Primary Care Medicine Office Evaluation and Management of the Adult Patient

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

• ISBN13: 9780781748780
• ISBN10: 078174878X
• Edition: 5th
• Format: Hardcover
• Copyright: 2005-08-02
• Publisher: LWW

Summary

Completely updated for its Fifth Edition, this comprehensive text presents a practical approach to the office evaluation and management of every problem seen by primary care practitioners. In 239 problem-oriented chapters, the book provides essential information on medical diagnosis, lab tests, treatment options, and health maintenance and offers authoritative guidance on clinical decision-making. Every chapter of this edition ends with practical, bulleted Recommendations based on the best evidence, expert consensus guidelines, and clinical judgement. Annotated bibliographies in each chapter highlight the best available studies and analyses. This edition includes more Internet references and more evidence-based references that indicate evidence grades.

Table of Contents

Contributors	xiii
Preface	xix
Acknowledgments	xxi
Foreword to the First Edition	xxiii
Principles of Primary Care	1	(42)
The Practice of Primary Care	1	(11)
Part 1: The Tasks of Primary Care	1	(6)
John D. Stoeckle
Part 2: Approaches to Common Ethical and Legal Issues in Primary Care Practice	7	(3)
Linda L. Emanuel
Appendix: Approaches to Encouraging Adherence	10	(2)
Selection and Interpretation of Diagnostic Tests	12	(6)
Health Maintenance and the Role of Screening	18	(4)
Estimating and Communicating Risk and Prognosis	22	(3)
Choosing Among Treatment Options	25	(2)
Immunization	27	(16)
Edward T Ryan
Systemic Problems	43	(50)
Screening for HIV-1 Infection	43	(4)
Stephen Boswell
Evaluation of Chronic Fatigue	47	(7)
Evaluation of Weight Loss	54	(5)
Evaluation of Overweight and Obesity	59	(6)
Evaluation of Fever	65	(8)
Evaluation of Lymphadenopathy	73	(5)
Approach to the Patient with HIV Infection	78	(15)
Stephen L. Boswell
Cardiovascular Problems	93	(210)
Screening for Hypertension	93	(3)
Katharine K. Treadway
Screening for Hyperlipidemia	96	(6)
Gale S. Haydock
Mason W. Freeman
Bacterial Endocarditis Prophylaxis	102	(3)
Rheumatic Fever Prophylaxis	105	(3)
Exercise for Prevention of Cardiovascular Disease	108	(9)
Evaluation of Hypertension	117	(8)
Katharine K. Treadway
Evaluation of Chest Pain	125	(15)
Evaluation of the Asymptomatic Systolic Murmur	140	(6)
Evaluation of Leg Edema	146	(5)
Evaluation of Arterial Insufficiency of the Lower Extremities	151	(4)
David C. Brewster
Evaluation of Syncope	155	(9)
Evaluation of Palpitations	164	(11)
Appendix: Evaluation of Atrial Fibrillation in the Outpatient Setting	171	(4)
Management of Hypertension	175	(15)
Katharine K. Treadway
Appendix: Coronary Heart Disease Risk Factor Prediction Chart	190	(1)
Approach to the Patient with Hypercholesterolemia	190	(17)
Mason W. Freeman
Outpatient Management of Atrial Fibrillation	207	(9)
Management of Ventricular Irritability in the Ambulatory Setting	216	(9)
Management of Chronic Stable Angina	225	(15)
Cardiovascular Rehabilitation and Secondary Prevention of Coronary Heart Disease	240	(10)
Approach to the Patient with Congestive Heart Failure	250	(17)
Appendix: Potassium Supplementation in Congestive Heart Failure	266	(1)
Management of Valvular Heart Disease	267	(12)
Richard R. Liberthson
Appendix: Management of Hypertrophic Cardiomyopathy	277	(2)
Management of Peripheral Arterial Disease	279	(6)
David C. Brewster
Management of Peripheral Venous Disease	285	(9)
David C. Brewster
Stress Testing and Other Noninvasive Studies for Detection of Coronary Disease	294	(9)
