Taylor’s Family Medicine Review

306 Pages·1999·5.338 MB·English

by  Gerald K. Goodenough M.D., M.S.P.H. (auth.), Robert B. Taylor M.D., Alan K. David M.D., Thomas A. Johnson Jr. M.D., D. Melessa Phillips M.D., Joseph E. Scherger M.D., M.P.H. (eds.)

Taylor's Family Medicine Review
Springer
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Taylor's Family
Medicine Review
Robert B. Taylor
With 30 Illustrations
Editor:
Robert B. Taylor, M.D.
Professor and Chairman
Department of Family Medicine
Oregon Health Sciences University
School of Medicine
Portland, OR 97201, USA
Associate Editors:
Alan K. David, M.D. Joseph E. Scherger, M.D., M.P.H.
The Fred Lazarus, Jr. Associate Dean for Clinical Affairs
Professor and Director and
Department of Family Medicine Chair
University of Cincinnati College of Medicine Department of Family Medicine
Cincinnati, OH 45267, USA University of California-Irvine
College of Medicine
Thomas A. Johnson, Jr., M.D. Orange, CA 92868, USA
Chairman
Department of Family Medicine Contributor:
St. John's Mercy Medical Center
St. Louis, MO 63141, USA Gerald K. Goodenough, M.D., M.5.P.H.
Family Physician and Practicing Geriatrician
D. Melessa Phillips, M.D. St. Mark's Senior Health Center
Professor and Chairman Columbia H.CA.
Department of Family Medicine Salt Lake City, UT 84124, USA
University of Mississippi School of Medicine
Jackson, MS 39216, USA
Library of Congress Cataloging in Publication Data
Taylor's family medicine review / [edited by] Robert B. Taylor.
p. cm.
Referenced to: Family medicine / Robert B. Taylor, editor, 5th ed.
c1998
Includes bibliographical references and index.
1. Family medicine-Examinations, questions, etc. I. Taylor, Robert B.
[DNLM: 1. Family Practice-examination questions. 2. Clinical Medicine-
examination questions. WB 18.2 T247 1998]
RC46.F36 1998 Supp!.
616'.007t'r-dc21
98-21884
Printed on acid-free paper.
© 1999 Springer-Verlag New York, Inc.
Softcover reprint of the hardcover 15t edition 1999
All rights reserved. This work may not be translated or copied in whole or in part without the
written permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New York,
NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in
connection with any form of information storage and retrieval, electronic adaptation, computer
software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.
The use of general descriptive names, trade names, trademarks, etc. in this publication, even if
the former are not especially identified, is not to be taken as a sign that such names, as
understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely
by anyone.
While the advice and information in this book are believed to be true and accurate at the date
of going to press, neither the authors nor the editors nor the publisher can accept any legal
responsibility for any errors or omissions that may be made. The publisher makes no warranty,
express or implied, with respect to the material contained herein.
Production coordinated by Princeton Editorial Associates and managed by Theresa Kornak;
manufacturing supervised by Jacqui Ashri.
Typeset by Princeton Editorial Associates, Scottsdale, AZ, and Roosevelt, NJ.
9 8 7 6 5 4 3 2 1
ISBN-13: 978-0-387-98569-5 e-ISBN-13: 978-1-4612-2152-4
DOl: 10.1007/978-1-4612-2152-4
Preface
Test taking does not end upon completion of formal medical training. With
certification, recertification, and licensure examinations, test taking is as much
a part of modern clinical practice as medical records and quality assurance.
For example, during my career I have taken all three parts of what is now
called the United States Medical Licensure Examination (USMLE), one state
licensing board examination, plus the specialty certification exam and four
periodic recertification examinations of the American Board of Family Prac
tice (ABFP). Periodic examinations demonstrate the examinee's current fund
of knowledge, and are important to maintaining the highest standards of
medical practice. For the physician personally, it is reassuring to validate that,
when measured against peers (and even the bright young recent graduates),
one can achieve a respectable score on a standardized examination.
Taylor's Family Medicine Review is intended to help the reader review the full
scope of family medicine, whether to prepare for a broad-based clinical ex
amination or simply to enhance one's clinical knowledge. The book contains
more than 1200 questions, each followed by a discussion explaining the
correct response. The questions are based on the all-new Fifth Edition of
Family Medicine: Principles and Practice. The discussion following each ques
tion is taken directly from the Fifth Edition, with notations of the source
chapter and page. The reader will find that, in many instances, the discussion
goes beyond validating the correct response and expands upon the clinical
approach to the problem presented. Questions have been grouped by area
(e.g., preventive care, care of the elderly, and the female reproductive system)
to allow focused review of selected topics.
