- •Table of Contents
- •Copyright
- •Dedication
- •Introduction to the eighth edition
- •Online contents
- •List of Illustrations
- •List of Tables
- •1. Pulmonary anatomy and physiology: The basics
- •Anatomy
- •Physiology
- •Abnormalities in gas exchange
- •Suggested readings
- •2. Presentation of the patient with pulmonary disease
- •Dyspnea
- •Cough
- •Hemoptysis
- •Chest pain
- •Suggested readings
- •3. Evaluation of the patient with pulmonary disease
- •Evaluation on a macroscopic level
- •Evaluation on a microscopic level
- •Assessment on a functional level
- •Suggested readings
- •4. Anatomic and physiologic aspects of airways
- •Structure
- •Function
- •Suggested readings
- •5. Asthma
- •Etiology and pathogenesis
- •Pathology
- •Pathophysiology
- •Clinical features
- •Diagnostic approach
- •Treatment
- •Suggested readings
- •6. Chronic obstructive pulmonary disease
- •Etiology and pathogenesis
- •Pathology
- •Pathophysiology
- •Clinical features
- •Diagnostic approach and assessment
- •Treatment
- •Suggested readings
- •7. Miscellaneous airway diseases
- •Bronchiectasis
- •Cystic fibrosis
- •Upper airway disease
- •Suggested readings
- •8. Anatomic and physiologic aspects of the pulmonary parenchyma
- •Anatomy
- •Physiology
- •Suggested readings
- •9. Overview of diffuse parenchymal lung diseases
- •Pathology
- •Pathogenesis
- •Pathophysiology
- •Clinical features
- •Diagnostic approach
- •Suggested readings
- •10. Diffuse parenchymal lung diseases associated with known etiologic agents
- •Diseases caused by inhaled inorganic dusts
- •Hypersensitivity pneumonitis
- •Drug-induced parenchymal lung disease
- •Radiation-induced lung disease
- •Suggested readings
- •11. Diffuse parenchymal lung diseases of unknown etiology
- •Idiopathic pulmonary fibrosis
- •Other idiopathic interstitial pneumonias
- •Pulmonary parenchymal involvement complicating systemic rheumatic disease
- •Sarcoidosis
- •Miscellaneous disorders involving the pulmonary parenchyma
- •Suggested readings
- •12. Anatomic and physiologic aspects of the pulmonary vasculature
- •Anatomy
- •Physiology
- •Suggested readings
- •13. Pulmonary embolism
- •Etiology and pathogenesis
- •Pathology
- •Pathophysiology
- •Clinical features
- •Diagnostic evaluation
- •Treatment
- •Suggested readings
- •14. Pulmonary hypertension
- •Pathogenesis
- •Pathology
- •Pathophysiology
- •Clinical features
- •Diagnostic features
- •Specific disorders associated with pulmonary hypertension
- •Suggested readings
- •15. Pleural disease
- •Anatomy
- •Physiology
- •Pleural effusion
- •Pneumothorax
- •Malignant mesothelioma
- •Suggested readings
- •16. Mediastinal disease
- •Anatomic features
- •Mediastinal masses
- •Pneumomediastinum
- •Suggested readings
- •17. Anatomic and physiologic aspects of neural, muscular, and chest wall interactions with the lungs
- •Respiratory control
- •Respiratory muscles
- •Suggested readings
- •18. Disorders of ventilatory control
- •Primary neurologic disease
- •Cheyne-stokes breathing
- •Control abnormalities secondary to lung disease
- •Sleep apnea syndrome
- •Suggested readings
- •19. Disorders of the respiratory pump
- •Neuromuscular disease affecting the muscles of respiration
- •Diaphragmatic disease
- •Disorders affecting the chest wall
- •Suggested readings
- •20. Lung cancer: Etiologic and pathologic aspects
- •Etiology and pathogenesis
- •Pathology
- •Suggested readings
- •21. Lung cancer: Clinical aspects
- •Clinical features
- •Diagnostic approach
- •Principles of therapy
- •Bronchial carcinoid tumors
- •Solitary pulmonary nodule
- •Suggested readings
- •22. Lung defense mechanisms
- •Physical or anatomic factors
- •Antimicrobial peptides
- •Phagocytic and inflammatory cells
- •Adaptive immune responses
- •Failure of respiratory defense mechanisms
- •Augmentation of respiratory defense mechanisms
- •Suggested readings
- •23. Pneumonia
- •Etiology and pathogenesis
- •Pathology
- •Pathophysiology
- •Clinical features and initial diagnosis
- •Therapeutic approach: General principles and antibiotic susceptibility
- •Initial management strategies based on clinical setting of pneumonia
- •Suggested readings
- •24. Bacterial and viral organisms causing pneumonia
- •Bacteria
- •Viruses
- •Intrathoracic complications of pneumonia
- •Respiratory infections associated with bioterrorism
- •Suggested readings
- •25. Tuberculosis and nontuberculous mycobacteria
- •Etiology and pathogenesis
- •Definitions
- •Pathology
- •Pathophysiology
- •Clinical manifestations
- •Diagnostic approach
- •Principles of therapy
- •Nontuberculous mycobacteria
- •Suggested readings
- •26. Miscellaneous infections caused by fungi, including Pneumocystis
- •Fungal infections
- •Pneumocystis infection
- •Suggested readings
- •27. Pulmonary complications in the immunocompromised host
- •Acquired immunodeficiency syndrome
- •Pulmonary complications in non–HIV immunocompromised patients
- •Suggested readings
- •28. Classification and pathophysiologic aspects of respiratory failure
- •Definition of respiratory failure
- •Classification of acute respiratory failure
- •Presentation of gas exchange failure
- •Pathogenesis of gas exchange abnormalities
- •Clinical and therapeutic aspects of hypercapnic/hypoxemic respiratory failure
- •Suggested readings