Respiratory Problems	303	(110)
Screening for Lung Cancer	303	(3)
Tuberculosis Screening and Prophylaxis	306	(3)
Benjamin Davis
Evaluation and Prevention of Occupational and Environmental Respiratory Disease	309	(5)
L. Christine Oliver
John D. Stoeckle
Evaluation of Chronic Dyspnea	314	(6)
Evaluation of Subacute and Chronic Cough	320	(5)
Evaluation of Hemoptysis	325	(4)
Evaluation of Pleural Effusions	329	(5)
Evaluation of the Solitary Pulmonary Nodule	334	(4)
Evaluation of Clubbing	338	(2)
Approach to the Patient with Sleep Apnea	340	(5)
Management of Chronic Obstructive Pulmonary Disease	345	(12)
Management of Asthma	357	(14)
Management of Tuberculosis	371	(5)
Benjamin Davis
Management of the Common Cold	376	(4)
William A. Kormos
Management of Sarcoidosis	380	(8)
Appendix: Evaluation of Interstitial Lung Disease	384	(4)
Approach to the Patient with Acute Bronchitis or Pneumonia in the Ambulatory Setting	388	(10)
William A. Kormos
Approach to the Patient with Lung Cancer	398	(7)
Jeffrey W. Clark
Smoking Cessation	405	(8)
Nancy A. Rigotti
Gastrointestinal Problems	413	(166)
Screening for Gastric Cancer	413	(3)
Screening for Colorectal Cancer	416	(9)
Michael J. Barry
Appendix: Examination of the Anorectum and Sigmoid Colon with Digital Rectal Examination, Anoscopy, and Sigmoidoscopy	420	(5)
Lawrence S. Friedman
Prevention of Viral Hepatitis	425	(8)
Jules L. Dienstag
Evaluation of Abdominal Pain	433	(11)
James M. Richter
Evaluation of Nausea and Vomiting	444	(5)
Evaluation of Dysphagia and Suspected Esophageal Chest Pain	449	(6)
Approach to the Patient with Heartburn and Reflux (Gastroesophageal Reflux Disease)	455	(6)
Francis X. Campion
James M. Richter
Evaluation of Jaundice	461	(5)
James M. Richter
Appendix: Evaluation of the Patient with an Incidental Asymptomatic Elevation in Serum Aminotransferase (Transaminase) Levels	465	(1)
Evaluation of Gastrointestinal Bleeding	466	(5)
James M. Richter
Evaluation and Management of Diarrhea	471	(13)
James M. Richter
Approach to the Patient with Constipation	484	(5)
James M. Richter
Approach to the Patient with Anorectal Complaints	489	(7)
Appendix: Management of Hemorrhoids	495	(1)
Approach to the Patient with an External Hernia	496	(3)
Management of Peptic Ulcer Disease	499	(12)
Management of Asymptomatic and Symptomatic Gallstones	511	(6)
Management of Hepatitis	517	(12)
Jules L. Dienstag
Management of Cirrhosis and Chronic Liver Failure	529	(9)
Management of Pancreatitis	538	(4)
James M. Richter
Management of Inflammatory Bowel Disease	542	(10)
James M. Richter
Approach to the Patient with Functional Gastrointestinal Disease	552	(10)
Management of Diverticular Disease	562	(3)
Management of Gastrointestinal Cancers	565	(14)
Jeffrey W. Clark
Hematologic and Oncologic Problems	579	(100)
Screening for Anemia	579	(2)
Screening for Sickle Cell Disease and Sickle Cell Trait	581	(2)
Evaluation for Anemia	583	(9)
Evaluation of Erythrocytosis (Polycythemia)	592	(5)
Evaluation of Bleeding Problems and Abnormal Bleeding Studies	597	(9)
Management of Common Anemias	606	(6)
Outpatient Oral Anticoagulant Therapy	612	(6)
Elaine M. Hylek
Robert A. Hughes
Approach to the Patient with Lymphoma	618	(9)
Jeffrey W. Clark
Approach to the Patient with Metastatic Tumor of Unknown Origin	627	(5)
Jeffrey W. Clark
Approach to Staging and Monitoring	632	(5)
Jeffrey W. Clark
Comprehensive Care of the Cancer Patient	637	(6)
Jeffrey W. Clark
Principles of Cancer Chemotherapy	643	(7)
Jeffrey W. Clark
Principles of Radiation Therapy	650	(5)
Thomas Delaney
Management of Chronic Cancer Pain and Palliative Care	655	(13)
Part 1: Management of Chronic Cancer Pain	655	(8)
