CURRENT diagnosis & treatment family medicine [5 ed.] 9781260134896, 126013489X

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a LANGE medical book

CURRENT Diagnosis & Treatment: Family Medicine FIFTH EDITION Jeannette E. South-Paul, MD, DHL (Hon), FAAFP Andrew W. Mathieson UPMC Professor and Chair Department of Family Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Samuel C. Matheny, MD, MPH, FAAFP Assistant Provost for Global Health Initiatives Professor of Family and Community Medicine University of Kentucky Lexington, Kentucky Evelyn L. Lewis, MD, MA, FAAFP, DABDA Chief Medical Officer, Warrior Centric Health, LLC Columbia, Maryland Adjunct Associate Professor Department of Family Medicine and Community Health Rutgers, Robert Wood Johnson Medical School Piscataway, New Jersey

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Copyright© 2020 by McGraw Hill. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-1-26-013490-2 1-26-013490-3

MIIlD:

The material in this eBook also appears in the print version of this title: ISBN: 978-1-26-013489-6, MIIlD: 1-26-013489-X.

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Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view ofthe possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication ofthis work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. TERMSOFUSE This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill Education's prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms.

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We would like to dedicate this book to all family physicians and clinical partners, especially our colleagues in uniform, and the families who support them. Jeannette E. South-Pau~ MD, DHL (Hon), FAAFP Samuel C. Matheny, MD, MPH, FAAFP Evelyn L. Lewis, MD, MA, FAAFP. DABDA

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Contents Authors Preface

Section II. Adolescence

ix

xix

1o. Physical Activity in Adolescents

Section I. Infancy 8r Childhood 1. Well-Child Care

Marie B. Stephens, MD, MS, FMFP Scott K. Andrews, MD, MBA

1

Donald B. Middleton, MD

2. Failure to Thrive

11. Nutrition and the Development of Healthy Eating Habits

15

12. Adolescent Sexuality

23

112

Amy Crawford-Faucher, MD, FMFP

Andrew B. Symons, MD, MS Martin C. Mahoney, MD, PhD, FAAFP

4. Breastfeeding & Infant Nutrition

106

Natalie E. Gentile, MD Evelyn L. Lewis, MD, MA, FMFP, DABDA

James C. Dewar, MD Stephanie B. Dewar, MD

3. Neonatal Hyperblllrublnemla

95

13. Menstrual Disorders

119

Mary V. Krueger, DO, MPH Patricia R. Millner, MD, FMFP

30

Tracey D. Conti, MD

5. Common Acute Infections in Children

14. Sexually Transmitted Diseases

36

Robin Maier, MD, MA Peter J. Katsufrakis, MD, MBA

Stephanie B. Dewar, MD Heather M. Bernard, MD

6. Skin Diseases In Infants Br Children

Section Ill. Adults

56

1s. Health Maintenance for Adults

Marie A Knox,, MD Barry Coutinho, MBBS Teiichi Takedai, MD, FAAFP Scott R. Brown, DO

7. Routine Vaccines

130

149

Stephen A. Wilson, MD, MPH, FAAFP Paul R. Larson, MD, MS, MBA, CPE, FAAFP David Yuan, MD, MS Lora Cox-Vance, MD, CMD

68 16. Preconception Care

Donald B. Middleton, MD

164

Karen Moyer, MD

8. Behavloral Disorders In Children

76 17. Prenatal Care

Richard Welsh, LCSW, MSW Marian Swope, MD

9. Seizures

176

Martin Johns, MD Julie Gallo, DO

82 18. Contraception

Donald B. Middleton, MD

Susan C. Brunsell, MD

v

184

CONTENTS

19. Adult Sexual Dysfundion

194

Charles W. Mackett, JJJ, MD, MMM

20. Acute Coronary Syndrome

202

Stephen A. Wilson, MD, MPH, FAAFP Suzan Skef, MD, MS Victoria McCurry, MD Jacqueline S. Weaver-Agostoni, DO, MPH

21. Heart Failure

214

226

230

33. Hepatobiliary Disorders

34. Abnormal Uterine Bleeding 260

35. Hypertension 270

278

Nicole Powe/I-Dunford, MD, MPH, FAAFP, FAsMA Katie L. Westerfield, DO, IBCLC, FAAFP Abigail K. Varyo, MD, MPH

Anja Dabe/it, MD, FAAFP

371

Maureen O'Hara Padden, MD, MPH, FAAFP Kevin M. Bernstein, MD, MMS, CAQSM, FAAFP Kerry Sadler, MD Courtney M. Saint, DO Joseph Sapovai DO

389

Belinda Vail, MD, MS, FAAFP

37. Endocrine Disorders 285

364

Shannon Voogt, MD Patricia Evans, MD, MA

36. Diabetes Mellitus

28. Respiratory Problems

347

243

Stephanie Singh, DO Garry W. K. Ho, MD, FACSM, FAMSSM, FAAFP, RMSK, CIC Thomas M. Howard, MD, FACSM, RMSK

27. Cancer Screening in Women

339

Samuel C. Matheny, MD, MPH, FAAFP Kristin L Long, MD, MPH, FACS J. Scott Roth, MD, FACS

Charles W. Webb, DO, FAAFP, FAMSSM, CAQSM Francis G. O'Connor, MD, MPH

26. Neck Pain

32. Anemia Alan K. David, MD

Bruce£ Johnson, MD

25. Low Back Pain in Primary care

320

Cindy M. Barter, MD, MPH, IBCLC, CTTS, FAAFP Laura Dunne, MD, CAQSM, FAAFP Carla Jardim, MD, FAAP

