Appendix I: Chronology of the Evolution of Family Practice as a Specialty in the United States

Robert B. Taylor

Year Event Significance 1900 At least 80% of American physicians were General practice was the predominant model of general practitioners: one general practitioner medical care. for every 600 people.

1910 Publication of the Flexner Report by the Prompted changes in methods and quality of Carnegie Foundation with cooperation of the medical education: premedical education, American Medical Association (AMA). biomedical research, and postgraduate training.

1940 Generalists comprised 76% of private medical Decline of general ism paralleled the rise of specialty practitioners. practice. 1950-62% of practitioners were generalists 1960-45% of practitioners were generalists 1970-21 % of practitioners were generalists AMA petitioned to approve a general practice Request refused. specialty board.

1941 General Practice Certifying Board proposed at First call for a certifying board for general ists. AMA House of Delegates.

1946 Section on General Practice of the AMA An early organization of generalists with nationwide organized. representation.

1947 American Academy of General Practice (MGP) First major medical organization to require founded. continuing medical education as a condition of membership.

1950 First residency training programs in general Signified need for postgraduate generalist training practice established. beyond the internship year. Publication of journal GP. First scientific journal for generalists.

1958 Family Health Foundation of America Early funding for conferences on family medicine incorporated. education. 1154 Robert B. Taylor

Year Event Significance

1960 American Board of General Practice formed. First effort to obtain general practice board status.

1964 19% of U.S. medical graduates entered general Continued decline in numbers of general practice. practitioners. American Board of Family Practice Advisory Developed objectives for the American Board of Group formed. Family Practice (1969).

1965 National Family Health Conference sponsored Studied unmet needs of American family for by Family Health Foundation of America. comprehensive health care, what practitioner can meet this need, and how he or she can best be trained.

1966 Report of Citizens' Commission on Graduate Identified fragmentation in health care and proposed Medical Education: The Graduate Education concept of a "primary physician." of Physicians (Millis Commission Report). Report of the Ad Hoc Committee on Education Recommended training of a "family physician." for Family Practice of the Council on Medical Education: Meeting the Challenge of Family Practice (Willard Commission Report).

1967 Formation of Society of Teachers of Family First organization of family medicine educators. Medicine (STFM).

1968 STFM published Family Medicine Teacher First publication (newsletter) for family medicine (FMT). educators. American Board of Family Practice (ABFP) Organized as official certifying board for the new founded. specialty.

1969 Recognition of family practice as a The 20th American medical specialty. specialty February 6, 1969, based on approval of the Liaison Committee for Specialty Boards. Fifteen approved family practice residencies Model graduate training programs established. in the U.S.

1970 First examination by ABFP. Successful candidates sitting for 1970 and 1971 examinations became charter diplomates.

1971 American Academy of General Practice changed The Academy recognized shift in emphasis to family its name to American Academy of Family practice. Physicians (AAFP).

1972 AAFP fellowships first awarded. Recognized "interest and participation in special educational programs designed to enhance professional competence and the quality of health care provided to the people of America." First meeting of North American Primary Care Forum for presentation of fami Iy practice research Research Group (NAPCRG). resu Its.

1973 Publication of Family Practice (Conn, Rakel, First major family practice textbook. Johnson editors). First National Conference of Family Practice First national meeting of family practice trainees. Residents and Student Members. Appendix I: Chronology of the Evolution of Family Practice as a Specialty in the United States 1155

Year Event Sign ificance 1974 Journal of Family Practice began publication. First family practice peer-reviewed journal.

1975 Residency Assistance Program (RAP) initiated. Family medicine educators develop guidelines and offer consultation to family practice residency training programs.

1976 First recertification examination by ABFP. First recertification examination by any medical specialty. Publication of the Virginia Study in the Journal First major report of doctor-patient contacts in of Family Practice. family practice.

1977 Doctors Ought to Care (DOC) founded. Championed positive health strategies for the clinic, classroom, and community.

1978 Publication of Family Medicine: Principles Second major family practice textbook. and Practice, 1st edition (Taylor, editor; Buckingham, Donatelle, Jacott, Rosen, associate editors).

Practice eligible route to ABFP certification Candidates for the ABFP certification examination expired. subsequently must have satisfactorily completed a 3-year approved family practice residency. Association of Departments of Family Medicine First organization of family medicine academic established. units.

1979 End of first decade as a specialty. Continuing growth of the speciality. Residency training programs = 364 FP residents in training = 6,531 Members of AAFP = 43,956 Diplomates of ABFP = 22,246

1980 26% of active allopathic practitioners were Beginning upward trend in number of generalists. generalists. Graduate Medical Education National Advisory "Near balance" of general practitioners/family Committee (GMENAC) report published. physicians vs. need was predicted for 1990; no change recommended for family practice residencies.

1981 Family Medicine Teacher became Family Conversion of FMT newsletter to an academic Medicine. journal. Family Practice Research Journal began Third academic journal in family practice. publ ication.

1982 Report of the Study Group on Family Medicine Documented past achievements and current status; Research: Meeting the Challenge of Research indicated future directions in family medicine in Family Medicine. research.

1983 Publication of Family Medicine: Principles Principles and practice of discipline integrated as and Practice, 2nd edition (Taylor, editor; "Family Medicine Content." Buckingham, Donatelle, Jacott, Rosen, associate ed itors).

1984 Conjoint meeting of STFM and NAPCRG. First joint assembly of family medicine educators and researchers. 1156 Robert B. Taylor

Year Event Sign ificance 1985 Liaison Committee on Medical Education Official recognition of need for medical schools to (LCME) report Functions and Structure of a present family medicine knowledge, skills, Medical School called for predoctoral training attitudes and behaviors. "necessary to enter graduate medical education programs in family medicine ...."

1986 Family Practice redefined by AAFP and ABFP. New definition affirms independence from other specialties. More than 20,000 physicians have been Record number of residency trained family graduated from 3-year family practice physicians. residenc ies. "Michigan lawsuit" won in United States Successful challenge of a Medicare statute that Supreme Court after 10-year battle. discriminated against family physicians on basis of different fees for the same procedure.

1987 First Leadership Skills Development Conference Emphasis on enhancing the skills of family physician held by the AAFP. leaders.

1988 Journal of the American Board of Family Practice Fourth U.S. academic journal in the specialty. begins publication. More than half of all MFP members are certified Predominant practitioner has become board-certified by ABFP (26,500 ABFP diplomates). family physician. First examination for Certificate of Added Joint venture of American Board of Family Practice Qualifications (CAQ) in Geriatric Medicine. and American Board of Internal Medicine. Publication of Family Medicine: Principles and Core problems and procedures in family medicine Practice, 3rd edition. (Taylor, editor; identified. Buckingham, Donatelle, Johnson, Scherger, associate editors).

1989 Anniversary of 20 years as a specialty: 384 Family medicine entered third decade as residency residency training programs, 7392 FP trained physicians began to assume leadership residents in training. roles. New active members of AAFP must be residency Affirmed the distinction between family physicians trained family physicians. and general practitioners and others.

1990 Association of Family Practice Residency First organization of directors of family practice Directors formed. residenc ies. President Bush signed into law Medicare Projected Medicare payment to be based on Physician Payment Reform based on Resource resource costs integral to providing a service. Based Relative Value Scale (RBRVS). AMA adopted policy that every U.S. medical Recognition of need for medical student exposure to school should have a family practice family medicine content and family physician role department. models. 33% of active allopathic physicians were Increasing trend toward general ist practice. general ists.

1991 AMA resolved "to develop recommendations for Evidence of AMA support of family practice and adequate reimbursement of primary care primary care. physicians, improved recruitment of medical school graduates, and training a sufficient number of primary care physicians to meet projected national needs."

1992 Medicare physician payment reform began. Beginning phase-in Medicare fee schedule; eliminating specialty differentials. Appendix I: Chronology of the Evolution of Family Practice as a Specialty in the United States 1157

Year Event Significance 1992 Council on Graduate Medical Education Recognition that medical schools must meet health (cont) (COG ME) recommended that half of all care needs of the nation. medical school graduates enter primary care careers. Archives of Family Practice began publication. AMA affirmed value of family medicine research through support of a new specialty journal.

1993 First examination for CAQ in Sports Medicine for Joint venture of the American Boards of Family primary care physicians. Practice, Emergency Medicine, Internal Medicine and Pediatrics. Liaison Committee on Medical Education Family medicine achieved parity with other document "Functions and Structure of a specialties in requirements for the medical school Medical School" now reads: "Clinical curriculum. education programs involving patients should include disciplines such as family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery." Number of family practice residencies exceeded New residencies included inner city, rural and 400. health maintenance organizations.

1994 Publication of Family Medicine: Principles and Emphasis on core problems in clinical family Practice, 4th edition (Taylor, editor; David, medicine. Johnson, Phillips, Scherger, associate editors). End of practice pathway to CAQ in Geriatric Candidates must complete formal accredited Medicine. geriatric fellowship program.

1995 15.4% of U.S. medical school seniors matched Fourth consecutive year for an increase in family in family practice and 87.1 % of family practice positions filled through the National practice residency positions filled through the Resident Matching Program (NRMP). National Residency Matching Program. American Boards of Family Practice and Internal Indicated trend for family physicians to teach our Medicine called for educational resource knowledge and skills to other specialists. sharing and collaborative training.

1996 Publication of Fundamentals of Family Medicine First predoctoral clerkship textbook based on health (Taylor, editor; David, Johnson, Phillips, problems of a single extended family. Scherger, associate editors). Number of U.S. medical school seniors choosing Continued increase in students choosing careers in family practice and number of family practice family practice. positions filled through the NRMP both highest in history. Alaska's first graduate medical education Family practice became the first specialty to program was a family practice residency. have residency programs establ ished in all 50 states.

1997 Fiftieth anniversary of the AAGP/AAFP. Fifty years since 1947 founding of AAGP in Kansas City, Missouri. Number of U.S. family practice residencies Largest number of family practice residencies in increased to 463. history. Revised Program Requirements for Residency Changes reflect the evolution of the discipline by no Education in Family Practice. longer defining training elements as derivatives of other specialties and emphasizing the use of family physician teachers. 1158 Robert B. Taylor

Year Event Significance 1998 Publication of Family Medicine: Principles and Expanded emphasis on clinical problems in Practice, 5th edition (Taylor, editor; David, generalist health care. Johnson, Phillips, Scherger, associate editors) and Fundamentals of Family Medicine as the family medicine clerkship textbook.

1999 Practice pathway to CAQ in Sports Medicine One-year sports medicine fellowship required for ends. eligibility. Append ix II: Recommended Book List

The following is the list of recommended books for family Kansas City, Missouri 64114 practice library collections. This core library is adapted, Telephone: 1-800-274-2237, extension 4400 with permission, from a longer list prepared by the Amer­ FAX: 816-822-0907 ican Academy of Family Physicians Foundation Library e-mail: [email protected] and is intended to be helpful for developing residency and private practice library collections. The complete list Cunningham FG, et ai, editors. Williams' obstetrics, 20th ed. contains a large number of books in 45 categories. The Norwalk, CT: Appleton & Lange, 1997. AAFP Foundation Library has ranked these books accord­ Dorland's illustrated medical dictionary, 28th ed. Philadelphia: Saunders, 1994. ing to one star, two stars, three stars, and four stars. Books Hazzard WR, et ai, editors. Principles of geriatric medicine and with four and three stars are, respectively, first and second gerontology, 3rd ed. New York: McGraw-Hill, 1994. purchase items, and a current estimate of the cost of all three Hurst JW, et ai, editors. The heart: arteries and veins, 8th ed. and four star items on the list is about $1100. Many physi­ New York: McGraw-Hill, 1994. cians become familiar with these recommended books and Isselbacher KJ, editor. Harrison's principles of internal medicine, 14th ed. New York: McGraw-Hill, 1997. purchase each new edition as it is published. Kaplan HI, Sa dock BJ, editors. Comprehensive textbook of psy­ The three and four star books are listed below. A full copy of chiatry, 6th ed. Baltimore: Williams & Wilkins, 1995. the recommended book list can be obtained by contacting: Sauer Gc. Manual of skin diseases, 7th ed. Philadelphia: lip­ David W. Wright, M.L.S. pincott, 1996. Research Librarian, Huffington Library Taylor RB, editor. Family medicine: principles and practice, 5th ed. New York: Springer-Verlag, 1998. American Academy of Family Physicians Foundation Tierney LM Jr, et ai, editors. Current medical diagnosis and 8880 Ward Parkway treatment, 36th ed. Norwalk, CT: Appleton & Lange, 1997. Index

ABC model, 708 Acquired immunodeficiency syndrome Acute inflammatory demyelinating ABCDE rule, 1046 (AIDS), see AIDS entries; Human polyradiculoneuropathy, see Abdomen immunodeficiency virus Guillain-Barre syndrome aortic aneurysm of, 954-955 Acquired neutropenia, 1121 Acute inflammatory otitis externa, 622 neonatal abnormalities of, 153 Acquired polycystic kidney disease, 848, Acute labyrinthitis, 474 pain in, 801-802 850-851 Acute lacerations, 421-433 trauma to, 804 Acrallentiginous melanoma, 1046 across a landmark, 429 Ablative therapy, 667 Acrochordon, 1041 anesthesia for, 423-424 Abscesses, 1030 Acromioclavicular (AC) joint beveled, 429 anorectal, 790-791 arthritis of, 963-964 complex, 430 Bartholin's, 791 dislocations of, 963 postrepair management, 432 brain, 585-586 separation of, 459-460 sedation and, 424 wound closure in, 427-427 peritonsillar, 340 ACTG (AIDS Clinical Trials Group) wound healing in, 421 Absence spells, 549, 551 Protocol, 75-76, 150, 151 wound preparation in, 425-426 Absolute volume depletion, 829, 830 Actinic keratosis (AK), 1042-1043 Acute mountain sickness (AMS), 70-71 Acarbose, 1073-1074 Actinomycotic pelvic inflammatory Acute otitis externa (AOE), 622 Accidents, 7 disease (PID), 881 Acute otitis media (AOM) Accupril (quinapril), 644, 700 Activated charcoal, 418 in adults, 620-621 Accutane (isotretinoin), 77, 1017, Active phase of labor, 123 in children, 616-620 1023 Activities of daily living (ADLs), 233, recurrent, 620 ACE inhibitors, see Angiotensin- 258,395,554 Acute pain, 231 converting enzyme inhibitors Acular (ketorolac), 318,1008 Acute pancreatitis, 774-776 Acupuncture, 631 Acebutolol, 644, 668 Acute Physiology and Chronic Health Acute acquired toxoplasmosis, 372, 374 Acetaldehyde, 509 Evaluation (APACHE) grading Acetaminophen Acute alcoholic hepatitis, 784-785 system, 775, 776 hepatitis and, 785-786 Acute angle-closure glaucoma, 593, 599, Acute renal failure (ARF), 844-847 poisoning with, 409-411 612-613 postrenal, 845 Acetazolamide (Diamox), 71 Acute bacterial meningitis, 583 prerenal, 844-845 N-Acetylcysteine (NAC), 410-411 Acute bacterial prostatitis, 853 renal, 845 Achilles tendon rupture, 982 Acute blood loss, 1111 Acute respiratory distress syndrome Acid-base disorders, 825-842 Acute cervical swelling, 166-168 (ARDS), 752-753 differential diagnosis, 825-829 Acute cystitis, 819 Acute rheumatic fever (ARF), 340, mixed,841-842 Acute epiglottitis, 163, 164-165 722-723 ACLS (advanced cardiopulmonary life Acute glomerulonephritis, 340 Acute sinusitis, 337-338 support),435-436 Acute gout, 1095-1096 Acute suppurative parotitis, 634-635 Acne rosacea, 1022-1023 Acute heart failure, 693-695 Acute thyroiditis, 1082 Acne vulgaris, 1016-1017 Acute idiopathic brachial neuropathy, Acute urethritis, 819 Acoustic trauma, 402 576 Acute viral hepatitis, 780-782 1162 Index

Acyclovir, 327, 353, 360, 361, 1033-1034, Age, see also Aging; specific age groups pharmacotherapy for, 515-516 1044 alcoholism and, 507-508 physiology of, 509 Addison's disease, 1105 endometrial hyperplasia and cancer and, prevalence of, 507 Adenosine, 653, 669 920 prevention of, 517 Adenoviruses, 330 suicide and, 293-294 rehabilitation and, 516 ADH, see Antidiuretic hormone Agency for Health Care Policy and supportive therapy during withdrawal, Adhesive capsulitis, 966 Research (AHCPR), 58, 390, 1129 513 Adhesives, 432 Agency for Toxic Substances and withdrawal syndrome in, 515 Adipex-P (phentermine hydrochloride), Disease Registry (ATSDR), 388 ALDH2,509 469 Aging, 6-12 Allergic conjunctivitis, 593, 596 Adolescents, 207-217 Agoraphobia, 274-276 Allergic contact dermatitis, 393-395, alcoholism in, 507 AHCPR (Agency for Health Care Policy 1024-1025 clinical prevention for, 44 and Research), 58, 390, 1129 Allergic rhinitis, 314-318 concerns about growth and AIDS, see also Human immunodeficiency Allergies development in, 208-211 virus food,811-812 depression in, 214 AIDS Clinical Trials Group (ACTG) latex, 393 description of developmental stage, 8 Protocol, 75-76, 150, 151 Alloimmune neutropenia, 1122 developmental tasks of, 220-221 AIDS-dementia complex, 239, 364, 585 Allopurinol, 1096, 1097 disabilities in, 223 Air pollution, 728 Alomide (lodoxamide), 318 drug abuse in, 215-217 Airplane glue, 524 Alopecia, 1053-1055 eating disorders in, 213-214 Akathisia, 312 Alopecia areata, 1054 growth and somatic changes in, 208 Alaska natives, 45 a-blockers, 855,1070 health care maintenance for, 211 Albuterol,446 arblockers, 644,647 homeless, 222 Aldactone (spironolactone), 645, 700 a-fetoprotein (AFP), 786 homosexual and lesbian, 221-222 Alcohol, defined, 508 maternal, 87, 139, 142 informed consent for parents of, 226 Alcohol abuse Alprazolam (Xanax), 276 legal and ethical considerations when defined, 508 Alzheimer's disease, 237-242 treating, 217 diagnosis of, 511 catastrophic reactions in, 241 nutrition and, 212-213 on the job, 393 causes of, 239-240 as parents, 161 physical findings in, 216 Down syndrome and, 140, 200 physical and hormonal development of, Alcohol dependence drug tratment for, 240 219-20 defined,508 elder abuse and, 256 physical examination of, 212 diagnosis of, 511 familial, 239 psychological development tasks of, 211 Alcohol-drug interactions, 508 families and, 241, 242 resources for sexuality education for, 226 Alcohol-related dementia, 239, 510 laboratory evaluation of, 238 sexual concerns of, 219-226 Alcohol use special care units for patients, 241 sexual intercourse risks and, 222 acute pancreatitis and, 774 sporadic, 239 sexuality issues in, 502, 505 breast-feeding and, 154 wandering in, 241 somatization in, 301-302 chronic pancreatitis and, 776 Amantadine (Symmetrel), 332, 567 suicide in, 214-215 colorectal cancer and, 797 Amaurosis fugax, 610-611 Adoption studies, 509 domestic violence and, 251-252 Ambien (zolpidem), 484, 1007 Adrenal dysfunction, 363-364, 1105-1106 infants and, 161 Amblyomma cajennense, 382 Adrenarche, 1101 osteoporosis and, 1088, 1091 Amblyopia, 613 Adrenocortical insufficiency, 1105 preconception care and, 80 Ambulatory practice, 1146 Adriamycin, 751 pregnancy and, 85, 510-511 Amenorrhea, 899, 900-904 Adult children of alcoholics (ACOA), 508 Alcohol Use Disorders Identification in athletes, 904-905 Adult-onset obesity, 465 Test (AUDIT), 512-513 primary, 900 Adults Alcoholic, defined, 508 secondary, 900 acute otitis media in, 620-621 Alcoholic hepatitis, 510, 784-785 secondary to anovulation, 901 circumcision in, 864 Alcoholic neuropathy, 580 secondary to elevated prolactin levels, 901 hearing impairment in, 632-633 Alcoholics Anonymous (AA), 513, 516 secondary to genetic disorders, 903 hypogonadism in, 1103 Alcoholism, 507-518 secondary to ovarian failure, 904 serous otitis media in, 622 anemia and, 1114-1115 secondary to pituitary and hypothalamic sexuality issues in, 502-504, 506 clinical presentation of, 509-511 disorders, 901-903 Advance directives, 534, 710 comprehensive assessment of, 513 secondary to pituitary and hypothalamic Advanced cardiopulmonary life support continuing care in, 516-517 failure, 904 (ACLS),435-436 detoxification in, 513-515 secondary to uterine outflow tract Advanced sleep phase syndrome, 483 diagnosis of, 511-513 disorders, 903 Aerobic fitness, 956 ethical issues and physican American Academy of Family AFP, see a-fetoprotein responsibilties, 517-518 Physicians (AAFP), 1,3, 1144 African Americans, see Blacks etiology of, 508-509 Order Department, 51 African Burkitt's lymphoma, 325 intervention for, 513 Stop Smoking Kit, 52, 58 Index 1163

