{"id":102117,"date":"2026-05-31T05:22:28","date_gmt":"2026-05-31T09:22:28","guid":{"rendered":"https:\/\/medicalebooks.org\/?post_type=product&p=102117"},"modified":"2026-06-26T12:45:32","modified_gmt":"2026-06-26T16:45:32","slug":"internal-medicine-2026-a-comprehensive-clinical-textbook-pathophysiology-diagnosis-pharmacotherapy-and-hospital-medicine-an-evidence-based-guide-for-physicians-residents-and-medical-students","status":"publish","type":"product","link":"https:\/\/medicalebooks.org\/th\/internal-medicine-2026-a-comprehensive-clinical-textbook-pathophysiology-diagnosis-pharmacotherapy-and-hospital-medicine-an-evidence-based-guide-for-physicians-residents-and-medical-students","title":{"rendered":"Internal Medicine 2026: A Comprehensive Clinical Textbook: Pathophysiology, Diagnosis, Pharmacotherapy and Hospital Medicine – An Evidence-Based Guide for Physicians, Residents and Medical Students"},"content":{"rendered":"

Table of Contents<\/strong><\/h3>\n

Preface …………………………………………………….. iii
\nHow to Use This Textbook …………………………… v
\nChapter Architecture ………………………………. v
\nRecurring Elements…………………………………. v
\nDrug Names and Dosing…………………………… v
\nGuidelines and Evidence…………………………. vi
\nProcedural Content………………………………… vi
\nThe Clinical Method and Diagnostic Reasoning
\n……………………………………………………………….14
\n1.1 Introduction ……………………………………14
\n1.2 The Structure of the Clinical Encounter 14
\n1.2.1 The History ……………………………….15
\n1.2.2 The Physical Examination……………15
\n1.3 Generating and Refining the Differential
\nDiagnosis………………………………………………16
\n1.3.1 Illness Scripts…………………………….16
\n1.3.2 Must-Not-Miss Diagnoses…………..17
\n1.4 Diagnostic Testing and Bayesian
\nReasoning……………………………………………..17
\n1.5 Cognitive Biases in Diagnosis…………….18
\n1.6 High-Risk Clinical Situations………………20
\n1.7 The Clinical Record…………………………..20
\nEvidence-Based Medicine and Critical Appraisal
\n……………………………………………………………….23
\n2.1 Evidence-Based Medicine: Definition and
\nPractice ………………………………………………..23
\n2.2 The Hierarchy of Evidence ………………..23
\n2.3 Appraising a Randomized Controlled Trial
\n……………………………………………………………24
\n2.3.1 Internal Validity………………………… 25
\n2.3.2 External Validity……………………….. 25
\n2.3.3 Effect Size and Precision ……………. 25
\n2.4 Systematic Reviews and Meta-Analyses
\n…………………………………………………………… 26
\n2.5 Patient-Centered Application …………… 26
\nPrinciples of Pharmacotherapy in Adult
\nMedicine…………………………………………………. 28
\n3.1 Introduction…………………………………… 28
\n3.2 Pharmacokinetics……………………………. 28
\n3.2.1 Absorption and Bioavailability……. 28
\n3.2.2 Distribution……………………………… 29
\n3.2.3 Metabolism……………………………… 29
\n3.2.4 Elimination………………………………. 30
\n3.3 Dose Adjustment in Organ Dysfunction30
\n3.3.1 Renal Impairment …………………….. 30
\n3.3.2 Hepatic Impairment………………….. 31
\n3.4 Special Populations…………………………. 31
\n3.4.1 The Older Adult………………………… 31
\n3.4.2 Pregnancy and Lactation……………. 32
\n3.5 Medication Reconciliation and
\nDeprescribing……………………………………….. 32
\n3.6 Therapeutic Drug Monitoring …………… 33
\nHeart Failure ……………………………………………. 36
\n4.1 Epidemiology and Clinical Importance . 36
\n4.2 Classification ………………………………….. 36
\n4.3 Pathophysiology……………………………… 37
\n4.3.1 HFrEF………………………………………. 37
\n4.3.2 HFpEF ……………………………………… 38
\n4.4 Clinical Presentation ……………………….. 38 Textbook of Internal Medicine 2026
\n\u2014 2 \u2014
\n4.5 Diagnostic Evaluation……………………….39
\n4.5.1 Natriuretic Peptides…………………..39
\n4.5.2 Echocardiography………………………39
\n4.5.3 Evaluation for Coronary Disease….40
\n4.6 Chronic Pharmacotherapy: The Four
\nPillars of HFrEF ………………………………………40
\n4.6.1 ARNI, ACE Inhibitors, and ARBs……41
\n4.6.2 Beta-Blockers ……………………………41
\n4.6.3 Mineralocorticoid Receptor
\nAntagonists ……………………………………….41
\n4.6.4 SGLT2 Inhibitors………………………..42
\n4.6.5 Adjunctive Therapies………………….42
\n4.7 Acute Decompensated Heart Failure….42
\n4.7.1 Initial Assessment ……………………..42
