Primary Care in Obstetrics and Gynecology (eBook)

Preface 5
Contents 7
Contributors 10
Primary Care and the Obstetrician-Gynecologist 14
Primary Care in Obstetrics and Gynecology: Health Maintenance and Screening 15
Background Information 15
Screening, Counseling, and Immunization 32
Suggested Reading 43
Pediatric and Adolescent Patients 44
Introduction 44
Prepubertal Vulvovaginitis 44
Genital Bleeding in Childhood 50
Abnormal Genitalia 51
Pubertal Aberrancy 57
Menstrual Dysfunction 59
Contraception 63
Case Studies 63
Suggested Reading 65
Elderly Patients 66
Background Information 66
Establishing a Diagnosis 70
Clinical Intervention 79
Special Considerations 82
Summary 83
Suggested Reading 84
Lesbian Patients 85
Background Information 85
How Common Is Female Homosexuality? 87
Neuroendocrinology of Homosexuals 87
Family Relationships and Other Factors 88
Sexuality and Safe Sex 88
Diagnostic Considerations 88
Gynecologic Care 92
How to Approach the Patient 92
Summary 94
Case Studies 95
Suggested Reading 96
The Role of Genomic and Applied Molecular Biology 98
Introduction 98
Background Information 99
A Quick Review of Molecular Biology 99
Where to Find DNA 101
Principles of DNA Diagnosis 101
Further Refinements 105
DNA Arrays = The Chip 108
Clinical Applications 109
Keeping Up with the Developments in the Field 109
Case Studies 110
Glossary 111
Suggested Reading 111
Emergencies in the Office Setting 113
Background Information 113
Establishing the Diagnoses 115
Clinical Intervention 115
Neurologic Deficits/Disability 121
Thought-Provoking Cases 124
Summary 125
Suggested Reading 126
Clinical Management Principles for the Office Setting 127
Abnormal Pap Smear: Gynecologic Pathology and Management 128
Introduction 128
Screening Guidelines 134
Triage for Cytologic Abnormalities 137
Case Studies 150
Suggested Reading 151
Mood Disorders 153
Major Depressive Disorder 153
Bipolar Disorder 156
Other Mood Disorders 157
Treatment of Depression 161
Treatment of Bipolar Disorders 172
Special Clinical Situations 175
Suggested Reading 179
Breast Disease 181
Background Information 181
Establishing a Diagnosis 182
Common Problems 192
Screening for Breast Cancer 192
Clinical Intervention and Treatment 193
Summary 198
Suggested Reading 199
Cardiovascular Hypertension 201
Background Information 201
Establishing the Diagnosis of Hypertension 205
Therapy 211
Monitoring Therapy 216
Case Study 217
Summary 218
Suggested Reading 218
Chronic Pelvic Pain 221
Introduction 221
Overview 222
History 222
Physical Examination 223
Laboratory and Diagnostic Studies 224
Gynecologic Causes of Chronic Pelvic Pain 226
Miscellaneous Gynecologic Causes of Chronic Pelvic Pain 232
Urologic Causes of Chronic Pelvic Pain 237
Gastroenterologic Causes of Chronic Pelvic Pain 239
Musculoskeletal Causes of Chronic Pelvic Pain 243
Psychiatric Causes of Chronic Pelvic Pain 244
Conclusion 244
Suggested Reading 245
Contraception Update 246
Introduction 246
Hormonal Contraception 247
Intrauterine Contraception 258
Barrier Methods of Contraception 262
Emergency Contraception 266
Case Studies 267
Coronary Heart Disease in Women: Diagnosis, Evaluation, and Preventive Therapy 270
Background Information 270
Evaluation of Chest Pain Syndromes 271
Clinical Characteristics and Therapies of Coronary Heart Disease in Women 274
Coronary Preventive Interventions 277
Menopausal Hormone Therapy: Is There Evidence for Coronary Disease Prevention 283
Summary 286
Suggested Reading 286
Dermatologic Disorders 288
Background Information 288
Common Tumors 292
Pigmented Lesions 298
Rashes 300
Purpura—Macular and Palpable 310
Urticaria/Urticarial Lesions 311
Pruritus Without Rash 312
Suggested Reading 312
Diabetes Mellitus 313
Background Information 313
Diagnosis 314
Classification 315
Initial Evaluation of the Patient with Diabetes Mellitus 316
Management 316
Gestational Diabetes 328
Suggested Reading 328
Gastrointestinal Disorders 330
Background Information 330
Establishing the Diagnosis 335
Clinical Intervention 340
Case Studies 344
Suggested Reading 345
Headaches 348
Background Information 348
Diagnosing Headaches 349
Classification of Headaches 350
Primary Headaches 350
Headaches—Migraine or Not? 353
Summary 358
Suggested Reading 359
Nutrition, Obesity, and Eating Disorders 360
Introduction 360
Cardiovascular Disease 360
Hypertension 363
Weight Control 364
Herbs and Surgery 373
At What Age to Supplement and with Which Nutrients 373
Osteoporosis 374
Eating Disorders 378
Weight Loss Case Study 380
Suggested Reading 380
Respiratory Disorders 382
Background Information 382
Establishing the Diagnosis 389
Clinical Intervention 391
Case Study 396
Suggested Reading 396
Sexual Dysfunction 400
Background Information 400
Sexual Functioning 400
Establishing the Diagnosis: Sexual Dysfunctions and Problems 403
Management of Sexual Problems 417
Case Study 430
Summary 431
Suggested Reading 432
Sports Medicine and Injuries in the Athletic Woman 435
Background Information 435
Benefits of Exercise in Females 436
Orthopedic Issues in Active Women 437
Medical Issues in Active Women 444
Prevention and Return to Play 448
Suggested Reading 449
Thyroid Disease 450
Introduction 450
Regulation of Thyroid Hormone Synthesis and Secretion 451
Thyroid Function Tests 452
Interpretation of Thyroid Function Studies 453
Epidemiology and Screening for Thyroid Disorders 454
Hypothyroidism 455
Hyperthyroidism 457
Thyroid Nodules 460
The Thyroid During Pregnancy 462
Case Studies 463
Suggested Reading 465
Appendix: Ready Reference Tables for Preventive Health Care and Health Maintenance 467
Cardiovascular Disease 467
Nutrition 470
Vaccine Administration Record 484
Contraception 486
Drugs In Pregnancy 487
Exercise 494
Laboratory Reference Values 496
Index 511