(c) 2015 Wolters Kluwer. All Rights Reserved. The Cleveland Clinic Foundation Intensive Review of Internal Medicine S I X T H E D I T I O N (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 1 10/8/14 2:29 PM The Cleveland Clinic Foundation Intensive Review of Internal Medicine S I X T H E D I T I O N EDITORS n JamES K. STOllER, mD, mS, FaCP, FCCP, FaaRC Jean Wall Bennett Professor of Emphysema Research Respiratory Institute Samson Global Leadership Academy Endowed Chair Chairman, Education Institute Cleveland Clinic Cleveland, Ohio n CRaIG NIElSEN, mD, FaCP Director, Internal Medicine Residency Program Vice Chairman, Internal Medicine Medicine Institute Cleveland Clinic Cleveland, Ohio n JaNET BUCCOla, mD Staff, Department of Hospital Medicine Medicine Institute Cleveland Clinic Cleveland, Ohio n aNDREI BRaTEaNU, mD, FaCP Associate Program Director, Internal Medicine Residency Program Medicine Institute Cleveland Clinic Cleveland, Ohio (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 3 10/8/14 2:29 PM Executive Editor: Rebecca Gaertner Senior Product Development Editor: Kristina Oberle Production Project Manager: Alicia Jackson Senior Manufacturing Manager: Beth Welsh Design Coordinator: Stephen Druding Production Service: Integra Software Services Pvt. Ltd. © 2014 Wolters Kluwer Health 2001 Market Street Philadelphia, PA 19103 USA LWW.com 5th edition, © 2009 by Lippincott Williams & Wilkins 4th edition, © 2005 by Lippincott Williams & Wilkins 3rd edition, © 2002 by Lippincott Williams & Wilkins 2nd edition, © 2000 by Lippincott Williams & Wilkins 1st edition, © 1998 by Lippincott Williams & Wilkins All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in the USA Library of Congress Cataloging-in-Publication Data The Cleveland Clinic Foundation intensive review of internal medicine/editors, James K. Stoller, Craig Nielsen, Janet Buccola, Andrei Brateanu. — Sixth edition. p. ; cm. Intensive review of internal medicine Preceded by: The Cleveland Clinic Foundation intensive review of internal medicine/editors, James K. Stoller, Franklin A. Michota Jr., Brian F. Mandell. 5th ed. c2009. Includes bibliographical references and index. ISBN 978-1-4511-8656-7 (paperback) I. Stoller, James K., editor of compilation. II. Nielsen, Craig, editor of compilation. III. Buccola, Janet, editor of compilation. IV. Brateanu, Andrei, editor of compilation. V. Cleveland Clinic Foundation, issuing body. VI. Title: Intensive review of internal medicine. [DNLM: 1. Internal Medicine—Examination Questions. WB 18.2] RC46 616.0076—dc23 2013048360 Care has been taken to confirm the accuracy of the information presented and to describe gener- ally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dos- age set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health-care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST. 10 9 8 7 6 5 4 3 2 1 (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 4 10/8/14 2:29 PM Dedication I dedicate this book to the memory of my father, Alfred Stoller (1919–2011), whose unending love, support, and relentless tenacity have forged his sons; to my wife, Terry, whose unceasing support and love have allowed all things; and to my son, Jake, whose huge spirit, energy, and drive light the way forward. James K. Stoller, MD, MS I would like to dedicate this edition to my lovely wife Simone for her continued support and encouragement and to my Father, Earl Nielsen, MD, for consistently role-modeling excellence. Craig Nielsen, MD, FACP To my daughters, my family, and my residents, who motivate and inspire me every day. Andrei Brateanu, MD, FACP (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 5 10/8/14 2:29 PM Contributors Abby Abelson, MD Aaron Brzezinksi, MD Chair Staff Department of Rheumatic and Immunologic Diseases Center for Inflammatory Bowel Disease Orthopedic and Rheumatology Institute Digestive Disease Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Abraham D. Abernethy, MD Janet Buccola, MD Resident Physician Staff Department of Internal Medicine/Pediatrics Department of Hospital Medicine Case Western Reserve University Medicine Institute Cleveland, Ohio Cleveland Clinic Loutfi S. Aboussouan, MD Cleveland, Ohio Staff Matthew P. Bunyard, MD Respiratory Institute Staff Cleveland Clinic Department of Rheumatic and Cleveland, Ohio Immunologic Disease M. Chadi Alraies, MD, FACP Orthopedic and Rheumatology Institute Staff Cleveland Clinic Department of Hospital Medicine Cleveland, Ohio Medicine Institute Carol A. Burke, MD Cleveland Clinic Director Cleveland, Ohio Center for Colon Polyp and Cancer Prevention Gerald B. Appel, MD Department of Gastroenterology and Hepatology Professor of Clinical Medicine Digestive Disease Institute Department of Medicine Cleveland Clinic Columbia University College of Physicians and Surgeons Cleveland, Ohio Director of Clinical Nephrology Columbia University Medical Center David B. Chaiffetz, MD New York, New York Resident, Adult Psychiatry Department of Psychiatry Charles J. Bae, MD Neurological Institute Staff Cleveland Clinic Department of Sleep Medicine Cleveland, Ohio Neurological Institute Cleveland Clinic Leslie Cho, MD Cleveland, Ohio Director Gerald