BOOK
Primary Care - E-Book
Terry Mahan Buttaro | JoAnn Trybulski | Patricia Polgar-Bailey | Joanne Sandberg-Cook
(2016)
Additional Information
Book Details
Abstract
Prepare for success in today's fast-paced, collaborative healthcare environment! Offering expert perspectives from a variety of primary care and nurse practitioners, Primary Care: A Collaborative Practice, 5th Edition helps you diagnose, treat, and manage hundreds of adult disorders. Care recommendations indicate when to consult with physicians or specialists, and when to refer patients to an emergency facility. This edition includes six new chapters, a fresh new design, the latest evidence-based guidelines, and a new emphasis on clinical reasoning. Combining academic and clinical expertise, an author team led by Terry Mahan Buttaro shows NPs how to provide effective, truly interdisciplinary health care.
- UNIQUE! A collaborative perspective promotes seamless continuity of care, with chapters written by NPs, physicians, PAs, and other primary care providers.
- Comprehensive, evidence-based content covers every major disorder of adults seen in the outpatient office setting, reflects today's best practices, and includes the knowledge you need for the NP/DNP level of practice.
- A consistent format in each chapter is used to describe disorders, facilitating easier learning and quick clinical reference.
- Diagnostics and Differential Diagnosis boxes provide a quick reference for diagnosing disorders and making care management decisions.
- Complementary and alternative therapies are addressed where supported by solid research evidence.
- Referral icons highlight situations calling for specialist referral or emergency referral.
- NEW chapters cover topics including transitional care, risk management, LGBTQ patient care, bullous pemphigoid, pulmonary embolism, and dysphagia.
- NEW! An emphasis on clinical reasoning helps you develop skills in diagnosis and treatment, with coverage moving away from pathophysiology and toward diagnostic reasoning and disease management — including pharmacologic management.
- NEW focus on interdisciplinary care underscores the importance of interprofessional education and practice, and includes Interdisciplinary Management features.
- UPDATED chapters reflect the latest literature and evidence-based treatment guidelines, including new content on the Affordable Care Act as well as new coverage of patient satisfaction metrics, quality metrics, value-based purchasing, pharmacogenetics/genomics, and teen pregnancy and abnormal pregnancy.
- NEW quick-reference features make it easier to locate important information, through colorful section tabs, bulleted summaries, additional algorithms, a more logical table of contents, an Index to Standardized Treatment Guidelines, and a Reference to Common Laboratory Values.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Primary Care | i | ||
| Copyright Page | ii | ||
| Dedication | iii | ||
| Contributors | v | ||
| Reviewers | xiv | ||
| Preface | xv | ||
| New Chapters | xv | ||
| Format | xv | ||
| The Future | xvi | ||
| Acknowledgments | xvi | ||
| Transitions | xvi | ||
| Contributors to Previous Edition | xvii | ||
| Table Of Contents | xix | ||
| 1 Introduction | 1 | ||
| 1 The Changing Landscape of Collaborative Practice | 1 | ||
| Current Forces Shaping the Primary Care Landscape | 1 | ||
| Evidence-Based Practice | 1 | ||
| Value-Based Purchasing | 1 | ||
| Management of Care Transitions | 1 | ||
| Accountable Care Organizations | 1 | ||
| The New Look of Primary Care | 2 | ||
| Opportunities to Shape the Landscape | 2 | ||
| APRN Compact License Movement | 2 | ||
| Building Collaborative Practice Initiatives | 2 | ||
| Conclusion | 3 | ||
| References | 3.e1 | ||
| 2 Transitional Care | 3 | ||
| Health Literacy | 3 | ||
| Cognitive Impairment | 4 | ||
| Medication Safety | 4 | ||
| Cultural Competence and Language | 4 | ||
| Transitional Care | 5 | ||
| References | 6.e1 | ||
| 3 Translating Research into Clinical Practice | 6 | ||
| Research Designs and Data Analysis Methods | 6 | ||
| Level I Research: Descriptive Studies | 6 | ||
| Level II Research: Relationships Between or Among Variables | 6 | ||
| Research Methods for Level II Questions. | 6 | ||
| Level III Research: Cause and Effect | 6 | ||
| Experimental Design. | 7 | ||
| Quasi-Experimental Design. | 7 | ||
| Level IV Research: Randomized Clinical Trials | 8 | ||
| Random Selection and Random Assignment. | 8 | ||
| Placebos. | 8 | ||
| Blinding of the Subject and Researcher. | 8 | ||
| Weighing the Evidence: Evaluating Key Study Parameters | 8 | ||
| Type I and Type II Errors | 9 | ||
| Power Analysis | 10 | ||
| Description of Data and Measures of Central Tendency | 10 | ||
| Standard Deviation | 10 | ||
| Distribution and Error | 10 | ||
| Statistical Significance (Alpha Values) | 10 | ||
| Statistics of Differences and Associations | 11 | ||
| Clinical Significance Versus Statistical Significance | 11 | ||
| Crossing the Divide: Translating Research Results into Clinical Practice | 11 | ||
| What Is Translational Research? | 11 | ||
| Thornicroft’s Translational Medicine Continuum | 12 | ||
| Translational Science Spectrum | 13 | ||
| Strategies to Form Research Collaborations | 13 | ||
| Forming Research Partnerships Between Clinicians and Researchers | 13 | ||
| Initiating Collaborations. | 13 | ||
| Merging Perspectives. | 13 | ||
| Understanding the Research Process | 14 | ||
| Developing the Research Question, Proposal, and Research Protocol | 14 | ||
| Role of the Team Leader. | 14 | ||
| Resource Issues. | 14 | ||
| Enhancing the Research Infrastructure: Interdisciplinary Team Building. | 14 | ||
| Challenges of Research Collaboration on Career Development. | 14 | ||
| Collaborative Research as a Strategy for Career Development. | 15 | ||
| Benefits of Having a Mentor. | 15 | ||
| Summary | 15 | ||
| References | 15.e1 | ||
| 4 The Patient, the Provider, and Primary Care | 15 | ||
| Integrative Health Care and Alternative Therapies | 15 | ||
| Alternative Therapies for Common Chronic Conditions | 15 | ||
| Prehypertension and Hypertension. | 16 | ||
| Glucose Intolerance and Impaired Fasting Glucose. | 16 | ||
| Dyslipidemia. | 17 | ||
| Neuropathy. | 17 | ||
| Insomnia. | 18 | ||
| Joint Pain. | 18 | ||
| Conclusion | 18 | ||
| References | 18.e1 | ||
| 5 Population-Based Care for Primary Care Providers | 19 | ||
| Current Challenges | 19 | ||
| Solutions to Current Challenges | 19 | ||
| Chronic Care Model | 19 | ||
| Organizational Support | 19 | ||
| Clinical Information Systems | 19 | ||
| Delivery System Design | 20 | ||
| Decision Support | 20 | ||
| Self-Management Support | 20 | ||
| Community Resources | 21 | ||
| The Patient-Centered Medical Home | 21 | ||
| Population Management | 21 | ||
| Population Health | 22 | ||
| Population Disease Management | 22 | ||
| Case and Care Management | 23 | ||
| Conclusions | 23 | ||
| Preparing for the Primary Care Practice of the Future | 23 | ||
| Design of Clinical Information Systems | 23 | ||
| Leading Teams | 23 | ||
| Self-Management Support and Delivery System Design | 24 | ||
| Techniques to Encourage Patient Self-Management: the Transtheoretical Model and Motivational Interviewing | 25 | ||
| Summary | 25 | ||
| References | 27.e1 | ||
| 6 Health Literacy, Health Care Disparities, and Culturally Responsive Primary Care | 27 | ||
| Health Literacy | 27 | ||
| Health Literacy and Health Care Outcomes | 27 | ||
| Health Literacy Components | 28 | ||
| Oral Communication | 28 | ||
| Reading Comprehension | 28 | ||
| Numeracy | 28 | ||
| Technology | 28 | ||
| Health Literacy Assessment | 28 | ||
| REALM-SF | 28 | ||
| Ask Me 3 | 28 | ||
| Newest Vital Sign | 28 | ||
| Health Literacy Interventions | 29 | ||
| Patient-Centered Interventions | 29 | ||
| Organization Centered Interventions | 29 | ||
| Health Care Disparities | 29 | ||
| Culturally Responsive Care | 29 | ||
| Obligations in Culturally Responsive Primary Care | 29 | ||
| Address Cultural Variations among Diverse Patient Groups | 29 | ||
| Create a Patient-Centered Environment | 30 | ||
| Minimize Clinician Bias | 30 | ||
| Overcome Patient Barriers: Language Environment | 30 | ||
| Conclusion | 30 | ||
| References | 30.e1 | ||
| 7 Genetic Considerations in Primary Care | 30 | ||
| Risk Assessment | 32 | ||
| Family History | 32 | ||
| Personal and Family History | 32 | ||
| Gathering a Family History | 34 | ||
| Interpreting a Family History | 36 | ||
| Common Inheritance Patterns | 37 | ||
| Genetic Information Nondiscrimination Act | 38 | ||
| Direct-to-Consumer Genetic Testing | 41 | ||
| Conclusion | 42 | ||
| Resources | 42 | ||
| References | 42.e1 | ||
| 8 Risk Management | 43 | ||
| Nurse Practitioner Malpractice Claims | 43 | ||
| Disclosure of Errors and Adverse Medical Events | 43 | ||
| The “Second Victim” | 44 | ||
| The National Practitioner Data Bank | 44 | ||
| Defending Against a Board of Nursing Complaint | 44 | ||
| Telemedicine | 44 | ||
| Medical Malpractice Risk Management Strategies | 45 | ||
| Patients First | 45 | ||
| Patient Communication | 45 | ||
| First Impressions. | 45 | ||
| Communication Issues. | 45 | ||
| Patient Concerns. | 45 | ||
| Informed Consent | 46 | ||
| Informed Refusal. | 47 | ||
| Patient Adherence and Compliance | 47 | ||
| Patient Dismissal. | 47 | ||
| Patient Handoffs. | 47 | ||
| Electronic Medical Records | 47 | ||
| Release of Information | 48 | ||
| Patient Portals | 48 | ||
| Patient Request to Amend or Make an Addendum to the Medical Record. | 48 | ||
| Meaningful Use and Automatic Technology. | 48 | ||
| Electronic Mail Communication with Patients. | 48 | ||
| Social Media | 49 | ||
| Removal of Social Media Posts | 49 | ||
| Threats on Social Media | 49 | ||
| Responding to Negative Comments | 49 | ||
| Surreptitious Recording by Patients | 49 | ||
| Scope of Practice | 49 | ||
| Legal Documents | 49 | ||
| Third-Party Cases | 50 | ||
| Against Medical Advice | 50 | ||
| High-Liability Clinical Areas | 50 | ||
| Medications | 50 | ||
| Reconciliation. | 50 | ||
| Medication Samples and Dispensing. | 50 | ||
| Office Medication Administration Safety. | 50 | ||
| Prescription Pad Security. | 50 | ||
| Chronic Pain Management | 50 | ||
| Practitioner’s Duty to Prescribe Responsibly. | 50 | ||
| Evaluation of the Patient in Chronic Pain. | 50 | ||
| Establish a Chronic Pain Diagnosis and Medical Necessity. | 51 | ||
| Medical Record Documentation. | 51 | ||
| Falls | 51 | ||
| Managing Risk in the Nursing Home | 52 | ||
| Curbside Consultations | 52 | ||
| Staff as Patients | 52 | ||
| Patient Requests for Waiver, Write-Off, or Reimbursement of Fees for Services | 52 | ||
| Chaperones | 52 | ||
| Policies | 53 | ||
| References | 53 | ||
| References | 53.e1 | ||
| 2 Primary Care: Adolescence Through Adulthood | 54 | ||
| 9 Adolescent Issues | 54 | ||
| Physical Development | 54 | ||
| Cognitive Development | 55 | ||
| Emotional Development | 55 | ||
| Social Development | 55 | ||
| The Adolescent Health Visit | 56 | ||
| Adolescent Mental Health | 57 | ||
| Adolescents and Violence | 57 | ||
| Adolescents and Sexual Activity | 58 | ||
| Physical Examination | 58 | ||
| Health Maintenance and Health Promotion | 58 | ||
| References | 59.e1 | ||
| 10 LGBTQ Patient Care | 59 | ||
| Definitions | 60 | ||
| Goals of Care | 60 | ||
| Access to Care | 61 | ||
| Barriers to Care | 61 | ||
| Challenges in Primary Care | 62 | ||
| Risky Behavior | 62 | ||
| Specific Health Screenings | 62 | ||
| Cancer Screening | 63 | ||
| Human Papillomavirus | 63 | ||
| Human Immunodeficiency Virus | 63 | ||
| Issues with Health Screening | 64 | ||
| Sexual Reassignment Intervention | 64 | ||
| Life Span Considerations | 64 | ||
| Patient Education and Health Promotion | 65 | ||
| References | 65.e1 | ||
| 11 Pregnancy and Prenatal Care | 65 | ||
| Goals of Prenatal Care | 65 | ||
| Use of Prenatal Care | 66 | ||
| Delivery of Prenatal Care | 66 | ||
| Content of Prenatal Visit | 66 | ||
| Diagnosis of Pregnancy | 66 | ||
| Estimated Date of Delivery | 68 | ||
| Gravidity and Parity | 68 | ||
| Health History | 68 | ||
| Nutrition and Weight Gain in Pregnancy | 69 | ||
| Activity in Pregnancy | 70 | ||
| Physical Examination and Laboratory and Diagnostic Tests | 70 | ||
| Counseling and Education | 70 | ||
| Common Problems in Pregnancy | 70 | ||
| Infections | 70 | ||
| Urinary Tract Infections. | 70 | ||
| Vaginitis. | 70 | ||
| Group B Streptococcus | 72 | ||
| Nausea and Vomiting | 72 | ||
| Gastroesophageal Reflux | 72 | ||
| Constipation and Hemorrhoids | 72 | ||
| Obstetric Complications | 73 | ||
| Bleeding in Pregnancy | 73 | ||
| Preterm Labor | 73 | ||
| Other Medical Conditions in Pregnancy | 74 | ||
| Asthma | 74 | ||
| Hypertension | 75 | ||
| Diabetes | 76 | ||
| Thyroid Disease | 77 | ||
| Gallbladder Disease | 78 | ||
| Integrated Health Care for Women | 78 | ||
| References | 78.e1 | ||
| 12 Lactation Guidance | 78 | ||
| Prenatal Preparation for Breastfeeding | 78 | ||
| Prenatal Lactation Counseling | 78 | ||
| Breast and Nipple Evaluation for Breastfeeding | 79 | ||
| The First Few Days | 79 | ||
| Discharge Instructions | 80 | ||
| Neonatal Jaundice | 80 | ||
| Physiologic Jaundice | 80 | ||
| Pathologic Jaundice | 81 | ||
| Breast Milk Jaundice | 81 | ||
| Managing Challenges to Breastfeeding Success | 81 | ||
| Attachment and Latch-on in Newborns | 81 | ||
| Breast Engorgement | 81 | ||
| Delayed Let-Down | 82 | ||
| Low Milk Production. | 82 | ||
| Low Infant Weight Gain | 82 | ||
| Cracked Nipples | 83 | ||
| Mastitis | 83 | ||
| Referrals | 83 | ||
| Other Considerations | 83 | ||
| Breast Pumps and Hand Expression | 83 | ||
| Working Mothers | 83 | ||
| Multiple Births | 83 | ||
| Weaning | 83 | ||
| Summary | 84 | ||
| References | 84.e1 | ||
| 13 Aging and Common Geriatric Syndromes | 84 | ||
| Challenges in Primary Care | 84 | ||
| Mental Status and Functional Assessments | 84 | ||
| Health Screening | 85 | ||
| Counseling Elder Drivers | 85 | ||
| Importance of Advance Directives | 86 | ||
