Practical Guide to the Care of the Medical Patient

SECTION I: SURVIVING THE WARDS A. Evaluating the Patient (H&P) 1. The Medical History 2. The Physical Exam 3. The Elderly Patient 4. Diagnostic Aids B. Charting 1. Admission Orders 2. Lab Shorthand Notation 3. Dictating the H&P 4. Progress (SOAP) Note 5. Consult Note 6. Preoperative Note 7. Operative Note 8. Procedure Note 9. Discharge Summary 10. Pronouncing Death While on Call 11. Discharge Against Medical Advice (AMA) C. Evaluating the Labs D. Diagnostic Tests: The Basics 1. The Chest X-Ray 2. The Electrocardiogram 3. The Pulmonary Artery Catheter (Swan-Ganz) 4. Pulmonary Function Tests 5. Mechanical Ventilation 6. Pacemakers 7. Prosthetic Heart Valves E. Procedures 1. Lumbar Puncture 2. Thoracentesis 3. Paracentesis 4. Arthrocentesis 5. Radial Artery Cannulation (A-Line) 6. Central Venous Access (CVP Line) F. Facts and Formulas 1. Cardiovascular 2. Pulmonary 3. Renal, Fluids, Electrolytes 4. Calcium 5. Nutrition 6. Epidemiology 7. Miscellaneous G. Formulary 1. IV Drips 2. Steroid Conversion Table 3. Regular Insulin (SC) Sliding Scale 4. Opioid Analgesics Dosing Table 5. Heparin Sliding Scale 6. Nutrition Feeds 7. Rx of Common Side Effects H. DVT Prophylaxis I. ACLS Algorithms SECTION II: THE DIFFERENTIAL DIAGNOSIS: ZEBRAS OR HORSES? 1. Abdominal Distention 2. Abdominal Pain 3. Abortion, Recurrent 4. Aches and Pains, Diffuse 5. Adnexal Mass 6. Adrenal Masses 7. Adynamic Ileus 8. Aerophagia 9. Alveolar Consolidation 10. Alveolar Hemorrhage 11. Amenorrhea 12. Amnesia 13. Anal Incontinence 14. Anisocoria 15. Anovulation 16. Arterial Occlusion 17. Arthritis and Eye Lesions 18. Arthritis and Heart Murmur 19. Arthritis and Muscle Weakness 20. Arthritis and Rash 21. Arthritis and Subcutaneous Nodules 22. Arthritis and Weight Loss 23. Arthritis, Fever, and Rash 24. Arthritis, Monoarticular and Oligoarticular 25. Arthritis, Polyarticular 26. Ataxia 27. AV Nodal Block 28. Back Pain 29. Bone Pain 30. Bradycardia, Sinus 31. Breast Inflammatory Lesion 32. Breast Mass 33. Breath Odor 34. Breathing, Noisy 35. Bullous Diseases 36. Calcifications on Chest X-Ray 37. Cardiac Arrest, Nontraumatic 38. Cardiac Enlargement 39. Cardiac Murmurs 40. Cavitary Lesion on Chest X-Ray 41. Chest Pain (Nonpleuritic) 42. Chest Pain (Pleuritic) 43. Clubbing 44. Color Changes, Cutaneous 45. Coma 46. Coma, Normal Computed Tomography 47. Constipation 48. Cough 49. Crystal Deposition Arthritides 50. Cyanosis 51. Demyelinating Diseases 52. Diarrhea, Tube-Fed Patient 53. Diplopia, Binocular 54. Dry eye 55. Dysphagia 56. Dyspnea 57. Dysuria 58. Dystonia 59. Earache 60. ECG: ST-T Wave Changes 61. ECG: T Wave Changes 62. Edema, Generalized 63. Edema, Leg, Unilateral 64. Edema of Lower Extremities 65. Elevated Hemidiaphragm 66. Emboli, Arterial 67. Encephalopathy, Metabolic 68. Epilepsy 