\n4.7.2 Diuresis…………………………………….43
\n4.7.3 Vasodilators………………………………43
\n4.7.4 Inotropes………………………………….44
\n4.8 Device Therapy and Advanced Heart
\nFailure ………………………………………………….44
\n4.9 Transitions of Care and Self-Management
\n……………………………………………………………45
\nAcute Coronary Syndromes and Chronic
\nCoronary Disease ………………………………………47
\n5.1 Epidemiology and Classification…………47
\n5.2 Pathophysiology………………………………47
\n5.3 Clinical Presentation ………………………..48
\n5.4 Diagnostic Approach ………………………..49
\n5.4.1 Electrocardiography …………………..49
\n5.4.2 Cardiac Biomarkers……………………49
\n5.5 STEMI Management…………………………49
\n5.5.1 Initial Medical Therapy……………….49
\n5.6 NSTEMI Management……………………… 50
\n5.7 Secondary Prevention……………………… 51
\n5.8 Chronic Coronary Disease………………… 51
\nArrhythmias and Conduction Disorders………. 53
\n6.1 Electrophysiologic Foundations………… 53
\n6.2 Bradyarrhythmias and Conduction
\nDisease………………………………………………… 54
\n6.2.1 Sinus Node Dysfunction…………….. 54
\n6.2.2 Atrioventricular Block ……………….. 54
\n6.2.3 Temporary and Permanent Pacing 55
\n6.3 Supraventricular Tachycardias………….. 55
\n6.3.1 Atrial Fibrillation ………………………. 55
\n6.3.2 Atrial Flutter…………………………….. 57
\n6.3.3 Paroxysmal Supraventricular
\nTachycardia………………………………………. 57
\n6.4 Ventricular Tachyarrhythmias ………….. 57
\n6.4.1 Monomorphic Ventricular
\nTachycardia………………………………………. 57
\n6.4.2 Polymorphic Ventricular Tachycardia
\nand Torsades de Pointes…………………….. 57
\n6.5 Cardiac Arrest ………………………………… 58
\nHypertension, Valvular Disease, and Venous
\nThromboembolism …………………………………… 59
\n7.1 Hypertension …………………………………. 59
\n7.1.1 Definition and Classification ………. 59
\n7.1.2 Epidemiology and Impact ………….. 59
\n7.1.3 Evaluation ……………………………….. 59
\n7.1.4 Non-Pharmacologic Management. 60
\n7.1.5 Pharmacologic Management……… 60
\n7.1.6 Hypertensive Emergency and
\nUrgency……………………………………………. 61 Textbook of Internal Medicine 2026
\n\u2014 3 \u2014
\n7.2 Valvular Heart Disease ……………………..62
\n7.2.1 Aortic Stenosis…………………………..62
\n7.2.2 Mitral Regurgitation…………………..62
\n7.2.3 Aortic and Mitral Regurgitation of
\nAcute Onset……………………………………….62
\n7.2.4 Endocarditis………………………………63
\n7.3 Venous Thromboembolism……………….63
\n7.3.1 Epidemiology and Risk ……………….63
\n7.3.2 Diagnosis………………………………….63
\n7.3.3 Risk Stratification in Acute PE ……..63
\n7.3.4 Treatment ………………………………..63
\n7.3.5 Advanced Therapies in PE …………..64
\nAsthma and Chronic Obstructive Pulmonary
\nDisease …………………………………………………….67
\n8.1 Airway Obstruction: A Shared Framework
\n……………………………………………………………67
\n8.2 Asthma …………………………………………..67
\n8.2.1 Pathophysiology………………………..68
\n8.2.2 Diagnosis………………………………….68
\n8.2.3 Classification and Control …………..68
\n8.2.4 Chronic Pharmacotherapy ………….68
\n8.2.5 Biologics for Severe Asthma………..69
\n8.2.6 Acute Exacerbation ……………………70
\n8.3 Chronic Obstructive Pulmonary Disease
\n……………………………………………………………71
\n8.3.1 Epidemiology and Pathophysiology
\n………………………………………………………..71
\n8.3.2 Diagnosis and Staging ………………..71
\n8.3.3 Chronic Pharmacotherapy ………….71
\n8.3.4 Non-Pharmacologic Interventions.72
\n8.3.5 Acute Exacerbation ……………………72
\nPneumonia and Pulmonary Infections ………… 75
\n9.1 Classification and Epidemiology ……….. 75
\n9.2 Community-Acquired Pneumonia …….. 75
\n9.2.1 Microbiology ……………………………. 75
\n9.2.2 Diagnosis…………………………………. 76
\n9.2.3 Severity Assessment and Disposition
\n……………………………………………………….. 76
\n9.2.4 Empirical Antibiotic Therapy………. 77
\n9.3 Hospital-Acquired and Ventilator-
\nAssociated Pneumonia ………………………….. 78
\n9.4 Aspiration Pneumonia …………………….. 79
\n9.5 Tuberculosis and Non-Tuberculous
\nMycobacteria……………………………………….. 79
\n9.6 Pneumonia in the Immunocompromised
\nHost…………………………………………………….. 79
\nRespiratory Failure and the Acute Respiratory
\nDistress Syndrome……………………………………. 82
\n10.1 Classification of Respiratory Failure … 82
\n10.2 The Five Causes of Hypoxemia ……….. 82
