Primary Care Medicine Office Evaluation and Management of the Adult Patient

by Goroll, Allan H.; Mulley, Albert G.

• ISBN13: 9780781712484
• ISBN10: 0781712483
• Edition: 4th
• Format: Hardcover
• Copyright: 2000-08-28
• Publisher: LWW

Summary

This easy-to-use reference helps practitioners quickly diagnose common skin disorders and determine appropriate treatment options. More than 500 fullcolor images speed diagnosis by showing the reader distinguishing characteristics of each disorder, as well as providing clear comparisons between similar looking conditions. Features of the text include fornulary tables of leading topical agents and preparations by brand name, as well as patient handouts in English and Spanish. Basic derm rologic procedures are presented in a simple, easyto-understand format, making this guide an invaluable reference for office surgery. The Second Edition features new, larger photos, more patient handouts, and new material on several disorders. Also included is an expanded basic procedures section with new and more detailed procedures and more illustrations and photos of necessary equipment.

Table of Contents

Contributors	xiii
Preface	xix
Acknowledgments	xxi
Principles of Primary Care	1	(36)
The Practice of Primary Care
The Tasks of Primary Care	1	(4)
John D. Stoeckle
Appendix: Approaches to Encouraging Compliance	5	(1)
Approaches to Common Ethical and Legal Issues in Primary Care Practice	6	(3)
Linda L. Emanuel
Selection and Interpretation of diagnostic Tests	9	(5)
Health Maintenance and the Role of Screening	14	(3)
Estimating and Communicating Risk and Prognosis	17	(2)
Choosing among Treatment Options	19	(2)
Immunization	21	(16)
Edward T. Ryan
Systemic Problems	37	(43)
Screening for HIV-1 Infection	37	(4)
Stephen L. Boswell
Evaluation of Chronic Fatigue	41	(6)
Evaluation of Weight Loss	47	(4)
Evaluation of Overweight and Obesity	51	(6)
Evaluation of Fever	57	(6)
Harvey B. Simon
Evaluation of Lymphadenopathy	63	(4)
Harvey B. Simon
Approach to the patient with HIV-1 Infection	67	(13)
Stephen L. Boswell
Cardiovascular Problems	80	(177)
Screening for Hypertension	80	(3)
Katharine K. Treadway
Screening for Hyperlipidemia	83	(4)
Gale S. Haydock
Mason W. Freeman
Bacterial Endocarditis Prophylaxis	87	(3)
Rheumatic Fever Prophylaxis	90	(2)
Exercise for Prevention of Cardiovascular Disease	92	(9)
Harvey B. Simon
Evaluation of Hypertension	101	(7)
Katharine K. Treadway
Evaluation of Chest Pain	108	(12)
Evaluation of the Asymptomatic Systolic Murmur	120	(5)
Evaluation of Leg Edema	125	(4)
Evaluation of Arterial Insufficiency of the Lower Extremities	129	(4)
David C. Brewster
Evaluation of Syncope	133	(8)
Evaluation of Palpitations	141	(8)
Appendix: Evaluation of Atrial Fibrillation in the Outpatient Setting	146	(3)
Management of Hypertension	149	(15)
Katharine K. Treadway
Appendix: Coronary Heart Disease Risk Factor Prediction Chart	164	(1)
Approach to the Patient with Hypercholesterolemia	164	(15)
Mason W. Freeman
Outpatient Management of Atrial Fibrillation	179	(7)
Management of Ventricular Irritability in the Ambulatory Setting	186	(8)
Management of Chronic Stable Angina	194	(14)
Cardiovascular Rehabilitation and Secondary Prevention of Coronary Heart Disease	208	(7)
Management of chronic Congestive Heart Failure	215	(12)
Appendix: Potassium Supplementation in Congestive Heart Failure	225	(2)
Management of Valvular Heart Disease	227	(9)
Richard R. Liberthson