Joe E. Kingery, DO, MBA, FACOFP

24. Arthritis: Osteoarthritis, Gout, & Rheumatoid Arthritis

308

Jeannette E. South-Paul, MD, DHL (Hon), FAAFP Mehret Birru Talabi, MD, PhD

31. Abdominal Complaints

Brian V. Reamy, MD

23. UrinaryTrad lnfedions

300

Scott A. Harper, MD Jennifer E. Roper, MD Rachel K. F. Woodruff, MD, MPH C Randall Clinch, DO, MS

30. Osteoporosis

Michael King, MD, MPH, FAAFP Angelina Rodriguez, MD, FAAFP Yelena Tarasenko, DO Tiffany Simon, DO, MS Billy R. Davis, DO

22. Dyslipidemias

29. Evaluation & Management of Headache

401

Pamela Allweiss, MD, MSPH Peter J. Carek, MD, MS

38. Acute Musculoskeletal Complaints Jeanne Doperak, DO Kelley Anderson, DO

413

CONTENTS

39. Common Upper&: Lower Extremity Fractures

48. Genetics for Family Physicians 432

Wade M. Rankin, DO, CAQSM Richard A Okragly, MD, FAMSSM Michael A. Fitzgerald, DO Kelly Evans-Rankin, MD, CAQSM Amanda C Goodale, DO Steven Sanker, DO Tyler K. Drewry, MD, CAQSM

548

Matthew D. Krasowski, MD, PhD

50. Complementary&: Integrative Health

554

Wayne B. Jonas, MD Mary P. Guerrero, MD, FAAFP, FAAMA, DABIHM

40. Healthy Aging &: Geriatric Assessment 447 Lora Cox-Vance, MD, CMD

460

Robert 8. Allison II, DO

42. Urinary Incontinence

536

Mylynda B. Massart, MD, PhD Natasha Robin Berman, MA, MS, MPH, LCGC

49. Pharmacogenomics

Sedion IV. Geriatrics

41. Common Geriatric Problems

vii

51. Chronic Pain Management

52. Travel Medicine 471

569

John N. Boll, Jr, DO, FAAFP Ronald M. Glick, MD

581

Deepa Burman, MD, FAASM Timothy Scott Prince, MD, MSPH, FACOEM, FACPM

Robert J. Carr, MD

53. Tickborne Disease 43. Elder Abuse

483

David Yuan, MD, MS Katherine Wilhelmy, MD Matthew Koperwas, MD

44. Movement Disorders Yaqin Xia, MD, MHPE

45. Hearing &: Vision Impairment In the Elderly

509

517

Ramakrishna Prasad, MD, MPH Praneeth Pilla/a, MBBS Gordon Liu, MD, AAHIVS

56. Depression in Diverse Populations &: Older Adults

635

Poh Choo How, MD, PhD Ruth S. Shim, MD, MPH Annelle B. Primm, MD, MPH

Sedion V. Therapeutics, Genetics, & Prevention

Jennie 8. Jarrett, PharmD, BCPS, MMedEd, FCCP Paul Stranges, PharmD, BCACP Katie B. Kaczmarski, PharmD, BCACP, AE-C

612

Sedion VI. Psychological Disorders

Wanda C. Gonsalves, MD

47. Pharmacotherapy Principles for the Famlly Physician

600

N. Randall Kolb, MD Gordon Liu, MD, AAHIVS

55. HIV Primary Care

Arehano M. Kudrimoti, MD Saranne E. Perman, MD Nathaniel D. Stewart, MD

46. Oral Health

Niladri Das, MD

54. Tuberculosis

488

593

57. Anxiety Disorders 529

Philip J. Michels, PhD

643

viii

CONTENTS

58. Personality Disorders

656

William G. Elder, PhD

64. Cultural & Linguistic Competence

59. Somatic Symptom Disorder (Previously Somatoform Disorder), Factitious Disorder, & Malingering 664

671

Kimberly Mallin, MD Robert Mallin, MD

707

Kim A Bullock, MD, FAAFP Darci L. Graves, MPP, MA, MA

65. Health & Healthcare Disparities

William G. Elder, PhD

60. Substance Use Disorders

Section VII. Physician-Patient Issues

715

Jeannette E. South-Paul, MD, DHL (Hon), FAAFP Evelyn L lewis, MD, MA, FAAFP, DABDA

66. Caring for LGBTQIA Patients

726

Steven R. Wolfe, DO, MPH, FAAFP, AAHIVS

61. Tobacco Cessation

683 67. Hospice & Palliative Medicine

Martin C. Mahoney, MD, PhD, FAAFP K. Michael Cummings, PhD, MPH

62. lnterpersonalViolence

737

Eva B. Reitschuler-Cross, MD Robert M. Arnold, MD

690 68. Telemedicine

Amy Crawford-Faucher, MD, FAAFP

752

Charles R. Doam, MBA, FATA, FAsMA

63. Combat-Related Posttraumatic Stress Disorder &Traumatic Brain Injury Evelyn L Lewis, MD, MA, FAAFP, DABDA Layne D. Bennion, PhD Ronald J. Koshes, MD, DFAPA Jeanette M. Witter, PhD

697

Index

765

Authors Robert B. Allison, II, DO

Layne D. Bennion, PhD

Assistant Professor Department of Family Medicine/WVU Medicine Morgantown, West Virginia [email protected] Common Geriatric Problems

Assistant Professor of Psychology (Clinical Educator)/SOM Director of Academic Success Uniformed Services University Bethesda, Maryland [email protected] Combat-Related Posttraumatic Stress Disorder & Traumatic Brain Injury

Pamela Allweiss, MD, MSPH Private practice Lexington, Kentucky [email protected] Endocrine Disorders

Natasha Robin Berman, MA, MS, MPH, LCGC Licensed Certified Genetic Counselor UPMC Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania [email protected] Genetics for Family Physicians