| The Challenge of Geriatrics | 86 | ||
| Common Geriatric Syndromes | 86 | ||
| Polypharmacy | 87 | ||
| 3 Health Maintenance | 109 | ||
| 15 Obesity and Weight Management | 109 | ||
| Epidemiology | 109 | ||
| Definition | 109 | ||
| Body Mass Index and Waist Circumference | 109 | ||
| Bioimpedance Analysis | 110 | ||
| Pathophysiology | 110 | ||
| Energy Output | 111 | ||
| Insufficient Physical Activity | 111 | ||
| Energy Intake | 111 | ||
| Genetics | 111 | ||
| Maternal Influences | 112 | ||
| Smoking Status and Smoking Cessation | 112 | ||
| Pharmaceuticals Associated with Weight Gain | 112 | ||
| Diabetes Medications. | 113 | ||
| Antidepressants, Neuroleptic and Seizure Medications. | 113 | ||
| Antihistamines. | 113 | ||
| Hormonal Preparations. | 113 | ||
| Cardiac Medications. | 113 | ||
| Environmental Factors | 113 | ||
| Sleep Factors | 114 | ||
| Gut Microbiota | 114 | ||
| Psychosocial Stress | 114 | ||
| Food Quality, Nutrients, and Availability | 114 | ||
| Complications, Social Stigma, and Discrimination | 114 | ||
| Increased Morbidity and Mortality | 114 | ||
| Clinical Presentation | 115 | ||
| Physical Examination | 115 | ||
| Diagnostics | 116 | ||
| Differential Diagnosis | 116 | ||
| Management | 116 | ||
| Motivational Interviewing and the Transtheoretical Model for Change | 116 | ||
| Strategies for Weight Loss | 116 | ||
| Reducing Energy Intake | 118 | ||
| Proteins. | 118 | ||
| Carbohydrates. | 118 | ||
| Fats. | 118 | ||
| Alcohol. | 118 | ||
| Weight Loss Diets | 118 | ||
| Look AHEAD | 119 | ||
| Side Effects of Weight Loss | 119 | ||
| Resources for Weight Loss, Physical Activity, and Overweight and Obesity | 119 | ||
| Pharmaceutical Options | 120 | ||
| Dietary Supplements | 123 | ||
| Bariatric Surgery | 123 | ||
| Indications and Contraindications. | 123 | ||
| Surgical Techniques and Outcomes. | 123 | ||
| Nutritional Supplementation. | 124 | ||
| Monitoring. | 124 | ||
| Medications. | 124 | ||
| Pregnancy. | 124 | ||
| Weight Gain. | 124 | ||
| Psychological Results. | 124 | ||
| Preoperative Management. | 124 | ||
| Life Span Considerations | 125 | ||
| Indications for Referral or Hospitalization | 125 | ||
| Education and Health Promotion | 125 | ||
| References | 125.e1 | ||
| 16 Lifestyle Management | 125 | ||
| Lifestyle Management | 125 | ||
| Interconnection among Lifestyle Components | 126 | ||
| Obesity | 126 | ||
| Sedentary Lifestyle | 126 | ||
| Stress | 126 | ||
| Lifestyle Assessment | 126 | ||
| Nutrition | 126 | ||
| Exercise | 127 | ||
| Stress | 127 | ||
| Physical Examination | 127 | ||
| Diagnostics | 127 | ||
| Lifestyle-Related Medical Problems | 128 | ||
| Hypertension | 128 | ||
| Hyperlipidemia | 128 | ||
| Diabetes | 128 | ||
| Metabolic Syndrome | 129 | ||
| Life Span Issues | 129 | ||
| Components of a Healthy Lifestyle | 129 | ||
| Nutrition | 129 | ||
| The Vegetarian Diet. | 130 | ||
| Weight Management. | 130 | ||
| Dietary Considerations. | 130 | ||
| Dietary Influences on Heart Health | 131 | ||
| Exercise | 131 | ||
| Physical Activity and Chronic Illness | 134 | ||
| Stress Management | 134 | ||
| Sleep. | 134 | ||
| Interpersonal Relationships. | 135 | ||
| Relaxation. | 135 | ||
| Time Management. | 135 | ||
| Prayer. | 135 | ||
| Perspective on Life. | 135 | ||
| Safety | 135 | ||
| Home Safety. | 135 | ||
| Personal Preparedness. | 135 | ||
| Biologic Threats and Epidemics. | 136 | ||
| Sports and Vehicular Safety. | 136 | ||
| Smoking Cessation | 136 | ||
| Effects of Nicotine | 136 | ||
| Neurochemical Effects of Nicotine | 136 | ||
| Nicotine Withdrawal | 136 | ||
| Genetics of Nicotine Addiction | 136 | ||
| Strategies to Help Patients Quit Smoking | 136 | ||
| Modifying the Approach | 138 | ||
| Pharmacologic Interventions | 138 | ||
| Incorporation of Smoking Cessation with Primary Care Strategies | 139 | ||
| Intimate Partner Violence | 140 | ||
| Definition and Epidemiology | 140 | ||
| Violence Perspectives | 141 | ||
| Power and Control. | 141 | ||
| Cycle of Abuse. | 142 | ||
| Barriers to Identification and Treatment | 142 | ||
| Patient Barriers. | 142 | ||
| Health Care Barriers. | 142 | ||
| Provider Barriers. | 142 | ||
| Clinical Presentation | 142 | ||
| Physical Complaints | 142 | ||
| Psychosocial Indicators | 143 | ||
| Physical Examination | 143 | ||
| Management | 144 | ||
| Clinical Intervention | 144 | ||
| Universal Screening. | 144 | ||
| Framing the Question. | 144 | ||
| Patient Denial of Victimization. | 144 | ||
| Patient Disclosure of Victimization. | 144 | ||
| Psychosocial Intervention | 144 | ||
| Safety Assessment and Planning. | 144 | ||
| Life Span Considerations | 145 | ||
| Patient and Family Education | 145 | ||
| Health Promotion | 145 | ||
| References | 145.e1 | ||
| 17 Routine Health Screening and Immunizations | 145 | ||
| Routine Health Screenings | 145 | ||
| Overall Health Evaluation and Screening | 146 | ||
| U.S. Preventive Services Task Force Recommendations. | 147 | ||
| Tools for Health Risk Assessment | 147 | ||
| Cancer Screening | 152 | ||
| Genetic Testing. | 155 | ||
| Screening for Coronary Artery Disease | 155 | ||
| Screening for Tuberculosis | 155 | ||
| Immunizations | 155 | ||
| Standards for Adult Immunization Practice | 155 | ||
| Vaccine Acronyms | 155 | ||
| Vaccine Information Statements | 155 | ||
| Issues with Vaccine Administration | 155 | ||
| Decision-Making. | 155 | ||
| Safe Administration. | 155 | ||
| Recognition and Management of Anaphylaxis to Vaccines. | 156 | ||
| Vaccine Adverse Event Reporting System. | 156 | ||
| Vaccine-Specific Information | 156 | ||
| Hepatitis A Vaccine. | 156 | ||
| Hepatitis B Vaccine. | 157 | ||
| Herpes Zoster (Shingles) Vaccine. | 157 | ||
| Human Papillomavirus Vaccine. | 157 | ||
| Influenza Vaccine. | 158 | ||
| Measles, Mumps, Rubella Vaccine. | 158 | ||
| Meningococcal Vaccine. | 159 | ||
| Pertussis Vaccination. | 159 | ||
| Pneumococcal Vaccination. | 159 | ||
| Tetanus, Diphtheria, and Acellular Pertussis (Td/Tdap) Vaccination. | 159 | ||
| General Administration Considerations. | 160 | ||
| Vaccine Recommendations for Health Care Personnel | 160 | ||
| Influenza. | 160 | ||
| Hepatitis B. | 160 | ||
| Measles, Mumps, Rubella. | 160 | ||
| Varicella. | 160 | ||
| Tetanus, Diphtheria, Pertussis. | 160 | ||
| Meningococcal. | 163 | ||
| Additional Resources | 163 | ||
| CDC Vaccine Schedules App for Clinicians and Other Immunization Providers, 2015 | 163 | ||
| Popular Websites | 163 | ||
| Handouts for Patients and Staff | 163 | ||
| Vaccine Information Statements | 163 | ||
| State Information | 163 | ||
| Ask the Experts | 163 | ||
| Practical Resources for Vaccinating Health Care Personnel Against Influenza | 163 | ||
| Centers for Disease Control and Prevention | 163 | ||
| National Adult and Influenza Immunization Summit (NAIIS) | 163 | ||
| Adult Vaccination Resources Library | 163 | ||
| Immunization Action Coalition (IAC). | 163 | ||
| References | 163.e1 | ||
| 18 Principles of Occupational and Environmental Health in Primary Care | 163 | ||
| Primary Care Role in Occupational and Environmental Health | 164 | ||
| Workplace Health Protection and Promotion | 164 | ||
| PrePlacement Health Evaluation | 164 | ||
| Workplace Surveillance | 165 | ||
| Drug and Alcohol Testing | 165 | ||
| Workers’ Compensation Treatment and Case Management | 165 | ||
| Treatment of Work-Related Injuries, Illnesses, and Exposures | 166 | ||
| Occupational Respiratory Diseases | 166 | ||
| Definition and Scope of the Problem | 166 | ||
| Military Personnel and Veterans: Overlooked Populations | 166 | ||
| Pathophysiology | 167 | ||
| History and Clinical Presentation | 167 | ||
| Physical Examination | 168 | ||
| Diagnostics | 168 | ||
| Management | 169 | ||
| Life Span Considerations | 169 | ||
| Complications | 169 | ||
| Indications for Referral or Hospitalization | 169 | ||
| Patient and Family Education | 169 | ||
| Regulatory Agency and Other Requirements in Occupational and Environmental Health | 169 | ||
| Occupational Safety and Health Administration | 170 | ||
| National Institute for Occupational Safety and Health | 170 | ||
| Americans with Disabilities Act | 170 | ||
| Professional Organizations | 170 | ||
| References | 170.e1 | ||
| 19 College Health | 170 | ||
| Roles of College Health Care Providers | 170 | ||
| Topics in College Health | 171 | ||
| Confidentiality | 171 | ||
| Health Care Issues: Female College Students | 171 | ||
| Reproductive, Substance, and Safety Issues. | 171 | ||
| Eating Disorders and Weight Management. | 171 | ||
| Health Care Issues: Male College Students | 171 | ||
| Reproductive, Substance, and Safety Issues. | 172 | ||
| Lesbian, Gay, Bisexual, and Transgender Students | 172 | ||
| Mental Health Issues | 172 | ||
| Sleep | 172 | ||
| Alcohol and Tobacco | 172 | ||
| Other Drugs of Abuse and Prescription Abuse | 173 | ||
| Screenings and Immunizations | 173 | ||
| Cultural Issues | 173 | ||
| Resources | 173 | ||
| References | 173.e1 | ||
| 20 Health Care of the International Traveler | 173 | ||
| Pre-Travel Preparation and Patient Education | 176 | ||
| Immunizations | 177 | ||
| Medications and Prescriptions | 177 | ||
| Malaria | 177 | ||
| Food and Water Precautions and Traveler’s Diarrhea | 179 | ||
| Air Travel Risks | 179 | ||
| Travel Safety | 179 | ||
| Summary | 180 | ||
| References | 181.e1 | ||
| 21 Presurgical Clearance | 181 | ||
| Definition and Epidemiology | 181 | ||
| Pathophysiology | 181 | ||
| Clinical Presentation | 181 | ||
| Physical Examination | 182 | ||
| Diagnostics | 182 | ||
| Differential Diagnosis | 182 | ||
| Management | 183 | ||
| Medication and Fasting Guidelines | 183 | ||
| Complications | 183 | ||
| Indications for Referral or Hospitalization | 183 | ||
| Life Span Considerations | 183 | ||
| Education and Health Promotion | 184 | ||
| Surgical or Perioperative Home | 185 | ||
| References | 185.e1 | ||
| 22 Preparticipation Sports Physical | 185 | ||
| History | 185 | ||
| Physical Examination | 186 | ||
| Diagnostics | 187 | ||
| Medical Clearance | 187 | ||
| Patient and Family Education | 187 | ||
| References | 187 | ||
| References | 187.e1 | ||
| 4 Office Emergencies | 188 | ||
| 23 Disaster and Emergency Preparedness and Response in Primary Care | 188 | ||
| The Evolution of Emergency and Disaster Preparedness Efforts in Health Care | 188 | ||
| Disaster Preparedness in the Primary Care Setting | 188 | ||
| Preparing the Primary Care Office for Small-Scale Emergencies and Disasters | 188 | ||
| The Critical Role of Primary Care Practices in Large-Scale Disasters | 189 | ||
| Primary Patient Care Continues During a Disaster | 189 | ||
| Primary Care and Surge Capacity | 190 | ||
| Case Study 1: H1N1—Primary Care during a Pandemic Influenza Event | 190 | ||
| Case Study 2: Hurricane Katrina—Primary Care during the Postdisaster Period | 191 | ||
| Summary | 191 | ||
| Resources | 191 | ||
| References | 191.e1 | ||
| 24 Acute Bronchospasm | 192 | ||
| Definition and Epidemiology | 192 | ||
| Pathophysiology | 192 | ||
| Clinical Presentation | 192 | ||
| Physical Examination | 192 | ||
| Diagnostics | 192 | ||
| Differential Diagnosis | 193 | ||
| Initial Stabilization and Management | 193 | ||
| Disposition and Referral | 193 | ||
| Prevention and Patient Education | 193 | ||
| References | 194.e1 | ||
| 25 Anaphylaxis | 194 | ||
| Definition and Epidemiology | 194 | ||
| Pathophysiology | 194 | ||
| Physical Examination and Clinical Presentation | 195 | ||
| Physical Examination | 195 | ||
| Diagnostics | 195 | ||
| Differential Diagnosis | 195 | ||
| Management | 195 | ||
| Complications | 196 | ||
| Indications for Referral or Hospitalization | 196 | ||
| Life Span Considerations | 196 | ||
| Education and Health Promotion | 196 | ||
| References | 196.e1 | ||
| 26 Bites and Stings | 197 | ||
| Insect Bites and Stings | 197 | ||
| Definition and Epidemiology | 197 | ||
| Pathophysiology and Clinical Presentation | 197 | ||
| Physical Examination | 197 | ||
| Diagnostics | 198 | ||
| Differential Diagnosis | 198 | ||
| Initial Stabilization and Management | 198 | ||
| Disposition and Referral | 198 | ||
| Prevention and Patient Education | 198 | ||
| Spider Bites | 198 | ||
| Definition and Epidemiology | 198 | ||
| Pathophysiology and Clinical Presentation | 199 | ||
| History and Physical Examination | 199 | ||
| Diagnostics | 199 | ||
| Differential Diagnosis | 199 | ||
| Initial Stabilization and Management | 199 | ||
| Disposition and Referral | 200 | ||
| Prevention and Patient Education | 200 | ||
| Reptile Bites and Scorpion Stings | 200 | ||
| Definition and Epidemiology | 200 | ||
| Pathophysiology | 200 | ||
| Clinical Presentation | 200 | ||
| Physical Examination | 200 | ||
| Diagnostics | 200 | ||
| Differential Diagnosis | 200 | ||
| Initial Stabilization and Management | 201 | ||
| Disposition and Referral | 201 | ||
| Prevention and Patient Education | 201 | ||
| References | 201.e1 | ||
| 27 Bradycardia and Tachycardia | 201 | ||
| Bradycardia | 201 | ||
| Definition and Epidemiology | 201 | ||
| Pathophysiology | 201 | ||
| Clinical Presentation | 202 | ||
| Physical Examination | 202 | ||
| Diagnostics | 202 | ||
| Differential Diagnosis | 202 | ||
| Initial Stabilization and Management | 202 | ||
| Disposition and Referral | 202 | ||
| Prevention | 203 | ||
| Patient and Family Education | 203 | ||
| Tachycardia | 203 | ||
| Definition and Epidemiology | 203 | ||
| Pathophysiology | 203 | ||
| Clinical Presentation | 203 | ||
| Physical Examination | 203 | ||
| Diagnostics | 203 | ||
| Differential Diagnosis | 203 | ||
| Initial Stabilization and Management | 204 | ||
| Disposition and Referral | 205 | ||
| Prevention and Patient Education | 205 | ||
| References | 205.e1 | ||
| 28 Cardiac Arrest | 205 | ||
| Definition and Epidemiology | 205 | ||
| Pathophysiology | 206 | ||
| Clinical Presentation | 206 | ||
| Physical Examination | 206 | ||
| Diagnostics | 207 | ||
| Differential Diagnosis | 207 | ||
| Initial Stabilization and Management | 207 | ||
| Complications | 207 | ||
| Disposition and Referral | 207 | ||