Appendix: Management of Hypertrophic Cardiomyopathy	236	(1)
Management of Peripheral Arterial Disease	236	(6)
David C. Brewster
Management of Peripheral Venous Disease	242	(7)
David C. Brewster
Stress Testing	249	(8)
Respiratory Problems	257	(100)
Screening for Lung Cancer	257	(2)
Tuberculosis Screening and Prophylaxis	259	(3)
Benjamin Davis
Harvey B. Simon
Evaluation and Prevention of Occupational and Environmental Respiratory Disease	262	(5)
L. Christine Oliver
John D. Stoeckle
Evaluation of Chronic Dyspnea	267	(4)
Evaluation of chronic Cough	271	(5)
Evaluation of Hemoptysis	276	(3)
Evaluation of Pleural Effusions	279	(5)
Evaluation of the Solitary Pulmonary Nodule	284	(4)
Evaluation of Clubbing	288	(2)
Approach to the Patient with Sleep Apnea	290	(3)
Management of Chronic Obstructive Pulmonary Disease	293	(11)
Management of Asthma	304	(12)
Management of Tuberculosis	316	(6)
Benjamin Davis
Harvey B. Simon
Management of the Common Cold	322	(4)
William A. Kormos
Management of Sarcoidosis	326	(7)
Appendix: Evaluation of Interstitial Lung Disease	330	(3)
Approach to the Patient with Acute Bronchitis or Pneumonia in the Ambulatory Setting	333	(9)
William A. Kormos
Approach to the Patient with Lung Cancer	342	(6)
Smoking Cessation	348	(9)
Nancy A. Rigotti
Gastrointestinal Problems	357	(149)
Screening for Gastric Cancer	357	(2)
Screening for Colorectal Cancer	359	(9)
Michael J. Barry
Appendix: Examination of the Anorectum and Sigmoid Colon with Digital Rectal Examination, Anoscopy, and Sigmoidoscopy	363	(5)
Lawrence S. Friedman
Prevention of Viral Hepatitis	368	(7)
Jules L. Dienstag
Evaluation of Abdominal Pain	375	(9)
James M. Richter
Evaluation of Nausea and Vomiting	384	(5)
Evaluation of Dysphagia and Suspected Esophageal Chest Pain	389	(5)
Approach to the Patient with Heartburn and Reflux (Gastroesophageal Reflux Disease)	394	(5)
James M. Richter
Evaluation of Jaundice	399	(5)
James M. Richter
Appendix: Evaluation of the Patient with an Incidental Asymptomatic Elevation in Serum Transaminase (Aminotransferase) Levels	403	(1)
Evaluation of Gastrointestinal Bleeding	404	(4)
James M. Richter
Evaluation and Management of Diarrhea	408	(12)
James M. Richter
Approach to the Patient with Constipation	420	(5)
James M. Richter
Approach to the Patient with Anorectal Complaints	425	(6)
Appendix: Management of Hemorrhoids	430	(1)
Approach to the Patient with an External Hernia	431	(3)
Management of Peptic Ulcer Disease	434	(13)
Management of Asymptomatic and Symptomatic Gallstones	447	(6)
Management of Hepatitis	453	(10)
Jules L. Dienstag
Management of Cirrhosis and Chronic Liver Failure	463	(7)
Management of Pancreatitis	470	(4)
James M. Richter
Management of Inflammatory Bowel Disease	474	(10)
James M. Richter
Approach to the Patient with Functional Gastrointestinal Disease	484	(9)
Management of Diverticular Disease	493	(3)
Management of Gastrointestinal Cancers	496	(10)
Hematologic and Oncologic Problems	506	(92)
Hematology	506	(1)
Screening for Anemia	506	(1)
Screening for Sickle Cell Disease and Sickle Cell Trait	507	(2)
Evaluation of Anemia	509	(9)
Evaluation of Erythrocytosis (Polycythemia)	518	(4)
Evaluation of Bleeding Problems and Abnormal Bleeding Studies	522	(9)
Management of Common Anemias	531	(5)
Outpatient Oral Anticoagulant Therapy	536	(5)
Elaine M. Hylek
Robert A. Hughes
Approach to the Patient with Lymphoma	541	(9)
Oncology	550	(1)
Approach to the Patient with Metastatic Tumor of Unknown Origin	550	(5)
