Index

AAFP, see American Academy of Family Physicians

Abdomen scaphoid, of newborn, 492 surgical problems of, 629-632

Abdominal distention, newborn, 492 Abdominal examination, 629 Abdominal hernias, 641-642 Abdominal pain, 629-632 Abdominal ultrasound, 257 ABFP (American Board of Family Prac-

tice), 2 ABO system, 451 Abortion, spontaneous, 469 ABPA (allergic bronchopulmonary asper-

gillosis), 226 Abrasion, 704 Abruptio placentae, 473, 474 Abscess, 625

anorectal, 636 Bartholin duct, 324-325, 326 brain, 118-119 dentoalveolar, 167-168 epidural, 119 ischiorectal, 635-636 perianal, 635-636 pilonidal sinus, 626-627 superficial, 625-629

Absence seizures, 106-107 Abuse

alcohol, 82-83, 518; see also Alco-holism

child, 76-77 drug, 60, 518 elder, 78 nasal vasoconstrictor, 154 sexual, see Sexual abuse spouse, 77-78 substance, see Substance abuse

Accelerated idioventricular rhythm (AIVR), 684

Accidents, 83-84 adolescents and, 517

ACE (angiotensin-converting enzyme) inhibitors, 189

Achalasia, 243 Achilles tendon rupture, 349 Achilles tendinitis, 711 Acid-base balance, 681 Acid-base disturbances, 276-277 Acid-base homeostasis, 672-673 Acidosis, 673

metabolic, 276 respiratory, 276-277

ACLS (Advanced Cardiac Life Support), 647

Acne vulgaris, 383-384 Acoustic trauma, 151 Acquired immunodeficiency syndrome

(AIDS), 84, 119, 405-407, 575-576

counseling of patients at risk for developing, 406-407

oral findings in, 166, 167 pregnancy and, 458-459 transmission in utero of, 495

Acrochordons, 386 Acrolentiginous melanoma, 391 Acromegaly, 433 Acromioclavicular joint pain, 340 Acromioclavicular separation, 708-709 ACTH (adrenocorticotropic hormone),

428-430 Actinic keratosis, 388-389 Actinomycosis, 226-227 Activated charcoal, 656 Acyanotic congenital heart disease, 200,

202

Addiction, 690 management of, 696-701

Adenocarcinomas, 220 Adenomatous polyps, 252 ADH, see Antidiuretic hormone Adjustment problems of adults, 536-537 Adolescent anticipatory guidance, 509,

511 Adolescent developmental period, 504 Adolescents, 22-24

accidents and, 517 alcohol abuse and, 518 approach to care of families with, 505 complete physical examination for,

509-511 contraception and, 509, 515 depression in, 517 dietary practices of, 511 drug abuse and, 518 drug use in, 504 health care for, 504-519 health care maintenance for, 509-511 homosexuality in, 514 mental disorders in, 505 mortality rates of, 504 nutrition for, 511 obesity in, 513-514 parenting by, 515 physical growth and development of,

505-508 physicians and, 505 pregnancy and, 504, 515 psychosocial developmental tasks of,

508-509 risk-taking behavior in, 517-519 school problems of, 516 sexual abuse of, 518-519 sexual concerns of, 514-515 sexual maturation in, 507-508

722 Index

Adolescents (cont.) sexually transmitted diseases and, 504,

516 somatic changes in, 506 suicide in, 517 treating families with, with chronic ill­

ness or disability, 513 ADOLFSS mnemonic, 618-619 ADRDA (Alzheimer's Disease and Related

Disorders Association), 528 Adrenal cortex disorders, 428-430 Adrenal hyperplasia, congenital (CAH),

429-430 Adrenal medulla disorders, 430-431 Adrenocortical insufficiency, 429 Adrenocortical tumor, isolated nonfunc-

tioning, 430 Adrenocorticotropic hormone (ACTH),

428-430 Adult development, 24-25 Adult respiratory distress syndrome

(ARDS), 672, 677-678 Adults, see also Female entries; Male

entries adjustment problems of, 536-537 health promotion and, 103 immunizations for, 91 otitis media in, 151

Advanced Cardiac Life Support (ACLS), 647

Advanced Trauma Life Support (ATLS), 647

Aerobic exercise, 84 Aerotitis, 151 Affective disorders, 501-502, 539, 559

in elderly, 530-531 Affective responses, 52 Age

gestational, see Gestational age old, see Elderly

AIDS, see Acquired immunodeficiency syndrome

Air support with helicopters, 648 Airway disease, reactive, 400 Airway pressure, 676-677 Airway suctioning, 659-660 Airways

esophageal obturator (EOA), 651 nasopharyngeal, 660-661 obstructed, management of, 659-663 oropharyngeal, 660

AIVR (accelerated idioventricular rhythm), 684

Alcohol, see also Alcoholism behavioral effects of, 695 blood pressure and, 176 cardiovascular system and, 695 central nervous system and, 692-695 family effects of, 695-696 gastrointestinal system and, 692

hematological system and, 695 management of, 696-701 physical effects of, 692-695 refraining from driving after use of, 651

Alcohol misuse, 82-83 adolescents and, 518

Alcohol use worksheet, 98 Alcoholic hepatitis, 260-261 Alcoholic liver disease, 260-262 Alcoholism, 101, 690-701; see also Alco-

hol consequences of, 692-696 prevalence and economic impact of, 691

Alcoholism treatment lay resources, 699-700 professional resources, 699

Aldosterone, 428 Alkalosis, 673

metabolic, 276 respiratory, 277

ALL (acute lymphocytic leukemia), 594-595

Allergic bronchopulmonary aspergillosis (ABPA), 226

Allergic conjunctivitis, 131 Allergic diagnosis, 395-396 Allergic disease management, 396-398 Allergic hyposensitization, 397-398 Allergic rhinitis, 154, 398-399 Allergic skin testing, 396 Allergies, 395

drug, 399-400 food, 409-410 insect sting, 408-409 milk, 409, 488

Alopecia areata, 393 Alpha-fetoprotein screening, 458 Alpha-methyl fentanyl, 693 Alprazolam, 538 ALS (amyotrophic lateral sclerosis), 125 Alzheimer's disease, 521-528

criteria for clinical diagnosis of, 523 DAT Inventory, 524, 525 management of, 525-528

Alzheimer's Disease and Related Disorders Association (ADRDA), 528

Amblyopia, 136, 137 Amebiasis, 247, 600 Amenorrhea

athletic, 715-716 primary, 304-305 secondary, 305-306, 307

American Academy of Family Physicians (AAFP), 1, 2, 3

statistical data from, 16-18 American Academy of Pediatrics guide­

lines, 88, 89 American Board of Family Practice

(ABFP), 2 Amine hypothesis, 540

Aminophylline, 403 AML (acute myelogenous leukemia), 595 Amnesia, 126 Amniocentesis, 468 Amniotic fluid, 468 Amniotic membranes, premature rupture

of, 470 Amphetamines, 693, 717 Amyotrophic lateral sclerosis (ALS), 125 ANA (antinuclear antibodies), 260 Anabolic steroids, 716-717 Anaerobic bacteria, 218 Anal fissures, 635, 636 Analgesia

for delivery, 466 in labor, 465-466

Analgesics, 620 Anaphylactic shock, 675 Anaphylactoid reactions, 400 Anaphylaxis, acute, 407-408 Androgenetic baldness, 392-393 Androgens, 428 Anemia

aplastic, 447 of chronic disease, 449 of chronic renal failure, 447 defined, 442 exercise-related, 714 hemolytic, see Hemolytic anemia iron-deficiency, 439, 443-447, 497 megaloblastic, 447-448 pernicious (PA), 118, 448 prevalence and incidence of, 439 sickle-cell, 450

Anesthesia, 620-621 risk of, 617-618

Angina pectoris, 179-183 heart failure and, 182-183 medical management of, 180-182

Angiography, 113 cardiac, 209

Angiotensin-converting enzyme (ACE) inhibitors, 189

Angular stomatitis, 166 Anion gap, 276 Anisometropia, 133, 135 Anisometropic amblyopia, 137 Ankle fracture, lateral, 350 Ankle injuries, medial, 350 Ankle problems, 349-350 Ankle sprains, 710-711

lateral, 349-350 Ankylosing spondylitis, 363 Ann Arbor staging system, 594 Anogenital warts, 385 Anorectal abscess, 636 Anorectal disease, 632-636 Anorectal examination, 633 Anorexia nervosa, 557 Anorgasmia, female, 556

Anterior cerebral artery syndrome, 115 Anthrax, 601 Antibiotics

in bronchitis, 214-215 in infectious diseases, 578-580 long-term, 579-580

Antibody-mediated hemolysis, 451 Anticipatory guidance, 44, 46

adolescent, 509, 510 children, 486 elderly, 528-529

Anticipatory mourning, 76 Anticoagulant therapy, 185, 221 Antidepressants, 542-544

heterocyclic, 543, 544 tricyclic (TCAs), 542

Antidiuretic hormone (ADH) (vasopres­sin), 434

syndrome of inappropriate secretion of (SIADH), 434

Antidotes to poisons, 656 Antigen screening, 565 Antihistamines, 397 Antihypertensive therapy, 114 Antiinflammatory drugs, nonsteroidal

(NSAIDs), 358, 360 Antimicrobial agents during pregnancy,

462-463 Antinuclear antibodies (ANA), 260 Antipsychotic drugs, 552

for schizophrenia, 553 Antisocial behavior, 59 Antisocial personality disorders, 548 ANUG (acute necrotizing ulcerative gingi-

vitis), 165-166 Anxiety

cardiac symptoms and, 205 in elderly, 531

Anxiety disorders, 537-539 Aorta, coarctation of, 202 Aortic insufficiency, 197 Aortic stenosis, 196-197 Aortic valvular stenosis, 202 APGAR, family, 33 Aphakia, 139-140 Aphthous ulcers, 156 Aplastic anemia, 447 Apnea, sleep, 227-228 Appendicitis, 629-630 Appetite suppressants, 420 ARDS (adult respiratory distress syn-

drome), 672, 677-678 Arrhythmias, cardiac, 186, 189-194, 200 Arsenic, 609 Arterial blood gases, 672-673 Arterial disease of extremities, 639-641 Arterial surgery, 641 Arteriography, 640 Arteriolosclerosis, 141 Arteriosclerosis, 141

Arteriosclerotic retinopathy, 141 Arteriosclerotic vascular disease, 179 Arteriovenous (AV) dissociation and

block, 193-194 Arteriovenous malformations, 110 Arthralgia, 355 Arthritis

psoriatic, 362-363 rheumatoid, see Rheumatoid arthritis septic, 362

Arthrocentesis, 364-365 Asbestosis, 227 ASH (asymmetrical septal hypertrophy),

204 Aspergillosis, 226 Asphyxia, 657 Asphyxiants, chemical, 607 Aspirin, 114 Assault, sexual, 78-79 Assaultive behavior, 526 Asthma, 215, 400-405

behavioral aspects of, 404 drugs for, 402 in pregnancy, 404-405

Astigmatism, 133 Astrocytoma, 122 Asymmetrical hypertrophy, 203, 204 Asymmetrical septal hypertrophy (ASH),

204 Asystole, 682-683 Atelectasis, 619 Atherosclerosis, 173, 178-179

intimal, 141 Atherosclerotic coronary artery disease,

713-714 Athletes, 703 Athletic amenorrhea, 715-716 Athletic injuries

in children, 712-713 physical therapy of, 717-719

Athletic trauma, 705 ATLS (Advanced Trauma Life Support),

647 Atmospheric pressure, 603-604 Atopic dermatitis, 377-378 Atrial contractions, premature, 190-191 Atrial fibrillation, 191-193 Atrial flutter, 191 Atrial septal defect, 202 Atrial tachycardia, multifocal, 191 Audiometry, 158-159 Autoimmune hemolytic reactins, 451 Automatism, 107 AV, see Arteriovenous entries

B-lymphocytes, 512 Baby, see Newborn BAC (blood alcohol concentration),

692-694

Bacillary dysentery, 247 Back pain

low, 336, 338 lumbosacral, 336, 338 during pregnancy, 464 thoracic, 335-336

Index 723

Bacterial conjunctivitis, 131 Bacterial endocarditis, subacute, 567 Bacterial gastroenteritis, 247 Bacterial infection of skin, 375 Bacterial meningitis, 118 Bag-valve masks, 663 Baker's cyst, 638 Balanoposthitis, 295 Baldness, androgenetic, 392-393 Band ligation, 634-635 Barany rotation, 148 Barbiturates, 693 Barotrauma, 604 Barrier contraceptives, 311 Bartholin duct cyst, 324-325, 326 Barton's fracture, 343 Basal cell carcinoma, 390 Bathing during pregnancy, 461 Battering cycle, 77 Beginning family, 45-46 Behavior, assaultive, 526 Behavior patterns, type A, 174 Behavioral disorders in elderly, 532 Behavioral effects of alcohol, 695 Behavioral factors in alcoholism, 691 Behavioral issues, childhood,

501-502 Behavioral problems, see Psychiatric

problems Bell's palsy, 124 Bennett's fracture, 344 Benzene, 447 Benzodiazepines, 693 Bereavement process, 73-74 Beryllium, 609 Beta-blocker therapy, 185 Beta-blocking agents, 180-181 , 182 Beta-hemolytic streptococci, 581 Bicarbonate infusion, 414 Bicarbonate loading, 717 Bicipital tendinitis, 708 Bier block, 621 Bilharzia, 602 Biliary tract diseases, 257-258 Bilirubinuria, 298 Biofeedback, 294 Biomedical models, 35-36 Biopsy

bone marrow, 453-455 breast, 643-644 cervical, 322 curettage, 644-645 endometrial, 325-328 excisional, 643, 644

724 Index

Biopsy (cont.) fine-needle aspiration (FNAB), of

thyroid, 425 incisional, 643, 644 lymph node, 452-453 oval excision, 370 punch, 370, 644 scissors, 371 skin, 370-371

Biopsy needle, Jamshidi, 453 Biopsychosocial model, 36 Bipolar disorders, 539 Birth

postterm, 474 preterm, 469-470

Birth canal, lacerations of, 481 Birth control, see Contraception Birthing process, 485 Bites from mammals, 657-658 Bladder aspiration, 502 Bladder cancer, 591 Bladder carcinoma, 283 Bladder spasm, 298 Bladder training, 294 Blastomycosis, 226 Bleeding, see also Hemorrhage

dysfunctional uterine (DUB), 306-308 lower gastrointestinal, 253-254 nasal, 155 postmenopausal (PMPB), 319-320 third trimester, 473 upper gastrointestinal, 245-247 vaginal, 308