American Academy of General Practice, penicillin, 322 Anovulatory dysfunctional uterine 1 Anaplastic thyroid carcinoma, 1085 bleeding (DUB), 905 American Association of Marriage and Ancephalopathy, 78 Antabuse (disulfiram), 509 Family Therapy, 272 Androgen deprivation therapy, 646-647, Antacids, 762, 765 American Association of Poison Control 854-855 Anterior cruciate ligament (ACL) Centers (AAPCC), 409 Androgenic alopecia, 1054-1055 injuries, 457, 979 American Board of Family Practice, 1, 3 Anemia, 1108-1115 Anterior dislocation of shoulder, 964 American Board of Genetic Counseling, aplastic, 1113 Anterior drawer test, 457 143 in athletes, 448-449 Anterior tarsal tunnel syndrome, 984 American Cancer Society, 937 of chronic disease (ACD), 1112 Anterior uveitis, 593, 598-599 American College of Obstetricians and dysfunctional uterine bleeding and, Anthralin, 1021 Gynecologists (ACOG), 111 907-908 Anthranilic acids, 996 American College of Rheumatology hemolytic, 448, 1112 Anthrax, 394 (ACR),992 in infants, 158 Anti-adrenergic agents, 646-647, 854-855 American College of Sports Medicine iron deficiency, 97,1109-1110 Antiarrhytmic drugs, 710 (ACSM), 59-60, 444 macrocytic, 1114-1115 Antibiotics American Fertility Society (AFS), 942 megaloblastic, 1114 for acne vulgaris, 1017 American Lung Association, 58 microcytic, 1109-1111 for acute lacerations, 433 American Rheumatism Association myelophthisic, 1113 for acute otitis media, 617-620 Medical Information System in newborns, 150 for asthma, 732 (ARAMIS),994 nonmegaloblastic, 1114-1115 for bite injuries, 405 American Society of Addiction Medicine normocytic, see Normocytic anemias for chronic obstructive pulmonary (ASAM), 513, 516 postpartum, 135 disease, 732 American Urological Association (AUA) pseudo, 448 for cystitis, 820 Symptom Scoring Index, 853-854 sickle cell, see Sickle cell anemia for food poisoning, 814 Americans with Disabilities Act (ADA), sideroblastic, 1111 for inflammatory bowel disease, 771 387 Anesthesia for peptic ulcer disease, 764 Amiloride (Midamor), 645, 700 for acute lacerations, 423-424 for pneumonia, 736, 737, 738 Amiodarone (Cordarone), 667, 669 epidural (spinal), 84, 90, 124, 489 for prostatitis, 853 Amitriptyline, 176,290, 543,545, 1007 general, 489 for pyelonephritis, 820 Amnesic shellfish poisoning, 815 injectable, 423 for sepsis, 367 Amniocentesis, 87, 139 during labor, 84, 90, 124 for sinusitus, 338 Amnioinfusion, 126-127 Anesthesia anaphylaxis, 322 for tuberculosis, 741 Amniotic fluid index (AFI), 123 Angina pectoris, 652, 654-656 Anticholinergics, 567, 732, 871 Amniotomy, 124 atypical, 652 Anticoagulants, 700 Amoxapine (Asendin), 290 classic, 652 Anticonvulsants Amoxicillin, 618,619,621,820 heart failure and, 701 for chronic pain, 530 Amoxicillin/ clavulanic acid microvascular (syndrome X), 652 drug interactions with, 553 (Augmentin), 618, 619 unstable, 656-658 preconception care and, 77 Amphetamines, 522-523 variant (Prinzmetal's), 652 pregnancy and, 552-553 Amphotericin B, 361 Anginal equivalent, 652 side effects of, 553 Ampicillin, 820 Angiotensin-converting enzyme (ACE) for status epilepticus, 555 Ampicillin-sulbactam, 820 inhibitors, 447,643 Antidepressants, see also Tricyclic Amputated fingertip, 430-432 for chronic heart failure, 698-699, 700 antidepressants Anafranil, see Clomipramine for chronic renal failure, 847 for anorexia nervosa, 305 Anagen defluvium, 1054 diabetes mellitus and, 1070 for headaches, 545-546 Anal carcinoma, 794 for glomerulonephritis, 848 for pain, 529-530, 535 Anal diseases, 788-794 specific types, 644 for tinnitus, 631 Anal fissure, 790 Angiotensin receptor antagonists, Antidiuretic hormone (ADH), 749,829, Anal fistula, 791 643-645 831,832,833-834,1098,1101 Anal incontinence, 791-792 Angle of gait, 183 Antidiuretics, 1102 Anal intercourse, 355 Angular abnormalities of the knee, 186 Antihistamines, 315, 316 Analgesic ladder approach to pain Angular cheilitis, 627, 1037 Antihypertension medication, 642-647 management, 535 Anisocoria, 606 major classes of, 643-647 Anaphylactic triggers, 321-323 Anisometropia, 613 quality of life issues and, 647 Anaphylactoid reactions, 319-323 Ankle injuries, 981-983 selection of, 647-648 Anaphylactoid triggers, 323 athletic,454-456 Antimalarial drugs, 997 Anaphylaxis, 319-323 Ankle sprains, 981-982 Antioxidants, 569 anesthesia, 322 Ankylosing spondylitis, 954, 1002-1003 Antiplatelet therapy, 657 exercise-induced, 322 Anorectal abscess, 790-791 Antisocial personality disorder, 177, idiopathic,323 Anorexia nervosa, 213-214, 304-305 307-308,310 latex-induced,322 Anovulation, 901 Antispasmodics, 871 1164 Index

arAntitrypsin deficiency, 782, 783 Reye syndrome and, 341 Augmentin (amoxicillin/ clavulanic Anxiety, 723-724 for rheumatoid arthritis, 995-996 acid), 618,619 Anxiety disorders, 274--283 spontaneous abortion and, 107 Auranofin, 997 in children, 178-179 surgical patients and, 493 Auras depression and, 287 tinnitus and, 630 in migraine, 542 Aortic insufficiency, 688-689 Asthma, 726-733 in seizure disorders, 547, 550 Aortic stenosis, 689-690 in athletes, 445-446 Aurothioglucose, 997 APACHE (Acute Physiology and clinical presentation of, 727 Austin Flint murmur, 689 Chronic Health Evaluation) grading diagnosis of, 727-728 Autoimmune neutropenia, 1121-1122 system, 775,776 exercise-induced, 727 Automated medical records, 1132-1134 Aplastic anemia, 1113 international travelers and, 71 Automatisms, 542 Apnea, 148-149 management of, 728-732 Autosomal dominant polycystic kidney ApoE gene, 239-240 occupational, 391 disease (ADPKD), 850 Apophyseal injuries, 193-194 pregnancy and, 101 Autosomal recessive polycystic kidney Apophysitis of the hip, 193 prevention of, 732 disease (ARPKD), 850 Appendicitis, 804--805 Astigmatism, 614 Aventyl, 290 Apresoline (hydralazine), 114,645 Asymptomatic bacteriuria (ASB), 93 Avoidant personality disorder, 308, 310 Arcing spring diaphragm, 882 Atelectasis, 758-759 Azathiprine, 997 ARDS (acute respiratory distress Atenolol (Tenormin), 644, 668 Azelastine, 317 syndrome), 752-753 Athletes, 444-451, see also Athletic Azithromycin, 360, 618, 619 Argonz-Del Castillo syndrome, 930 injuries AZT, see Zidovudine Argyll Robertson pupil, 606 amenorrheain,904--905 Aztreonam, 820 Aricept (donepezil), 240 anemia in, 448-449 Azulfidine (sulfasalazine), 771, 997 Arrhythmias, see Cardiac arrhythmias asthma in, 445-446 Arrhythmic syncope, 706 cardiac murmurs in, 692 B cell lymphomas, 325 Arterial blood gases, 728 diabetes mellitus in, 448 Babinski's maneuver, 951 Arterial occlusive retinal disease, 609 fluids and electrolytes in, 449-451 Bacille Calmette Guerin (BCG), 875 Arthritis gastrointestinal disorders in, 449 Bacille Calmette Guerin (BCG) vaccine, of acromioclavicular joint, 963-964 hypertension in, 447-448 96,742 international travelers and, 71 Athletic heart syndrome, 446-447 Back disorders, 389-390, 950-958 Lyme, 380 Athletic injuries, 453-463 clinical presentation of, 951-952 osteo, see Osteoarthritis mechanisms of, 453-454 diagnosis of, 952-955 psoriatic, 1003 overuse, 460-463 management of, 955-958 rheumatoid, see Rheumatoid arthritis prevention of, 463 natural history of, 950-951 systemic lupus erythematosus and, 1000 traumatic, 454-460 prevention of, 958 Arthritis Clearinghouse, 995 Ativan (lorazepam), 276, 555 Back school, 956-957 Arthritis Foundation, 995, 1006 Atonic seizures, 549, 554 Baclofen (Lioresal), 575-576 Arthritis Self-Help Course, 995 Atopic dermatitis, 157, 1017-1019 Bacteremia, 366-371 Arylacetic acids, 996 Atosiban, 118 occult,369 Arylalkanoic acids, 996 Atrial fibrillation (AF), 491--492,671, in special populations, 370 Arylcarboxylic acids, 996 675-676 Bacterial food poisoning, 812-814 Arylpropionic acids, 996 Atrial flutter, 671, 676-677 Bacterial prostatitis, 852-853 Asbestos, 746 Atrial gallop, 684--685 Bacterial skin infections, 1027-1031 Asendin (amoxapine), 290 Atrial premature beats, 671, 672, 673 Bacterial tracheitis, 164--165, 166 Asherman syndrome, 899, 903 Atrial tachycardia, 672 Bacterial vaginosis (BV), 77, 116,248, Ashkenazi Jews, 141, 143 Atrioventricular reciprocating 894--895 Asians tachycardias (AVRTs), 674-675 Bacteriuria, 821, 822, 823 alcoholism in, 507 Atrophic gastritis, 765 asymptomatic, 93 cerebrovascular disease in, 557 Atrophic vaginitis, 895, 911 Barium enema, 798 demographic shifts in, 21 Atrovent (ipratropium bromide), 317 Barotitis media, 437 health status of, 21 ATSDR (Agency for Toxic Substances Barotrauma, 436-438,474 osteoporosis in, 1088 and Disease Registry), 388 ear, 436-437 Aspiration biopsy and curettage, 921 Attention deficit/hyperactivity disorder pulmonary, 437-438 Aspirin (AD/HD), 174--176,177 Barrier contraceptives, 346, 882-883 for angina pectoris, 655 Atypical angina pectoris, 652 Bartholin's abscesses, 791 asthma and, 726 Atypical cells of uncertain significance Basal body temperature (BBT), 905, 945 cerebrovascular disease and, 562 (ASCUS),917-918 Basal cell carcinoma (BCC), 1045 colorectal cancer and, 799 Atypical glandular cells of uncertain Battery ingestion, 441 coronary heart disease and, 47-48 significance (AGUS), 918 BCG, see Bacille CaImette Guerin myocardial infarction and, 660 Atypical pneumonia, 735, 738-739 Bean-shaped foot, 184 poisoning with, 414-416 AUDIT (Alcohol Use Disorders Bedside urodynamics (BUD) testing, preeclampsia and, 113 Identification Test), 512-513 869-870 Index 1165

Behavior modification, 173 Bites, 246 Botulism, 814, 815 Behavioral problems, 304-312 arthropod,407-408 Bowel obstructions, 807-809 of children, 173-182 mammalian, 404-405 Bowenoid papulosis, 1044-1045 Behavioral therapy snake, 407 Bowen's disease, 1044 for generalized anxiety disorder, 277 spider, 405-406 Bowlegs, 186 for obsessive compulsive disorder, 280 Bixoprolol (Zebeta), 644 Brachial plexus injury, 460 for panic disorder, 275 Black widow spider, 405 Brachial plexus neuropathies, 576 for posttraumatic stress disorder, 281-282 Blackout, defined, 508 Bradycardia, 447 Bell's palsy, 104,380,576,607 Blacks Bradykinesia, 566 Benadryl (diphenhydramine), 423 ACE inhibitors and, 643 Brain, alcoholism and, 510 Benazepril (Lotensin), 644, 700 alcoholism in, 507 Brain abscesses, 585-586 Benign paroxysmal positional vertigo ~-blockers and, 646 Branch retinal artery occlusions (BRAO), (BPPV), 472, 473 breast cancer in, 937 609 Benign partial epilepsy of childhood cerebrovascular disease in, 557 Branch retinal vein occlusions (BRVO), (BPEC), 549,552 chronic heart failure in, 696 609 Benign prostatic hyperplasia (BPH), chronic renal failure in, 847 BRCAl gene, 143 853-855 colorectal cancer in, 795 BRCA2 gene, 143 Benign skin tumors, 1041-1042 demographic shifts and, 21 Breast abscess, 929 Bentoquatum (IvyBlock), 1022 depression in, 214 Breast anatomy and physiology, 925 Benzodiazepines diabetes mellitus in, 1071 Breast aspiration, 932 for generalized anxiety disorder, 277 drug abuse in, 215 Breast biopsy, 932-933 for insomnia, 484 health status of, 21 Breast cancer, 474, 934-937 for panic disorder, 276 homicide in, 202 clinical prevention and, 44 poisoning with, 416-417 obesity in, 213 detection of, 934-935 for posttraumatic stress disorder, 283 osteoarthritis in, 988 ductal,935 Bereavement, 288, 536 osteoporosis in, 1088 endometrial hyperplasia and cancer and, ~2-adrenergic agonists, 730-731 pancreatic cancer in, 777 920 ~-blockers, 645 preterm labor in, 115 estrogen-replacement therapy and, 913 for angina pectoris, 655 prostate cancer in, 855 genetic factors in, 143 for cardiac arrhythmias, 667 pulmonary sarcoidosis in, 758 incidence of, 934 for Graves' disease, 1080 scrotal masses in, 871 lobular, 935 for heart failure, 702 scrotal tumors in, 861 oral contraceptives and, 885 for hypertension, 644, 646 sickle cell anemia in, 1123 prognosis for, 936-937 for hypertension in athletes, 448 systemic lupus erythematosus in, 1000 reconstructive options post-surgery, 936 for migraine, 543 urinary bladder cancer in, 873 risk factors for, 934 specific types, 644 Bladder training, 230, 870 terminal care issues, 937 surgical patients and, 493 Bleeding disorders treatment of, 935-936 Betapace (sotalol), 667, 669 congenital, 1116-1117 Breast disease, benign, 925-933 Betaxolol (Kerlone), 644 in menopause, 912 Breast examination Bethanechol, 763 Blepharitis, 607 clinical, 931 Bethesda classification system, 917-918 Blepharoptosis, 607 self, 931-932, 934, 935 Beveled lacerations, 429 Blocadren (timolol), 644, 669 Breast-feeding, 131, 133, 136, 154 Bezold-Jarish reflex, 704 Blood-borne pathogens, 392-393 asthma and, 732 Biaxin, see Clarithromycin Blood Borne Pathogens Act, 387 breast abscesses and, 929 Bicipital tendonitis and rupture, 965 Blood disorders, 1116-1125 care of lactating breast, 931 Bicycle injuries, 202 Blount's disease, 186 HIVand,364 Bile acid sequestrants, 1061, 1062-1064 Blowout fractures of the orbit, 604 jaundice and, 150 Billing, 1131-1132 Body dysmorphic disorder (BDD), 298 Breast lesions, painful, 930-931 Binge drinking, defined, 508 Body language, 15 Breast masses, 927,935 Binge eating/purging subtype of Body lice, 1039 Breast milk jaundice, 150 anorexia nervosa, 305 Body mass index (BMI), 305, 465, 466, 467 Brevibloc (esmolol), 668 Bioelectrical impedance, 466 Body packing, 442, 521, 522 Bromocriptine, 312, 567,901,927-928 Biopsies Boils, 1029 Bronchiectasis, 759 breast, 932-933 Bonding, 7 Bronchiolitis, 166-167, 333-334 endometrial, 945 Bone abnormalities, 1010-1014 Bronchitis, 71, 333 skin, 1047-1049 Bone mineral density (BMD), 975, 1087, Brown fat theory, 467 Biopsychosocial model, 13, 285 1089-1090 Brown recluse spider, 405 Bipolar disorder, 214, 286, 289, 291 Bone tumors, 1010-1013 Brucellosis, 394 Birth injuries, 150 Borderline personality disorder (BPD), Bruising Bisexuals, 503-504, 860 251,308,310 in child abuse, 245 Bismuth subsulfate (Pepto-Bismol), 814 Borrelia burgdorferi, 379, 381 simple, easy, 1120 Bisphosphonates, 535, 1092 Botulinum toxin, 571 Bucket handle lesions, 246-247 1166 Index

Bulbocavernous reflex, 501 Capitation, 4, 33 pregnancy and, 101-102 Bulimia nervosa, 213-214, 304, 305-306 Capsaicin, 1009 Rocky Mountain spotted fever and, 383 Bumetamide (Bumex), 645, 700 Captopril, 643, 644, 700, 1070 Cardiovascular emergencies, 704-711 Bunions, 985 Captopril Diabetic Nephropathy Study, Cardioversion, 667 Bupivacaine, 423 1070 Cardizem (diltiazem), 644, 669 Buproprion, 290 Carbamazepine, 283, 530,551, 552 Cardura (doxazosin), 447, 644 Burns,202,438-441 pregnancy and, 103 Carbidopa, 568 chemical, of eye, 603 side effects of, 553 Caries, 625 child abuse and, 245-246 trigeminal neuralgia and, 575-576 ~-Carotene, 747, 1059 first degree, 438 Carbocaine, 423 Carotid endarterectomy, 562 fourth degree, 439 Carbohydrate antigen, see CA entries Carotid sinus syncope, 705 second degree, 438-439 Carboplatin, 750-751 Carpal fractures, 968 third degree, 439 Carbuncles, 1029 Carpal tunnel syndrome, 104, 135, 389, Bursitis, 977-978 Carcinoembryonic antigen (CEA), 777, 576-577 Buspirone, 277, 280, 283 936 Carteolol (Cartrol), 644 Byssinosis, 391 Carcinogens, 392, 746 CASH (Cancer and Steroid Hormone) Carcinoma in situ, breast, 935 study, 885 CA 15.3, 936 Carcinomatous sensory neuropathy, 575 CASS (Coronary Artery Surgery Study), CA 19-9,777 Cardene (nicardipine), 644 654 CA 125, 777, 922, 942 Cardiac arrhythmias, 664-681 Catamenic anovulatory uterine bleeding, Cafe au lait spots, 152 diagnosis of, 665-667 905-906 CAGE acronym, 512 general causes of, 665 Cataplexy, 485 Calan, see Verapamil history in, 666 Catapres, see Clonidine Calcipotriene (Dovonex), 1021 physical examination in, 666 Cataracts, 200, 612 Calcitonin, 1009, 1092 supraventricular, 670-677 Cathartics, 418-419 Calcitriol, 1092 in surgical patients, 491-492 Catheter-associated urinary tract Calcium, 642, 904 therapy for, 667-670 infections (UTIs), 821 metabolism of, 1104-1105 torsade de pointes, 667, 680, 707 Caucasians, see Whites osteoporosis and, 1087, 1090-1091 ventricular, 677-681 Cavernous hemangiomas, 1041-1042 preconception care and, 79 Cardiac catheterization, 656 Cavus foot, 187 preeclampsia and, 113 Cardiac effects Cawthorne's head exercises, 475 urolithiasis and, 877 of alcohol, 511 CD4 cells, 357, 362, 374 Calcium channel blockers, 447 of Lyme disease, 380 CD-ROMs, 1134 for angina pectoris, 644, 645,655 Cardiac hypertrophy, 447 CEA (carcinoembryonic antigen), 777, for cardiac arrhythmias, 667 Cardiac murmurs 936 for chronic renal failure, 847 in athletes, 692 Ceclor (cefaclor), 618, 619 for COPD, 732 Austin Flint, 689 Cefixime, 618, 619, 820 specific types, 644 in children, 690-691 Cefpodoxime proxetil, 820 for urinary incontinence, 871 hemic,158 Ceftriaxone, 820 Calluses, 1052 in infants, 158, 690-691 Cefuroxime (Ceftin), 618,619 Caloric needs, 61 innocent and physiologic, 685 Cellulitis, 1029-1030 Campylobacter food poisoning, 812-813 in newborns, 149, 158 Celomic metaplasia theory, 942 Campylobacter jejuni, 768 pregnancy and, 691-692 Centers for Disease Control and Canadian-American Ticlopidine Study, pulmonary outflow ejection, 158 Prevention (CDC), 59-60 562 right-sided, 690 Central