| Prevention | 207 | ||
| Patient and Family Education | 208 | ||
| References | 208.e1 | ||
| 29 Chemical Exposure | 208 | ||
| Definition and Epidemiology | 208 | ||
| Pathophysiology | 208 | ||
| Clinical Presentation | 208 | ||
| Physical Examination | 209 | ||
| Diagnostics and Differential Diagnosis | 209 | ||
| Initial stabilization and Management | 210 | ||
| Ingestions | 210 | ||
| Skin Exposure | 210 | ||
| Disposition and Referral | 210 | ||
| Prevention and Patient Education | 210 | ||
| Resources | 211 | ||
| References | 211.e1 | ||
| 30 Electrical Injuries | 211 | ||
| Definition and Epidemiology | 211 | ||
| Pathophysiology | 211 | ||
| Clinical Presentation | 211 | ||
| Physical Examination | 212 | ||
| Diagnostics | 212 | ||
| Differential Diagnosis | 212 | ||
| Initial Stabilization and Management | 212 | ||
| Disposition and Referral | 212 | ||
| Prevention and Patient and Family Education | 213 | ||
| References | 213.e1 | ||
| 31 Environmental and Food Allergies | 213 | ||
| Environmental Allergies | 213 | ||
| Definition and Epidemiology | 213 | ||
| Common Environmental Allergens | 213 | ||
| Pathophysiology | 214 | ||
| Clinical Presentation and Physical Examination | 214 | ||
| Diagnostics | 215 | ||
| Differential Diagnosis | 215 | ||
| Management | 215 | ||
| Specialist Consultation | 215 | ||
| Complications | 216 | ||
| Patient education | 216 | ||
| Food Allergies | 216 | ||
| Definition and Epidemiology | 216 | ||
| Pathophysiology | 217 | ||
| Diagnostics | 217 | ||
| Differential Diagnoses | 217 | ||
| Management and Patient and Family Education | 217 | ||
| References | 218.e1 | ||
| 32 Head Trauma | 218 | ||
| Definition and Epidemiology | 218 | ||
| Pathophysiology | 219 | ||
| Clinical Presentation | 219 | ||
| Physical Examination | 219 | ||
| Diagnostics | 220 | ||
| Differential Diagnosis | 220 | ||
| Initial Stabilization and Management | 220 | ||
| Traumatic Brain Injury | 220 | ||
| Minor Head Trauma | 220 | ||
| Disposition and Referral | 220 | ||
| Patient and Family Education | 221 | ||
| References | 221.e1 | ||
| 33 Hypotension | 221 | ||
| Definition and Epidemiology | 221 | ||
| Pathophysiology | 221 | ||
| Clinical Presentation and Physical Examination | 222 | ||
| Diagnostics | 222 | ||
| Differential Diagnosis | 223 | ||
| Management | 223 | ||
| Life Span Considerations | 224 | ||
| Indications for Referral or Hospitalization | 224 | ||
| Patient and Family Education | 224 | ||
| References | 224.e1 | ||
| 34 Poisoning | 224 | ||
| Definition | 224 | ||
| Epidemiology | 224 | ||
| Pathophysiology | 224 | ||
| Clinical Presentation | 224 | ||
| Physical Examination | 225 | ||
| Diagnostics | 225 | ||
| Differential Diagnosis | 225 | ||
| Initial Stabilization and Management | 225 | ||
| Terrorism | 226 | ||
| Prevention and Patient Education | 226 | ||
| References | 226.e1 | ||
| 35 Sexual Assault | 227 | ||
| Definition and Epidemiology | 227 | ||
| Clinical Presentation | 227 | ||
| Physical Examination | 227 | ||
| Diagnostics | 228 | ||
| Documentation | 228 | ||
| Primary Care Management | 228 | ||
| Indications for Referral or Hospitalization | 229 | ||
| Life Span Considerations | 229 | ||
| Children and Adolescents | 229 | ||
| Older Adults | 229 | ||
| Specific Populations | 229 | ||
| Male Patients | 229 | ||
| Disabled Adults | 229 | ||
| Homeless or Marginally Housed | 230 | ||
| Immigrants | 230 | ||
| Patient Education and Health Promotion | 230 | ||
| References | 230.e1 | ||
| 36 Syncope | 230 | ||
| Definition and Epidemiology | 230 | ||
| Pathophysiology | 230 | ||
| Clinical Presentation | 231 | ||
| Physical Examination | 232 | ||
| Diagnostics | 232 | ||
| Differential Diagnosis | 232 | ||
| Initial Stabilization and Management | 232 | ||
| Disposition and Referral | 233 | ||
| Prevention and Patient Education | 233 | ||
| References | 233.e1 | ||
| 37 Thermal Injuries | 233 | ||
| Heat-Related Illness | 233 | ||
| Definition and Epidemiology | 233 | ||
| Pathophysiology | 233 | ||
| Clinical Presentation | 233 | ||
| Physical Examination | 234 | ||
| Diagnostics | 234 | ||
| Differential Diagnosis | 234 | ||
| Management | 234 | ||
| Complications | 234 | ||
| Indications for Referral or Hospitalization | 235 | ||
| Life Span Considerations | 235 | ||
| Patient Education and Health Promotion | 235 | ||
| Cold Injury | 235 | ||
| Definition and Epidemiology | 235 | ||
| Pathophysiology | 235 | ||
| Clinical Presentation | 235 | ||
| Physical Examination | 235 | ||
| Diagnostics | 235 | ||
| Differential Diagnosis | 236 | ||
| Management (Including Interdisciplinary Management) | 236 | ||
| Complications | 236 | ||
| Indications for Referral or Hospitalization | 236 | ||
| Life Span Considerations | 236 | ||
| Education and Health Promotion | 236 | ||
| References | 236 | ||
| References | 236.e1 | ||
| 5 Evaluation and Management of Skin Disorders | 237 | ||
| 38 Examination of the Skin and Approach to Diagnosis of Skin Disorders | 237 | ||
| Definition and Epidemiology | 237 | ||
| Overview of Skin Function, Anatomy, and Structures | 237 | ||
| Changes in the Skin Associated with Aging | 237 | ||
| Assessment | 237 | ||
| History | 239 | ||
| Physical Examination | 239 | ||
| References | 240.e1 | ||
| 39 Surgical Office Procedures | 240 | ||
| Cryosurgery | 240 | ||
| Electrocautery | 240 | ||
| Curettage | 241 | ||
| Biopsy | 241 | ||
| Summary | 242 | ||
| References | 242.e1 | ||
| 40 Principles of Dermatologic Therapy | 243 | ||
| Definition and Epidemiology | 243 | ||
| Skin Structure | 243 | ||
| Medications | 243 | ||
| Variables to Consider in Prescribing | 243 | ||
| Dermatologic Vehicles | 243 | ||
| Ointments. | 243 | ||
| Creams. | 244 | ||
| Lotions. | 244 | ||
| Solutions. | 244 | ||
| Gels. | 244 | ||
| Topical Corticosteroids | 245 | ||
| Patient and Family Education | 245 | ||
| References | 245.e1 | ||
| 41 Screening for Skin Cancer | 245 | ||
| Definition and Epidemiology | 245 | ||
| Pathophysiology | 246 | ||
| Clinical Presentation | 246 | ||
| Physical Examination | 246 | ||
| Diagnostics | 246 | ||
| Differential Diagnosis | 247 | ||
| Management | 248 | ||
| Treatment | 248 | ||
| Interdisciplinary Management | 248 | ||
| Complications and Life Span Considerations | 248 | ||
| Indications for Referral or Hospitalization | 248 | ||
| Patient Education and Health Promotion | 248 | ||
| References | 248.e1 | ||
| 42 Acne Vulgaris | 249 | ||
| Definition and Epidemiology | 249 | ||
| Pathophysiology | 249 | ||
| Clinical Presentation and Physical Examination | 249 | ||
| Diagnostics and Differential Diagnosis | 250 | ||
| Management | 250 | ||
| Rosacea | 251 | ||
| Complications | 252 | ||
| Indications for Referral or Hospitalization | 252 | ||
| Patient and Family Education | 252 | ||
| Health Promotion | 252 | ||
| References | 252.e1 | ||
| 43 Alopecia | 252 | ||
| Definition and Epidemiology | 252 | ||
| Pathophysiology | 252 | ||
| Anagen Phase Disturbances | 252 | ||
| Telogen Phase Disturbance | 253 | ||
| Clinical Presentation | 253 | ||
| Physical Examination | 253 | ||
| Diagnostics | 253 | ||
| Differential Diagnosis | 254 | ||
| Management | 254 | ||
| Complications | 255 | ||
| Indications for Referral or Hospitalization | 255 | ||
| Patient and Family Education | 255 | ||
| References | 255.e1 | ||
| 44 Animal and Human Bites | 255 | ||
| Definition and Epidemiology | 255 | ||
| Pathophysiology | 255 | ||
| Clinical Presentation | 256 | ||
| Physical Examination | 256 | ||
| Diagnostics | 256 | ||
| Management | 256 | ||
| Complications | 257 | ||
| Indications for Referral or Hospitalization | 257 | ||
| Patient Education and Health Promotion | 257 | ||
| References | 258.e1 | ||
| 45 Bullous Pemphigoid | 258 | ||
| Definition and Epidemiology | 258 | ||
| Pathophysiology | 258 | ||
| Clinical Presentation and Physical Examination | 258 | ||
| Diagnostics | 258 | ||
| Differential Diagnosis | 259 | ||
| Management | 259 | ||
| Life Span Considerations | 259 | ||
| Complications | 259 | ||
| Indications for Referral or Hospitalization | 259 | ||
| Patient and Family Education | 259 | ||
| References | 259.e1 | ||
| 46 Burns (Minor) | 259 | ||
| Definition and Epidemiology | 259 | ||
| Pathophysiology | 260 | ||
| Clinical Presentation | 260 | ||
| Physical Examination | 260 | ||
| Diagnostics | 260 | ||
| Differential Diagnosis | 260 | ||
| Management | 260 | ||
| Complications | 261 | ||
| Indications for Referral or Hospitalization | 261 | ||
| Patient and Family Education | 261 | ||
| Health Promotion | 261 | ||
| References | 261.e1 | ||
| 47 Cellulitis | 261 | ||
| Definition and Epidemiology | 261 | ||
| Pathophysiology | 262 | ||
| 6 Evaluation and Management of Eye Disorders | 326 | ||
| 70 Evaluation of the Eyes | 326 | ||
| Screening Recommendations | 326 | ||
| History | 326 | ||
| Physical Examination | 327 | ||
| Visual Acuity | 327 | ||
| Pupil Response | 327 | ||
| Intraocular Pressure | 328 | ||
| Ocular Alignment and Extraocular Movements | 328 | ||
| Visual Fields | 329 | ||
| External Structures | 329 | ||
| Anterior Segment | 329 | ||
| Posterior Segment | 330 | ||
| Signs and Symptoms of Ocular Disease | 331 | ||
| Red Eye | 331 | ||
| Vision Loss and Other Visual Disturbances | 331 | ||
| Ocular and Periocular Pain | 334 | ||
| Other Ocular Signs and Symptoms | 335 | ||
| References | 335.e1 | ||
| 71 Cataracts | 335 | ||
| Definition and Epidemiology | 335 | ||
| Pathophysiology | 335 | ||
| Clinical Presentation | 335 | ||
| Physical Examination | 336 | ||
| Diagnostics | 336 | ||
| Differential Diagnosis | 336 | ||
| Management | 336 | ||
| Complications | 336 | ||
| Indications for Referral or Hospitalization | 337 | ||
| Life Span Considerations | 337 | ||
| Education and Health Promotion | 337 | ||
| References | 337.e1 | ||
| 72 Blepharitis, Hordeolum, and Chalazion | 337 | ||
| Definition and Epidemiology | 337 | ||
| Pathophysiology | 337 | ||
| Clinical Presentation | 337 | ||
| Physical Examination | 337 | ||
| Diagnostics | 338 | ||
| Differential Diagnosis | 338 | ||
| Management | 338 | ||
| Life Span Considerations | 339 | ||
| Complications | 339 | ||
| Indications for Referral or Hospitalization | 339 | ||
| Patient and Family Education | 339 | ||
| Health Promotion | 339 | ||
| References | 339.e1 | ||
| 73 Conjunctivitis | 339 | ||
| Definition | 339 | ||
| Epidemiology | 340 | ||
| Pathophysiology | 340 | ||
| Clinical Presentation and Physical Examination | 340 | ||
| Viral Conjunctivitis | 340 | ||
| Bacterial Conjunctivitis | 341 | ||
| Acute Allergic Conjunctivitis | 341 | ||
| Vernal and Atopic Conjunctivitis | 341 | ||
| Medication Toxicity | 341 | ||
| Diagnostics | 341 | ||
| Management | 341 | ||
| Viral Conjunctivitis | 341 | ||
| Bacterial Conjunctivitis | 342 | ||
| Acute Allergic Conjunctivitis | 342 | ||
| Vernal and Atopic Conjunctivitis | 342 | ||
| Medication Toxicity | 342 | ||
| Differential Diagnosis | 342 | ||
| Indications for Referral | 342 | ||
| Education and Health Promotion | 343 | ||
| References | 343.e1 | ||
| 74 Corneal Surface Defects and Ocular Surface Foreign Bodies | 343 | ||
| Definition and Epidemiology | 343 | ||
| Pathophysiology | 343 | ||
| Clinical Presentation | 343 | ||
| Physical Examination | 343 | ||
| Diagnostics | 344 | ||
| Differential Diagnosis | 344 | ||
| Management | 344 | ||
| Complications | 345 | ||
| Indications for Referral | 345 | ||
| Prevention | 345 | ||
| References | 345.e1 | ||
| 75 Dry Eye Syndrome | 345 | ||
| Definition and Epidemiology | 345 | ||
| Pathophysiology | 346 | ||
| Clinical Presentation | 346 | ||
| Physical Examination | 346 | ||
| Diagnostics | 347 | ||
| Differential Diagnosis | 347 | ||
| Management | 348 | ||
| Complications | 348 | ||
| Indications for Referral or Hospitalization | 348 | ||
| Life Span Considerations | 348 | ||
| Education and Health Promotion | 348 | ||
| References | 349.e1 | ||
| 76 Nasolacrimal Duct Obstruction and Dacryocystitis | 349 | ||
| Definition and Epidemiology | 349 | ||
| Pathophysiology | 349 | ||
| Clinical Presentation | 349 | ||
| Physical Examination | 349 | ||
| Diagnostics | 349 | ||
| Differential Diagnosis | 350 | ||
| Management | 350 | ||
| Complications | 350 | ||
| Indications for Referral or Hospitalization | 350 | ||
| Patient and Family Education | 350 | ||
| References | 350.e1 | ||
| 77 Preseptal and Orbital Cellulitis | 350 | ||
| Definition and Epidemiology | 350 | ||
| Pathophysiology | 351 | ||
| Clinical Presentation and Physical Examination | 351 | ||
| Diagnostics | 352 | ||
| Differential Diagnosis | 352 | ||
| Management | 352 | ||
| Life Span Considerations | 352 | ||
| Complications | 353 | ||
| Indications for Referral or Hospitalization | 353 | ||
| Patient and Family Education | 353 | ||
| Education and Health Promotion | 353 | ||
| References | 353.e1 | ||
| 78 Pinguecula and Pterygium | 353 | ||
| Definition and Epidemiology | 353 | ||
| Pathophysiology | 353 | ||
| Clinical Presentation | 353 | ||
| Physical Examination | 353 | ||
| Diagnostics | 354 | ||
| Differential Diagnosis | 354 | ||
| Management | 354 | ||
| Indications for Referral | 354 | ||
| Patient Education and Health Promotion | 355 | ||
| References | 355.e1 | ||
| 79 Traumatic Ocular Disorders | 355 | ||
| Definition | 355 | ||
| Epidemiology | 355 | ||
| Pathophysiology | 356 | ||
| Mechanical Injuries | 356 | ||
| Chemical Injuries | 357 | ||
| Clinical Presentation | 357 | ||
| Physical Examination | 357 | ||
| Diagnostics | 357 | ||
| Differential Diagnosis | 358 | ||
| Management and Indications for Referral | 358 | ||
| Complications | 358 | ||
| Life Span Considerations | 358 | ||
| Education and Health Promotion | 358 | ||
| References | 358 | ||
| References | 358.e1 | ||
| 7 Evaluation and Management of Ear Disorders | 359 | ||
| 80 Auricular Disorders | 359 | ||
| Definition and Epidemiology | 359 | ||
| Pathophysiology | 359 | ||
| Clinical Presentation | 359 | ||
| Physical Examination | 360 | ||
| Diagnostics | 360 | ||
| Differential Diagnosis | 360 | ||
| Management | 360 | ||
| Life Span Considerations | 360 | ||