Blepharitis, 137 Blepharoplasty, 138 Blepharoptosis, 138 Blood

fetal, sampling of, 481 occult, screening of feces, 263 oxygen content of, 671

Blood alcohol concentration (BAC), 692-694

Blood doping, 717 Blood element disorders, classification of,

442 "Blood poisoning;' 628 Blood pressure, 174-175

alcohol and, 176 Blood problems, 439-455 Blood smear, 440 Blood urea nitrogen (BUN), 271 Blowout fracture, 171 Blue nevus, 387 Blunt trauma to eye, 130 Body language, 53-54 Body placement, 53-54 Boils, 383 Bone marrow aspiration and biopsy,

453-455 Bone marrow interpretation, 453-455

Bone marrow iron stores, 445 Borderline personality disorders, 546-548 Boric acid ophthalmic powder, 135 Bouchard's nodes, 357 Bowel

diseases of small and large, 247-254 inflammatory bowel disease (IBD),

251-252, 253 irritable bowel syndrome (IBS),

239-240 parasitic infections of, 247

Bowel incontinence, 526 BPH (benign prostatic hypertrophy),

290-292 Brachial plexus neuropathy, 126 Bradycardia, 683-684

sinus, 190 Brady-tachycardia syndrome, 190 Brain abscess, 118-1I9 Brain injury, II0-1I6 Brain syndromes, organic, 532 Brainstem glioma, I22 Brainstem hemorrhage, 114-II5 Breast, cystic disease of, 642 Breast biopsy, 643-644 Breast cancer, 588-589

screening for, 86 Breast care in puerperium, 467 Breast cyst aspiration, 642 Breast development, 304-305 Breast enlargement in males, 436 Breast-feeding, 486 Breast infection, 478 Breech presentation, 475, 477 Bronchiectasis, 224 Bronchiolitis, 224-225 Bronchiolitis obliterans, 229 Bronchitis, 2I4-2I5

antibiotics in, 214-215 Bronchogenic carcinoma, 220 Bronchopulmonary aspergillosis, allergic

(ABPA), 226 Bronchospasm, exercise-induced, 714 Brucellosis, 60 I Bulimia, 557-558 BUN (blood urea nitrogen), 27I Bupivacaine (Marcaine), 620 Burn care, outpatient, 655 Burns, 654-655

chemical, I29-130 radiation, 130 thermal, I30

Bursae, aspiration and injection of, 332-333

Bursitis calcaneal, 351 of hip, 346 of knee, 347-348 olecranon, 342 retrocalcaneal, 351 , 7Il

CAD, see Coronary artery disease Cadmium, 609 Caffeine, 83, 7I7 CAGE questions, 82-83, 696 CAH (congenital adrenal hyperplasia),

429-430 Calcaneal bursitis, 35I Calcaneoapophysitis, 352 Calcium, inadequate, 83 Calcium antagonists, 18I-I82 Calcium metabolism, 426-427 Calcium pyrophosphate deposition

(CPPD), 357 Calluses, 385-386 Cancer, 583-596

family cancer syndrome, 593 family influences in, 583, 585 mortality rates for, 585 natural history of, 586 palliative care of, 586 role of family physician in, 585-586 specific neoplastic diseases, 587-596

Cancer deaths, 584 Cancer screening test recommendations,

584 Cancer staging, 586-587 Candida albicans infections, 374 Candidiasis, oral, I66-167 Canker sores, 156 Cannabis, 693 Carbamates, 606-607 Carbamazepine, I 08 Carbocaine (mepivacaine), 620 Carbon monoxide, 85 Carcinoma in situ (CIS), 86-87, 3I4 Carcinomas, screening for, 86-87 Cardiac angiography, 209 Cardiac arrest

drug dosing for, 681 infusions of medications in, 680-681

Cardiac arrhythmias, 186, 189-194, 200 Cardiac catheterization in evaluation of

chest pain, 209 Cardiac cycle, 195 Cardiac death, sudden, 173, 678 Cardiac function, tests of, 208-209 Cardiac murmurs, 194-196 Cardiac patient, preoperative evaluation

of, 205 Cardiac rehabilitation, 209-210 Cardiac risk index, 206 Cardiac symptoms, anxiety and, 205 Cardiac syncope, 649-650 Cardiogenic shock, 186, 673-674 Cardiomyopathy, 203-204

obstructive hypertrophic, 713 Cardiopulmonary arrest in critical care

setting, 678-686 Cardiopulmonary resuscitation (CPR),

648-649' 659

Cardiovascular disease, 648 behavioral aspects of, 174

Cardiovascular emergencies, 648-650 Cardiovascular system, alcohol and, 695 Cardiovascular system problems, 173-210 Care, see Health care Caries, dental, 167 Carotid endarterectomy, 113 Carotid system, 113 Carpal tunnel syndrome, 344 Casting and splinting, 333-334 Cataract surgery, 140 Cataracts, 139-140 Catarrhal otitis media, 148 Catecholamines, 430 Cathartics, 656 Catheterization

cardiac, in evaluation of chest pain, 209 urinary, 297-298

Cause-specific mortality, 82 CBG (corticosteroid-binding globulin),

428 CCU (coronary care unit), 184 Cellulitis, 382-383, 628-629 Central nervous system (CNS), alcohol

and, 692-695 Central nervous system infections,

118-119 Central nervous system vertigo, 147 Central slip disruption, 709-710 Central venous pressure (CVP), 184 Cephalhematoma, 492 Cerebellar astrocytoma, 122 Cerebral edema, 112 Cerebrospinal fluid (CSF), laboratory

analysis of, 126-127 Cerebrovascular disease, 112 Cerumen removal, 159 Cervical biopsy, 322 Cervical cancer, 589, 590

screening for, 86-87 Cervical caps, 311 Cervical intraepithelial neoplasia (CIN),

314 Cervical polypectomy, 321, 322 Cervical polyps, 314 Cervical spine injuries, 654 Cervical spondylosis, 125 Cervicitis, 314-315

mucopurulent (MPC), 572-573 Cesarean section, 477 Chalazion, 137 Chancroid, 575 Charcoal, activated, 656 CHD (coronary heart disease), 173-174 Chelation therapy, 608 Chemical asphyxiants, 607 Chemical bums, 129-130 Chemical contraceptives, 311 Chemical exposure, 85

Chemical hazards, 605-607 Chemodectomas, 152 Chest consultant, role of, 213-214 Chest intubation, 232 Chest pain, 179-184

cardiac catheterization in evaluation of, 209

causes of, 179 decision making for patients with,

183-184 exercise tolerance tests for evaluating,

207-208 Chest roentgenogram interpretation,

229-230 in infants, 199

CHF, see Congestive heart failure Chickenpox, 376, 377, 495 Child abuse, 76-77, 502 Child health care, 484-502

longitudinal, 484-489 for normal child, 487

Child health maintenance, 487 Child sexual abuse, 502 Childbearing family, 46-47 Children, 19-22

athletic injuries in, 712-713 behavioral issues for, 501-502 communicable diseases of, 495-497 death of, 75 developmental delay in, 500 diarrhea in, 488, 499 failure to thrive, 489-490 injury to, 712-713 with limps, 352 nutrition for, 486, 488 obese, 489 orthopedic problems of, 351-353 poisoning of, 83, 656 vomiting, 488, 499

Chin lift, 659, 660 Chinese restaurant syndrome, 410 Chlamydia! infections, 571-572 Chloracne, 611-612 Chloral hydrate, 693 Chloramphenicol, 447 Chloroquine-resistant Plasmodium falcipa-

rum (CRPF) malaria, 602 Choana! atresia, posterior, 154 Cholecystitis, 257-258, 630 Cholelithiasis, 257-258 Cholera, 600, 601 Cholesteatoma, 153 Cholesterol, 83, 420-421 Choroiditis, 140 Chromium, 609 Cigarette smoking, see Smoking entries CIN (cervical intraepithelial neoplasia),

314 Circulation vertigo, 147 Circumcision, neonatal, 294-296

Index 725

Cirrhosis, 261-262 CIS (carcinoma in situ), 86-87, 314 Clarifying responses, 51-52 Claudication symptoms, 639 Clavicular fractures, 340 Cleft palate, 154 Clinical decision making, 67-70 Clinical diagnosis, 565-566 Clinical problem-solving process, 66-67 Clinical reasoning, 66, 67 CLL (chronic lymphocytic leukemia),

595-596 Clonazepam, 108 Clostridial infections, 451 Cluster headaches, 109-110 CMV (cytomegalovirus), 512, 565, 567 CNS, see Central nervous system entries Coarctation of aorta, 202 Cocaine, 620, 693, 717 Coccidioidomycosis, 225 Cochlear function, drugs affecting, 147 Coffee consumption, 83 Coitus during pregnancy, 463 Cold, common, 578 Cold environment, 605 Cold sores, 375 . Cold water immersion, 657 Colic, 488 Colitis

pseudomembranous, 247 ulcerative, 251-252

Colles' fractures, 343 Colon polyps, 252-253 Colorectal cancer, 252-253, 592-593

screening for, 87 Coma, 116-117

causes of, 117 Combativeness, 526 Communication

clear, 60 elements of, 51-54 linguistic, 51-53 nonlinguistic, 53-54 paralinguistic, 53 special challenges in, 56

Community, health promotion and, 102-104

Community resources, 72-73 Compassionate Friends, 73 Complementary movements, 54 Complete abortion, 469 Complexion problems, 383-384 Compliance of patients, 63-64 Compound nevi, 387 Compulsive personality disorders,

548-549 Computed tomography (CT), 220, 654 Concussion, 110

classification of, 707 Condoms, 311

726 Index

Conduct disorders, 501 Conductive hearing loss, 163 Condylar fractures, 342 CoiJ.finement, expected date of (EDC), 457 Confrontation interviewing skill, 560 Congenital heart disease

acyanotic, 200, 202 cyanotic, 200

Congestive heart failure (CHF), 176, 185-189

Conjunctivitis, 130-131, 132 Connective tissue problems, 354-365 Conn's syndrome, 429 Constipation, 235-237

in children, 488 during pregnancy, 464

Consultation, 39, 70-71 for depression, 545 for psychiatric problems, 536 use of, 62-63

Contact dermatitis, 377, 611 Contact lenses, 135-136 Contaminated water, 85 Contingency contract, 98-99 Continuing medical education, 2 Continuous ambulatory ECG monitoring,

208 Continuous positive pressure breathing

(CPPB), 676 Contraception, 308-314

adolescents and, 509, 515 postcoital, 310

Contraceptives barrier and chemical, 311 contraindications to, 311 pills, oral (OCPs), 308-310 sponges, vaginal, 311

Contract, contingency, 98-99 Contusions, 332, 704-705 Coombs' test, 451 COPD (chronic obstructive pulmonary dis-

eases), 213, 215-217 Cor pulmonale, 204-205 Corium, 369 Corneal abrasion, 130, 133 Corneal foreign body removal, 144 Cornified skin appendages, 369 Corns, 385-386 Coronary angiography, 209 Coronary artery disease (CAD), 420-421

atherosclerotic, 713-714 Coronary artery spasm, 182 Coronary care unit (CCU), 184 Coronary heart disease (CHD), 173-174 Coronary-prone behavior pattern, 174 Corpus luteum, 304 Corpuscular volume, mean (MCV), 442 Corticosteroid-binding globulin (CBG),

428 Corticosteroids, 403

intralesional injection of, 372

Corticotropin-releasing factor (CRF), 428 Corticotropin-releasing hormone (CRH),

433 Cortisol, 428 Coryza, 578 Costovertebral and costotransverse joints,

dysfunction of, 336 Cough, 219-220 Counseling, 559

in office setting, 559-561 of patients at risk for developing AIDS,

406-407 phases of, 559

Counterimaging, 101-102 CPK (creatine phosphokinase), 106 CPK-MB (cratine phosphokinase

myocardial band), 184 CPPB (continuous positive pressure

breathing), 676 CPPD (calcium pyrophosphate deposi­

tion), 357 CPR (cardiopulmonary resuscitation),

648-649, 659 Cramps, heat, 604 Cranial nerve diseases, 123-124 Creatine phosphokinase (CPK), 106 Creatine phosphokinase myocardial band

(CPK-MB), 184 Creatinine clearance, 271 Crepitation, 214 CRF (corticotropin-releasing factor), 428 CRH (corticotropin-releasing hormone),

433 Cricothyreotomy, emergency, 663, 664 Crisis, defined, 72 Crisis management, 72-79

principles of, 72-73 Critical care, 667-688

calculations of physiologic parameters in, 671

expense of, 667 family physician role in, 668

hemodynamic patterns in, 670-672 monitoring in, 668-673 normal physiological parameters in, 671

Crohn's disease, 251-252 Cromolyn sodium, 403 Croup,499-500 CRPF (chloroquine-resistant Plasmodium

falciparum) malaria, 602 Cryosurgery, 372 Cryptococcosis, 226 Cryptorchidism, 294 CSF (cerebrospinal fluid), laboratory

analysis of, 126-127 CT (computed tomography), 220, 654 Cue identification, 66-67 Culdocentesis, 323-324 Cultural factors in alcoholism, 692 Culture of infected material, 565 Curettage biopsy, 644-645

CVP (central venous pressure), 184 Cyanosis, 200

flow sheet for evaluation of, 201 of newborn, 492

Cyanotic congenital heart disease, 200 Cyclitis, 140 Cystic disease

of breast, 642 medullary, 283

Cystic glioblastoma, 123 Cystitis, 477 Cysts, 627-628 Cytomegalovirus (CMV), 512, 565, 567

D & C (dilation and curettage), 328-330 Dacryocystitis, 138 Dandruff, 378 DAT (dementia of Alzheimer type), see

Alzheimer's disease DAT Inventory, 524, 525 Data collection, 55 DDAVP (desmopressin), 434 Death, 26

anticipated, 76 cancer, 584 in childhood, 75 in family, 73-76 premonitions of, 688 sudden, see Sudden death sudden infant death syndrome (SIDS),

75,497 Death rates, leading, 82 Debridement technique, 622 Decision making, clinical, 67-70 Decision tree, 67-68 Decompression sickness, 604 Defibrillation, 648 Degenerative joint disease (DJD), 357-358 Delivery

analgesia for, 466 normal, 466-467 problems complicating, 474-477 spontaneous, 466

Delusions, 550 Dementia, 117-118

of Alzheimer type (DAT), see Alzheimer's disease

defined, 522 multiinfarct (MID), 524

Dengue, 601 Dental caries, 167 Dental emergencies, 168 Dentoalveolar abscess, 167-168 Denture stomatitis, 166 Denver Developmental Screening Test, 88 Dependent personality disorders, 548 Depressants, 693 Depressed skull fractures, 110-111 Depression, 26, 539-545

in adolescents, 517

atypical, 541 consultation for, 545 in critically ill patient, 687-688 in elderly, 530-531 errors of drug treatment of, 544 masked, 540-541 psychotherapy for, 542 in puerperium, 477 reactive, 530 "typical;' 540