Cerebrospinal fluid (cant.) abnormal development in, 198-199 Chromosomal disorders, 138-141 in meningitis, 582 acute otitis externa in, 622 Chronic alcoholic hepatitis, 785 in multiple sclerosis, 590 acute otitis media in, 616-620 Chronic bacterial prostatitis, 852-853 in neurosyphilis, 587 behavioral problems of, 173-182 Chronic benign neutropenia of Cerebrovascular disease, 475, 557-563 cardiac murmurs in, 690-691 childhood, 1121 in children, 560 cerebrovascular disease in, 560 Chronic cancer pain, 231 clinical presentation of, 558-560 cocaine exposure and, 521 Chronic cough, 727, 728 epidemiology of, 557 communicable diseases of, 163-172 Chronic cutaneous lupus erythematosus, evaluation and diagnosis of, 560-561 depression in, 291-292 1051-1052 pathogenesis of, 558 description of stage, 6-8 Chronic fatigue syndrome (CFS), rehabilitation and, 563 domestic violence and, 252 477-478,479-480 risk factors for, 557-558 encopresis in, 205 Chronic heart failure, 695-703 treatment of, 561-563 enuresis in, 203-205 Chronic hypertension of pregnancy, Cerebrovascular Survey Report, 557 hearing impairment in, 631-632 101-102 Cerebrovascular syncope, 706 HIV in, 364 Chronic indwelling catheters, 230 Cerebrovascular syphilis, 586-587 injury prevention in, 202-203 Chronic inflammatory demyelinating Certifica tion, 1 musculoskeletal disorders in, 183-196 polyradiculoneuropathy (CIDP), 579 Cerumen impaction, 633 neurosyphilis and, 588 Chronic insomnia, 482 Cervical cancer, 885, 917-920 physical examination for sexual Chronic liver disease, 1113 Cervical cap, 882-883 complaints, 500-501 Chronic meningitis, 584 Cervical intraepithelial neoplasia (CIN), respiratory tract viral infections in, 335 Chronic myelogenous leukemia, 144 917 scrotal tumors in, 861 Chronic obstructive pulmonary disease Cervical myelopathy, 959-960 selected problems of, 198-205 (COPD),726-733 Cervical radiculopathy, 958-959 sepsis in, 368-370 clinical presentation of, 727 Cervical vertigo, 474 sexuality issues in, 501-502, 505 diagnosis of, 727-728 Cervical whiplash, 960 sinusitis in, 338-339 international travelers and, 71 Cervicitis, 891-898 somatization in, 301-302 management of, 728-732 diagnostic assessment of, 891-893 special needs of dying, 536 prevention of, 732 negative tests and, 896-897 urinary tract infections in, 817-818 Chronic open-angle glaucoma (COAG), Cesarean delivery, 84, 90, 99, 122, 123, Chinese people, 988 612 134,364 Chlamydia, 345-346 Chronic otitis externa (COE), 623 Chalazion, 607 adolescents and, 222 Chronic otitis media, 622-623 Chancroid, 353-354 clinical presentation of, 345 Chronic pain, 527-530 Charcot-Marie-Tooth disease, 580 diagnosis of, 345-346 of cancer, 231 Chelation therapy, 201-202 oral contraceptives and, 884 Chronic pancreatitis, 776-777 Chemical dermatitis, 894 sexual abuse and, 248 Chronic paronychia, 1037 Chemical exposure, 154 sexual assault and, 264 Chronic recurrent sinusitis, 338 Chemonucleolysis, 957 spermicides and, 883 Chronic renal failure (CRF), 847-848, Chemoprophylaxis, 47-48 treatment of, 346 1113 Cherry angiomas, 1042 vulvovaginitis and, 891, 892, 896 Chronic serous otitis media (CSOM), Chest pain, 650-654 Chlamydia pneumoniae, 734, 736,738-739 621-622 cardiac, see Angina pectoris Chlamydia psittaci, 377 Cicatricial alopecia, 1054 distinguishing cardiac from noncardiac, Chlamydia trachomatis, 347, 353, 595 Ciguatera poisoning, 815 652-654 Chlamydial conjunctivitis, 593, 595-596 Cimetidine, 763, 765 esophageal, 650-651 Chlorambucil, 998 Ciprofloxacin (Cipro), 360, 820 noncardiac, 650-651 Chloroquine phosphate, 69 Circumcision, 157 psychiatric illness and, 651-652 Chlorothiazide (Diuril), 645 adult, 864 Chiari-Frommel syndrome, 930 Chlorpheniramine, 446 neonatal,861-862 Chickenpox, see Varicella Chlorthalidone (Hygroton), 645, 700 Cirrhosis, 510 Chiggers, 1039 Chocolate cysts, 942, 943 cis-Linoleic acid, 928 Chilblains, 399 Cholecystitis, 805-806 Cisapride, 763 Child abuse, 244-249 Cholecystostomy, 806 Cisplatin, 750, 751, 875 acute pancreatitis and, 774 Cholelithiasis, 805-806 CIWA-Ar scale, 515 elder abuse compared with, 256 Cholera vaccine, 66, 68, 69 Clarithromycin, 360, 618, 619 emotional, 245 Cholesterol levels, 910-911,1056-1057, CLASP (Collaborative Low-dose Aspirin physical, 245-247 see also Hyperlipidemia Study in Pregnancy), 113 reporting of, 248 Cholestyramine, 1062 Classic angina, 652 sexual, 247-248, 501, 502, 939 Chondral fractures, 980 Clavicular disorders, 963-964 treatment and prevention of, 248-249 Chondroma, 1011 Clavicular fractures, 963 Child care, 159 Chordoma, 1012-1013 Cleft lip/palate, 142, 152,617 Child neglect, 244-245 Chorioamnionitis, 127-128 Climacteric, 909-911 Children Chorionic villus sampling, 139 Climate, 728 1168 Index

Clindamycin, 116,361, 895 Colic, 155-156 Congestive cardiomyopathy, 362-363 Clinic without walls (CWW), 1140, 1142 Collaborative Low-dose Aspirin Study Congestive heart failure (CHF), 491, Clinical guidelines, 1127-1130 in Pregnancy (CLASP), 113 699-700,832,834,835 Clinical prevention, 37-54 Collateral ligament tear, 979 Conjunctiva birth to ten years, 39-41 Colon cancer, 44-46, 48 disorders of, 607-608 eleven to twenty-four years, 41, 43-44 Colonoscopy, 798 trauma to, 601 physician-patient encounter and, 37 Colorectal cancer (CRC), 143, 795-799 Conjunctivitis, 592-596 physician's office in, 37 Colposcopy, 897-898 allergic, 593, 596 selection of services, 38-39 Combined dose oral contraceptive pills, bacterial, 592-594 sixty-five and older, 48-49 883-885 chlamydial, 593, 595-596 strategies for integrating into practice, Combined dyslipidemia, 1059, 1060, giant papillary, 596 49-53 1063,1064 viral, 593, 594-595 twenty-five to sixty-four years, 42-48 Committee of Safety and Medicines Consensus formation, 17 Clinoril (sulindac), 799 (CSM),885 Constipation, 135, 156, 158, 811 Clofazimine, 360 Common cold, 163, 164-165, 331-332 Contact bleeding, 900 Clofibrate, 1061, 1062 Common warts, 1034 Contact dermatitis, 1024-1025 Clomiphene citrate, 901 Communicable diseases, 163-172 allergic,393-395,1024-1025 Clomipramine, 179, 180,275,280,290, Communication skills, 15-16 of the eye, 607 309 Community-acquired pneumonias irritant, 395, 1024, 1025 Clonazepam,276,309,551,552,553,572 (CAPs),734-738 vulvovaginitis and, 894 Clonidine, 175,176,276,493,529,572,644 Community linkages, 52 Continuing care, 2 Clorazepate, 552, 553 Community-oriented primary care Continuing medical education, 1 Closed-ended questions, 14, 15 (COPC), 32, 34-36 Continuous electronic fetal monitoring Closed head injuries, 458 Completed stroke, 559 (EFM), 84, 90,123-124,125-126 Closed lock, 628 Complex lacerations, 430 Continuous partial epilepsy, 549 Clostridium botulinum, 814 Complex partial seizures, 547,549, 554 Continuous positive airway pressure Clostridium difficile, 769 Complex ventricular arrhythmia (VA), (CPAP),486 Clotting disorders, 98-99 678 Continuous stitch, 428 Clozaril,310-311 Complicated urinary tract infections Continuous subcutaneous insulin Clubfoot, 154, 187 (UTIs),820 infusion (CSII) pumps, 1071 Cluster A personality disorders, 306,307 Compound nevi, 1042 Contraception, 880-888, see also specific Cluster B personality disorders, 306, Comprehensive care, 2 methods 307-308 Compulsions, 278 Contrast venography, 714 Cluster C personality disorders, 308-309 Computed tomography (CT) Conventional vasectomy, 858-859 Cluster headaches, 539, 540, 543-545 abdominal trauma and, 804 Conversion disorder (CD), 298 Cluster suicides, 293 acute pancreatitis and, 775 Coordinated care, 2 Co-dependent, defined, 508 Alzheimer's disease and, 238 COPC (Community-oriented primary Coagulation disorders, 495 back disorders and, 952-953 care), 32, 34-36 acquired,1117-1118 bowel obstructions and, 808 COPD, see Chronic obstructive congenital,1116-1117 cerebrovascular disease and, 561 pulmonary disease Coal tar, 1021 cervical carcinoma and, 919-920 Copycat suicides, 293 Cocaine, 215, 520-522 cervical myelopathy and, 959 Cor pulmonale, 723 body packing of, 442, 521 lung cancer staging and, 749 Cordarone (amiodarone), 667, 669 breast-feeding and, 154 multiple sclerosis and, 590 Corgard (nadolol), 644 complications of use, 520-522 pancreatic cancer and, 777 Corneal abrasion, 602 effects of, 520 seizure disorders and, 550 Comer lesions, 246-247 infants and, 161 syncope and, 707 Corns, 1052 physical findings associated with use, Computer-generated systems, 51 Coronary artery bypass graft (CABC) 216 Conditioned insomnia, 483 surgery, 490,493,657-658,701 pregnancy and, 85, 521 Condom use, 346, 883, 1033 Coronary artery disease, 490-491, 701 Coccidioidomycosis, 740 Conduct disorders, 177-178 Coronary Artery Surgery Study (CASS), Cochrane Collaboration, 122 Conductive hearing loss, 631 654 Coffee, 777 Condyloma acuminata, 248, 793-794, Coronary heart disease (CHD) Cogan syndrome, 473 1034 aspirin and, 47-48 Cognex (tacrine), 240 Confidentiality, 1132-1133 clinical prevention of, 42-44 Cognitive disorders, 287 Congenital bleeding disorders, 1116-1117 dyslipidemias and, 1056, 1057, 1058, Coil spring diaphragm, 882 Congenital hypothyroidism, 1083 1059, 1061 Coin ingestion, 441 Congenital nevomelanocytic nevus exercise and, 58 Colchicine, 1096 (CNN),1045 Coronaviruses, 330 Cold injuries, 398-399 Congenital rubella syndrome, 76 Cortical cataracts, 612 Cold sores, 1032 Congenital torticollis, 152 Corticosteroids Colestipol, 1062 Congenital toxoplasmosis, 372, 373 for allergic rhinitis, 316, 317 Index 1169

Corticosteroids (cont.) Cytomegalovirus (CMV) retinitis, 360 bipolar, 214, 286,289,291 for asthma, 731 dementia and, 240, 287 idiopathic thrombocytopenic purpura Dacryoadenitis, 608 diagnosis of, 285-288 and,1118 Dacryocystitis, 608 epidemiology of, 285, 286 for inflammatory bowel disease, 771 Danazol,906,927,928,943,1118 etiology of, 285 in pain management, 535 Dapsone, 361 evaluation of, 288-289 Corynebacterium, 1027-1028 Date rape, 261-262 major, 285-286 Cough, chronic, 727 DCCT (Diabetes Control and postpartum, 135 Coumadin, see Warfarin Complications Trial), 1067 pseudodementia of, 287 Coxsackie virus, 331 ddC, see Zalcitabine psychological therapies for, 291 Cozaar (lorsartan), 643-645, 645 ddI, see Didanosine social treatment for, 291 Crack cocaine, 520, 522 De Quervain's tenosynovitis, 969 unipolar, 214, 289 Cranial neuropathies, 575-576 Death, 11-12, see also Dying Dermacentor andersoni, 382, 407 Craniotabes, 152 Decadron (dexamethasone), 71 Dermacentor variabilis, 382, 407 Crank,522 Decision support systems, 1135 Dermal mycoses, 1038 Creatinine clearance, 828 Decompression sickness, 437-438 Dermatitis Creatinine concentration, 828 Decongestants, 316, 317, 338 atopic, 157, 1017-1019 Creighton Model Natural Family Decreased arterial plasma, 828 chemical, 894 Planning System, 887 Decreased arterial plasma pH, 828 contact, see Contact dermatitis Crescentic glomerulonephritis, 849-850 Decreased preload, 685 diaper, 157 CREST syndrome, 1002 Deep venous thrombosis (DVT), infectious, of the eye, 607 Cretinism, 1083 713-717, 753-755 photosensitivity, 1051 Cri du chat, 140-141 clinical presentation of, 714 seborrheic, 157,362, 1022 Crisis intervention, 160 diagnosis of, 716-717, 754 Dermatofibromas, 1041 Crohn's disease, 770-771 diagnostic tests for, 714-716 Dermatologic manifestations Cromolyn sodium, 316-317, 322,731 epidemiology of, 713 of child abuse, 245-246 Cross-tolerance, defined, 508 pathophysiology of, 713 of Lyme disease, 381 Croup, 163-166,333 pregnancy and, 98-99 of Rocky Mountain spotted fever, 383 Cryoablation, 667 prevention of, 714, 754-755 Dermatomycoses, 1035 Cryosurgery, 790,861, 1043, 1048-1049 in surgical patients, 495 Dermatophytoses, 1035-1037 Cryptococcus neojormans, 361 treatment of, 717, 754-755 Cryptomenorrhea, 899 DEET, see Diethyltoluamide Dermatoses, 1016-1026 Cryptorchidism, 153 Defibrillators, see Implantable cardiac occupational, 393-395 Cubital tunnel syndrome, 577 defibrillators Derotational osteotomy, 185 Culture, 20 Delayed puberty, 1103 DES (diethylstilbestrol), 108,934 clinician-patient relationship and, 22 Delayed sleep phase syndrome, 483 Desensitization, 728 managing differences in, 23 Delirium, 287 Designer drugs, 523 recognizing differences in, 21-22 alcoholic, 509 Desipramine, 290 Cumulative trauma, 388-389 Delirium tremens, 515 for attention deficit/hyperactivity Cushing syndrome, 749, 835, 1105-1106 Delivery, 90-91 disorder, 175, 176 Cutaneous findings, see Dermatologic cesarean, see Cesarean delivery for bulimia nervosa, 306 manifestations preterm, 115 for nail biting, 180 Cutaneous lupus erythematosus, problems during, 122-129 for panic disorder, 275 1051-1052 Dementia, 237-242 Desmopressin, 204-205 Cyanosis, 149 alcohol-related, 239, 510 Desyrel (trazodone), 290 Cyclic antidepressant poisoning, 411-413 depression and, 240, 287 Detoxification, 513-515 Cyclic neutropenia, 1122 elder abuse and, 258 Detrusor hyperactivity with impaired Cyclobenzaprine, 1007 neurosyphilis and, 587 contractility (DHIC), 867 Cyclophosphamide, 751, 997 progressive, 239 Detrusor hyperflexia, 867 Cyclosporine, 998 reversible, 237-238 Developing and Evaluating Methods to Cyclothymia, 286 Demerol (meperidine), 529 Promote Ambulatory Care Quality Cylert (pemoline), 175, 176 Demodex jolliculorum, 1039 (DEMPAQ),53 Cystic fibrosis, 78, 142,378,620 DemographiC shifts, 20-21 Development, 6-12 Cystic hygroma, 152 DEMPAQ (Developing and Evaluating abnormal, 198-199 Cystic kidney disease, 850-851, see also Methods to Promote Ambulatory Developmental dysplasia of the hip Polycystic kidney disease Care Quality), 53 (DDH),190-191 Cystitis, 820 Demyelinating neuropathies, 575 Developmental surveillance and acute, 819 Depakene, see Valproate screening, 198-199 honeymoon, 503 Dependent personality disorder, 308,310 Devil's pinches, 1120 pregnancy and, 93-94 Depression, 285-292 Dexamethasone (Decadron), 71 recurrent, 819 in adolescents, 214 Dexfenfluramine hydrochloride (Redux), Cystoscopy, 874 biologic therapies for, 289 468,469 1170 Index

Dextroamphetamine (Dexedrine), 175, Digoxin (Lanoxin), 669, 699 Dovonex (calcipotriene), 1021 176 Dilacor XR, 644 Down syndrome, 85,138-140 Diabetes Control and Complications Dilantin, see Phenytoin acute otitis media and, 617,620 Trial (DCCT), 1067 Dilated cardiomyopathy, 721-722 childhood growth and common clinical Diabetes insipidus, 203, 834, 835, 1101 Dilation and curettage (D&C), 906-907, concerns, 199-200 Diabetes mellitus (OM), 1066-1075, see 921 developmental functioning and also Type 1 diabetes mellitus; Type 2 Diltiazem (cardizem), 644, 669 problems of later life, 200 diabetes mellitus Diphenhydramine (Benadryl), 423 disorders in, 139-140 achieving glycemic control, 1071-1074 Diphtheria, 579 internet resources for, 144 in athletes, 448 Diphtheria vaccine, 42, 67, 68, 211 screening for, 78,87,138-139 cerebrovascular disease and, 558 Dipyridamole thallium scintigraphy, Doxazosin (Cardura), 447, 644 chronic renal failure and, 847, 848 492-493,653 Doxepin hydrochloride, 290, 871 complications of, 1069-1071 Disabilities Doxorubicin (Adriamycin), 751 in COPC philosophy, 34-35 in adolescents, 223 Doxycycline, 69 defining glycemic control, 1068 in international travelers, 71 Dressings, wound, 236 digestive system surgery and, 803 Discectomy, 957 Drop attacks, 549 exercise and, 58 Discoid lupus erythematosus, 1051-1052 Drowning, 202,435 gallstones and, 806 Disease-illness distinction, 14,20 near-, 435-436 genetic factors in, 27-28 Disease model of alcoholism, 508 secondary, 435 gestational, 87, 99-100,1074 Disease-modifying antirheumatic drugs Drug abuse importance of glycemic control, (DMARDs),997-999 adolescents and, 215-217 1067-1068 Disopyramide (Norpace), 668 care of patients in recovery, 524-525 insulin hypothesis and, 447 Disseminated intravascular coagulation care of patients who continue misuse, 525 malignant otitis externa and, 623 (DIC),1120 domestic violence and, 251-252 pathophysiology of, 1066-1067 Disseminated sporotrichosis, 1038 infants and, 161 patient education about, 1068-1069 Disseminated toxoplasmosis, 372 patient care and, 520-525 preconception care and, 77 Dissociative identity disorder, 309 preconception care and, 80 pregnancy and, 87, 99-100,1074 Distal axonopathy, 575 pregnancy and, 85 in surgical patients, 496 Distal radius fractures, 967-968 treatment of specific disease related to, Diabetic ketoacidosis (DKA), 1074-1075 Distal tip fractures, 970 525 Diabetic nephropathy, 1070 Disulfiram (Antabuse), 509 Drug eruptions, 1023-1025 Diabetic neuropathy, 579, 1070 Diuretics, 699-700, 928 Drug-induced hepatitis, 785-786 Diabetic retinopathy, 610,1069-1070 loop,645,646,699,700 Drug-induced neutropenia, 1121 Diagnostic peritoneal lavage (DPL), 804 potassium-sparing, 645,646,700 Drug ingestion, 442 Dialysis, 846-847, 847 thiazide,645,646,699,700 Drug testing, 393, 395 Diamox (acetazolamide), 71 Diuril (chlorothiazide), 645 Dry age-related macular degeneration, Diaper dermatitis, 157 Diurnal enuresis, 203 611 Diaper rash, 157, 1037 Divalproex, 551, 552, 553 Dry eye, 608 Diaphragm (contraceptive device), 882 Diverticular disease, 771-772 d4T (stavudine), 360 DIAPPERS mnemonic, 866 Diverticulitis, 772 Ductal breast cancer, 935 Diarrhea, 768-769 Diverticulosis, 771-772 Dukes staging system, 798 traveler's, 70, 813 Dix-Hallpike maneuver, 472,473,474 Duncan's disease, 327 viral gastroenteritis, 168-169 Dizziness,471,472,475-476 Duplex scanning, 715 Diastolic heart failure, 700-701 Dobutamine, 709 Dupuytren's contracture (DC), 969-970, Diazepam (Valium), 555 Doctors Ought to Care (DOC), 215 1010 Dicyclomine hydrochloride, 871 Dog ears, 429-430, 431 Dyanacirc (isradipine), 644 Didanosine (ddI), 359, 360, 525 Domestic violence, 244, 250-255, see also Dying, 11-12,531-536 Diet, see also Nutrition Child abuse communication with patient, 532 chronic heart failure and, 697--698 characteristics of female victims, 252 palliative care and, 533-536 colorectal cancer and, 796 characteristics of male abusers, 252 psychosocial support and, 533 obesity and, 467-468 clinical presentation of, 250-252 Dying-back axonopathy, 575 rheumatoid arthritis and, 995 cycle of, 250 Dyrenium (triamterene), 645,700 Diethylstilbestrol (DES), 108,934 diagnosis of, 252 Dysequilibrium, 471-476 Diethyltoluamide (DEET), 65, 66, 381,408 documentation of, 253 Dysfunctional uterine bleeding (DUB), Diffuse antigen, 326 preconception care and, 79 905-908 Diffuse proliferative glomerulonephritis, prevalence of, 250 Dyshidrotic eczema, 1023 849 Dominant disorders, 141 Dyskinesia, 568 Digestive system Donepezil (Aricept), 240 Dyslipidemias, 1056-1065 disorders of, 811 Dopamine, 367, 709 classification of, 1057-1059 surgical problems of, 801-809 Dopamine agonists, 567 combined, 1059, 1060, 1063, 1064 Digital rectal examination (ORE), 797, Dorsal hand infections, 969 diabetes mellitus and, 1067 854,855-856 Doulas,90 Dyslipidemias (cont.) Index 1171

nonpharmacologic management of, health promotion and disease Endoscopic retrograde 1059-1061 prevention in, 232 cholangiopancreatography (ERCP), pharmacologic management of, in nursing homes, 232-233 775,777,806 1061-1065 nutrition in, 232 Endoscopy, 770-771 screening for, 1056-1057 pain management in, 231 Enolic acids, 996 Dyspepsia, 761-762 prescription drug use in, 230-231 Enoxacin, 820 Dysproteinemic neuropathies, 581 pressure sores in, 233-236 Enoxaparin, 754 Dysthymia, 286 respiratory tract viral infections in, 335 Entamoeba histolytica, 264 Dystocia, 123-125 sexuality issues in, 504-506 Enteric pathogens, 355 shoulder, 124-125 suicide in, 294 Enteritis, 355 Dystonia, 311-312, 571-572 urinary incontinence in, 228-230 Enterobius vermicularis, 169-172 urinary tract infections in, 821 Entropion, 606-607 Enuresis, 203-205 E-mail.1136 Electrical injury, 401 Enuresis alarms, 204 Ear Electrocardiography (ECG), 659 foreign bodies in, 638 Epicanthus, 606 cardiac arrhythmias and, 666 infant abnormalities of, 157 Epicondylitis, 967 peripheral vascular disease and, 492 neonatal abnormalities of, 152 Epidemiology, 34 of surgical patients, 489 Ear barotrauma, 436-437 Epidermodysplasia verruciformis, 1034 syncope and, 706 Early and Periodic Screening, Epidermophyton, 1035 Diagnostic, and Treatment Program Electroconvulsive therapy (ECT), 280, Epidural (spinal) anesthesia, 84,90, 124, (EPSDT),53 289,291 489 Early antigen (EA), 326 Electroencephalography (EEG) Epigastric pain, 761-762 Eating disorders, 213-214, 304-306 encephalitis and, 585 Epiglottitis, 163, 164-165 amenorrhea and, 904-905 seizure disorders and, 550, 551 Epilepsy, 103-104, see also Seizure Eaton-Lambert syndrome, 749 Electrolytes disorders EBNA (Epstein-Barr virus nuclear athletes and, 449-451 continuous partial, 549 antigen), 326 disorders of, 825-842 etiology of, 547 EBV, see Epstein-Barr virus Electromyography, 588 gelastic, 549 Ecchymosis, 603 Electrophysiologic stimulation (EPS) juvenile myoclonic, 549, 551, 552 Echoviruses, 331 studies, 667, 706-707 primary, 548 Eclampsia, 111-115 Electrosurgery, 1048 secondary acquired, 548 Ecologic model, 32-33 Elevated arterial plasma, 828 temporal lobe, 554 Ecological model of intervention, Elevated arterial plasma pH, 828 tonic-clonic, 547, 549, 551 160-161 Elevated BUN concentration, 828 Epiphora, 608 ECPPA (Estudo Colaborativo para Emergency oral contraceptive pill, Episcleritis, 593, 597 Prevencao da Pre-eclampsia con 886-887 Episiotomy, 90-91, 134 Aspirina), 113 Emla,423 Epistaxis, 633-634 ECST (European Carotid Surgery Trial), Emotional abuse, 245 EPSDT (Early and Periodic Screening, 562 Emphysema, 71 Diagnostic, and Treatment Ecstasy (MDMA), 215, 523 Empty sella syndrome, 1100 Program), 53 Ecthyma, 1028 Enabler, defined, 508 Epstein-Barr virus (EBV), 325-327, 341, Ectoparasitic infections, 354-355 Enalapril (Vasotec), 644, 700 479 Ectopic beats, 685 Encephalitis, 584-585 Epstein-Barr virus (EBV) antibody Ectopic pregnancy, 108-111 testing, 326 Encopresis, 205 Ectropion, 607 Epstein-Barr virus nuclear antigen End-stage renal disease (ESRD), 847 Effective circulating volume (ECV), 829, (EBNA),326 Endep, see Amitripryline 830,831,832,834,835 Epstein's pearls, 152 Endocarditis, 719-720 Effexor (venlafaxine), 290 Epulus fissuratum, 627 Endocervical curettage, 918 Ehlers-Danlos syndrome, 686, 688 Erb's palsy, 150 Ehrlichiosis, 367 Endocrine disorders, 1098-1107 Ergotamines, 543,544 Elavil, see Amitriptyline anemia and, 1113 Erysipelas, 1029 Elbow, 966-967 pregnancy and, 99-100 Erythema chronicum migrans (ECM), 380 Elbow-radial head fractures, 966-967 in surgical patients, 496 Erythema infectiosum, 170-171,1031 Elbow-radial head subluxation, 188-189, Endolymphatic hydrops, see Meniere's Erythrasma, 1027-1028 967 disease Erythromycin, 618 Eldepryl (selegiline), 566-567, 569 Endometrial ablation, laser, 906, 907 Erythroplasia of Querat, 1044 Elderly, 227-236 Endometrial biopsy, 945 Escherichia coli, 768-769 abuse of, 256-260 Endometrial cancer, 913, 920-921 food poisoning and, 812-813, 814 alcoholism in, 507-508 Endometrial cytology, 921 sepsis and, 368, 369 depression in, 292 Endometrial hyperplasia, 920-921 Esmolol (Brevibloc), 668 description of old age stage, 10-11 Endometriosis, 941-944, 946 Esophageal chest pain, 650-651 falls in, 227-228, 1092 Endometritis, 134 Esophagitis, 761-762 1172 Index

