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  • Book
    Elana Sydney, Eleanor Weinstein, Lisa M. Rucker, editors.
    Summary: The practice of outpatient medicine in the 21st century has become fast-paced and challenging. The busy practitioner learns to make accurate decisions regarding diagnoses and treatments, individualizing them based on the patients particular characteristics and desires. Patients typically present with more than one issue, spanning from wanting information about a vaccine to having symptoms of an acute and serious infectious disease, while also needing care of their chronic conditions. In order to function in a timely manner, the provider needs a reliable resource to aid in making efficient decisions. This text is designed to fulfill this purpose. Now fully revised and expanded, Handbook of Outpatient Medicine, 2e provides a quick, portable, algorithm-based guide to diagnosis and management of common problems seen in adult patients. Written by experienced primary care practitioners, this text emphasizes efficient decision-making necessary in the fast-paced realm of the medical office. It covers general considerations such as the physical examination, care of special populations, and pain management and palliative care. It also focuses on common symptoms and disorders by system, including endocrine, respiratory, cardiac, orthopedic, neurologic, genitourinary, and gynecologic. For each disorder, symptoms, red flags, algorithms for differential diagnosis, related symptoms and findings, laboratory workup, treatment guidelines, and clinical pearls are discussed. One of the major updates in this edition is a chapter dedicated to COVID-19. This chapter focuses on COVID-19 diagnosis, care and sequelae, including what to do after discharge from the hospital. Since the global pandemic has affected medicine as a whole, many of the chapters also discuss COVID-19 as a differential diagnosis. Newer and higher quality photos have also been added in several chapters to help illustrate techniques more efficiently, including new imaging modalities for chest pain.

    Contents:
    Intro
    Preface
    Contents
    Part I: General Considerations
    Chapter 1: Screening/Physical Exam/Health Maintenance
    Introduction
    Intersection of Public Health and Primary Care
    Social Determinants of Health (SDOH) [1]
    Prevention
    Harm Reduction
    Decision-Making/Differential Diagnosis
    Screening
    Physical Exam
    Vaccinations
    Health Maintenance
    References
    Chapter 2: Covid-19 for the Primary Care Clinician: Current Recommendations-Don't Blink!
    Introduction
    Symptoms
    Other History
    Physical Exam
    Lab Tests
    Differential Diagnosis
    Treatment
    Prevention
    Long Covid
    References
    Chapter 3: Transition Care of Teens with Chronic Health Conditions
    Introduction
    Barriers in Transition Care
    Patient and Family Perspectives
    Provider Perspectives
    Initial Evaluation of Teens with Chronic Health Conditions Transitioning to Adult Providers
    Portable Medical Summary
    Assessment of Functional Status
    Education
    Living Arrangement and Family Support
    Employment
    Health Insurance and Benefits Relevant to the Transitioning Adult
    Medicaid, Medicare, SSI, and SSDI
    Medical Decision-Making and Guardianship
    Local Resources for Intellectual and Developmental Disabilities (IDD)
    Unique Considerations in Teens and Young Adults with Chronic Health Conditions Transitioning to Adult Providers
    Specialist-Dominated Care
    Internist-Dominated Care
    Condition-Specific Medical Knowledge
    Medication Reconciliation/Polypharmacy
    Secondary Medical Conditions
    Behavioral Health
    Anxiety and Depression
    Health Maintenance
    Sexual Health
    Sexual Abuse
    Contraception
    Cervical Cancer Screening
    Health Disparities
