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273 Lymphoma. 327 Hypertensive Emergency 273 Carcinoma of Unknown Primary Origin 329 Hypertension in PregnancY Glomerular Diseases. 274 Melanoma 330 Kidney Manifestations of Deposition Diseases . , 278 Effects of Cancer TheraPY. 330 Autosomal Dominant Polycystic Kidney Disease 278 Cancers ol Infectious Origin . 331

273 Lymphoma. 327 Hypertensive Emergency 273 Carcinoma of Unknown Primary Origin 329 Hypertension in PregnancY Glomerular Diseases. 274 Melanoma 330 Kidney Manifestations of Deposition Diseases . , 278 Effects of Cancer TheraPY. 330 Autosomal Dominant Polycystic Kidney Disease 278 Cancers ol Infectious Origin . 331 Inherited Collagen Type IV- Related Cancer Emergencies 332 Nephropathies...... 279 Febrile Neutropenia 334 Acute Kidney Injury . 279 Nephrolithiasis .... 282 Pulmonary and Critical Care Medicine Chronic Kidney Disease 284 Pulmonary Function Tests. . 336 Asthma. 338 Neurology Chronic Obstructive Pulmonary Disease. . 341 Primary Headaches. 287 CysticFibrosis..... 343 Selected Secondary Headache Disorders . . . . 289 Diffuse Parenchymal Lung Disease 344 Traumatic Brain Injury. 290 Acute HypersensitivifyPneumonitis ..... 345 Epilepsy 292 Idiopathic Pulmonary Fibrosis 346 Ischemic Stroke and Transient Sarcoidosis 346 Ischemic Attack. 294 Occupational Lung Disease 348 Subarachnoid Hemorrhage 296 Pleural Effusion. 349 Intracerebral Hemorrhage 297 Pneumothorax.... . . 351 Dementia 298 Pulmonary Hypertension 352 Delirium. 300 Lung Cancer Screening. 3s3 Parkinson Disease. 301 Hemoptysis 353 Hyperkinetic Movement Disorders 302 Solitary Pulmonary Nodule 354 Multiple Sclerosis 303 Mediastinal Masses 355 Myelopathy 305 Obstructive Sleep Apnea 355 Amyotrophic Lateral Sclerosis. . . . 306 Obesity-Hypoventilation Syndrome. . . . . . 3s6 Myasthenia Gravis. 307 Hypercapnic Respiratory (Ventilatory) Peripheral Neuropathy 307 Failure. 357 Myopathy 309 Hypoxemic Respiratory Failure 357 Primary Central Nervous System Lymphoma 310 Noninvasive Positive-Pressure Ventilation . 359 Meningioma. 310 Invasive Mechanical Ventilation 359 Metastatic Brain Tumors 310 Sepsis . 360 Coma.. 311 Nutritional Support during Critical Illness. 361 ICU Acquired Weakness. 361 0ncology Hyperthermic Emergencies 362 Breasl Cancer 313 Anaphylaxis 363 Lung Cancer. 315 Angioedema. 363 Castric Cancer 316 Smoke Inhalation 364 Colorectal Cancer 377 Carbon Monoxide Poisoni ng 365 Hepatocellular Carcinoma 319 Toxidromes 365 Pancreatic Cancer 320 Neuroendocrine Tumors . 321 Rheumatology Cervical Cancer 32t Approach to the Patient 367 Ovarian Cancer 322 Serologic Studies in Rheumatologic Disorders 368 Endometrial Cancer . .... 323 Rheumatoid Arthritis 368 Prostate Cancer 323 Sjogren Syndrome. 371 Testicular Cancer. 324 Osteoarthritis 371 Renal Cell Carcinoma. . . . 326 Spondyloarthritis .. J/J Thyroid Cancer 326 Systemic Lupus Erythematosus. 376

