More phenomenal Netter resources… for an optimal visual understanding! Runge & Greganti: Smith: Netter’s Netter’s Internal Obstetrics and Madden et al.: Ferri: Medicine, Gynecology, 2nd Edition Netter’s 2nd Edition Ferri’s Sports Netter Advisor (Book & Online Access) (Book & Online Access) (978-1-4160-4997-5) Medicine (978-1-4160-5683-6) Desk Display (Book & Online Access) Charts (978-1-4160-5924-0) (978-1-4160-6039-0) Also coming soon! • Floch: Netter’s Gastroenterology, 2nd Edition (Book & Online Access) (978-1-4377-0122-7) • Jones et al.: Netter’s Neurology, 2nd Edition (Book & Online Access) (978-1-4377-0274-3) • Hansen: Netter’s Clinical Anatomy, 2nd Edition (978-1-4377-0272-9) Want Netter images? View more Netter titles and other great resources at www.elsevierhealth.com! Visit Netterimages.com! Make clinical decisions efficiently... solve diagnostic challenges with certainty! In print and online, these titles by best-selling author Fred F. Ferri, MD, FACP equip you with fast-access solutions to meet your everyday clinical challenges! Ferri Ferri’s Clinical Advisor: 5 Books in 1 Expert Consult – Online and Print Simply the fastest, most effective way to access current diagnostic and therapeutic information on over 700 conditions. • Effortlessly search each thoroughly updated volume online. • Quickly locate actionable guidance on diseases and disorders, differential diagnosis, clinical algorithms, laboratory evaluations, and clinical preventive services...year after year! 2010 ISBN: 978-0-323-05609-0 • 2011 ISBN: 978-0-323-05610-6 • 2012 ISBN: 978-0-323-05611-3 Ferri Ferri’s Color Atlas and Text of Clinical Medicine Expert Consult – Online and Print • Follow a one-of-a-kind approach to facilitate the diagnosis of virtually every condition encountered in daily practice! • Review the full range of visual findings associated with any disorder through nearly 4,000 high-quality photographs complemented by concise explanatory text. • Conveniently access the complete contents online—including downloadable images. ISBN: 978-1-4160-4919-7. Order your copies today! Visit www.elsevierhealth.com or call 1-800-545-2522. F E R R I ’ S NETTER PATIENT ADVISOR 2nd Edition Fred F. Ferri, MD, FACP Clinical Professor Department of Community Health Alpert Medical School at Brown University Providence, Rhode Island Illustrations by Frank H. Netter, MD Contributing Illustrators Carlos A. G. Machado, MD John A. Craig, MD 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 FERRI’S NETTER PATIENT ADVISOR ISBN: 978-1-4160-6038-3 Copyright © 2012 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this book may be produced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system, without permis- sion in writing from the publishers. Permissions for Netter Art figures may be sought directly from Elsevier’s Health Science Licensing Department in Philadelphia PA, USA: phone 1-800-523-1649, ext. 3276 or (215) 239-3276; or email [email protected]. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such informa- tion or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2010 International Standard Serial Number (ISSN) 1943-9822 ISBN: 978-1-4160-6038-3 Publishing Manager, Netter Products and Services: Elyse O’Grady Senior Developmental Editor: Marybeth Thiel Publishing Services Manager: Julie Eddy Senior Project Manager: Celeste Clingan Design Direction: Louis Forgione Publishing Director, Medical Education: Anne Lenehan Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 PREFACE As a practicing primary care physician for the past 25 years, I am Knowledge is essential in maintaining good health. I hope aware of the patient’s needs for reliable, practical, and easy to that this book fulfills your every expectation and provides valu- understand medical