Approach to Staging and Monitoring	555	(4)
Comprehensive Care of the Cancer Patient	559	(5)
Principles of Cancer Drug Therapy	564	(7)
Principles of Radiation Therapy	571	(5)
Thomas Delaney
Management of Chronic Cancer Pain and Palliative Care	576	(12)
Management of Chronic Cancer Pain	576	(7)
Linda A. King
J. Andrew Billings
Palliative Care	583	(5)
Eric L. Krakauer
Managing the Gastrointestinal complications of Cancer and Cancer Treatment	588	(5)
Complications of Cancer: Oncologic Emergencies and Paraneoplastic Syndromes	593	(5)
Endocrinologic Problems	598	(69)
Screening for Diabetes Mellitus	598	(3)
Screening for Thyroid Cancer	601	(3)
Evaluation of Thyroid Nodules	604	(5)
Approach to the Patient with Hypercalcemia	609	(5)
Samuel R. Nussbaum
Evaluation of Hypoglycemia	614	(5)
Evaluation of Hirsutism	619	(4)
Samuel R. Nussbaum
Evaluation of Gynecomastia	623	(2)
Evaluation Galactorrhea and Hyperprolactinemia	625	(3)
Evaluation of Suspected Diabetes Insipidus	628	(2)
Approach to the Patient with Diabetes Mellitus	630	(16)
Approach to the Patient with Hyperthyroidism	646	(8)
Approach to the Patient with Hypothyroidism	654	(6)
Glucocorticoid Therapy	660	(7)
Gynecologic Problems	667	(72)
Screening for Breast Cancer	667	(4)
Screening for Cervical Cancer	671	(3)
Screening for Ovarian Cancer	674	(2)
Screening for Endometrial Cancer	676	(2)
Vaginal Cancer and Other Effects of Diethylstilbestrol Exposure	678	(2)
Approach to the Woman with Abnormal Vaginal Bleeding	680	(5)
Evaluation of Secondary Amenorrhea	685	(6)
Evaluation of Breast Masses and Nipple Discharges	691	(2)
Evaluation of Vulvar Pruritus	693	(2)
Medical Evaluation of Female Sexual Dysfunction	695	(3)
Approach to the Patient with Menstrual or Pelvic Pain	698	(4)
Approach to the Patient with a Vaginal Discharge	702	(5)
Approach to the Menopausal Woman	707	(6)
Approach to Fertility Control	713	(8)
Nancy J. Gagliano
Susan Oliverio
Approach to the Infertile Couple	721	(6)
Approach to the Woman with an Unplanned Pregnancy	727	(3)
Management of Breast Cancer	730	(4)
Management of the Woman with Genital Tract Cancer	734	(5)
Genitourinary Problems	739	(82)
Screening for Syphilis	739	(2)
Benjamin Davis
Harvey B. Simon
Screening for Chlamydial Infection	741	(2)
Benjamin Davis
Screening for Prostate Cancer	743	(4)
Michael J. Barry
John D. Goodson
Screening for Asymptomatic Bacteriuria and Urinary Tract Infection	747	(2)
Screening for Cancers of the Lower Urinary Tract	749	(2)
Evaluation of the Patient with Hematuria	751	(3)
Leslie S.-T. Fang
Evaluation of the Patient with Proteinuria	754	(5)
Leslie S.-T. Fang
Evaluation of Scrotal Pain, Masses, and Swelling	759	(2)
Medical Evaluation and Management of Erectile Dysfunction	761	(9)
Approach to Dysuria and Urinary Tract Infections in Women	770	(6)
Leslie S.-T. Fang
Approach to Incontinence and Other Forms of Lower Urinary Tract Dysfunction	776	(6)
John D. Goodson
Approach to the Patient with Nephrolithiasis	782	(5)
Leslie S.-T. Fang
Approach to the Male Patient with Urethritis	787	(3)
John D. Goodson
Approach to the Patient with Gonorrhea	790	(4)
Benjamin Davis
Harvey B. Simon
Approach to Benign Prostatic Hyperplasia	794	(4)
Michael J. Barry
John D. Goodson
Management of Acute and Chronic Prostatitis	798	(4)
John D. Goodson
Management of Urinary Tract Infection in Men	802	(3)
Management of Syphilis and Other Sexually Transmitted Diseases	805	(3)
Benjamin Davis
Harvey B. Simon