J. Beck, PhD Women’s Cardiovascular Center Head, Section of Clinical Trials Section Head and Medial Director, Preventive Department of Health Sciences Cardiology and Rehabilitation Lerner Research Institute Heart and Vascular Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Andrei Brateanu, MD, FACP Humberto Kukhyun Choi, MD Associate Program Director Staff Internal Medicine Residency Program Department of Pulmonary and Critical Care Medicine Medicine Institute Respiratory Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio vii (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 7 10/8/14 2:29 PM viii Contributors Mina K. Chung, MD Michael D. Faulx, MD Staff Staff Department of Cardiovascular Medicine Department of Cardiology Heart and Vascular Institute Heart and Vascular Institute Cleveland Clinic Associate Program Director Cleveland, Ohio Department of Internal Medicine Cleveland Clinic Patrick H. Collier, MD, PhD Fellow Cleveland, Ohio Advanced Cardiac Imaging Jeffery A. Fowler, DO Heart and Vascular Institute Chief Medical Resident Cleveland Clinic Clinical Associate Cleveland, Ohio Medicine Institute Steven R. Deitcher, MD Cleveland Clinic President, CEO, and Board Member Cleveland, Ohio Talon Therapeutics, Inc. Kathleen Franco-Bronson, MD, MS South San Francisco, California Associate Dean Sevag Demirjian, MD Cleveland Clinic Lerner College of Medicine Associate Staff Staff Department of Hypertension and Nephrology Psychiatry and Education Institute Glickman Urologic and Kidney Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Jorge A. Garcia, MD Krupa B. Doshi, MD Staff Staff Department of Solid Tumor Department of Endocrinology, Diabetes, and Metabolism Oncology/Urology Endocrinology and Metabolism Institute Taussig Cancer Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Raed A. Dweik, MD, FACP, FRCP(C), FCCP, FSSC, FAHA Steven M. Gordon, MD Director Chairman Pulmonary Vascular Program Department of Infectious Disease Staff Medicine Institute Respiratory Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Brian P. Griffin, MD, FACC Kristin A. Englund, MD Staff Staff Department of Cardiovascular Medicine Department of Infectious Disease Heart and Vascular Institute Medicine Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Ronan Factora, MD Vedant Gupta, MD Staff Chief Medical Resident Center for Geriatric Medicine Clinical Associate Medicine Institute Medicine Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Charles Faiman, MD Jorge A. Guzman, MD Consultant Head, Section of Critical Care Department of Endocrinology, Diabetes, and Metabolism Director, Medical Intensive Care Unit Endocrinology and Metabolism Institute Respiratory Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 8 10/8/14 2:29 PM Contributors ix Aaron C. Hamilton, MD, MBA Vidyasagar Kalahasti, MD Associate Staff Staff, Section of Cardiovascular Imaging Department of Hospital Medicine Heart and Vascular Institute Medicine Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Subramanian Kannan, MD Amir H. Hamrahian, MD Chief Clinical Fellow Staff Department of Endocrinology, Diabetes, and Metabolism Department of Endocrinology Endocrinology and Metabolism Institute Endocrinology and Metabolism Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Samir Kapadia, MD Robert E. Hobbs, MD Director Staff Sones Cardiac Catheterization Laboratory Department of Cardiovascular Medicine Department of Cardiovascular Medicine Heart and Vascular Institute Heart and Vascular Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Edward P. Horvath, Jr., MD Aanchal Kapoor, MD Department of Veterans Affairs Medical Center Associate Program Director, Critical Care Cleveland, Ohio Staff Erik H. Howell, MD Department of Critical Care Medicine Resident, Internal Medicine Respiratory Institute Medicine Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio Michael Kenneth Keng, MD Carlos M. Isada, MD Fellow, Hematology-Oncology Vice Chairman Taussig Cancer Institute Department of Infectious Disease Cleveland Clinic Medicine Institute Cleveland, Ohio Program Director Leila Khan, MD Infectious Disease Fellowship Associate Staff Cleveland Clinic Department of Endocrinology Cleveland, Ohio Endocrinology and Metabolism Institute Sunguk Jang, MD Cleveland Clinic Staff Cleveland, Ohio Department of Gastroenterology Sumita B. Khatri, MD Digestive Disease Institute Co-Director, Asthma Center Cleveland Clinic Staff Cleveland, Ohio Respiratory Institute Hani Jneid, MD, FACC, FAHA, FSCAI Cleveland Clinic Assistant Professor Cleveland, Ohio Department of Medicine Christopher S. Kovacs, Jr., MD Baylor College of Medicine Chief Medical Resident Director of Interventional Cardiology Research Clinical Associate Division of Cardiology Medicine Institute The Michael E. DeBakey VA Medical Hospital Cleveland Clinic Houston, Texas Cleveland, Ohio Seby John, MD Richard Krasuski, MD Chief Resident Director of Adult Heart Services Department of Neurology Department of Cardiovascular Medicine Neurological Institute Heart and Vascular Institute Cleveland Clinic Cleveland Clinic Cleveland, Ohio Cleveland, Ohio (c) 2015 Wolters Kluwer. All Rights Reserved. FM.indd 9 10/8/14 2:29 PM