\n10.3 Acute Respiratory Distress Syndrome 83
\n10.3.1 Definition and Pathophysiology… 83
\n10.3.2 Causes…………………………………… 84
\n10.3.3 Management………………………….. 84
\n10.3.4 Ventilator Management ………….. 85
\n10.4 Non-Invasive Ventilation ……………….. 85
\n10.5 High-Flow Nasal Oxygen ………………… 85
\n10.6 Invasive Mechanical Ventilation……… 86
\n10.6.1 Indications and Mode Selection .. 86
\n10.6.2 Sedation and Analgesia……………. 86
\n10.6.3 Weaning and Liberation…………… 86 Textbook of Internal Medicine 2026
\n\u2014 4 \u2014
\nGastrointestinal Bleeding and Inflammatory
\nBowel Disease …………………………………………..89
\n11.1 Upper Gastrointestinal Bleeding………89
\n11.1.1 Etiology…………………………………..89
\n11.1.2 Initial Management………………….89
\n11.1.3 Pharmacologic Therapy…………….90
\n11.1.4 Endoscopy ………………………………90
\n11.1.5 Variceal Bleeding……………………..90
\n11.2 Lower Gastrointestinal Bleeding………91
\n11.3 Inflammatory Bowel Disease …………..91
\n11.3.1 Ulcerative Colitis ……………………..91
\n11.3.2 Crohn Disease………………………….92
\n11.3.3 Pharmacotherapy…………………….92
\n11.3.4 Acute Severe Ulcerative Colitis….93
\nAcute Pancreatitis, Peptic Ulcer Disease, and
\nGERD ……………………………………………………….95
\n12.1 Acute Pancreatitis………………………….95
\n12.1.1 Epidemiology and Etiology………..95
\n12.1.2 Diagnosis and Severity ……………..95
\n12.1.3 Management…………………………..96
\n12.2 Peptic Ulcer Disease……………………….96
\n12.2.1 Pathophysiology………………………96
\n12.2.2 Clinical Presentation and Diagnosis
\n………………………………………………………..97
\n12.2.3 Treatment ………………………………97
\n12.3 Gastroesophageal Reflux Disease …….97
\nCirrhosis and Acute Liver Injury …………………..99
\n13.1 Cirrhosis………………………………………..99
\n13.1.1 Diagnosis and Severity Scoring ….99
\n13.1.2 Ascites and Spontaneous Bacterial
\nPeritonitis………………………………………..100
\n13.1.3 Hepatic Encephalopathy………… 100
\n13.1.4 Hepatorenal Syndrome………….. 101
\n13.1.5 Hepatocellular Carcinoma
\nSurveillance…………………………………….. 101
\n13.2 Liver Transplantation…………………… 101
\n13.3 Acute Liver Injury………………………… 101
\n13.3.1 Acetaminophen Hepatotoxicity. 101
\n13.3.2 Viral Hepatitis ………………………. 102
\n13.3.3 Alcohol-Associated Liver Disease
\n……………………………………………………… 102
\nAcute Kidney Injury and Chronic Kidney Disease
\n…………………………………………………………….. 105
\n14.1 Acute Kidney Injury……………………… 105
\n14.1.1 Definition and Staging……………. 105
\n14.1.2 Causes…………………………………. 105
\n14.1.3 Evaluation ……………………………. 106
\n14.1.4 Management………………………… 107
\n14.2 Chronic Kidney Disease………………… 107
\n14.2.1 Definition and Staging……………. 107
\n14.2.2 Slowing Progression………………. 108
\n14.2.3 Complications of CKD…………….. 108
\n14.2.4 Renal Replacement Therapy…… 109
\nAcid-Base and Electrolyte Disorders………….. 110
\n15.1 Acid-Base Interpretation………………. 110
\n15.1.1 Metabolic Acidosis………………… 111
\n15.1.2 Metabolic Alkalosis……………….. 111
\n15.1.3 Respiratory Disorders……………. 111
\n15.2 Sodium Disorders………………………… 111
\n15.2.1 Hyponatremia ………………………. 111
\n15.2.2 Hypernatremia……………………… 112 Textbook of Internal Medicine 2026
\n\u2014 5 \u2014
\n15.3 Potassium Disorders……………………..112
\n15.3.1 Hyperkalemia ………………………..112
\n15.3.2 Hypokalemia …………………………113
\n15.3.3 Calcium, Phosphate, and Magnesium
\n………………………………………………………….113
\nDiabetes and Its Complications………………….117
\n16.1 Classification and Epidemiology……..117
\n16.2 Diagnosis…………………………………….117
\n16.3 Glycemic Management …………………117
\n16.3.1 Targets………………………………….117
\n16.3.2 Type 1 Diabetes……………………..118
\n16.3.3 Type 2 Diabetes……………………..118
\n16.3.4 GLP-1 Receptor Agonists and Dual
\nAgonists…………………………………………..119
\n16.4 Acute Complications …………………….119
\n16.4.1 Diabetic Ketoacidosis……………..119
\n16.4.2 Hyperosmolar Hyperglycemic State
\n………………………………………………………120
\n16.5 Hypoglycemia………………………………120
\n16.6 Inpatient Glycemic Management……120
\n16.7 Chronic Complications ………………….121
\nThyroid, Adrenal, and Pituitary Disorders……123
\n17.1 Thyroid Disease……………………………123