DeQuervain's disease, 423 Dermal sinus, 492 Dermatitis, 377-379 . contact, 611

Dermatochalasis, 138 Dermatofibroma, 387 Dermatophyte infection, 373-374 Dermis, 369 DES (diffuse esophageal spasm), 244 Designer drugs, 693 Desmopressin (DDAVP), 434 Detoxification, drug, 697-699 Developmental delay, 500 Developmental levels of involvement in

family-centered care, 28-29 Diabetes insipidus, 434 Diabetes mellitus, 412-418

childhood and adult Type I, 412-416 complications of, 417-418 diet and, 415-416 exercise and, 416, 715 hypertension in, 418 pregnancy and, 417, 458, 470-471 Type I insulin-deficient (IDDM),

412-416 Type II non-insulin-dependent, 416-418

Diabetic ketoacidosis (DKA), 413-414, 417

Diabetic nephropathy, 283-284 Diabetic retinopathy, 142, 417-418 Diagnosis

clinical, 565-566 problems versus, 61 serologic, 566

Diagnostic and Statistical Manual of Men­tal Disorders, Third Edition (DSM-lll), 535

Diagnostic history, 598 Diagnostic principles, 565-566 Diagnostic testing, 62 Dialysis, 279-280 Diaper rash, 489 Diaphragms, 311

fitting of, 321 Diarrhea, 238

in childhood, 488, 499 chronic, 248-249 travelers', 600, 603

Diarrheal diseases, infectious, 247-249 Diary, habit, 98 Diastolic blood pressure, 175

Diazepam (Valium), 108, 620 Diet

of adolescents, 511 diabetes mellitus and, 415-416 "fad;' 419 obesity and, 419

Dietary changes, 176 Dietary suggestions for international

travelers, 602-603 Digestive system problems, 235-266 Digital blocks, 621 Digitalis, dosage schedule for, 199 Digoxin, 191 Dilated cardiomyopathy, 203-204 Dilation and curettage (D & C), 328-330 Dilaudid, 693 Diltiazem, 182-183 DIP (distal interphalangeal) joints, 346,

709 Disability, evaluation of, 612-613 Discharge examination of newborn, 485 Disease prevention, 81-92

stages of, 81 Diseases

bacterial, see Bacterial entries common,60 communicable, of children, 495-497 fungal, see Fungal diseases illness versus, 66 infectious, see Infectious diseases natural history of, 60-61 neoplastic, 587-596 pattern of, 62 quarantinable, 599-601 rare, 60 screening for, see Screening sexually transmitted (STD), see Sexually

transmitted diseases viral, see Viral entries

Disks, intervertebral, 335 Disordered thinking, 550 Disorganized patients, 56 Distal interphalangeal (DIP) joints, 346,

709 Distal radial epiphyseal fractures, 343 Diuretics, loop, 199 Diverticular diseases, 250-251 Diverticulitis, 631 Diverticulosis, 254 Divorce, effects of, 502 Dizziness, 146-148 DJD (degenerative joint disease), 357-358 DKA (diabetic ketoacidosis), 413-414,

417 DOC (Doctors Ought to Care), 96 Doctor-patient relationship, 7, 63, 535 Doctors, see Physicians Doctors Ought to Care (DOC), 95 Documentation of health care, 64 Dog bites, 657 Dog ears, 624, 625

Dohle bodies, 440 Dopamine, 680

Index 727

Doppler echocardiography, 208-209 Downey cells, 512 Down's syndrome, 500-501 Drinking problems, 82-83; see also Alco­

holism Driving after alcohol use, refraining from,

651 Drowning, 657 Drug allergies, 399-400 Drug eruptions, 379-380 Drug-induced hepatic injury, 262-263 Drug-induced hepatitis, 223 Drug-induced immune hemolysis, 451 Drug-induced shock, 675 Drugs

abuse of, 60 adolescents and, 504, 518 in cardiac arrest, 680-681 impotence and, 555 intrapartum, 493-494 mood-altering, 693 in sports, 716-717 testing for, 717

Drusen, 143 Dry skin, 381 DSM-l/1 (Diagnostic and Statistical

Manual of Mental Disorders, Third Edition), 535

DUB (dysfunctional uterine bleeding), 306-308

Duodenal ulcers, 240 perforated, 631

Duodenitis, 237 Duodenum, diseases of, 244-247 Dyclonine (Dyclone), 620 Dynamometry, isokinetic, 719 Dysentery, bacillary, 247 Dyshidrosis, 379 Dyskinesia, tardive; 120-121 Dyspepsia, 244-245 Dysphagia, 242 Dysphasia, 113 Dystocia, 474 Dysuria, 286 Dysuria-pyuria syndrome, 287

Ear external, 150 frostbite of, 150 middle, neoplasms, 152-153

Ear canal, 150-151 Ear irrigation syringe, 159 Ear piercing, 150 Ear problems, 146, 150-154 Eating disorders, 557-558 E-B virus, see Epstein-Barr virus entries EBV, see Epstein-Barr virus entries ECG, see Electrocardiogram

728 Index

Echocardiography, 208-209 Eclampsia, 472 Ecological-transactional model, 39-41 Ecothrix infection, 374 ECT (electroconvulsive therapy), 531, 545 Ectopic pregnancy, 323, 468-469 Ectopion, 137 Eczema, 377 EDC (expected date of confinement), 457 Edema during pregnancy, 464 Education

health, 91-92, 94 medical, continuing, 2

EEG (electroencephalogram), 106 Efudex (5-fluorouracil)(5-FU), 389 Ejaculation, premature, 555-556 Elbow

nursemaid's, 353 tennis, 341-342

Elbow dislocations, 342, 709 Elbow problems, 341-343 Elderly, 25-26, 102

abuse of, 78 affective disorders in, 530-531 anticipatory guidance, 528-529 depression in, 530-531 depression screening scale for, 531 health care of, 521-532 health maintenance for, 528-529 neurotic disorders in, 531 organic brain syndromes in, 532 paranoid states in, 532 psychiatric syndromes of, 529-532 suicide in, 530

Electrocardiogram (ECG), 180, 184 continuous ambulatory monitoring, 208 fetal, 479

Electroconvulsive therapy (ECT), 531, 545 Electroencephalogram (EEG), 106 Electrolyte disturbances, 274-276 Electrolyte replacement, 714 Electromechanical dissociation, 683 Electronic media, 104 Electrosurgery, 372 ELISA (enzyme-linked immunosorbent)

test, 406 Elliptocytes, 440 EM (explanatory model), 36-40 Embolic strokes, 114 Emergency care, 64 7-666

cardiovascular, 648-650 dental, 168 family physician role in, 647, 648 problems requiring, 654-658

Emergency cricothyreotomy, 663, 664 Emergency medical systems (EMS),

647-648 Emergency pack, office, 616 Emergency room management, 653-654 Emphysema, 215

Employment during pregnancy, 461 Empyema, 218-219

subdural, 119 EMS (emergency medical systems),

647-648 Encephalitis

Japanese, 600 viral, 119

Encephalopathy, hypertensive, 116 Encopresis, 498 Endocarditis, 202

subacute bacterial, 567 Endocrine disorders, 412-437 Endometrial aspiration and biopsy,

325-328 Endometrial cancer, 589-590

screening for, 87 Endometrial cycle, 304 Endometritis, 477 Endothrix infection, 374 Endotracheal intubation, 661-662 Endotracheal tubes, 661 ENT (ear, nose, and throat) problems, 146 Enteric infections, 574-575 Enterobiasis, 498 Entropion, 137-138 Enuresis, 498 Environment, physical, 54

cold, 605 hot, 604-605 hyperbaric, 604 hypobaric, 603-604

Environmental factors in alcoholism, 691-692

Environmental health care, 598-613 Enzyme-linked immunosorbent (ELISA)

test, 406 EOA (esophageal obturator airway), 661 Eosinophilic pneumonia, 229 Ependymoma, 122 Epicondylar fractures, 342 Epicondylitis, lateral, 341-342 Epidermal cysts, 386 Epidermis, 368-369 Epidermoid cysts, 627-628 Epididymitis, 299 Epideural abscess, 119 Epidural effusion, 112 Epigastric hernias, 642 Epigastric pain, 244-245 Epiglottitis, 500 Epileptic seizures, classification of, 107 Epinephrine, 403, 408, 680 Episcleritis, 131, 132 Episiotomy, 481 Epistaxis, 155 Epstein-Barr virus (E-B virus), 496 Epstein-Barr virus (EBV), 511-512, 567 Epstein-Barr virus infection, 511-512 Equipment and instruments, 616

Erectile dysfunction, 434-435 Erysipelas, 382 Erythema infectiosum, 496 Erythema multiforme, 380 Erythema nodosum, 380 Erythema toxicum, 491 Erythrocytosis, 442 Erythroid series, 454 Erythroplasia, 389 Escape beats, junctional, 192 Escape rhythms, junctional and ventricu-

lar, 192 Esophageal cancer, 592 Esophageal dysphagia, 242 Esophageal motility disorders, 243-244 Esophageal obturator airway (EOA), 661 Esophageal spasm, diffuse (DES), 244 Esophagus

cancer of, 244 diseases of, 241-242

Esotropia, 136 Essential tremor, 120 Estrogen replacement therapy, 318-319 Estrogens, 428

in oral contraceptives, 309 Ethical values in health care, 10 Ethinyl estradiol, 308-309 Ethmoid sinusitis, 150 Ethnomedical cultural model, 36-37 Ethosuximide, 108 Ethylene glycol, 607 Ethynodiol diacetate, 309 Eustachian tube, 151 Euthyroid sick syndrome, 425 Examination

abdominal, 629 anorectal, 633 discharge, of newborn, 485 emergency room, 653 mental status, 558-559 periodic health (PHE), 88, 90, 91 physical, see Physical examination well-baby, 485-486

Examination room, 97-98 Exanthem subitum, 496 Exanthems, viral, 379 Excisional biopsy, 643, 644 Exercise, 101-102, 176

diabetes mellitus and, 416, 715 need for, 84 obesity and, 420 during pregnancy, 460, 716

Exercise-induced bronchospasm, 714 Exercise programs, 209 Exercise-related anemia, 714 Exercise tolerance tests, 205-208

for evaluating chest pain, 207-208 maximal, 207

Exercise worksheet, 98 Exfoliative dermatitis, generalized, 378

Exostoses, 169 Exotropia, 136 Expectations of patients, 59 Expected date of confinement (EDC), 457 Explanatory model (EM), 36-40 Exploratory responses, 51 Extremities

arterial disease of, 639-641 lower, injury to, 710-712 soft tissue tumors of, 638 upper, injury to, 708-710 vascular disease of, 638-641

Eye, outer, diseases of, 136 Eye contact, good, 53 Eye enhancement, cosmetic, 138 Eye medications, topical, 134-135 Eye problems, 129-145 Eyeglasses, 135 Eyeguards, 135

Face-hand test, 524 FACES (family adaptability and cohesion

evaluation scale), 33 Facial cellulitis, 628 Facial expressions, 53 Facial nerve paralysis, 124 Facilitation interviewing skill, 560 "Fad" diets, 419 Family

beginning, 45-46 childbearing, 46-47 death in, 73-76 effect of critical illness on, 688 infections in, 563-565 launched, 49-50 launching, 48-49 of patients, 62 with school-age children, 47-48

Family adaptability and cohesion evalua-tion scale (FACES), 33

Family APGAR, 33 Family cancer syndrome, 593 Family-centered health care, 28-34 Family circle technique, 33 Family circumflex model, 31-32 Family effects of alcohol, 695-696 Family environmental scale (FES), 33 Family function, normal, 30-32 Family genograms, 30, 31, 32-33 Family Health Foundation of America

(FHFA), 2 Family life cycle, 44

stages of, 44-50 Family medicine, 1

background, 1-3 chronology of evolution of, 14-16 clinical content of, 4 core concepts in, 3-11 current practice, 3

current trends and future practice, 11-13

definition of, 7 discipline of, 4-7 emerging areas of excellence in, 4 overview of family systems in, 29-33 practitioner of, 9-11 research areas in, 6 residency training in, 2 specialty of, 7-9

Family oriented health care, 4-5 Family pattern in seeking medical atten-

tion, 59 Family physician, see Physicians Family planning, natural, 311-312 Family practice, 1; see also Family medi-

cine Family pressure, 58-59 Family resources, 5 Family structure, 30 Family system, 5 Family systems approach, 29-33 Family therapy, 29 Family violence, 76-79 Fansidar, 602 Fantasy and play, 21 Farsightedness, 132-133 Fascicular blocks, 194 FDPAC (flow-directed pulmonary artery

catheterization), 668, 669-670 Fear-pain dyad, 58 Fears in children, 501 Febrile seizures, 107-108 Fecal incontinence, 526 Feces, occult blood screening of, 263 Federation of Gynecology and Obstetrics

(FIGO) staging system, 589, 590 Feeding problems, 488 Feet, see Foot entries Felon, 626, 627 Female anorgasmia, 556 Female genital examination, 510 Female reproductive system problems,

302-330 Female sexual development, 507-508 Females, see also Adults in sports,

715-716 Femoral condylar fractures, 349 Femoral epiphysis, slipped capital, 352 Femoral fractures, 347 Femoral hernias, 642 Fentanyl, 693 Ferritin, 444, 445 Ferrous sulfate, 446 FES (family environmental scale), 33 Fetal alcohol syndrome, 695 Fetal blood sampling, 481 Fetal distress during labor, 481 Fetal growth, serial assessment of,

464

Index 729

Fetal health, antepartum assessment of, 464-465

Fetal heart rate (FHR), 465 contraction stress testing, 478-479 monitoring during labor, 479-480 nonstress testing, 478

Fetal heart tones, detection of, 464 Fetal monitoring, 478-481 Fetal movement monitoring, 464 Fetal pH, 481 FEY (forced expired volume), 215, 231 Fever

of undetermined origin, 566-568 undiagnosed, 568

FHFA (Family Health Foundation of America), 2

FHR, see Fetal heart rate Fibrillation

atrial, 191-193 ventricular (YF), 193, 678-679

Fibromas, 168, 169 Fibrositis, 361-362 Fibula fractures, 349 Field blocks, 620-621 FIGO (Federation of Gynecology and