69. Epistaxis 70. Esophageal Perforation 71. Eye Pain 72. Facial Pain 73. Facial Paralysis 74. Fatigue 75. Fatty Liver 76. Fever and Jaundice 77. Fever and Rash 78. Flank Pain 79. Flushing 80. Galactorrhea 81. Gastric Emptying, Delayed 82. Gastric Emptying, Rapid 83. Genital Discharge 84. Genital Sores 85. Goiter 86. Granulomatous Lung Diseases 87. Gynecomastia 88. Halitosis 89. Headache 90. Hearing Loss, Acute 91. Heartburn and Indigestion 92. Hemarthrosis 93. Hematuria 94. Hemiparesis/Hemiplegia 95. Hemolysis and Hemoglobinuria 96. Hemoptysis 97. Hepatic Coma 98. Hepatic Cysts 99. Hepatic Granulomas 100. Hepatomegaly 101. Hirsutism 102. Hoarseness 103. Hydrocephalus 104. Hydronephrosis 105. Hypercapnia, Persistent 106. Hyperpigmentation 107. Hypertrophic Osteoarthropathy 108. Hyperventilation, Persistent 109. Hypocapnia 110. Hypogonadism 111. Hypopigmentation 112. Hypotension, Postural 113. Ischemic Colitis, Nonocclusive 114. Ischemic Necrosis of Cartilage and Bone 115. Jaundice 116. Joint Swelling 117. Jugular Venous Distention 118. Leg Cramps, Nocturnal 119. Leg Ulcers 120. Leukocoria 121. Livedo Reticularis 122. Lymphadenopathy 123. Mediastinal Masses or Widening on Chest X-Ray 124. Mesenteric Ischemia, Nonocclusive 125. Mesenteric Venous Thrombosis 126. Metastatic Neoplasms 127. Miosis 128. Mononeuropathy 129. Muscle Weakness 130. Mydriasis 131. Myelopathy and Myelitis 132. Myopathies, Infectious 133. Myopathies, Inflammatory 134. Myotonia 135. Nail Clubbing 136. Nausea and Vomiting 137. Neck Mass 138. Nystagmus 139. Ophthalmoplegia 140. Palpitations 141. Papilledema 142. Paraplegia 143. Paresthesias 144. Pelvic Mass 145. Pericardial Effusion 146. Pleural Effusions 147. Pneumonia, Recurrent 148. Polyneuropathy, Symmetric 149. Polyuria 150. Popliteal Swelling 151. Portal Hypertension 152. Postmenopausal Bleeding 153. Proptosis 154. Proteinuria 155. Pruritus 156. Pruritus Ani 157. Pseudoinfarction 158. Ptosis 159. Pulmonary Crackles 160. Pulmonary Lesions 161. Pulmonary Nodule, Solitary 162. Purpura 163. Rectal Pain 164. Red Eye 165. Renal Artery Occlusion, Causes 166. Scrotal Swelling 167. Seizures 168. Shoulder Pain 169. Small Bowel Obstruction 170. Sore Throat 171. Spastic Paraplegias 172. Spinal Cord Dysfunction 173. Splenomegaly 174. Spondyloarthropathies 175. Steatohepatitis 176. Stroke 177. Stroke, Young Adult 178. Swollen Limb 179. Tardive Dyskinesia 180. Taste and Smell Loss 181. Testicular Pain 182. Tick-Related Infections 183. Tremor 184. Urethral Discharge and Dysuria 185. Urinary Retention, Acute 186. Vaginitis 187. Vasculitis 188. Vertigo 189. Viral Hepatitis 190. Vision Loss, Acute, Painful 191. Vision Loss, Acute, Painless 192. Vision Loss, Chronic, Progressive 193. Visual Field Defects 194. Vocal Cord Paralysis 195. Vomiting 196. Weakness, Acute, Emergent 197. Weight Gain 