Management of the Patient with Chronic Renal Failure	808	(5)
Leslie S.-T. Fang
Management of Genitourinary Cancers in Men	813	(8)
Musculoskeletal Problems	821	(110)
Screening for Osteoporosis	821	(2)
Evaluation of Acute Monoarticular Arthritis	823	(4)
Evaluation of Polyarticular Complaints	827	(8)
Evaluation of Back Pain	835	(9)
Evaluation of Neck Pain	844	(3)
Approach to the Patient with Muscle Cramps	847	(3)
Approach to the Patient with Shoulder Pain	850	(7)
Jesse B. Jupiter
David Ring
Evaluation of Hip Pain	857	(3)
Robert J. Boyd
Evaluation of Knee Pain	860	(4)
Approach to Minor Orthopedic Problems of the Elbow, Wrist, and Hand	864	(4)
Jesse B. Jupiter
David Ring
Approach to Minor Orthopedic Problems of the Foot and Ankle	868	(5)
Jesse B. Jupiter
David Ring
Approach to the Patient with Asymptomatic Hyperuricemia	873	(3)
Management of Rheumatoid Arthritis	876	(12)
Management of Osteoarthritis	888	(6)
Management of Gout	894	(5)
Approach to the Patient with Fibromyalgia	899	(4)
Approach to the Patient with Lyme Disease	903	(8)
Approach to the Patient with Polymyalgia Rheumatica or Temporal Arteritis	911	(4)
Management of Paget's Disease	915	(4)
Samuel R. Nussbaum
Approach to the Patient with Raynaud's Phenomenon	919	(3)
Prevention and Management of Osteoporosis	922	(9)
Neurologic Problems	931	(64)
Approach to the Patient with Headache	931	(10)
Amy A. Pruitt
Evaluation of Dizziness	941	(6)
Amy A. Pruitt
Focal Neurologic Complaints: Evaluation of Nerve Root and Peripheral Nerve Syndromes	947	(7)
Amy A. Pruitt
Evaluation of Tremor	954	(2)
Amy A. Pruitt
Evaluation of Dementia	956	(6)
Amy A. Pruitt
Approach to the Patient with a Seizure	962	(8)
Amy A. Pruitt
Management of Transient Ischemic Attack and Asymptomatic Carotid Bruit	970	(5)
Amy A Pruitt
Management of Multiple Sclerosis	975	(3)
Amy A. Pruitt
Management of Alzheimer's Disease and Related Dementias	978	(8)
M. Cornelia Cremens
Appendix: Use of Psychotropic Drugs in the Elderly	984	(2)
Michael A. Jenike
Approach to the Patient with Parkinson's Disease	986	(5)
Amy A. Pruitt
Management of Bell's Palsy (Idiopathic Facial Mononeuropathy)	991	(2)
Amy A. Pruitt
Management of Tic Douloureux (Trigeminal Neuralgia)	993	(2)
Amy A. Pruitt
Dermatologic Problems	995	(80)
Screening for Skin Cancers	995	(6)
Arthur J. Sober
Evaluation of Pruritus	1001	(4)
William V. R. Shellow
Evaluation of Purpura	1005	(3)
Evaluation of Disturbances in Pigmentation	1008	(3)
William V. R. Shellow
Evaluation of Urticaria and Angioedema	1011	(4)
Approach to the Patient with Hair Loss	1015	(4)
William V. R. Shellow
Disturbances of Skin Hydration: Dry Skin and Excessive Sweating	1019	(4)
William V. R. Shellow
Management of Dry Skin	1019	(2)
Approach to Excessive Sweating	1021	(2)
Approach to the Patient with Dermatitis	1023	(4)
William V. R. Shellow
Atopic or Contact Dermatitis	1023	(2)
Management of Seborrheic Dermatitis	1025	(2)
Management of Acne	1027	(3)
Paul J. Gethner
Management of Rosacea and Other Acneiform Dermatoses	1030	(3)
Alice Y. Liu
William V. R. Shellow
Management of Psoriasis	1033	(4)
Amber Owen
Nicholas J. Lowe
Management of Intertrigo and Intertriginous Dermatoses	1037	(2)
William V. R. Shellow
Management of Corns and Calluses	1039	(1)
William V. R. Shellow
Approach to Bacterial Skin Infections	1040	(5)
William V. R. Shellow
Cellulitis	1040	(2)
Management of Pyoderma	1042	(3)
Management of Superficial Fungal Infections	1045	(4)
William V. R. Shellow