Esotropia, 606, 613 External femoral rotation, 183, 184 Fecal impaction, 792 Essential tremor, 570-571 External hemorrhoids, 790 Fecal incontinence, 241 Estrogen-replacement therapy (ERT), External hordeolum, 607 Fecal occult blood testing (FOET), 911,913-914 Extracorporeal shock wave lithotripsy 797-798 common preparations for, 912 (ESWL),878 Felodipine (Plendil), 644 contraindications for, 914 Extracutaneous systemic sporotrichosis, Felon, 972 osteoporosis and, 913, 1091-1092 1038 Female reproductive system risks and benefits of, 913 Extraocular movements, 602 disorders of, 939-948 urinary incontinence and, 870 Extrinsic falls, 227 tumors of, 916-922 Estrogens Eye Femoral antetorsion, 183 dyslipidemias and, 1062, 1064 disorders of, 606-614 Femoral anteversion, 183, 186 specific types, 1102 HIYand,362 Femoral neuropathy, 578 Estudo Colaborativo para Prevencao da infant abnormalities of, 157 Femoral rotation, 183, 184 Pre-eclampsia con Aspirina injuries suggesting child abuse, 246 Fenfluramine (Pondimin), 469 (ECPPA), 113 Lyme disease and, 380 Fentanyl, 424-425,529,535 Ethacrynic acid, 700 neonatal abnormalities of, 152 Fetal alcohol effect (FAE), 510-511 Ethambutol, 96,360,741 Rocky Mountain spotted fever and, 383 Fetal alcohol syndrome (FAS), 80, 161, Ethionamide, 96 trauma to, 601-605 510-511 Ethnicity, see also specific ethnic groups Eyelids, 606-607 Fetal assessment, 89 alcoholism and, 507 congenital abnormalities of, 606 Fetal fibronectin (fFN), 117 issues in, 19 lacerations of, 603 Fetal heart rate (FHR) monitoring, Ethosuximide, 551, 552, 553 positional abnormalities of, 606-607 125-127 Ethyl chloride, 423 trauma to, 601 Fetal pulse oximetry, 126 E thylsuccinate / sulfisoxazole Fetal scalp pH monitoring, 126 (Pediazole), 618 Factitious disorder by proxy, 302 Fetal surveillance, 122-123 Etoposide (YPI6), 750, 751 Factitious disorders, 297, 302 intrapartum, 125-127 European Carotid Surgery Trial (ECST), Failure to thrive (FTT), 156 Fetal tissue transplants, 569 562 Falls, 227-228, 1092 Fetal ultrasonography, 87, 100 Eustachian tube dysfunction, 616 Famciclovir (Famvir), 353 FEYl (forced expiratory volume in Euthyroid sick syndrome, 1083 Familial adenomatous polyposis (FAP), 1 second), 727-728 Evoked potentials, 590 143,796 Fever, 156-159 Ewing's sarcoma, 1011 Familial Alzheimer's disease, 239 Fiber, 61, 811 Exanthem subitum, 170-171 Familial dysbetalipoproteinemia (type Fibric acids, 1062 Exanthema subitum, 1031 III),1059 Fibroadenomas, 884,928-929,935 Excision of large lesions, 1048 Familial hypercholesterolemia (FH), 1058 Fibroblastic phase of wound healing, 421 Exercise, 58-61 Familial hypoalphalipoproteinemia, 1058 Fibrocystic breasts, 884, 927-928 for asthma, 729 Families, 26-30 Fibromyalgia (FM), 1005-1007 for back disorders, 956 Family-centered care, 2, 160 FICSIT (Frailty and Injuries: Cooperative chronic heart failure and, 697 Family counseling, 266-273, see also Studies of Intervention Techniques), for COPD, 729 Family therapy 227 counseling to increase, 59-60 Family health advisor, 28-29 Field blocks, 424 dyslipidemias and, 1060-1061 Family physicians Fifth disease, 170-171, 1031 effects of starting, 59 number of, 2 Fifth metatarsal fracture, 986 fibromyalgia and, 1007 profile of, 1144-1152 Finasteride (Proscar), 855 impact on health, 58 role in managed care, 1140-1141 Finger, 970-972 obesity and, 468 Family planning, 880-888, 887 athletic injuries to, 460 osteoporosis and, 1091 Family practice fractures of, 970-971 pregnancy and, 451 evolution of, 1153-1158 infection of, 972 rheumatoid arthritis and, 995 history of specialty, 1-2 injuries to, 430-432 stress testing prior to, 60 international, 1-2 tendon injuries in, 971 Exercise-induced anaphylaxis (EIA), 322 Family stress, 266-273 Fires, 202 Exercise-induced asthma (EIA), 727 Family systems theory, 26-27 First aid kits, 66 Exercise prescription, 60-61 Family therapy, 30, see also Family First degree atrioventicular block, 671, Exercise tolerance (treadmill) testing counseling 677 (ETT),653 medical, 272 First degree bums, 438 Exotropia, 613 Famotidine, 763 First fail philosophy, 516 Expectorants, 732 Fastin (phentermine hydrochloride), 469 First heart sound (Sd, 683 Explicit approach, 1128 Fat, dietary, 61 Fishhook removal, 442-443 Exposure therapy, 280 Fat cell theory, 467 Fissured tongue, 627 Extension exercises, 956 Fatigue, 135, 477-481 Flagyl, see Metronidazole External barotitis, 437 Fatty liver, 510 Flat spring diaphragm, 882 External beam radiation therapy, 856 Febrile convulsions, 555 Flatfoot, 187-188 Index 1173

Flecainide (Tambocor), 668 swallowed,441-442 cerebrovascular disease and, 557 Flexible fiberoptic nasolaryngoscopy, Formula feeding, 154-155 Gender socialization, 7-8 636-637 Foscarnet (Foscavir), 360 General anesthesia, 489 Flexible flatfoot, 187-188 Fosinopril (Monopril), 644, 700 General practitioners, 2 Flexible sigmoidoscopy, 798 Fosphenytoin, 555 Generalized anxiety disorder, 276-278 Flexion exercises, 956 Fourth degree bums, 439 Generalized lichen planus, 1051 Flooding therapy, 280, 282 Fourth heart sound (S4, atrial gallop), Generalized seizures, 547-549, 551 Flow sheets, 50-51 684-685 Genetic disorders, 138-144 Fluconazole, 361 Fractional excretion of sodium, 829 amenorrhea secondary to, 903 Fluid disorders, 825-842 Fragile X disease, 78 chromosomal,138-141 Fluid therapy, 802-803 Frailty and Injuries: Cooperative Studies internet resources for, 144 Fluids, 449-451 of Intervention Techniques (FICSIT), in lung cancer, 747 Flumadine (rimantadine), 332 227 Mendelian, 138, 141-142 Flunarizine, 543 Framingham Study, 557, 558, 696, 704 mitochondrial, 138 Fluoride, 154,155,625,1092-1093 Franzel's glasses, 472 multifactorial, 138, 142 5-Fluorouracil (5-FU), 778, 798 Free thyroxine index (FTI), 1078 somatic, 138, 143-144 Fluoxetine, 290 Freebase, 520 Genetic screening, 78 for bulimia nervosa, 306 Freon, 524 Genital herpes, 222,248,1033-1034 for migraine, 543 Frostbite, 398-399 Genital ulcer disease, 353-354 for obsessive compulsive disorder, 280 FSH, see Follicle-stimulating hormone Genital warts, 248, 351-352,1034 for obsessive compulsive personality Functional fecal retention, 205 Genitalia, ambiguous, 153 disorder, 309 Functional incontinence, 229, 867, 868 Genitourinary system for panic disorder, 275 Fungal infections, 1035-1037, 1054 disorders of, 866-878 for sleep apnea, 486 Furnucles, 1029 neonatal abnormalities of, 153 for weight loss, 469 Furosemide, 645, 694, 700 Genograms, 141 Flurazepam, 484 Gentamicin, 820 Flutamide, 857 Gabapentin, 552, 553 Geographic tongue, 627 Fluvastatin, 1062 GABHS (group A ~-hemolytic Gestational diabetes mellitus (GDM), 87, Fluvoxamine (Luvox), 275-276, 280 Streptococcus),339-343 99-100,1074 Focal segmental glomerulonephritis, 849 Gait abnormalities, 183-186 Giant cell tumor, 1011 Focal segmental glomerulonephrosis, 849 Galactorrhea, 929-930 Giant papillary conjunctivitis, 596 Folate deficiency, 1114 Galleazzi's sign, 191 Giardia lamblia, 264, 378 Folic acid, 61 Gallstones, 805-806 Giardiasis, 378-379 anticonvulsants and, 553 Gamekeeper's thumb, 460, 971-972 GIFT (gamete intrafallopian tube deficiency of, 580, 1114 Gamete intrafallopian tube transfer transfer),943 neural tube defects and, 78-79, 85, 142 (GIFT),943 Gingivitis, 626 Folic acid antagonists, 77 y-globulin, 1119 Glaucoma, 612-613 Follicle-stimulating hormone (FSH), 884, Ganciclovir, 360 acute angle-closure, 593, 599, 612-613 899,909, 1101 Ganglion cysts, 1010 chronic open-angle, 612 Follicular carcinoma, 1085 Gardnerella vaginalis, 895 Gleason staging system, 856 Folliculitis, 1029 Gasoline sniffing, 524 Glenohumeral disorders of the shoulder, Food allergies, 811-812 Gastric cancer, 766 965-966 Food impaction, 441 Gastric lavage, 410, 418 Global subjective judgment, 1128 Food poisoning Gastritis, 761-762, 765 Globe rupture, 604 associated with neurological disorders, Gastrocnemius partial tear, 981 Glomerulonephritis, 847, 848-850 814-815 Gastroenteritis, 168-169 acute, 340 bacterial,812-814 Gastroesophageal reflux disease nonproliferative, 848-849 Food safety, for international travelers, 65 (GERD), 156, 761, 762-763 proliferative, 849-850 Foot Gastrointestinal disorders Glucocorticoids, 998, 1102 diabetes mellitus and, 1071 in athletes, 449 Glucophage (metformin hydrochloride), injuries of, 983-986 HIV and, 363 1072-1073 problems of, 187-188 in infants and neonates, 158 Glucose-6-phosphate dehydrogenase Foot axis, 183, 184 pregnancy and, 102 (G6PD), 70,619 Foot progression angle, 183-184 Rocky Mountain spotted fever and, 383 Goeckerman regimen, 1021 Forced expiratory volume in 1 second Gate control theory of pain transmission, Goiter, 1078, 1079-1080 (FEV)), 494, 727-728 527 Gold compounds, 77, 997 Fordyce's granules, 627 Gaucher's disease, 141 Goldman Cardiac Risk Index, 490 Forefoot injuries, 985 Gays, see Homosexuals; Lesbians Gonadarche, 1101 Foreign bodies Gelastic epilepsy, 549 Gonadotropin-releasing hormone in the ear, 638 Gemfibrozil, 1061, 1062, 1064 (GnRH), 884, 899, 1101 in the eye, 602-603 Gender, see also Men; Women Gonorrhea, 346-347 in the nose, 637-638 alcoholism and, 508 adolescents and, 222 1174 Index

Gonorrhea (cont.) clinical approach to, 538-539 Hemangiomas, 152,627, 1041-1042 clinical presentation, 346 cluster, 539, 540, 543-545 Hematocrit,494-495 diagnosis of, 347 diagnosis of, 539-540 Hematologic disorders sexual assault and, 264 follow-up care, 542 pregnancy and, 97-99 treatment of, 347 history of, 540 systemic lupus erythematosus and, 1001 Gopher, 1136 migraine, see Migraine Hematologic malignancies, 1124-1125 Gout, 1095-1097 mixed,539 Hematologic system, 494-495 acute, 1095-1096 negotiation of management, 541-542 Hematopoietic system pseudo, 1097 physical examination for, 541 disorders of, 1116-1125 Graded exercise testing (GXT), 666 primary, 539 HIVand,362 Granulocyte / macrophage-stimulating secondary, 539, 546 Hemic murmur, 158 factors, 362 tension/stress, 539, 540, 544, 545-546 Hemochromatosis, 1122-1123 Granulomatous thyroiditis, 1082 Healers, 23 Hemodialysis, 847 Graves' disease, 78, 100,1079-1081,1085 Health care agents, 534 anaphylactoid reactions to, 323 Grief,536 Health care workers, 392-393 Hemoglobin, 494-495 Group A ~-hemolytic Streptococcus Health examinations, periodic, 39 Hemoglobin E, 1111 (GABHS) pharyngitis, 339-343 Health Information for International Travel Hemolytic anemia, 448,1112 Group B streptococci, 368, 369 (HIT),66 Hemophilia, 560 Group model health maintenance Health maintenance organizations Hemophilia A, 1116-1117 organizations (HMOs), 1140 (HMOs), 39, 53, 1139-1140 Hemophilia B, 1117 Growth hormone, 1100 Health Plan Employer Data and Hemorrhage Guanabenz (Wytensin), 175,644 Information Set (HEDIS), 52-53 postpartum, 132-133 Guanfacine (Tenex), 644 Health Professional Assistance stroke and, 559-560 Guide to Clinical Preventive Services, 37, 39 Amendments, 32 subconjunctival, 603, 607 Guidelines for Adolescent Preventive Health promotion, 56-62 Hemorrhoids, 788-790 Services (GAPS), 207 for elderly, 232 Henoch-Sch6nlein purpura (HSP), "Guidelines for the Selection of Office preconception care and, 74 1119-1120 Computer Systems for Family pregnancy and, 85-86 Heparin Physicians", 1133 Health risk appraisals (HRAs), 51-52 cerebrovascular disease and, 561-562 Guillain-Barre syndrome, 327, 588-589 Healthy People 2000, 52, 53 Guyon's canal syndrome, 577 Hearing aids, 631,633 deep venous thrombosis and, 714, 717, 754-755 Gynecologic problems, HIV and, 363 Hearing impairment, 631-633 Gynecomastia, 925, 931 in adults, 632-633 inhaled, 446 in children, 631-632 low-molecular weight, 495,714,717 Habit reversal, 179, 180 Down syndrome and, 200 myocardial infarction and, 660 Haemophilus ducreyi, 353, 354 in infants, 157 preconception care and, 77 Haemophilus inJluenzae, 367, 368, 369, 370, noise-induced, 391-392,402 spontaneous abortion and, 107 734, 736, 738 Heart, 664-665, see also Cardiac entries Hepatitis Haemophilus inJluenzae vaccine, 42, 738 Heart disease alcoholic, 510, 784-785 Haglund's deformity, 984 HN and, 362-363 chronic, 782-783 Hair loss, 1053-1055 international travelers and, 71 drug-induced, 785-786 pathologic, 1053-1054 valvular, 492 viral, see Viral hepatitis physiologic, 1054-1055 Heart failure, 693-703 Hepatitis A vaccine, 67, 68, 95, 783 postpartum, 135 acute, 693-695 Hepatitis A virus (HAV), 94-95, 780-781, Hairy leukoplakia, 325, 327, 362, chronic, 695-703 783 1043-1044 congestive, see Congestive heart failure Hepatitis B immunoglobulin (HBIG), Halfan (halofantrine), 70 diastolic, 700-701 392,784 Halitosis, 626-628 Heart sounds, 683-685 Hepatitis B vaccine, 42, 68, 69, 95, 211, Hallucinogens, 523 Heartburn, 102 358,784 Halperidol, 572 Heat exhaustion, 397, 449-450 Hepatitis B virus (HBV), 781 Hand, disorders of, 969-970 Heat illness, 449 chronic, 782-783 Hand-foot-mouth disease, 341, 1034 Heat injuries, 397-398 Down syndrome and, 200 Hashimoto's thyroiditis, 1082, 1083 Heat rash, 1019 health care workers and, 392 Hay fever, 314-318 Heat stroke, 397-398, 450 preconception care and, 76 hCG, see Human chorionic gonadotropin Heat syncope, 449 pregnancy and, 95 Head Heavy drinking, defined, 508 prevention of, 783-784 infant abnormalities of, 157 HE DIS (Health Plan Employer Data and sexual assault and, 264 neonatal abnormalities of, 152 Information Set), 52-53 Hepatitis C virus (HCV), 76,95, 392, Head lice, 1039 Heimlich maneuver, 436 781-782 Headache syndromes, 546 Helicobacter pylori, 762, 763-764 Hepatitis D virus (HDV), 95,782,783 Headaches, 538-546 HELLP syndrome, 99, 102, 111, 112 Hepatitis E virus (HEV), 782 classification of, 539 HELPER mnemonic, 125 Hepatocellular carcinoma, 786 Index 1175

Hereditary hemorrhagic telangiectasia Hodgkin's lymphoma, 474 vulvovaginitis and, 894, 897 (HHT),1119 Holmes and Rahe life events scale, 267 Human papillomavirus (HPV), 1034 Hereditary neuropathies, 580 Home blood glucose monitoring adolescents and, 222 Hereditary nonpolyposis colon cancer (HBGM),1068 cervical carcinoma and, 917 (HNPCC),143 Homelessness, 222 condyloma acuminata and, 793-794 Heroin,216,442,522 Homicide, 202 features of vaginal infection with, 896 Herpangina, 164-165,334-335,341 Homosexuals genital warts and, 351 Herpes gestationalis, 103 in adolescence, 8, 221-222 of male genital tract, 860-861 Herpes simplex labialis, 627, 1032, 1033 HPVand,860 Humerus fractures, 966 Herpes simplex virus (HSV), 352-353 sexual care for, 503-504 Hydralazine (Apresoline), 114, 645 clinical presentation of, 353 in young adulthood, 9 Hydroceles, 153,872-873 diagnosis of, 352 Honeymoon cystitis, 503 Hydrochlorothiazide (Hydrodiuril), HIV and, 360, 362 Horman sign, 98 447-448,645,700 infections with, 1032-1034 Hormonal contraception, 883-886 Hydroxychloroquine, 997 mucocutaneous, 360 Hormone replacement therapy, 913-915, H ygroton (chlorthalidone), 645, 700 in respiratory tract infections, 331 1102 Hymenoptera stings, 406 sexual abuse and, 248 Hospice programs, 533-534,748 Hyperaldosteronism, 1106 Herpes simplex virus 1 (HSV-1), Hospital admission privileges, 1150-1151 Hyperbicarbonatemia, 840-841 1032-1033 Hot flashes, 910, 911 Hypercalcemia, 828, 1104 Herpes simplex virus 2 (HSV-2), Hot-tub folliculitis, 1029 Hyperchloremia, 825 1032-1033 HPY, see Human papillomavirus Hypercholesterolemia screening, 41 Herpes zoster, 361, 362, 578, 1032 Human chorionic gonadotropin (hCG), Hyperglycemia, 828 Herpesviruses, 87, 896 87,108-110,139,880 Hyperkalemia, 825, 836-837 Heteroarylacetic acids, 996 Human Genome Project, 144 Hyperlipidemia, 447 Heterophile antibodies, 326 Human immunodeficiency virus (HIV), Hypermagnesemia, 828 Hidradenitis suppurativa, 793, 1029 4,364-357,743-744,860 Hypernatremia, 825, 827,834-835 High altitude cerebral edema (HACE), acute pancreatitis and, 774 Hyperopia, 614 70-71 adolescents and, 8, 207, 222 Hyperosmolality, 825 High altitude pulmonary edema antiretroviral therapy for, 359 Hyperparathyroidism, 1104 (HAPE), 70-71 bacteremia and, 370 Hyperphosphatemia, 829 High density lipoprotein (HDL), clinical presentation of, 359-364 H yperprolactinemia, 1098-1099 910-911,1056-1057 condom use and, 883 Hypersensitivity, 391 diabetes mellitus and, 1067 counseling and, 357-358 Hypertension, 640-648 low, 1058-1059, 1060, 1063, 1064 cultural issues in, 20 in athletes, 447-448 High-risk populations, 39 drug abuse and, 525 cerebrovascular disease and, 557 High urine pH, 829 hairy leukoplakia and, 1043-1044 chronic renal failure and, 847 Hip health care maintenance and, 358-359 detection of, 640 apophysitis of, 193 in health care workers, 392-393 diabetes mellitus and, 1070 developmental dysplasia of, 190-191 hepatitis C virus and, 95 emergencies in, 648 dislocation of, 975-976 inflammatory neuropathies and, 578-579 medical history in, 641 fractures of, 974-975 international travelers and, 66 nonpharmacologic therapeutic problems of, 189-194 Kaposi's sarcoma and, 362, 364, 1045, approachesto,642 rotation of, 184 1046 pharmacologic therapy for, see septic,189-190 laboratory markers of, 359 Antihypertensive medication transient synovitis of, 189 meningitis and, 584 physical examination and laboratory Hirschsprung's disease, 199 in neonates and infants, 150-151 tests in, 641-642 Hirsutism, 1103-1104 neurosyphilis and, 588 pregnancy-associated, 101-102, 111-115 Hispanics opportunistic infection prophylaxis, pulmonary, 468 alcoholism in, 507 359,362 severe, 648 demographic shifts and, 21 preconception care and, 75-76 in surgical patients, 491 health status of, 21 pregnancy and, 87 Hyperthyroidism, 100, 1077-1081 systemic lupus erythematosus in, 1000 risk factors, risk reduction, and patient Hypertrichosis, 1103-1104 Histamine-1 (Hl) receptor antagonists, education, 357 Hypertriglyceridemias, 1058, 1064, 1071 317 seborrheic dermatitis and, 1022 Hypertrophic cardiomyopathy, 690, 721, Histamine-2 (H2) receptor antagonists, sepsis and, 366 722 761-762,763,764,765 sexual abuse and, 248 Hypertrophic lichen planus, 1051 Histoplasmosis, 739-740 sexual assault and, 264 Hyperuricemia, 1095, 1096-1097 Histrionic personality disorder, 307, 310 spermicides and, 883 Hyperventilation, 759 HIV, see Human immunodeficiency virus testing for, 357-358 Hypervolemia, 832-833 HMG CoA reductase inhibitors, 1061, toxoplasmosis and, 372, 373, 374-375 Hyphema, 603-604 1062 treatment regimens for, 360-361 Hypnotherapy, 631 Hoarseness, 635-636 tuberculosis and, 740, 741,742 Hypnotics, 530 1176 Index