198. Weight Loss 199. Wheezing SECTION III: DISEASES AND DISORDERS 1. Abscess, Brain 2. Abscess, Breast 3. Abscess, Epidural 4. Abscess, Liver 5. Abscess, Lung 6 Abscess, Pelvic 7. Abscess, Perirectal 8. Abscess, Peritonsillar 9. Abscess, Retropharyngeal 10. Abscess, Spinal Epidural 11. Acetaminophen Poisoning 12. Acid-Base Disturbances 13. Acidosis, Metabolic 14. Acidosis, Respiratory 15. Acromegaly 16. Actinomycosis 17. Acute Coronary Syndrome (ACS; MI, STEMI, NSTEMI, Unstable Angina) 18. Acute Respiratory Distress Syndrome (ARDS) 19. Acute Tubular Necrosis (ATN) 20. Adrenal Insufficiency (Addison's Disease) 21. Alcohol Withdrawal 22. Alkalosis, Metabolic 23. Alkalosis, Respiratory 24. Alpha-1-Antitrypsin Deficiency (AAT) 25. Altitude Sickness 26. Amaurosis Fugax 27. Amebiasis 28. Amphetamine Overdose 29. Amyotrophic Lateral Sclerosis 30. Anaphylaxis 31. Anemia, Aplastic 32. Anemia, Autoimmune Hemolytic 33. Anemia, Iron Deficiency 34. Anemia, Macrocytic 35. Anemia, Microcytic 36. Anemia, Normocytic 37. Anemia of Chronic Disease (ACD) 38. Anemia, Pernicious 39. Anemia, Sideroblastic 40. Aneurysm, Abdominal Aorta 41. Angioedema 42. Ankylosing Spondylitis 43. Anorexia Nervosa 44. Anoxic Brain Injury 45. Anticoagulant Therapy Overdose 46. Antiphospholipid Antibody Syndrome (APS) 47. Aortic Dissection 48. Aortic Regurgitation 49. Aortic Stenosis 50. Appendicitis 51. Arthritis, Infectious (Septic Arthritis) 52. Arthritis, Juvenile Rheumatoid (Juvenile Idiopathic Arthritis) 53. Arthritis, Psoriatic 54. Asbestosis 55. Ascariasis 56. Ascites 57. Aseptic Necrosis 58. Aspergillosis 59. Asthma 60. Astrocytoma 61. Atelectasis 62. Atrial Fibrillation (AF) 63. Atrial Flutter 64. Atrial Myxoma 65. Atrial Septal Defect (ASD) 66. Babesiosis 67. Balanitis 68. Barbiturate Overdose 69. Barrett's Esophagus 70. Bartter's Syndrome 71. Behcet's Syndrome 72. Bell's Palsy 73. Benzodiazepine Overdose 74. Bite Wounds 75. Bites and Stings, Arachnids 76. Bites and Stings, Insect 77. Bites, Snake 78. Botulism 79. Breast Cancer 80. Bronchiectasis 81. Brugada Syndrome 82. Budd-Chiari Syndrome (BCS) 83. Bulimia Nervosa 84. Bullous Pemphigoid 85. Burns 86. Candidiasis 87. Carbon Monoxide Poisoning 88. Carcinoid Syndrome 89. Cardiac Risk Assessment for Noncardiac Surgery 90. Cardiac Tamponade 91. Cardiomyopathy, Arrhythmogenic Right Ventricular 92. Cardiomyopathy, Dilated (Congestive) 93. Cardiomyopathy, Hypertrophic (HCM, IHSS) 94. Cardiomyopathy, Restrictive 95. Carotid Sinus Syndrome 96. Carpal Tunnel Syndrome 97. Cat-Scratch Disease (CSD, Bartonellosis) 98. Cavernous Sinus Thrombosis (CST) 99. Celiac Disease 100. Cellulitis 101. Chancroid 102. Chlamydia Genital Infections 103. Cholangitis 104. Cholecystitis 105. Choledocholithiasis 106. Cholelithiasis 107. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) 108. Chronic Obstructive Pulmonary Disease (COPD) 109. Churg-Strauss Syndrome (Allergic Angiitis, Allergic Granulomatosis) 110. Cirrhosis 111. Cirrhosis, Primary Biliary 112. Clostridial Myonecrosis (Gas Gangrene) 113. Cocaine Overdose 114. Coccidioidomycosis 115. Colorectal Cancer (CRC) 116. Condyloma Acuminatum 117. Congestive Heart Failure (CHF) 118. Constrictive Pericarditis, Chronic 119. Cor Pulmonale 120. Coronary Artery Disease (CAD; Angina, Atherosclerotic Heart Disease) 121. Crohn's Disease 122. Cryoglobulin Syndromes 123. Cryptococcosis 124. Cryptosporidiosis 125. Cushing's Syndrome 126. Cystic Fibrosis (CF) 127. Cytomegalovirus 128. Decubitus Ulcers (Pressure Ulcers) 129. Deep Vein Thrombosis (DVT) 130. Delirium and Dementia 131. Diabetes Insipidus 132. Diabetic Ketoacidosis 133. Diabetes Mellitus (DM) 134. Diarrhea 135. Diffuse Interstitial Lung Disease (Interstitial Lung Disease, ILD) 136. Digitalis Toxicity 137. Disseminated Intravascular Coagulation (DIC) 138. Diverticular Disease 139. Dumping Syndrome 140. Echinococcosis 141. Ehrlichiosis (Human Granulocytic Ehrlichiosis, HGE) 142. Electrical Injury 143. Electromechanical Dissociation (EMD) 144. Emergency Contraception 145. Empyema 146. Encephalitis, Acute Viral 147. Encephalopathy 148. Endocarditis 149. Eosinophilic Fasciitis 150. Eosinophilic Pneumonia 151. Epididymitis 152. Epidural Hematoma 153. Epiglottitis 154. Erysipelas 155. Erythema Multiforme 156. Erythema Nodosum 157. Essential Tremor 158. Ethanol Poisoning 159. Ethylene Glycol, Isopropyl Alcohol, and Methanol Poisoning 160. Euthyroid Sick Syndrome 161. Felty's Syndrome (FS) 162. Fever and Neutropenia (Infections in the Immunocompromised Host) 163. Fever of Undetermined Origin (FUO) 164. Folliculitis 165. Friedreich's Ataxia 166. Frostbite 167. Gardner's Syndrome 168. Gastritis 169. Gastroesophageal Reflux Disease (GERD) 170. Genital Herpes 171. Giant Cell Arteritis (Temporal Arteritis, Cranial Arteritis) 172. Giardiasis 173. GI Bleeding 174. Glomerulonephritis, Acute 175. Gonorrhea 176. Goodpasture's Syndrome 177. Gout 178. Graves' Disease 179. Guillain-Barre Syndrome (GBS) 180. Heart Block, Second Degree 181. Heart Block, Third Degree 182. Heat Stroke 183. HELLP Syndrome 184. Hemochromatosis 185. Hemolytic-Uremic Syndrome (HUS) 186. Hemophilia 187. Henoch-Schonlein Purpura (HSP) 188. Heparin-Induced Thrombocytopenia (HIT) 189. Hepatic Encephalopathy 190. Hepatitis A 191. Hepatitis B 192. Hepatitis C 193. Hepatitis, Autoimmune 194. Hepatocellular Carcinoma (HCC) 195. Hepatorenal Syndrome (HRS) 196. Herpes Zoster 197. Histoplasmosis 198. HIV/AIDS 199. Hodgkin's Lymphoma 200. Horner Syndrome 201. Hydrocephalus, Normal Pressure (NPH) 202. Hydronephrosis 203. Hyperaldosteronism (Aldosteronism) 204. Hypercalcemia 205. Hypercoagulable State 206. Hyperkalemia 207. Hyperlipidemia 208. Hypermagnesemia 