The book begins with a chapter on "Test Taking Techniques," by Gerald
Goodenough, M.D., M.5.P.H. I am the author of all questions, which allows
uniformity of style and the exercise of my bias toward clinically pertinent
family medicine topics. I have attempted to write questions that address key
points for each clinical problem.
I have used the two most common question types: multiple choice and
multiple true-false, and avoided the less-oft en-used question types that may
not reflect what the examinee actually knows. Whenever appropriate, ques
tions are framed in a case-based" format. The result, I hope, is a book that can
/I
help the reader become both a better test-taker and a more knowledgeable
physician.
vi Preface
I gratefully acknowledge the contributions of Dr. Goodenough, all authors
in the Fifth Edition of Family Medicine: Principles and Practice, and the Fifth
Edition Associate Editors: Alan K. David, M.D., Thomas A. Johnson, M.D.,
D. Melessa Phillips, M.D., and Joseph E. Scherger, M.D., M.P.H. Thanks are
also due Harmony Matthews, Coelleda O'Neil, Laretta Borg, and Laurie Char
ron for their assistance in manuscript preparation. I appreciate the work of
family physicians Keith A. White, M.D., John V. Mackel, M.B., and Laura E.
Holmes, M.D., who reviewed all questions in this manuscript in preparation
for their own ABFP examinations.
This is a new book. As readers take examinations after using this book in
preparation, I would welcome comments and suggestions that could make
ours the very best Family Medicine Review.
Robert B. Taylor, M.D.
Portland, Oregon, USA
Contents
Leading numbers in italics indicate the relevant chapter number in Family
Medicine: Principles and Practice (Fifth Edition) for each chapter in this book.
Preface ..................................................... v
Contributors to Fifth Edition of Family Medicine: Principles
and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. xi
Chapter 1 Test Taking Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Gerald K. Goodenough, MD., M.S.P'H.
Chapter 2 Preventive Care ............................................... 8
7 Clinical Prevention
8 Health Promotion
9 Health Care of the International Traveler
Chapter 3 Pregnancy, Childbirth, and Postpartum Care ................... 21
10 Preconception Care
11 Normal Pregnancy, Labor, and Delivery
12 Medical Problems During Pregnancy
13 Obstetric Complications During Pregnancy
14 Problems During Labor and Delivery
15 Postpartum Care
Chapter 4 Care of the Infant and Child .................................. 44
16 Genetic Disorders
17 Problems of the Newborn and Infant
18 Communicable Diseases of Children
19 Behavioral Problems of Children
20 Musculoskeletal Problems in Children
21 Selected Problems of Infancy and Childhood
Chapter 5 Care of the Adolescent ....................................... 64
22 Health Care of the Adolescent
23 Sexual Concerns of Adolescents
Chapter 6 Care of the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
24 Common Problems of the Elderly
25 Alzheimer's Disease and Related Dementias
viii Contents
Chapter 7 Family Conflict and Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
26 Child Abuse and Neglect
27 Domestic Violence
28 Elder Abuse
29 Sexual Assault
30 Family Stress and Counseling
Chapter 8 Behavioral and Psychiatric Problems .......................... 82
31 Anxiety Disorders
32 Depression
33 Suicidal Patient
34 Somatoform Disorders and Related Syndromes
35 Selected Behavioral and Psychiatric Problems
Chapter 9 Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
36 Allergic Rhinitis and Hay Fever
37 Anaphylaxis and Anaphylactoid Reactions
Chapter 10 Infectious Diseases .......................................... 95
38 Epstein-Barr Virus Infection and Infectious Mononucleosis
39 Viral Infections of the Respiratory Tract
40 Sinusitis and Pharyngitis
41 Sexually Transmitted Diseases
42 Human Immunodeficiency Virus Infection and
Acquired Immunodeficiency Syndrome
43 Bacteremia and Sepsis
44 Selected Infectious Diseases
Chapter 11 Environmental and Occupational Health Problems 109
45 Occupational Health Care
46 Problems Related to Physical Agents
Chapter 12 Injuries and Poisoning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 114