| Complications | 360 | ||
| Indications for Referral or Hospitalization | 360 | ||
| Patient and Family Education | 360 | ||
| Health Promotion | 360 | ||
| References | 360.e1 | ||
| 81 Cerumen Impaction | 361 | ||
| Definition and Epidemiology | 361 | ||
| Pathophysiology | 361 | ||
| Clinical Presentation | 361 | ||
| Physical Examination | 361 | ||
| Diagnostics | 361 | ||
| Differential Diagnosis | 361 | ||
| Management | 361 | ||
| Life Span Considerations | 362 | ||
| Complications | 362 | ||
| Indications for Referral or Hospitalization | 362 | ||
| Education and Health Promotion | 362 | ||
| References | 362.e1 | ||
| 82 Cholesteatoma | 362 | ||
| Definition | 362 | ||
| Pathophysiology | 363 | ||
| Clinical Presentation | 363 | ||
| Physical Examination | 363 | ||
| Diagnostics and Differential Diagnosis | 363 | ||
| Management | 363 | ||
| Indications for Referral or Hospitalization | 364 | ||
| Patient and Family Education | 364 | ||
| References | 364.e1 | ||
| 83 Impaired Hearing | 364 | ||
| Definition and Epidemiology | 364 | ||
| Pathophysiology | 364 | ||
| Clinical Presentation and Physical Examination | 365 | ||
| Diagnostics | 365 | ||
| Differential Diagnosis | 365 | ||
| Management and Interdisciplinary Management | 366 | ||
| Life Span Considerations | 366 | ||
| Complications | 366 | ||
| Indications for Referral or Hospitalization | 366 | ||
| Patient and Family Education | 366 | ||
| Health Promotion | 367 | ||
| References | 367.e1 | ||
| 84 Inner Ear Disturbances | 367 | ||
| Vestibular Neuritis | 367 | ||
| Definition and Epidemiology | 367 | ||
| Pathophysiology | 367 | ||
| Clinical Presentation | 367 | ||
| Physical Examination | 367 | ||
| Diagnostics | 367 | ||
| Differential Diagnosis | 367 | ||
| Management | 368 | ||
| Life Span Considerations | 368 | ||
| Complications | 368 | ||
| Indications for Referral or Hospitalization | 368 | ||
| Patient and Family Education | 368 | ||
| Meniere Disease | 368 | ||
| Definition and Epidemiology | 368 | ||
| Pathophysiology | 368 | ||
| Clinical Presentation | 368 | ||
| Physical Examination | 368 | ||
| Diagnostics | 369 | ||
| Differential Diagnosis | 369 | ||
| Management and Interdisciplinary Management | 369 | ||
| Life Span Considerations | 369 | ||
| Complications | 369 | ||
| Indications for Referral or Hospitalization | 369 | ||
| Patient and Family Education | 369 | ||
| Tinnitus | 369 | ||
| Definition and Epidemiology | 369 | ||
| Pathophysiology | 370 | ||
| Clinical Presentation | 370 | ||
| Physical Examination | 370 | ||
| Diagnostics | 370 | ||
| Differential Diagnosis | 370 | ||
| Management | 370 | ||
| Complications | 371 | ||
| Indications for Referral or Hospitalization | 371 | ||
| Patient and Family Education | 371 | ||
| References | 371.e1 | ||
| 85 Otitis Externa | 371 | ||
| Definition and Epidemiology | 371 | ||
| Pathophysiology | 371 | ||
| Clinical Presentation | 371 | ||
| Physical Examination | 371 | ||
| Diagnostics | 371 | ||
| Differential Diagnosis | 372 | ||
| Management | 372 | ||
| Life Span Considerations | 372 | ||
| Complications | 372 | ||
| Indications for Referral or Hospitalization | 372 | ||
| Education and Health Promotion | 372 | ||
| References | 373.e1 | ||
| 86 Otitis Media | 373 | ||
| Definition and Epidemiology | 373 | ||
| Pathophysiology | 373 | ||
| Clinical Presentation and Physical Examination | 373 | ||
| Diagnostics | 374 | ||
| Differential Diagnosis | 375 | ||
| Management | 375 | ||
| Complications | 376 | ||
| Indications for Referral or Hospitalization | 376 | ||
| Life Span Considerations | 376 | ||
| Education and Health Promotion | 376 | ||
| References | 377.e1 | ||
| 87 Tympanic Membrane Perforation | 377 | ||
| Definition and Epidemiology | 377 | ||
| Pathophysiology | 377 | ||
| Clinical Presentation and Physical Examination | 377 | ||
| Diagnostics and Differential Diagnosis | 377 | ||
| Management | 377 | ||
| Complications and Indications for Referral or Hospitalization | 377 | ||
| Patient and Family Education | 377 | ||
| References | 377 | ||
| References | 377.e2 | ||
| 8 Evaluation and Management of Nose Disorders | 378 | ||
| 88 Chronic Nasal Congestion and Discharge | 378 | ||
| Definition and Epidemiology | 378 | ||
| Pathophysiology | 378 | ||
| Clinical Presentation | 378 | ||
| Physical Examination | 378 | ||
| Diagnostics | 378 | ||
| Differential Diagnosis | 379 | ||
| Allergic Rhinitis | 379 | ||
| Sinusitis | 379 | ||
| Rhinitis Medicamentosa | 379 | ||
| Cocaine Use | 379 | ||
| Pregnancy Rhinitis | 379 | ||
| Mechanical Obstruction | 379 | ||
| Autoimmune Vasculitides | 379 | ||
| Management | 379 | ||
| Complications | 379 | ||
| Indications for Referral or Hospitalization | 379 | ||
| Life Span Considerations | 380 | ||
| Patient and Family Education and Health Promotion | 380 | ||
| References | 380.e1 | ||
| 89 Epistaxis | 380 | ||
| Definition and Epidemiology | 380 | ||
| Pathophysiology | 380 | ||
| Clinical Presentation | 380 | ||
| Physical Examination | 380 | ||
| Diagnostics | 380 | ||
| Differential Diagnosis | 381 | ||
| Management | 381 | ||
| Anterior Epistaxis | 381 | ||
| Posterior Epistaxis | 381 | ||
| Complications | 381 | ||
| Indications for Referral or Hospitalization | 381 | ||
| Life Span Considerations | 381 | ||
| Patient and Family Education and Health Promotion | 382 | ||
| References | 382.e1 | ||
| 90 Nasal Trauma | 382 | ||
| Definition and Epidemiology | 382 | ||
| Pathophysiology | 382 | ||
| Clinical Presentation | 382 | ||
| Physical Examination | 382 | ||
| Diagnostics | 382 | ||
| Differential Diagnosis | 383 | ||
| Management | 383 | ||
| Complications | 383 | ||
| Indications for Referral or Hospitalization | 383 | ||
| Life Span Considerations | 383 | ||
| Pediatric | 383 | ||
| Geriatric | 383 | ||
| Patient and Family Education | 384 | ||
| References | 384.e1 | ||
| 91 Rhinitis | 384 | ||
| Allergic Rhinitis | 384 | ||
| Definition and Epidemiology | 384 | ||
| Pathophysiology | 384 | ||
| Clinical Presentation | 384 | ||
| Physical Examination | 384 | ||
| Diagnostics | 385 | ||
| Differential Diagnosis | 385 | ||
| Management | 385 | ||
| Environmental Control | 385 | ||
| Medications | 386 | ||
| Co-Management with Specialists | 386 | ||
| Complications | 387 | ||
| Indications for Referral or Hospitalization | 387 | ||
| Patient and Family Education | 387 | ||
| Idiopathic, or Vasomotor, Rhinitis | 387 | ||
| Definition and Epidemiology | 387 | ||
| Pathophysiology | 387 | ||
| Clinical Presentation | 387 | ||
| Physical Examination | 387 | ||
| Diagnostics and Differential Diagnosis | 388 | ||
| Management | 388 | ||
| Complications | 388 | ||
| Indications for Referral or Hospitalization | 388 | ||
| Patient and Family Education | 388 | ||
| Other Causes of Rhinitis | 388 | ||
| Infectious | 388 | ||
| Anatomic | 388 | ||
| Rhinitis Medicamentosa | 388 | ||
| Pharmacologic | 389 | ||
| Food- or Drink-Related Rhinitis | 389 | ||
| Other Medical Causes | 389 | ||
| References | 389.e1 | ||
| 92 Sinusitis | 389 | ||
| Definition and Epidemiology | 389 | ||
| Pathophysiology | 389 | ||
| Clinical Presentation | 389 | ||
| Physical Examination | 390 | ||
| Diagnostics | 390 | ||
| Differential Diagnosis | 390 | ||
| Dental Abscess | 391 | ||
| Trigeminal Neuralgia | 391 | ||
| Optic Neuritis | 391 | ||
| Viral Rhinosinusitis | 391 | ||
| Migraine Headache | 391 | ||
| Management | 391 | ||
| Complications | 391 | ||
| Indications for Referral or Hospitalization | 392 | ||
| Patient and Family Education and Health Promotion | 392 | ||
| References | 392.e1 | ||
| 93 Smell and Taste Disturbances | 392 | ||
| Definition and Epidemiology | 392 | ||
| Pathophysiology | 392 | ||
| Clinical Presentation | 393 | ||
| Physical Examination | 393 | ||
| Diagnostics | 393 | ||
| Differential Diagnosis | 393 | ||
| Management | 393 | ||
| Complications | 394 | ||
| Indications for Referral or Hospitalization | 394 | ||
| Life Span Considerations | 394 | ||
| Pediatrics | 394 | ||
| Geriatrics | 394 | ||
| Patient and Family Education and Health Promotion | 394 | ||
| References | 394.e1 | ||
| 94 Tumors and Polyps of the Nose | 394 | ||
| Nasal Tumors and Polyps | 394 | ||
| Definition and Epidemiology | 394 | ||
| Pathophysiology | 395 | ||
| Clinical Presentation | 395 | ||
| Physical Examination | 395 | ||
| Diagnostics | 395 | ||
| Differential Diagnosis | 395 | ||
| Management | 395 | ||
| Complications | 396 | ||
| Indications for Referral or Hospitalization | 396 | ||
| Life Span Considerations | 396 | ||
| Pediatric | 396 | ||
| Geriatric | 396 | ||
| Patient and Family Education | 396 | ||
| Granulomatosis with Polyangiitis (Wegener Granulomatosis) | 396 | ||
| Definition and Epidemiology | 396 | ||
| Pathophysiology | 396 | ||
| Clinical Presentation | 396 | ||
| Physical Examination | 396 | ||
| Diagnostics | 396 | ||
| Differential Diagnosis | 397 | ||
| Management and Indications for Referral or Hospitalization | 397 | ||
| Complications | 397 | ||
| Patient and Family Education | 397 | ||
| References | 397 | ||
| References | 397.e1 | ||
| 9 Evaluation and Management of Oropharyynx Disorders | 398 | ||
| 95 Dental Abscess | 398 | ||
| Definition and Epidemiology | 398 | ||
| Pathophysiology | 398 | ||
| Clinical Presentation | 398 | ||
| Physical Examination | 398 | ||
| Diagnostics | 398 | ||
| Differential Diagnosis | 398 | ||
| Management | 398 | ||
| Complications | 399 | ||
| Indications for Referral or Hospitalization | 399 | ||
| Patient and Family Education and Health Promotion | 399 | ||
| References | 399.e1 | ||
| 96 Diseases of the Salivary Gland | 399 | ||
| Definition and Epidemiology | 399 | ||
| Pathophysiology | 399 | ||
| Clinical Presentation | 400 | ||
| Physical Examination | 401 | ||
| Diagnostics | 401 | ||
| Differential Diagnosis | 402 | ||
| Management | 402 | ||
| Life Span Considerations | 402 | ||
| Complications | 403 | ||
| Indications for Referral or Hospitalization | 403 | ||
| Patient and Family Education | 403 | ||
| Health Promotion | 403 | ||
| References | 403.e1 | ||
| 97 Epiglottitis | 403 | ||
| Definition and Epidemiology | 403 | ||
| Pathophysiology | 403 | ||
| Clinical Presentation | 404 | ||
| Physical Examination | 404 | ||
| Diagnostics | 404 | ||
| Differential Diagnosis | 405 | ||
| Management | 405 | ||
| Life Span Considerations | 406 | ||
| Complications | 406 | ||
| Indications for Referral or Hospitalization | 406 | ||
| Patient and Family Education | 406 | ||
| Health Promotion | 406 | ||
| References | 406.e1 | ||
| 98 Oral Infections | 406 | ||
| Definition and Epidemiology | 406 | ||
| Pathophysiology | 406 | ||
| Clinical Presentation | 407 | ||
| Physical Examination | 407 | ||
| Diagnostics | 407 | ||
| Differential Diagnosis | 408 | ||
| Management | 408 | ||
| Complications | 408 | ||
| Indications for Referral or Hospitalization | 409 | ||
| Patient Education and Health Promotion | 409 | ||
| References | 409.e1 | ||
| 99 Parotitis | 409 | ||
| Definition and Epidemiology | 409 | ||
| Pathophysiology | 409 | ||
| Clinical Presentation | 410 | ||
| Physical Examination | 410 | ||
| Diagnostics | 410 | ||
| Differential Diagnosis | 410 | ||
| Management | 410 | ||
| Complications | 411 | ||
| Indications for Referral or Hospitalization | 411 | ||
| Patient and Family Education and Health Promotion | 411 | ||
| References | 411.e1 | ||
| 100 Peritonsillar Abscess | 411 | ||
| Definition and Epidemiology | 411 | ||
| Pathophysiology | 411 | ||
| Clinical Presentation | 411 | ||
| Physical Examination | 411 | ||
| Diagnostics | 412 | ||
| Differential Diagnosis | 412 | ||
| Management | 412 | ||
| Life Span Considerations | 412 | ||
| Complications | 412 | ||
| Indications for Referral or Hospitalization | 413 | ||
| Patient and Family Education | 413 | ||
| Health Promotion | 413 | ||
| References | 413.e1 | ||
| 101 Pharyngitis and Tonsillitis | 413 | ||
| Definition and Epidemiology | 413 | ||
| Pathophysiology | 413 | ||
| Clinical Presentation | 413 | ||
| Physical Examination | 414 | ||
| Diagnostics | 414 | ||
| Differential Diagnosis | 414 | ||
| Management | 415 | ||
| Life Span Considerations | 415 | ||
| Complications | 416 | ||
| Indications for Referral or Hospitalization | 416 | ||
| Patient and Family Education | 416 | ||
| Health Promotion | 416 | ||
| References | 416 | ||
| References | 416.e1 | ||
| 10 Evaluation and Management of Pulmonary Disorders | 417 | ||
| 102 Acute Bronchitis | 417 | ||
| Definition and Epidemiology | 417 | ||
| Pathophysiology | 417 | ||
| Clinical Presentation and Physical Examination | 417 | ||
| Diagnostics | 418 | ||
| Differential Diagnosis | 418 | ||
| Management | 419 | ||
| Complications | 420 | ||
| Indications for Referral or Hospitalization | 420 | ||
| Patient and Family Education | 420 | ||
| References | 420.e1 | ||
| 103 Asthma | 421 | ||
| Definition and Epidemiology | 421 | ||
| Pathophysiology | 422 | ||
| Clinical Presentation | 423 | ||
| Physical Examination | 424 | ||
| Diagnostics | 428 | ||
| Differential Diagnosis | 429 | ||
| Management | 430 | ||
| Medications | 431 | ||
| Long-Term Control Medications | 431 | ||
| Corticosteroids. | 431 | ||
| Cromolyn. | 437 | ||
| Xanthine Derivatives. | 439 | ||
| Leukotriene Modifiers. | 439 | ||
| Immunomodulators. | 440 | ||
| Long-Acting Beta2-Adrenergic Agonists. | 441 | ||
| Quick-Relief Medications | 441 | ||
| Short-Acting Beta2-Adrenergic Agonists. | 441 | ||
| Anticholinergic Agents. | 441 | ||
| Monitoring Therapy and Asthma Severity | 441 | ||
| Interdisciplinary Management | 442 | ||
| Life Span Considerations | 442 | ||
| Complications | 443 | ||
| Indications for Referral or Hospitalization | 443 | ||
| Patient Education | 443 | ||
| References | 445.e1 | ||
| 104 Chest Pain (Noncardiac) | 445 | ||
| Definition and Epidemiology | 445 | ||
| Pathophysiology | 446 | ||
| Clinical Presentation | 446 | ||
| Physical Examination | 447 | ||
| Diagnostics | 447 | ||
| Differential Diagnosis | 447 | ||
| Age Considerations | 449 | ||
| Management | 449 | ||
| Complications | 449 | ||