Kelley Anderson, DO Assistant Professor Centre for Sports Medicine University of Pittsburgh Assistant Primary Care Sports Medicine Fellowship Director UPMC Medical Advisor UPMC Sports Concussion Program Team Physician Pittsburgh Ballet Theatre Point Park University Carnegie Mellon University Pittsburgh, Pennsylvania [email protected] Acute Musculoskeletal Complaints

Heather M. Bernard, MD Clinical Fellow of Pediatrics Harvard Medical School General Academic Pediatric Fellow Boston Children's Hospital Boston, Massachusetts [email protected] Common Acute Infections in Children

Kevin Bernstein, MD, MMS, CAQSM, FAAFP Family and Sports Medicine Physician Naval Branch Health Clinic Mayport Jacksonville, Florida [email protected] Hypertension

Scott K. Andrews, MD, MBA Assistant Professor Department of Family Medicine Pennsylvania State University College of Medicine University Park, Pennsylvania [email protected] Physical Activity in Adolescents

John N. Boll, Jr., DO, FAAFP Associate Director UPMC Williamsport Family Medicine Residency Williamsport, Pennsylvania [email protected] Chronic Pain Management

Robert M. Arnold, MD Distinguished Service Professor of Medicine Chief, Section of Palliative Care and Medical Ethics Director, Institute for Doctor-Patient Communication University of Pittsburgh School of Medicine Medical Director, UPMC Palliative and Supportive Institute Pittsburgh, Pennsylvania [email protected] Hospice & Palliative Medicine

Scott R. Brown, DO Faculty UPMC Shadyside Family Medicine Residency Fellow UPMC Faculty Development Fellowship Pittsburgh, Pennsylvania [email protected] Skin Diseases in Inf1mts & Children

Cindy M. Barter, MD, MPH, IBCLC, CTTS, FAAFP Residency Faculty Hunterdon Family Medicine Residency Program Flemington, New Jersey [email protected] Abdominal Complaints

Susan C. Brunsell, MD Medstar Medical Group at The World Bank Washington, DC [email protected] Contraception

ix

AUTHORS

Kim A. Bullock, MD, FAAFP

Tracey D. Conti, MD

Director Community Health Division Director Community Health Leadership Development Fellowship Associate Director Service Learning Associate Clinical Professor Department of Family Medicine Georgetown Medical School Washington, DC [email protected] Cultural 6' Linguistic Competence

Assistant Professor and Vice Chair Department of Family Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Program Director UPMC McKeesport Family Medicine Residency Vice Chair UPMC McKeesport Department of Family Medicine McKeesport, Pennsylvania [email protected] Breastfeeding 6' Infant Nutrition

Deepa Burman, MD, FAASM

Clinical Assistant Professor Department Family Medicine University of Pittsburgh School of Medicine Faculty Family Medicine Residency, UPMC Shadyside Hospital Pittsburgh, Pennsylvania [email protected] Skin Diseases in Infants 6' Children

Barry Coutinho, MBBS Co-Director Pediatric Sleep Program UPMC Children's Hospital of Pittsburgh Associate Professor of Pediatrics University of Pittsburgh Pittsburgh, Pennsylvania [email protected]

Travel Medicinl!

Peter J. Carek, MD, MS C. Sue and Louis C. Murray. M.D. Chair and Professor Department of Community Health and Family Medicine University of Florida College of Medicine Gainesville, Florida [email protected]

Lora Cox-Vance, MD, CMD

Endocrine Disorders

Chief, Geriatrics & Extended Care Services Chillicothe VA Medical Center-VHA Chillicothe, Ohio [email protected]

Robert J. Carr, MD

Health Maintenance for Adults Healthy Aging 6' Geriatric Assessment

Vice President Clinical Transformation Western Connecticut Health Network Danbury, Connecticut Adjunct Associate Clinical Professor University ofVermont School of Medicine Burlington. Vermont [email protected]

Amy Crawford-Faucher, MD, FAAFP

Urinary Incontinence

Program Director Forbes Family Medicine Residency Program Vice Chair Department of Family Medicine Allegheny Health Network Pittsburgh, Pennsylvania [email protected]

C. Randall Clinch, DO, MS

Adolescent Sexuality Interpersonal Violence

Professor Department of Family & Community Medicine Wake Forest University School of Medicine Winston-Salem, North Carolina [email protected] Evaluation 6' Management of Headache

K. Michael Cummings, PhD, MPH Professor Department of Psychiatry & Behavioral Sciences Co-lead Tobacco Research Hollings Cancer Center Medical University of South Carolina Charleston, South Carolina [email protected]

Tobacco Cessation

Anja Dabelic, MD, FAAFP United States Navy Commander Navy Medicine Millington, Tennessee [email protected]

Respiratory Problems

AUTHORS

Niladri Das, MD

Tyler K. Drewry, MD, CAQSM

Physician Penn State Health Community Medical Group Lancaster, Pennsylvania [email protected] Tickbome Disease

Sports Medicine Specialist and Associate Program Director Beaumont Wayne Family Medicine Residency Program Department of Family Medicine Westland, Michigan [email protected] Common Upper & Lower Extremity Fractures

Alan K. David, MD Professor of Family Medicine Department of Family and Community Medicine Medical College of Wisconsin Milwaukee, Wisconsin [email protected] Anemia

Laura Dunne, MD, CAQSM, FAAFP OAA Orthopedic Specialists Sports Medicine Institute Allentown, Pennsylvania [email protected] Abdominal Complaints

Billy R. Davis, DO

William G. Elder, PhD

Fellow of Addiction Medicine Department of Medical Education Baptist Memorial Hospital Memphis, Tennessee [email protected] Heart Failure

Clinical Professor and Chair Department ofBehavioral and Social Sciences University of Houston College of Medicine Houston, Texas welder@Central. UH.EDU Personality Disorders Somatic Symptom Disorder (Previously Somatoform Disordllr), Factitious Disorder, & Malingering