Linda A. King
J. Andrew Billings
Part 2: Palliative Care	663	(5)
Eric L. Krakauer
Managing the Gastrointestinal Complications of Cancer and Cancer Treatment	668	(5)
Jeffrey W. Clark
Complications of Cancer: Oncologic Emergencies and Paraneoplastic Syndromes	673	(6)
Jeffrey W. Clark
Endocrinologic Problems	679	(80)
Screening for Diabetes Mellitus	679	(4)
Screening for Thyroid Cancer	683	(2)
Evaluation of Thyroid Nodules	685	(6)
David M. Slovik
Approach to the Patient with Hypercalcemia	691	(6)
David M. Slovik
Evaluation of Hypoglycemia	697	(5)
David M. Slovik
Evaluation of Hirsutism	702	(5)
David M. Slovik
Appendix: Approach to an Incidentally Encountered Adrenal Mass	706	(1)
Evaluation of Gynecomastia	707	(4)
David M. Slovik
Evaluation of Galactorrhea and Hyperprolactinemia	711	(3)
David M. Slovik
Evaluation of Suspected Diabetes Insipidus	714	(3)
David M. Slovik
Approach to the Patient with Diabetes Mellitus	717	(18)
David M. Slovik
Approach to the Patient with Hyperthyroidism	735	(10)
David M. Slovik
Approach to the Patient with Hypothyroidism	745	(6)
David M. Slovik
Glucocorticoid Therapy	751	(8)
David M. Slovik
Gynecologic Problems	759	(88)
Screening for Breast Cancer	759	(5)
Screening for Cervical Cancer	764	(4)
Screening for Ovarian Cancer	768	(2)
Screening for Endometrial Cancer	770	(2)
Vaginal Cancer and Other Effects of Diethylstilbestrol Exposure	772	(2)
Approach to the Woman with Abnormal Vaginal Bleeding	774	(6)
Shana L. Birnbaum
Evaluation of Secondary Amenorrhea	780	(6)
Shana L. Birnbaum
Evaluation of Breast Masses and Nipple Discharges	786	(3)
Evaluation of Vulvar Pruritus	789	(3)
Shana L. Birnbaum
Medical Evaluation of Female Sexual Dysfunction	792	(4)
Shana L. Birnbaum
Approach to the Patient with Menstrual or Pelvic Pain	796	(5)
Shana L. Birnbaum
Approach to the Patient with a Vaginal Discharge	801	(6)
Shana L. Birnbaum
Approach to the Menopausal Woman	807	(7)
Shana L. Birnbaum
Approach to Fertility Control	814	(9)
Approach to the Infertile Couple	823	(7)
Shana L. Birnbaum
Approach to the Woman with an Unplanned Pregnancy	830	(5)
Shana L. Birnbaum
Management of Breast Cancer	835	(5)
Management of the Woman with Genital Tract Cancer	840	(7)
Genitourinary Problems	847	(92)
Screening for Syphilis	847	(2)
Screening for Chlamydial Infection	849	(3)
Benjamin Davis
Screening for Prostate Cancer	852	(4)
Michael J. Barry
Screening for Asymptomatic Bacteriuria and Urinary Tract Infection	856	(3)
Screening for Cancers of the Lower Urinary Tract	859	(2)
Evaluation of the Patient with Hematuria	861	(4)
Leslie S-T. Fang
Evaluation of the Patient with Proteinuria	865	(6)
Hasan Bazari
Evaluation of Scrotal Pain, Masses, and Swelling	871	(3)
Medical Evaluation and Management of Erectile Dysfunction	874	(9)
Approach to Dysuria and Urinary Tract Infections in Women	883	(6)
Leslie S -T. Fang
Approach to Incontinence and Other Forms of Lower Urinary Tract Dysfunction	889	(8)
John D. Goodson
Approach to the Patient with Nephrolithiasis	897	(5)
Leslie S.-T. Fang
Approach to the Male Patient with Urethritis	902	(4)
John D. Goodson
Approach to the Patient with Gonorrhea	906	(3)
Benjamin Davis
Approach to Benign Prostatic Hyperplasia	909	(5)
Michael J. Barry
Management of Acute and Chronic Prostatitis	914	(5)
John D Goodson
Appendix: Urine and Prostatic Fluid Collections in Men	918	(1)
Management of Urinary Tract Infection in Men	919	(3)
Management of Syphilis and Other Sexually Transmitted Diseases	922	(3)
Benjamin Davis
Management of the Patient with Chronic Kidney Disease	925	(6)
Hasan Bazari
Management of Genitourinary Cancers in Men	931	(8)
Musculoskeletal Problems	939	(138)