    Ethical Considerations
    Conclusion
    References
    Chapter 4: Care of the Elderly Patient
    Introduction
    Outpatient Assessment. Tips for Effective Communication
    Past Medical and Surgical History
    Social History
    Medications
    Review of System for Older Adults
    Physical Examination: Evaluate for Pertinent Findings in the Geriatric Patient
    Functional Assessment
    Health Promotion and Disease Prevention
    Vaccines for Individuals over 65 Years of Age [6]
    Primary and Secondary Disease Prevention
    Lifestyle and Behaviors
    Geriatric Syndromes
    Urinary Incontinence (See Table 4.2)
    Dementia (See Chapter on Cognitive Impairment)
    Delirium
    Confusion Assessment Method (CAM): Short version [14]
    Delirium Evaluation
    Depression
    Medication Management
    Falls and Immobility
    Examination of the Older Adult After a Fall [16]
    Get Up and Go Test [17]
    Preventing Future Falls
    Polypharmacy
    Sensory Loss
    Vision
    Hearing Loss
    Malnutrition and Unexplained Weight Loss
    Osteoporosis
    Sleep Disorders
    Advanced Care Planning
    Elder Abuse and Neglect
    Home Care
    References
    Chapter 5: Care at the End of Life: Palliative and Hospice Care-Symptom Management
    History
    Palliative Care/Hospice Care
    Role of the Primary Care Physician in Palliative Care/Hospice
    When to Refer
    Starting the Conversation/Important Documents
    Management of Common Symptoms in Palliative Care
    Shortness of Breath
    Constipation
    Nausea/Vomiting
    Pain
    Conclusion
    References
    Chapter 6: Substance Use Disorder
    Introduction
    Definitions
    Decision-Making
    Identification
    Key History
    Workup
    Management
    Risky or Unhealthy Alcohol Use
    Risky Opioid Use or OUD
    References
    Part II: Endocrine
    Chapter 7: Diabetes
    Introduction
    Diagnosis of DM
    Screening for DM
    Key H&amp
    P in Early DM
    History
    Physical Exam
    Healthcare Maintenance in the Patient with Diabetes [11]
    Treatment of DM. Type 1 Diabetes
    Type 2 Diabetes
    Lifestyle Changes
    Pharmacological Therapy in T2D
    Choice of Therapy
    Metformin
    Sulfonylureas (Glimepiride, Glyburide, Glipizide) and Meglitinides (Repaglinide, Nateglinide)
    GLP-1 Receptor Agonists (Exenatide, Liraglutide, Dulaglutide, Lixisenatide)
    DPP-4 Inhibitors (Sitagliptin, Saxagliptin, Linagliptin, Alogliptin)
    SGLT-2 Inhibitors (Canagliflozin, Dapagliflozin, Empagliflozin, Ertugliflozin)
    Thiazolidinediones (Pioglitazone)
    Alpha-Glucosidase Inhibitors (AGIs) (Acarbose, Miglitol)
    Insulin
    References
    Chapter 8: Thyroid Dysfunction
    Hypothyroidism
    Brief Introduction
    Key H&amp
    P
    Decision-Making/Diagnosis
    Treatment
    Overt Hypothyroidism
    Subclinical Hypothyroidism
    Treatment Challenges
    Hyperthyroidism
    Brief Introduction
    Key H&amp
    P
    Decision-Making/Differential Diagnosis
    Treatment
    Graves' Disease
    Radioactive Iodine (RAI)
    Surgery
    Treatment: Subclinical Hyperthyroidism
    Thyroid Nodules
    Brief Introduction
    Key H&amp
    P
    Decision-Making/Differential Diagnosis
    Treatment
    References
    Chapter 9: Lipids
    Introduction
    Key History and Physical
    History
    Medical History
    Family History
    Social History
    Physical Exam
    Decision-Making/Differential Diagnosis
    Screening Population
    Testing Lipid Levels: Fasting vs. Non-fasting
    Assessing Risk for ASCVD
    Treatment
    Principles of Therapy
    Treatment Strategies
    Lifestyle Modification
    Statins
    Fibrates
    Fish Oil
    Other Non-statin Medications
    Monitoring After Initiating Therapy
    References
    Chapter 10: Obesity
    Introduction
    Key History and Physical Exam
    History
    Physical Examination and Diagnostics
    Who Should Lose Weight?