| Indications for Referral or Hospitalization | 449 | ||
| Patient and Family Education and Health Promotion | 451 | ||
| References | 451.e1 | ||
| 105 Chronic Cough | 451 | ||
| Definition and Epidemiology | 451 | ||
| Pathophysiology | 451 | ||
| Clinical Presentation | 452 | ||
| Physical Examination | 452 | ||
| Diagnostics | 452 | ||
| Differential Diagnosis | 454 | ||
| Management | 455 | ||
| Complications | 456 | ||
| Indications for Referral or Hospitalization | 456 | ||
| Patient and Family Education | 457 | ||
| References | 457.e1 | ||
| 106 Chronic Obstructive Pulmonary Disease | 457 | ||
| Definition and Epidemiology | 457 | ||
| Pathophysiology | 458 | ||
| Clinical Presentation | 458 | ||
| Physical Examination | 458 | ||
| Diagnostics | 459 | ||
| Differential Diagnosis | 460 | ||
| Management | 460 | ||
| Pharmacotherapy | 461 | ||
| Bronchodilators. | 461 | ||
| Anticholinergic Therapy. | 461 | ||
| Beta2-Adrenergic Agonist Therapy. | 464 | ||
| Combination Therapy. | 464 | ||
| Methylxanthine Therapy. | 464 | ||
| Corticosteroids. | 464 | ||
| Combination Inhaled Glucocorticosteroid and Bronchodilator Therapy. | 464 | ||
| Phosphodiesterase-4 Inhibitors. | 464 | ||
| Mucoactive Agents. | 464 | ||
| Antibiotics. | 464 | ||
| Pulmonary Rehabilitation | 465 | ||
| Exercise Training | 465 | ||
| Immunizations | 465 | ||
| Psychological Support | 465 | ||
| Nutrition | 465 | ||
| Surgery | 465 | ||
| Palliative Care and Hospice | 466 | ||
| Complications | 466 | ||
| Indications for Referral or Hospitalization | 466 | ||
| Patient and Family Education | 467 | ||
| References | 467.e1 | ||
| 107 Dyspnea | 467 | ||
| Definition and Epidemiology | 467 | ||
| Pathophysiology | 467 | ||
| Clinical Presentation | 467 | ||
| Quality | 468 | ||
| Timing | 468 | ||
| Intensity | 468 | ||
| Associated Symptoms | 468 | ||
| Exposures | 469 | ||
| Physical Examination | 469 | ||
| Differential Diagnosis | 470 | ||
| Diagnostics | 470 | ||
| Management | 471 | ||
| Complications | 471 | ||
| Indications for Referral or Hospitalization | 471 | ||
| Patient and Family Education and Health Promotion | 471 | ||
| References | 471.e1 | ||
| 108 Hemoptysis | 471 | ||
| Definition and Epidemiology | 471 | ||
| Pathophysiology | 472 | ||
| Clinical Presentation | 472 | ||
| Physical Examination | 472 | ||
| Diagnostics | 472 | ||
| Differential Diagnosis | 473 | ||
| Management | 473 | ||
| Complications | 474 | ||
| Indications for Referral or Hospitalization | 474 | ||
| Patient and Family Education | 474 | ||
| References | 474.e1 | ||
| 109 Lung Cancer | 474 | ||
| Definition and Epidemiology | 474 | ||
| Pathophysiology | 475 | ||
| Clinical Presentation and Physical Examination | 475 | ||
| Diagnostics | 475 | ||
| Differential Diagnosis | 477 | ||
| Management | 477 | ||
| Stage I and II Non–Small Cell Lung Cancer | 477 | ||
| Stage III Non–Small Cell Lung Cancer | 478 | ||
| Stage IV Non–Small Cell Lung Cancer | 478 | ||
| Small Cell Lung Cancer | 478 | ||
| Complications | 478 | ||
| Indications for Referral or Hospitalization | 478 | ||
| Life Span Considerations | 479 | ||
| Education and Health Promotion | 479 | ||
| References | 479.e1 | ||
| 110 Pleural Effusions and Pleurisy | 479 | ||
| Pleural Effusions | 479 | ||
| Definition and Epidemiology | 479 | ||
| Pathophysiology | 480 | ||
| Clinical Presentation | 481 | ||
| Physical Examination | 481 | ||
| Diagnostics | 481 | ||
| Differential Diagnosis | 482 | ||
| Management | 483 | ||
| Complications | 483 | ||
| Indications for Referral or Hospitalization | 483 | ||
| Patient and Family Education | 483 | ||
| Pleurisy | 483 | ||
| Definition and Epidemiology | 483 | ||
| Pathophysiology | 483 | ||
| Clinical Presentation | 483 | ||
| Physical Examination | 484 | ||
| Diagnostics | 484 | ||
| Differential Diagnosis | 484 | ||
| Management | 485 | ||
| Complications | 485 | ||
| Indications for Referral or Hospitalization | 485 | ||
| Patient and Family Education | 485 | ||
| References | 485.e1 | ||
| 111 Pneumonia | 485 | ||
| Definition and Epidemiology | 485 | ||
| Pathophysiology | 485 | ||
| Clinical Presentation and Physical Examination | 486 | ||
| Bacterial Pneumonia Syndromes | 487 | ||
| Gram-Positive Bacteria. | 487 | ||
| Gram-Negative Bacteria. | 487 | ||
| Atypical Pneumonia Syndromes | 487 | ||
| Diagnostics | 488 | ||
| Chest Radiography | 488 | ||
| Pulse Oximetry | 488 | ||
| Sputum Analysis | 488 | ||
| Other Tests | 488 | ||
| Differential Diagnosis | 489 | ||
| Management | 489 | ||
| Life Span Considerations | 490 | ||
| Complications | 490 | ||
| Indications for Referral or Hospitalization | 490 | ||
| Patient and Family Education | 491 | ||
| Health Promotion | 491 | ||
| References | 491.e1 | ||
| 112 Pneumothorax | 491 | ||
| Definition and Epidemiology | 491 | ||
| Pathophysiology | 491 | ||
| Clinical Presentation | 491 | ||
| Physical Examination | 492 | ||
| Diagnostics | 492 | ||
| Differential Diagnosis | 492 | ||
| Management | 492 | ||
| Life Span Considerations | 493 | ||
| Complications | 493 | ||
| Indications for Referral or Hospitalization | 493 | ||
| Patient and Family Education | 493 | ||
| References | 493.e1 | ||
| 113 Pulmonary Embolism | 493 | ||
| Definition and Epidemiology | 493 | ||
| Pathophysiology | 493 | ||
| Clinical Presentation | 494 | ||
| Physical Examination | 494 | ||
| Diagnostics | 494 | ||
| Diagnosis | 494 | ||
| Management | 495 | ||
| Life Span Considerations | 495 | ||
| Complications | 495 | ||
| Indications for Referral or Hospitalization | 495 | ||
| Patient and Family Education | 495 | ||
| References | 495.e1 | ||
| 114 Pulmonary Hypertension | 496 | ||
| Definition and Epidemiology | 496 | ||
| Pathophysiology | 496 | ||
| Clinical Presentation | 496 | ||
| Physical Examination | 497 | ||
| Diagnostics | 497 | ||
| Differential Diagnosis | 498 | ||
| Management | 498 | ||
| Complications | 499 | ||
| Indications for Referral or Hospitalization | 499 | ||
| Patient and Family Education | 499 | ||
| Health Promotion | 500 | ||
| References | 500.e1 | ||
| 115 Sarcoidosis | 500 | ||
| Definition and Epidemiology | 500 | ||
| Pathophysiology | 500 | ||
| Clinical Presentation and Physical Examination | 500 | ||
| Diagnostics | 501 | ||
| Differential Diagnosis | 501 | ||
| Management | 502 | ||
| Life Span Considerations | 502 | ||
| Complications | 502 | ||
| Indications for Referral or Hospitalization | 503 | ||
| Patient and Family Education | 503 | ||
| References | 503 | ||
| References | 503.e1 | ||
| 11 Evaluation and Management of Cardiovascular Disorders | 504 | ||
| 116 Cardiac Diagnostic Testing | 504 | ||
| Pathophysiology of Coronary Artery Disease | 504 | ||
| Role of Inflammation and Atherogenesis | 504 | ||
| Relation to Cardiac Stress Testing | 504 | ||
| Overview of Cardiac Diagnostic Testing | 504 | ||
| Noninvasive Tests and Biomarkers for Coronary Artery Disease | 504 | ||
| Exercise Tolerance Test | 506 | ||
| Imaging Adjuncts to the Exercise Tolerance Test | 506 | ||
| Myocardial Perfusion Imaging. | 507 | ||
| Exercise Echocardiography. | 508 | ||
| Comparison of Myocardial Perfusion Imaging with Two-Dimensional Echocardiography. | 508 | ||
| Three-Dimensional and Doppler Flow Echocardiography. | 508 | ||
| Cardiac Magnetic Resonance Imaging and Ultrafast Computed Tomography Cardiac Scans. | 508 | ||
| Pharmacologic Stress Testing | 509 | ||
| Diagnostic Testing for Cardiovascular Disease in Women | 509 | ||
| Summary | 510 | ||
| References | 510.e1 | ||
| 117 Abdominal Aortic Aneurysm | 510 | ||
| Definition and Epidemiology | 510 | ||
| Pathophysiology | 511 | ||
| Clinical Presentation | 511 | ||
| Physical Examination | 511 | ||
| Diagnostics | 511 | ||
| Differential Diagnosis | 512 | ||
| Management | 512 | ||
| Preoperative Cardiac Risk Stratification | 513 | ||
| Open Surgical Repair | 513 | ||
| Endovascular Stent Grafts | 513 | ||
| Life Span Considerations | 514 | ||
| Complications | 514 | ||
| Indications for Referral or Hospitalization | 514 | ||
| Patient Education | 515 | ||
| Health Promotion | 515 | ||
| References | 515.e1 | ||
| 118 Cardiac Arrhythmias | 515 | ||
| Definition and Epidemiology | 515 | ||
| Tachyarrhythmias | 515 | ||
| Bradyarrhythmias | 516 | ||
| Pathophysiology | 516 | ||
| Clinical Presentation | 516 | ||
| Tachyarrhythmias | 516 | ||
| Bradyarrhythmias | 517 | ||
| Physical Examination | 517 | ||
| Initial Diagnostics | 518 | ||
| 12-Lead Electrocardiogram | 518 | ||
| Laboratory (Serum Testing) | 518 | ||
| Echocardiography | 518 | ||
| Radiologic Imaging | 518 | ||
| Stress Testing | 518 | ||
| Other Diagnostics | 518 | ||
| Holter Monitor | 518 | ||
| Event Monitor and Loop Recorder | 519 | ||
| Tilt-Table Test | 519 | ||
| Electrophysiologic Studies | 519 | ||
| Transesophageal Echocardiography | 519 | ||
| Carotid Sinus Massage and Valsalva Maneuvers | 519 | ||
| Differential Diagnosis of Tachyarrhythmias | 520 | ||
| Narrow Complex Tachycardia | 520 | ||
| Sinus Tachycardia. | 520 | ||
| Multifocal Atrial Tachycardia. | 520 | ||
| Paroxysmal Supraventricular Tachycardia. | 520 | ||
| Atrioventricular Nodal Reentry Tachycardia. | 520 | ||
| Atrioventricular Reentry Tachycardia. | 520 | ||
| Wolff-Parkinson-White Pattern. | 520 | ||
| Atrial Flutter. | 520 | ||
| Atrial Fibrillation. | 520 | ||
| Wide-Complex Tachycardia | 520 | ||
| Supraventricular Tachycardia with Aberrancy. | 520 | ||
| Ventricular Tachycardia. | 521 | ||
| Ventricular Outflow Tract Tachycardia. | 521 | ||
| Torsades De Pointes. | 521 | ||
| Ventricular Fibrillation. | 521 | ||
| Additional Complexes | 521 | ||
| Premature Atrial Contractions. | 521 | ||
| Premature Junctional Contractions. | 522 | ||
| Premature Ventricular Contractions. | 522 | ||
| Differential Diagnosis of Bradyarrhythmias | 522 | ||
| Sinus Bradycardia | 522 | ||
| Sinoatrial Exit Block | 522 | ||
| Atrioventricular Nodal Blocks | 522 | ||
| First-Degree Block. | 522 | ||
| Second Degree Block. | 522 | ||
| Second Degree, Type I. | 522 | ||
| Second Degree, Type II. | 523 | ||
| Third-Degree AV Block. | 523 | ||
| Bundle Branch Blocks | 523 | ||
| Right Bundle Branch Block. | 524 | ||
| Left Bundle Branch Block. | 524 | ||
| Hemiblocks. | 524 | ||
| Management | 524 | ||
| Management of Tachyarrhythmias | 524 | ||
| Sinus Tachycardia | 525 | ||
| Multifocal Atrial Tachycardia | 525 | ||
| Paroxysmal Supraventricular Tachycardia | 525 | ||
| Atrial Fibrillation or Atrial Flutter | 525 | ||
| Prevention of Thromboembolism in Atrial Fibrillation | 526 | ||
| Premature Atrial and Junctional Contractions | 526 | ||
| Premature Ventricular Contractions | 526 | ||
| Ventricular Tachycardia | 527 | ||
| Management of Bradyarrhythmias | 527 | ||
| Sinus Bradycardia | 527 | ||
| Sinoatrial Exit Block | 528 | ||
| Heart Blocks | 528 | ||
| Complications | 528 | ||
| Indications for Referral or Hospitalization | 528 | ||
| Hospital | 528 | ||
| Cardiologist | 528 | ||
| Electrophysiology Cardiologist | 528 | ||
| Life Span Considerations | 528 | ||
| Patient and Family Education | 528 | ||
| References | 529.e1 | ||
| 119 Carotid Artery Disease | 529 | ||
| Pathophysiology | 529 | ||
| Clinical Presentation | 530 | ||
| Physical Examination | 531 | ||
| Diagnostics | 531 | ||
| Differential Diagnosis | 531 | ||
| Management | 532 | ||
| Medical Therapy | 532 | ||
| Carotid Endarterectomy | 532 | ||
| Carotid Endarterectomy for Symptomatic Patients. | 532 | ||
| Carotid Endarterectomy for Asymptomatic Patients. | 533 | ||
| Periprocedural Care. | 533 | ||
| Complications of Carotid Endarterectomy. | 533 | ||
| Carotid Angioplasty and Stenting | 534 | ||
| Procedure. | 534 | ||
| Traditional Approach to Carotid Angioplasty and Stenting. | 534 | ||
| Innovative Approach to Carotid Angioplasty and Stenting. | 535 | ||
| Postprocedural Care. | 535 | ||
| Complications of Carotid Angioplasty and Stenting. | 535 | ||
| Life Span Considerations | 535 | ||
| Indications for Referral or Hospitalization | 535 | ||
| Patient Education | 536 | ||
| References | 536.e1 | ||
| 120 Chest Pain and Coronary Artery Disease | 536 | ||
| Definition and Epidemiology | 536 | ||
| Patient-Related Delays and Initial Treatment | 536 | ||
| Risk Factors for Coronary Artery Disease | 537 | ||
| Lipid Guidelines | 537 | ||
| Pathophysiology | 538 | ||
| Chronic Stable Angina | 538 | ||
| Silent Myocardial Ischemia (Asymptomatic Coronary Heart Disease) | 538 | ||
| Microvascular Angina (Syndrome X) | 538 | ||
| Variant Angina (Coronary Artery Spasm, Prinzmetal Angina) | 539 | ||
| Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction | 539 | ||
| Acute ST-Segment Elevation Myocardial Infarction | 539 | ||
| MINOCA: Suspected Myocardial Infarction with Nonobstructed Coronary Arteries | 539 | ||
| Clinical Presentation | 540 | ||
| Chronic Stable Angina | 540 | ||
| Anginal Equivalents | 540 | ||
| Microvascular Angina | 541 | ||
| Variant Angina | 541 | ||
| Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction | 541 | ||
| Acute ST-Segment Elevation Myocardial Infarction | 542 | ||
| Physical Examination | 542 | ||
| Diagnostics | 542 | ||
| Chronic Stable Angina | 542 | ||
| Electrocardiography. | 542 | ||
| Exercise Tolerance Testing (Stress Testing). | 542 | ||
| CT Angiography. | 543 | ||
| The Dilemma | 543 | ||
| Microvascular Angina | 544 | ||
| Variant Angina | 544 | ||
| 12 Evaluation and Management of Gastrointestinal Disorders | 623 | ||
| 127 Abdominal Pain and Infections | 623 | ||
| 13 Evaluation and Management of Genitourinary Disorders | 731 | ||
| 145 Incontinence | 731 | ||
| Definition and Epidemiology | 731 | ||
| Pathophysiology | 731 | ||
| Stress Incontinence | 731 | ||
| Anatomic Stress Urinary Incontinence. | 731 | ||
| Intrinsic Sphincter Deficiency. | 731 | ||
| Urinary Urge Incontinence | 731 | ||
| Detrusor Overactivity. | 731 | ||
| Idiopathic Causes. | 731 | ||
| Neurogenic Causes. | 732 | ||
| Poor Bladder Compliance. | 732 | ||
| Mixed Incontinence | 732 | ||
| Overflow Incontinence | 732 | ||
| Functional or Transient Incontinence | 732 | ||
