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Decision Making in Medicine - An Algorithmic Approach PDF

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Decision Making in Medicine An Algorithmic Approach This page intentionally left blank Decision Making in Medicine An Algorithmic Approach Third Edition Stuart B. Mushlin, MD, FACP, FACR Assistant Professor of Medicine Harvard Medical School Master Clinician Brigham and Women’s Hospital Julian Cohen Teaching Scholar Brigham and Women’s Hospital Director of Primary Care, ad interim, Department of Medicine Brigham and Women’s Hospital Boston, Massachusetts Harry L. Greene II, MD Former Executive Vice President Massachusetts Medical Society Waltham, Massachusetts Instructor in Medicine Harvard Medical School Boston, Massachusetts 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 DECISION MAKING IN MEDICINE: AN ALGORITHMIC ISBN: 978-0-323-04107-2 APPROACH, THIRD EDITION Copyright © 2010 by Mosby, Inc., an affi liate of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and re- trieval system, without permission in writing from the publisher. Details on how to seek permis- sion, further information about the Publisher’s permissions policies, and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Knowledge and best practice in this fi eld are constantly changing. As new research and expe- rience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identifi ed, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manu- facturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of prac- titioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, prod- ucts, instructions, or ideas contained in the material herein. Previous editions copyrighted 1998, 1992 Library of Congress Cataloging-in-Publication Data Decision making in medicine : an algorithmic approach / [edited by] Stuart B. Mushlin, Harry L. Greene II. -- 3rd ed. p. ; cm. Includes bibliographical references and index. ISBN 978-0-323-04107-2 1. Medical protocols. 2. Medicine--Decision making. I. Mushlin, Stuart B. II. Greene, Harry L. (Harry Lemoine), 1942- [DNLM: 1. Diagnosis. 2. Algorithms. 3. Decision Making. 4. Therapeutics. WB 141 D294 2009] RC64.D43 2009 616--dc22 2009036313 Acquisitions Editor: Druanne Martin Developmental Editor: Agnes Byrne Publishing Services Manager: Mary Stermel Design Direction: Steven Stave Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my wonderful wife, Francine. She is generous, wise, witty, literate, constructive, and patient. There are many events we have forgone so that I may work on “the book.” I thank her for believing in me and embracing the concept that every day we should strive to do more than we thought we could do. SBM To my family: Linda Clark Greene, Harry L. Greene III, Evelyn Lockwood Greene, Michele Greene Moynihan, Chris Moynihan, Hayden Moynihan, Jennifer Greene Reynoso, and David Reynoso. HLG This page intentionally left blank SECTION EDITORS Sherleen Chen, MD, FACS Ana Maria López, MD, MPH, FACP Instructor in Ophthalmology, Harvard Medical School; Associate Dean for Outreach and Multicultural Affairs, Director, Comprehensive Ophthalmology Service, Boston, Professor of Medicine and Pathology, Medical Director, Massachusetts Arizona Telemedicine Program, University of Arizona, Ocular Tucson, Arizona Hematology/Oncology Bradford C. Dickerson, MD Instructor in Neurology, Harvard Medical School; Assistant Graham T. McMahon, MD, MMSc in Neurology, Department of Neurology, Massachusetts Department of Endocrinology, Brigham and Women’s General Hospital; Associate Neurologist, Division of Hospital, Boston, Massachusetts Cognitive and Behavioral Neurology, Brigham and Endocrinology Women’s Hospital, Boston, Massachusetts Paul A. Monach, MD, PhD Neurology Assistant Professor of Medicine, Section of Rheuma- M. Brian Fennerty, MD tology, Boston University School of Medicine, Boston, Professor of Medicine, Division of Gastroenterology and Massachusetts Hepatology, Health and Science University, Portland, Rheumatology Oregon Stuart B. Mushlin, MD, FACP, FACR Gastroenterology Assistant Professor of Medicine, Harvard Medical School; John A. Fromson, MD Master Clinician, Brigham and Women’s Hospital; Julian Assistant Clinical Professor of Psychiatry, Harvard Medical Cohen Teaching Scholar, Brigham and Women’s Hospital; School; Chairman, Department of Psychiatry, Metro West Director of Primary Care, ad interim, Department Medical Center, Boston, Massachusetts of Medicine, Brigham and Women’s Hospital, Boston Behavioral Medicine Massachusetts Women’s Health Barbara A. Gilchrest, MD Professor and Chair, Department of Dermatology, Boston Ajay K. Singh, MBBS, FRCP University School of Medicine; Chief