James C. Dewar, MD Family Physician East Hills Primary Care Conemaugh Health System Johnstown, Pennsylvania [email protected] Failure to Thrive

Stephanie B. Dewar, MD Associate Professor of Pediatrics University of Pittsburgh School of Medicine Co-Director Pediatric Residency Program UPMC Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania [email protected] Common Acute Infections in Children Failure to Thrive

Patricia Evans, MD, MA Assistant Professor Department of Family Medicine Georgetown University Washington, DC [email protected] Abnormal Uterine Bleeding

Kelly Evans-Rankin, MD, CAQSM Core Faculty Family Medicine Residency Program Bon Secour Mercy Health Mercy Health-Anderson Cincinnati, Ohio [email protected] Common Upper & Lower Extremity Fractures

Charles R. Doarn, MBA, FATA, FAsMA Department of Environmental and Public Health Sciences, College of Medicine University of Cincinnati Cincinnati, Ohio [email protected] Telemedicine

Michael A. Fitzgerald, DO

Jeanne Doperak. DO

Julle Gallo, DO

Assistant Professor Sports Medicine University of Pittsburgh Primary Care Sports Medicine Fellowship Director UPMC Chief of Primary Care Sports Medicine Pittsburgh Children's Hospital Team Physician University of Pittsburgh Pittsburgh, Pennsylvania [email protected] Acute Musculoskeletal Complaints

PGY-3 UPMC Horizon Family Medicine Residency Farrell, Pennsylvania gallojl@upmc:.edu Prenatal Care

Department of Family & Community Medicine University of Kentucky Lexington, Kentucky [email protected] Common Upper & Lower Extremity Fractures

xii

AUTHORS

Natalie E. Gentile, MD Physician and Founder Gentile Family Direct Primary Care Pittsburgh, Pennsylvania [email protected] Nutrition and the Development of Healthy Eating Habits

Ronald M. Glick, MD Associate Professor of Psychiatry Physical Medicine and Rehabilitation and Family Medicine Center for Integrative Medicine-UPMC Shadysi.de Pittsburgh, Pennsylvania [email protected] Chronic Pain Management

Wanda C. Gonsalves, MD Professor and Interim Dean of Natural, Applied and Health Sciences Kentucky State University Frankfort, Kentucky [email protected] Oral Health

Amanda C. Goodale, DO Clinical Faculty Bethesda Family Medicine Residency Program TriHealth Primary Care Sports Medicine Fellowship Program Cincinnati, Ohio [email protected] Common Upper 6' Lower Extremity Fractures

Darci L. Graves, MPP, MA, MA Former Instructor and Research Assistant Office of Medical Education and Research University of Missouri-Kansas City School of Medicine Kansas City, Missouri [email protected] Cultural and Linguistic Competence

Mary P. Guerrera, MD, FAAFP, FAAMA, DABIHM Professor Emeritus of Family Medicine and Director of Integrative Medicine Department of Family Medicine University of Connecticut School of Medicine Farmington, Connecticut [email protected] Comp~mentary & Integrative Health

Scott A. Harper, MD Assistant Professor Director of Medical Student Education Department of Family & Community Medicine Wake Forest School of Medicine Winston-Salem, North Carolina [email protected] Evaluation 6' Management of Headache

GarryW. K. Ho, MD, FACSM, FAMSSM, FAAFP, RMSK,CIC Program Director Virginia Commonwealth University (VCU) Fairfax Family Practice Sports Medicine Fellowship Program Associate Physician Fairfax Family Practice Comprehensive Concussion Center, Fairfax, Virginia

Associate Professor Department of Family Medicine Virginia Commonwealth University School of Medicine Richmond, Virginia

Associate Professor Department of Family Medicine Georgetown University School of Medicine Washington, DC [email protected] Neck Pain

Poh Choo How, MD, PhD Assistant Clinical Professor Department of Psycltlatry and Behavioral Sciences University of California Davis Sacramento, California [email protected] Depression in Diverse Populations & Older Adults

Thomas M. Howard, MD, FACSM, RMSK Flexogenix Adjwict, Associate Professor Department of Family Medicine Campbell University Jerry M Wallace School of Osteopathic Medicine Cary, North Carolina [email protected] Neck Pain

Carla Jardim, MD, FAAP Medical Director Hunterdon Family Medicine Delaware Valley Faculty Hunterdon Family Medicine Residency Clinical Instructor in Family Medicine UMDNJ Robert Wood Johnson Flemington, New Jersey [email protected] Abdominal Complaints

Jennie B. Jarrett, PharmD, BCPS, MMedEd, FCCP Assistant Professor College of Pharmacy University oflllinois at Chicago Chicago, Illinois [email protected] Pharmacotherapy Principles for the Family Physician

AUTHORS

Martin Johns, MD

N. Randall Kolb, MD

Program Director UPMC Horizon Family Medicine Residency Family Medicine Residency Farrell, Pennsylvania [email protected] Prenatal Care

Associate Program Director, UPMC Shadyside Family Medicine Residency Program Pittsburgh, Pennsylvania [email protected] Tuberculosis

Bruce E. Johnson, MD Professor of Medicine Virginia Tech Carillon School of Medicine Roanoke, Virginia [email protected] Arthriti5: Osteoarthriti5, Gout, & Rheumatoid Arthriti5

Wayne B. Jonas, MD Executive Director Samuell Integrative Health Programs Alexandria, Vu:ginia [email protected] Complementary & Integrative Health

Katie B. Kaczmarski, PharmD, BCACP, AE-C Clinical Asmtant Professor University oflllinois at Chicago College of Pharmacy Chicago, Illinois [email protected] Pharmacotherapy Principles for the Family Physician

