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Textbook of Family Medicine E-Book

Textbook of Family Medicine E-Book

David Rakel | Robert E. Rakel

(2011)

Additional Information

Book Details

Abstract

Edited by Robert E. Rakel, MD and David P. Rakel, MD, Textbook of Family Medicine remains your #1 choice for complete guidance on the principles of family medicine, primary care in the community, and all aspects of clinical practice. Ideal for both residents and practicing physicians, it includes evidence-based, practical information to optimize your patient care and prepare you for the ABFM exam. The full-color format features a clean, quick-reference layout that makes it easy for you to put information to work immediately in your practice. You can also access the complete contents online at www.expertconsult.com, plus 30 videos of common office procedures, additional chapters on timely topics, and figures, tables, and photographs that supplement the text.

  • Prepare for success on the ABFM exam with complete coverage of all aspects of family medicine.
  • Access information quickly with an efficient, full-color layout that makes it easy to apply the latest knowledge in your practice.
  • Take advantage of today’s most useful online resources with a convenient list of outstanding clinical websites.
  • Quickly spot "Best Evidence Recommendations" with special boxes located throughout the text.
  • Glean helpful tips on diagnosis and therapy from "Key Points" boxes found on every page.
  • Access the complete contents and illustrations online at www.expertconsult.com - fully searchable – plus additional figures, tables, and photographs online, as well as online-only chapters that cover topics such as prescribing nutritional supplements and botanicals.
  • View 30 videos online covering common office procedures such as vasectomy, the proper use of today’s diabetic equipment, and endometrial biopsy.
  • Gain a new understanding of the patient-centered medical home and how to achieve this status in outpatient clinics.
  • Make the most effective care decisions with help from "Evidence vs. Harm" icons that guide you through key treatments of common medical conditions.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Textbook of Family Medicine iii
Copyright\r iv
Contributors v
Dedication\r xiii
Preface xv
Contents xvii
Part One - Principles of Family Medicine 1
Chapter 1 - The Family Physician 3
Key Points 3
The Joy of Family Practice 4
Development of the Specialty 4
Definitions 5
Personalized Care 6
Characteristics and Functions of the Family Physician 7
The Family Physician in Practice 14
Patient-Centered Medical Home 15
Looking toward the Future 15
References 16
Web Resources 16
References 16.e1
Chapter 2 - The Patient-Centered Medical Home 17
Key Points 17
History 17
Healing, Curing, and the Goals of the Medical Home 17
Health Teams 20
The Health Home Checklist 22
Conclusion 22
References 23
Web Resources 23
References 23.e1
Chapter 3 - Psychosocial Influences on Health 24
Key Points 24
Conceptual Models 25
Integration of Psychosocial Issues in Clinical Practice 29
Evidence-Based Practice 30
The Patient-Centered Medical Home and Psychosocial Issues 31
Conclusion 31
References 32
Web Resources 32
References 32.e1
Chapter 4 - Care of the Elderly Patient 33
Geriatric Assessment 33
Falls 36
Elder Abuse 39
Pressure Ulcers 42
Rational Drug Prescribing for Elderly Patients 45
Urinary Incontinence 47
References 52
Web Resources 52
Videos 52
References 52.e1
Chapter 5 - Care of the Dying Patient 53
The Physician’s Attitude 54
Communication 55
Denial 57
“Watch with Me” 58
Patient Control 58
The Importance of Hope 59
Prolonging Living or Prolonging Dying? 59
Management of Symptoms 59
Nutrition 67
Where to Die 68
Hospice Care 68
Advance Directives 69
Social Support and Resources in the Community 69.e3
References 71
Web Resources 71
Euthanasia and Assisted Suicide 71.e1
References 72.e1
Suggested Readings 72.e2
Chapter 6 - Preventive Health Care 73
Key Concepts in Evidence-Based Prevention 73
Statistical Concepts in Prevention 76
Preventive Services by Disease Category 77
Special Populations 90
Counseling 92
Systems Change 94
Conclusions 95