| Clinical Presentation | 732 | ||
| Physical Examination | 732 | ||
| Diagnostics | 732 | ||
| Differential Diagnosis | 733 | ||
| Management | 733 | ||
| Stress Incontinence | 733 | ||
| Behavioral Therapies. | 733 | ||
| Medical Therapies. | 734 | ||
| Surgical Therapies. | 734 | ||
| Urge Incontinence | 734 | ||
| Behavioral Therapies. | 734 | ||
| Medical Therapies. | 735 | ||
| Surgical Therapies. | 735 | ||
| Mixed Incontinence | 735 | ||
| Overflow Incontinence | 735 | ||
| Functional Incontinence | 735 | ||
| Life Span Considerations | 735 | ||
| Complications | 735 | ||
| Consideration for Referral | 736 | ||
| Patient Education | 736 | ||
| References | 736.e1 | ||
| 146 Prostate Cancer | 736 | ||
| Definition and Epidemiology | 736 | ||
| Pathophysiology | 736 | ||
| Clinical Presentation | 736 | ||
| Physical Examination | 736 | ||
| Diagnostics and Differential Diagnosis | 736 | ||
| Management | 737 | ||
| Life Span Considerations | 737 | ||
| Complications | 738 | ||
| Indications for Referral or Hospitalization | 738 | ||
| Patient and Family Education | 738 | ||
| Health Promotion | 738 | ||
| References | 738.e1 | ||
| 147 Prostatic Hyperplasia (Benign) | 738 | ||
| Benign Prostatic Hyperplasia | 738 | ||
| Definition and Epidemiology | 738 | ||
| Pathophysiology | 738 | ||
| Clinical Presentation | 738 | ||
| Physical Examination | 739 | ||
| Diagnostics | 739 | ||
| Differential Diagnosis | 740 | ||
| Management | 740 | ||
| Complications | 740 | ||
| Indications for Referral or Hospitalization | 740 | ||
| Patient and Family Education | 740 | ||
| Prostatitis | 741 | ||
| Definition and Epidemiology | 741 | ||
| Pathophysiology | 741 | ||
| Clinical Presentation | 741 | ||
| Physical Examination | 741 | ||
| Diagnostics | 741 | ||
| Differential Diagnosis | 742 | ||
| Management | 742 | ||
| Life Span Considerations | 743 | ||
| Complications | 743 | ||
| Indications for Referral or Hospitalization | 743 | ||
| Patient and Family Education | 743 | ||
| References | 743.e1 | ||
| 148 Proteinuria and Hematuria | 743 | ||
| Proteinuria | 743 | ||
| Definition and Epidemiology | 743 | ||
| Pathophysiology | 744 | ||
| Clinical Presentation | 744 | ||
| Physical Examination | 744 | ||
| Diagnostics and Differential Diagnosis | 744 | ||
| Management | 746 | ||
| Complications | 746 | ||
| Indications for Referral or Hospitalization | 746 | ||
| Patient and Family Education | 747 | ||
| Hematuria | 747 | ||
| Definition and Epidemiology | 747 | ||
| Pathophysiology | 747 | ||
| Clinical Presentation | 747 | ||
| Physical Examination | 747 | ||
| Diagnostics and Differential Diagnosis | 747 | ||
| Management | 749 | ||
| Complications | 749 | ||
| Indications for Referral or Hospitalization | 749 | ||
| Patient and Family Education | 749 | ||
| References | 749.e1 | ||
| 149 Renal Failure | 749 | ||
| Definition and Epidemiology | 749 | ||
| Pathophysiology | 750 | ||
| Clinical Presentation | 751 | ||
| Physical Examination | 752 | ||
| Diagnostics | 752 | ||
| Differential Diagnosis | 753 | ||
| Management | 753 | ||
| Complications | 755 | ||
| Cardiovascular Management and Complications | 755 | ||
| Dietary Management and Metabolic Complications | 755 | ||
| Hematologic Management and Complications | 755 | ||
| Psychosocial Management and Complications | 755 | ||
| Indications for Referral or Hospitalization | 755 | ||
| Life Span Considerations | 755 | ||
| Patient and Family Education | 756 | ||
| References | 756.e1 | ||
| 150 Sexual Dysfunction (Male) | 756 | ||
| Definition and Epidemiology | 756 | ||
| Pathophysiology | 757 | ||
| Disorders of Desire | 757 | ||
| Disorders of Excitement | 757 | ||
| Psychogenic. | 758 | ||
| Hormonal Risk Factors. | 758 | ||
| Cardiovascular Risk Factors. | 758 | ||
| Pharmacologic Risk Factors. | 758 | ||
| Surgical Risk Factors. | 758 | ||
| Other Factors. | 758 | ||
| Disorders of Orgasm | 758 | ||
| Clinical Presentation | 758 | ||
| Physical Examination | 759 | ||
| Diagnostics | 760 | ||
| Differential Diagnosis | 760 | ||
| Management | 760 | ||
| Complications | 762 | ||
| Indications for Referral | 762 | ||
| Life Span Considerations | 763 | ||
| Patient and Partner Education | 763 | ||
| Health Promotion | 763 | ||
| References | 763.e1 | ||
| 151 Testicular Disorders | 763 | ||
| Definition and Epidemiology | 763 | ||
| Pathophysiology | 763 | ||
| Clinical Presentation | 765 | ||
| Varicocele | 765 | ||
| Epididymitis | 765 | ||
| Orchitis | 765 | ||
| Spermatocele | 765 | ||
| Hydrocele | 765 | ||
| Hematocele | 765 | ||
| Testicular Torsion | 765 | ||
| Torsion of the Appendix Testis | 765 | ||
| Trauma | 765 | ||
| Scrotal-Inguinal Hernia | 765 | ||
| Testicular Tumor | 765 | ||
| Elephantiasis | 766 | ||
| Physical Examination | 766 | ||
| Varicocele | 766 | ||
| Epididymitis | 766 | ||
| Orchitis | 766 | ||
| Spermatocele | 766 | ||
| Hydrocele | 766 | ||
| Hematocele | 766 | ||
| Testicular Torsion | 766 | ||
| 14 Evaluation and Management of Gynecologic Concerns | 799 | ||
| 155 Amenorrhea | 799 | ||
| Definition and Epidemiology | 799 | ||
| Pathophysiology | 799 | ||
| Clinical Presentation | 799 | ||
| Physical Examination | 800 | ||
| Diagnostics | 800 | ||
| Differential Diagnosis | 801 | ||
| Primary Amenorrhea | 801 | ||
| Secondary Amenorrhea | 801 | ||
| Management | 802 | ||
| Life Span Considerations | 803 | ||
| Complications | 803 | ||
| Indications for Referral or Hospitalization | 803 | ||
| Patient and Family Education and Health Promotion | 803 | ||
| References | 803.e1 | ||
| 156 Bartholin Gland Cysts and Abscesses | 803 | ||
| Definition and Epidemiology | 803 | ||
| Pathophysiology | 804 | ||
| Clinical Presentation | 804 | ||
| Physical Examination | 804 | ||
| Diagnostics | 804 | ||
| Differential Diagnosis | 804 | ||
| Management | 804 | ||
| Antibiotics | 804 | ||
| Surgical Treatments | 805 | ||
| Incision and Drainage. | 805 | ||
| Excision of Bartholin Gland. | 805 | ||
| Marsupialization and Window Operation. | 805 | ||
| Catheter or Drain Placement. | 805 | ||
| Carbon Dioxide Laser Therapy. | 805 | ||
| Silver Nitrate. | 805 | ||
| Life Span Considerations | 805 | ||
| Complications | 805 | ||
| Indications for Referral or Hospitalization | 805 | ||
| Patient and Family Education | 805 | ||
| References | 805.e1 | ||
| 157 Breast Disorders | 806 | ||
| Risk Assessment | 806 | ||
| Risk Factors | 806 | ||
| Risk Assessment Models | 806 | ||
| Genetic Testing | 806 | ||
| Risk Reduction | 807 | ||
| Screening Recommendations | 807 | ||
| Breast Pain (Mastalgia, Mastodynia) | 807 | ||
| Definition and Epidemiology | 807 | ||
| Pathophysiology | 807 | ||
| Clinical Presentation | 808 | ||
| Physical Examination | 808 | ||
| Diagnostics | 808 | ||
| Differential Diagnosis | 808 | ||
| Management | 809 | ||
| Complications | 809 | ||
| Indications for Referral or Hospitalization | 809 | ||
| Patient Education | 809 | ||
| Mastitis | 810 | ||
| Definition and Epidemiology | 810 | ||
| Pathophysiology | 810 | ||
| Clinical Presentation | 810 | ||
| Diagnostics | 810 | ||
| Differential Diagnosis | 810 | ||
| Management | 810 | ||
| Complications | 810 | ||
| Indications for Referral | 810 | ||
| Patient Education | 811 | ||
| Nipple Discharge and Galactorrhea | 811 | ||
| Definition and Epidemiology | 811 | ||
| Pathophysiology | 811 | ||
| Clinical Presentation | 811 | ||
| Physical Examination | 811 | ||
| Diagnostics | 811 | ||
| Differential Diagnosis | 812 | ||
| Management | 812 | ||
| Co-Management with Specialists | 813 | ||
| Life Span Considerations | 813 | ||
| Indications for Referral or Hospitalization | 813 | ||
| Patient and Family Education | 813 | ||
| Paget Disease of the Nipple | 813 | ||
| Pathophysiology | 813 | ||
| Clinical Presentation | 813 | ||
| Physical Examination | 813 | ||
| Diagnostics | 813 | ||
| Differential Diagnosis | 813 | ||
| Management | 814 | ||
| Indication for Referral | 814 | ||
| Patient Education | 814 | ||
| Breast Masses | 814 | ||
| Definition and Epidemiology | 814 | ||
| Pathophysiology | 814 | ||
| Clinical Presentation | 814 | ||
| Physical Examination | 815 | ||
| Diagnostics | 815 | ||
| Differential Diagnosis | 815 | ||
| Management | 815 | ||
| Life Span Considerations | 815 | ||
| Indications for Referral or Hospitalization | 815 | ||
| 15 Evaluation and Management of Musculoskeletal and Arthritic Disorders | 897 | ||
| 171 Ankle and Foot Pain | 897 | ||
| Ankle Sprains | 897 | ||
| Definition and Epidemiology | 897 | ||
| Pathophysiology | 897 | ||
| Clinical Presentation | 897 | ||
| Physical Examination | 897 | ||
| Diagnostics | 897 | ||
| Differential Diagnosis | 898 | ||
| Management | 898 | ||
| Complications | 899 | ||
| Indications for Referral or Hospitalization | 899 | ||
| Patient and Family Education | 899 | ||
| Achilles Tendinopathy | 899 | ||
| Definition and Epidemiology | 899 | ||
| Pathophysiology | 899 | ||
| Clinical Presentation | 899 | ||
| Physical Examination | 899 | ||
| Diagnostics | 899 | ||
| Differential Diagnosis | 899 | ||
| Management | 899 | ||
| 16 Evaluation and Management of Neurologic Disorders | 999 | ||
| 188 Neuropsychological Evaluation | 999 | ||
| Overview of Clinical Neuropsychology | 999 | ||
| Professional Functions and Roles | 999 | ||
| Assessment Tools and Approaches | 1000 | ||
| Neuropsychology Within Primary Care Settings | 1001 | ||
| When to Refer | 1002 | ||
| Overview of the Assessment Process | 1002 | ||
| Scoring and Interpretation of Neuropsychological Test Data | 1003 | ||
| Additional Considerations in Neuropsychological Assessment | 1003 | ||
| Case Study | 1004 | ||
| Summary | 1004 | ||
| References | 1004.e1 | ||
| 189 Amyotrophic Lateral Sclerosis | 1005 | ||
| Definition and Epidemiology | 1005 | ||
| Pathophysiology | 1005 | ||
| Clinical Presentation and Physical Examination | 1005 | ||
| Diagnostics | 1005 | ||
| Differential Diagnosis | 1006 | ||
| Management | 1006 | ||
| Life Span Considerations | 1006 | ||
| Complications | 1006 | ||
| Indications for Referral or Hospitalization | 1007 | ||
| Patient and Family Education | 1007 | ||
| References | 1007.e1 | ||
| 190 Bell Palsy | 1008 | ||
| Definition and Epidemiology | 1008 | ||
| Pathophysiology | 1008 | ||
| Clinical Presentation | 1008 | ||
| Physical Examination | 1008 | ||
| Diagnostics | 1008 | ||
| Differential Diagnosis | 1009 | ||
| Management | 1009 | ||
| Complications | 1009 | ||
| Indications for Referral or Hospitalization | 1009 | ||
| Life Span Considerations | 1010 | ||
| Education and Health Promotion | 1010 | ||
| References | 1010.e1 | ||
| 191 Cerebrovascular Events | 1010 | ||
| Definition and Epidemiology | 1010 | ||
| Pathophysiology | 1010 | ||
| Ischemic Stroke | 1010 | ||
| Hemorrhagic Stroke | 1011 | ||
| Clinical Presentation | 1011 | ||
| Physical Examination | 1011 | ||
| Diagnostics | 1011 | ||
| Differential Diagnosis | 1012 | ||
| Management | 1012 | ||
| Thrombolytic Therapy | 1014 | ||
| Surgery | 1014 | ||
| Antiplatelet Agents | 1014 | ||
| Life Span Considerations | 1015 | ||
| Pregnancy | 1015 | ||
| Geriatric Patients | 1015 | ||
| Complications | 1015 | ||
| Indications for Referral or Hospitalization | 1015 | ||
| Education and Health Promotion | 1015 | ||
| References | 1016.e1 | ||
| 192 Delirium | 1016 | ||
| Definition and Epidemiology | 1016 | ||
| Pathophysiology | 1016 | ||
| Clinical Presentation | 1017 | ||
| Physical Examination | 1017 | ||
| Diagnostics | 1017 | ||
| Differential Diagnosis | 1018 | ||
| Management | 1019 | ||
| Complications | 1019 | ||
| Indications for Referral or Hospitalization | 1019 | ||
| Patient and Family Education | 1019 | ||
| References | 1019.e1 | ||
| 193 Dementia | 1019 | ||
| Definition and Epidemiology | 1019 | ||
| Mild Cognitive Impairment | 1020 | ||
| Pathophysiology | 1020 | ||
| Alzheimer Disease | 1020 | ||
| Vascular Dementia | 1020 | ||
| Lewy Body Dementia | 1020 | ||
| Pseudodementia | 1020 | ||
| Clinical Presentation | 1021 | ||
| Physical Examination | 1021 | ||
| Diagnostics | 1022 | ||
| Differential Diagnosis | 1022 | ||
| Management | 1023 | ||
| Complications | 1023 | ||
| Indications for Referral or Hospitalization | 1023 | ||
| Patient and Family Education | 1023 | ||
| References | 1024.e1 | ||
| 194 Dizziness and Vertigo | 1024 | ||
| Dizziness | 1024 | ||
| Definition and Epidemiology | 1024 | ||
| Pathophysiology | 1024 | ||
| Clinical Presentation | 1025 | ||
| Physical Examination | 1025 | ||
| Diagnostics | 1025 | ||
| Differential Diagnosis | 1026 | ||
| 17 Evaluation and Management of Endocrine and Metabolic Disorders | 1071 | ||
| 204 Acromegaly | 1071 | ||
| Definition and Epidemiology | 1071 | ||
| Pathophysiology | 1071 | ||
| Clinical Presentation | 1071 | ||
| Physical Examination | 1071 | ||
| Diagnostics | 1072 | ||
| Differential Diagnosis | 1072 | ||
| Management and Co-Management with Specialists | 1072 | ||
| Life Span Considerations | 1073 | ||
| Complications | 1073 | ||
| Indications for Referral or Hospitalization | 1073 | ||
| Patient Education and Health Promotion | 1073 | ||
| References | 1074.e1 | ||
| 205 Adrenal Gland Disorders | 1074 | ||
| Definition and Epidemiology | 1074 | ||
| Addison Disease (Primary Adrenal Insufficiency) | 1074 | ||
| Cushing Syndrome | 1074 | ||
| Pheochromocytoma | 1074 | ||
| Pathophysiology | 1074 | ||
| Clinical Presentation | 1075 | ||
| Physical Examination | 1075 | ||
| Diagnostics | 1075 | ||
| Addison Disease | 1075 | ||
| Cushing Syndrome | 1075 | ||
| Pheochromocytoma | 1075 | ||
| Differential Diagnosis | 1076 | ||
| Management | 1076 | ||
| Addison Disease | 1076 | ||
| Cushing Syndrome | 1076 | ||
| Pheochromocytoma | 1076 | ||
| Alternative Therapies | 1076 | ||
| Complications | 1077 | ||
| Indications for Referral or Hospitalization | 1077 | ||
| Patient Education and Health Promotion | 1077 | ||
| References | 1077.e1 | ||
| 206 Diabetes Mellitus | 1077 | ||
| Definition and Epidemiology | 1077 | ||
| Pathophysiology | 1078 | ||
| Clinical Presentation | 1079 | ||
| Physical Examination | 1079 | ||
| Diagnostics | 1079 | ||
| Differential Diagnosis | 1080 | ||