\n17.1.1 Hyperthyroidism ……………………123
\n17.1.2 Thyroid Storm ……………………….124
\n17.1.3 Hypothyroidism……………………..124
\n17.1.4 Myxedema Coma …………………..124
\n17.2 Adrenal Disease……………………………124
\n17.2.1 Adrenal Insufficiency………………124
\n17.2.2 Adrenal Crisis…………………………125
\n17.2.3 Cushing Syndrome and
\nPheochromocytoma ………………………… 125
\n17.3 Pituitary Disease …………………………. 125
\n17.3.1 Pituitary Adenomas ………………. 125
\n17.3.2 Hypopituitarism……………………. 126
\nAnemia, Thrombocytopenia, and Bleeding
\nDisorders……………………………………………….. 129
\n18.1 Anemia………………………………………. 129
\n18.1.1 Classification ………………………… 129
\n18.1.2 Iron Deficiency Anemia………….. 130
\n18.1.3 Anemia of Chronic Disease …….. 130
\n18.1.4 Macrocytic Anemia ……………….. 130
\n18.1.5 Hemolytic Anemia…………………. 131
\n18.2 Thrombocytopenia ……………………… 131
\n18.2.1 Approach……………………………… 131
\n18.2.2 Heparin-Induced
\nThrombocytopenia ………………………….. 131
\n18.2.3 Thrombotic Thrombocytopenic
\nPurpura ………………………………………….. 132
\n18.3 Bleeding Disorders………………………. 132
\n18.3.1 Evaluation ……………………………. 132
\n18.3.2 Hemophilia and von Willebrand
\nDisease…………………………………………… 132
\n18.3.3 Coagulopathy in the Hospitalized
\nPatient……………………………………………. 132
\n18.4 Transfusion Medicine ………………….. 133
\n18.4.1 Transfusion Reactions……………. 133
\nOncologic Emergencies……………………………. 135
\n19.1 Febrile Neutropenia…………………….. 136
\n19.2 Tumor Lysis Syndrome…………………. 136
\n19.3 Hypercalcemia of Malignancy……….. 136 Textbook of Internal Medicine 2026
\n\u2014 6 \u2014
\n19.4 Spinal Cord Compression ………………137
\n19.5 Superior Vena Cava Syndrome……….137
\n19.6 Immune-Related Adverse Events……137
\n19.7 Cytokine Release Syndrome and
\nNeurotoxicity ………………………………………138
\nSepsis and Bloodstream Infections…………….140
\n20.1 Defining Sepsis: The Sepsis-3
\nFramework………………………………………….140
\n20.1.1 Pathophysiology…………………….140
\n20.2 The Hour-1 Bundle ……………………….141
\n20.2.1 Empiric Antimicrobial Therapy…142
\n20.3 Resuscitation and Hemodynamic
\nSupport ………………………………………………143
\n20.3.1 Vasopressor Selection…………….143
\n20.3.2 Corticosteroids………………………144
\n20.4 Source Control……………………………..144
\n20.5 Bloodstream Infections…………………145
\n20.5.1 Staphylococcus aureus Bacteremia
\n………………………………………………………145
\n20.5.2 Gram-Negative Bacteremia……..145
\n20.5.3 Infective Endocarditis……………..146
\n20.5.4 Catheter-Related Bloodstream
\nInfection………………………………………….146
\n20.5.5 Candidemia …………………………..147
\n20.6 Sepsis Supportive Care………………….147
\nAntimicrobial Stewardship and Common
\nPathogens ………………………………………………150
\n21.1 Principles of Antimicrobial Stewardship
\n………………………………………………………….150
\n21.2 Beta-Lactam Antibiotics………………..151
\n21.2.1 Beta-Lactam Allergy ……………….152
\n21.3 Non\u2013Beta-Lactam Agents for Gram-
\nPositive Infection ………………………………… 153
\n21.4 Multidrug-Resistant Gram-Negatives153
\n21.4.1 ESBL-Producing Enterobacterales
\n……………………………………………………… 153
\n21.4.2 AmpC Producers…………………… 154
\n21.4.3 Carbapenem-Resistant Organisms
\n……………………………………………………… 154
\n21.5 Clostridioides difficile Infection …….. 155
\n21.6 Urinary Tract Infection…………………. 156
\n21.7 Skin and Soft Tissue Infection……….. 156
\n21.8 Meningitis………………………………….. 157
\n21.9 Additional Common Pathogens…….. 158
\n21.9.1 Influenza ……………………………… 158
\n21.9.2 HIV-Associated Opportunistic
\nInfection…………………………………………. 158
\n21.9.3 Tick-Borne Disease………………… 158
\nRheumatologic Emergencies and Acute
\nInflammatory Disease……………………………… 162
\n22.1 Approach to the Patient with Acute
\nInflammatory Disease………………………….. 162
\n22.2 Giant Cell Arteritis……………………….. 162
\n22.3 ANCA-Associated Vasculitis………….. 163
\n22.4 Other Vasculitides……………………….. 164
\n22.5 Septic Arthritis vs. Crystal Arthritis… 164
\n22.6 Systemic Lupus Erythematosus …….. 166
\n22.7 Antiphospholipid Syndrome …………. 167
\n22.8 Inflammatory Myopathy………………. 167
\n22.9 Spondyloarthropathy…………………… 167
\n22.10 Principles of Immunosuppressive