Peter J. Katsufrakis, MD, MBA President and CEO National Board of Medical Examiners Philadelphia, Pennsylvania [email protected] Sexually Transmitted Diseases

Michael King, MD, MPH, FAAFP Program Director and Associate Professor Family Medicine Residency Program HCA Healthcare/USF Morsani College of Medicine GME Programs Oak Hill Hospital Brooksville, Florida [email protected] Heart Failure

Joe E. Kingery, DO, MBA, FACOFP Associate Dean of Osteopathic Medical Education Associate Professor and Chair of Family Medicine University of Pikeville Kentucky College of Osteopathic Medicine Pikeville, Kentucky [email protected] Urinary Tract Infections

xiii

Mark A. Knox. MD Associate Director Hawaii Island Family Medicine Residency Program Clinical Associate Professor John A. Burns School of Medicine Department of Family Medicine and Community Health University of Hawaii Hilo, Hawaii [email protected] Skin Diseases in Infants 6' Children

Matthew Koperwas, MD Teaching Physician AHN Department of Geriatrics Pittsburgh, Pennsylvania [email protected] Elder Abuse

Ronald J. Koshes, MD, DFAPA Private Practice Washington, DC ronkoshes@aoLcom Combat-Related Posttraumatic Stress Disorder 6' Traumatic Brain Injury

Matthew D. Krasowskl, MD, PhD Clinical Professor Department of Pathology Vice Chair of Clinical Pathology and Laboratory Services University oflowa Hospitals and Clinics Iowa City, Iowa [email protected] Pharmacogenomics

COL Mary V. Krueger, DO, MPH United States Army Medical Corps Hospital Commander Tripler Army Medical Center Honolulu, Hawaii [email protected] Menstrual Disorders

Archana M. Kudrlmotl, MD Associate Professor and Director of Residency Department of Family and Community Medicine University of Kentucky Lexington, Kentucky [email protected] Hearing 0- Vision Impairment in the Elderly

xiv

AUTHORS

Paul R. Larson, MD, MS, MBA, CPE, FAAFP

Martin C. Mahoney, MD, PhD, FAAFP

Director Global Health Education UPMC St. Margaret Family Medicine Residency Program Clinical Assistant Professor Department of Family Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania [email protected] Health Maintenance for Adults

Professor Department of Family Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Professor of Oncology Department of Internal Medicine and Department of Health Behavior Roswell Park Cancer Institute Buffalo, New York [email protected] Neonatal Hyperbilirubinemia Tobacco Cessation

Evelyn L. Lewis, MD, MA, FAAF~ DABDA Clinical Instructor Rosalind Franklin University of Medicine and Science North Chicago, Illinois Chief Medical Officer, Warrior Centric Health Ellicott City, Maryland President and Chair Warrior Centric Healthcare Foundation Rockville, Maryland Adjunct Associate Professor Department of Family Medicine and Community Health Rutgers, Robert Wood Johnson Medical School Piscataway, New Jersey [email protected] Combat-Related Posttraumatic Stress Disorder & '!Taumatic Brain Injury Health & Healthcare Disparities Nutrition and the Development of Healthy Eating Habits

Gordon Liu, MD, AAHIVS HIV Primary Care Physician Maple Leaf Medical Clinic Toronto, Ontario, Canada [email protected] HIV Primary Care Tuberculosis

Robin Maier, MD, MA Assistant Professor of Family Medicine Department of Family Medicine Director of Medical Student Education Clerkship Director University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania [email protected] Sexually '!Tansmitted Diseases

Kimberly Mallln, MD Associate Dean for Wellness and Inclusion Professor and Director of AUA Health Clinic American University of Antigua Coolidge, Antigua [email protected] Substance Use Disorders

Robert Mallin, MD University Provost American University of Antigua Coolidge, Antigua [email protected] Substance Use Disorders

Kristin L. Long, MD, MPH, FACS Assistant Professor of Surgery Department of Surgery, Section ofEndocrine Surgery University ofWisconsin School of Medicine and Public Health Madison, Wisconsin [email protected] Hepatobiliary Disorders

Charles W. Mackett, Ill, MD, MMM President Indian River Medical Associates Cleveland Clinic Indian River Hospital Vero Beach, Florida [email protected] Adult Sexual Dysfunction

Mylynda B. Massart, MD, PhD Assistant Professor Department of Family Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania [email protected] Genetics for Family Physicians

Samuel C. Matheny, MD, MPH, FAAFP Assistant Provost for Global Health Initiatives Professor of Family and Community Medicine University of Kentucky Lexington, Kentucky [email protected] Hepatobiliary Disorders

AUTHORS

Vidoria Mccurry, MD

Maureen O'Hara Padden, MD, MPH, FAAFP

Clinical Assistant Professor Department of Family Medicine University of Pittsburgh Pittsburgh, Pennsylvania [email protected]

Family Physician Ascension Sacred Heart Medical Group Pensacola, Florida [email protected]

Hypertension

Acute Coronary Syndrome

Saranne E. Perman, MD Phlllp J. Michels, PhD Michels Psychological Services LLC Columbia, South Carolina mi.chelsfour@hotmailcom

Assistant Professor of Family Medicine Augusta University Augusta, Georgia [email protected]

Hearing 6' VJSion Impairment in the Elderly

Anxiety Disorders

Nicole Powell-Dunford, MD, MPH, FAAFP, FAsMA Donald B. Middleton, MD Professor Department of Family Medicine University of Pittsburgh School of Medicine Vice President Family Medicine Residency Education UPMC St. Margaret Pittsburgh, Pennsylvania [email protected]

Routine Vaccines Seizures Well-Child Care

MAJ Patricia R. Miiiner, MD, FAAFP United States Army Medical Corps Family Medicine Residency Faculty Tripler Army Medical Center Honolulu, Hawaii [email protected]