Hypobicarbonatemia, 825, 837-839 for international travelers, 66-69 of oral cavity, 627 Hypocalcemia, 828, 1104-1105 Immunoglobulin A (IgA) nephropathy, Inflammatory bowel disease, 770-771, Hypochloremia, 825 849 797 Hypochondriasis, 299,300-301 Immunosuppressive agents, 1119 Inflammatory neuropathies, 578-579 Hypoglycemia, 150,828,1106-1107 Immunotherapy Inflammatory phase of wound healing, Hypogonadism, 1103 for asthma and COPD, 728-729 421 Hypokalemia, 825,835-836 for Guillain-Barre syndrome, 589 Inflammatory ulcer, of oral cavity, 627 pseudo, 836 for multiple sclerosis, 590 Influenza, 332-333 Hypomagnesemia, 828 Impairment evaluation, 395 Influenza vaccine, 68, 69, 333, 737 Hypomenorrhea, 899 Impedance plethysmography (IPG), 715 Influenza viruses, 329-330 Hyponatremia, 825, 826, 832, 833-834 Impetigo, 1028 Informatics, 34 Hypoparathyroidism, 1104-1105 Impetigo herpetiformis, 103 Information management, 1131-1137 Hypophosphatemia, 828-829 Implantable cardiac defibrillators Infrared radiation, 400 Hypopigmentation disorders, 1050-1051 (ICDs), 667-670, 710 Ingrown toenails, 1053 Hypopituitarism, 1099-1100 Implicit approach, 1127-1128 Inguinal hernia, 806-807 Hypospadias, 153 In-toeing, see Metatarsus adductus Inhalants, 216 Hypotension In vitro fertilization, 943 Inhalation injury, 401-402 in newborns, 149 Incontinence Injectable anesthesia, 423 orthostatic, 228,475, 706 anal,791-792 Injuries, 435-443 Hypothalamic disorders, 901-903 fecal,241 Injury prevention, 202-203 Hypothalamic failure, 904 urinary, see Urinary incontinence Injury Prevention Program, The (TIPP), Hypothermia, 398 Increased afterload, 685 203 Hypothyroidism, 1082-1083 Increased preload, 685 Inner ear barotrauma, 437 amenorrhea and, 900,901 Indapamide (Lozol), 645 Inositol, 275 Down syndrome and, 199-200 Indene acetic acids, 996 Insect avoidance, 65 preconception care and, 78 Independent practice associations Insect skin infestations, 1038 pregnancy and, 100 (IPAs),1140 Insect stings, 321-322 Hysterectomy, 906, 907, 920, 921, 941 Inderal, see Propranolol Insomnia, 482-485 Hysterosalpingography (HSP), 946 Indinavir, 360 chronic, 482 Hytrin (terazosin), 644 Indole acetic acids, 996 psychophysiologic (conditioned), 483 Indomethacin, 118, 119, 1096 transient, 482 lAPP (islet amyloid polypeptide), 778 Infants, 151-161, see also Neonatal entries; Instrumental activities of daily living Ice (drug), 215, 522 Newborns (IADLs),233 Ideal body weight (IBW), 1069 approaches to common problems of, Insulin, 1069 Idiopathic anaphylaxis, 323 157-158 surgical patients and, 496 Idiopathic scoliosis, 195-196 cardiac murmurs in, 690-691 type I diabetes mellitus and, 1071-1072 Idiopathic thrombocytopenic purpura description of stage, 6-8 type II diabetes mellitus and, 1072-1074 (ITP),1118-1119 family risks and resources, 159-61 Insulin-dependent diabetes mellitus IDLH (immediately dangerous to life or HIV in, 150-151 (IDDM), see Type I diabetes mellitus health),388 language delays in, 198 Insulin hypothesis, 447 Iliad,1135 motor delays in, 198 Insulin resistance, 1070, 1071, 1072, 1074 Imipenem-cilastatin, 820 neurosyphilis and, 588 Integrated delivery systems, 1140, 1141 Imipramine, 290 nutrition, feeding, and associated Interdigital neuralgia, 578 for attention deficit/hyperactivity problems, 151-156 Interdigital neuritis, 986 disorder, 176 selected problems of, 198-205 Interferon, 875 enuresis and, 204 sepsis in, 368-370 Interferon-a, 95 for panic disorder, 275, 276 sexuality issues and, 501-502 Intermittent positive reinforcement, 173 for posttraumatic stress disorder, 283 of substance-abusing mothers, 161 Internal femoral rotation, 183 for urinary incontinence, 870, 871 Infections Internal hemorrhoids, 788-790 Immediately dangerous to life or health finger, 972 International Agency for Research on (IDLH),388 hand,969 Cancer (!ARC), 392 Immersion foot, 399 in infants, 154 International travelers, 64-71 Immune serum globulin (ISG), 67, 68 skin, see Skin infections immunizations for, 66-69 Immune thrombocytopenia, 78 Infectious dermatitis, of the eye, 607 medical history of, 64 Immune thrombocytopenic purpura Infectious diarrhea syndromes, 768-769 posttravel evaluation of, 71 (ITP),99 Infectious diseases, 372-384 preexisting diseases in, 71 Immunizations, see also specific types Infectious mononucleosis, 325-327, 341 pretravel education of, 65-66 for adolescents, 211 Infectious proctitis, 793 trip risk assessment for, 64 analphylaxis induced by, 323 Infertility, 942, 943, 944-946 Internet, 1135-1136 for asthma and COPD patients, 729 Infiltration blocks, 423-424 Interstitial lung disease (ILD), 757-758 childhood schedule for, 42 Inflammation Intestinal artresia, 153 for health care workers, 392-393 of the eye, 607 Intracranial injuries, 246 Index 1177

Intracuticular running suture, 428, 429 Ketamine, 424 Learning model of alcoholism, 508 Intrapartum fetal surveillance, 125-127 Ketoconazole (Nizoral), 894 Legg-Calve-Perthes disease (LCPD), 189, Intrauterine devices (IUDs), 880-882, 906 Ketorolac (Acular), 318, 1008 191, 192 Intravenous immunoglobulin (ivIg), 589 Kidney, see entries beginning with Renal Legionella, 734, 735, 739 Intrinsic falls, 227 Kindling, 515 Legionnaire's disease, 736, 739 Iodine 131 ablation, 1080 defined,508 Leiomyomas, 916-917 Ionizing radiation injuries, 399--400 Klebsiella, 369 Lennox-Gastaut syndrome, 549, 554 Ipecac, 410,413,417 Klinefelter syndrome, 140 Lens of the eye, 612 Ipratropium bromide (Atrovent), 317 Klonopin, see Clonazepam Lentigo maligna, 1045 Iron deficiency anemia (IDA), 97, Knee Lentigo maligna melanoma (LMM), 1046 1109-1110 angular abnormalities of, 186 Leprosy, 579 Iron supplementation, 97, 154, 448 athletic injuries of, 456 Lesbians Irritable bowel syndrome (IBS), 772-773 dislocation of, 978-979 in adolescence, 8, 221-222 Irritant contact dermatitis, 395, 1024, 1025 pain in, 978-980 sexual care for, 504 Irritation fibromas, 627 Knock-knees, 186 in young adulthood, 9 Ischemic heart disease (IHO), 650-661, Korsakoff's psychosis, 510 Leucovorin calcium, 361 see also Chest pain; Myocardial Leukemias, 1125 infarction L-dopa,312,567-569 chronic myelogenous, 144 ISIS-2 (Second International Study of Labetolol (Normodyne), 644, 645 Down syndrome and, 200 Infarct Survival), 660 Labor, 89-90 Leukoplakia, 627, 1043 Islet amyloid polypeptide (lAPP), 778 active phase of, 123 hairy, 325, 327, 362, 1043-1044 Isoimmune neutropenia, 1122 bleeding complications during, 128-129 Leukorrhea, 896 Isoniazid, 96, 359, 741, 742 normal, 89-90 Leuprolide (Lupron), 857, 917 Isoproterenol, 707 preterm, 115-120 Levatol (penbutolol), 644 Isoptin, see Verapamil primary dysfunctional, 123 Levocabastine (Livostin), 317-318 Isotretinoin (Accutane), 77, 1017, 1023 problems during, 122-129 Levodopa, see L-dopa Isradipine (Dynacirc), 644 prolonged latent phase of, 123 Lewy body dementia, 239 IUDs, see Intrauterine devices prolonged second-stage of, 123 Lhermitte's sign, 959 IvyBlock (bentoquatum), 1022 support during, 90 Lice, 1039 Ixodes pacificus, 379 Labyrinthitis, 474 Lichen planus, 896, 1051 Ixodes scapularis, 379 Lachman test, 457 Lichen sclerosis, 896 Lacrimal system, 608 Lichen simplex chronicus, 896 Janimine, see Imipramine Lactic acidosis, 1072-1073 Lid lag, 1078 Japanese encephalitis vaccine, 68, 69 Lactose intolerance, 155, 168, 812 Lidocaine,423,544,668 Jaundice, 149-150 Lamivudine, 359, 360, 525 Life cycle approach to sexuality, 501-506 Jet lag, 66 Lamotrigine, 551, 553 Life-long obesity, 465 Jock itch, 1036 Language delays, 198 Life support withdrawal, 711 Joint National Committee on the Lanoxin (digoxin), 669, 699 Ligamentous knee injuries, 980 Detection and Evaluation and Laparoscopic surgery, 109, 110-111, 803 Light therapy, 484 Treatment of High Blood Pressure, Laparoscopy,940-941,946 Lioresal (baclofen), 575-576 447, 642, 643 Large bowel diseases, 768-773 Lipid Research Clinics Study, 445 Joint pain, 991-992 Large-cell carcinoma, of the lung, 748 Lipomas, 1042 Jones' fractures, 463 Large fontanels, 152 Lisfranc injury, 984-985 Junctional nevi, 1042 Lariam (mefloquine), 69 Lisinopril, 644, 700 Jungle, The (Sinclair), 386 Laryngitis, 163,334 Lispro, 1072 Juvenile kyphosis, 196 Laryngotracheobronchitis, 163, 164-165, Listening skills, 15 Juvenile myoclonic epilepsy, 549, 551, 552 333 Listeria monocytogenes, 368, 369 Juvenile rheumatoid arthritis, 999-1000 Laser assisted keratomileusis (LASIK), Listeriosis, 94 614 Lithium, 289 K-ras gene, 778 Lasers, 400 for narcissistic personality disorder, 307 Kaiser Health Plan, 1139, 1140 Lasix, see Furosemide for obsessive compulsive disorder, 280 Kaposi's sarcoma, 362, 364, 1045, 1046 Late syphilis, 349 for posttraumatic stress disorder, 283 Karyotyping, 138 Latent syphilis, 349 preconception care and, 77 Katch and McArdle's body fat test, 466 Lateral epicondylitis, 461 properties of, 291 Kawasaki disease, 167-168 Latex allergy, 393 Lithotomy position, 89, 90 Keflex, see Cephalexin Latex-induced anaphylaxis, 322 Liver disease, 780-786 Kegel pelvic muscle exercises (PME), LD50, 387 alcoholism and, 510 870,912 LD90, 387 anemia and, 1113 Keloids, 1042 Lead poisoning, 41, 176,200-202,580, chronic, 1113 Keratitis, 593, 596-597 1111 in surgical patients, 495--496 Keratoacanthomas, 1042 LEARN moodel, 24 Living wills, 534 Kerlone (betaxolol), 644 Learning disabilities, 176-177 Livostin (levocabastine), 317-318 1178 Index

Lobar atelectasis, 758 Lymphogranuloma venereum (LGV), Maternal a-fetoprotein (AFP), 87, 139, Lobular breast cancer, 935 353-354 142 Lobular carcinoma in situ, breast, 935 Lymphomas Maturation (remodeling) phase of Localized lichen planus, 1051 African Burkitt's, 325 wound healing, 421 Lodoxamide (Alomide), 318 HIVand,364 Maxillofacial surgery, 486 Lomefloxacin, 820 Hodgkin's, 474 Maximal predicted heart rate (MPHR), 61 Loop diuretics, 645, 646, 699,700 non-Hodgkin's, 364 Mazindol (Sanorex; Mazanor), 469 Lopressor, 644, 668 Lysergic acid diethylamide (LSD), 215, MD Computing, 1133 Lorazepam (Ativan), 276, 555 216,523 MDMA (ecstasy), 215,523 Losartan (Cozaar), 643-645 Measles, 170-171 Lotensin (benazepril), 644, 700 Macrocephaly, 152 Measles/mumps/rubella (MMR) Lovastatin, 1062, 1064 Macrocrystalline nitrofurantoin, 820 vaccine, 41, 42, 68, 76, 167,211 Low back pain, 389-390, 958 Macrocytic anemias, 1114-1115 Measles vaccine, 67, 68 Low-birth-weight newborns, 147-48 Macrovascular disease, 1070-1071 Measles virus, 331 Low density lipoprotein (LDL), 646, 910, Macular degeneration, 611 Meconium ileus, 153 1056-1057 Magnesium, 515, 642 Medial collateral ligament (MCL) sprain, diabetes mellitus and, 1071 Magnesium sulfate, 114, 118, 119 457 elevated, 1058, 1059-1060, 1062-1064 Magnetic resonance imaging (MRI) Median neuropathies, 576-577 Low-molecular-weight heparin Alzheimer's disease and, 238 Median rhomboid glossitis, 627 (LMWH), 495, 714, 717 back disorders and, 952-953 Medicaid, 32, 53 Low urine pH, 829 cerebrovascular disease and, 561 Medical family therapy, 272 Lower extremity cervical carcinoma and, 919-920 Medical literature, 1134 disorders of, 189-194,974-986 cervical myelopathy and, 959 Medical records, 18 torsional and other variations of, 183-188 encephalitis and, 585 automated, 1132-1134 Lower leg injuries, 981 multiple sclerosis and, 590 patient-held mini, 51 MedicAlert bracelet, 320 Lower respiratory tract infections, 101 seizure disorders and, 550 Medicare, 32, 53 Lown-Ganong-Levine (LGL) syndrome, Mailing lists, 1136 670,674 MEDLINE, 1134 Major depression, 285-286 Lozol (indapamide), 645 Medroxyprogesterone acetate, 901, 906, Malabsorption, 769-770 LSD (lysergic acid diethylamide), 215, 943 Malaria 216,523 Medullary carcinoma, 1085 cerebral, 584 Ludiomil (maprotiline), 290 Mefloquine (Lariam), 69 prophylaxis for, 69-70 Lumbar spondylolisthesis, 461-462 Megaloblastic anemias, 1114 Male genital tract, surgery of, 858-864 Lumbar spondylolysis, 461-462 Megestrol acetate (Megase), 857, 936 Male pattern baldness, 1054-1055 Lumbosacral neuropathies, 577-578 Melanocytic nevocellular nevus, 1042 Malignancy-associated neuropathies, 581 Lung cancer, 474, 746-751 Melatonin, 66, 484 diagnosis of, 748-749 Malignant melanoma, 1046 Membranous nephropathy, 849 non-small-cell, 748, 749-751 Malignant otitis externa (MOE), 623 Men, see also Gender primary prevention of, 746-747 Malignant skin tumors, 1045-1046 as perpetrators of domestic abuse, 252 secondary prevention, 747 Malingering, 297, 302 physical examination for sexual small-cell, 748, 749, 751 Mallet finger injuries, 971 complaints, 501 staging of, 749 Malocclusion, 626 as sexual assault victims, 261, 264 tertiary prevention, 747-748 Mammalian bites, 404-405 urinary tract infections in, 820-821 treatment of, 749-751 Mammograph~913,920929,934-935 Menarchal anovulatory uterine bleeding, Lung disorders, see also Pulmonary Managed care, 18,1139-1143 905 entries Managed competition, 1140 Menarche,209,219,899 HIV and, 363 Mantoux tuberculin test, 96,742 Mendelian disorders, 138, 141-142 occupational, 390-391 MAOIs, see Monoamine oxidase Meniere's disease, 473, 630, 633 Lupron (leuprolide), 857, 917 inhibitors Meningitis, 582-584 Luteinizing hormone (LH), 880,883,899, Maprotiline (Ludiomil), 290 acute bacterial, 583 904,905,909,945,1101 Marcaine, 423 noninfectious, 584 Luvox (fluvoxamine), 275-276, 280 Marcus Gunn pupil, 602 recurrent, 584 Lyme arthritis, 380 Marfan syndrome, 686, 688, 691 rickettsial, 584 Lyme disease, 367, 379-382, 407, 578 Marginal placenta previa, 129 syphilitic, 584, 586 clinical presentation of, 379-381 Marijuana, 154, 215, 216, 523 tuberculous, 584 diagnosis of, 381 Marine animal stings, 408 viral,584 epidemiology of, 379 MAST (Michigan Alcoholism Screening Meningococcus vaccine, 67, 68 management of, 381 Test),512 Meniscal injuries, 456-457, 978, 980 meningitis and, 584 Mast stabilizers, 317 Menometrorrhagia, 900 Lymph nodes, HIV and, 362 Masticatory fibromyalgia, 628 Menopause, 9,909-915, 1087,1091-1092 Lymphadenectomy, 920 Mastitis, 134, 929 hormone use in, 913-915 Lymphocytic thyroiditis, 1082 Material Safety Data Sheets (MSDSs), 387 late onset and endometrial cancer, 921 Index 1179