\nTherapy……………………………………………… 168 Textbook of Internal Medicine 2026
\n\u2014 7 \u2014
\nStroke, Seizures, and Altered Mental Status .170
\n23.1 Acute Ischemic Stroke…………………..170
\n23.1.1 Initial Evaluation…………………….171
\n23.1.2 Intravenous Thrombolysis……….171
\n23.1.3 Mechanical Thrombectomy …….172
\n23.1.4 Post-Thrombolysis and Post-
\nThrombectomy Care …………………………172
\n23.1.5 Secondary Prevention…………….172
\n23.2 Intracerebral Hemorrhage …………….173
\n23.3 Subarachnoid Hemorrhage ……………173
\n23.4 Seizures and Status Epilepticus………174
\n23.5 Approach to Altered Mental Status..175
\n23.6 Delirium in the Hospitalized Adult….176
\nShock, Mechanical Ventilation, and ICU
\nSedation …………………………………………………179
\n24.1 Shock: A Unified Framework………….179
\n24.1.1 Hypovolemic Shock ………………..180
\n24.1.2 Cardiogenic Shock ………………….180
\n24.1.3 Obstructive Shock ………………….180
\n24.1.4 Distributive Shock ………………….180
\n24.2 Mechanical Ventilation …………………181
\n24.2.1 Modes of Ventilation ……………..181
\n24.2.2 Initial Settings………………………..181
\n24.2.3 Lung-Protective Ventilation …….182
\n24.2.4 PEEP, Prone Positioning, and
\nRescue Therapies……………………………..182
\n24.2.5 Ventilator Alarms and
\nTroubleshooting……………………………….183
\n24.3 Sedation and Analgesia…………………183
\n24.4 Complications of Critical Illness ……..184
\n24.5 Weaning and Liberation from
\nMechanical Ventilation………………………… 184
\n24.6 Goals-of-Care and End-of-Life Care in
\nthe ICU………………………………………………. 185
\nBedside Procedures and Point-of-Care
\nUltrasound…………………………………………….. 188
\n25.1 The Universal Procedural Framework
\n…………………………………………………………. 188
\n25.2 Central Venous Catheterization…….. 189
\n25.2.1 Indications and Site Selection…. 189
\n25.2.2 Technique: Ultrasound-Guided
\nInternal Jugular……………………………….. 189
\n25.2.3 Complications ………………………. 189
\n25.3 Arterial Catheterization ……………….. 190
\n25.4 Thoracentesis……………………………… 190
\n25.4.1 Technique ……………………………. 190
\n25.4.2 Pleural Fluid Analysis …………….. 191
\n25.5 Paracentesis……………………………….. 192
\n25.6 Lumbar Puncture ………………………… 193
\n25.6.1 Technique ……………………………. 193
\n25.6.2 Post-Dural Puncture Headache.. 194
\n25.7 Arthrocentesis…………………………….. 195
\n25.8 Point-of-Care Ultrasound……………… 195
\n25.8.1 Cardiac POCUS ……………………… 195
\n25.8.2 Lung POCUS …………………………. 196
\n25.8.3 Integrated POCUS Protocols…… 196
\n25.9 Documentation and Handoff………… 196
\nGeriatric Medicine ………………………………….. 200
\n26.1 The Scope of Geriatric Medicine……. 200
\n26.2 Physiologic Aging ………………………… 200
\n26.3 Functional Assessment ………………… 201 Textbook of Internal Medicine 2026
\n\u2014 8 \u2014
\n26.4 Cognitive Assessment and Dementia202
\n26.5 Polypharmacy and Deprescribing …..203
\n26.6 Falls ……………………………………………204
\n26.7 Pressure Injury …………………………….204
\n26.8 Urinary Incontinence…………………….205
\n26.9 Hospital-Acquired Functional Decline
\n………………………………………………………….205
\nPalliative Care and End-of-Life Medicine…….207
\n27.1 Palliative Care and Hospice……………207
\n27.2 Communication and Goals of Care …207
\n27.3 Symptom Management ………………..208
\n27.3.1 Pain………………………………………208
\n27.3.2 Opioid Dosing and Conversion…209
\n27.3.3 Dyspnea………………………………..210
\n27.3.4 Nausea and Vomiting ……………..210
\n27.3.5 Constipation………………………….211
\n27.3.6 Delirium at the End of Life ………211
\n27.4 Advance Care Planning………………….211
\n27.5 Care of the Actively Dying Patient ….211
\n27.6 Hospice……………………………………….212
\nPerioperative Medicine…………………………….214
\n28.1 Preoperative Assessment………………214
\n28.2 Cardiac Risk Assessment……………….214
\n28.3 Perioperative Beta-Blockade and Statins
\n………………………………………………………….215
\n28.4 Perioperative Anticoagulation and
\nAntiplatelet Management……………………..216
\n28.5 Perioperative VTE Prophylaxis……….217
\n28.6 Pulmonary Risk…………………………….217
\n28.7 Diabetes and Glycemic Management
\n………………………………………………………….217
\n28.8 Other Specific Populations……………. 218
