Sections
Index
Symptoms
Cardiovascular Disorders
Clinical Pharmacology
Critical Care Medicine
Dental Disorders
Dermatologic Disorders
Ear, Nose, and Throat Disorders
Endocrine and Metabolic Disorders
Eye Disorders
Gastrointestinal Disorders
Genitourinary Disorders
Geriatrics
Gynecology and Obstetrics
Hematology and Oncology
Hepatic and Biliary Disorders
Immunology; Allergic Disorders
Infectious Diseases
Injuries; Poisoning
Musculoskeletal and Connective Tissue Disorders
Neurologic Disorders
Nutritional Disorders
Pediatrics
Psychiatric Disorders
Pulmonary Disorders
Special Subjects
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Abdominal Pain, Acute
Abdominal Pain, Chronic
Alopecia
Amenorrhea
Amnesia
Anosmia
Bleeding, Excessive
Breast Lumps
Chest Pain
Constipation in Adults
Constipation in Children
Cough in Adults
Cough in Children
Crying
Diarrhea in Adults
Diarrhea in Children
Diplopia
Dizziness
Dry Mouth
Dysmenorrhea
Dyspepsia
Dysphagia
Dyspnea
Dysuria
Earache
Ear Discharge
Edema
Edema During Late Pregnancy
Epistaxis
Erectile dysfunction
Eyelid Swelling
Eye Pain
Fever
Fever, Acute, in Adults
Fever, Chronic (FUO)
Fever in Infants and Children
Floaters
Gas
Gastrointestinal Bleeding
Halitosis
Headache
Hearing Loss
Hearing Loss: Sudden Deafness
Hematospermia
Hematuria
Hemoptysis
Hiccups
Hirsutism
Insomnia and Excessive Daytime Sleepiness
Itching
Itching, Anal
Jaundice in Adults
Jaundice in Neonates
Joint Pain, Monarticular
Joint Pain, Polyarticular
Knee pain
Lump in Throat
Nasal Congestion and Rhinorrhea
Nausea and Vomiting During Early pPregnancy
Nausea and Vomiting in Adults
Nausea and Vomiting in Infants and Children
Neck and Back Pain
Neck Mass
Nipple Discharge
Orthostatic Hypotension
Pain
Pain, Chronic
Palpitations
Pelvic Pain
Pelvic Pain During Early Pregnancy
Polyuria
Priapism
Red Eye
Scrotal Pain
Sore Throat
Stomatitis
Stridor
Syncope
Tearing
Tinnitus
Toothache
Tremor
Urinary Frequency
Urinary Incontinence in Adults
Urinary Incontinence in Children
Urinary Retention
Urticaria
Vaginal Bleeding
Vaginal Bleeding During Early Pregnancy
Vaginal Bleeding During Late Pregnancy
Vaginal Itching and Discharge
Vision, Blurred
Vision Loss, Acute
Weakness, Generalized
Wheezing
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Trade Names of Some Commonly Used Drugs
Normal Laboratory Values
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Health Care Professionals
Cardiovascular Disorders
Clinical Pharmacology
Critical Care Medicine
Dental Disorders
Dermatologic Disorders
Ear, Nose, and Throat Disorders
Endocrine and Metabolic Disorders
Eye Disorders
Gastrointestinal Disorders
Genitourinary Disorders
Geriatrics
Gynecology and Obstetrics
Hematology and Oncology
Hepatic and Biliary Disorders
Immunology; Allergic Disorders
Infectious Diseases
Injuries; Poisoning
Musculoskeletal and Connective Tissue Disorders
Neurologic Disorders
Nutritional Disorders
Pediatrics
Psychiatric Disorders
Pulmonary Disorders
Special Subjects
Merck Manual
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Health Care Professionals
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Hepatic and Biliary Disorders
Hepatic and Biliary Disorders
Approach to the Patient with Liver Disease
Liver Structure and Function
Pathophysiology
Evaluation of the Patient With a Liver Disorder
History
Physical examination
Ascites
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Spontaneous Bacterial Peritonitis(SBP)
Symptoms and Signs
Diagnosis
Treatment
Fatty Liver
Nonalcoholic Steatohepatitis(NASH)
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Jaundice
Pathophysiology
Mechanisms of hyperbilirubinemia
Consequences
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Geriatrics Essentials
Key Points
Inborn Metabolic Disorders Causing Hyperbilirubinemia
Gilbert Syndrome
Crigler-Najjar Syndrome
Primary Shunt Hyperbilirubinemia
Dubin-Johnson Syndrome and Rotor's Syndrome
Dubin-Johnson syndrome
Rotor's syndrome
Portal Hypertension
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Portal-Systemic Encephalopathy
Etiology
Precipitants
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Systemic Abnormalities in Liver Disease
Circulatory Abnormalities
Endocrine Abnormalities
Hematologic Abnormalities
Renal and Electrolyte Abnormalities
Hepatorenal syndrome