47 Bites and Stings
48 Poisoning
49 Care of Acute Lacerations
50 Selected Injuries
Chapter 13 Care of the Athlete. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
51 Medical Problems of the Athlete
52 Athletic Injuries
Chapter 14 Common Clinical Problems .................................. 127
53 Care of the Obese Patient
54 Care of the Patient with Dysequilibrium
55 Care of the Patient with Fatigue
56 Care of the Patient with a Sleep Disorder
57 Medical Care of the Surgical Patient
58 Counseling Patients with Sexual Concerns
59 Care of the Alcoholic Patient
60 Care of the Patient Who Misuses Drugs
61 Care of the Patient with Chronic Pain
62 Care of the Dying Patient
Chapter 15 The Nervous System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
63 Headache
Contents ix
64 Seizure Disorders
65 Cerebrovascular Disease
66 Movement Disorders
67 Disorders of the Peripheral Nervous System
68 Selected Disorders of the Nervous System
Chapter 16 The Eye. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 153
69 The Red Eye
70 Ocular Trauma
71 Selected Disorders of the Eye
Chapter 17 The Ear, Nose, and Throat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 159
72 Otitis Media and Otitis Externa
73 Oral Cavity
74 Selected Disorders of the Ear, Nose, and Throat
Chapter 18 The Cardiovascular System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 163
75 Hypertension
76 Ischemic Heart Disease
77 Cardiac Arrhythmias
78 Heart Sounds, Murmurs, and Valvular Heart Disease
79 Heart Failure
80 Cardiovascular Emergencies
81 Venous Thromboembolism
82 Selected Disorders of the Cardiovascular System
Chapter 19 The Respiratory System ...................................... 182
83 Obstructive Airway Disease
84 Pulmonary Infections
85 Lung Cancer
86 Selected Disorders of the Respiratory System
Chapter 20 The Digestive System ........................................ 189
87 Gastritis, Esophagitis, and Peptic Ulcer Disease
88 Diseases of the Large and Small Bowel
89 Pancreatic Diseases
90 Diseases of the Liver
91 Diseases of the Rectum and Anus
92 Colorectal Cancer
93 Surgical Problems of the Digestive System
94 Selected Disorders of the Digestive System and Nutrition
Chapter 21 The Renal, Urinary, and Male Genital Systems. . . . . . . . . . . . . . . . .. 201
95 Urinary Tract Infections
96 Fluid, Electrolyte, and Acid-Base Disorders
97 Diseases of the Kidney
98 Prostate Disease
99 Surgery of the Male Genital Tract
100 Selected Disorders of the Genitourinary System
Chapter 22 The Female Reproductive System ............................. 212
101 Family Planning and Contraception
102 Vulvovaginitis and Cervicitis
103 Menstrual Disorders
104 Menopause
105 Tumors of the Female Reproductive Organs
x Contents
106 Benign Breast Conditions and Disease
107 Breast Cancer
108 Selected Disorders of the Female Reproductive System
Chapter 23 The Musculoskeletal System and Connective Tissue. . . . . . . . . . . .. 226
109 Disorders of the Back and Neck
110 Disorders of the Upper Extremity
111 Disorders of the Lower Extremity
112 Osteoarthritis
113 Rheumatoid Arthritis and Related Disorders
114 Selected Disorders of the Musculoskeletal System
Chapter 24 The Skin and Subcutaneous Tissue ............................ 241
115 Common Dermatoses
116 Skin Infections and Infestations
117 Skin Tumors
118 Selected Disorders of the Skin
Chapter 25 The Endocrine and Metabolic System . . . . . . . . . . . . . . . . . . . . . . . . .. 251
119 Dyslipidemias
120 Diabetes Mellitus
121 Thyroid Disease
122 Osteoporosis
123 Gout
124 Selected Disorders of the Endocrine and Metabolic System
Chapter 26 The Blood and Hematopoietic System ......................... 260
125 Anemia
126 Selected Disorders of the Blood and Hematopoietic System
Chapter 27 Principles and Applications .................................. 265
1 Family Medicine: Current Issues and Future Practice
2 Human Development and Aging
3 Approach to the Patient
4 Sociocultural Issues in Health Care
5 Families and Health
6 Population-Based Health Care
127 Clinical Guidelines
128 Information Management
129 Managed Care
130 Profile of Family Physicians in the United States
Index....................................................... 275