Acknowledgments 99
References 99
Web Resources 99
References 99.e1
Chapter 7-Lifestyle Interventions and Behavior Change 100
Prevention from the Disease-Oriented Perspective: A Focus on Heart Disease 100
Primary Prevention: A Focus on Lifestyle 103
After the Evidence: Motivational Interviewing 108
Crux of the Lifestyle Dilemma: Do Physicians Believe in Primary Prevention? 109
Summary 110
References 111
Web Resources 111
Chapter 8 - Interpreting the Medical Literature: Applying Evidence-Based Medicine in Practice 112
Building Clinical Evidence from Published Research 112
Understanding the Statistical Significance of Study Results 114
Interpreting Study Results: Statistical and Clinical Significance 115
Other Keys to Interpreting Clinical Evidence 115
Using Evidence at the Point of Care 116
References 119
Web Resources 119
References 119.e3
Chapter 9 - Using Health Information Technology for Optimal Patient Care and Service 120
Components of Patient Care 120
Office Business and Management Functions 122
Integrating and Connecting Systemsand Functions 122
Conclusion 123
References 123
Web Resources 123
Reference 123.e1
Chapter 10 - Clinical Problem Solving 124
Making Clinical Decisions 124
Focusing the Question 125
Finding the Evidence 125
Incorporating Patient Preferences 127
Conclusion 129
References 130
Web Resources 130
References 130.e1
Chapter 11 - Complementary and Alternative Medicine: Integration into Primary Care 131
What Is Complementary and Alternative Medicine? 132
Important U.S. Reports 135
Conclusion 144
References 145
Web Resources 145
References 145.e1
Chapter 12 - Establishing Rapport 146
Respect 147
Patient Satisfaction 147
Part Two - Practice of Family Medicine 205
Chapter 16 - Infectious Diseases 207
Bronchitis 208
Chronic Bronchitis: Acute Exacerbation 209
Pneumonia 209
INFLUENZA 210
Systemic Viral Infections 212
Varicella and Herpes Zoster 213
Measles 214
Epstein-Barr Virus and Cytomegalovirus 214
Tuberculosis 215
Sexually Transmitted Infections 218
Genital Ulcers 219
Urethritis and Cervicitis 222
Pelvic Inflammatory Disease 224
Human Papillomavirus 224
Ectoparasites 225
Genitourinary Infections 225
Tick-Borne Infections 228
Rocky Mountain Spotted Fever 228
Ehrlichiosis 228
Babesiosis 230
Lyme Disease 230
Tularemia 230
Colorado Tick Fever 231
Prevention of Tick-Borne Disease 231
Cellulitis 231
FURUNCLES AND CARBUNCLES 232
Diabetic Ulcers 234
Bite Infections 235
Animal Bites 235
Human Bites 235
Treatment 237
Bone and Joint Infections 237
Osteomyelitis 237
Diabetic Foot Osteomyelitis 239
Orthopedic Hardware Infections 239
Septic Arthritis 240
Fever Of Unknown Origin 240
Complicated Intra-Abdominal Infections 242
Spontaneous Bacterial Peritonitis 242
Central Nervous System Infections 243
Bacterial Meningitis 243
Viral Encephalitis 244
Brain Abscess 244
Infectious Diarrhea 244
Viral Gastroenteritis 245
Travelers’ Diarrhea 246
Antibiotic-Associated Diarrhea 246
References 247
Web Resources 247
Infectious Viral Hepatitis 247.e1
Endocarditis 247.e3
References 247.e1
Chapter 17 - Care of the Adult HIV-Infected Patient 248
Epidemiology 248
Modes of Transmission and Relative Risk 249
Pathophysiology 250
Life Cycle of HIV and Relevance to Treatment 250
Classification and Staging of HIV/AIDS 251
Natural History and Clinical Course 252
Diagnosis 253
Approach to the Patient 254
Use of Antiretroviral Agents 255
Summary 259
References 260
Web Resources 260
References 260.e1
Chapter 18 - Pulmonary Medicine 261
Lung Disease in Primary Care 261
Disorders of Breathing 298
Obstructive Lung Disease 268
Acute Infectious Diseases 278
Chronic Infectious Diseases 282
Fungal Infections of the Lung 287
Vascular Disease 287
Pulmonary Complications of Sickle Cell Disease 290
Malignant Disease 291
Occupational Lung Disease 292
Granulomatous Diseases 294
Interstitial Lung Diseases 296
Lung Manifestations of Autoimmune Connective Tissue Disorders and Other Systemic Diseases 297
Diseases of the Pleura and Extrapulmonary Space 297
References 299
Web Resources 299
References 299.e1
Chapter 19 - Otorhinolaryngology 300
Emergencies 300
The Ear 305
Facial Nerve Paralysis 318
The Nose and Paranasal Sinuses 319
Oral Cavity and Pharynx 330
The Larynx 333
The Neck 338