209. Hypernatremia 210. Hyperosmolar Hyperglycemic State (HHS) 211. Hyperparathyroidism 212. Hyperphosphatemia 213. Hypersensitivity Pneumonitis (HP) 214. Hypersplenism 215. Hypertension (HTN) 216. Hypertensive Crisis 217. Hyperthyroidism 218. Hypoaldosteronism 219. Hypocalcemia 220. Hypoglycemia 221. Hypokalemia 222. Hypomagnesemia 223. Hyponatremia 224. Hypophosphatemia 225. Hypopituitarism 226. Hypothermia 227. Hypothyroidism 228. Idiopathic Pulmonary Fibrosis 229. IgA Nephropathy 230. Immune Thrombocytopenic Purpura (ITP) 231. Impetigo 232. Inclusion Body Myositis (IBM) 233. Inflammatory Myopathies (Polymyositis, Dermatomyositis) 234. Interstitial Lung Disease (ILD) 235. Interstitial Nephritis 236. Irritable Bowel Syndrome (IBS) 237. Kaposi Sarcoma (KS) 238. Korsakoff's Psychosis 239. Labyrinthitis 240. Lactose Intolerance 241. Lambert-Eaton Myasthenic Syndrome (LEMS) 242. Lead Poisoning 243. Leukemia, Acute Lymphocytic (ALL) 244. Leukemia, Acute Myelogenous (AML) 245. Leukemia, Chronic Lymphocytic (CLL) 246. Leukemia, Chronic Myelogenous (CML) 247. Leukemia, Hairy Cell 248. Listeriosis 249. Liver Failure 250. Long QT Syndrome 251. Lung Neoplasm 252. Lyme Disease 253. Lymphogranuloma Venereum 254. Melanoma 255. Meningitis, Bacterial 256. Meningitis, Aseptic (Viral) 257. Mesenteric Adenitis 258. Mesenteric Ischemia 259. Mesenteric Venous Thrombosis (MVT) 260. Microscopic Polyangiitis (MPA) 261. Mitral Regurgitation (MR) 262. Mitral Stenosis 263. Mitral Valve Prolapse (MVP) 264. Mixed Connective Tissue Disease (MCTD) 265. Monoclonal Gammopathy of Uncertain Significance (MGUS) 266. Mucormycosis 267. Multifocal Atrial Tachycardia (MAT) 268. Multiple Endocrine Neoplasia (MEN) 269. Multiple Myeloma 270. Multiple Sclerosis (MS) 271. Myasthenia Gravis (MG) 272. Myelodysplastic Syndrome (MDS) 273. Myeloid Metaplasia with Myelofibrosis (Agnogenic Myeloid Metaplasia with Myelofibrosis, Idiopathic Myelofibrosis) 274. Myocarditis 275. Myxedema Coma 276. Near Drowning 277. Necrotizing Fasciitis 278. Nephrotic Syndrome 279. Neuroleptic Malignant Syndrome (NMS) 280. Non-Alcoholic Fatty Liver Disease (NAFLD) 281. Non-Hodgkin's Lymphoma (NHL) 282. Nosocomial Infections 283. Opioid Overdose 284. Optic Neuritis 285. Orthostatic Hypotension 286. Osteomyelitis 287. Paget's Disease of Bone 288. Pancreatitis, Acute 289. Pancreatitis, Chronic 290. Parkinson's Disease (PD) 291. Paroxysmal Atrial Tachycardia (PAT; Paroxysmal Supraventricular Tachycardia, PSVT) 292. Paroxysmal Cold Hemoglobinuria (PCH) 293. Paroxysmal Nocturnal Hemoglobinuria (PNH) 294. Pediculosis 295. Pelvic Inflammatory Disease (PID) 296. Peptic Ulcer Disease (PUD) 297. Pericarditis 298. Pericardial Tamponade 299. Peripheral Arterial Disease (PAD) 300. Peripheral Nerve Dysfunction (Peripheral Neuropathy) 301. Peritonititis, Spontaneous (Primary, SBP) 