Menstrual Disorders

Karen Moyer, MD Director of Family Medicine Obstetrics UPMC St Margaret Family Medicine Residency Program Pittsburgh, Pennsylvania [email protected]

Associate Professor Department of Military and Emergency Medicine Uniformed Services University of the Health Sciences Bethesda, Maryland School of Army Aviation Medicine Ft Rucker, Alabama [email protected]

Cancllr Screening in Womlln

Praneeth Pillala, MBBS HIV Primary Care Physician PCMH Restore Health Bangalore, India [email protected]

HN Primary Care

Ramakrishna Prasad, MD, MPH Foundllr & Director PCMH Restore Health Chair National Center for Primary Care Research and Policy Academy of Family Physicians of India (AFPI) Bangalore, India dr.rk.prasad@gmailcom

Tuberculosis HN Primary Care

Preconception Care

Annelle B. Primm, MD, MPH Francis G. O'Connor, MD, MPH Professor, Medical Director, Consortium for Health and Military Performance Department of Military and Emergency Medicine Uniformed Services University ofthe Health Sciences Bethesda, Maryland [email protected] Low Back Pain in Primary Care: An Evidence-Based Approach

Richard A. Okragly, MD, FAMSSM Program Director Primary Care Sports Medicine Fellowship TriHealth Cincinnati, Ohio [email protected]

Common Upper & Lower Extremity Fractures

Senior Medical Director The Steve Fund Baltimore, Maryland [email protected] Depression in Diverse Populations & Older Adults

Timothy Scott Prince, MD, MSPH, FACOEM, FACPM Associate Professor Department of Preventive Medicine and Environmental Health University of Kentucky College of Public Health Lexington, Kentucky [email protected]

Travel Medicine

AUTHORS

Wade M. Rankin, DO, CAQSM

Kerry Sadler, MD

Program Director Family Medicine Residency Program Bon Secour Mercy Health Mercy Health-Anderson Cincinnati, Ohio [email protected] Common Upper 0- Lower Bxtremity Fractures

Family Physician Naval Hospital Jacksonville Jacksonville, Florida [email protected]

Brian V. Reamy, MD Senior Associate Dean for Academic Affairs & Professor of Family Medicine F. Edward Hebert School of Medicine Uniformed Services University Bethesda, Maryland [email protected]

Dyslipidemias

Eva B. Reitschuler-Cross, MD Assistant ProfeS60r of Medicine University of Pittsburgh School of Medicine University of Pittsburgh Medical Center Division of General Medicine Section of Palliative Care and Medical Ethics Pittsburgh, Pennsylvania [email protected]

Hospice & Palliative Medicine

Angelina Rodriguez, MD, FAAFP Associate Program Director and Assistant Professor Family Medicine Residency Program HCA Healthcare/USF Morsani College of Medicine GME Programs Oak Hill Hospital Brooksville, Florida [email protected]

Heart Failure

Jennifer E. Roper, MD Assistant ProfeS60r Department of Family and Community Medicine Wake Forest University School of Medicine Winston-Salem, North Carolina [email protected] Evaluation 0- Management of Headache

J. Scott Roth, MD, FACS Professor of Surgery Chief Gastrointestinal Surgery College of Medicine University of Kentucky Lexington, Kentucky [email protected]

Hepatobiliary Disorders

Hypertension

Courtney M. Saint, DO Family Medicine Attending Branch Health Clinic Atsugi Atsugi. Japan Courtneysaint89@gmaiLcom

Hypert-ension

Steven Sanker, DO Family Medicine/Sports Medicine Physician TriHealth - Group Health Anderson Cincinnati, Ohio [email protected] Common Upper 0- Lower Extremity Fractures

Joseph Sapoval, DO Family Physician United States Naval Hospital Okinawa Okinawa, Japan [email protected]

Hypertension

Ruth S. Shim, MD, MPH Luke & Grace Kim Professor in Cultural Psychiatry Department of Psychiatry and Behavioral Sciences University of California, Davis Sacramento, California [email protected]

DeprefJion in Diverse Populatiom

Tiffany Simon, DO, MS Chief Resident Family Medicine Residency Program HCA Healthcare/USP Morsani College of Medicine GME Programs Oak Hill Hospital Brooksville, Florida [email protected]

Hwrt Failure

Stephanie Singh, DO Sports Medicine/Primary Care Physician VCU-Fairfax Family Practice and Sports Medicine Fairfax, V1tginia scart019@gmaiLcom

Neck Pain

AUTHORS

Suzan Skef, MD, MS

Teiichi Takedai, MD, FAAFP

Assistant Professor UPMC-St. Margaret Family Medicine Residency Program Assistant Director of the Bloom.field-Garfield Family Health Center Pittsburgh, Pennsylvania [email protected]

Acute Coronary Syndrome

Clinical Assistant Professor of Family Medicine University of Pittsburgh School of Medicine Faculty UPMC Shadyside Family Medicine Residency Pittsburgh, Pennsylvania [email protected] Skin Diseases in Infants & Children

Jeannette E. South-Paul, MD, DHL {Hon), FAAFP

Mehret BirruTalabi, MD, PhD

Andrew W. Mathieson UPMC Professor and Chair Department of Family Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania soutj:x:@upmc.edu or [email protected]

Assistant Professor of Medicine Associate Program Director UPMC Rheumatology Fellowship Division of Rheumatology and Clinical Immunology University of Pittsburgh Department of Medicine Pittsburgh, Pennsylvania [email protected]

Osteoporosis Health & Healthcare Disparities

xvii

Osteoporosis

Mark B. Stephens, MD, MS, FAAFP Professor of Family and Community Medicine Professor of Humanities Penn State College of Medicine University Park, Pennsylvania [email protected]

Physical Activit;y in Adolescents

Nathaniel D. Stewart, MD Family and Community Medicine University of Kentucky Lexington, Kentucky [email protected]