References 342
Web Resources 342
References 342.e1
Chapter 20 - Allergy 343
Allergic Rhinitis 344
Asthma 347
Paradoxical Vocal Cord Motion 353
Anaphylaxis 354
Best Evidence Sources 358
Web Resources 358
References 358.e1
Chapter 21 - Obstetrics 359
Woman and Child Health 360
Preconception Counseling 361
Nutrition 361
Medical Risk Assessment 363
Routine Prenatal Care 363
Prenatal Genetic Diagnostic Testing 367
Drug and Chemical Exposures in Pregnancy 368
Infections in Pregnancy 369
Medical Disorders in Pregnancy 371
Complications of Early Pregnancy 375
Complications of Late Pregnancy 377
Multiple Gestation 382
Antepartum Fetal Surveillance 382
Normal Labor and Delivery 384
Abnormalities of Labor and Delivery 387
Electronic Fetal Monitoring 389
Vaginal Birth after Cesarean 393
Intrapartum Procedures 395
The Puerperium 399
Postpartum Hemorrhage 400
References 401
Web Resources 401
References 401.e1
Chapter 22 - Care of the Newborn 402
Preconception and Intrapartum Health 402
Initial Newborn Evaluation 406
Postnatal Assessment of Gestational Age 410
Audiology Screening 410
Signs and Symptoms of Concern 410
Common Problems Encountered in the Term Newborn 415
Parental Education and Anticipatory Guidance before Discharge 418
References 419.e1
Early Care of the Well Newborn after HospitalDischarge 419.e1
Care of the Neonatal Intensive Care UnitGraduate 419.e1
Web Resources 420
References 420.e1
Chapter 23 - Growth and Development 421
Care of Children in Family Medicine 421
Blood Pressure Monitoring 422
Measuring Physical Parameters of Growth 423
Screening Healthy Children 425
Discipline 427
Nutrition 428
Behavior and Neurodevelopment 431
Guidelines for Clinical Assessment 431
Immunizations 437
Acknowledgment 441
Key Resource 441
References 441
Web Resources 441
References 441.e1
Chapter 24 - Behavioral Problems in Children and Adolescents 442
Sleep Problems 443
Autism 445
Encopresis and Enuresis 446
Attention-Deficit/Hyperactivity Disorder 446
Oppositional Defiant Disorder 450
Conduct Disorder 450
Eating Disorders 452
References 453
Web Resources 454
References 454.e1
Chapter 25 - Gynecology 455
Patient-Centered Approach to the Well-Woman Examination 455
Abnormal Vaginal Bleeding 456
Pelvic Mass 459
Vaginal Discharge 460
Vulvar Lesions 463
Acute Pelvic Pain 464
Menopause 466
References 467
Web Resources 467
References 467.e1
Chapter 26 - Contraception 468
Use of Contraception 468
Sterilization 476
Emergency Contraception 477
Conclusion 477
References 477
Web Resources 477
References 477.e1
Chapter 27 - Cardiovascular Disease 478
Atherosclerosis 479
Dyslipidemia 479
Hypertension 486
Metabolic Syndrome 492
Diabetes Mellitus 495
C-Reactive Protein 497
Homocysteine 498
Cigarette Smoking 498
Coronary Artery Disease 499
Congestive Heart Failure 508
Valvular Heart Disease 513
Peripheral Arterial Disease 518
Cardiac Electrophysiology and Arrhythmias 531
References 549
Web Resources 549
References 549.e1
Chapter 28 - Common Office Procedures 550
Basic Skills 551
Principles of Healing 556
Principles of Skin Closure 558
Excisions 562
Cryotherapy 563
Incision and Drainage of Cutaneous Abscess 564
Lipomas 565
Surgery of the Nail and Digits 565
Anorectal Disease 566
Gynecologic Office Procedures 569
Neonatal Circumcision 574
Musculoskeletal Office Procedures 575
References 576
Web Resources 576
References 576.e1
Chapter 29 - Sports Medicine 577
Preparticipation Physical Evaluation 578
Cardiac Disorders in Athletes 580
Concussion in Sports 582
Cervical Spine Injuries 584
Environmental Influences 586
Sports Trauma to the Teeth, Face, and Eyes 588
Infectious Disease 590
Sports Dermatology 591
Pulmonary Problems 592
Hematologic Problems 593
Gastrointestinal Problems 594
Genitourinary Problems 594
Low Back Pain 594
Spondylolysis 594
Muscle and Tendon Injuries 594
Shin Pain 596
Stress Fractures 597
The Pediatric Athlete 597
Special Concerns for the Female Athlete 598
References 600
Web Resources 600
References 600.e1
Chapter 30 - Common Issues in Orthopedics 601
Fractures 601
Shoulder 603
Elbow 610
Wrist and Hand 612
Knee 616
Ankle and Foot 624
References 629
Web Resources 629
References 630.e1
Chapter 31 - Back: Cervical and Thoracolumbar Spine 631
Cervical Spine 631