information. The goal of this book is to able learning support to your understanding of the numerous be a comprehensive, current, and clinically relevant medical illnesses afflicting humanity. resource for the public. This medical reference (book and online information) covers Acknowledgment hundreds of topics, ranging from common disorders to rare diseases. Each section follows a similar format and consists of This product represents a highly collaborative and dynamic effort an initial description of the medical disorder and its causes, com- between the Editor and Elsevier. I am greatly indebted to the mon signs and symptoms, diagnostic methods, recommended First-Consult department at Elsevier for sharing some of their treatment, do’s and don’ts in managing the specific disorder, and patient education material and to Drs. Frank Netter and Carlos sources of additional information on each topic. Illustrations Machado for their unparalleled illustrations. I also wish to thank accompany each topic and facilitate its understanding. Visuals are Elsevier for their exceptional support and guidance in this project. the critical language of medical education. The old adage of “a Finally, I want to express my gratitude to the many authors of the picture is worth a thousand words” is certainty true in medicine. Patient Teaching Guides in Ferri’s Clinical Advisor, and Dr. Peter Recognition of disorders from illustrations remains crucial to Petropoulos in particular, for their superb contributions and early diagnosis and treatment, both of which are usually essential friendship. to improve prognosis. The use of thousands of illustrations from Dr. Frank Netter, an outstanding physician and perhaps the best Fred F. Ferri, MD, FACP medical illustrator of all time, makes this book unique amongst Clinical Professor medical texts for the general public. Alpert Medical School No book can replace the consultation and physical examina- Brown University tion by a qualified physician; but by providing the reader with Providence, Rhode Island better understanding of his or her medical condition, this medical guide is far superior its competitors and will certainly enhance communication between patients and physicians. v This page intentionally left blank FERRI’S NETTER PATIENT ADVISOR Full book online at www.NetterReference.com. See inside front cover for pin code. CONTENTS Plus, available online only: Spanish translations Bonus handouts Endocarditis (infective endocarditis; subacute bacterial Cardiology endocarditis) 513 Exercises and cardiovascular health Abdominal aortic aneurysm (AAA) 1 Heart attack (myocardial infarction) 29 Acute coronary syndrome (ACS) female Aldosteronism (hyperaldosteronism) 171 Heart, anatomy of Angina (angina pectoris) 3 High blood pressure (hypertension) 33 Angina, unstable 63 child Aortic dissection High cholesterol (hyperlipidemia; hypercholesterolemia) Aortic insufficiency (aortic regurgitation) 5 31 Aortic stenosis 7 High triglyceride levels (high blood lipid levels) Aortic valve disease Hypertension (high blood pressure) 33 Atrial fibrillation 9 pulmonary Atrial flutter (AFL) Hypertrophic cardiomyopathy 35 Atrial myxoma Hypothermia Atrial septal defect (ASD) 11 Long QT syndrome (LQTS) Bundle branch block 13 Lymphedema (lymphatic obstruction) Cardiac pacemaker and debrillator Marfan’s syndrome, child 857 Cardiac tamponade 15 Mitral regurgitation 37 Cardiopulmonary circulation Mitral stenosis 39 Carotid stenosis Mitral valve disease Claudication (poor circulation) 17 Mitral valve prolapse (MVP) 41 Coarctation of aorta Myocarditis 43 Complete heart block Percutaneous coronary intervention (third-degree heart block) 19 Pericarditis 45 Congestive heart failure (CHF) 21 Peripheral arterial disease (PAD) 47 Coronary artery bypass surgery