Obstetrics) staging system, 589, 590 Filariasis, 601 Finances for health care, 64 Fine-needle aspiration biopsy (FNAB)

of thyroid, 425 Finger injuries, 709 Fingernails, 369 Fitness, 703 Flat warts, 385 Flow-directed pulmonary artery catheteri-

zation (FD-PAC), 668, 669-670 Fluid replacement, 714 Fluoride supplementation, 85 Fluorinated steroids, 371 Fluoroscopy, 651 5-Fluorouracil (Efudex)(5-FU), 389 Flutter, atrial, 191 FNAB (fine-needle aspiration biopsy) of

thyroid, 425 Focal motor seizures, 107 Folic acid deficiency, 448 Follicle-stimulating horrrione (FSH),

303-309 Follicles, hair, 392 Follicular phase of ovarian cycle, 304 Folstein Mini-Mental State questionnaire,

524, 558 Food allergies, 409-410 Food dyes, 410 Foot care, 641 Foot disorders, 711 Foot pain, 350 Foot problems, 350-351 Forced expired volume (FEY), 215, 231 Forced vital capacity (FYC), 231

730 Index

Forearm flexion reflex, 494 Forearm fractures, 343 Forearm problems, 343 Foreign body in skin, 651 Formula feeding, 486 Foveae, 334 Fractures, 332 Freiberg's disease, 352 Friedman curves, 474, 475 Frontal sinusitis, 150 Frostbite of ear, 150 FSH (follicle-stimulating hormone),

303-309 5-FU (5-fluorouracil)(Efudex), 389 Fungal diseases, 370, 567

of lung, 225-227 superficial, 373-375

Furuncles, 383 FVC (forced vital capacity), 231

G6PD (glucose-6-phosphate dehydrogenase deficiency), 449-450

GABA (gamma-aminobutyric acid), 694 Gallbladder diseases, 257-258, 630 Gallstones, 257-258 Gamma-aminobutyric acid (GABA), 694 Ganglion cyst, 638 Gardner's syndrome, 252 Gas exchange monitoring, 672 Gastric cancer, 245 Gastric carcinoma, 592 Gastric dilatation, acute, 686-687 Gastric lavage, 656 Gastric polyps, 245 Gastric stress ulceration, 686 Gastric ulcers, 240 Gastritis, 237-238 Gastroenteritis, 499

bacterial, 247 viral, 238

Gastroesophageal (GE) reflux, 242-243 Gastrointestinal (GI) bleeding

lower, 253-254 upper, 245-247

Gastrointestinal diseases, 235-266 Gastrointestinal dysfunction, 686-687 Gastrointestinal system, alcohol and, 692 Gaze palsy, 123-124 GE (gastroesophageal) reflux, 242-243 Geller probability tables, 91 Gender assignment, 430 Gender identity, 514 Genetic predispositions, 84

in alcoholism, 691 Genital examination

female, 510 male, 510-511

Genital herpes during pregnancy, 458 Genital tract infection in puerperium, 477

Genital warts, 574 Genitourinary anomalies, 294 Genitourinary considerations

in elderly, 294 in young, 293-294

Genitourinary system problems, 286-300 Genograms, family, 30, 31, 32-33 Geriatric depression screening scale, 531 Geriatrics, 102; see also Elderly Geropsychiatric syndromes, 529-532 Gestational age

evaluating, 474 large-for-gestational-age infants, 493 physical signs of, 493 reflexes in assessing, 494

GHRH (growth hormone-releasing hor-mone), 433

GI, see Gastrointestinal entries Giant cell tumor of tendon sheath, 638 Giardiasis, 247, 600 Gingivitis, 165-166

acute necrotizing ulcerative (ANUG), 165-166

Gingivostomatitis herpetic (HGS), 156, 166, 496 uremic, 166

Glabellar tap reflex, 494 Glasgow coma scale (GSC), 111, 113 Glaucoma, 138-139

acute, 132 screening for, 86

Glenohumeral joint, 339 Glenohumeral joint dislocation, 341,

708 Glioblastoma multiforme, 122 Globin chains, 448 Glomerulonephritis, 281-282 Glucocorticoids, topical, 371 Glucose-6-phosphate dehydrogenase defi-

ciency (G6PD), 449-450 Glucose tolerance test, oral (OGfT),

422-423 Glucosuria, 298 GnRH (gonadotropin-releasing hormone),

304, 305 Gold, parenteral, 360 Gonadotropin-releasing hormone (GnRH),

304, 305 Gonorrhea, 314, 570-571 Goodpasture's syndrome, 284, 364 Gout, 356-357 Graduating residents, 17-18 Gram-negative pneumonia, 218 Gram's stain, 581

in bacterial pneumonias, 218 of sputum, 232

Grand mal seizures, 106 Granuloma, umbilical, 491 Graves' disease, 423-424 Greenstick fractures, 712

Grief, 61, 73 stages of, 73-74 unresolved, 74

Growth and development problems, 431-433

Growth failure, 431-433 Growth hormone-releasing hormone

(GHRH), 433 Growth plate injuries, 712 Growth retardation, intrauterine (IUGR),

432, 473-474 Growths, new, see New growths GSC (Glasgow coma scale), 111, 113 Guaiac-positive stools, 254 Guidance, anticipatory, see Anticipatory

guidance Guillain-Barre syndrome, 125-126 Gyn pack, 616 Gynecomastia, 436

H2 receptor antagonists, 241 Habit diary, 98 Habitual abortion, 469 Hair, 369 Hair follicles, 392 Hair problems, 392-393 Hallucinations, 550 Hallucinogens, 693 Halo nevus, 387 Halothane hepatitis, 262 Hand infections, 628-629 Hand injuries, 709-710 Hand problems, 344-346 Hangnail, 394 Haptoglobin, 449 Hashish, 693 Hay fever, 399 Hazards

chemical, 605-607 physical, 603-605

HBM (health belief model), 43-44 hCG (human chorionic gonadotropin), 303 HDL (high-density lipoproteins), 421 Head trauma, 110, 706-708 Headaches, 108-110

during pregnancy, 464 Healing action, 39 Health belief model (HBM), 43-44 Health care, 19

abuse of system of, 59-60 of adolescents, 504-519 child, see Child health care continuum of, 8 critical, see Critical care documentation of, 64 of elderly, 521-532; see also Elderly emergency, see Emergency care environmental, 598-613 ethical values in, 10

Health care (cont.) family-centered, 28-34 family oriented, 4-5 finances for, 64 legislation and, 104 longitudinal, 43-50 maintenance for adolescents, 509-511 maintenance for elderly, 528-529 models of, 35-41 occupational, 598-613 postoperative, 618-620 preoperative, 617-618 reasons for seeking, 58-60 source of, 534-535 in sports, see Sports medicine during and after travel, 603 for travelers, 599

Health education, 91-92, 94 Health examination, periodic (PHE), 88,

90, 91 Health maintenance, 81-92 Health maintenance organization (HMO),

11-12 Health promotion, 94-105

adults and, 103 community and, 102-104 implementing strategies for, 100-101 media and, 103-104 youth and, 103

Health Risk Appraisal (HRA), 88, 91 Health risks, 81-85 Health seeking process, 37-39 Hearing deficit, screening for, 86 Hearing impairment, 153 Hearing loss, conductive, 163 Heart disease

congenital, see Congenital heart disease coronary (CHD), 173-174 valvular, 196-198

Heart failure angina pectoris and, 182-183 congestive (CHF), 176

Heart rate, fetal, see Fetal heart rate Heartburn, 242

during pregnancy, 463 Heat, 604-605 Heat cramps, 604 Heat exhaustion, 604-605 Heat injuries, 174 Heat rash, 604 Heat stroke, 605 Heavy metals, 85, 607-610 Heberden's nodes, 357 Height and weight tables, 418 Heimlich maneuver, 659 Heinz bodies, 449, 451 Helicopter and air support, 648 HELLP syndrome, 472 Helmet use while driving motorcycles, 650 Helminths, 600, 602

Hemangiomas, 169, 388 Hematemesis, -245 Hematocrit, 440 Hematologic evaluation, kidney, 271 Hematological system and alcohol, 695 Hematoma

subdural, 111, 112 subungual, 645

Hematopoietic system problems, 439-455 Hematuria, 288-290

in athletes, 714-715 Heme iron, 443 Hemoccult tests, 253 Hemodialysis, 279-280 Hemodynamic monitoring, 668-669 Hemodynamic patterns in critical illness,

670-672 Hemoglobin, 439, 440, 444

abnormal, 450 Hemoglobin synthesis, disturbance of,

448-449 Hemolysis

antibody-mediated, 451 immune, drug-induced, 451 from infection and chemical agents,

450-451 Hemolytic anemia, 449-451, 497

microangiopathic, 450 Hemolytic disorders, 449 Hemolytic reactions, autoimmune, 451 Hemolytic uremic syndrome, 284 Hemoperitoneum, suspected, 324 Hemorrhage, see also Bleeding

brainstem, 114-115 intracerebral, 114-115 postextraction, 168 subarachnoid (SAH), 115 in surgery, 619

Hemorrhagic pancreatitis, 630 Hemorrhagic strokes, 114-115 Hemorrhoidal nerve block, inferior, 621,

622 Hemorrhoids, 633-635

during pregnancy, 464 Hemosiderin, 444 Hemothorax, 654 Henoch-Schonlein (HS) purpura, 284,

364 Heparin therapy, 221

intravenous, 637 Hepatic injury, drug-induced, 262-263 Hepatitis

acute, 258-259 alcoholic, 260-261 chronic, 259-260 drug-induced, 223 halothane, 262 isoniazid, 262 posttransfusion, 259

Hepatitis A, 258-259, 260, 600, 601

Hepatitis B, 259, 260, 600, 601 during pregnancy, 458

Hepatitis B virus, 565 Hepatitis D, 259, 260 Hepatoma, 262 Hepatorenal syndrome, 285 Hernias

abdominal, 641-642 epigastric, 642 femoral, 642 hiatus, 242 incisional, 642 inguinal, 641-642 umbilical, 491, 642

Heroin, 693 Herpangina, 156 Herpes genitalis, 573-574 Herpes keratitis, 133 Herpes simplex, 375-376 Herpes zoster, 376

Index 731

Herpesvirus infections, 375-377 Herpetic gingivostomatitis (HGS), 156,

166, 496 Herpetic keratoconjunctivitis, 131 Heterocyclic antidepressants, 543, 544 HGS (herpetic gingivostomatitis), 156,

166, 496 Hiatus hernia, 242 Hiccups in children, 488 Hidradenitis, 384 High-altitude illness, 603-604 High-density lipoproteins (HDL), 421 Hip

bursitis of, 346 musculotendinous conditions about,

346-347 Hip dislocations, 347 Hip dysplasia/dislocation, congenital,

352-353 Hip fractures, 347 Hip problems, 346-347 Hirsutism, 431 Histoplasmosis, 225 History

basic occupational, 598 diagnostic, 598 occupational, see Occupational history sexual, 569

Histrionic personality disorders, 548 HIV (human immunodeficiency virus),

405-406 Hives, 380 HLA (human leukocyte)

antigen, 280 HLP (hyperlipoproteinemia), 420 HMO (health maintenance organization),

11-12 Hodgkin's disease, 593-594 Holistic health model, 36 Holmes-Rahe Life Change Index, 222

732 Index

Holter monitoring, 208 Homosexuality, 569

in adolescents, 514 Honest labeling, 52 Hookworm, 602 Hordeolum, 136-137 Hospices, 586 Hot environment, 604-605 Household safety, 83 Howell-Jolly bodies, 440, 450 HPO (hypothalamic-pituitary-ovarian)

axis, 302 HRA (Health Risk Appraisal), 88, 91 HS (Henoch-Schonlein) purpura, 284, 364 Human chorionic gonadotropin (hCG),

303 Human development, 19-27 Human immunodeficiency virus (HIV),

405-406 Human leukocyte associated (HLA)

antigen, 280 Humeral fractures, 340-341 Hyaline bodies, 143 Hydralazine, 188 Hydrocarbon solvents, 606 Hydrocortisone, 371, 429 Hydroxychloroquine, 360 Hygiene, 611 Hyperaldosteronism, primary, 429 Hyperamylasemia, 255 Hyperbaric environment, 604 Hypercalcemia, 426-427 Hypercalciuria, 426 Hypercholesterolemia, 420-421

screening for, 86 Hyperchylomicronemia, 421 Hypercortisolism, 429 Hyperglycemia, 413 Hyperinsulinism, 413 Hyperkalemia, 275-276 Hyperlipidemias, 420-421 Hyperlipoproteinemia (HLP), 420 Hypernatremia, 274-275 Hyperopia, 132-133 Hyperparathyroidism, 426 Hyperpigmentation, 612 Hyperplasias, 384-388 Hyperplastic polyps, 252 Hyperprolactinemia, 433 Hypersensitivity, 400 Hypertension, 112, 173, 174-178

in diabetes mellitus, 418 etiology of, 175 late or transient, 473 malignant, 283 during pregnancy, 471-473 pulmonary, 204-205 screening for, 86 stepped care method for treating,

177-178 treatment of, 175-178

Hypertensive disease, chronic, 472-473 Hypertensive encephalopathy, 116 Hypertensive retinopathy, 141 Hyperthyroidism

juvenile, 423 lymphocytic thyroiditis with spontane­

ously resolving (LTSRH), 423 treatment of, 424

Hyperthyroidism medicamentosa, 423 Hyperthyroxinemia, 423 Hypertonic uterine dysfunction, 475 Hypertriglyceridemia, 421 Hypertrophic cardiomyopathy, 203, 204 Hypertropia, 136 Hyperuricemia, 356 Hyperventilation, 228-229 Hyperventilation syndrome, 556-557 Hyphema, 130 Hypobaric environment, 603-604 Hypocalcemia, 427 Hypochondriasis, 549 Hypocortisolism, 428-429 Hypoglycemia, 416, 422-423 Hypogonadism, 435 Hypokalemia, 275 Hyponatremia, 274, 434 Hypoparathyroidism, 427 Hypopigmentation, 612 Hypopituitarism, 433-434 Hyposensitization, allergic, 397-398 Hypospadias, 294 Hypothalamic-pituitary-ovarian (HPO)

axis, 302 Hypothermia, 605, 657 Hypothyroidism, 424-425 Hypotonic uterine dysfunction, 475 Hypovolemia, 648 Hypovolemic shock, 674 Hypoxia, 604

IBC (iron-binding capacity), 444 IBD (inflammatory bowel disease),

251-252, 253 IBS (irritable bowel syndrome), 239-240 ICUs (intensive care units), 667 IDDM (Type I insulin-deficient diabetes

mellitus), 412-416 Identity crises, 504 Identity formation, 23 Idiosyncratic reactions, 400 IgM antibody, 566 IHSS (idiopathic hypertrophic subaortic

stenosis), 203, 204 Ileus, 619 Illness, disease versus, 66 Illness prototype (IP), 36-41 Imaging procedures, 62 Immersion, cold water, 657 Immune hemolysis, drug-induced, 451 Immune mechanism, 395

