37 HYPERNATREMIA General Discussion Hypernatremia is defined as a serum sodium concentration exceeding 145 mEq/L. In contrast to hyponatremia, which usually results from a defect in renal water handling, the…

35 HYPERCOAGULABLE STATES General Discussion Hypercoagulable conditions are classified as primary (an inherited condition) or secondary (an acquired state). The inherited disorders include factor V Leiden, prothrombin G20210A gene mutation,…

36 HYPERKALEMIA General Discussion Hyperkalemia is defined as a serum potassium concentration greater than 5.0 mEq/L and can become life threatening when the potassium concentration rises above 6.5 mEq/L. Hyperkalemia…

32 HEMOPTYSIS General Discussion Hemoptysis, the coughing up of blood from the respiratory tract, must be differentiated from hematemesis (the vomiting of blood) and pseudohemoptysis (blood in the sputum that…

33 HIRSUTISM General Discussion Hirsutism is defined as the presence of excessive coarse terminal hair in a pattern not normal in the female in areas such as the face, chest,…

30 HEMATOSPERMIA General Discussion Hematospermia, or blood in the ejaculate, may result from many different causes. Most men with hematospermia are young, with infections or inflammatory disorders accounting for 39%…

28 HEADACHE General Discussion The majority of patients with headache experience either migraine, tension-type, or medication rebound headaches. Serious or anatomical causes of headaches are uncommon but have to be…

29 HEARING LOSS General Discussion More than 28 million Americans have some degree of hearing impairment, and 25–40% of those aged 65 years or older are hearing impaired. The differential…

27 HAIR LOSS General Discussion Hair loss, or alopecia, can be classified in various ways, but the most common classification distinguishes nonscarring from scarring alopecia. The hair loss of scarring…

26 GYNECOMASTIA General Discussion Gynecomastia, the excessive development of the male mammary glands, which occurs when there is a disturbance in the normal ratio of circulating androgens to estrogens. The…