfusion reactions, 147 ‘Transient fchemla, 31 ‘Transient ischemic attack, SoeTA ‘Transient LBS relaxation, 89 ‘Transmaral inflammation, 93 “Trauma, acute inflammation seating to, 1 "TRE (thyrotropin-eleasing hormones). 181. 183 ‘ricuspld regurgitation, acute murmur of £3 ‘Tricuspid vale, insulfikency’of 23, 35. rigiverdes, fasting, 238, Trilodothyroaine 238 nox > “Trimucleoide repeats, 215 ‘Trisomy 21,211 TSH (thyroidstimulating hormones), 181. 183 ‘Tubercaln test reaction, 151 ‘Tuberealosts, 173 ‘Ubiguttn proteosome system dysfunction, 213 Uleerative colitis, 91 Urea nitrogen (HUN), 238 emia, 115, redhat, 169 Unie ald, 55,238 Urinary tract infection Se UT Urine low, obstruction of 113, 169 Urine osmolality. 113.195, 197 Urosepss, 169 Urticaria, chron, 147 Dterusand outflow tract anatomic aboormalites of 229 [DTT urinary tract infection) boctria eating to, 169, ‘community acquire, 169, nosocomial acquired. 169 Valvular regurgitation, 27,29 Valvular stenosis, 27,29 Vascular endothelium, injury to, 63 Vascular permeability. inerese tn. 11 Vascular reactions, t acute inflammation, 1 Vasculature peripheral, 33 systemic 23, 35, Vasoconstriction, 111 ‘coronas 31 intrarenal 113 Vasodlation. 1 Vasogenle edema, 167 Vaso-occlusie eras 5 Vasopressin arginine, 237 release of 21 Yasospasm. 31 Veins. See sper entres Venous stasis, 43, Venivicle ef, 23, 25,27 right, 23,35 Ventricular hypectropby 23, 31.35,111 Vial envelope phyeoprotein, 120, Viremia, 163 Vitamin B12 defckney. 79 Vitamin D deficiency. 207 Voltage gradient, 129, 131 Von Willebrand disease, 63 ro mismatch, 43, 45,47 Willettan deyeneration, 219 Water homeostasis, 195,197 loss of, 12 retention of 125 ‘Wide puke pressure, 29 Wiskott- Aldrich syndzome, 155 inked agammaglobulinemia, 153,Acquisitions Ealtor: Nancy Dally Developmental Eltor: Kathleen H. Seogna, Marketing Manger: Emi Moyer Sles Representative: Job Friscia Production altar: Gina Aiello Art Director: Doug Smock Compostor: International Typesetting and Compesition Printer: Data Reproduction Corp. Copyright © 2008 Lippincott Williams & Wilkins 351 West Camden Street Baltimore, MD 21201 530 Walnut Stceot Philadelphia, PA 19106 All rights reserved. This book is protected by copyright. No part of this book may be reproduced Inany form or by any means. including photocopying. or utilized by any information storage and retrieval system without written permission from the copyright owner, ‘The publisher isnot responsible (asa matter of product lability, negligence, or otherwise) for any Injury resulting from any material contained herein, This publication contains information relat- ing to general peinciples of medical care that should not be construed as specie instructions for individual patients. Manufacturers’ product information and package inserts should be reviewed for current information. including contralndications, dosages. and precautions. Printed inthe Unitod States of America Library of Congress Cataloging-in-Publication Data Agostl, Yasmeen. MedMaps for pathophysiology / Yasmeen Agost, Pamela Duke. prem. Includes bibliographical references and index, $BN-13:978-0-7817-7755¢1 ISBN-10: 0-7817-7755-0 1, Pathology. L Duke, Pamela, IL. Tie IDNLM: 1. Pathology. 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