Immune system, stress and, 564 Immunizations

for adults, 91 childhood, 490

Immunodeficiency virus, human (HIV), 405-406

Immunologic system problems, 395-410 Immunoprophylaxis, see also Prophylaxis

Rh factor, 459 tetanus, 651, 652

Immunotherapy, 397 Impairment, evaluation of, 612-613 Impetigo, 375 Impotence, 434-435, 554, 555 IMV (intermittent mandatory ventilation),

676 Incessant talkers, 56 Incision and drainage pack, 616 Incisional biopsy, 643, 644 Incisional hernias, 642 Inclusion cysts, 150 Incontinence, 294, 526 Inevitable abortion, 469 Infancy, 20

communicable diseases of, 495-497 high-risk conditions in, 493-495

Infants care of, 484-499 congestive heart failure in, 199 large-for-gestational-age, 493 low-birth-weight, 493 premature, 493 sudden infant death syndrome (SIDS),

75, 497 Infected material, culture of, 565 Infections

in family, 563-565 "ping-pong;' 564 symptomatic versus asymptomatic,

568 Infectious diseases, 563-581

antibiotics in, 578-580 prevention of, in international travelers,

600-601 screening for, 87-88

Infectious mononucleosis, 496, 511-512 Infertility, male, 436-437 Infiltration blocks, 620-621 Inflammation, 332 Inflammatory bowel disease (IBD),

251-252, 253 Inflammatory lesions, 384 Influenza, viral, 576-577 Influenza A or B, 219 Influenza syndrome, 576 Influenza vaccine, 91 Ingrown nail, 394 Ingrown toenails, 645 Inguinal hernias, 641-642 INH, see Isoniazid entries Inhalers, metered-dose (MDI), 403

Injuries musculoskeletal, acute, 331-332 musculoskeletal, chronic, 332, 333 sun, 372

Injury prevention, 83-84 Insect sting allergies, 408-409 Insomnia, 526-527 Instruments and equipment, 616 Insulin, 412, 415 Insulin dosage, 413 Insulin pumps, 417 Insulin therapy, 414 Intensive care units (ICUs), 667 Intermittent mandatory ventilation (IMV),

676 Intermittent positive pressure ventilation

(IPPV), 676 Interpretation interviewing skill, 560 Interstitial lung diseases, 223-224 Intervention, addiction, 697 Interviewing skills, 560 Interviews, medical, guidelines for, 54-56 Intestinal obstruction, 632 Intimal atherosclerosis, 141 Intracerebral hemorrhage, 114-115 Intracranial tumors, 121-123 Intradermal nevus, 387 Intradermal skin test, 231 Intraocular tumors, 143 Intrapartum drug use, 493-494 Intrauterine devices (IUDs), 310-311

insertion of, 320 removal of, 321

Intrauterine growth retardation (IUGR), 432, 473-474

Intravenous heparin, 637 Intravenous pyelogram (IVP), 271, 272 Intravenous regional block, 621 Iodine, radioactive, 424 IP (illness prototype), 36-41 Ipecac, syrup of, 656 IPPV (intermittent positive pressure venti-

lation), 676 Iritis, 132, 140 Iron absorption, 443-444 Iron-binding capacity (IBC), 444 Iron deficiency, 83

progressive, 445 Iron-deficiency anemia, 439, 443-44 7,

497 Iron dextran, intramuscular, 446 Iron level, serum, 445 Iron metabolism, 443-444 Iron stains, 454 Iron stores, bone marrow, 445 Iron therapy, 446 Irritable bowel syndrome (IBS), 239-240 Ischemia, silent, 182 Ischiorectal abscess, 635-636 Isokinetic dynamometry, 719 Isometric amblyopia, 137

Isoniazid (INH), 222-223 Isoniazid hepatitis, 262 IUDs, see Intrauterine devices IUGR (intrauterine growth retardation),

432, 473-474 IVP (intravenous pyelogram), 271, 272

Jacksonian seizures, 107 Jamshidi biopsy needle, 453 Japanese encephalitis, 600 Jaundice, newborn, 492 Jaw thrust maneuver, 659, 660 Jealousy in childhood, 502 Jock itch, 373 Joint disease, degenerative (DJD),

357-358 Joint problems, 354-365 Journal of Family Practice, 6 JRA (juvenile rheumatoid arthritis), 361 Junction nevus, 387 Junctional contractions, premature, 192 Junctional escape beats and rhythms, 192 Juvenile hyperthyroidism, 423 Juvenile rheumatoid arthritis (JRA), 361

Kaposi's sarcoma, 405, 406 of hard palate, 167

Karman cannula, 327 Karyotyping, 430 Kawasaki disease, 364 Kawasaki syndrome, 498 Keloid, 387-388 Keratoacanthoma, 389-390 Keratoconjunctivitis, 131 Keratoconjunctivitis sicca, 131 Keratosis

actinic, 388-389 seborrheic, 386-387

Kerion, 374 Ketoacidosis, diabetic (DKA), 413-414,

417 Ketone bodies, 413 Ketonuria, 298 Kidney disease, polycystic, 282 Kidney problems, 270-275 Knee, bursitis of, 347-348 Knee injuries, 710 Knee pain, 710 Knee problems, 347-349 Knowledge required in clinical reasoning

process, 69-70 Kohler's disease, 352 Koplik's spots, 495

Labial adhesions, 492 Labor

abnormalities in pattern of, 476 analgesia in, 465-466

fetal distress during, 481 identification of, 465

Index 733

monitoring fetal heart rate during, 479-480

normal, 465-467 preterm, 469-470 problems complicating, 474-477

Laboratory analysis of cerebrospinal fluid, 126-127

Laboratory procedures, 62 Laboratory screening, prenatal, 458 Labyrinthine disorders, 124 Labyrinthitis, 146 Lacerations, 332, 621-625

vaginal, repair of, 481 Lacrimal tract disorders, 138 Lactase deficiency, 409 Lacunar strokes, 116 Large cell carcinomas, 220 Large-for-gestational-age infants, 493 Laryngeal carcinomas, 158 Laryngeal tumors, 158 Laryngitis, 148 Laryngoscope blades, 661 Laryngoscopy, indirect, 159-160 Laryngotracheobronchitis, 148 Lateral medullary syndrome, 115 Launched family, 49-50 Launching family, 48-49 Lay treatment resources for alcoholism,

699-700 LDL (low-density lipoproteins),

420-421 Lead poisoning, 85, 451 , 609-610 LEARN framework, 36-37 Leg pain, 711-712 Leg varicosities during pregnancy, 464 Legg-Calve-Perthes disease, 352 Legionnaire's disease, 219 Legislation, health care and, 104 Lenses, contact, 135-136 Lentigo maligna, 390 Leprosy, 602 Leptospirosis, 60 1 Lethargy in infants, 492-493 LET'S HEAR mnemonic, 37, 38 Leukemia

acute myelogenous (AML), 595 lymphocytic, see Lymphocytic leukemia

Leukocyte esterase and nitrite tests, 298-299

Leukocytes, see White blood cells Leukoplakia, 389 Leukorrhea during pregnancy, 464 LH (luteinizing hormone), 303-309 Lice, 382 Lichen planus, 375 Lichen simplex chronicus, 381-382 Lid diseases, 136-138 Lidocaine (Xylocaine), 620, 681 Life, years of potential, lost, 82

734 Index

Life cycles, 537 family, see Family life cycle natural history of cancer and, 586

Life-support skills, basic, 659-666 Ligaments, interspinous, 335 Limps, children with, 352 Linguistic communication, 51-53 Lipoma, 387 Lipoproteins

high-density (HDL), 421 low-density (LDL), 420-421 very-low-density (VLDL), 421

Lips, 156 cancer of, 157

Liquid nitrogen, 372 Lithium, 544 Liver disease(s), 258-263

alcoholic, 260-262 Loaded words, 52 Local anesthetic agents, 620 Lochia, 467 U>ffler's syndrome, 229 Loop diuretics, dosage schedule for, 199 Lordotic curve, 334 Low back pain, 336, 338 Low-birth-weight infants, 493 Low-density lipoproteins (LDL), 420-421 Lower leg problems, 349 LP (lumbar puncture), 126-127 LSD, 693 LTSRH (lymphocytic thyroiditis with

spontaneously resolving hyper­thyroidism), 423

Ludwig's angina, 167 Lumbar disk disease, 125 Lumbar puncture (LP), 126-127 Lumbar spine, 334-335 Lumbosacral back pain, 336, 338 Lumpectomy, 588 Lung cancer, 220-221, 587-588

screening for, 87 Lung diseases

air travel for patient with, 229 interstitial, 223-224

Lungs, fungal diseases of, 225-227 Lupus erythematosus, systemic (SLE), 284 Luteal phase of ovarian cycle, 304 Luteinizing hormone (LH), 303-309 LVH (left ventricular hypertrophy), 176 Lying in childhood, 502 Lyme disease, 118 Lymph node biopsy, 452-453 Lymph node disorders, 439-440 Lymph node syndrome,. mucocutaneous,

498 Lymph nodes, enlarged, 452-453 Lymphadenitis, 628 Lymphadenopathy, differential characteris­

tics of, 452 Lymphangiomas, 169

Lymphangitis, 382 Lymphocytic leukemia

acute (ALL), 594-595 chronic (CLL), 595-596

Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (LTSRH), 423

Macroadenomas, pituitary, 433 Macular disease, 142 Macular eruptions, 379-380 Magazines in reception area, 96 Magnetic resonance imaging (MRI), 271,

272 Malabsorption, 249-250 Malaria, 600, 602 Male genital examination, 510-511 Male infertility, 436-437 Male sexual development, 508 Males, see also Adults

breast enlargement in, 436 disorders found in, 434-437

Mammography, 86, 588 Mandatory recertification, 2 Mandible

acute dislocation of, 172 fracture of, 169-170

Manganese, 609 Mania in elderly, 531 Mantoux skin test, 231 MAOis (monoamine oxidase inhibitors),

531, 544, 618 Marcaine (bupivacaine), 620 Marfan's syndrome, 713 Marijuana, 693 Marrow, see Bone marrow entries Marsupialization of cysts, 325 Masked depression, 540-541 MAST (Michigan Alcoholism Screening

Test), 83 MAST (military antishock trouser)

suits, 650, 651 Mast cell inhibitors, 134 Mastectomy, 588 Mastitis, 478 Mastodynia, 588 Masturbation, 21-22, 501 Mattress sutures, 623, 624 Maxilla, fracture of, 170-171 Maxillary sinusitis, 149 Maxillofacial trauma, 169-171 MCP, see Metacarpophalangeal entries MCV (mean corpuscular volume), 442 MDA, 693 MDI (metered-dose inhalers), 403 MDMA, 693 M:E (myeloid-precursor to erythroid­

precursor) ratio, 453-454 Measles, 495

Measles vaccination, 91 Mechanical ventilation, 675-676, 677 Mechanical ventilators, 663 Meckel's diverticulum, 253 Media, health promotion and, 103-104 Media Watch Notebook, 95-96 Medical care, see Health care Medical education, continuing, 2 Medical interviews, guidelines for, 54-56 Medicare, 521 Medicare hospices, 586 Medications, see Drugs Medicine

family, see Family medicine prospective, 88, 91 sports, see Sports medicine

Medullary cystic disease, 283 Medulloblastoma, 122 Megaloblastic anemia, 447-448 Melanocytes, 358 Melanoma, 390-392

acrolentiginous, 391 malignant, 143 nodular, 391 superficial spreading, 391

Melanotic freckle, 390 Melena, 245 Men, see Male entries Menarche, 507-508 Meniere's disease, 124, 146-147 Meningitis, 580-581

bacterial, 118 meningococcal, 600, 602 viral, 119

Meningococcal meningitis, 600, 602 Menopause, 317-320 Menorrhagia, 308 Menstrual cycle, normal, 303 Menstrual irregularities, 302-308 Menstrual transition period, 317 Menstruation, normal, regulation of, 304 Mental disorders in adolescents, 505 Mental status changes in critical care, 687 Mental status examination, 558-559 Meperidine, 693 Mepivacaine (Carbocaine), 620 Mercury, 609, 610 Mescaline, 693 Mesenteric thrombosis, acute, 631 Mesothelioma, 227 Messages, revealing, 51 Mestranol, 308-309 Metabolic acidosis, 276 Metabolic alkalosis, 276 Metabolic disorders, 412-437 Metacarpal shaft fractures, 344-345 Metacarpophalangeal (MCP) joint, 345 Metacarpophalangeal joint dislocation, 344 Metal exposures, 85, 607-610 Metatarsal fractures, 350

Metatarsal head, aseptic necrosis of, 352 Metatarsalgia, 351 Metatarsophalangeal (MTP) joint, 356 Metered-dose inhalers (MDI), 403 Methanol, 607 Methaqualone, 693 Methemoglobinemia, 451, 607 Methimazole (Tapazole), 424 Methylphenidate, 693 Methylxanthine drugs, 397 MG (myasthenia gravis), 124-125 Michigan Alcoholism Screening Test

(MAST), 83 Microadenomas, pituitary, 433 Microangiopathic hemolytic anemia, 450 Micro-expressions, 53 Microscopically controlled surgery, 372 MID (multiinfarct dementia), 524 Middle cerebral artery syndrome, 115 Midface, fracture of, 171 Midlife crisis, 25 Migraine headaches, 108-109 Migratory polyarthritis, 363 Milia, 386, 491 Miliaria, 375 Military antishock trouser (MAST) suits,

650, 651 Milk allergy, 409, 488 Milk crust, 377 Milk intolerance, 409, 488 Mini-Mental State questionnaire, Folstein,

524, 558 Missed abortion, 469 Mites, scabies, 370 Mitral regurgitation, 672 Mitral valve insufficiency, 198 Mitral valve prolapse, 198 Mitral valve stenosis, 197-198 Mobitz I and II blocks, 194 Molding of skull, newborn, 491 Molds, 395 Moles, 387 Molluscum contagiosum, 385 Monoamine oxidase inhibitors (MAOis),

531, 544, 618 Monocular aphakia, 139-140 Mononeuritis multiplex, 126 Mononucleosis, infectious, 496, 511-512 Monteggia fractures, 343 Mood-altering drugs, 693 MOPP regimen, 594 Moro reflex, 494 Morphine, 693 Mortality rates

of adolescents, 504 from cancer, 585 cause-specific, 82

Morton's neuroma, 638 Mother, care of, during puerperium,

467-468

Motility disorders, 243-244 Motor vehicle accidents, 83 Motorcycles, helmet use while driving,

650 Mountain sickness, acute, 604 Mourning, 26

anticipatory, 76 Mouth, see Oral cavity Movement disorders, 120-121 MPC (mucopurulent cervicitis), 572-573 MPV (mean platelet volume), 441 MRI (magnetic resonance imaging), 271,