Screening for Osteoporosis in Postmenopausal Women	939	(3)
Appendix: Screening for Osteoporosis in Men	942	(1)
Evaluation of Acute Monoarticular Arthritis	942	(4)
Evaluation of Polyarticular Complaints	946	(9)
Evaluation of Back Pain	955	(15)
Evaluation of Neck Pain	970	(4)
Approach to the Patient with Muscle Cramps	974	(3)
Approach to the Patient with Shoulder Pain	977	(7)
Jesse B. Jupiter
David Ring
Evaluation of Hip Pain	984	(4)
Evaluation of Knee Pain	988	(11)
Approach to Minor Orthopedic Problems of the Elbow, Wrist, and Hand	999	(1)
Jesse B. Jupiter
David Ring
Approach to Common Problems of the Foot and Ankle	999	(6)
Christopher P. Chiodo
Jesse P. Jupiter
David Ring
Approach to the Patient with Asymptomatic Hyperuricemia	1005	(2)
Management of Rheumatoid Arthritis	1007	(15)
Management of Osteoarthritis	1022	(8)
Management of Gout	1030	(6)
Approach to the Patient with Fibromyalgia	1036	(7)
Approach to the Patient with Lyme Disease	1043	(8)
Approach to the Patient with Polymyalgia Rheumatica or Giant-Cell (Temporal) Arthritis	1051	(7)
Management of Paget's Disease	1058	(4)
David M. Slovik
Approach to the Patient with Raynaud's Phenomenon	1062	(4)
Prevention and Management of Osteoporosis	1066	(11)
Neurologic Problems	1077	(78)
Approach to the Patient with Headache	1077	(10)
Amy A. Pruitt
Evaluation of Dizziness	1087	(7)
Amy A. Pruitt
Focal Neurologic Complaints: Evaluation of Nerve Root and Peripheral Nerve Syndromes	1094	(7)
Amy A. Pruitt
Evaluation of Tremor	1101	(3)
Amy A. Pruitt
Evaluation of Dementia	1104	(8)
Amy A. Pruitt
Approach to the Patient with a Seizure	1112	(8)
Amy A. Pruitt
Management of Transient Ischemic Attack and Asymptomatic Carotid Bruit	1120	(6)
Amy A. Pruitt
Management of Multiple Sclerosis	1126	(5)
Amy A. Pruitt
Management of Alzheimer's Disease and Related Dementias	1131	(11)
M. Cornelia Cremens
Appendix: Use of Psychotropic Drugs in the Elderly	1140	(2)
Michael A. Jenike
Approach to the Patient with Parkinson's Disease	1142	(6)
Amy A. Pruitt
Approach to the Patient with Bell's Palsy (Idiopathic Facial Mononeuropathy)	1148	(3)
Amy A. Pruitt
Management of Tic Douloureux (Trigeminal Neuralgia)	1151	(4)
Amy A. Pruitt
Dermatologic Problems	1155	(90)
Screening for Skin Cancers	1155	(6)
Arthur J. Sober
Evaluation of Pruritus	1161	(5)
Adam M. Rotunda
William V.R. Shellow
Evaluation of Purpura	1166	(3)
Evaluation of Disturbances in Pigmentation	1169	(4)
Adam M. Rotunda
William V. R. Shellow
Evaluation of Urticaria and Angioedema	1173	(4)
Approach to the Patient with Hair Loss	1177	(5)
Adam M. Rotunda
William V. R. Shellow
Disturbances of Skin Hydration: Dry Skin and Excessive Sweating	1182	(4)
William V. R. Shellow
Part 1: Management of Dry Skin	1182	(2)
Part 2: Approach to Excessive Sweating	1184	(2)
Approach to the Patient with Dermatitis	1186	(5)
William V. R. Shellow
Part 1: Atopic or Contact Dermatitis	1186	(3)
Part 2: Management of Seborrheic Dermatitis	1189	(2)
Management of Acne	1191	(4)
Delphine J. Lee
William V. R. Shellow
Management of Rosacea and Other Acneiform Dermatoses	1195	(2)
Delphine J. Lee
William V. R. Shellow
Management of Psoriasis	1197	(6)
Delphine J. Lee
William V. R. Shellow
Management of Intertrigo and Intertriginous Dermatoses	1203	(2)
William V. R. Shellow
Management of Corns and Calluses	1205	(1)
William V. R. Shellow
Approach to Bacterial Skin Infections	1206	(5)
Noah Craft
William V. R. Shellow
Part 1: Cellulitis	1206	(3)
Part 2: Management of Pyoderma	1209	(2)
Management of Superficial Fungal Infections	1211	(5)
Noah Craft
William V. R. Shellow
Management of Cutaneous and Genital Herpes Simplex	1216	(6)