\n28.9 Postoperative Complications………… 218
\n28.9.1 Myocardial Injury after Non-Cardiac
\nSurgery (MINS)………………………………… 218
\n28.9.2 Postoperative Atrial Fibrillation. 219
\n28.9.3 Postoperative Ileus……………….. 219
\n28.9.4 Postoperative Delirium………….. 219
\nPreventive Medicine and Health Maintenance
\n…………………………………………………………….. 222
\n29.1 The Framework of Prevention………. 222
\n29.2 Screening: Principles and Pitfalls…… 222
\n29.3 Cancer Screening ………………………… 223
\n29.3.1 Colorectal Cancer………………….. 223
\n29.3.2 Breast Cancer……………………….. 224
\n29.3.3 Cervical Cancer …………………….. 224
\n29.3.4 Lung Cancer …………………………. 224
\n29.3.5 Prostate Cancer…………………….. 225
\n29.4 Cardiovascular Prevention……………. 225
\n29.4.1 Diabetes Prevention ……………… 226
\n29.5 Adult Immunization …………………….. 227
\n29.6 Behavioral Counseling …………………. 228
\n29.7 Obesity and Metabolic Health ………. 228
\n29.8 Preconception and Interconception
\nHealth ……………………………………………….. 229
\nDermatology for the Internist…………………… 231
\n30.1 The Internist and the Skin…………….. 231
\n30.2 Life-Threatening Cutaneous Drug
\nReactions …………………………………………… 231
\n30.2.1 Stevens-Johnson Syndrome and
\nToxic Epidermal Necrolysis……………….. 232 Textbook of Internal Medicine 2026
\n\u2014 9 \u2014
\n30.2.2 Drug Reaction with Eosinophilia
\nand Systemic Symptoms……………………232
\n30.2.3 Acute Generalized Exanthematous
\nPustulosis………………………………………..233
\n30.3 Skin and Soft-Tissue Infections ………234
\n30.3.1 Cellulitis and Erysipelas…………..234
\n30.3.2 Necrotizing Soft-Tissue Infection
\n………………………………………………………235
\n30.3.3 Other Common Infections……….235
\n30.4 Inflammatory Dermatoses…………….235
\n30.5 Autoimmune Blistering Diseases ……236
\n30.6 Urticaria, Pruritus, and Angioedema 236
\n30.7 Cutaneous Manifestations of Systemic
\nDisease ……………………………………………….237
\n30.8 Skin Cancer………………………………….238
\nMedical Toxicology and Environmental
\nMedicine ………………………………………………..241
\n31.1 The General Approach to Poisoning .241
\n31.2 Acetaminophen……………………………242
\n31.3 Salicylate …………………………………….243
\n31.4 Tricyclic Antidepressants……………….244
\n31.5 Beta-Blocker and Calcium Channel
\nBlocker Poisoning…………………………………244
\n31.6 Digoxin ……………………………………….244
\n31.7 Opioids and Stimulants…………………245
\n31.8 Toxic Alcohols………………………………245
\n31.9 Carbon Monoxide and Cyanide………246
\n31.10 Envenomation……………………………246
\n31.11 Hyperthermia and Hypothermia…..247
\nAllergy and Immunology …………………………..251
\n32.1 Anaphylaxis…………………………………251
\n32.2 Drug Allergy ……………………………….. 252
\n32.2.1 Radiocontrast Reactions………… 253
\n32.3 Angioedema……………………………….. 253
\n32.4 Primary Immunodeficiency in the Adult
\n…………………………………………………………. 254
\n32.5 Biologic Therapy: Mechanisms and
\nMonitoring…………………………………………. 254
\n32.6 Food Allergy ……………………………….. 256
\n32.7 Mast Cell Disorders……………………… 256
\nSleep Medicine for the Internist……………….. 259
\n33.1 The Physiology and Importance of Sleep
\n…………………………………………………………. 259
\n33.2 Obstructive Sleep Apnea ……………… 259
\n33.3 Central Sleep Apnea…………………….. 261
\n33.4 Insomnia ……………………………………. 261
\n33.5 Restless Legs Syndrome and Periodic
\nLimb Movements………………………………… 262
\n33.6 REM Sleep Behavior Disorder and
\nParasomnias……………………………………….. 262
\n33.7 Narcolepsy and Hypersomnolence… 263
\nPsychiatric Emergencies and Substance Use
\nDisorders……………………………………………….. 266
\n34.1 The Internist and Psychiatric Care …. 266
\n34.2 Suicide Risk Assessment ………………. 266
\n34.3 Acute Agitation …………………………… 267
\n34.4 Serotonin Syndrome and Neuroleptic
\nMalignant Syndrome …………………………… 268
\n34.5 Lithium Toxicity…………………………… 269
\n34.6 Alcohol Use Disorder and Withdrawal
\n…………………………………………………………. 269
\n34.7 Opioid Use Disorder…………………….. 270 Textbook of Internal Medicine 2026
\n\u2014 10 \u2014
\n34.8 Stimulant Use Disorder…………………271
\n34.9 Tobacco Use Disorder …………………..271
\n34.10 Depression and Anxiety in the Medical
\nPatient………………………………………………..271