Menopause (cant.) pregnancy and, 104 Multifocal atrial tachycardia (MAT), 671, management of common problems, Milia, 157 672-674 911-912 Miliaria, 157, 1019 Multiple endocrine neoplasia type II preventive care for, 912-913 Mineralocorticoids, 1102 (MEN-II), 1084 Menorrhagia,881-882,900,906-907 Minerals, 61-62, 213 Multiple myeloma, 1124 Menstrual disorders, 899-908 Minicounseling topics, 52 Multiple neuropathies, 575 Meperidine (Demerol), 529 Minimal change nephropathy, 848 Multiple personality disorder, 309 Mepivacaine, 423 Minipress, see Prazosin Multiple Risk Factor Intervention Trial Meralgia paresthetica, 577 Minoxidil, 645,1055 (MRFIT),445 Mesalamine, 771 Miosis, 606 Multiple sclerosis (MS), 474, 589-591 Mesangiocapillary glomerulonephritis, MIRNET (Michigan Research Network), Mumps, 166-167 849 650 Mumps orchitis, 167 Metabolic acidosis, 837-839 Misoprostol, 765 Mumps vaccine, 41, 42, 68, 76, 167, 211 Metabolic alkalosis, 840 Mitochondrial disorders, 138 Munchausen syndrome, 308 Metabolic disorders, 150, 474, 476, Mitomycin C, 875 Munchausen syndrome by proxy, 247, 1098-1107 Mitral stenosis, 687-688 302 Metabolic equivalents (METs), 59-60 Mitral valve prolapse, 686-687 Murmurs, see Cardiac murmurs Metabolic neuropathies, 575, 579-580 Mitral valve regurgitation, 686 Muscle relaxants, 956 Metacarpal fractures, 969 Mixed acid-base disorders, 841-842 Muscle strain, 976-977 Metacarpophalangeal (MCP) joint Mixed headaches, 539 Musculoskeletal disorders, 1005-1014 in children, 183-196 sprain, 460 Mixed hearing loss, 631 Metastatic malignant bone tumors, 1013 HIVand,364 Mixed incontinence, 867, 868, 871 Metatarsal injuries, 985-986 neonatal, 154 Mobitz type I block, 67l, 677, 678 Metatarsalgia, 985 Musculoskeletal injury Mobitz type II block, 671, 677, 678 Metatarsus adductus, 154, 184-186 occupational, 388 Moexipril (Univasc), 644 Metformin hydrochloride (Glucophage), vertigo and, 474 Moles, 1042 1072-1073 Mushrooms (hallucinogenic), 216 Molluscum contagiosum, 1035 Methadone, 522 Myasthenia gravis, 118 Mongolian spots, 153 Methamphetamine, 175 Mycobacterium avium intracellulare Monoamine oxidase inhibitors (MAOls), Methazolamide, 571 complex (MAC), 359, 360, 361, 362, 276,283,289,291 Methimazole, 1080 743 Monomorphic ventricular tachycardia Methotrexate, 110, 111, 875, 997, 998 Mycobacterium bovis, 96 (VT),679 Methoxyflurane inhaled, 544 Mycobacterium tuberculosis, 96, 362, 363, Mononeuropathies, 575, 576-578 Methsuximide, 552, 553 740 Mononucleosis, infectious, 325-327, 341 Methyldopa, 114, 644 Mycoplasma pneumoniae, 101,734, 738-739 Methylphenidate (Ritalin), 175, 176 Monopril (fosinopril), 644, 700 Mycotic diseases, 894 Methysergide, 543 Moral model of alcoholism, 508 Mydriasis, 606 Metoclopramide (Reglan), 570, 763 Moraxella catarrhalis, 734 Myelinopathy, 575 Metolazone (Zaroxolyn), 645, 700 Morbilliform rashes, 1031 Myelodysplastic syndromes (MDS), Metoprolol (Lopressor), 644, 668 Morpheaform basal cell carcinoma 1114,1124-1125 Metronidazole, 116, 894, 895, 1023 (BCC),1045 Myelophthisic anemia, 1113 Metrorrhagia, 900 Morphine,535,659-660,694,747-748 Myocardial infarction, 656-657,658-661 Mexilitine (Mexitil), 668 Morton's neuroma, 986 electrical complications of, 660 MICE mnemonic, 390 Mosaic warts, 1034 evaluation following, 661 Michigan Alcoholism Screening Test Mosquitoes, 407-408 heart failure and, 701 (MAST),512 Motion sickness, 66 management of, 659-660 Michigan Research Network (MIRNET), Motor delays, 198 mechanical complications of, 660 650 Motor vehicle injuries, 202 primary prevention of, 47 Microcephaly, 79, 152 Mouth, neonatal abnormalities of, 152 Q-wave versus non-Q-wave, 659 Microcytic anemias, 1109-1111 Movement disorders, 565-572 rehabilitation following, 661 Microdiscectomy, 957 Moyamoya disease, 560 Myocarditis, 724 Microsporosis, 1035 MPTP, 570 Myofascial pain syndrome, 1007 Microsporum, 1035 MRFIT (Multiple Risk Factor Intervention Myopia, 614 Microvascular angina, 652 Trial),445 Myringotomy, 620 Microwave radiation, 400 Mucoceles, 627 Myringotomy and tympanostomy with Midamor (amiloride), 645 Mucocutaneous herpes simplex, 360 tube placement (MTTP), 621 Midazolam (Versed), 424 Mucocutaneous lymph node syndrome, Mysoline, see Primidone Middle age, 9-10 167-168 Middle phalangeal fractures, 970-97l Mucocutaneous sporotrichosis, 1038 Nadolol (Corgard), 644 Midfoot injuries, 984-985 Mucolytics, 732 Nail bed injuries, 432 Migraine, 539,540,542-543,544 Mucosal lichen planus, 1051 Nail biting, 180 ocular, 611 Multifactorial disorders, 138, 142 Nail problems, 1052-1053 1180 Index

Naloxone, 522, 904 Neonatal seizures, 555-556 Nociceptive pain, 534-535 Naltrexone (Revia), 517 Neonatal sepsis, 148 Nocturnal enuresis, 203, 204 NAMCS (National Ambulatory Medical Neoplasia, 954 Nodular basal cell carcinoma (BCC), 1045 Care Survey), 1146 Nerve blocks, 424 Nodular melanoma, 1046 Narcissistic personality disorder, 307,310 Nerve conduction studies, 588 Noise-induced hearing loss (NIHL), Narcolepsy, 485 Nervous system, see also Neurologic 391-392,402 Narcotics, 956 disorders Nonacetylated nonsteroidal Nasal steroids, 338 disorders of, 582-591 antiinflammatory drugs, 996-998 NASCET (North American Symptomatic neonatal abnormalities of, 154 Nonarrhythmic syncope, 706 Carotid Endarterectomy Trial), 562 Neural tube defects (NTDs), 78-79,85, Nonbacterial prostatitis, 852, 853 Nasolacrimal duct obstruction, 152, 157 142,553 Noncardiac chest pain, 650-652 Nasopharyngeal carcinoma, 325 Neuroendocrine system, 1100-1101 Noncardiac syncope, 704-705, 706 National Ambulatory Medical Care Neuroleptic malignant syndrome Noncompliance, 17-18 Survey (NAMCS), 207, 1146 (NMS),312 Non-Hodgkin's lymphoma, 364 National Cancer Institute, 58, 937 Neurologic disorders, see also Nervous Noninfectious meningitis, 584 National Cholesterol Education system Nonionizing radiation injuries, 400-401 Program, 1070-1071 HIV and, 364 Nonmegaloblastic anemias, 1114-1115 National Coalition against Domestic Lyme disease and, 380, 381 Nonopioid analgesics, 528, 535 Violence, 255 pregnancy and, 103-104 Nonossifying fibroma, 1013-1014 National Coalition of Physicians against Rocky Mountain spotted fever and, 383 Nonoxynol-9,883 Violence, 255 systemic lupus erythematosus and, 1001 Nonproliferative diabetic retinopathy, National Committee for Quality Neuromas, 1009-1010 610 Assurance (NCQA), 1142 Neuropathic pain, 534-535 Nonproliferative glomerulonephritis, National Council on Child Abuse and Neurosyphilis, 349, 586-588 848-849 Family Violence, 255 Neutropenia, 1120-1122 Non-Q-wave myocardial infarction, 659 National Down Syndrome Society, 140 Nevi Nonrecurrent croup, 163, 164-165,333 National Institute for Occupational compound, 1042 Nonscalpel vasectomy, 859-860 Safety and Health (NIOSH), 387, congenital nevomelanocytic, 1045 Non-smaIl-cell lung cancer (NSCLC), 388,390 junctional, 1042 748,749-751 National Institutes of Drug Testing in neonates, 153 Nonsteroidal antiinflammatory drugs (NIDA),393 strawberry, 1041 (NSAIDs) National Psoriasis Foundation, 1021 Nevus flameus, 1042 for back disorders, 956 Native Americans New York Heart Association (NYHA) for glomerulonephritis, 848 acute otitis media in, 617 classification system, 695 for gout, 1096 alcoholism in, 507 Newborn murmur, 149, 158 for menorrhagia, 906 chronic renal failure in, 847 Newborns, 146-151, see also Infants; nonacetylated, 996-998 clinical prevention for, 45 Neonatal entries peptic ulcer disease and, 761, 764 health status of, 21 guidelines for early hospital discharge, for rheumatoid arthritis, 995-998 osteoarthritis in, 988 151 Nonstress tests, 122-123 , tuberculosis in, 96 low-birth-weight, 147-48 Nonsustained ventricular tachycardia volatile substance abuse in, 524 postterm, 148 (VT), 671, 679, 680 Natural Death Act, 534 resuscitation of, 146 Nonulcer dyspepsia (NUD), 761,762 Natural family planning, 887 Newsgroups, 1136 Norepinephrine, 709 Navelbine (vinorelbine), 751 Niacin, 1061, 1064 Norfloxacin, 820 Near-drowning, 435-436 Nicardipine (Cardene), 644 Normocytic anemias, 1111-1114 Neck Nicotine gum, 57-58, 59 with decreased reticulocytes, 1112-1114 athletic injuries of, 458 Nicotine patches, 57-58 with elevated reticulocytes, 1111-1112 disorders of, 958-961 Nicotine replacement therapy, 57-58 Normodyne (labetolol), 644, 645 neonatal abnormalities of, 152 Nifedipine, 114, 119,644,871,1008-1009 Norpace (disopyramide), 668 Necrotizing fasciitis, 134, 1031 Nightmares, 181 Norplant, 886 Nedocromil, 731 Nimodipine, 562-563 Norpramin, see Desipramine Needle sheath technique, 442 NIOSH (National Institute for North American Symptomatic Carotid Nefazodone (Serzone), 290 Occupational Safety and Health), Endarterectomy Trial (NASCET), 562 Negative reinforcement, 173 387,388,390 Nortriptyline, 290 Negativistic personality disorder, 309 Nipple discharge, 926, 927, 929-930, 935 Norwegian scabies, 354 Negotiation, 17 Nipple pain, 930 Nose Neisseria gonorrhoeae, 346, 347, 348 Nisoldipine (Sulan), 644 foreign bodies in, 637-638 Neisseria meningitidis, 367,368, 369 Nitrates, 654-655 infant abnormalities of, 157 Neonatal abnormalities, 152-154 Nitroglycerin, 654, 655, 659, 694, 709 Nosebleeds, 633-634 Neonatal circumcision, 861-862 Nitrous oxide, 425 Novocain,423 Neonatal human immunodeficiency Nizatidine, 763 Nuclear sclerotic cataracts, 612 virus (HIV), 150-151 Nizoral (ketoconazole), 894 Nulliparity,920 Index 1181

Nursing caries, 625 Oligomenorrhea, 900 Otitis media Nursing home patients, 232-233 Omeprazole, 763, 765 acute, see Acute otitis media Nutrition, 61-62, see also Diet Omnibus Transportation Employee serous, 621-622 adolescents and, 212-213 Testing Act of 1991, 393 Otitis media with effusion, 621 dyslipidemias and, 1059 Oncogenes, 144 Ototoxicity, 474 elderly and, 232 Onychomycosis, 1037, 1052-1053 Ovarian cancer, 143,474,885,921-922 infants and, 151-156 Open-ended questions, 15, 16 Ovarian failure, 904 lung cancer and, 747 Ophthalmic involvement, see Eye Ovaries, menopause and, 909-910 preconception care and, 79 Ophthalmoscopy, 601-602 Overanxious disorder, 178-179 surgical patients and, 496-497 Opiate intoxication, 522 Overflow incontinence, 228-229, 230, Nutrition Screening Initiative (NSI), 232 Opioid analgesics, 528-529,535 867, 868, 871 Nutritional neuropathies, 580 Opportunistic infections, 359, 362 Overuse injuries, 460-463 Nutritional neutropenia, 1122 Oppositional defiant disorder, 177 Ovulation method of family planning, Nystagmus, 472, 473 Optic nerve, 612 887 Nystatin, 894 Optic nerve head edema (papilledema), Ovulatory dysfunctional uterine 612 bleeding, 906 Obesity, 465-469 Oral cancer, 626 Oxicams, 996 in adolescents, 213 Oral cavity, 362, 625-628 Oxyazolepropionic acids, 996 adult-onset, 465 Oral contraceptive pills Oxybutynin chloride, 871 defined, 465 combined dose, 883-885 Oxygen diet and, 467-468 diabetes mellitus and, 1074 for chronic obstructive pulmonary drug treatments for, 468, 469 emergency, 886-887 disease, 732 endometrial hyperplasia and cancer and, leukorrhea secondary to, 896 for headaches, 544, 545 920 progestin-only, 886 for myocardial infarction, 660 etiology and treatment of, 466-468 Oral herpes, see Herpes simplex labialis Oxytocin, 124 in infants, 155 Orbit of the eye insulin hypothesis and, 447 blowout fractures of, 604 p53 gene, 144, 747 life-long, 465 disorders of, 608-609 PAC (pontocaine / adrenaline / cocaine), methods for determining percent body trauma to, 601 423 fat, 466 Orbital cellulitis, 608-609 Pacemakers, 667-670 surgery for, 468, 469 Orientals, see Asians Paget's disease, 1014, 1104 Obsessions, 278 Ornithosis, 394 Pain Obsessive compulsive disorder (OCD), Orthostatic hypotension, 228,475,706 chronic, see Chronic pain 179,278-280 Osgood-Schlatter disease, 193 neuropathic, 534-535 Obsessive compulsive personality OSHA (Occupational Health and Safety nociceptive, 534-535 disorder, 278, 309, 310 Administration),387 somatic, 534-535 Obstructive airway disease, 726-733 Osler-Weber-Rendu disease, 1119 visceral, 534-535, 801 Obstructive sleep apnea syndrome Osteoarthritis, 953, 988-990, 994 Pain disorder, 299-300 (OSAS),485-486 Osteochondral fractures, 980 Pain management, 231 Occiput posterior position, 124 Osteochondritis dissecans (OCD), 194, for bums, 440 Occult bacteremia, 369 980 for dying patients, 534-535 Occupational cancer, 392 Osteochondroma, 1011 Palate, neonatal abnormalities of, 152 Occupational carcinogens, 746 Osteoid osteoma, 985,1011 Palliative care, 533-536 Occupational Health and Safety Osteoma, 1011 Palmar hand infections, 969 Administration (OSHA), 387 Osteonecrosis, 966 Paludrine (proguanil), 69 Occupational health care, 386-395 Osteoporosis, 974,1087-1093 Pamelor, 290 causation in, 387 clinical prevention for, 47 Pancreatectomy, 778 clinical conditions in, 388-390 diagnosis of, 954, 1089-1090 Pancreatic cancer, 777-778 for health care workers, 392-393 estrogen-replacement therapy and, 913, Pancreatic disease, 774-778 history in, 388 1091-1092 alcoholism and, 510 impairment evaluation in, 395 menopause and, 910, 1087, 1091-1092 Pancreatitis, 510 legal foundations of, 386-387 prevention of, 1090-1092 acute, 774-776 plant walk-throughs in, 395 risk factors for primary, 1088 chronic,776-777 toxicology in, 387-388 secondary causes of, 1088 Panic disorder, 274-276, 287 Occupational lung disease, 390-391 treatment of, 1092-1093 Papanicolaou (Pap) smear, 212, 351, 352, Ocular migraine, 611 Osteoporotic fractures, 1088-1089 917-918,921 Ocular toxoplasmosis, 372, 373,374 Osteosarcoma, 1011-1012 Papillary carcinoma, 1085 Oculomotor motility, 613 Osteroarthritis,59 Papillary hyperplasia, 627 Ofloxacin, 820 Otitis extema Papilloma, 627 OKY-1581, 562 acute, 622 Paracervical blocks, 941 Old age, 10-11 chronic, 623 ParaGard (TCU 380A), 881 Olecranon bursitis, 967 malignant, 623 Parainfluenza viruses, 330 1182 Index

Paralytic shellfish poisoning, 815 Pelvic pain, 939-941 side effects of, 553 Paraneoplastic syndromes, 474 Pemoline (Cylert), 175, 176 trigeminal neuralgia and, 575-576 Paranoid personality disorder (PPD), Penbutolol (Levatol), 644 Pheochromocytoma, 1106 307,310 Penicillamine, 997 Phobias, 179 Parasitic infections, 96-97 Penicillin, 618 Photokeratoconjunctivitis, 400 Parathyroid hormone (PTH), 1104-1105 Penicillin anaphylaxis, 322 Photorefractive keratectomy (PRK), 614 Parkinson-like symptoms, 312 Penile cancer, 860 Photosensitivity dermatitis, 1051 Parkinsonism-plus syndromes (PSP), 570 Pentamidine, 361 Physical abuse, 245-247 Parkinson's disease, 239, 565-570 Peptic ulcer disease (PUD), 102, 761-762, Physical Activity and Health, 444 clinical features of, 565-566 763-765 Physical therapy, 959, 960 diagnosis of, 566 Pepto-Bismol,814 Physician-assisted suicide, 534 drug therapy for, 566-569 Percutaneous discectomy, 957 Physician-centered physical epidemiology of, 565 Percutaneous nephrostolithotomy, 878 examination, 16 staging of, 566 Percutaneous trans luminal coronary Physician hospital organizations surgical therapy for, 569 angioplasty (PTCA), 490, 493, 654, (PHOs), 1140, 1141, 1142 Parlodel, see Bromocriptine 656, 657, 701 Physician networks (PNs), 1140, 1141 Paronychia, 972 Pergolide (Permax), 567 Physician's office, 37 Parotid gland swelling, 166-168 Periarticular shoulder problems, 965 Pick's disease, 239 Paroxetine,275,276,290 Pericarditis, 720-721 Pill-rolling tremor, 566 Parsonage-Turner syndrome, 576 Pericardium, 362-363 Pindolol (Visken), 644, 669 Partial previa, 129 Perimenopausal anovulatory uterine Pingueculum, 608 Partial seizures, 547-548, 549, 551 bleeding, 905-906 Pinworms, 169-172, 793 Passive-aggressive personality disorder, Periodontal disease, 626 Piperacillin-tazobactam, 820 309,310 Periodontitis, 626 Pitted keratolysis, 1028 Patellar dislocation, 457-458, 979, 980 Periorbital cellulitis, 608 Pituitary disorders, 901-903, 1098 Patent ductus arteriosus (PDA), 691 Peripheral acting drugs, 647 Pituitary failure, 904 Patient-centered approach, 15 Peripheral nervous system disorders, Pityriasis alba, 1050 Patient counseling, 1148-1150 574-581 Pityriasis rosea (PR), 1019-1020 Patient education, 16-17, 1148-1150 Peripheral neuropathy, 574-575 Pityriasis versicolor, see Tinea versicolor materials for, 52 Peripheral precocious puberty, 1101-1103 Pityrosporum (Malassezia) furfur, 1037 Patient-held minirecords, 51 Peripheral vascular disease (PVD), 492, Pivot shift test, 457 Patient Placement Criteria (PPC-II), 513 493,1071 Pizotifen, 543 Patient Self-Determination Act, 534 Peripheral vertigo, 473-474 PKU (phenylketonuria), 79 Patients Reports on System Performance Peritoneal dialysis, 847 PL99-457, 161 (PROSPER), 53 Peritonsillar abscess (PTA),340 Placenta, delivery of, 91 Pauciarticular juvenile rheumatoid Permax (pergolide), 567 Placenta previa, 129 arthritis, 999 Permethrin, 65, 381, 408 Placental abruption, 128-129 Paxil, see Paroxetine Permissible exposure limit (PEL), 388 Plague vaccine, 68, 69 PCP, see Pneumocystis carinii pneumonia Peroneal neuropathy, 578 Plant walk-throughs, 395 PCP (phencyclidine), 523-524 Personality disorders, 306-309 Plantar fasciitis heel spurs, 983-984 Peak expiratory flow rate (PEFR), defined, 306 Plantar warts, 1034 727-728 depression and, 288 Plantaris muscle strain, 981 Pedestrian injuries, 202 Pertofrane, 290 Plasma exchange (PE), 589 Pediazole Pertussis, 164-165 Platelet disorders, 1118-1119 (ethylsuccinate/sulfisoxazole),618 Pertussis vaccine (DPT), 42 Platelets, 495 Pediculosis, 1039 Petechiae, 153 Plendil (felodipine), 644 Pediculosis pubis, 354-355, 1039 Petit mal, 549 Pleural effusion, 756-757 PEEP (positive end-expiratory pressure), Peyronie's disease, 501 Pneumococcal vaccine, 737-738 753 Pharyngitis, 339-343 Pneumoconiosis, 391 PEFR (peak expiratory flow rate), Pharyngoconjunctival fever, 164-165,334 Pneumocystis carinii pneumonia (PCP), 727-728 Phencyclidine (PCP), 523-524 359,361,362,363,734,743-744 PEL (permissible exposure limit), 388 Phenelzine, 276, 283 clinical presentation of, 744 Pelvic adhesions, 940-941 Phenobarbital, 78,103-104,551,552,553, management of, 744 Pelvic avulsion injuries, 976 555 in neonates and infants, 151 Pelvic inflammatory disease (PID), Phenothiazines, 530 prevention of, 744 347-348 Phentermine hydrochloride (Adipex-P; Pneumonia, 734-738 actinomycotic, 881 Fastin),469 atypical, 735, 738-739 clinical presentation, 347-348 Phenylalanine, 79, 142 community-acquired,734-738 diagnosis, 348 Phenylketonuria (PKU), 79, 141, 142 Pneumocystis carin ii, see Pneumocystis intrauterine devices and, 881 Phenylpropanolamine hydrochloride, 870 carinii pneumonia oral contraceptives and, 884 Phenytoin, 78,85,551,552,555 pregnancy and, 101 treatment for, 348 pregnancy and, 103,104 typical, 735 Index 1183