of Dermatology, Associate Professor of Medicine, Harvard Medical School; Boston Medical Center, Boston, Massachusetts Renal Division, Brigham and Women’s Hospital, Boston, Dermatology Massachusetts Nephrology Michael D. Katz, PharmD Associate Professor, Department of Pharmacy Practice Graeme Steele, MD, FCS, FACS and Service, University of Arizona, College of Pharmacy, Division of Urologic Surgery, Brigham and Women’s Tucson, Arizona Hospital, Boston, Massachusetts Pharmacology Urology Lisa Kaufmann, MD Stephen D. Wiviott, MD Professor of Medicine, SUNY Upstate Medical University, Assistant Professor of Medicine, Cardiovascular Division, Syracuse, New York Department of Medicine, Harvard Medical School; General Medicine Investigator, TIMI Study Group, Brigham and Women’s Hospital, Boston, Massachusetts Michael Klompas, MD, MPH, FRCPC Cardiology Associate Hospital Epidemiologist, Brigham and Women’s Hospital, Boston, Massachusetts Richard D. Zane, MD, FAAEM Infectious Diseases Assistant Professor of Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Patricia Kritek, MD Brigham and Women’s Hospital, Boston, Massachusetts Pulmonary and Critical Care Medicine, Brigham and Emergency Medicine Women’s Hospital, Boston, Massachusetts Pulmonary Disease vii This page intentionally left blank CONTRIBUTORS Sandeep K. Agarwal, MD, PhD Homeira Baghdadi, MD Assistant Professor, Division of Rheumatology and Immu- Clinical Associate in Medicine, University of Arizona nogenetics, University of Texas Medical School at College of Medicine, Tucson, Arizona Houston, Houston, Texas Nipple Discharge Scleroderma; Elevated Creatine Kinase Level Juan Diego Baltodano, MD Frederick R. Ahmann, MD Assistant Professor of Medicine, Virginia Commonwealth Professor of Medicine and Surgery, University of Arizona, University, Division of Gastroenterology, Hepatology, and Arizona Cancer Center, Tucson, Arizona Nutrition, Richmond, Virginia Superior Vena Caval Syndrome Acute Abdominal Pain; Chronic Abdominal Pain; Nausea and Vomiting; Dyspepsia; Jaundice; Ascites; Rectal Essam Al-Ansari, MD Bleeding; Chronic Diarrhea; Asymptomatic Abnormal Pulmonary Specialists-Northern, Florence, Kentucky Liver Aminotransferases Dyspnea Glen W. Barrisford, MD Erik K. Alexander, MD Department of Urology, National Naval Medical Center, Assistant Professor of Medicine, Harvard Medical School; Bethesda, Maryland Department of Endocrinology, Brigham and Women’s Urinary Retention Hospital, Boston, Massachusetts Iris R. Bell, MD, PhD Tests of Thyroid Function; Goiter; Thyroid Function Tests in Nonthyroidal Illness Associate Professor, Department of Psychiatry, University of Arizona College of Medicine; Director, Program in Elaine J. Alpert, MD Geriatric Psychiatry, Tucson VA Medical Center, Formerly Associate Professor of Medicine, Boston Tucson, Arizona University, Boston, Massachusetts Depression Domestic Violence Jeanne E. Bishop, MD Nenad Antic, MD Associate Professor of Medicine, SUNY Upstate Medical Arizona Center for Hematology and Oncology, Glendale, University, Syracuse, New York Arizona Falls in Geriatric Patients Polycythemia Marc P. Bonaca, MD Elliott M. Antman, MD Division of Cardiovascular Medicine, Brigham and Professor of Medicine, Harvard Medical School; Women’s Hospital, Boston, Massachusetts Department of Medicine, Brigham and Women’s Hospi- Stable Angina; Post–Myocardial Infarction Care and tal, Boston, Massachusetts Counseling Assessment and Initial Management of ST-Segment Yvette M. Bordelon, MD, PhD Elevation Myocardial Infarction Assistant Professor, Department of Neurology, University Mohammed Asmal, MD, PhD of California Medical School, Los Angeles, California Division of Infectious Diseases, Brigham and Women’s Tremor; Hyperkinesias Hospital, Boston, Massachusetts Jessica Byron, MD Encephalitis Clinical Assistant Professor, Department of Obstetrics Usman Baber, MD and Gynecology, University of Arizona College of Department of Medicine, University of Texas Southwestern Medicine, Tucson, Arizona Medical School, Dallas, Texas Premenstrual Dysphoric Disorder Hypertension Christopher P. Cannon, MD Aaron L. Baggish, MD Associate Professor of Medicine, Harvard Medical Division of Cardiology, Massachusetts General Hospital, School; TIMI Study Group, Brigham and Women’s Boston, Massachusetts Hospital, Boston, Massachusetts Systolic Murmurs; Diastolic Murmurs; Cardiac Dyspnea Unstable Angina/Non-ST-Elevation Myocardial Infarction ix

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Making in. Medicine. An Algorithmic Approach. Third Edition. Stuart B. Mushlin, MD, FACP, FACR . School; Vice Chair, Department of Emergency Medicine,.
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