    Treatment
    Management of Obesity
    Diet
    Physical Activity
    Pharmacotherapy. Weight-Loss Surgery and Procedures
    Long-Term Follow-Up After Uncomplicated Bariatric Surgery
    References
    Part III: Respiratory
    Chapter 11: Cough
    Brief Introduction
    Decision-Making/Differential Diagnosis
    Acute Cough
    Subacute Cough
    Chronic Cough
    Evaluation/Investigation
    Disease-Specific Features
    Acute Cough
    Subacute Cough
    Chronic Cough
    Treatment
    References
    Chapter 12: Shortness of Breath
    Introduction
    Decision-Making/Differential Diagnosis and Key History and Physical Exam
    Sudden-Onset Dyspnea
    Acute-Onset Dyspnea
    Episodic Dyspnea
    Chronic Dyspnea
    Treatment
    References
    Chapter 13: Sinusitis or Rhinosinusitis
    Introduction
    Acute Sinusitis
    Chronic/Recurrent Sinusitis
    Symptoms of Acute Sinusitis
    Symptoms of Chronic Sinusitis
    Physical Findings
    Diagnosis
    Diagnostic Tests
    Treatment of Acute Sinusitis
    Treatment of Chronic Sinusitis
    Additional Evaluation
    References
    Chapter 14: Sore Throat
    Introduction
    Decision-Making/Differential Diagnosis
    Key H&amp
    P
    Rapid Antigen Detection Tests
    Treatment
    Symptomatic Treatment
    References
    Chapter 15: Sleep Apnea
    Introduction
    ICSD3 Classifies Sleep Disorders into Seven Major Categories [4]
    Prevalence
    Sleep History
    Screening Questionnaires to Assess the Risk of OSA
    STOP-Bang Questionnaire
    Understanding ESS Score
    Focused Physical Exam
    OSA/SDB (Obstructive Sleep Apnea/Sleep-Disordered Breathing)
    Definition
    Risk Factors
    Pathophysiology
    Diagnosis
    Differential Diagnosis of Excessive Daytime Sleepiness (EDS)
    Complications and Consequences of Untreated Sleep Apnea
    Treatment: OSAHS/SDB (Usual Therapy)
    Treatment of CSA
    References
    Part IV: Cardiac
    Chapter 16: Hypertension
    Brief Introduction
    Scope of the Problem. History and Review of Systems
    Decision-Making/Differential Diagnoses
    Physical Examination
    Measuring Blood Pressure
    Diagnostic Studies
    Clinical Quality Measure
    Assessment
    Treatment
    Lifestyle Management
    Pharmacological Interventions
    Office, Home Blood Pressure Monitoring (HBPM), and Ambulatory Blood Pressure Monitoring (ABPM)
    Refractory or Resistant Hypertension
    Role of Digital Health in Hypertension
    References
    Chapter 17: Chest Pain
    Chest Pain
    History
    Physical Exam
    Differential Diagnosis
    Potentially Life-Threatening
    Acute Coronary Syndromes
    Aortic Dissection
    Pulmonary Embolism
    Pneumothorax
    Non-Life-Threatening Causes
    Gastroesophageal Reflux Disease
    Pleuritic Chest Pain
    Cervical Angina
    Pericarditis
    Chronic Angina
    Herpes Zoster
    Muscular Pain
    Rib Fracture
    Costochondritis
    Esophageal Spasm
    Approach to Management in the Primary Care Setting
    Diagnostic Testing
    Electrocardiogram
    Blood Testing
    Imaging
    Chest X-Ray
    X-Ray C-Spine
    Transthoracic Echocardiogram
    Diagnostic Testing for Obstructive Coronary Artery Disease
    Treatment of Non-Life-Threatening Causes of Chest Pain
    References
    Chapter 18: Anemia
    Introduction
    Key History and Physical Exam
    Laboratory Evaluation
    Hypoproliferative Anemias
    Microcytic Anemia
    Differential Diagnosis
    Iron Deficiency Anemia
    Epidemiology
    Pathophysiology
    Key History
    Physical Exam
    Laboratory Evaluation
    Diagnosis
    Treatment
    Normocytic Anemia
    Differential Diagnosis [6]
    Anemia of Chronic Disease/Inflammation (AOCD)
    Epidemiology
    Pathophysiology
    Key History and Physical Exam
    Laboratory Evaluation
    Diagnosis
    Treatment
    Macrocytic Anemia
    Differential Diagnosis [2]
    Megaloblastic Anemia
    Vitamin B12 Deficiency
    Epidemiology.
    Digital Access Springer 2022
  • Article
    Roberts MW, Moffa JP, Jenkins WA.
    J Am Dent Assoc. 1978 Nov;97(5):829-32.
    One hundred fifty-seven fractured anterior teeth were restored with one of three acid-etch composite resin systems and were clinically and radiographically evaluated for 24 months. Of the three systems evaluated, the material activated by ultraviolet light provided the highest retention rate and clinical acceptance.
    Digital Access Access Options