Inherited Collagen Type IV- Related Cancer Emergencies 332 Nephropathies...... 279 Febrile Neutropenia 334 Acute Kidney Injury . 279 Nephrolithiasis .... 282 Pulmonary and Critical Care Medicine Chronic Kidney Disease 284 Pulmonary Function Tests. . 336 Asthma. 338 Neurology Chronic Obstructive Pulmonary Disease. . 341 Primary Headaches. 287 CysticFibrosis..... 343 Selected Secondary Headache Disorders . . . . 289 Diffuse Parenchymal Lung Disease 344 Traumatic Brain Injury. 290 Acute HypersensitivifyPneumonitis ..... 345 Epilepsy 292 Idiopathic Pulmonary Fibrosis 346 Ischemic Stroke and Transient Sarcoidosis 346 Ischemic Attack. 294 Occupational Lung Disease 348 Subarachnoid Hemorrhage 296 Pleural Effusion. 349 Intracerebral Hemorrhage 297 Pneumothorax.... . . 351 Dementia 298 Pulmonary Hypertension 352 Delirium. 300 Lung Cancer Screening. 3s3 Parkinson Disease. 301 Hemoptysis 353 Hyperkinetic Movement Disorders 302 Solitary Pulmonary Nodule 354 Multiple Sclerosis 303 Mediastinal Masses 355 Myelopathy 305 Obstructive Sleep Apnea 355 Amyotrophic Lateral Sclerosis. . . . 306 Obesity-Hypoventilation Syndrome. . . . . . 3s6 Myasthenia Gravis. 307 Hypercapnic Respiratory (Ventilatory) Peripheral Neuropathy 307 Failure. 357 Myopathy 309 Hypoxemic Respiratory Failure 357 Primary Central Nervous System Lymphoma 310 Noninvasive Positive-Pressure Ventilation . 359 Meningioma. 310 Invasive Mechanical Ventilation 359 Metastatic Brain Tumors 310 Sepsis . 360 Coma.. 311 Nutritional Support during Critical Illness. 361 ICU Acquired Weakness. 361 0ncology Hyperthermic Emergencies 362 Breasl Cancer 313 Anaphylaxis 363 Lung Cancer. 315 Angioedema. 363 Castric Cancer 316 Smoke Inhalation 364 Colorectal Cancer 377 Carbon Monoxide Poisoni ng 365 Hepatocellular Carcinoma 319 Toxidromes 365 Pancreatic Cancer 320 Neuroendocrine Tumors . 321 Rheumatology Cervical Cancer 32t Approach to the Patient 367 Ovarian Cancer 322 Serologic Studies in Rheumatologic Disorders 368 Endometrial Cancer . .... 323 Rheumatoid Arthritis 368 Prostate Cancer 323 Sjogren Syndrome. 371 Testicular Cancer. 324 Osteoarthritis 371 Renal Cell Carcinoma. . . . 326 Spondyloarthritis .. J/J Thyroid Cancer 326 Systemic Lupus Erythematosus. 376 x

Systemic Sclerosis 379 Infectious Arthritis 385 Mixed Connective Tissue Disease . . 381 Inflammatory Myopathies 387 Fibromyalgia 382 Vasculitis 389 Gout .. 382 Adult-Onset Still Disease 391 Calcium Pyrophosphate Deposition 384 Genetic Diseases of Connective Tissue 392 xt

Ca rd iovascu lar Med ici ne Acute Chest Pain Diagnosis Typical angina includes substemal chest pain with exertion and relief with rest or nitroglycerin. Atypical symptoms (dyspnea, fatigue, nausea, and vomiting) are most commonly found in women and in patients with diabetes. Signs of cardiac ischemia may include a new MR murmur and Sn. Patients presenting with ACS may also have HF, pulmonary edema, shock, and dysrhythmias. Several other conditions can also cause acute chest pain: SrUtrY fABLE: Other Causes of Acute Chest Pain Vignette Consider Chest pain at night or at rest or use of illicit substances (methamphetamines, Coronary vasospasm cocaine),5-FU A tall, thin person with long arms with tearing acute chest and back pain Marfan syndrome and aortic dissection A patient with sharp or pleuritic chest pain, dyspnea, and risk factors for WE PE A tall, thin young man who smokes with sudden pleuritic chest pain and Spontaneous pneumothorax dyspnea I A postmenopausal woman with STEMI following severe emotional/physical Stress-induced (takotsubo) cardiomyopathy; look for stress and normal coronary angiography characteristic apical ballooning on ventriculogram Forcefulvomiting followed by chest pain Esophageal rupture and mediastinitis Chest pain during the peripartum period Spontaneous coronary artery dissection Sharp anterior chest pain, pleuritic, worse when rditis Acute Coronary Syndromes (STEMl, NSTE-ACS) Acute coronary syndromes occur when coronary blood flow is disrupted or metabolic requirements exceed supply. Testing The 12 lead ECG and serum biomarkers distinguish three types of ACS: STUEY ?ABLE: Diagnosis of ACS in Patients With Chest Pain Syndrome Description NSTE-ACS

Acute Coronary Syndromes (STEMl, NSTE-ACS) Acute coronary syndromes occur when coronary blood flow is disrupted or metabolic requirements exceed supply. Testing The 12 lead ECG and serum biomarkers distinguish three types of ACS: STUEY ?ABLE: Diagnosis of ACS in Patients With Chest Pain Syndrome Description NSTE-ACS Unstable Normal cardiac biomarkert angina May have nonspecific ECG changes, ST-segment depression, orT-wave inversion NSTEMI Fositive biomarkers without ST elevations or ST-elevation equivalents May have nonspecific ECG changes, ST-segment depression, and T-wave inversion STEMI ST-segment elevation of >1 mm in >2 contiguous limb or chest leads, although ST-segment elevation in leads V2 and V3 must be >2 mm in men and >1.5 mm in women ST-elevation equivalents include new LBBB or posterior Ml (tall R waves and ST depressions in V1-Va) I