| Management | 1080 | ||
| Lifestyle Interventions | 1080 | ||
| Pharmacotherapy | 1081 | ||
| Insulin Therapy | 1082 | ||
| Type 1 Diabetes. | 1082 | ||
| Type 2 Diabetes. | 1083 | ||
| Medications for Type 2 Diabetes | 1084 | ||
| Blood Glucose Monitoring | 1085 | ||
| Follow-up Care | 1086 | ||
| Diabetes and Pregnancy | 1086 | ||
| Gestational Diabetes. | 1086 | ||
| Pregnancy in the Woman with Type 1 Diabetes. | 1087 | ||
| Pregnancy in the Woman with Type 2 Diabetes. | 1088 | ||
| Co-Management with Specialists | 1088 | ||
| Complications | 1088 | ||
| Psychological Complications | 1088 | ||
| Acute Complications of Diabetes | 1089 | ||
| Hypoglycemia. | 1089 | ||
| Hyperglycemia. | 1090 | ||
| Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. | 1090 | ||
| Chronic Complications of Diabetes | 1091 | ||
| Microvascular Complications | 1091 | ||
| Diabetic Retinopathy. | 1091 | ||
| Diabetic Nephropathy. | 1091 | ||
| Diabetic Neuropathy. | 1092 | ||
| Macrovascular Complications. | 1093 | ||
| Indications for Referral or Hospitalization | 1095 | ||
| Life Span Considerations | 1095 | ||
| Education and Health Promotion | 1096 | ||
| References | 1096.e1 | ||
| 207 Hirsutism | 1096 | ||
| Definition and Epidemiology | 1096 | ||
| Polycystic Ovary Syndrome | 1097 | ||
| Pathophysiology | 1097 | ||
| Clinical Presentation | 1098 | ||
| Physical Examination | 1098 | ||
| Diagnostics | 1099 | ||
| Testosterone | 1099 | ||
| Ovarian Source | 1100 | ||
| Adrenal Source | 1100 | ||
| Cortisol Excess | 1100 | ||
| Insulin Excess | 1100 | ||
| Prolactin Excess | 1100 | ||
| Pituitary Source | 1100 | ||
| Thyroid-Stimulating Hormone Excess | 1101 | ||
| 5α-Reductase Excess | 1101 | ||
| Amenorrhea | 1101 | ||
| Pregnancy | 1101 | ||
| Differential Diagnosis | 1101 | ||
| Management | 1102 | ||
| Complications | 1103 | ||
| Indications for Referral or Hospitalization | 1103 | ||
| Life Span Considerations | 1103 | ||
| Education and Health Promotion | 1103 | ||
| References | 1104.e1 | ||
| 208 Hypercalcemia and Hypocalcemia | 1104 | ||
| Definition and Epidemiology | 1104 | ||
| Hypercalcemia | 1104 | ||
| Pathophysiology | 1104 | ||
| Clinical Presentation | 1105 | ||
| Physical Examination | 1105 | ||
| Diagnostics | 1105 | ||
| Differential Diagnosis | 1105 | ||
| Management | 1106 | ||
| Life Span Considerations | 1106 | ||
| Complications | 1106 | ||
| Hypocalcemia | 1106 | ||
| Pathophysiology | 1106 | ||
| Clinical Presentation | 1106 | ||
| Physical Examination | 1107 | ||
| Diagnostics | 1107 | ||
| Differential Diagnosis | 1107 | ||
| Management | 1107 | ||
| Life Span Considerations | 1108 | ||
| Complications | 1108 | ||
| Indications for Referral or Hospitalization | 1108 | ||
| Patient and Family Education and Health Promotion | 1108 | ||
| References | 1108.e1 | ||
| 209 Hyperkalemia and Hypokalemia | 1108 | ||
| Definition and Epidemiology | 1108 | ||
| Pathophysiology | 1108 | ||
| Clinical Presentation | 1109 | ||
| Physical Examination | 1109 | ||
| Diagnostics | 1109 | ||
| Hypokalemia | 1109 | ||
| Hyperkalemia | 1110 | ||
| Differential Diagnosis | 1110 | ||
| Management | 1111 | ||
| Acute Hypokalemia | 1111 | ||
| Chronic Hypokalemia | 1111 | ||
| Acute Hyperkalemia | 1111 | ||
| Chronic Hyperkalemia | 1111 | ||
| Complications | 1111 | ||
| Indications for Referral or Hospitalization | 1112 | ||
| Patient and Family Education | 1112 | ||
| Health Promotion | 1112 | ||
| References | 1112.e1 | ||
| 210 Hypernatremia and Hyponatremia | 1112 | ||
| Hypernatremia | 1112 | ||
| Definition and Epidemiology | 1112 | ||
| Pathophysiology | 1112 | ||
| Clinical Presentation and Physical Examination | 1112 | ||
| Diagnostics | 1113 | ||
| Differential Diagnosis | 1113 | ||
| Management | 1113 | ||
| Life Span Considerations | 1114 | ||
| Complications | 1114 | ||
| Indications for Referral or Hospitalization | 1114 | ||
| Patient and Family Education | 1114 | ||
| Hyponatremia | 1114 | ||
| Definition and Epidemiology | 1114 | ||
| Pathophysiology | 1115 | ||
| Clinical Presentation | 1115 | ||
| Physical Examination | 1115 | ||
| Diagnostics | 1116 | ||
| Differential Diagnosis | 1116 | ||
| Management | 1116 | ||
| Isotonic Hyponatremia and Hypertonic Hyponatremia | 1117 | ||
| Hypotonic Hyponatremia | 1117 | ||
| Complications | 1119 | ||
| Indications for Referral or Hospitalization | 1119 | ||
| Patient and Family Education | 1119 | ||
| References | 1119.e1 | ||
| 211 Lipid Disorders | 1120 | ||
| Definition and Epidemiology | 1120 | ||
| Pathophysiology | 1120 | ||
| Low-Density Lipoprotein | 1120 | ||
| High-Density Lipoprotein | 1120 | ||
| Triglycerides | 1120 | ||
| Role of Lifestyle, Including Diet and Exercise | 1121 | ||
| Insulin Resistance, Diabetes, and Metabolic Syndrome | 1121 | ||
| Clinical Presentation | 1121 | ||
| Physical Examination | 1121 | ||
| Diagnostics | 1121 | ||
| Differential Diagnosis | 1122 | ||
| Management | 1122 | ||
| Atherosclerotic Cardiovascular Disease Risk Assessment | 1122 | ||
| Lifestyle Modification | 1122 | ||
| Diet. | 1122 | ||
| Exercise. | 1123 | ||
| Other Risk Factors. | 1123 | ||
| Pharmacotherapy | 1123 | ||
| Primary Prevention for Specific Populations | 1125 | ||
| Young Adults. | 1125 | ||
| Men. | 1126 | ||
| Women. | 1126 | ||
| Older Adults. | 1126 | ||
| Diabetes. | 1126 | ||
| Metabolic Syndrome. | 1126 | ||
| Complications | 1126 | ||
| Indications for Referral | 1126 | ||
| Patient Education | 1126 | ||
| References | 1126.e1 | ||
| 212 Metabolic Syndrome | 1126 | ||
| Definition and Epidemiology | 1126 | ||
| Pathophysiology | 1127 | ||
| Hypertension | 1127 | ||
| Dyslipidemia | 1127 | ||
| Prothrombotic State | 1128 | ||
| Proinflammatory State | 1128 | ||
| Microalbuminuria | 1128 | ||
| Other Pathophysiologic Effects | 1128 | ||
| Clinical Presentation | 1128 | ||
| Physical Examination | 1128 | ||
| Diagnostics | 1128 | ||
| Differential Diagnosis | 1128 | ||
| Management | 1129 | ||
| Life Span Considerations | 1130 | ||
| Complications | 1131 | ||
| Indications for Referral or Hospitalization | 1131 | ||
| Patient and Family Education | 1131 | ||
| Health Promotion | 1131 | ||
| References | 1131.e1 | ||
| 213 Parathyroid Gland Disorders | 1131 | ||
| Definition and Epidemiology | 1131 | ||
| Pathophysiology | 1132 | ||
| Clinical Presentation | 1132 | ||
| Physical Examination | 1133 | ||
| Diagnostics | 1133 | ||
| Differential Diagnosis | 1134 | ||
| Management | 1134 | ||
| Complications | 1135 | ||
| Indications for Referral or Hospitalization | 1135 | ||
| Life Span Considerations | 1135 | ||
| Patient Education and Health Promotion | 1135 | ||
| References | 1135.e1 | ||
| 214 Thyroid Disorders | 1135 | ||
| Thyroid Function Testing | 1136 | ||
| Thyroid Imaging | 1136 | ||
| Thyroid Cytology | 1137 | ||
| Goiter (Simple, Nontoxic) | 1137 | ||
| Definition and Epidemiology | 1137 | ||
| Pathophysiology | 1137 | ||
| Clinical Presentation | 1138 | ||
| Physical Examination | 1138 | ||
| Diagnostics | 1138 | ||
| Differential Diagnosis | 1138 | ||
| Management | 1138 | ||
| Complications | 1139 | ||
| Indications for Referral or Hospitalization | 1139 | ||
| Life Span Considerations | 1139 | ||
| Patient and Family Education and Health Promotion | 1139 | ||
| Thyroid Nodules and Thyroid Cancer | 1139 | ||
| Definition and Epidemiology | 1139 | ||
| Pathophysiology | 1139 | ||
| Clinical Presentation and Physical Examination | 1139 | ||
| Diagnostics and Differential Diagnosis | 1139 | ||
| Management | 1140 | ||
| Life Span Considerations | 1141 | ||
| Complications | 1141 | ||
| Indications for Referral or Hospitalization | 1141 | ||
| Patient and Family Education and Health Promotion | 1141 | ||
| Hyperthyroidism | 1141 | ||
| Definition and Epidemiology | 1141 | ||
| Pathophysiology | 1142 | ||
| Clinical Presentation and Physical Examination | 1142 | ||
| Diagnostics | 1142 | ||
| Differential Diagnosis | 1143 | ||
| Management | 1143 | ||
| Graves Disease | 1143 | ||
| Subclinical Hyperthyroidism | 1144 | ||
| Thyroiditis | 1145 | ||
| Subacute Thyroiditis | 1145 | ||
| Painless Postpartum Thyroiditis | 1145 | ||
| Toxic Nodule | 1145 | ||
| Toxic Multinodular Goiter | 1145 | ||
| Life Span Considerations | 1145 | ||
| Complications | 1145 | ||
| Indications for Referral or Hospitalizations | 1145 | ||
| Patient and Family Education | 1145 | ||
| Hypothyroidism | 1145 | ||
| Definition and Epidemiology | 1145 | ||
| Pathophysiology | 1146 | ||
| Clinical Presentation | 1146 | ||
| Physical Examination | 1146 | ||
| Diagnostics | 1147 | ||
| Differential Diagnosis | 1147 | ||
| Management | 1147 | ||
| Subclinical Hypothyroidism | 1148 | ||
| Complications | 1148 | ||
| Indications for Referral or Hospitalization | 1148 | ||
| Life Span Considerations | 1148 | ||
| Patient and Family Education and Health Promotion | 1149 | ||
| Nonthyroidal Illness | 1149 | ||
| Drugs and the Thyroid Gland | 1149 | ||
| Thyroid Disease in Pregnancy | 1150 | ||
| Hyperthyroidism in Pregnancy | 1151 | ||
| Diagnostics | 1151 | ||
| Management | 1151 | ||
| Hypothyroidism in Pregnancy | 1151 | ||
| References | 1151 | ||
| References | 1151.e1 | ||
| 18 Evaluation and Management of Rheumatic Disorders | 1152 | ||
| 215 Ankylosing Spondylitis and Related Disorders | 1152 | ||
| Ankylosing Spondylitis | 1152 | ||
| Definition and Epidemiology | 1152 | ||
| Pathophysiology | 1152 | ||
| Clinical Presentation | 1152 | ||
| Physical Examination | 1153 | ||
| Diagnostics | 1153 | ||
| Differential Diagnosis | 1154 | ||
| Management | 1154 | ||
| Life Span Considerations | 1155 | ||
| Complications | 1155 | ||
| Indications for Referral or Hospitalization | 1155 | ||
| Patient Education | 1155 | ||
| Reactive Arthritis (Formerly Known as Reiter Syndrome) | 1156 | ||
| Definition and Epidemiology | 1156 | ||
| Pathophysiology | 1156 | ||
| Clinical Presentation and Physical Examination | 1156 | ||
| Extra-Articular Manifestations | 1156 | ||
| Diagnostics | 1156 | ||
| Differential Diagnosis | 1157 | ||
| Management | 1157 | ||
| Complications | 1157 | ||
| Indications for Referral | 1157 | ||
| Patient Education | 1157 | ||
| Psoriatic Arthritis | 1157 | ||
| Definition and Epidemiology | 1157 | ||
| Pathophysiology | 1157 | ||
| Clinical Presentation and Physical Examination | 1157 | ||
| Diagnostics | 1157 | ||
| Differential Diagnosis | 1158 | ||
| Management | 1158 | ||
| Complications | 1158 | ||
| Indications for Referral | 1158 | ||
| Patient Education | 1158 | ||
| Arthritis of Inflammatory Bowel Disease | 1158 | ||
| Definition and Epidemiology | 1158 | ||
| Pathophysiology | 1159 | ||
| Clinical Presentation and Physical Examination | 1159 | ||
| Diagnostics | 1159 | ||
| Differential Diagnosis | 1159 | ||
| Management | 1159 | ||
| Complications | 1159 | ||
| Indications for Referral | 1159 | ||
| Patient Education | 1159 | ||
| References | 1159.e1 | ||
| 216 Polymyalgia Rheumatica and Giant Cell Arteritis | 1159 | ||
| Definition and Epidemiology | 1159 | ||
| Pathophysiology | 1160 | ||
| Clinical Presentation | 1160 | ||
| Classification Criteria | 1160 | ||
| Diagnostics | 1160 | ||
| Imaging | 1160 | ||
| Differential Diagnosis | 1161 | ||
| Management | 1161 | ||
| Complications | 1161 | ||
| Indications for Referral | 1161 | ||
| Patient Education | 1161 | ||
| Association Between Polymyalgia Rheumatica and Giant Cell Arteritis | 1161 | ||
| Epidemiology of Giant Cell Arteritis | 1161 | ||
| Pathophysiology | 1162 | ||
| Clinical Presentation | 1162 | ||
| Physical Examination and Classification Criteria of Giant Cell Arteritis | 1162 | ||
| Diagnostics | 1162 | ||
| Differential Diagnosis | 1163 | ||
| Management | 1163 | ||
| Monitoring Treatment | 1163 | ||
| Complications | 1163 | ||
| Life Span Considerations | 1163 | ||
| Considerations for Referral or Hospitalization | 1163 | ||
| References | 1164.e1 | ||
| 217 Raynaud Phenomenon | 1164 | ||
| Definition and Epidemiology | 1164 | ||
| Pathophysiology | 1164 | ||
| Clinical Presentation | 1164 | ||
| Physical Examination | 1164 | ||
| Diagnostics | 1165 | ||
| Differential Diagnosis | 1165 | ||
| Management | 1165 | ||
| Complications | 1166 | ||
| Indications for Referral or Hospitalization | 1166 | ||
| Patient Education | 1166 | ||
| References | 1166.e1 | ||
| 218 Rheumatoid Arthritis | 1166 | ||
| Definition and Epidemiology | 1166 | ||
| Pathophysiology | 1166 | ||
| Clinical Presentation | 1167 | ||
| Physical Examination | 1167 | ||
| Diagnostics | 1167 | ||
| Radiographs | 1167 | ||
| Synovial Fluid Analysis | 1167 | ||
| Differential Diagnosis | 1168 | ||
| Management | 1168 | ||
| Assessing Cardiovascular Risk | 1168 | ||
| Pharmacologic Agents | 1168 | ||
| Disease-Modifying Antirheumatic Drugs. | 1168 | ||
| Glucocorticoids. | 1169 | ||
| Nonsteroidal Anti-Inflammatory Drugs. | 1169 | ||
| Nonpharmacologic Treatment | 1169 | ||
| Interdisciplinary Management | 1169 | ||
| Life Span Considerations | 1169 | ||
| Complications | 1170 | ||
| Indications for Referral or Hospitalization | 1170 | ||
| Patient and Family Education | 1170 | ||
| References | 1170.e1 | ||
| 219 Systemic Lupus Erythematosus | 1170 | ||
| Definition and Epidemiology | 1170 | ||
| Pathophysiology | 1170 | ||
| Clinical Presentation and Physical Examination | 1171 | ||
| Diagnostics | 1172 | ||
| Differential Diagnosis | 1173 | ||
| Management | 1173 | ||
| Life Span Considerations | 1175 | ||
| Complications | 1175 | ||
| Indications for Referral or Hospitalization | 1176 | ||
| Patient and Family Education | 1176 | ||
| References | 1176.e1 | ||
| 220 Vasculitis | 1176 | ||
| Definition and Epidemiology | 1176 | ||
| Classification of Vasculitic Syndromes | 1176 | ||
| Pathophysiology | 1177 | ||
| Clinical Presentation and Physical Examination | 1177 | ||
| Diagnostics | 1178 | ||
| Differential Diagnosis | 1179 | ||
| Management | 1180 | ||
| Complications | 1180 | ||
| Indications for Referral or Hospitalization | 1180 | ||
| Patient and Family Education | 1180 | ||
| References | 1180 | ||
| References | 1180.e1 | ||