- •29. Acute respiratory distress syndrome
- •Physiology of fluid movement in alveolar interstitium
- •Etiology
- •Pathogenesis
- •Pathology
- •Pathophysiology
- •Clinical features
- •Diagnostic approach
- •Treatment
- •Suggested readings
- •30. Management of respiratory failure
- •Goals and principles underlying supportive therapy
- •Mechanical ventilation
- •Selected aspects of therapy for chronic respiratory failure
- •Suggested readings
- •Index
Copyright
Elsevier
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PRINCIPLES OF PULMONARY MEDICINE, EIGHTH EDITION ISBN: 978-0-323-88056-5
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Senior Content Development Specialist: Vasowati Shome
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Project Manager: Nandhini Thanga Alagu
Design Direction: Bridget Hoette
Printed in India
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication
To our families and to the students and trainees we have had the privilege of teaching over many years.
Introduction to the eighth edition
Steven E. Weinberger, MD, MACP, FRCP, Barbara A. Cockrill, MD, Jess Mandel, MD, MACP, FRCP
Principles of Pulmonary Medicine was first published in 1986 as a “concise, core reference [that] emphasizes pathophysiology and diagnosis as the basis for optimal management of respiratory disorders. Physiologic, radiologic, and pathologic features of diseases are correlated with clinical findings providing an integrated, comprehensive approach.” Much has changed over eight editions of the book and the more than 35 years that have elapsed since the first edition. Our understanding of many disease processes has improved, our diagnostic tests have become more sophisticated, and our therapeutic armamentarium has been expanded and improved. The single author of the first four editions, Steven E. Weinberger, MD, MACP, FRCP, was joined starting with the fifth edition by two additional authors, Barbara A. Cockrill, MD, and Jess Mandel, MD, MACP, FRCP; their knowledge, experience, and perspectives have greatly enhanced the quality of the book. Since the fifth edition, we added and subsequently expanded supplementary images and self-assessment questions accessible on the internet, recognizing the importance of learners being able to assess their knowledge and their understanding of concepts that can at times be difficult to grasp.
Although the primary audience has always been the medical student taking a respiratory pathophysiology course, the book has also been extensively used by residents and practicing physicians and by other healthcare professionals who care for patients with pulmonary disease. A persistent goal throughout all editions of the book has been to present physiologic concepts, pathogenetic and pathophysiologic mechanisms, and radiologic and pathologic correlates of disease in a clear fashion that can be easily understood even by the beginning student of pulmonary medicine. We have also continued to include margin notes throughout the text, which summarize the major points and concepts and allow the reader to quickly review the material. Starting with the second edition, we included three appendices that provide simplified methods for interpreting pulmonary function tests and arterial blood gases, while also presenting sample problems that test the reader’s ability to use respiratory equations, assess pulmonary function abnormalities, and interpret arterial blood gases.
Many changes and updates have been incorporated in the eighth edition. Whereas histopathologic and other images were printed in black and white in previous editions, these and additional images are shown in color in the current edition. We have also added more images—particularly plain chest radiographs and computed tomographic scans—to provide additional examples of the appearance of many clinical disorders on imaging studies. Finally, in the era of COVID-19 and new diagnostic and therapeutic options for a number of disorders, we have updated the text to include information about organisms such as SARS-CoV-2 and expanded coverage of new biologic and immunologic treatments available for a variety of diseases.
We have been most gratified by the popularity of the textbook, which has been used extensively not only in the United States and Canada but also in other countries throughout the world. Various editions have been translated into Spanish, Portuguese, Italian, Japanese, Chinese, and Polish. Although there may be
some differences in diagnostic and therapeutic approaches to pulmonary diseases in different countries, the conceptual underpinnings of physiology, pathophysiology, and disease mechanisms that we are trying to convey in a readable fashion are universal.
It has been a pleasure to work with the editorial staff at Elsevier in development of this edition, just as it has been for past editions. We particularly want to express our appreciation to Robin Carter, Content Strategist; Vasowati Shome, Content Development Specialist; Nandhini Thanga Alagu, Project Manager; Bridget Hoette, Book Designer; and the efforts of Elsevier. Finally, we are most grateful to our families for their support and understanding as we had to sacrifice time with them to prepare this new edition of the book.