Management of Cutaneous and Genital Herpes Simplex	1049	(5)
Management of Herpes Zoster	1054	(2)
Management of Warts	1056	(4)
William V. R. Shellow
Management of Scabies and Pediculosis	1060	(3)
Alice Y. Liu
William V. R. Shellow
Management of Skin Trauma: Bites and Burns	1063	(4)
Animal and Human Bites	1063	(2)
Ellie J. C. Goldstein
Management of Minor Burns	1065	(2)
Management of Skin Ulceration	1067	(8)
William V. R. Shellow
Appendix: Minor Surgical Office Procedures for Skin Problems	1070	(5)
Eric Kortz
Charles J. McCabe
Ophthalmic Problems	1075	(31)
Screening for Open-angle Glaucoma	1075	(1)
Claudia U. Richter
Evaluation of the Red Eye	1076	(5)
Roger F. Steinert
Evaluation of Impaired Vision	1081	(4)
Claudia U. Richter
Evaluation of Eye Pain	1085	(2)
Roger F. Steinert
Evaluation of Dry Eyes	1087	(2)
David A. Greenberg
Evaluation of Common Visual Disturbances: Flashing Lights, Floaters, and Other Transient Phenomena	1089	(2)
Claudia U. Richter
Evaluation of Exophthalmos	1091	(2)
Claudia U. Richter
Evaluation of Excessive Tearing	1093	(1)
Roger F. Steinert
Management of Patient with Age-Related Macular Degeneration	1094	(2)
Management of Glaucoma	1096	(2)
Claudia U. Richter
Management of Cataracts	1098	(2)
Roger F. Steinert
Management of Diabetic Retinopathy	1100	(3)
Claudia U. Richter
Correction of Vision	1103	(3)
Contact Lenses	1103	(1)
Elizabeth S. Gould
Refractive Surgery	1104	(2)
Roger F. Steinert
Elizabeth S. Gould
Ear, Nose and Throat Problems	1106	(41)
Screening for Oral Cancer	1106	(2)
John P. Kelly
Evaluation of Hearing Loss	1108	(4)
A. Julianna Gulya
Approach to Epistaxis	1112	(3)
William R. Wilson
Evaluation of Facial Pain and Swelling	1115	(2)
John P. Kelly
Evaluation of Smell and Taste Disturbances	1117	(3)
Approach to the Patient with Hoarseness	1120	(3)
William R. Wilson
Evaluation of Tinnitus	1123	(2)
A. Julianna Gulya
Approach to the Patient with Otitis	1125	(2)
A. Julianna Gulya
Approach to the Patient with Sinusitis	1127	(4)
William A. Kormos
Approach to the Patient with Pharyngitis	1131	(4)
William A. Kormos
Approach to the Patient with Hiccups	1135	(2)
Approach to the Patient with Chronic Nasal Congestion and Discharge	1137	(6)
Approach to the Patient with Excessive Snoring	1143	(1)
Management of Aphthous Stomatitis	1144	(1)
Management of Temporomandibular Joint Dysfunction	1145	(2)
Psychiatric and Behavioral Problems	1147	(80)
Approach to the Patient with Anxiety	1147	(10)
John J. Worthington III
Scott L. Rauch
Appendix: Strategies for Stress Management	1155	(2)
William E. Minichiello
Approach to the Patient with Depression	1157	(12)
John J. Worthington III
Scott L. Rauch
Approach to the Patient with Alcohol Abuse	1169	(9)
Eleanor Z. Hanna
Approach to the Patient with Sexual Dysfunction	1178	(5)
Linda C. Shafer
Approach to the Somatizing Patient	1183	(4)
Arthur J. Barsky III
Approach to the Angry Patient	1187	(1)
Arthur J. Barsky III
Approach to the Patient with Insomnia	1188	(5)
Jeffrey B. Weilburg
Management of Obesity	1193	(12)
Carolyn J. Crimmins-Hintlian
Approach to Eating Disorders	1205	(6)
Nancy A. Rigotti
Approach to the Substance-abusing Patient	1211	(6)
Patrick L. Lillard
Approach to the Patient with Chronic Nonmalignant Pain	1217	(10)
Todd E. Gorman
Appendix: Screening for Domestic Violence	1226	(1)
Allied Fields	1227	(10)
Alternative/Complementary Therapies: Evidence-Based Guides	1227	(6)
Ernie-Paul Barrette
Caring for the Adolescent Patient	1233	(4)
Lawrence J. Ronan
Index	1237