Pneumothorax, 755-756 Potassium, 642 obstetric complications during, 106-120 Poison ivy, 1021-1022 Potassium-sparing diuretics, 645,646, parasitic infections in, 96-97 Poison oak, 1021-1022 700 postdates, 122-123 Poisoning, 409--419 PPIP (Put Prevention into Practice) postpartum care and, 131-136 acetaminophen, 409--411 program, 51 prenatal care and, 85-89 aspirin/salicylate, 414--416 Practice management systems, 1131-1132 pyelonephritis in, 819-820 benzodiazepine,416--417 Practice patterns, 1145-1146 respiratory disorders and, 100-101 cyclic antidepressant, 411--413 Pravastatin, 1062 risk assessment in, 87-88 food, see Food poisoning Prazosin, 447, 644,1009 sexual assault and, 263, 264 Polio vaccine, 42, 67, 68, 358 Precocious puberty, 209,1101-1103 skin disorders and, 103 Polyarticular juvenile rheumatoid Preconception care, 73-81 thyroid disease during, 100, 1085 arthritis, 999 family and genetic history in, 78 urinary tract infections and, 93-94, Polycystic kidney disease, 847 health promotion in, 74 818-819 acquired, 848, 850-851 history in, 75 varicella and, 95-96 autosomal dominant, 850 infectious disease history in, 75-77 viral hepatitis and, 94-95 autosomal recessive, 850 interventions during, 81 Premalignant skin lesions, 1042-1045 Polycystic ovarian disease, 903 laboratory tests in, 75, 80 Premature atrial complexes (PACs), see Polycythemia, 150,560, 1123 medical history in, 77-78 Atrial premature beats Polydactyly, 154 medications during, 77 Premature death, 38 Polydipsia, 1100-1101 physical examination in, 75, 80 Premature ventricular contractions Polymenorrhea, 900 psychosocial factors in, 79-80 (PVCs),491 Polymorphic ventricular tachycardia reproductive history in, 75 Prenatal care, 85-89 (VT),679 risk assessment in, 74-80 Prenatal screening, 86-87 Polymyalgia rheumatica, 1003 Preeclampsia, 79,102,111-115 Prerenal acute renal failure (ARF), Polyneuropathies, 575, 578-581 diagnosis of, 111-113 844-845 Polyps, 796 management of, 113-114 Presbyopia, 614 Polysomnography, 485 pathophysiology of, 111 Preschool-age child, developmental Polyuria, 1100 prevention of, 113 problems in, 199 Pomphylox, 1023 seizure disorders and, 103, 114 Prescription drug use, in elderly, 230-231 Pondimin (fenfluramine), 469 Preexcitation syndromes, 671, 673, Preseptal cellulitis, 608 Population-based health care, 32-36 674-675 Pressure sores, 233-236 Port-wine stain, 153, 1042 Preferred provider organizations (PPOs), Preterm delivery (PTD), 115 Positive end-expiratory pressure (PEEP), 1140 Preterm labor (PTL), 115-120 753 Pregnancy, see also Delivery; Labor; Preventive Services Task Force, U. S. Positive reinforcement, 173 Preconception care (USPSTF), 37, 38, 56 Positron emission tomography (PET) in adolescence, 8, 222 PRICEMM mnemonic, 978 lung cancer staging and, 749 alcohol use in, 85, 510-511 Primaquine, 70, 361 Parkinson's disease and, 566 anticonvulsants and, 552-553 Primary amenorrhea, 900 Postcoital bleeding, 900 asthma and, 732 Primary chondrosarcoma, 1011 Postdates pregnancy, 122-123 cardiac murmurs during, 691-692 Postencephalitic parkinsonism, 570 cardiovascular disease and, 101-102 Primary dysfunctional labor, 123 Posterior cruciate ligament (PCL) tear, cocaine use and, 85, 521 Primary encopresis, 205 979-980 domestic violence and, 244, 251 Primary enuresis, 203 Posterior dislocation of shoulder, 965 in Down syndrome women, 200 Primary epilepsy, 548 Posterior facet syndrome, 954 duration of, 89 Primary headaches, 539 Posterior interosseus syndrome, 577 ectopic, 108-111 Primary hypogonadism, 1103 Posterior segment injuries (eye), 604 endocrine disorders and, 99-100 Primary sleep disorders, 483 Posterior subcapsular cataracts, 612 exercise and, 451 Primary syphilis, 349 Postinfectious neutropenia, 1121 fetal assessment in, 89 Primidone, 104,551, 552, 553, 570-571 Postpartum care, 131-136 gastrointestinal disorders and, 102 Prinzmetal's angina, 652 Postpartum depression, 135 hematologic disorders and, 97-99 Probenecid, 1096-1097 Postpartum fever / infection, 133 hepatitis A virus and, 94-95, 783 Procainamide (Pronestyl), 668 Postpartum hemorrhage, 132-133 hepatitis B virus and, 95, 784 Procaine, 423 Postpartum thyroiditis, 135, 1085 heroin use in, 522 Procan SR, 668 Postpartum urinary retention, 132 HIV and, 75-76 Procardia, see Nifedipine Postrenal acute renal failure, 845 infections during, 93-94 Proctitis, 264 Postseptal cellulitis, 608-609 interventions considered for health Proctocolectomy, 771 Postterm newborns, 148 examination, 46--47 Proctocolitis, 355 Posttraumatic stress disorder (PTSD), medical problems during, 93-104 Progestasert (progesterone-releasing 251,281-283,287 neurological disorders and, 103-104 intrauterine devices), 881 Postvoiding residual volume (PVR), 229, neurosyphilis and, 587-588 Progesterone challenge test, 901-903,904 869 normal, 84-91 Progesterone level evaluation, 945 1184 Index

Progesterone-releasing intrauterine Psychiatric disorders, 304-312 Rabies vaccine, 68, 69, 405 devices (IUDs) (Progestasert), 881 chest pain and, 651-652 Race, 19, see also specific racial groups Progestin, 914 dizziness and, 476 Radial keratotomy, 614 Progestin-only pills (POPs), 886 insomnia and, 482 Radial neuropathies, 577 Progestin-releasing intrauterine devices Psychiatric syncope, 706, 707 Radial tunnel syndrome, 577 (IUDs),108 Psychophysiologic insomnia, 483 Radiation injuries Progestogens, 1102 Psychosocial issues, 15-16 ionizing, 399-400 Progressing stroke, 561-562 back disorders and, 955 nonionizing, 400-401 Progressive dementia, 239 in preconception care, 79-80 Radiation sickness, 399-400 Proguanil (Paludrine), 69 Psychotherapy, 312 Radiation therapy, 751, 936 Prolactin level elevation, 901 Psychotic disorders, 287 Radical prostatectomy, 856 Proliferative diabetic retinopathy, 610 Psyllium, 1062-1064 Radioallergosorbent test (RAST), 315, Proliferative glomerulonephritis, 849-850 PTCA, see Percutaneous trans luminal 320,322,812 Prolonged latent phase of labor, 123 coronary angioplasty Radiocontrast media, anaphylactoid Prolonged second-stage labor, 123 Pterygium, 608 reactions to, 323 Pronestyl, 668 Puberty, 1101-1103 Radiofibrinogen, 715-716 Pronestyl SR, 668 delayed, 1103 Radiofrequency catheter ablation (RFA), Propafenone (Rhythmol), 668 precocious, 209,1101-1103 667 Propantheline bromide, 871 Pubic lice, 354-355, 1039 Radiofrequency radiation, 400 Propionobacterium, 1027-1028 Pulmonary barotrauma, 437-438 Radionuclide perfusion imaging, 653 Propranolol,283,570-571,644,668,1009 Pulmonary embolism, 78, 98-99, 753-755 Radon, 747 Propylthiouracil, 1080 Pulmonary function tests, 727-728 Ramipril, 700 Proscar (finasteride), 855 Pulmonary hypertension, 468, 723, 755 Ramsey Hunt syndrome, 1032 PROSPER (Patients Reports on System Pulmonary infections, 734-744 Ranitidine, 763 Performance),53 Pulmonary outflow ejection murmur, 158 Rape, 262, 281, see also Sexual assault Prostat, see Metronidazole Pulmonary sarcoidosis, 758 Rape trauma syndrome, 264 Prostate cancer, 3-4, 46-47, 855-857 Pulmonary system, see also Lung entries RAST (Radioallergosorbent test), 315, Prostate disease, 852-857 Rocky Mountain spotted fever nd, 383 320,322, 812 Prostate-specific antigen (PSA), 3-4, 854, surgical patients and, 493-494 Raynaud's disease, 1001-1002 855-856 Punch biopsy, 1048 RBR'VS (Resource-based relative value Prostatitis, 852-853 Pupil of the eye scale),53 bacterial, 852-853 disorders of, 606 Reactive seizures, 548 nonbacterial, 852, 853 trauma to, 602 Recertifica tion, 1 Prostatodynia, 852, 853 Purified protein derivative (PPD) Recessive disorders, 141-142 Protease inhibitors, 360 tuberculin test, 96, 211, 358-359, 742 Recombinant interferon-p, 590 Proton pump inhibitors (PPI), 761-762, Push and clip technique, 442-443 Recommended book list, 1159 763,764,765 Put Prevention into Practice (PPIP) Rectal diseases, 788-794 Protraction disorders, 123 program, 51 Rectal prolapse, 792 Protriptyline, 290, 486 PU'VA,861, 1021, 1050 Recurrent acute otitis media, 620 Proximal fifth metatarsal fractures, 463 P'VR (postvoiding residual volume), 229, Recurrent cystitis, 819 Proximal interphalangeal (PIP) joint 869 Recurrent meningitis, 584 dislocations, 971 Pyelonephritis, 94, 818, 819-820 Recurrent spontaneous abortion, 106 Proximal phalangeal fractures, 970-971 Pyloric stenosis, 158 Red blood cell dysplasia, 1113 Prozac, see Fluoxetine Pyodermas, 1027-1031 Red eye, 592-599 Prurigo gestationalis, 103 Pyranocarboxylic acids, 996 Redux (dexfenfluramine hydrochloride), Pruritic urticarial papules and plaques Pyrazinamide, 96, 741 468,469 (PUPP),103 Pyridoxine, 96, 555 Referred pain, 801 Pruritus ani, 792-793 deficiency of, 580 Reflex incontinence, 867 Pruritus gravidarum, 103 urinary bladder cancer and, 875 Reflex sympathetic dystrophy (RSD), PSA, see Prostate-specific antigen Pyrimethamine, 361 1007-1009 Pseudoanemia,448 Pyuria, 822 Reflux esophagitis, 102 Pseudodementia of depression, 287 Refractive disorders, 613-614 Pseudoephedrine hydrochloride, 870 Q-tip test, 869 Reglan (metoclopramide), 570, 763 Pseudogout, 1097 Q-wave myocardial infarction, 659 Regression diet, 1059 Pseudohermaphroditism, 903 Quality assurance, 1132 Reimbursement, 53, 1140-1141, 1150 Pseudohypokalemia, 836 Quality of care and outcomes, 1142 Reiter syndrome, 364,1001 Pseudomonas aeruginosa, 369 Quick Medical Reference (QMR), 1135 Relative volume depletion, 829 Pseudopapilledema, 612 Quid pro quo technique, 272 Relaxation techniques, 484 Pseudostrabismus, 606 Quinapril, 644, 700 Reminder/prompting systems, 51 Psittacosis, 377-378 Quindine, 668 Renal, acute failure (ARF), 845-847 Psoriasis, 1020-1021 Renal adenocarcinoma, 851 Psoriatic arthritis, 1003 Rabies, 394, 405, 585 Renal cancers, 851 Index 1185

Renal disease, 844-851 pregnancy and, 101 hypertension and, 642 HIV and, 363-364 Rhinoviruses, 330 orthostatic hypotension and, 228 Rocky Mountain spotted fever and, 383 Rhipicephalus fanguineus, 382 SAMHSA (Substance Abuse and Mental systemic lupus erythematosus and, Rhogam,87 Health Services Administration), 393 1000-1001 Rhus allergy, 1021-1022 Sanorex (mazindol), 469 Renal failure Rhythmol (propafenone), 668 Saquinavir, 360 acute, see Acute renal failure RICE mnemonic, 457, 458, 977,980 Scabies,354-355,1038-1039 chronic, 847-848, 1113 defined, 456 Scapula, disorders of, 964 Renal system, in surgical patients, 496 Rickettsia ricketts ii, 382, 383 Scarlet fever, 340 Renal transplantation, 847-848 Rickettsial meningitis, 584 Scarring alopecia, 1054 Repolarization, alterations in, 446-447 Rifabutin, 360 Scheduling, 1132 Reproductive hormones, 909-901 Rifampin,360, 741 Scheuermann's disease, 196 Residency training, 1, 1144 Right-sided heart murmurs, 690 Schistosomiasis, 66 Resistant ovarian syndrome, 904 Rigid flatfoot, 188 Schizoid personality disorder (SPD), 307, Resource-based relative value scale Rimantadine (Flumadine), 332 310 (RBRVS),53 Risperidone (Risperdal), 311 Schizophrenia, 309-312 Respiratory acidosis, 840-841 Ritalin (methylphenidate), 175, 176 Schizotypal personality disorder (SzPD), Respiratory alkalosis, 838, 839 Ritodrine hydrochloride (Yutopar), 118, 307,310 Respiratory disorders, 752-759 119 School-age child, developmental drug abuse and, 525 Ritonavir, 360 problems in, 199 pregnancy and, 100-101 Robertsonian translocation, 138 Sciatic neuropathy, 578 Respiratory distress, 148 Rockwood technique, 459 Sciatica, 950 Respiratory failure, 752 Rocky Mountain spotted fever, 367, 381, Sclera, trauma to, 601 Respiratory syncytial virus (RSV), 133, 382-384,407 Scleritis, 593, 597-598 166,328-329 Rodent ulcers, 1045 Scleroderma, 1002 Respiratory tract viral infections, 328-335 Rogaine, see Minoxidil Sclerosing basal cell carcinoma (BCC), presentation of, 331-335 Rosacea, 1022-1023 1045 upper, 328-331 Roseola, 170-171 Sclerotherapy, 790 in very young and very old patients, 335 Ross-Loos Health Plan, 1139 Scoliosis, 195-196 Restless legs syndrome, 486 Rotator cuff injuries, 965 Scopolamine, transdermal, 66 Restricted antigen, 326 Rovsing's sign, 805-806 Scorpions, 407 Restricted subtype of anorexia nervosa, RSV, see Respiratory syncytial virus Scrotal masses, 871-873 305 Rubella, 76,170-171,1031 Scrotal squamous cell carcinoma (SCC), Restrictive cardiomyopathy, 721, 722 Rubella vaccine, 41, 42, 67,68, 76, 167, 860 Resuscitation, 146 211,393 Scrotal tumors,861 Retin-A (tretinoin), 1017, 1023 Running stitch, 428 Seborrheic dermatitis, 157, 362, 1022 Retina,609-{;11 Second degree atrioventicular block, 671, Retinal detachment, 610 SAD PERSONS scale, 295 677,678 Retinopathy of prematurity (RaP), 611 Sadomasochistic personality disorder, Second degree bums, 438-439 Retirement, 10 309 Second heart sound (S2), 683 Retropatellar pain syndrome (RPPS), 462 SAFE KIDS Campaign, 203 Second International Study of Infarct Retrovir, see Zidovudine Safe sex counseling, 500 Survival (ISIS-2), 660 Revascularization, 701 SAFE TEENS mnemonic, 211 Secondary acquired epilepsy, 548 Reverse transcriptase inhibitors, 360 Safety counseling, 202-203 Secondary amenorrhea, 900 Reversible dementias, 237-238 Salicylates Secondary drowning, 435 Reversible ischemic neurologic deficit poisoning with, 414-416 Secondary encopresis, 205 (RIND),559 for rheumatoid arthritis, 995-996 Secondary enuresis, 203 ReVia (naltrexone), 517 Salivary gland abnormalities, 634-{j35 Secondary headaches, 539, 546 Reye syndrome, 341, 999 Salivary gland swelling, 634-635 Secondary hypogonadism, 1103 Rh antibodies, 87, 107 Salivary stones, 635 Secondary parkinsonism, 570 Rheumatic fever, 340, 722-723 Salmeterol, 730 Secondary sexual characteristic Rheumatoid arthritis, 991-1000 Salmonella, 768 disorders, 1101-1104 clinical course of, 994 food poisoning and, 812-813, 814 Secondary syphilis, 349 clinical presentations of, 993-994 sepsis and, 368, 369 Sectral, see Acebutolol diagnosis of, 992-993 Salmonella enteriditis, 813 Sedation, 424 extraarticular manifestations of, 993 Salmonella paratyphi, 814 Sedatives, 530 juvenile, 999-1000 Salmonella typhi, 814 Sedentary life style, 58-61, 445 laboratory studies of, 994 Salmonella typhimurium, 813 SEER (Surveillance, Epidemiology, and osteoarthritis and, 994 Salpingocentesis, 110, 111 End Results), 921 treatment of, 994-999 Salt Seizure disorders, 547-556, see also Rhinitis chronic heart failure and, 697-{;98 Epilepsy allergic, 314-318 diabetes mellitus and, 1070 classification of, 547-548 1186 Index

Seizure disorders (cant.) Shave biopsy, 1048 Skin tags, 1041 diagnosis of, 549-550 Shelter leg, 399 Skin tumors, 1041-1049 differential diagnosis of, 550-551 SHEP (Systolic Hypertension in the benign, 1041-1042 Down syndrome and, 200 Elderly Program), 557 malignant, 1045-1046 drugs causing, 548 Shigella, 769 premalignant, 1042-1045 drugs of choice for, 551-554 food poisoning and, 812-813, 814 Skull fracture, 246 etiology of, 547 Shin splints, 462-463 Sleep apnea, 485-486 management of, 551 Shingles, see Herpes zoster Sleep disorders, 482-486 pregnancy and, 103-104,114 Shock,149 in children, 180-182 surgical and avoidance therapy for, 554 Short-term exposure limit (STEL), 388 in infants, 158 syncope differentiated from, 705-706, 708 Shoulder, 964-966 primary, 483 Seizures dislocation of, 458-459 Sleep hygiene education, 483 alcoholism and, 515, 516 dystocia of, 124-125 Sleep restriction therapy, 483-484 cocaine abuse and, 521 glenohumeral disorders of, 965-966 Sleep terrors, 181 from poisoning, 413 impingement syndromes of, 460-461 Sleep walking and talking, 181 preconception care and, 78 periarticular problems of, 965 Slipped capital femoral epiphysis Selective serotonin reuptake inhibitors traumatic dislocation of, 964-965 (SCFE),190 (SSRIs), 275-276, 289-291, 305, 517 Shy-Drager syndrome, 475, 570 Small bowel diseases, 768-773 Selegiline (Eldepryl), 566-567, 569 Sialadenosis, 635 Small-cell lung cancer (SCLC), 748, 749, Self-neglect, 256 Sialolithiasis, 635 751 Senile purpura, 1119 Sick building syndrome, 391 Small fontanels, 152 Seniors, see Elderly Sickle cell anemia, 141 Smoking, 56-58 Sensorineural hearing loss, 631, 633 bacteremia and, 370 adolescents and, 215 Separation anxiety, 178 cerebrovascular disease and, 560 assessment form for, 57 Sepsis, 366-371 description of, 1123-1124 breast-feeding and, 154 neonatal,148 screening for, 78,87 chronic obstructive pulmonary disease severe, 366 Sideroblastic anemia, 1111 and,732 Septic hip, 189-190 SIDS (sudden infant death syndrome), colorectal cancer and, 797 Septic pelvic thrombophlebitis, 134 159 impact on health, 56 Septic shock, 366 Silent ischemia, 658 lung cancer and, 746 Serositis, 1000 Simple, easy bruising, 1120 oral contraceptives and, 884, 885 Serotonin, 509, 529 Simple interrupted stitch, 427-428 osteoporosis and, 1088, 1091 Serotonin receptor agonists, 543,544 Simple partial seizures, 547, 549, 554 preconception care and, 80 Serous otitis media (SOM), 621-622 Simple pull technique, 442 pregnancy and, 85 Sertraline (Zoloft), 280,290 Simple ventricular arrhythmia (VA), prevalence of, 56 Serzone (nefazodone), 290 677-678 tobacco psychopharmacology and, 56 Sesamoids, 985 Simvastatin, 1062 urinary bladder cancer and, 873-874 Set point theory, 467 Sindig-Larsen-Johansson syndrome, 193 Smoking cessation Severe sepsis, 366 Sinsemilla, 523 adolescents and, 215 Sever's disease, 193-194 Sinus barotrauma, 437 dyslipidemias and, 1061 Sexual abuse Sinus bradycardia, 670, 671 impact on health, 56 of children, 247-248, 501,502, 939 Sinus pause/sinus arrest, 670-672 interventions to assist, 57-58 pelvic pain and, 939 Sinus tachycardia, 671, 672, 673 Snakebites, 407 somatization and, 301-302 Sinusitis, 337-339 Society of Prospective Medicine, 52 Sexual assault, 261-265 acute, 337-338 Sociocultural issues, 19-24 collection of evidence, 263 chronic recurrent, 338 Sodium, see Salt female victims, 261 Sixth disease, 1031 Sodium nitroprusside, 709 male victims, 261, 264 Sjogren syndrome, 635, 993, 1002-1003 Sodium/potassium pump theory, 467 spousal, 262 Skeletal injury, as child abuse, 246-247 Soft tissue disorders, 1005-1010 Sexual counseling, 499-506 Skin anatomy, 421 Somatic genetic disorders, 138, 143-144 Sexual dysfunction, 503 Skin disorders, 1050-1055, see also Somatic pain, 534-535, 801 Sexual history, 499-500 Dermatologic manifestations Somatization, 301-302 Sexual patterns, 503 HIV and, 362 Somatization disorder (SO), 298-299 Sexuality, life cycle approach to, 501-506 in infants, 157 Somatoform disorders, 297-303 Sexually transmitted diseases (STDs), in neonates, 152-153 depression and, 287 345-355, 895-896, see also specific pregnancy and, 103 management of, 301 types Skin infections, 1027-1038 not otherwise specified, 301 international travelers and, 66 bacterial, 1027-1031 undifferentiated, 301 sexual abuse and, 248 fungal,1035-1037 Sotalol (Betapace), 667, 669 sexual assault and, 263, 264 viral, 1031-1035 Spasmodic croup, 163,164-165,333 Shaken baby syndrome, 246 yeast, 1037-1038 Spermarche, 219 Sharp object ingestion, 442 Skin infestations, 1038-1039 Spermatoceles, 873 Index 1187