Hearing & Vision Impairment in the Elderly

Paul Stranges, PharmD, BCACP University oflllinois at Chicago Chicago, Illinois [email protected]

Yelena Tarasenko, DO Core Faculty Family Medicine Residency Program HCA Healthcare/USP Morsani College of Medicine GME Programs Oak Hill Hospital Brooksville, Florida [email protected]

Heart Failure

Belinda Vail, MD, MS, FAAFP David M. Huben Professor and Chair Department of Family Medicine and Community Health University of Kansas School of Medicine Kansas City, Kansas [email protected]

Diabetes Mellitus

Pharmacotherapy Principles for the Family Physician

Ablgall K. Vargo, MD, MPH

Marian Swope, MD

Aerospace and Occupational Medicine Resident School of Army Aviation Medicine Fort Rucker, Alabama [email protected]

Professor of Psychiatry Program Director Child and Adolescent Psychiatry University of Kentucky College of Medicine Lexington, Kentucky [email protected]

Behavioral Disortkrs in Children

Andrew B. Symons, MD, MS Clinical Associate Professor and Vice Chair for Medical Student Education Department of Family Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo, New York [email protected]

Neonatal Hyperbilirubinemia

Cancer Screening in Women

Shannon Voogt, MD Assistant Professor of Family Medicine Department of Family & Community Medicine University of Kentucky Lexington, Kentucky [email protected]

Abnormal Uterine Bleeding

David Yuan, MD, MS Program Director, Geriatrics Fellowship UPMC St Margaret's Pittsburgh, Pennsylvania [email protected]

Health Maintenance for Adults Elder Abuse

xviii

AUTHORS

Jacqueline S. Weaver-Agostoni, DO, MPH

Stephen A. Wilson, MD, MPH, FAAFP

Program Director, Family Medicine Residency Co-Chair, UPMC Med Ed ARQC Committee University of Pittsburgh Department of Family Medicine UPMC Shadyside Pittsburgh, Pennsylvania [email protected] Acute Coronary Syndrome

Chair

Charles W. Webb, DO, FAAFP, FAMSSM, CAQ Sports Medicine Sports Medicine Physician Department of Orthopedic Surgery & Sports Medicine Legacy Medical Group Portland, Oregon [email protected] Low Back Pain in Primary Care: An Evidence-Based ApprORch

Richard Welsh, LCSW, MSW Professor Department of Psychiatry University of Kmtucky College of Medicine Professor College of Social Work University of Kmtucky Lexington, Kentucky [email protected] Beha'Vioral Disorders in Children

Katie L. Westerfield, DO, IBCLC, FAAFP Aasistant Professor of Family Medicine Uniformed Services University of the Health Sciences Bethesda, Maryland lst Security Force Assistance Brigade Fort Benning. Georgia katielwester:[email protected] Cancer Screening in Women

Katherine Wilhelmy, MD Family Medicine Physician Renaissance Family Practice Pittsburgh, Pennsylvania [email protected] Elder Abuse

Department of Family Medicine Boston University School of Medicine Chief of Family Medicine Boston Medical Center Boston, Massachusetts [email protected] Health Maintenana for Adults Acute Coronary Syndrome

Jeanette M. Witter, PhD Aasistant Professor Department of Medical and Clinical Psychology Uniformed Services University Bethesda, Maryland [email protected] Combat-Related PosttTaumatic Stress Disorder 6' Traumatic Brain Injury

Steven R. Wolfe, DO, MPH, FAAFP, AAHIVS Dean AHN/LECOM Clinical Campus Clinical Professor LECOM Department of Family Medicine Associate Clinical Professor Temple Department of Family Medicine Osteopathic Program Director Forbes Family Medicine Residency Program Forbes Hospital, AHN Monroeville, Pennsylvania [email protected] Caring/or LGBTQIA Patients

Rachel K.F. Woodruff, MD, MPH Assistant Professor Wake Forest Department of Family and Community Medicine Wake Forest University School of Medicine Winston-Salem, North Carolina [email protected] E'Valuation 6' Management ofHeadache

Yaqln Xia, MD, MHPE Assistant Professor Department of Family Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania [email protected] Mo-..ement Disorders

Preface The Fifth Edition of Current Diagnosis & Treatment: Family Medicine is a comprehensive, single source reference for practicing family physicians and trainees delivering primary care in a continuity environment for all patients across the lifespan. The text is organized according to the developmental lifespan beginning with infancy, childhood, and adolescence, including a focus on the reproductive years, and progressing through adulthood and the mature, senior years. The text has been adapted from one edition to another to incorporate emerging areas that impact individual patients and/or populations and are likely to present in a primary care setting. Areas such as immunization updates, genetics in primary care, pharmacogenomics, and telemedicine are presented, as well as current approaches and treatments for the usual chronic diseases such as hypertension and diabetes mellitus.

OUTSTANDING FEATURES •

Evidence-based recommendation

• Culturally related aspects of each condition and alternative • Conservative and pharmacologic therapies • Complementary and alternative therapies when relevant • Suggestions for collaborations with other healthcare providers •

Attention to the mental and behavioral health of patients as solitary as well as comorbid conditions

•

Recognition of the impact of illness on the family

•

Patient education information

•

End-of-life issues

INTENDED AUDIENCE Primary care trainees and practicing physicians will fmd this text a useful resource for common conditions seen in ambulatory practice. Detailed information in tabular and text format provides a ready reference for selecting diagnostic procedures and recommending treatments. Advanced practice nurses and physician's assistants will also find the approach provided here a practical and complete first resource for both diagnosed and undifferentiated conditions and an aid in continuing management Unlike smaller medical manuals that focus on urgent, one-time approaches to a particular presenting complaint or condition, this text was envisioned as a resource for clinicians who practice continuity of care and have established a longitudinal, therapeutic relationship with their patients. Therefore, each chapter includes recommendations for immediate as well as subsequent clinical encounters.