302. Peritonitis, Bacterial (Secondary) 303. Pheochromocytoma 304. Pinworms 305. Pneumonia, Aspiration 306. Pneumonia, Bacterial 307. Pneumonia, Mycoplasma 308. Pneumonia, Pneumocystis jiroveci (PCP) 309. Pneumothorax 310. Polyarteritis Nodosa 311. Polycystic Kidney Disease (Autosomal Dominant Polycystic Kidney Disease, ADPKD) 312. Polycythemia Vera 313. Polymyalgia Rheumatica (PMR) 314. Portal Vein Thrombosis 315. Primary Sclerosing Cholangitis 316. Prolactinoma 317. Prostate Cancer 318. Prostatitis 319. Pseudogout (Calcium Pyrophosphate Dehydrate Deposition Disease [CPPDP]) 320. Pseudomembranous Colitis 321. Pulmonary Edema, Cardiogenic 322. Pulmonary Embolism (PE) 323. Pulmonary Hypertension (PPH) 324. Pyelonephritis 325. Ramsey-Hunt Syndrome 326. Raynaud's Phenomenon (RP) 327. Reiter's Syndrome and Reactive Arthritis 328. Renal Artery Stenosis (RAS) 329. Renal Failure, Acute 330. Renal Failure, Chronic 331. Renal Tubular Acidosis (RTA) 332. Renal Vein Thrombosis 333. Rhabdomyolysis 334. Rheumatoid Arthritis (RA) 335. Salicylate Poisoning 336. Sarcoidosis 337. Scabies 338. Scleroderma (Systemic Sclerosis) 339. Seizure Disorder, Absence 340. Seizure Disorder, Partial 341. Sepsis/Septic Shock 342. Serotonin Syndrome (SS) 343. Short Bowel Syndrome 344. Sickle Cell Disease 345. Sick Sinus Syndrome (Bradycardia-Tachycardia Syndrome) 346. Sinusoidal Obstruction Syndrome (SOS; Veno-Occlusive Disease) 347. Sjogren's Syndrome (SS) 348. Small Bowel Obstruction 349. Spinal Cord Compression 350. Status Asthmaticus 351. Status Epilepticus 352. Stevens-Johnson Syndrome (SJS) 353. Stroke, Intracerebral Hemorrhage 354. Stroke, Ischemic 355. Subarachnoid Hemorrhage 356. Subclavian Steal Syndrome 357. Subdural Hematoma 358. Superior Vena Cava Syndrome 359. Syncope 360. Syndrome of Inappropriate Antidiuresis (SIAD; Syndrome of Inappropriate Antidiuretic Hormone, SIADH) 361. Syphilis 362. Systemic Lupus Erythematosus (SLE) 363. Takayasu's Arteritis 364. Thoracic Outlet Syndrome 365. Thrombocythemia, Essential (ET) 366. Thrombocytopenia 367. Thrombophlebitis, Superficial 368. Thrombotic Thrombocytopenic Purpura (TTP) 369. Thyroid Nodule 370. Thyrotoxic Storm 371. Thyroiditis 372. Tinea Cruris 373. Torsades de Pointes s 374. Toxic Shock Syndrome (TSS) 375. Transfusion Reaction 376. Transient Ischemic Attack (TIA) 377. Tuberculosis, Pulmonary 378. Tumor Lysis Syndrome 379. Ulcerative Colitis (UC) 380. Urinary Tract Infection (UTI) 381. Urolithiasis 382. Vaginitis, Fungal 383. Vaginitis, Trichomonas 384. Vaginosis, Bacterial 385. Ventricular Tachycardia (VT) 386. Vitamin K Deficiency 387. Von Willebrand's Disease (vWD) 388. Waldenstrom's Macroglobulinemia (WM) 389. Warfarin Skin Necrosis 390. Wegener's Granulomatosis 391. Wernicke's Encephalopathy 392. Wilson's Disease 393. Wolff-Parkinson-White Syndrome (WPW)