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 (Addisons 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. Barretts Esophagus

70. Bartters Syndrome

71. Behcets Syndrome

72. Bells 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. Crohns Disease

122. Cryoglobulin Syndromes

123. Cryptococcosis

124. Cryptosporidiosis

125. Cushings 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. Feltys Syndrome (FS)

162. Fever and Neutropenia (Infections in the Immunocompromised Host)

163. Fever of Undetermined Origin (FUO)

164. Folliculitis

165. Friedreichs Ataxia

166. Frostbite

167. Gardners 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. Goodpastures Syndrome

177. Gout

178. Graves Disease

179. Guillain-Barré 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. Hodgkins 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. Korsakoffs 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-Hodgkins Lymphoma (NHL)

282. Nosocomial Infections

283. Opioid Overdose

284. Optic Neuritis

285. Orthostatic Hypotension

286. Osteomyelitis

287. Pagets Disease of Bone

288. Pancreatitis, Acute

289. Pancreatitis, Chronic

290. Parkinsons 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. Raynauds Phenomenon (RP)

327. Reiters 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. Sjögrens 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. Takayasus 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 Willebrands Disease (vWD)

388. Waldenstroms Macroglobulinemia (WM)

389. Warfarin Skin Necrosis

390. Wegeners Granulomatosis

391. Wernickes Encephalopathy

392. Wilsons Disease

393. Wolff-Parkinson-White Syndrome (WPW)