\nHIV Medicine for the Internist …………………..276
\n35.1 HIV in the Third Decade of Antiretroviral
\nTherapy ………………………………………………276
\n35.2 Pathophysiology and Natural History276
\n35.3 Diagnosis and Laboratory Monitoring
\n………………………………………………………….277
\n35.4 Antiretroviral Therapy…………………..278
\n35.5 Opportunistic Infections and
\nProphylaxis………………………………………….279
\n35.6 Non-AIDS Comorbidities and Primary
\nCare……………………………………………………281
\n35.7 Pre-exposure and Post-exposure
\nProphylaxis………………………………………….281
\nSolid Organ Transplant Medicine for the
\nInternist………………………………………………….284
\n36.1 The Growing Transplant Population .284
\n36.2 Immunosuppression …………………….284
\n36.3 Rejection …………………………………….286
\n36.4 Post-Transplant Infections…………….286
\n36.5 Long-Term Management ………………287
\n36.6 Drug Interactions and Perioperative
\nManagement……………………………………….288
\nObstetric Medicine and Women’s Health……291
\n37.1 The Internist in Women’s Health and
\nPregnancy……………………………………………291
\n37.2 Physiologic Adaptations of Pregnancy
\n………………………………………………………….291
\n37.3 Hypertensive Disorders of Pregnancy
\n…………………………………………………………. 292
\n37.4 Venous Thromboembolism in
\nPregnancy ………………………………………….. 293
\n37.5 Diabetes in Pregnancy …………………. 293
\n37.6 Thyroid Disorders………………………… 294
\n37.7 Other Chronic Disease in Pregnancy. 294
\n37.8 Menopause and Hormone Therapy.. 295
\n37.9 Contraception…………………………….. 295
\n37.10 Common Women’s Health Issues for
\nthe Internist……………………………………….. 296
\nTravel Medicine and Tropical Infectious
\nDiseases………………………………………………… 300
\n38.1 The Pretravel Consultation …………… 300
\n38.2 Fever in the Returned Traveler……… 301
\n38.3 Malaria………………………………………. 302
\n38.4 Enteric Fever………………………………. 303
\n38.5 Arboviral Infections……………………… 303
\n38.6 Rickettsial and Spirochetal Infections
\n…………………………………………………………. 304
\n38.7 Parasitic and Chronic Infections ……. 304
\n38.8 Tuberculosis and Emerging Infections
\n…………………………………………………………. 305
\nOphthalmology and Otolaryngology for the
\nInternist ………………………………………………… 307
\n39.1 The Internist at the Interface………… 307
\n39.2 The Red Eye ……………………………….. 307
\n39.3 Acute Vision Loss………………………… 308
\n39.4 Ocular Manifestations of Systemic
\nDisease………………………………………………. 309
\n39.5 Dizziness and Vertigo…………………… 309 Textbook of Internal Medicine 2026
\n\u2014 11 \u2014
\n39.6 Hearing Loss and Tinnitus……………..310
\n39.7 Rhinosinusitis and Sore Throat ………311
\n39.8 Epistaxis………………………………………311
\nHealth Systems, Quality, and Medical Ethics.314
\n40.1 Why This Chapter…………………………314
\n40.2 The U.S. Health System…………………314
\n40.3 Quality and Safety………………………..315
\n40.4 Medical Ethics……………………………..316
\n40.5 Common Ethical Challenges…………..316
\n40.5.1 Refusal of Treatment ……………..316
\n40.5.2 Futility ………………………………….317
\n40.5.3 Disclosure of Error and Adverse
\nEvents……………………………………………..317
\n40.5.4 Conflicts of Interest………………..317
\n40.6 Physician Wellbeing ……………………..317
\nMusculoskeletal Medicine and Sports Injuries
\nfor the Internist……………………………………….321
\n41.1 Structured Musculoskeletal Assessment
\n………………………………………………………….321
\n41.2 Shoulder Disorders………………………..322
\n41.3 Elbow, Wrist, and Hand …………………323
\n41.4 Hip and Pelvis……………………………….324
\n41.5 Knee ……………………………………………325
\n41.6 Ankle and Foot……………………………..326
\n41.7 Low Back Pain ………………………………326
\n41.8 Osteoporosis and Bone Health ……….327
\n41.9 Sports Injuries and Return to Play …..328
\nPain Medicine for the Internist………………….331
\n42.1 Classification and Mechanisms of Pain
\n………………………………………………………….331
\n42.2 Assessment and Measurement……….332
\n42.3 Multimodal Analgesia…………………… 332
\n42.4 Opioid Therapy: Principles and Pitfalls
\n…………………………………………………………. 333
\n42.5 Neuropathic Pain Syndromes………… 335
\n42.6 Fibromyalgia and Nociplastic Pain….. 335
\n42.7 Cancer and End-of-Life Pain…………… 335
\n42.8 Perioperative and Acute Pain