Pheochromocytoma 217 Coronary artery disease (CAD) 23 Preeclampsia (toxemia; pregnancy-induced hypertension) Deep vein thrombosis (DVT) 25 407 Diagnostic heart catheterization Premature ventricular contractions (PVCs) 49 Dilated cardiomyopathy 27 Pulmonary embolism (PE) 51 Electrical injury Pulmonary hypertension vii Pulmonary hypertension and thromboembolic disease Dermatomyositis 935 Renal artery stenosis 53 Diaper rash 87 Restrictive cardiomyopathy 55 Eczema 91 Rheumatic fever 587 Ehlers-Danlos syndrome 939 Second-degree heart block 57 Erysipelas 93 Sleep disorder and heart disease Erythema multiforme 95 Stasis dermatitis 147 Erythema nodosum (EN) 941 Stress test used to predict heart attack risk Fifth disease 97 Supraventricular tachycardia Folliculitis 99 Syncope (fainting; loss of consciousness; passing 59 Granuloma annulare 101 out) Granuloma inguinale 377 Tetralogy of Fallot, child 61 Hand-foot-mouth disease (HFMD) 103 Thoracic outlet syndrome (TOC) Henoch-Schonlein purpura (allergic purpura; anaphylactic Thromboangiitis obliterans (Buerger’s disease) purpura) Thrombophlebitis (phlebitis) 569 adult Tricuspid regurgitation child 105 Tricuspid stenosis Hives (urticaria; wheals, or bumps) 161 Ventricular septal defect (VSD) 65 Hyperhydrosis (excessive sweating) 611 Wolff-Parkinson-White syndrome (WPW) Impetigo 107 Impetigo, child Dermatology Jellyfish and other marine animals stings and bites Acne 67 Kaposi sarcoma Alopecia (hair loss) 69 Kawasaki disease (KD) 947 Angioedema 71 Keloids (hypertrophic scars) 109 Athlete’s foot (tinea pedis; ringworm of foot) 157 Leprosy (Hansen’s disease) 111 Basal cell skin cancer 75 Lice (pediculosis) 543 Bechet’s syndrome 77 Lichen planus (LP) 113 Bedbugs Lichen sclerosus Blisters Measles (rubeola) 115 Boils 519 Melanoma 117 Bullous pemphigoid Molluscum contagiosum Cellulitis 499 adult 119 Chickenpox (varicella) 81 child Contact dermatitis 83 Nail fungus (onychomycosis; tinea ungulum) 559 Dermatitis herpetiformis 85 Neurofibromatosis type 1 (NF1) 121 Neurofibromatosis type 2 (NF-2) viii Contents Oral herpes (HSV-1; herpes labialis) 561 Aldosteronism (hyperaldosteronism) 171 Paronychia 123 Amenorrhea Pemphigus vulgaris 125 Carcinoid syndrome Pityriasis rosea 129 Cushing’s syndrome 173 Poison ivy (Rhus dermatitis) 251 Delayed puberty Polymyositis 935 Diabetes insipidus (DI) Porphyria Diabetes mellitus type 1 (type 1 diabetes) Pressure ulcers (decubitus ulcers) 607 adolescent Psoriasis 131 adult Ringworm (tinea corporis) 133 child 175 Rosacea 135 Diabetes mellitus type 2 (type 2 diabetes) Roseola (sixth disease; exanthem subitum) adolescent Rubella (German measles) 521 adult 177 Scabies 137 child Scarlet fever, child 139 Diabetic retinopathy 179 Scleroderma 141 Erectile dysfunction (ED; impotence; sexual dysfunction) Seborrheic dermatitis 181 Shingles (herpes zoster) 143 Galactorrhea 183 Squamous cell carcinoma (skin cancer) 145 Gastrinoma (Zollinger-Ellison syndrome) prevention and screening Gestational diabetes (GD) 375 Stasis dermatitis 147 Graves’ disease 185 Steven-Johnson syndrome (SJS) 149 Gynecomastia 187 Sun poisoning (photodermatitis; sunburn) 127 Hirsutism 189 Systemic lupus erythematosus (SLE; lupus) 957 Hot flashes 191 Tinea capitis (ringworm) 149 Hydration (for athletes) Tinea cruris (jock itch) 153 Hyperparathyroidism 193 Tinea infections (ringworm) 155 Hyperthyroidism 195 Tinea versicolor 159 Hypoglycemia, in diabetes 197 Tuberous sclerosis Hypopituitarism (pituitary insufficiency; underactive pituitary) 199 Vitiligo 163 Hypothyroidism 201 Warts (plantar warts; flat warts; genital warts) 165 Infertility 205 Klinefelter’s syndrome 207 Endocrinology Menopause 209 Acromegaly 167 Metabolic syndrome 211 Addison’s disease (adrenal insufficiency) 169 Nutrition (for athletes) Contents ix