272 MS (multiple sclerosis), 121 MTP (metatarsophalangeal) joint, 356 Mucocutaneous lymph node syndrome,

498 Mucopurulent cervicitis (MPC), 572-573 Mucous retention cysts, 156 Mucus, excess, of newborn, 492 Multiinfarct dementia (MID), 524 Multiple myeloma, 284, 596 Multiple sclerosis (MS), 121 Mumps, 157, 495 Mumps vaccination, 91 Murmurs, cardiac, 194-196

systolic, 195-196 Murphy's sign, 630 Muscle strains, 336 Musculoskeletal system problems,

331-353 differential diagnosis of, 337-338

Musculotendinous conditions about hip and thigh, 346-347

Myalgia, 336 Myasthenia gravis (MG), 124-125 Mycobacteria, atypical, 229 Mycoplasma pneumoniae, 219 Myelogenous leukemia, acute (AML), 595 Myeloid cell types, 454 Myeloid-precursor to erythroid-precursor

(M:E) ratio, 453-454 Myocardial infarction, 183-186 Myocardial perfusion studies, 208 Myocarditis, 203 Myofascial pain syndrome, 171 Myopia, 132 Myositis, 361-362 Myositis ossificans, 705

Nagele's rule, 457 Nail infections, 626 Nail problems, 393-394 Nail surgery, 645 Nail trauma, 394 Nailbiting, 501 Nails, 369 NAPCRG (North American Primary Care

Research Group), 2

Narcotics, 693 withdrawal from, 698-699

Narrow angle glaucoma, 39 Nasal bleeding, 155 Nasal cautery, 161 Nasal discharge, foul, 156 Nasal fracture, 155 Nasal injury, 155

Index 735

Nasal packing, 155, 161-162 Nasal vasoconstrictor abuse, 154 Nasogastric suction, 246 Nasogastric tube feeding, 265-266 Nasopharyngeal airway, 660-661 N asopharyngoscopy, 160-161 Nasopharynx, 157 National Health and Nutrition

Examination Surveys (NHANES) I and II, 416, 418

Nausea during pregnancy, 463 Navicular fractures, 343-344 Nearsightedness, 132 Neck flexion reflex, 494 Neck lift, 659, 660 Neck trauma, 706-708 Neglect, 78 Neisseria gonorrhoeae, smear and culture

for, 581 Neonatal bonding, 19-20 Neonatal circumcision, 294-296 Neoplastic diseases, see Cancer Nephroblastoma, 283 Nephrotic syndrome, 280-281 Nervous system

central, see Central nervous system entries

peripheral, 125-126 Nervous system problems, 106-127 Neurodermatitis, localized, 381-382 Neurofibrillary tangles, 522 Neurogenic shock, 675 Neuroglycopenia, 422 Neuropathy

brachial plexus, 126 peripheral, 125-126 sensory, 126

Neuropraxic injuries, 709 Neurosyphilis, 119 Neurotic disorders in elderly, 531 Nevi, 387

giant congenital, 390 vascular, 491

Nevus flammeus, 388 New growths

benign, 384-388 malignant, 390-392 premalignant, 388-390

Newborn discharge examination of, 485 full-term, serious problems of, 492-493 infections in, 494-495

736 Index

Newborn (cont.) molding of skull of, 491 problems of, 491-493

NGU (nongonococcal urethritis), 571-572 NHANES (National Health and Nutrition

Examination Surveys) I and II, 416, 418

Nicotine chewing gum, 215 Nifedipine, 188-189 Nighttime awakening in children, 501 Nitrogen, liquid, 372 Nitroglycerin, 180, 674 Nocardiosis, 226 Nodular melanoma, 391 Nongonococcal urethritis (NGU), 571-572 Nonlinguistic communications, 53-54 Nonsteroidal antiinflammatory drugs

(NSAIDs), 358, 360 Norethindrone acetate, 309 · Norethynodrel, 308-309 Norgestrel, 309 North American Primary Care Research

Group (NAP-CRG), 2 Norwalk virus, 238 Nose

dryness of, 154 foreign body in, 155

Nose malformations, 154 Nose problems, 146, 154-156 Nosebleeds, 155 NSAIDs (nonsteroidal antiinflammatory

drugs), 358, 360 Nummular dermatitis, 378-379 Nursemaid's elbow, 353 Nutrition

for adolescents, 511 childhood, 486, 488 in pregnancy, 459, 460

Nutrition worksheet, 99 Nutritional growth, child, 488-489 Nylen-Barany maneuver, 147-148

Oat cell carcinomas, 220 Obese children, 489 Obesity, 83, 102, 176, 418-420

in adolescents, 513-514 diet and, 419 exercise and, 420 surgery and, 420

Obsessional patients, 56 Obstetric admitting procedures, 465 Obstetric ultrasound scanning, 464-465 Obstructive hypertrophic cardiomyopathy,

713 Occupational health care, 598-613 Occupational history, 610-611

basic, 598 Occupational skin disease, 610-612 Occupational skin neoplasms, 612

OCPs (oral contraceptive pills), 308-310 Ocular foreign body removal, 144 Ocular palsies, 123-124 Ocular tonometry, 144-145 Ocular trauma, 29-130 Odynophagia, 242 Office emergency pack, 616 Office equipment and preparation for sur-

gery, 615-617 Office setting, counseling in, 559-561 Office staff, 95 OGTT (oral glucose tolerance test),

422-423 Oil acne, 611 Old age, see Elderly Olecranon bursitis, 342 Oligodendroglioma, 122 Onychocryptosis, 645 Onycholysis, 394 Onychomycosis, 645 Open angle glaucoma, 139 Open loop knot, 623 Ophthaine (proparacaine), 144 Opinions, second, 59 Opium, 693 Optic atrophy, 143 Optic nerve damage, 130 Optic nerve disease, 143-144 Optic neuritis, 123 Optical devices, 135-136 Oral candidiasis, 166-167 Oral cavity, 156-157

benign tumors of, 168-169 cancer of, 157 lacerations of, 168 malignant tumors of, 169

Oral cavity problems, 165-172 Oral contraceptive pills (OCPs), 308-310 Oral glucose tolerance test (OCTT),

422-423 Oral mucosa lesions, 156-157 Oral thrush, 492 Organ donor programs, 658-659 Organic brain syndromes, 532 Organophosphates, 606-607 Orgasm, 554 Oropharyngeal airway, 660 Orthopedic problems of children, 351-353 Osgood-Schlatter disease, 352 Osteoarthritis, 357-358 Osteochondritis dissecans, 713 Osteochondroses, 712-713 Osteoporosis, 427-428 Otic polyps, 152-153 Otitis externa, 148-149 Otitis media, 148

in adults, 151 age-specific therapy for, 491 in children, 490-491 serous, 151-152

Otomycosis, 150-151 Otorrhea, 152 Ototoxic drugs, 147 Oval excision biopsy, 370 Ovarian cancer, 590

screening for, 87 Ovarian cycle, 304 Ovarian failure, premature, 318 Overuse syndromes, 705-706, 708 Ovulation, 304 Oxygen

consumption and delivery, 671 content of blood, 671 delivered, concentration of, 676 delivery, normal physiology of, 672 delivery of, 662

Oxytocin (Pitocin), 434, 475

PA (pernicious anemia), 118, 448 Pacemakers in asystole, 683 Paget's disease, 392

of bone, 335 Pain

abdominal, 629-632 acromioclavicular joint, 340 back, see Back pain chest, see Chest pain epigastric, 244-245 in foot, 350 functional classification of, 705, 706 knee, 710 leg, 711-712 myofascial pain syndrome, 171 psychogenic pain disorder, 549

Pain-fear dyad, 58 Palate

cleft, 154 hard, Kaposi's sarcoma of, 167

Pallor of newborn, 492 Pancreas problems, 54-257 Pancreatic cancer, 256-257, 592 Pancreatitis, 630-631

acute, 254-256 chronic, 256 hemorrhagic, 630

Panhypopituitarism, 433-434 Panic attacks, 538 Papanicolaou smears, 314, 322-323

abnormal, management of, 315 Papilledema, 143 Papillitis, 143 Papulosquamous diseases, 372-375 Paralinguistic communication, 53 Parallel movements, 54 Paranasal sinuses, transillumination of,

163 Paranoid disorder, 550 Paranoid personality disorders, 548 Paranoid states in elderly, 532

Paraphimosis, 295 Paraphrenia, 532 Parasitic bowel infections, 247 Parasympatholytics, 134 Parathyroid hormone (PTH), 426-427 Parenteral gold, 360 Parenting, 20, 23

by adolescents, 515 Parkinsonlike disorders, 120 Parkinson's disease, 120, 121 Paronychia, 394, 626 Parosmia, 155-156 Parotitis, 495 Paroxysmal supraventricular tachycardia

(PSVT), 191-192, 684-686 Partial seizures, 107 PASG (pneumatic antishock garment), 674 Patellar dislocation, 348 Patellofemoral arthralgia, 710 Patellofemoral dysfunction, 348 Patent ductus arteriosus, 202 Patient evaluation grid (PEG), 36, 37 Patient management, 7 Patient problems, 60-61 Patients

compliance of, 63-64 cultural background of, 61 disorganized, 56 expectations of, 59 family of, 62 obsessional, 56 rationalizations by, 100 relationship with physician, 7, 63, 535 understanding and expectation of, 61-62

PCOS (polycystic ovarian syndrome), 431 PCT (progesterone challenge test), 306 PCWP (pulmonary capillary wedge pres-

sure), 670 Peak expiratory flow rates (PEFR), 402 Pediatric injury, 712-713 Pediatric visit, prenatal, 484-485 Pediatrics, see Child entries; Children Pediculosis, 382 PEEP (positive end expiratory pressure),

676-677 Peer influence on adolescents, 23-24 PEFR (peak expiratory flow rate), 402 PEG (patient evaluation grid), 36, 37 Pelvic contraction, 475 Pelvic inflammatory disease (PID),

315-317,571 Penicillamine, 360 Penile carcinoma, 295 Penile hygiene, 295 Peptic ulcer disease, 240-241 Percutaneous transluminal coronary

angioplasty (PTCA), 183 Perianal abscess, 635-636 Pericardia! tamponade, 672 Pericarditis, 202-203

Pericoronal infection, 168 Peridiverticulitis, 250 Perimenopause, 317 Periodic health examination (PHE), 88,

90,91 Periodontitis, 166 Peripheral arterial disease, 639-641 Peripheral nervous diseases, 125-126 Peripheral neuropathy, 125-126 Peripheral vein cannulation, 664 Perisellar tumors, 433 Peritoneal dialysis, 279-280 Periungual conditions, 394 Pernicious anemia (PA), 118, 448 Peroral jejunal biopsies, 249 Personal identity, 504 Personal space, 53 Personality disorders, 545-549

antisocial, 548 borderline, 546-548 compulsive, 548-549 dependent, 548 in elderly, 532 histrionic, 548 paranoid, 548 schizoid, 548

Personality traits, 545-546 Personality types, 546 Pertussis syndrome, 496 Pesticides, 606-607 Petit mal seizures, 106-107 PGs (prostaglandins), 304 pH, fetal, 481 Phalangeal fractures, 345 Pharyngitis, 577-578

streptococcal, 496-497 Pharynx, 157-158 Phenobarbital, 107, 108 Phenylketonuria, 88 Phenytoin, 107, 108 Pheochromocytoma, 430-431 Phimosis, 295 Phobic disorders, 538 Phosphate loading, 717 Physical environment, 54 Physical examination

complete, for adolescents, 509-511 touch in, 54

Physical hazards, 603-605 Physical therapy of athletic injuries,

717-719 Physician-patient relationship, 7, 63, 535 Physicians, 9-11

adolescents and, 505 cancer and, 585-586 surgery and, 615 training and attitudes on alcoholism, 701

Pica during pregnancy, 464 PID (pelvic inflammatory disease),

315-317, 571

Index 737

Pigment changes, 612 Pilonidal sinus abscess, 626-627 "Ping-pong" infections, 564 Pink eye, 131 Pinworms, 498 PIP (proximal interphalangeal) joint,

345-346, 709-710 Piriformis syndrome, 346 Pitocin (oxytocin), 434, 475 Pituitary gland problems, 433-434 Pituitary tumors, 433 Pityriasis alba, 373 Pityriasis rosea, 373 Placenta previa, 473, 474 Plague, 600, 601 Plantar fasciitis, 351, 711 Plantar warts, 385 Plaque, dental, 167 Plasmodium falciparum malaria,

chloroquine-resistant (CRPF), 602 Platelet counts, 440 Platelet disorders, 439

classification of, 442 Platelet volume, mean (MPV), 441 Platelets, 440 Play and fantasy, 21 PUSS/Tmodel, 554 Plummer's disease, 423 PMPB (postmenopausal bleeding),

319-320 Pneumatic antishock garment (PASG),

674 Pneumococcal pneumonia, 217-218 Pneumococcal polysaccharide vaccine, 91 Pneumococcal polyvalent vaccine, 218 Pneumocystis carinii, 219 Pneumonia, 217-219 Pneumothorax, 228, 654 Pocket masks, 660, 661 Poikilocytosis, 440 Poiseuille and Hagen's law, 663 Poisoning, 655-658

chemical, 85 childhood, 83, 656 lead, 85, 451, 609-610

Poliomyelitis, 119, 600, 601 Polyarteritis nodosa, 229, 364 Polyarthritis, 363 Polycystic kidney disease, 282 Polycystic ovarian syndrome (PCOS), 431 Polycythemia, 442 Polymyalgia rheumatica, 363-364 Polypectomy, cervical, 321-322 Polyposis syndrome, 252 Polyps

adenomatous, 252 cervical, 314 colon, 252-253 gastric, 245 hyperplastic, 252

738 Index

Polyps (cont.) otic, 152-153 vocal cord, 158

Pontocaine (tetracaine), 620 Port-wine stain, 388 Positive end expiratory pressure (PEEP),

676-677 Postcoital contraception, 310 Posterior cerebral artery syndrome, 115 Postmenopausal bleeding (PMPB),

319-320 Postoperative care, 618-620 Postresuscitation syndrome, 686 Postterm pregnancy, 474 Posttransfusion hepatitis, 259 Posttraumatic stress disorder, 538-539 Potassium imbalance, 275-276 Potential life lost, years of, 82 PPD (purified protein derivative), 458 PPD-T and PPD-B tuberculin skin tests,

452 Precocious puberty, 508 Precordial thump, 679 Predictive value of screening test, 85 Preeclampsia, 471-472 Pregnancy, 19

adolescents and, 504, 515 AIDS and, 458-459 antimicrobial agents during, 462-463 asthma in, 404-405 bathing during, 461 coitus during, 463 common complaints during, 463-464 diabetes mellitus and, 417, 458,