| 19 Evaluation and Management of Multisystem Disorders | 1181 | ||
| 221 Barotrauma and Other Diving Injuries | 1181 | ||
| Decompression Sickness and Barotrauma | 1181 | ||
| Predive Physical Examination and Diagnostics | 1181 | ||
| Pathophysiology | 1182 | ||
| Clinical Presentation | 1182 | ||
| Physical Examination | 1182 | ||
| Differential Diagnosis | 1183 | ||
| Management | 1183 | ||
| Life Span Considerations | 1183 | ||
| Complications | 1183 | ||
| Indications for Referral | 1183 | ||
| Patient Education | 1184 | ||
| Ear Barotrauma | 1184 | ||
| 20 Evaluation and Management of Infectious Diseases | 1225 | ||
| 229 Emerging and Reemerging Infectious Diseases | 1225 | ||
| Definitions | 1225 | ||
| Risk Factors Favoring Emergence of Pathogens | 1225 | ||
| Pathogens | 1226 | ||
| Acute Respiratory Diseases | 1226 | ||
| Coronaviruses. | 1226 | ||
| Middle East Respiratory Syndrome. | 1226 | ||
| Human Metapneumovirus. | 1226 | ||
| Influenza A. | 1227 | ||
| Avian Influenza A (H5N1). | 1227 | ||
| Acute Diarrheal Illnesses | 1227 | ||
| Vibrio cholerae. | 1227 | ||
| Escherichia coli O157:H7. | 1228 | ||
| Vector-Borne Diseases | 1228 | ||
| Dengue Fever. | 1228 | ||
| Chikungunya Fever. | 1228 | ||
| Zika Fever. | 1229 | ||
| Tick-Borne Encephalitis. | 1229 | ||
| Zoonoses | 1230 | ||
| Ebola Virus Disease. | 1230 | ||
| Monkeypox. | 1230 | ||
| Antibiotic Resistance | 1231 | ||
| Methicillin-Resistant Staphylococcus aureus. | 1231 | ||
| Extensively Drug-Resistant Tuberculosis. | 1231 | ||
| Summary | 1232 | ||
| References | 1232.e1 | ||
| 230 HIV Infection | 1232 | ||
| Definition and Epidemiology | 1232 | ||
| Pathophysiology | 1233 | ||
| Clinical Presentation | 1233 | ||
| Physical Examination | 1234 | ||
| Diagnostics | 1235 | ||
| Diagnosis of HIV Infection | 1235 | ||
| Laboratory and Other Testing of the Patient with Newly Diagnosed HIV Infection | 1236 | ||
| Differential Diagnosis | 1237 | ||
| Management | 1237 | ||
| Complications | 1239 | ||
| Metabolic Toxicities | 1239 | ||
| Lipodystrophy | 1239 | ||
| Liver Disease | 1239 | ||
| Drug Interactions | 1239 | ||
| Immune Reconstitution Inflammatory Syndrome | 1239 | ||
| Indications for Referral or Hospitalization | 1239 | ||
| Life Span Considerations | 1240 | ||
| Education and Health Promotion | 1240 | ||
| References | 1241.e1 | ||
| 231 Influenza | 1241 | ||
| Definition and Epidemiology | 1241 | ||
| Pathophysiology | 1241 | ||
| Clinical Presentation | 1241 | ||
| Physical Examination | 1241 | ||
| Diagnostics | 1241 | ||
| Differential Diagnosis | 1242 | ||
| Management | 1242 | ||
| Complications | 1242 | ||
| Indications for Referral or Hospitalization | 1243 | ||
| Life Span Considerations | 1243 | ||
| Patient and Family Education | 1243 | ||
| Health Promotion and Prevention | 1243 | ||
| References | 1243.e1 | ||
| 232 Infectious Diarrhea | 1243 | ||
| Definition | 1243 | ||
| Epidemiology | 1244 | ||
| Pathophysiology | 1245 | ||
| Clinical Presentation | 1245 | ||
| Physical Examination | 1246 | ||
| Diagnostics | 1246 | ||
| Differential Diagnosis | 1246 | ||
| Noninflammatory Diarrhea: Acute Gastroenteritis | 1246 | ||
| Traveler’s Diarrhea | 1247 | ||
| Vibrio cholerae | 1247 | ||
| Inflammatory Diarrhea | 1247 | ||
| Shigella (Shigella dysenteriae, Shigella flexneri, Shigella sonnei). | 1247 | ||
| Salmonella (Non-Typhi Species). | 1248 | ||
| Campylobacter jejuni. | 1248 | ||
| Escherichia coli O157:H7. | 1248 | ||
| Clostridium difficile. | 1249 | ||
| Food Poisoning: Bacterial Toxins | 1249 | ||
| One to Six Hours After Ingestion | 1249 | ||
| Staphylococcus aureus Food Poisoning. | 1249 | ||
| Bacillus cereus Food Poisoning. | 1249 | ||
| Eight to Fourteen Hours After Ingestion | 1250 | ||
| Clostridium perfringens Food Poisoning. | 1250 | ||
| Bacillus cereus Food Poisoning. | 1250 | ||
| Management | 1250 | ||
| Complications | 1250 | ||
| Indications for Referral or Hospitalization | 1250 | ||
| Patient and Family Education | 1251 | ||
| Prevention | 1251 | ||
| References | 1251.e1 | ||
| 233 Infectious Mononucleosis | 1251 | ||
| Definition and Epidemiology | 1251 | ||
| Pathophysiology | 1252 | ||
| Clinical Presentation | 1252 | ||
| Physical Examination | 1252 | ||
| Diagnostics | 1252 | ||
| Differential Diagnosis | 1252 | ||
| Management | 1253 | ||
| Life Span Considerations | 1253 | ||
| Complications | 1253 | ||
| Indications for Referral or Hospitalization | 1254 | ||
| Patient and Family Education | 1254 | ||
| References | 1254.e1 | ||
| 234 Tick-Borne Illnesses | 1254 | ||
| Lyme Disease | 1254 | ||
| Definition and Epidemiology | 1254 | ||
| Pathophysiology | 1254 | ||
| Clinical Presentation | 1255 | ||
| Diagnostics | 1255 | ||
| Differential Diagnosis | 1256 | ||
| Management | 1256 | ||
| Prevention | 1257 | ||
| Complications | 1257 | ||
| Babesiosis | 1258 | ||
| Definition and Epidemiology | 1258 | ||
| Pathophysiology | 1258 | ||
| Clinical Presentation | 1258 | ||
| Diagnostics | 1258 | ||
| 21 Evaluation and Management of Hematologic Disorders | 1278 | ||
| 237 Anemia | 1278 | ||
| Definition and Epidemiology | 1278 | ||
| Pathophysiology | 1278 | ||
| Red Blood Cell Production Disorders | 1278 | ||
| Red Blood Cell Destruction Disorders | 1278 | ||
| Blood Loss | 1278 | ||
| Clinical Presentation | 1278 | ||
| Physical Examination | 1279 | ||
| Diagnostics | 1279 | ||
| Differential Diagnosis | 1280 | ||
| Microcytic Anemia | 1280 | ||
| Iron Deficiency Anemia | 1280 | ||
| Pathophysiology | 1280 | ||
| Clinical Presentation | 1281 | ||
| Physical Examination | 1281 | ||
| Diagnostics | 1281 | ||
| Differential Diagnosis | 1282 | ||
| Management | 1282 | ||
| Life Span Considerations | 1283 | ||
| Complications | 1283 | ||
| Indications for Referral or Hospitalization | 1283 | ||
| Patient and Family Education | 1283 | ||
| Health Promotion | 1283 | ||
| Thalassemia | 1284 | ||
| Definition and Epidemiology | 1284 | ||
| Pathophysiology | 1284 | ||
| Clinical Presentation | 1285 | ||
| Physical Examination | 1285 | ||
| Diagnostics | 1285 | ||
| Differential Diagnosis | 1285 | ||
| Management | 1285 | ||
| Life Span Considerations | 1286 | ||
| Complications | 1286 | ||
| Indications for Referral or Hospitalization | 1287 | ||
| Patient and Family Education | 1287 | ||
| Health Promotion | 1287 | ||
| Macrocytic Anemia: Megaloblastic Anemia | 1287 | ||
| Vitamin B12 and Folate Deficiency | 1287 | ||
| Definition and Epidemiology | 1287 | ||
| Pathophysiology | 1287 | ||
| Clinical Presentation | 1288 | ||
| Physical Examination | 1288 | ||
| Diagnostics | 1288 | ||
| Differential Diagnosis | 1288 | ||
| Management | 1289 | ||
| Life Span Considerations | 1289 | ||
| Complications | 1289 | ||
| Indications for Referral or Hospitalization | 1289 | ||
| Patient and Family Education | 1289 | ||
| Health Promotion | 1290 | ||
| Normocytic Anemia | 1290 | ||
| Sickle Cell Disease | 1290 | ||
| Definition and Epidemiology | 1290 | ||
| Pathophysiology | 1290 | ||
| Clinical Presentation | 1290 | ||
| Physical Examination | 1290 | ||
| Diagnostics | 1290 | ||
| Differential Diagnosis | 1290 | ||
| Management | 1290 | ||
| Life Span Considerations | 1291 | ||
| Complications | 1292 | ||
| Indications for Referral or Hospitalization | 1293 | ||
| Patient and Family Education | 1293 | ||
| Health Promotion | 1293 | ||
| Anemia of Chronic Disease | 1293 | ||
| Definition and Epidemiology | 1293 | ||
| Pathophysiology | 1293 | ||
| Clinical Presentation | 1294 | ||
| Physical Examination | 1294 | ||
| Diagnostics | 1294 | ||
| Differential Diagnosis | 1294 | ||
| Management | 1294 | ||
| Complications | 1294 | ||
| Indications for Referral or Hospitalization | 1294 | ||
| Patient and Family Education | 1294 | ||
| Aplastic Anemia | 1294 | ||
| Definition and Epidemiology | 1294 | ||
| Pathophysiology | 1294 | ||
| Clinical Presentation | 1295 | ||
| Physical Examination | 1295 | ||
| Diagnostics | 1295 | ||
| Differential Diagnosis | 1295 | ||
| Management | 1295 | ||
| Life Span Considerations | 1295 | ||
| Complications | 1295 | ||
| Indications for Referral or Hospitalization | 1295 | ||
| Patient and Family Education and Health Promotion | 1295 | ||
| Hemolytic Anemia | 1295 | ||
| Definition and Epidemiology | 1295 | ||
| Pathophysiology | 1296 | ||
| Clinical Presentation | 1296 | ||
| Physical Examination | 1296 | ||
| Diagnostics | 1296 | ||
| Differential Diagnosis | 1297 | ||
| Management | 1297 | ||
| Life Span Considerations | 1297 | ||
| Complications | 1297 | ||
| Indications for Referral or Hospitalization | 1297 | ||
| Patient and Family Education | 1297 | ||
| References | 1297.e1 | ||
| 238 Blood Coagulation Disorders | 1297 | ||
| Definition and Epidemiology | 1297 | ||
| Bleeding Disorders (Coagulopathies) | 1298 | ||
| Pathophysiology and Clinical Presentation | 1298 | ||
| Physical Examination | 1298 | ||
| Diagnostics and Differential Diagnosis | 1298 | ||
| Management and Indications for Referral or Hospitalization | 1301 | ||
| Von Willebrand Disease | 1302 | ||
| Hemophilia | 1303 | ||
| Complications | 1303 | ||
| Patient Education and Life Span Considerations | 1303 | ||
| Thrombosis Disorders (Thrombophilia) | 1303 | ||
| Pathophysiology and Clinical Presentation | 1303 | ||
| Physical Examination | 1304 | ||
| Diagnostics and Differential Diagnosis | 1304 | ||
| Management | 1305 | ||
| Complications | 1306 | ||
| Indications for Referral or Hospitalization | 1306 | ||
| Life Span Considerations | 1307 | ||
| Patient and Family Education | 1307 | ||
| References | 1307.e1 | ||
| 239 Leukemias | 1307 | ||
| Definition and Epidemiology | 1307 | ||
| Pathophysiology | 1308 | ||
| Clinical Presentation and Physical Examination | 1308 | ||
| 22 Evaluation and Management of Oncologic Disorders | 1325 | ||
| 242 Collaborative Management of the Oncology Patient | 1325 | ||
| Cancer Risks | 1325 | ||
| Screening for Cancer | 1325 | ||
| Patient Management Issues | 1325 | ||
| Role of the Primary Health Care Provider | 1326 | ||
| References | 1326.e1 | ||
| 243 Basic Principles of Oncology Treatment | 1326 | ||
| Radiation Therapy | 1327 | ||
| External Beam Radiotherapy | 1327 | ||
| Computed Tomography Simulation and Its Role in Radiotherapy | 1327 | ||
| Fractionation | 1327 | ||
| Brachytherapy | 1327 | ||
| Radiation Treatment Side Effects | 1328 | ||
| Radiosurgery | 1328 | ||
| Summary | 1328 | ||
| Chemotherapy | 1328 | ||
| Carcinogenesis, Cellular Kinetics, and Chemotherapy | 1328 | ||
| Role of Chemotherapy in Oncology | 1328 | ||
| Response to Chemotherapy | 1329 | ||
| Treating the Cancer Patient Today and Tomorrow | 1330 | ||
| References | 1330.e1 | ||
| 244 Oncology Complications and Paraneoplastic Syndromes | 1330 | ||
| Superior Vena Cava Syndrome | 1330 | ||
| Definition and Epidemiology | 1330 | ||
| Pathophysiology | 1330 | ||
| Clinical Presentation and Physical Examination | 1330 | ||
| Diagnostics | 1330 | ||
| 23 Evaluation and Management of Mental Health Disorders | 1349 | ||
| 247 Anxiety Disorders | 1349 | ||
| Definition and Epidemiology | 1349 | ||
| Pathophysiology | 1349 | ||
| Clinical Presentation | 1350 | ||
| Physical Examination | 1351 | ||
| Diagnostics | 1351 | ||
| Management | 1351 | ||
| Complications | 1353 | ||
| Indications for Referral or Hospitalization | 1353 | ||
| Life Span Considerations | 1354 | ||
| Education and Health Promotion | 1354 | ||
| References | 1354.e1 | ||
| 248 Mood Disorders | 1354 | ||
| Grief and Bereavement | 1355 | ||
| Depressive Disorders | 1356 | ||
| Definition and Epidemiology | 1356 | ||
| Pathophysiology | 1357 | ||
| Clinical Presentation | 1358 | ||
| Physical Examination | 1358 | ||
| Diagnostics | 1358 | ||
| Differential Diagnosis | 1359 | ||
| Management | 1359 | ||
| Life Span Considerations | 1363 | ||
| Complications | 1363 | ||
| Suicide | 1363 | ||
| Indications for Referral or Hospitalization | 1364 | ||
| Patient and Family Education | 1364 | ||
| Health Promotion | 1364 | ||
| Bipolar Disorders | 1364 | ||
| Definition and Epidemiology | 1364 | ||
| Pathophysiology | 1365 | ||
| Clinical Presentation | 1365 | ||
| Physical Examination | 1365 | ||
| Diagnostics | 1366 | ||
| Differential Diagnosis | 1366 | ||
| Management | 1366 | ||
| Life Span Considerations | 1366 | ||
| Complications | 1368 | ||
| Indications for Referral or Hospitalization | 1369 | ||
| Patient and Family Education | 1369 | ||
| References | 1369.e1 | ||
| 249 Substance Use Disorders | 1369 | ||
| Definition and Epidemiology | 1369 | ||
| Pathophysiology | 1370 | ||
| Major Drugs of Abuse | 1370 | ||
| Central Nervous System Sedatives. | 1370 | ||
| Opioids. | 1371 | ||
| Central Nervous System Stimulants. | 1372 | ||
| Psychotomimetics and Hallucinogens. | 1373 | ||
| Inhalants. | 1373 | ||
| Anabolic Steroids. | 1373 | ||
| Injection Drug Use | 1373 | ||
| Clinical Presentation and Physical Examination | 1374 | ||
| Diagnostics | 1375 | ||
| Management | 1375 | ||
| Indications for Referral or Hospitalization | 1376 | ||
| References | 1377.e1 | ||
| 250 Other Mental Health Disorders | 1377 | ||
| Definition and Epidemiology | 1377 | ||
| Pathophysiology | 1377 | ||
| Clinical Presentation | 1378 | ||
| Positive Symptoms | 1378 | ||
| Negative Symptoms | 1378 | ||
| Cognitive Symptoms | 1378 | ||
| Physical Examination | 1378 | ||
| Diagnostics | 1378 | ||
| Differential Diagnosis | 1379 | ||
| Management | 1379 | ||
| Interdisciplinary Management | 1380 | ||
| Complications | 1381 | ||
| Indications for Referral or Hospitalization | 1381 | ||
| Patient and Family Education | 1381 | ||
| Health Promotion | 1381 | ||
| References | 1381 | ||
| References | 1381.e1 | ||
| Index | 1383 | ||
| A | 1383 | ||
| B | 1387 | ||
| C | 1389 | ||
| D | 1393 | ||
| E | 1395 | ||
| F | 1398 | ||
| G | 1399 | ||
| H | 1400 | ||
| I | 1404 | ||
| J | 1406 | ||
| K | 1406 | ||
| L | 1406 | ||
| M | 1408 | ||
| N | 1410 | ||
| O | 1412 | ||
| P | 1413 | ||
| Q | 1417 | ||
| R | 1418 | ||
| S | 1420 | ||
| T | 1423 | ||
| U | 1425 | ||
| V | 1425 | ||
| W | 1427 | ||
| X | 1427 | ||
| Y | 1427 | ||
| Z | 1427 | ||
| Inside Back Cover | ibc1 |