Management of Herpes Zoster	1222	(3)
Management of Warts	1225	(4)
Noah Craft
William V. R. Shellow
Management of Scabies and Pediculosis	1229	(3)
Noah Craft
William V. R. Shellow
Management of Skin Trauma: Bites and Burns	1232	(4)
Ellie J. C. Goldstein
Part 1: Animal and Human Bites	1232	(2)
Part 2: Management of Minor Burns	1234	(2)
Management of Skin Ulceration	1236	(9)
William V. R. Shellow
Appendix to Section 12: Minor Surgical Office Procedures for Skin Problems	1240	(5)
Eric Kortz
Charles J. McCabe
Ophthalmologic Problems	1245	(36)
Screening for Open-Angle Glaucoma	1245	(2)
Claudia U. Richter
Evaluation of the Red Eye	1247	(6)
Claudia U. Richter
Evaluation of Impaired Vision	1253	(3)
Claudia U. Richter
Evaluation of Eye Pain	1256	(3)
Claudia U. Richter
Evaluation of Dry Eyes	1259	(2)
Claudia U. Richter
Evaluation of Common Visual Disturbances: Flashing Lights, Floaters, and Other Transient Phenomena	1261	(2)
Claudia A Richter
Evaluation of Exophthalmos	1263	(2)
Claudia U. Richter
Evaluation of Excessive Tearing	1265	(1)
Claudia U. Richter
Management of the Patient with Age-Related Macular Degeneration	1266	(2)
Claudia U. Richter
Management of Glaucoma	1268	(3)
Claudia U. Richter
Management of Cataracts	1271	(3)
Claudia U. Richter
Management of Diabetic Retinopathy	1274	(3)
Claudia U. Richter
Correction of Vision	1277	(4)
Claudia U. Richter
Ear, Nose, and Throat Problems	1281	(48)
Screening for Oral Cancer	1281	(2)
John P. Kelly
Evaluation of Hearing Loss	1283	(5)
Neil Bhattacharyya
Appendix: Audiometry	1287	(1)
Approach to Epistaxis	1288	(3)
Neil Bhattacharyya
Evaluation of Facial Pain and Swelling	1291	(3)
John P. Kelly
Evaluation of Smell and Taste Disturbances	1294	(4)
Neil Bhattacharyya
Approach to the Patient with Hoarseness	1298	(4)
Neil Bhattacharyya
Evaluation of Tinnitus	1302	(1)
Neil Bhattacharyya
Approach to the Patient with Otitis	1303	(3)
Neil Bhattacharyya
Approach to the Patient with Sinusitis	1306	(4)
William A. Kormos
Approach to the Patient with Pharyngitis	1310	(5)
William A. Kormos
Approach to the Patient with Hiccups	1315	(2)
Approach to the Patient with Chronic Nasal Congestion and Discharge	1317	(7)
Neil Bhattacharyya
Approach to the Patient with Excessive Snoring	1324	(2)
Neil Bhattacharyya
Management of Aphthous Stomatitis	1326	(1)
Management of Temporomandibular Joint Dysfunction	1327	(2)
Psychiatric Problems	1329	(94)
Approach to the Patient with Anxiety	1329	(10)
John J. Worthington III
Scott L. Rauch
Appendix: Strategies for Stress Management	1338	(1)
William E. Minichiello
Approach to the Patient with Depression	1339	(15)
John J. Worthington III
Scott L. Rauch
Approach to the Patient with Alcohol Abuse	1354	(12)
Eleanor Z. Hanna
Michael Bierer
Approach to the Patient with Sexual Dysfunction	1366	(5)
Linda C. Shafer
Approach to the Somatizing Patient	1371	(5)
Arthur J. Barsky III
Approach to the Angry Patient	1376	(2)
Arthur J. Barsky III
Approach to the Patient with Insomnia	1378	(6)
Jeffrey B. Weilburg
Management of Obesity	1384	(13)
Carolyn Crimmins Hintlian
Approach to Eating Disorders	1397	(7)
Nancy A. Rigotti
Approach to the Substance Abuse and Dependence	1404	(8)
Patrick L. Lillard
Appendix: Adult Attention-Deficit/Hyperactivity Disorder (AD/HD)	1410	(2)
Approach to the Patient with Chronic Nonmalignant Pain	1412	(11)
Appendix: Screening for Domestic Violence	1421	(2)
Allied Fields	1423
Herbal Supplements Commonly Used as Complementary or Alternative Therapy	1423	(6)
Ernie-Paul Barrette
Caring for the Adolescent Patient	1429	(5)
Laurence J. Ronan
Approach to Frailty in Older Adults	1434
Claus Hamann
Kenneth L. Minaker