The Asymptomatic Patient With Abnormal Laboratory Test Results
Aminotransferases
Alkaline phosphatase
Postoperative Liver Dysfunction
Postoperative jaundice
Postoperative hepatitis
Postoperative cholestasis
Testing for Hepatic and Biliary Disorders
Introduction
Laboratory Tests of the Liver and Gallbladder
Tests for Liver Injury
Aminotransferases
Lactate dehydrogenase
Tests for Cholestasis
Bilirubin
Alkaline phosphatase
5′-Nucleotidase
γ‑Glutamyl transpeptidase (GGT)
Tests of Hepatic Synthetic Capacity
PT and INR
Serum proteins
Other Laboratory Tests
Ammonia
Serum immunoglobulins
Antimitochondrial antibodies
Other antibodies
α‑Fetoprotein (AFP)
Imaging Tests of the Liver and Gallbladder
Ultrasonography
Doppler ultrasonography
CT
Cholescintigraphy
Radionuclide liver scanning
Plain x-ray of the abdomen
MRI
ERCP
Percutaneous transhepatic cholangiography (PTC)
Operative cholangiography
Liver Biopsy
Indications
Contraindications
Other routes
Drugs and the Liver
Introduction
Effects of Liver Disease on Drug Metabolism
Liver Injury Caused by Drugs
Pathophysiology
Patterns of liver injury
Diagnosis
Treatment
Prevention
Alcoholic Liver Disease
Alcoholic Liver Disease
Risk Factors
Quantity of alcohol
Sex
Genetic factors
Nutritional status
Other factors
Pathophysiology
Alcohol absorption and metabolism
Hepatic fat accumulation
Endotoxins in the gut
Oxidative damage
Resultant inflammation, cell death, and fibrosis
Pathology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Restricting alcohol intake
Supportive care
Specific treatment
Fibrosis and Cirrhosis
Introduction
Hepatic Fibrosis
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Cirrhosis
Pathophysiology
Complications
Histopathology
Symptoms and Signs
Diagnosis
General approach
Laboratory tests
Diagnostic imaging
Identification of the cause
Liver biopsy
Monitoring
Prognosis
Treatment
Primary Biliary Cirrhosis(PBC)
Etiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Hepatitis
Overview of Hepatitis
Acute Viral Hepatitis
Etiology
Hepatitis A virus (HAV)
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Hepatitis D virus (HDV)
Hepatitis E virus (HEV)
Symptoms and Signs
General
Virus-specific
Diagnosis
Initial diagnosis
Serology
Biopsy
Treatment
Prevention
HAV
HBV
HCV, HDV, and HEV
Fulminant Hepatitis
Chronic Hepatitis
Etiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Autoimmune hepatitis
HBV
HCV
Vascular Disorders of the Liver
Overview of Vascular Disorders of the Liver
Hepatic Ischemia
Ischemic Hepatitis
Diagnosis
Treatment
Ischemic Cholangiopathy
Congestive Hepatopathy
Diagnosis
Treatment
Hepatic Artery Disorders
Hepatic Artery Occlusion
Diagnosis
Treatment
Aneurysms
Hepatic Vein Disorders
Budd-Chiari Syndrome
Etiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Veno-Occlusive Disease
Diagnosis
Treatment
Portal Vein Disorders
Portal Vein Thrombosis
Etiology
Symptoms and Signs
Diagnosis
Treatment
Peliosis Hepatis
Liver Masses and Granulomas
Hepatic Cysts
Benign Liver Tumors
Hepatocellular adenoma
Focal nodular hyperplasia
Hemangiomas
Other benign tumors
Primary Liver Cancer
Hepatocellular Carcinoma
Etiology
Symptoms and Signs
Diagnosis
Staging
Screening
Treatment
Prevention
Other Primary Liver Cancers
Fibrolamellar carcinoma
Cholangiocarcinoma
Hepatoblastoma
Angiosarcoma
Metastatic Liver Cancer
Symptoms and Signs
Diagnosis
Treatment
Hematologic Cancers and the Liver
Hepatic Granulomas
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Gallbladder and Bile Duct Disorders
Overview of Biliary Function
Cholelithiasis
Pathophysiology
Symptoms and Signs
Diagnosis
Prognosis
Treatment
Surgery
Stone dissolution
Cholecystitis
Acute Cholecystitis
Acute acalculous cholecystitis
Symptoms and Signs
Complications
Acute acalculous cholecystitis
Diagnosis
Acute acalculous cholecystitis
Treatment
Chronic Cholecystitis
Symptoms and Signs
Diagnosis
Treatment
Acalculous Biliary Pain
Diagnosis
Treatment
Postcholecystectomy Syndrome
Diagnosis
Treatment
Choledocholithiasis and Cholangitis
Diagnosis
Treatment
Sclerosing Cholangitis
Primary Sclerosing Cholangitis(PSC)
Etiology
Symptoms and Signs
Diagnosis
Treatment
AIDS Cholangiopathy
Diagnosis
Treatment
Tumors of the Gallbladder and Bile Ducts
Symptoms and Signs
Diagnosis
Treatment
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