9th EDITION CLINICIAN’S POCKET REFERENCE EDITED BY LEONARD G. GOMELLA, MD, FACS The Bernard W. Godwin, Jr., Associate Professor Department of Urology Jefferson Medical College Thomas Jefferson University Philadelphia, Pennsylvania WITH Steven A. Haist, MD, MS, FACP Professor of Medicine Division of General Internal Medicine Department of Internal Medicine University of Kentucky Medical Center Lexington, Kentucky Based on a program originally developed at the University of Kentucky College of Medicine Lexington, Kentucky McGraw-Hill MEDICAL PUBLISHING DIVISION New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto McGraw-Hill abc Copyright © 2002 by Leonard G.Gomella. All rights reserved. Manufactured in the United States of America. 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CONTENTS Consulting Editors vii Contributors viii Preface xiii Abbreviations xv “So You Want to Be a Scut Monkey”: An Introduction to Clinical Medicine 1 1 History and Physical Examination 9 2 Chartwork 33 3 Differential Diagnosis: Symptoms, Signs, and Conditions 41 4 Laboratory Diagnosis: Chemistry, Immunology, and Serology 53 5 Laboratory Diagnosis: Clinical Hematology 95 6 Laboratory Diagnosis: Urine Studies 109 7 Clinical Microbiology 121 8 Blood Gases and Acid-Base Disorders 161 9 Fluids and Electrolytes 177 10 Blood Component Therapy 193 11 Diets and Clinical Nutrition 205 12 Total Parenteral Nutrition (TPN) 227 13 Bedside Procedures 239 14 Pain Management 315 15 Imaging Studies 325 16 Introduction to the Operating Room 339 17 Suturing Techniques and Wound Care 345 18 Respiratory Care 359 19 Basic ECG Reading 367 20 Critical Care389 21 Emergencies 445 22 Commonly Used Medications 475 Appendix 639 Index 659 Emergency Medications (inside front and back covers) Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use. This page intentionally left blank. CONSULTING EDITORS MARIANNE BILLETER, PharmD, BCPS Associate Professor of Pharmacy Practice, Division of Distance Education, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, Virginia TRICIA L. GOMELLA, MD Part-Time Clinical Assistant Professor of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland IRA HOROWITZ, MD Professor of Gynecology and Obstetrics and Oncology, Director of Gynecologic Oncology, Emory University, Atlanta, Georgia ALAN T. LEFOR, MD, MPH, FACS Director, Division of Surgical Oncology, Director, Surgical Education and Academic Affairs, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California; Associate Professor of Clinical Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, California JOHN A. MORRIS, MD Director, Division of Trauma, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use CONTRIBUTORS Aimee G. Adams, PharmD Director, Primary Care Pharmacy Practice Residency, University of Kentucky Medical Center; Assistant Professor College of Pharmacy and Department of Medicine, University of Kentucky, Lexington, Kentucky Marianne Billeter, PharmD, BCPS Associate Professor of Pharmacy Practice, Division of Distance Education, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, Virginia Pasquale Casale, MD Chief Resident, Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania Murray Cohen, MD Clinical Associate Professor of Surgery, Director, Division of Trauma/Critical Care, Department of Surgery, Jefferson Medical College, Philadelphia, Pennsylvania Marisa Davis Doctor of Pharmacy Candidate, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, Virginia Neil M. Davis, PharmD, FASHP Professor Emeritus of Pharmacy, Temple University, Philadelphia, Pennsylvania; Director, Safe Medication Practice Consulting, Inc., Huntingdon Valley, Pennsylvania Ehab A. El Gabry, MD Fellow, Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania Sue Fosson, MA Former Associate Dean for Student Affairs, University of Kentucky College of Medicine, Lexington, Kentucky Leonard G. Gomella, MD, FACS The Bernard W. Godwin, Jr., Associate Professor, Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania Copyright 2002 The McGraw-Hill Companies, Inc. Click Here for Terms of Use Contributors ix Steven A. Haist, MD, MS, FACP Professor of Medicine, Division of General Internal Medicine, Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky Sara Maria Haverty, MD Senior Resident, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania Mohamed Ismail, MD Senior Resident, Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania Gregory C. Kane, MD Clinical Associate Professor of Medicine, Program Director, Internal Medicine Residency, Jefferson Medical College, Philadelphia, Pennsylvania Matthew J. Killion, MD Assistant Professor of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania Alan T. Lefor, MD, MPH, FACS Director, Division of Surgical Oncology, Director, Surgical Education and Academic Affairs, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California; Associate Professor of Clinical Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, California Layla F. Makary, MD, MSC, PhD Lecturer, Department of Anesthesia, Cairo University, Clinical Fellow, Department of Anesthesia, Cleveland Clinic Foundation, Cleveland, Ohio John Moore, MD Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery, Jefferson Medical College, Philadelphia, Pennsylvania Nick A. Pavona, MD Associate Professor, Department of Surgery, Division of Urology, Benjamin Franklin University Medical Center, Chadds Ford, Pennsylvania Roger J. Pomerantz, MD, FACP Professor of Medicine, Biochemistry and Molecular Pharmacology, Division of Infectious Diseases