Spermicides, 883 Stress incontinence, 228, 229, 230, 867, Supraventricular tachycardia, 671, 673 Spider bites, 405--406 868,869, 870, 912 Suprax, see Cefixime Spina bifida, 78 postpartum, 135 Surgeon's knot, 428 Spina bifida occulta, 154 Stress testing, 60 Surgical patient medical care, 488--497 Spinal (epidural) anesthesia, 84, 90,124, String pull technique, 442 cardiac risk in, 490--493 489 Stroke, see also Cerebrovascular disease endocrine disorders and, 496 Spinal cord injuries, 821-822 completed,559 hematologic system in, 494--495 Spinal disorders in children, 194-196 hemorrhages and, 559-560 history in, 488 Spinal stenosis, 953-954 progressing, 561-562 laboratory testing of, 489 Spironolactone (Aldactone), 645, 700 Stuttering, 180 liver disease and, 495--496 Splenectomy, 1118 Subacromial bursitis, 965 physical examination in, 488--489 Splenomegaly, 1111-1112 Subacute cutaneous lupus preoperative report on, 489 Spondylolisthesis, 194-195 erythematosus, 1051-1052 pulmonary system in, 493--494 Spondylolysis, 194-195 Subacute painful thyroiditis, 1082 renal system in, 496 Spontaneous abortion, 106-108 Subacute painless thyroiditis, 1082 risk assessment in, 489--490 recurrent, 106 Subclavian steal syndrome, 705 Surmontil (trimipramine), 290 Spontaneous pneumothorax, 755-756 Subconjunctival hemorrhage, 603, 607 Surveillance, Epidemiology, and End Sporadic Alzheimer's disease, 239 Subcutaneous fat necrosis, 153 Results (SEER), 921 Sporotrichosis, 1038 Subluxation Sustained ventricular tachycardia, 671, Spousal sexual assault, 262 elbow-radial head, 188-189,967 679,680 Squamous cell carcinoma (SCC) shoulder, 964-965 Suture materials, 426 of the lung, 748 Sub segmental atelectasis, 758 Suture techniques, 427--428 Swallowed foreign body, 441--442 of the scrotum, 860 Substance abuse, see Drug abuse Swimmer's ear, 622 of the skin, 1043, 1044,1045-1046 Substance Abuse and Mental Health Services Administration Symmetrel (amantadine), 332,567 Squamous intraepidermal neoplasia (SAMHSA), 393 Sympathetic blockade, 1008 (SIN),1044 Subtotal thyroidectomy, 1080 Symptothermal method of family Staff model health maintenance Subungual hematoma, 1053 planning, 887 organizations (HMOs), 1140 Sucralfate, 761-762, 763, 764,765 Syncope, 704-708 Stages of life, 6-12 Sudden cardiac death (SCD), 677, arrhythmic, 706 Staghom calculus, 876 679-681 cardiac, 705, 706 Staphylococcus au reus Sudden infant death syndrome (SIDS), carotid sinus syncope, 705 bacteremia and, 370 159 cerebrovascular, 706 food poisoning and, 813 Suicide, 293-296 heat, 449 pneumonia and, 734 adolescents and, 214-215 nonarrhythmic, 706 sepsis and, 367, 368, 369 attempted versus completed, 294 noncardiac, 704-705, 706 Staphylococcus epidermidis, 368, 370 children and, 202 psychiatric, 706, 707 Staphylococcus food poisoning, 812-814 cluster, 293 vasovagal, vasodepressor, 704-705, Staples, 432 copycat, 293 706 STAR complex, 168 major risk factors for, 293 Syndactyly, 154 Status epilepticus, 551, 554-555 patient evaluation for, 294-295 Syndrome X, 652 Stavudine (d4T), 360 physician, 296 Synthroid, 1083 STEL (short-term exposure limit), 388 physician-assisted, 534 Syphilis, 348-351 Steroids, 496 prevention of, 295-296 cerebrovascular, 586-587 Stevens-Johnson syndrome, 623 Sulan (nisoldipine), 644 diagnosis of, 349 Stimson technique, 459 Sulfadiazine, 361 late (tertiary), 349 Stings Sulfamethoxazole, 618 latent, 349 hymenoptera, 406 Sulfasalazine (Azulfidine), 771,997 neuro,349,586-588 insect, 321-322 Sulfisoxazole, 618 primary, 349 marine animal, 408 Sulfonylureas, 1073 secondary, 349 Stomach surgery, 71 Sulindac (Clinoril), 799 sexual abuse and, 248 Stop Smoking Kit, 52, 58 Sumac, 1021-1022 sexual assault and, 264 Strabismus, 157, 200, 613 Sumatriptan, 543, 544, 545 treatment of, 349-350 Strawberry nevi, 1041 Sun lesions, 400--401 Syphilitic meningitis, 584, 586 Streptococcal toxic shock-like syndrome Sunburn, 440 Systematic desensitization, 275 (STSLS),340 Superficial basal cell carcinoma (BCC), Systemic lupus erythematosus (SLE), 78, Streptococcus pneumoniae, 101,369, 1045 1000-1001 370-371,734,735,738 Superficial spreading melanoma, 1046 Systemic-onset juvenile rheumatoid Streptococcus pyogenes, 367 Supraventricular arrhythmias, 670-677 arthritis, 999 Streptomycin, 96 Supraventricular / atrioventricular nodal Systemic sclerosis, 1002 Stress echocardiography, 654 reentrant tachycardias (AVNRT), Systolic Hypertension in the Elderly Stress fractures, 981 674 Program (SHEP), 557 1188 Index

TAC (tetracaine/ adrenaline/ cocaine), Therapeutic triangle, 28 TMP-SMX, see 423 Thiamine, 928 Trimethoprim-sulfamethoxazole Tacrine (Cognex), 240 Thiamine deficiency, 580 TNM staging system, 777, 798, 856 Takavasu's disease, 560 Thiazide diuretics, 645, 646, 699,700 description of, 750 Talar dome fractures, 982-983 Thigh-foot angle, 183, 184 Tobacco use, see Smoking Talipes equinovarus, 154, 187 Thiotepa, 875 Tocainide (Tonocard), 668 Tambocor (flecainide), 668 Third degree atrioventicular block, 671, Tocolytic treatment, 126 Tamotrigine, 552 677,678 Toe walking, 187 Tamoxifen, 927, 928, 930 Third degree burns, 439 Tofranil, see Imipramine Tampon use, 946-947 Third heart sound (S3), 683-684 Toilet training abuse, 501 Tanner stages of development Thoracic Scheuermann's disease, 196 Tolerance (alcohol), defined, 508 boys, 209,210 Thoracolumbar Scheuermann's disease, "Tongue-tied" neonates, 152 girls, 208 196 Tonic-clonic epilepsy, 547, 549, 551 Tardive akathisia, 312 Three-point mattress suture, 428,429 Tonocard (tocainide), 668 Tardive dyskinesia (TD), 312, 571-572 Throat, infant abnormalities of, 157 Tonsillectomy, 343 Tarsal tunnel syndrome, 984 Thrombocytopenia, 99 Tonsillopharyngitis, 163, 340, 341 Taxol, 750-751 Thromboembolic disorders, 98 Tophi,1097 Tay-Sachs disease, 78, 141 Thrombolytic therapy, 660, 755 Topical anesthesia, 423 TCD 380A (ParaGard), 881 Thrombophlebitis, 98, 134 TORCH,632 Technetium sestamibi (Cardiolyte), 653 Thrombotic thrombocytopenic purpura Torsade de pointes, 667, 680, 707 Technetium teboroxime (Cardiotech), 653 (TTP),99 Torsional variations of the lower Teething, 157 Thrush, 157,362, 1037 extremity, 183-188 Tegretol, see Carbamazepine Thumb injuries, 460, 970-971 Torus of palate or mandible, 627 Telemarche, 208 Thumb sucking, 179-180 Total cholesterol (TChol) levels, Telemedicine, 1135 Thyroid cancer, 1085 1056-1057 Television, 445 Thyroid disorders, 100, 1077-1085 Total joint replacement, 989 Telogen effluvium, 1054 Thyroid hormone, 1102 Total parenteral nutrition (TPN), 232, 497 Temper tantrums, 180 Thyroid hormone-binding ratio (THBR), Total placenta previa, 129 Temporal arteritis, 1003 1078 Tourette's syndrome, 179 Temporal lobe epilepsy, 554 Thyroid nodules, 1083-1085 Toxic Exposure Surveillance System (TESS),409 Temporomandibular arthralgia, 628 Thyroid-stimulating hormone (TSH), Toxic lung injury, 402 Temporomandibular joint syndrome 927,1078,1080 (TMJ),628 Toxic neuropathies, 580 Thyroid storm, 1077 Tenex (guanfacine), 644 Toxic shock syndrome (TSS), 367, 882, Thyroiditis, 135, 1082 Tennis elbow, 461 946-948 Thyrotoxic nodule, 1081-1082 Tenormin (atenolol), 644, 668 Toxic shock syndrome toxin-1 (TSST-1), Thyrotoxicosis, 1085 Tenosynovitis, 972 947 Thyroxine, 486, 1080, 1083 TENS (transcutaneous electrical nerve Toxicology, 387-388 TIAs, see Transient ischemic attacks stimulation), 956 Toxoplasma gondii, 96,359,361,362,372, Tension pneumothorax, 756 Tibial neuropathy, 578 373 Tibial periostitis, 462-463 Tension/stress headaches, 539, 540,544, Toxoplasmosis, 76, 86, 87, 96-97, 372-375 545-546 Tibial plafond fractures, 982 acute acquired, 372, 374 Teprolide, 562 Tibial rotation, 184 clinical presentation of, 373 Teratogens,77 Tibial torsion, 185 congenital, 372, 373 Terazosin (Hytrin), 644 Tic disorders, 179,572 diagnosis of, 373-374 Terbutaline, 118, 119 Ticarcillin-clavulanate, 820 disseminated, 372 Terminal care issues, 937 Ticks, 407-408 management of, 374 Tertiary syphilis, 349 Ticlopidine Aspirin Stroke Study, 562 ocular, 372, 373,374 TESS (Toxic Exposure Surveillance Tilt-table test, 475, 707 transmission of, 372-373 System), 409 Time-out, 173-174, 180 Tracking forms, 51 Testicular feminization, 903 Timolol (Blocadren), 644, 669 Tramadol, 535 Testicular torsion, 862-863 Tinea barbae, 1036 Transcutaneous electrical nerve Testosterones, 1102 Tinea capitis, 1035-1036 stimulation (TENS), 956 Tetanus prophylaxis, 433 Tinea corporis, 1036 Transesophageal echocardiography Tetanus vaccine, 42, 67, 68, 211, 433 Tinea cruris, 1036 (TEE), 561, 666 Tetracyclic antidepressants, 412 Tinea manus, 1036-1037 Transfusion reactions, 322-323 Thalamotomy, 569 Tinea pedis, 1036-1037 Transient hypertension of pregnancy, Thalassemia, 97-98,1110-1111 Tinea unguium, see Onychomycosis 102,115 (l-Thalassemia, 78 Tinea versicolor, 1037-1038,1050-1051 Transient insomnia, 482 ~-Thalassemia, 78 Tinnitus, 630-631 Transient ischemic attacks (TIAs), Thallium test, 653 TMJ (temporomandibular joint) 557-558,559,560,561-563 Theophylline, 731-732 syndrome, 628 Transient synovitis of the hip (TSH), 189 Index 1189

Transitional cell carcinoma, 851 pregnancy and, 96 Umbilical granuloma, 157 Translators, 24 preventive therapy for, 96 Unconjugated estriol (uE3), 87 Translocation, 144 therapy for, 96 Unconscious incontinence, 867 Transplant patients, 370 Tuberculous meningitis, 584 Undifferentiated somatoform disorder Transurethral resection of the prostate Tuberous sclerosis, 1050 (USD),301 (TURP), 854, 855 Tularemia, 394 Unipolar depression, 214, 289 Traumatic alopecia, 1054 Tullio phenomena, 475 Univasc (moexipril), 644 Traumatic athletic injuries, 454-460 Tumor necrois factor a (TNF-a), 366, University Group Diabetes Program Traumatic dislocation of shoulder, 367,368 (UGDP), 1073 964-965 Tumor suppressor genes, 144 Unstable angina pectoris, 656-658 Traumatic pneumothorax, 756 Tumors Upper extremity disorders, 963-964 Travelers, see International travelers bone, 1010-1013 Upper gastrointestinal bleed, 765-766 Traveler's diarrhea, 70, 813 of female reproductive organs, 916-922 Upper respiratory tract viral infections, Trazodone (Desyrel), 290 scrotal,861 328-331 Tremor, 565-566 skin, see Skin tumors Uremic neuropathy, 579-580 essential, 570-571 Turf toe, 985 Ureteroscopy, 878 pill-rolling, 566 Turner syndrome, 140,903 Urethritis, 819 Trench foot, 399 TURP (transurethral resection of the Urge incontinence, 228, 229, 230, Treponema pallidum, 348 prostate), 854, 855 866-867,868,870-871 Treponemal serology, 587 Twin studies Alzheimer's disease and, 241 Tretinoin (Retin-A), 1017, 1023 of alcoholism, 509 menopause and, 912 Triamterene (Dyrenium), 645, 700 of depression, 285 Uric acid nephropathy, 1097 Triceps skinfold test, 466 of osteoporosis, 1087 Urinalysis, 817 Trichiasis, 606 of seizure disorders, 547 Urinary bladder cancer, 873-875 Trichinella spira/is, 375 of systemic lupus erythematosus, 1000 Urinary incontinence, 228-230, 866-871 Trichinellosis, 375-377 Twins, birth of, 120 Alzheimer's disease and, 241 Trichlorethylene, 524 Tympanometry, 621 diagnostic tests for, 869-870 Trichomonas vagina/is, 891, 892, 894 Type A gastritis, 765 functional, 229, 867, 868 Trichomoniasis, 264, 354, 894 Type B gastritis, 765 history in, 867-868 Trichomycosis axillaris, 1027-1028 Type I diabetes mellitus (DM), 1069 mixed, 867, 868, 871 Trichophyton mentagrophytes, 1035 achieving glycemic control in, 1071-1072 overflow, 228-229,230, 867,868,871 Trichotillomania, 279, 1054 in athletes, 448 physical examination in, 868-869 Triclopidine, 562 chronic renal failure and, 847, 848 postpartum, 132 Tricyclic antidepressants metabolic acidosis and, 837 reflex, 867 for attention deficit/hyperactivity pathophysiology of, 1066 stress, see Stress incontinence disorder, 176 Type II diabetes mellitus (DM), 1069 therapy for, 870-871 for generalized anxiety disorder, 277 achieving glycemic control in, 1072-1074 unconscious, 867 for panic disorder, 275-276 in athletes, 448 urge, see Urge incontinence for posttraumatic stress disorder, 283 pathophysiology of, 1066-1067 Urinary magnesium concentration, 829 properties of, 289 Typhoid vaccine, 67, 68 Urinary potassium concentration, 829 for urinary incontinence, 870-871 Typical pelvic pain (TPP) posture, 940 Urinary retention, 132 Trigeminal neuralgia, 575-576 Typical pneumonia, 735 Urinary sodium concentration, 829 Trigger fingers, 971 Tzanck smear, 352 Urinary tract infections (UTIs), 817-823 Triglycerides (TG), 1058, 1060, 1063 acute uncomplicated in young women, Trimethadione, 103 UGDP (University Group Diabetes 819 Trimethoprim, 820 Program),1073 catheter-associated, 821 Trimethoprim-sulfamethoxazole Ulcerative colitis, 770-771, 791 in children, 817-818 (TMP-SMX), 361, 363, 618, 619, 744, Ulcers chronic in elderly, 821 820 genital, 353-354 complicated, 820 Trimetrexate, 361 international travelers and, 71 diaphragm use and, 882 Trimipramine (Surmontil), 290 of oral cavity, 627 laboratory guides and interpretation, Trisomy 13,140 peptic, 102,761-762,763-765 822-823 Trisomy 18, 87, 140 Ulnar neuropathies, 577 management of, 818 TSH, see Thyroid-stimulating hormone Ulnar tunnel syndrome, 577 postpartum, 134 Tubal ligation, 887-888 Ultrasonography pregnancy and, 93-94, 818-819 Tuberculin skin tests, 96, 211, 358-359, abdominal trauma and, 804 spinal cord injuries and, 821-822 742 breast cancer and, 935 in young men, 820-821 Tuberculosis, 740-742 deep venous thrombosis and, 715 Urinary urgency, 912 clinical presentation of, 741 endometrial hyperplasia and cancer Urine cultures, 817, 822-823 diagnosis of, 741 and,921 Urine osmolality, 829 in health care workers, 393 fetal, 87, 100 Urine specific gravity, 829 management of, 741-742 Ultraviolet radiation, 400 Urolithiasis, 875-878 1190 Index

Urticaria, 1025-1026 Vertical mattress suture, 428 Warfarin Uterine outflow tract disorders, 903 Vertigo, 471,472 cerebrovascular disease and, 561-562 Uvulopalatopharyngoplasty (UPPP), 486 benign paroxysmal positional, 472, 473 chronic heart failure and, 700 central,474 deep venous thrombosis and, 495, 714, Vaccines, see Immunizations cervical, 474 717, 754, 755 Vaginal candidiasis, 363 peripheral,473-474 preconception care and, 77 Vaginismus, 501, 940 Very low density lipoprotein (VLDL), surgical patients and, 493 Vaginitis, 819, see also Vulvovaginitis 1056-1057,1067 Warts, 248, 351-352,1034-1035 atrophic, 895, 911 Vestibular neuronitis, 473-474 Water balance, 1100-1101 prevention of, 898 Vestibulitis, 896 Water displacement, 466 recurrent or persistent, 897 Veterans Administration Cooperative Water safety, for international travelers, Vaginosis Study, 657 65,66 bacterial, 77, 116,248,894-895 Veterans Administration Parenteral Welder's flash, 400 cytolytic, 897 Nutrition Cooperative Study, 497 Well-child care, 151 Valacyclovir (Valtrex), 353 Vincent's angina, 339, 341 Wellbutrin (Bupropion), 290 Valium (diazepam), 555 Vincristine, 751 Wenckenbach block, see Mobitz type I Valproate, 276,551,552,553,555 Vinorelbine (Navelbine), 751 block Valproic acid, 78, 103,553 Viral capsid antigen (VCA), 326 Wernicke-Korsakoff syndrome, 510 Valsalva maneuver, 90 Viral conjunctivitis, 593, 594-595 Western medical model, 20 Valtrex (valacyclovir), 353 Viral exanthems, 168, 170-171 Wet age-related macular degeneration, Valvular heart disease, 492, 685-692 Viral gastroenteritis, 168-169 611 Variant angina, 652 Viral hepatitis WHACS mnemonic, 388, 389 Varicella (chickenpox), 76, 95-96, acute, 780-782 WHIMS, 541 170-171,1031-1032 pregnancy and, 94-95 Whipple's triad, 1106 Varicella (chickenpox) vaccine, 96, 393, prevention of, 783-786 White pupil, 152 1031-1032 Viral meningitis, 584 Whites Varicella-zoster virus (VZV), 1031-1032 Viral skin diseases, 1031-1035 alcoholism in, 507 Varicella-zoster virus (VZV) vaccine, 42, Viral upper respiratory tract infections, P-blockers and, 646 76 328-331 breast cancer in, 937 Varicoceles, 873 Virilization, 1103-1104 cerebrovascular disease in, 557 Vascular neuropathies, 581 Visceral disease, 954-955 chronic heart failure in, 696 Vascular wall disorders, 1119-1120 Visceral pain, 534-535,801 chronic renal failure in, 847 Vasculitis, 1119-1120 Visceral trauma, 247 demographic shifts and, 20-21 Vasectomy, 858-860 Visible radiation, 400 obesity in, 213 conventional, 858-859 Visken (pindolol), 644, 669 osteoarthritis in, 988 nonscalpel, 859-860 Visual acuity, 601 pancreatic cancer in, 777 Vasodilators, 645, 647, 698-699 Vitamin A, 61-62, 79, 874, 875 scrotal masses in, 871 Vasotec (enalapril), 644,700 Vitamin B1, 580 scrotal tumors in, 861 Vasovagal, vasodepressor syncope, Vitamin B6, see Pyridoxine systemic lupus erythematosus in, 1000 704-705,706 Vitamin B12, see Folic acid temporal arteritis in, 1003 VCA (viral capsid antigen), 326 Vitamin C, 332, 569, 747, 874,875,1059 toxic shock syndrome in, 947 Venereal Disease Research Laboratory Vitamin D, 154, 877, 1087, 1091, 1104, urinary bladder cancer in, 874 (VDRL) test, 349, 350, 587 1105 Whitmore Jewett (W-J) staging system, Venlafaxine (Effexor), 290 Vitamin E, 562, 569, 747, 875, 928,1059 856 Venom immune therapy (VIT), 322 Vitamin K, 104, 1117-1118 Whooping cough, 164-165 Venous occlusive retinal disease, 609 Vitamins, 61-62, 154, 213 Wide seal diaphragm, 882 Venous thromboembolism, 713-717, see Vitiligo, 1050 Wilmore body fat test, 466 also Deep venous thrombosis Vivactyl, 290 Wilms tumor, 851 Ventral pallidotomy, 569 Volatile substances, 524 Wilson's disease, 782, 783 Ventricular arrhythmias (VAs), 677-681 Volume depletion, 829-831, 834 Wolff-Parkinson-White (WPW) Ventricular fibrillation (VF), 680, 681 Volume excess, 832-833 syndrome, 670, 674 Ventricular premature beats (VPBs), 671, Volume repletion, 830 Women, see also Gender 679,680 Von Willebrand's disease (vWD), 1117 acute uncomplicated pyelonephritis in, Ventricular septal defect (VSD), 691 VP16 (etoposide), 750, 751 819-820 Ventricular tachycardia (VT), 679-681 Vulvar diseases, 896 acute uncomplicated urinary tract monomorphic, 679 Vulvovaginitis, 891-898, see also Vaginitis infections in, 819 nonsustained, 671, 679, 680 clinical presentation of, 893-896 as domestic abuse victims, 252 polymorphic, 679 diagnostic assessment of, 891-893 physical examination for sexual sustained, 671, 679, 680 negative tests and, 896-897 complaints, 501 Verapamil, 276, 543, 545, 644, 669 Vulvovaginosis, 1037 recurrent cystitis in, 819 Versed (midazolam), 424 as sexual assault victims, 261 Versive seizures, 549 Wallenberg syndrome, 474 Women's Health Study, 881 Index 1191

Worker's Compensation, 386-387 Y chromosome mosaicism, 903 Zebeta (bixoprolol), 644 World Health Organization (WHO) Yeast skin infections, 1037-1038 Zidovudine,359,360,364 analgesic ladder, 231 Yellow fever vaccine, 66, 68 drug abusers and, 525 World Wide Web (WWW), 1136 Yersenia enterocoiitica, 769 for health care workers, 393 Wound closure, 427-427 Yo-yo effect, 467 for infants and neonates, 150-151 Wound healing, 421 Young adults pregnancy and, 75-76 Wound preparation, 425-426 clinical prevention for, 41 Zinc,305,332 Wrist disorders, 967-969 description of stage, 9 Zithromax, see Azithromycin Wrist instability, 968-969 Yutopar (ritodrine hydrochloride), 118, 119 Zollinger-Ellison syndrome, 765 Wytensin (guanabenz), 175,644 Zoloft (sertraline), 280, 290 Zalcitabine (ddC), 359, 360, 525, 700 Zolpidem (Ambien), 484, 1007 Xanax (alprazolam), 276 Zaroxolyn (metolazone), 645 Zovirax, see Acyclovir Xerostomia, 635 ZDV, see Zidovudine