470-471 diagnosis of, 456-457 ectopic, 323, 468-469 employment during, 461 endocrine tests for, 456-457 exercise during, 460, 716 genital herpes during, 458 hepatitis B during, 458 hypertension during, 471-473 instructions to patients during, 459-463 medications during, 459-460, 461,

462-463 nutrition in, 459, 460 postterm, 474 problems complicating, 468-474 sexually transmitted diseases and, 570 smoking during, 460 thyrotoxicosis during, 423 uncomplicated, 456-465

Pregnancy loss, 73, 74-75 Premarital exam, 484 Premature atrial contractions, 190-191 Premature ejaculation, 555-556 Premature infants, 493 Premature rupture of amniotic mem­

branes, 470

Premature ventricular contractions (PVCs), 192-193

Premelanoma, 390 Premonitions of death, 688 Prenatal care, 19 Prenatal laboratory screening, 458 Prenatal patient education, 456 Prenatal pediatric visit, 484-485 Preoperative care, 617-618 Presbyopia, 133 Presyncope, 147 Preterm labor, 469-470 Prickly heat, 375, 604 Primidone, 108 Primum non nocere precept, 63 Print media, 104 Problem assessment, 72 Problem differentiation, 58-65 Problem-solving model, selection of, 70 Problem-solving process, clinical, 66-67 Problems

diagnosis versus, 61 first contact care of, 63-64 patient, 60-61

Procaine, 620 Proctosigmoidoscopy, 248, 263-265

rigid, procedure, 265 Professional treatment resources for alco­

holism, 699 Progesterone challenge test (PCT), 306 Progestin

injectable, 310 in oral contraceptives, 309

Progressing stroke, 114 Progressive resistance, 718 Prolactin, 306 Proparacaine (Ophthaine), 144 Prophylaxis, 579; see also

lmmunoprophylaxis for trauma, 650-651

Propoxyphene, 693 Propylthiouracil (PTU), 424 Prospective medicine, 88, 91 Prostaglandins (PGs), 304 Prostate cancer, 590-591

screening for, 87 Prostatic hypertrophy, benign (BPH),

290-292 Prostatism, term, 291 Prostatitis, 292-293 Prostatodynia, 292 Prostitutes, 569 Protectiveness, 20 Proteinuria, 271, 298

in athletes, 715 Proximal interphalangeal (PIP) joint,

345-346, 709-710 Pruritic conditions, 380-382 Pruritus ani, 382 Pseudodementia, 530

Pseudogout, 357 Pseudogynecomastia, 436 Pseudomembranous colitis, 247 Pseudostrabismus, 136 Pseudotumor cerebri, 110 Psilocybin, 693 Psoriasis, 372-373 Psoriatic arthritis, 362-363 PSVT (paroxysmal supraventricular

tachycardia), 191-192, 684-686 Psychiatric problems, 534-561

principles of treatment, 535-536 Psychiatric referral, 553 Psychogenic headaches, 110 Psychogenic pain disorder, 549 Psychomotor epilepsy, 107 Psychophysiologic disorders, 545 Psychosexual problems, 553-556 Psychosis, 559 Psychosomatic disorders, 545 Psychotherapy, 536

for depression, 542 Psychotic disorders, 550-553 Psychotic symptoms, 552 PTCA (percutaneous transluminal coronary

angioplasty), 183 PTH (parathyroid hormone), 426-427 PTU (propylthiouracil), 424 Ptyalism during pregnancy, 464 Pubert~ 23, 505-508

onset of, 505-506 precocious, 508

Puerperium breast care in, 467 care of mother during, 467-468 problems complicating, 477-478

Pulmonary alveolar proteinosis, 229 Pulmonary artery catheterization, flow­

directed (FD-PAC), 668, 669-670 Pulmonary aspiration, 654 Pulmonary capillary wedge pressure

(PCWP), 670 Pulmonary diseases, 212-232

chronic obstructive (COPD), 213, 215-217

Pulmonary edema, 672 Pulmonary embolism, 221 Pulmonary evaluation, preoperative,

229 Pulmonary function testing, 231 Pulmonary hypertension, 204-205 Pulmonary tuberculosis, 221-223 Pulmonary valvular stenosis, 202 Pulmonary vascular resistance (PVR),

670-672 Pulpitis, 167 Pulse oximetry, 672 Punch biopsy, 370, 644 Pupillary reaction, 494 Pupils, size of, 117

Purified protein derivative, see PPD entries

PUVA therapy, 372, 373 PVCs (premature ventricular contrac­

tions), 192-193 PVR (pulmonary vascular resistance),

670-672 Pyelonephritis, 271-274 Pyloric stenosis in newborn, 493 Pyodermas, 382-383 Pyogenic granuloma, 383 Pyuria, 299

Quarantinable diseases, 599-601

Rabies, 600, 601, 658 Radial head or neck fractures, 342 Radial head subluxation, 353 Radiation, ultraviolet, see Ultraviolet radi-

ation Radioactive iodine, 424 Radionuclide imaging, 208 Ranula, 157 RAP (Residency Assistance Program), 2 Rape, 78-79 Rash

diaper, 489 heat, 604

Raspberry hemangioma, 388 RAST testing, 396 Rationalizations by patients, 100 RBC, see Red blood cell entries RDW (red cell distribution width), 441,

442,443,445 Reactive airway disease, 400 Reactive depression, 530 Reasoning, clinical, 66, 67 Reception area, 95-97 Recertification, mandatory, 2 Red blood cell (RBC) counts, 440 Red blood cell destruction, increased,

449-451 Red blood cell disorders, 447-452

classification of, 442 Red blood cell distribution width (RDW),

441, 442, 443, 445 Red blood cell loss, 451-452 Red blood cell production, defects in,

447-449 Red blood cells, 440

extracorpuscular disorders of, 450-451 intracorpuscular defects, 449-450 mechanical damage to, 450

Red eye, 130-131, 132 differential diagnosis of, 132-133

Red patch, 389 Reed-Sternberg cell, 593

Referral, 70-71 psychiatric, 553 use of, 62-63

Refractive errors, 131-135 Regional anesthetic agents, 620 Regional block, intravenous, 621 Regurgitation, 488 Rehabilitation, process of, 718 Reiter's syndrome, 363 Renal cell carcinoma, 283 Renal disease, 270-285

adult polycystic, 282 hereditary, 282-283

Renal failure, 277-285 acute, 277-279 chronic, 279 chronic, anemia of, 447

Renal function, evaluation of, 270-271 Renal manifestations of systemic diseases,

283-285 Renal pelvis, transitional cell cancer of,

283 Renal transplantation, 280 Renal tumors, 283 Residency Assistance Program (RAP), 2 Residents, graduating, 17-18 Respiratory acidosis, 276-277 Respiratory alkalosis, 277 Respiratory diseases, 212-232 Respiratory distress, 199-200

of newborn, 492 Respiratory distress syndrome, adult

(ARDS), 672, 677-678 Respiratory failure, 675-677 Respiratory infection, upper, 578 Respiratory syncytial virus (RSV), 224,

565 Restrictive cardiomyopathy, 204 Resuscitation, cardiopulmonary (CPR),

648-649,659 Reticulocyte index, 441 Reticulocytes, 440-441 Reticulocytosis, 441 Retinal detachment, 142-143 Retinal disease, 140-143 Retinoblastoma, 143 Retinopathy

arteriosclerotic, 141 diabetic, 142, 417-418 hypertensive, 141

Retirement, 25, 49 Retroauricular cysts, 628 Retrobulbar neuritis, 143 Retrocalcaneal bursitis, 351, 711 Reversible ischemic neurological deficit

(RIND), 113 Reye's syndrome, 119, 263, 497-498 Rh factor immunoprophylaxis, 459 Rh incompatibility, 494 Rh sensitization, 451

Rheumatic fever, 197 acute, 204

Rheumatoid arthritis, 358-361 juvenile (JRA), 361

Rhinitis, 154 allergic, 398-399

Rhinophyma, 384 Rhinovirus, 578 Rib fractures, 228, 654 RICE mnemonic, 350

Index 739

RIND (reversible ischemic neurological deficit), 113

Rinne tuning fork test, 163 Risk-taking behavior in adolescents,

517-519 Ritodrine hydrochloride (Yutopar),

469-470 "Rollover" test, 472 Rooting reflex, 494 Rosacea, 384 Roseola infantum, 496 Rotator cuff strain, 339-340 Rotator cuff tear, 340 Rotator cuff tendinitis, 708 Rotavirus, 238 RSV (respiratory syncytial virus), 224,

565 Rubella,495-496

screening for, 87 Rubella vaccine, 91 Rubeola, 495

Sadness, showing, 26 SAH (subarachnoid hemorrhage), 115 Salivary glands, 157 Salt intake, 83 Salter Harris classification, 351 Sanitation, 85 Sarcoidosis, 227 Scabies, 380-381 Scabies mites, 370 Scaphoid abdomen of newborn, 492 Scapular body fractures, 340 Scheuermann's disease, 335 Schilling test, 249 Sch~tz tonometer, 144 Schistosomiasis, 601, 602 Schizocytes, 440 Schizoid personality disorders, 548 Schizophrenic disorders, 550-553

antipsychotic drugs for, 553 approach to treatment of, 551

School problems of adolescents, 516 Scissors biopsy, 371 Scleral inflammation, 131, 132 Scleroderma, 243, 284 Sclerosis, progressive systemic, 284 Scoliosis, 338-339

740 Index

Screening (for disease), 85-88 antigen, 565 medical conditions appropriate for,

86-88 Screening criteria, 85-86 SDS (Zung Self Rating Depression Scale),

540-541 Seat belts, 650 Sebaceous cysts, 150, 386, 627-628 Seborrheic dermatitis, 378 Seborrheic keratosis, 386-387 Sebum, 369 Second opinions, 59 Sedatives, 620 Seizures, 106-108

absence, 106-107 in childhood, 499 epileptic, classification of, 107 etiology of, 107 febrile, 107-108 generalized, 106-107 in newborn, 493 partial, 107 treatment of, 107, 108

Seldinger technique, 664, 665, 669 Self Rating Depression Scale (SDS), Zung,

540-541 Semen analysis, 437 Senile cataracts, 139-140 "Sensate focus" exercises, 555 Sensitivity of screening test, 85 Sensory neuropathy, 126 Sepsis, 580 Septic arthritis, 362 Septic shock, 674-675 Septum, deviated, 155 Serologic diagnosis, 566 Serous otitis media, 148, 151-152 Set Test, 524 Sever's disease, 352 Sexual abuse

of adolescents, 518-519 child, 502

Sexual assault, 78-79 Sexual concerns in adolescents, 514-515 Sexual development

female, 507-508 male, 508

Sexual dysfunction, 435 Sexual excitement, phases of, 554 Sexual history, 569 Sexual maturity states, Tanner classifica­

tion of, 506-508 Sexually transmitted diseases (STDs), 84,

568-576 adolescents and, 504, 516 pregnancy and, 570 screening for, 88 in various settings, 569

SHARE (Source of Help in Airing and Resolving Experiences), 73

Shigellosis, 247 Shin splints, 711 Shingles, 376 Shock, 673-675

treating, 653-654 Short Portable Mental Status Question-

naire (SPMSQ), 524 Shoulder injuries, 708-709 Shoulder problems, 339-341 SIADH (syndrome of inappropriate secre­

tion of antidiuretic hormone), 434 Sialadenosis, 157 Sick role, 38

legitimization of, 58 Sick sinus syndrome, 190 Sickle-cell anemia, 450 Sickle cell trait, 715 Sickled cells, 440 SIDS (sudden infant death syndrome), 75,

497 Sigmoidoscopy, 253, 263-265, 633

flexible, procedure, 264-265 Silent ischemia, 182 SIMV (synchronized intermittent manda-

tory ventilation), 676 Sinus arrest, 190 Sinus bradycardia, 190 Sinusitis, 149-150 Skills required in clinical reasoning

process, 69-70 Skin

bacterial infection of, 375 basic components of, 368-369 cysts of, 627-628 dry, 381 excision of lesions of, 644-645 foreign body in, 651 neoplasias of, 386-388 physical examination of, 370 surgical problems of, 621-629

Skin biopsies, 370-371 Skin cancer, screening for, 87 Skin disease, occupational, 610-612 Skin neoplasms, occupational, 612 Skin problems, 366-394 Skin-protecting agents, 372 Skin tags, 386 Skin testing, allergic, 396 Skin therapy, 371-372 Skull, molding of newborn, 491 Skull fractures, depressed, 110-111 Slang words, 52 Sleep apnea, 227-228 Sleep disorders, 501 Slipped capital femoral epiphysis, 352 Sm-C (somatomedin-C), 432-433 Small cell carcinoma, 220

Smallpox, 601 Smell, altered sense of, 155-156 Smith's fracture, 343 Smoking, 81-82, 101

during pregnancy, 460 Smoking cessation suggestions, 216 Smoking cessation worksheet, 98 Snoring, 228 Sobriety, long-term, promotion of,

700-701 Social pathology, 59 Social pressure, 58-59 Social Security Administration (SSA), 613 Socialization, disorders of, 501-502 Society of Teachers of Family Medicine

(STFM), 2 Socioeconomic factors in disease, 84-85 Sodium bicarbonate, 681 Sodium chloride, 83 Sodium imbalance, 274-275 Soft tissue tumors of extremities, 638 Solid feeding for infants, 486, 488 Solvents, 606 Somatization disorder, 549 Somatoform disorders, 549-550 Somatomedin-C (Sm-C), 432-433 Somogyi phenomenon, 413 Source of Help in Airing and Resolving

Experiences (SHARE), 73 Space, personal, 53 Specificity of screening test, 85 Spermatogenesis, 436 Spermicides, 311 SPF (Sun Protection Factor), 372 Spherocytosis, hereditary, 449 Sphincterotomy, 635, 636 Spinal cord and root diseases, 125 Spine

anatomy of, 334-335 disorders of, 334-339 lumbar, 334-335 thoracic, 334

Spirometry, 231 Splinting and casting, 333-334 SPMSQ (Short Portable Mental Status