ACKNOWLEDGMENTS We thank our many contributing authors for their diligence in creating complete, practical, and readable discussions of the many conditions seen on a daily basis in the average family medicine and primary care practice. Furthermore, the vision and support of our editors at McGraw-Hill for creating this resource for primary care have been outstanding and critical to its completion. ]Mnnette E. South-Paul, MD, DHL (Hon), FAAFP Samuel C. Matheny, MD, MPH, FAAFP Evelyn L. Lewis, MD, MA, FAAFP, DABDA

xix

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Section I. Infancy 8r Childhood

Well-Child Care Donald B. Middleton, MD

ESSENTIALS OF WELL-CHILD CARE Providing a comprehensive patient-centered medical home for children and assisting in the progressive transition to adulthood are integral components of family medicine. The provision of well-child care through a series of periodic examinations forms the foundation for the family physician to build lasting relationships with the entire family, a critical distinction between the family physician and other medical specialists. Healthcare for infants and children has changed markedly over the past half century. Prior focus on infectious disease and illness prevention has shifted to largely behavioral and environmental concerns. Paramount among behaviors is the issue of screen time, including television, iPads, computers, and cell phones. Environmental concerns such as water purity continue to be problematic. Of course, safety should always be emphasized. However, family physicians should remember that the goal of child care is to allow the child and family to experience joyous childrearing. Too often a well-child visit focuses on difficulties and not on pleasantries. Part of making certain that the child has a happy childhood is to limit toxic experiences such as corporal punishment that have been linked to later adult difficulties such as early myocardial infarction. Limiting negative experiences necessitates investigation into whether the parents and other family members are doing well, part of every family physician's goals. Enhanced nutrition, mandated safety standards, and expanded schedules for immunizations have significantly improved the health of US children, but serious childhood health problems persist. Inadequate prenatal care leading to poor birth outcomes, poor management of developmental delay, childhood obesity, lack of proper oral health, learning disabilities, and substance abuse are examples of ongoing dilemmas.

A key reference guide for childhood health promotion is the fourth edition of Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (https://brightfutures.aap.org/clinical-practice/Pages/default .aspx), funded by the US Department of Health and Human Services. The guidelines give providers a comprehensive system of care that addresses basic concerns of childrearing such as nutrition, parenting, safety, dental care, and infectious disease prevention with focused attention on evidence-based health components and interventions. Bright Futures materials include interim history forms for parents, well-child chart notes for each recommended visit, and anticipatory guidance sheets to be given to parents at the visit's conclusion. It also lists and describes numerous community resources, some of which are designed to address medical or behavioral issues and some of which are designed to enhance childrearing. One widely utilized, online schedule for routine well-child visits (Table 1-1) is the Bright Futures/AAP Periodicity Schedule (https://www.aap.org/en-us/Docurnents/ periodicity_schedule.pelf). Following a prenatal visit, seven visits are suggested during the first year, five visits age 12 to 30 months, and then yearly visits until adulthood at age 21 years. Table 1-1 provides a structured framework for anticipatory guidance, examinations, and growth and developmental screening at appropriate intervals. The most important components of a preventive wellchild visit include: (1) developmental/behavioral assessment; (2) physical examination, including measurement of growth; (3) screening tests and procedures; and (4) anticipatory guidance. One specific goal of each visit is to identify concerns about a child's development and then intervene with early treatment and monitor closely for changes. An essential component is adherence to the most recent schedule of recommended immunizations from the Advisory Committee

Table 1-1. Schedule ofroutine well-care visits.

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CHAPTER 1

Centen for Diseue Control and Prevention. Developmental disabilities. Accessed at https://www.cdc.gov/ncbddd/ developmentald.16abilities/index.html. Accessed November 12, 2019. Chaudhary SS, Pomerantz W, Miller B, Agarwal M. Pediatric injury prevention programs: identify markers for success and sustainability. l Trauma Acute Care Surg. 2017;83:Sl84-Sl89. [PMID: 28557845] Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines

for Health Supervision of Infflnts, Children, flnd Adolescent$. 4th ed. Elk Grove Village, II.: American Academy of Pediatrics; 2017. Accessed at https://brightfutures.aap.org/materials-andtools/Pages/default.aspx. Accessed November 12, 2019.

John1en SB, Riley AW, Granger DA, Riis J. The science of early toxic stress for pedlatric practice and advocacy. Pediatria. 2013;131:319-327. [PMID: 23339224] Kavan MG, Saxena SK, Rafiq N. General parenting strategies: practical suggestions for co=on child behavior issues. Am Fflm Physicifln. 2018:97:642-648. [PMID: 29763275] Patterson BL, Gregg WM, Biggers C, Barldn S. Improving delivery ofEPSDT well-child care at acute visits in an academic pediatric practice. Pediatrics. 2012;130(4):e988-e995. [PMID: 22987871] Silk H, McCollum W. Fluoride: the family physician's role. Am Fflm Physicifln. 2015;92:174-176. [PMID: 26280136] Turner K. Well-child visits for infants and young children. Am Fam Physician. 2018;98:347-353. [PMID: 30215922]

Failure to Thrive James C. Dewar, MD Stephanie B. Dewar, MD

.. Persistent weight loss over time. .. Growth failure associated with disordered behavior and development. .. Weight less than third percentile for age. .. Weight crosses two major percentiles downward over any period of time and continues to fall. .. Median weight for age of 76-90% (mild undernutrition), 61-75% (moderate undernutrition), or 1800 g at birth, provides 22 cal/oz in standard dilution.

...... Human Milk Fortifiers for Preterm Infants Human milk fortifiers (HMFs) are indicated for preterm infants