Thoracolumbar Spine 636
References 647
Web Resources 647
References 647.e1
Chapter 32 - Rheumatology and Musculoskeletal Problems 648
Evaluation of Joint and Other Musculoskeletal Symptoms 648
Pathogenesis of Rheumatic and Other Musculoskeletal Diseases 650
Laboratory Studies 652
Rheumatic Diseases 655
Rheumatic Disease in Children 687
Rheumatology Information on the Internet 688
References 688
Web Resources 688
References 689.e1
Chapter 33 - Dermatology 690
Principles of Diagnosis 690
General Management 692
Skin Problems Beginning in Childhood 693
Inflammatory Dermatologic Diseases 698
Infectious Skin Diseases 705
Infestations 716
Hypersensitivity Reactions and Other Eruptions 718
Skin Signs of Systemic Disease 720
Benign Growths 723
Premalignant and Malignant Skin Lesions 724
References 730
Web Resources 730
References 730.e1
Chapter 34 - Diabetes Mellitus 731
Definition and Pathogenesis 731
Classification and Diagnosis 732
Epidemiology 732
Pathophysiology 733
Presentation 735
Management 736
Diabetic Ketoacidosis 744
Nonketotic Hyperosmolality Syndrome 747
Diabetes and Pregnancy 747
Hospital Care of Diabetic Patients 748
Diabetic Complications 749
The Metabolic Syndrome 753
Office Management to Improve Diabetic Outcomes: Activating the Patient 754
References 755
Web Resources 755
References 755.e1
Chapter 35 - Endocrinology 756
Pituitary Disorders 756
Thyroid Disorders 767
Adrenal Glands 777
Ovarian and Testicular Disorders 784
Disturbances in Calcium and Phosphate 796
References 801
Web Resources 801
References 801.e1
Chapter 36 - Obesity 802
Overview 802
Assessment 804
Demographics 805
Determinants of Obesity 806
Medical Complications 808
Management and Interventions 810
Summary 817
References 817
Web Resources 817
References 817.e1
Chapter 37 - Nutrition and Family Medicine 818
Overview 818
Nutrition Assessment 819
Nutrition in the Life Cycle 827
Diet in Prevention and Management of Major Disease 831
Nutrition Decisions in the Hospitalized Patient 835
Future in Nutrition 840
Terminology 841
Conclusion 841
References 841
Web Resources 842
References 842.e1
Chapter 38 - Gastroenterology 843
Epidemiology and Social Impact of Gastrointestinal Disease 843
Common Pediatric Gastrointestinal Disorders 844
Common Adult Gastrointestinal Disorders 847
Gallbladder 855
Liver 856
Pancreas 861
Lower Gastrointestinal Tract 863
References 876
Web Resources 876
References 876.e1
Chapter 39 - Hematology 877
Overview 877
Disorders of Red Blood Cells 878
White Blood Cells 888
Platelets 892
Lymphoid System 896
Leukemia 898
References 898
Web Resources 898
Leukemia 898.e1
Lymphomas 898.e5
Additional Readings 898.e10
Chapter 40 - Urinary Tract Disorders 899
Evaluation of the Urinary Tract 899
Anatomic Disorders 909
Functional Disorders 912
Infectious Disorders 918
Neoplastic Disorders 923
References 927
Web Resources 927
References 827.e1
Chapter 41 - Ophthalmology 928
Red Eye 928
Symptoms and Signs 928
Ocular Trauma and Other Emergencies 936
Pediatric Ophthalmology 939
Adult Ophthalmology 947
References 957
Web Resources 957
Chapter 42 - Neurology 959
Neurologic Examination 959
Neurologic Conditions 962
References 999
Web Resources 999
References 999.e1
Chapter 43 - Medical Human Sexuality 1000
Overview 1000
Female Sexual Dysfunction 1002
Male Sexual Dysfunction 1005
Sexual Orientation Spectrum 1008
Sexuality Issues at Specific Times of Life 1009
Conclusion 1012
References 1012
Web Resources 1012
References 1012.e1
Chapter 44 - Clinical Genetics (Genomics) 1013
Overview 1013
Family History: Best Guide to Genetic Components of Disease 1014
Genetic Testing 1015
Ethical, Legal, and Social Issues 1018
Genetics in Primary Care Practice: Disease Illustrations 1018
References 1021
Web Resources 1021
References 1021.e1
Chapter 45 - Crisis Intervention, Trauma, and Intimate Partner Violence 1022
Development of Crisis Intervention, Trauma, and Disaster Theory 1022
Evaluating the Crisis or Disaster 1025
Crisis Intervention Treatment in the Office Setting 1029
Coping Skills and Adaptive Problem Solving 1032
Intimate Partner Violence Approach 1032
Other Trauma Treatments 1035
Medications for Symptoms of Psychiatric Disorders 1035
Conclusion 1036
References 1036
Index 1135