Questionnaire), 524 Spondylarthropathies, 363 Spondylitis, 335-336

ankylosing, 363 Spondylosis, cervical, 125 Spontaneous abortion, 469 Spontaneous delivery, 466 Sports

drugs in, 716-717 women in, 715-716

Sports medicine, 703-719 medical problems in, 713-715

Spouse abuse, 77-78 Sprains, 331-332

Sputum, Gram's stain of, 232 Squamous cell carcinoma, 152, 169, 170,

220, 390 SSA (Social Security Administration), 613 Staff, office, 95 Staphylococcal gastroenteritis, 247 Staphylococcal pneumonia, 218 Stasis dermatitis, 379 Stature, short, 431-433 Status epilepticus, 107 STDs, see Sexually transmitted diseases Stealing in childhood, 502 Steatorrhea, 249 Stepped care method for treating hyperten­

sion, 177-178 Sterilization, 299

permanent, 312 Steroids

anabolic, 716-717 fluorinated, 371

Stevens-Johnson syndrome, 156 STFM (Society of Teachers of Family

Medicine), 2 Stimulants, 693, 717 Stimulus deprivation amblyopia, 137 Stings, insect, allergies to, 408-409 Stomach, diseases of, 244-247 Stomach cancer, 592 Stomatitis, 165-166

angular, 166 denture, 166

Stool frequency, 235 Stools, guaiac-positive, 254 Strabismic amblyopia, 137 Strabismus, 135, 136 Strains, 331-332

muscle, 336 Strawberry hemangioma, 388 Strawberry marks, 491 Streptococcal tonsillitis and pharyngitis,

496-497 Streptococcus

Group A beta-hemolytic, 581 Group B, 494-495

Stress, 84, 102 gastric stress ulceration, 686 immune system and, 564 posttraumatic stress disorder, 538-539

Stress control worksheet, 99 Stress fractures, 711 Stridor in newborn, 493 Stroke volume, 649 Strokes, 112

embolic, 114 in evolution, 114 hemorrhagic, 114-115 lacunar, 116 progressing, 114 thrombotic, 115-116

Sturge-Weber syndrome, 388 Styes, 136-137 Subarachnoid hemorrhage (SAH), 115 Subdural empyema, 119 Subdural hematoma, 111, 112 Substance abuse, 690-701

consequences of, 692-696 Subungual hematoma, 645 Sucking reflex, 494 Suctioning, airway, 659-660 Sudden death, 713-714

cardiac, 173, 678 prevention of, 648-649

Sudden infant death syndrome (SIDS), 75, 497

Suicidal potential, 541 Suicide, 26, 75-76

in adolescents, 517 in elderly, 530

Sun-blocking agents, 372 Sun injuries, 372 Sun Protection Factor (SPF), 372 Sunburn, 372 Superhealth 2000, 103 Support groups, 73 Supracondylar fractures, 342 Supraventricular tachycardia (SVT),

684-686 paroxysmal (PSVT), 191-192, 684-686

Surgeon's knot, 623 Surgery

in asthmatics, 405 major, complications of, 619-621 microscopically controlled, 372 · obesity and, 420 office equipment and preparation for,

615-617 physicians and, 615

Surgical problems, 614-545 of abdomen, 629-632 of skin, 621-629

Surgical specimens, 568 Suture packet, 616 Suture placement, 623 SVT (supraventricular tachycardia),

684-686 Swan-Ganz catheters, 184, 670 Sympathomimetic agents, 134, 397, 403,

679-680, 717 Symptom definition, 37-38 Symptoms, evaluation of, 61-62 Synchronized intermittent mandatory ven-

tilation (SIMV), 676 Syncope, 147, 649-650 Syphilis, 119, 573 Systemic lupus erythematosus (SLE),

284 Systolic blood pressure, 175 Systolic murmurs, 195-196

T-lymphocytes, 512 T4, free, 423-425 Tachycardia

multifocal atrial, 191

Index 741

paroxysmal supraventricular (PSVT), 191-192, 684-686

supraventricular (SVT), 684-686 ventricular (VT), 193, 682

Tachypnea of newborn, 492 Taiwan flu, 577 Tanner classification of sexual maturity

stages, 506-508 Tantrums, temper, 21, 501 Tapazole (methimazole), 424 Tardive dyskinesia, 120-121 Target cells, 440 Tarsal navicular bone, aseptic necrosis of,

352 Taste disturbances, 157 TCAs (tricyclic antidepressants), 542 Tear preparations, 134 TEBG (testosterone-estrogen-binding

globulin), 436 Teenagers, see Adolescents Teeth, trauma to, 168 Teething, 486 Telogen, 392 Temper tantrums, 21, 501 Temporal arteritis, 110, 363-364 Temporomandibular joint (TMJ), 171-172 Tendinitis, 361, 708 Tendon sheaths, aspiration and injection

of, 332-333 Tennis elbow, 341-342 Tenosynovitis, 361 Tension headaches, 110 Tetracaine (Pontocaine), 620 Testicles, undescended, 294 Testicular cancer, 591

screening for, 87 Testicular failure, 435 Testosterone, 435 Testosterone-estrogen-binding globulin

(TEBG), 436 Tetanus immunoprophylaxis, 651, 652 Thalassemia syndromes, 448-449 Thallium-201 stress scintillography, 208 Theophylline derivatives, 402-403 Therapeutic contract, 560 Thermal bums, 130 Thiazide diuretics, 177-178 Thigh, musculotendinous conditions

about, 346-347 Thoracentesis, 231-232 Thoracic back pain, 335-336 Tho~cic spine, 334 Threatened abortion, 469 Threshold limit value (TLV), 605 Throat problems, 146, 157-158

742 Index

Thromboembolic disease, 619-620 Thrombolytic therapy, 185, 221 Thrombophlebitis, 478, 637 Thrombotic strokes, 115-116 Thrombotic thrombocytopenic purpura

(TTP), 284-285 Thrombus enucleation, 634 Thrush, 166

oral, 492 Thumb sucking, 501 Thyroid, fine-needle aspiration biopsy

(FNAB) of, 425 Thyroid function tests, 423 Thyroid gland problems, 423-426 Thyroid neoplasia, 425-426 Thyroid physiology, 423 Thyroid-stimulating hormone (TSH), 306,

423 Thyroid storm, 424 Thyroiditis

lymphocytic, with spol'taneously resolv­ing hyperthyroidism (LTSRH), 423

subacute, 423 Thyrotoxicosis during pregnancy, 423 Thyrotropin, 423 Thyrotropin-releasing hormone (TRH),

423, 433 Thyroxine, 425 TIA (transient ischemic attack), 112-114 Tibia fractures, 349 Tibial condylar fractures, 349 Tic douloureux, 124 Ticket, defined, 59 Tidal volume (TV), 676 Tinea capitis, 374 Tinea corporis, 374 Tinea cruris, 373 Tinea versicolor, 374-375 Tinnitus, 153-154 Tiredness during pregnancy, 463 TLV (threshold limit value), 605 TMJ (temporomandibular joint), 171-172 TNM system, 220, 587 Tobacco use, see Smoking Toddlers, 21-22; see also Children; Infants Toe fractures, 350 Toeing-in and toeing-out, 492 Toenails, 369

ingrown, 645 Toilet training, 21 Tongue, 157 Tonic-clonic seizures, generalized, 106 Tonometry, ocular, 144-145 Tonsillitis, 577-578

streptococcal, 496-497 Tooth, see Teeth entries Topical anesthetic agents, 620 Topical medication, 371 Torus fractures, 712 Touch, use of, 54

Towel clip, 659 Tracheitis, 148 Tracheobronchitis, 214-215 Transferrin, 444 Transient ischemic attack (TIA), 112-114 Transillumination of paranasal sinuses, 163 Transitional cell cancer of renal pelvis,

283 Transplantation, renal, 280 Transtracheal aspirates, 217 Transtracheal ventilation, 663 Trauma, 650-654

acoustic, 151 athletic, 705 blunt, to eye, 130 to bones, 351-352 head, 110, 706-708 major, 651, 652-654 maxillofacial, 169-171 nail, 394 neck, 706-708 ocular, 129-130 prophylaxis for, 650-651 to teeth, 168

Travel, health care during and after, 603 Travel-related disorders, 599-603 Travelers, international, dietary sugges-

tions for, 602-603 Travelers' diarrhea, 600, 603 Treatment adherence, 40 Tremor, essential, 120 Trench mouth, 165 TRH (thyrotropin-releasing hormone),

423, 433 Triage, criteria for, 655 Tricyclic antidepressants (TCAs), 542 Trigeminal neuralgia, 124 Trisomy 21, 500-501 Trypanosomiasis,· 601 TSH (thyroid-stimulating hormone), 306,

423 TTP (thrombotic thrombocytopenic pur-

pura), 284-285 Thbal occlusion, 312 Thberculin skin test, 230-231 Thberculosis, 458, 567, 600

pulmonary, 221-223 screening for, 87-88

Tumors adrenocortical, 430 giant cell, of tendon sheath, 638 intracranial, 121-123 intraocular, 143 laryngeal, 158 of oral cavity, 168-169 perisellar, 433 pituitary, 433 renal, 283 soft tissue, of extremities, 638 Wilms', 283

Thning fork tests, 163 Turcot's syndrome, 252 Thrner's syndrome, 432 TV (tidal volume), 676 Tympanic membrane, 151 Tympanic tubes, 148 Tympanometry, 163 Type A behavior patterns, 174 Typhoid, 600, 601 Typhus, 601 Tzanck smear, 376 Tzanck test, 370

UI (urinary incontinence), 294, 526 Ulcerative colitis, 251-252 Ulcerative gingivitis, acute necrotizing

(ANUG), 165-166 Ulcers

aphthous, 156 duodenal, 240 gastric, 240 peptic, 240-241

Ultrasound, obstetric, 464-465 Ultraviolet radiation, 372

bums from, 130 with psoralen (PUVA therapy), 372,

373 Umbilical granuloma, 491 Umbilical hernias, 491, 642 Undescended testicles, 294 Uniform Anatomical Gift Act, 658 Unresolved grief, 74 Unstable angina, 183 Uremic gingivostomatitis, 166 Urethral syndrome, acute, 287 Urethritis, nongonococcal (NGU),

571-572 Urinalysis, 270-271, 298-299 Urinary bladder, see Bladder entries Urinary catheterization, 297-298 Urinary frequency during pregnancy, 464 Urinary incontinence (UI), 294, 526 Urinary retention, acute, 297 Urinary tract infections (UTis), 272-273,

286-288 in children, 293 in elderly, 294 in puerperium, 477-478

Urine collection, 298 Urine culture, 288 Urticaria, 380 Urticarial eruptions, 380 Uterine bleeding, dysfunctional (DUB),

306-308 Uterine contractions, 465 Uterine dysfunction, 474-475 UTis, see Urinary tract infections Uveitis, 140

Vabra aspirator, 327 Vaccinations

for adults, 91 recommended, 600, 601-602 required, 599-601

Vaginal bleeding, 308 Vaginal contraceptive sponges, 311 Vaginal lacerations, repair of, 481 Vaginitis, 312-314

during childhood, 313 Vakutage, 327 Validity of screening test, 85 Valium (diazepam), 108, 620 Valproic acid, 108 Valsalva maneuver, 147 Valvular heart disease, 196-198 Variant angina, 182 Varicella, 377, 495 Varicella-zoster virus (VZV), 376 Varicocele, 436 Varicose veins, 638-639 Vascular access, 663-666 Vascular disease, 141

of extremities, 638-641 Vascular ectasias, 254 Vascular headaches, 108-110 Vascular nevi, 491 Vascular occulsive disorders, 142 Vasectomy, 299-300 Vasoconstrictor abuse, nasal, 154 Vasodilator therapy, 188-189, 640 Vasomotor rhinitis, 154 Vasopressin (ADH), 434 VBS (vertebral-basilar system), 113 Venereal warts, 385 Venous cutdown, 665-666 Ventilation

intermittent mandatory (IMV), 676 mechanical, 675-676, 677 simple methods of, 663 transtracheal, 663

Ventilators, mechanical, 663 Ventricular contractions, premature

(PVCs), 192-193 Ventricular dysrhythmias, 681 Ventricular escape rhythms, 192 Ventricular fibrillation (VF), 193,

678-679 Ventricular hypertrophy, left (LVH), 176 Ventricular rhythms, accelerated, 193

Ventricular septal defect, 202 Ventricular tachycardia (VT), 193, 682 Verapamil, 685-686 Verrucae, 384-385 Vertebral-basilar system (VBS), 113 Vertical mattress suture, 623, 624 Vertigo, 124, 146-148 Vesiculobullous diseases, 375-377 Vestibular function, drugs affecting, 147 VF (ventricular fibrillation), 193, 678-679 Vincent's infection, 165 Violence, family, 76-79 Viral conjunctivitis, 131 Viral croup, 148 Viral encephalitis, 119 Viral exanthems, 379 Viral gastroenteritis, 238 Viral infections, 119 Viral influenza, 576-577 Viral meningitis, 119 Viral pneumonia, 219 Virilization, 429-430, 431 Visual field defects, 143-144 Vitamin B12 deficiency, 447-448 Vitamin D, 427, 428 VLDL (very-low-density lipoproteins), 421 Vocal cord polyps, 158 Vocal nodules, 158 Volar plate injuries, 345 Volkmann's ischemic contracture, 342-343 Vomiting

in childhood, 488, 499 during pregnancy, 463

VT (ventricular tachycardia), 193, 682 Vulvovaginitis, 312 VZV (varicella-zoster virus), 376

Wallenberg's syndrome, 115 Wandering, 526-527 Warfarin, 221 Warts, 384-385

genital, 574 Water, contaminated, 85 Water deficit, 275 Water immersion, cold, 657 Water treatment methods, 603 WBC, see White blood cell entries Weber tuning fork test, 163 Wegener's granulomatosis, 229, 284

Index 743

Weight and height tables, 418 Weight control worksheet, 99 Welch-Allyn audio-otoscope, 159 Well-baby examination, 485-486 Wenckebach block, 194 Wens, 386 Wernicke-Korsakoff syndrome, 118,

694-695 Wheezing, differential diagnosis of, 401 Whipple's triad, 422 White blood cell (WBC) counts, 440 White blood cell disorders, 439, 443

classification of, 442 White blood cells, 440 White patch, 389 Widowhood, 25-26 Wilms' tumor, 283 Withdrawal from narcotics, 698-699 Women, see Female entries Word choice, 52-53 Workers' compensation system, 613 Workplace controls, 608-609 Worksheets for health, 98-99 Wound closure, 621-622, 623-625

preparing for, 622-623 Wound infections, 619 Wrist injuries, 709-710 Wrist problems, 343-344

Xanthelasma, 386 Xanthomas, 420, 638 Xylocaine (lidocaine), 620, 681 o-Xylose test, 249

Years of potential life lost, 82 Yeilow fever, 599-601 Youth, see also Adolescents; Children

health promotion and, 103 Yutopar (ritodrine hydrochloride),

469-470

Zinc protoporphyrin (ZPP), 610 Zoster, 376-377 ZPP (zinc protoporphyrin), 610 Zung Self Rating Depression Scale (SDS),

540-541 Zygoma, fractured, m