\nManagement ……………………………………… 336
\nNutrition and Obesity Medicine ……………….. 339
\n43.1 Nutritional Assessment…………………. 339
\n43.2 Nutritional Requirements and Therapy
\n…………………………………………………………. 340
\n43.3 Micronutrient Deficiencies……………. 340
\n43.4 Obesity as a Chronic Disease …………. 342
\n43.5 Pharmacotherapy of Obesity…………. 342
\n43.6 Bariatric and Metabolic Surgery …….. 344
\n43.7 Dietary Patterns and Evidence-Based
\nNutrition ……………………………………………. 344
\nNormal Laboratory Reference Values ……….. 348
\nA.1 Hematology …………………………………. 348
\nA.2 Chemistry…………………………………….. 349
\nA.3 Endocrinology………………………………. 350
\nA.4 Arterial Blood Gas…………………………. 350
\nDrug Formulary for Common Inpatient
\nConditions……………………………………………… 352
\nB.1 Cardiovascular ……………………………… 352
\nB.2 Antimicrobials (Common Empiric
\nRegimens) ………………………………………….. 353
\nB.3 Gastroenterology, Endocrine, and Other
\n…………………………………………………………. 354
\nClinical Formulas and Equations……………….. 355 Textbook of Internal Medicine 2026
\n\u2014 12 \u2014
\nC.1 Renal and Electrolyte ……………………..355
\nC.2 Acid-Base………………………………………355
\nC.3 Pulmonary…………………………………….355
\nC.4 Cardiovascular……………………………….356
\nC.5 Hepatic and Infectious Disease………..356
\nC.6 Endocrine ……………………………………..356
\nACLS Algorithms………………………………………358
\nD.1 Adult Cardiac Arrest: Shockable Rhythms
\n(VF\/Pulseless VT) ………………………………… 358
\nD.2 Adult Cardiac Arrest: Non-Shockable
\nRhythms (Asystole, PEA)………………………. 358
\nD.3 Bradycardia with a Pulse ……………….. 358
\nD.4 Tachycardia with a Pulse ……………….. 358
\nD.5 Post-Cardiac-Arrest Care ……………….. 359<\/p>\n","protected":false},"excerpt":{"rendered":"

Internal Medicine 2026: A Comprehensive Clinical Textbook: Pathophysiology, Diagnosis, Pharmacotherapy and Hospital Medicine – An Evidence-Based Guide for Physicians, Residents and Medical Students Original PDF
\nby Adrian Reis
\nInformation
\nFormat: Original PDF
\nPages: 364 pages
\nPublication Date of the Electronic Edition: April 26, 2026<\/p>\n","protected":false},"featured_media":102210,"comment_status":"open","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":""},"product_cat":[285],"product_tag":[1537,1770],"class_list":["post-102117","product","type-product","status-publish","has-post-thumbnail","hentry","product_cat-family-medicine-primary-care-hospital-medicine-books-cme-videos","product_tag-hospital-medicine","product_tag-interventional-medicine"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"th","enabled_languages":["en","uk","ar","au","ca","de","fr","es","pt","th","it","da","ko","he"],"languages":{"en":{"title":true,"content":true,"excerpt":true},"uk":{"title":false,"content":false,"excerpt":false},"ar":{"title":false,"content":false,"excerpt":false},"au":{"title":false,"content":false,"excerpt":false},"ca":{"title":false,"content":false,"excerpt":false},"de":{"title":false,"content":false,"excerpt":false},"fr":{"title":false,"content":false,"excerpt":false},"es":{"title":false,"content":false,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"th":{"title":false,"content":false,"excerpt":false},"it":{"title":false,"content":false,"excerpt":false},"da":{"title":false,"content":false,"excerpt":false},"ko":{"title":false,"content":false,"excerpt":false},"he":{"title":false,"content":false,"excerpt":false}}},"_links":{"self":[{"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/product\/102117","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/comments?post=102117"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/media\/102210"}],"wp:attachment":[{"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/media?parent=102117"}],"wp:term":[{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/product_cat?post=102117"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medicalebooks.org\/th\/wp-json\/wp\/v2\/product_tag?post=102117"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}