Page numbers printed in boldface type refer to tables and figures.
AAN.
See Atypical anorexia nervosa
A-B-C (airway, breathing, circulation),378
Abdominal pain and heartburnassessment and management in psychiatric settings,176–182
alarm symptoms for GERD,183algorithm for,180CT and use of contrast for specific causes of abdominal pain,179recommended imaging studies based on location of abdominal pain,178treatment of GERD,182clinical presentation of,169–170
differential diagnosis of,170–174
serious conditions producing abdominal painby timing of onset,175location of,183
outpatient considerations,182–183
risk stratification of,174–176
ABIM Choosing Wisely Campaign,472
Abuse, in the elderly,473–474
ACC.
See American College of Cardiology
Acetaminophen, as renal toxin,317
Acetazolamide, for management of headache,60
ACLS.
See Advanced cardiac life support
Activities of daily living (ADLs),399
Acute angle-closure glaucoma,242, 243
characteristics and treatment of,245Acute coronary syndromeabdominal pain and,183
shortness of breath and,130
Acute dyspnea,135
Acute glaucoma,246
Acute glomerulonephritis,319
evaluation of,323Acute interstitial nephritis (AIN),318–319,
319evaluation of,323treatment of,324
Acute myocardial infarction (AMI), presenting findings of chest pain, by sex,118Acute or chronic dyspnea,135
Acute pyelonephritis,216Acute tubular necrosis (ATN)evaluation of,323, 326
Acute urinary retention (AUR).
See also Urinary incontinence; Urinary tract infection, dysuria and urinary frequency associated with
clinical presentation of,226
description of,230
differential diagnosis of,226–227,
227management in psychiatric settings,228, 229
risk stratification of,227, 229
Acyclovirfor treatment of genital herpes,457
for treatment of meningitis and encephalitis,61
ADLs.
See Activities of daily living
Adolescents.
See also Children
bariatric surgery in,451
chest pain in,122
eating disorders and,444–448
fatigue,451–455
QTc prolongation and torsades de pointes in,337
sexually transmitted infections,455–461
weight gain and obesity,448–451
ADRD.
See Alzheimer’s disease and related dementias
Advanced cardiac life support (ACLS),43, 378–379
AED.
See Automated external defibrillator
Age.
See Adolescents; Children; Elderly
Aggression,400–401,
401Agitation.
See also Delirium
assessment and management in psychiatric settings,402–403,
404clinical presentation of,399–400
definition of,400
differential diagnosis of,400,
401risk stratification of,400–402
Agoraphobia,377
Agranulocytosis.
See Neutropenia
AHA.
See American Heart Association
AIN.
See Acute interstitial nephritis
Akathisia,403
AKI.
See Kidney injury, acute
Alcoholics Anonymous,437
Alcohol withdrawal syndrome.
See also Substance use/abuse
assessment and management in psychiatric settings,435–439
behavioral interventions,436–438
pharmacological intervention,435–436,
436,
437systemic interventions,438–439
clinical presentation of,429–431
differential diagnosis of,431
risk stratification,431, 433
trajectory, symptoms, and consequences of,432treatment setting,433–435
Alzheimer’s dementia,486
clinical presentation of,403–404
in the elderly,471–473
Alzheimer’s disease and related dementias (ADRD),471–472
American Academy of Pediatrics,450
American College of Cardiology (ACC)guidelines for definitions of hypertension,17
guidelines for unstable angina,119
American Geriatrics Society,472, 477
American Heart Association (AHA),339
Basic Life Support program,392
guidelines for definitions of hypertension,17
guidelines for unstable angina,119
American Medical Directors Association,472
American Psychiatric Association,472
American Society of Addiction Medicine (ASAM),433–434, 438
American Thyroid Association (ATA),286
AMI.
See Acute myocardial infarction
Amitriptyline, adverse effects and QTc prolongation and torsades de pointes with,333
Amitriptyline, QTc prolongation produced by,334Amyotrophic lateral sclerosis, shortness of breath and,134
Analgesicsassociated with serotonin syndrome,356as cause of abnormal liver function tests,305causing urinary incontinence and/or retention,225Anaphylaxis, shortness of breath and,133
Anasarca,147.
See also Edema
Anemia, shortness of breath and,134
Anestheticsas cause of abnormal liver function tests,305that can cause rhabdomyolysis,360Anorexia.
See also Eating disorders, in adolescents
in adolescents,444
hypokalemia and,273, 275
hypomagnesemia and,277, 280
Anorexia nervosa, in adolescents,445
Antacids, for treatment of GERD,182Antianxiety medications, with increased risk in the elderly,478Antiarrhythmic medicationsadverse effects and QTc prolongation and torsades de pointes with,333
implicated in drug-related fever and hyperthermia,8Antibioticsas cause of abnormal liver function tests,305implicated in drug-related fever and hyperthermia,8for treatment of infectious causes of headache,61
Anticholinergic medicationsas cause of urinary incontinence and/or retention,225for treatment of nausea and vomiting,197Anticonvulsantsassociated with serotonin syndrome,356as cause of abnormal liver function tests,305as cause of transient neutropenia,369Antidepressant medicationsassociated with a higher risk of seizure,76associated with hyponatremia,270associated with serotonin syndrome,356as cause of orthostatic hypotension,31,
causing urinary incontinence and/or retention,225with increased risk in the elderly,478increasing risk of hypoglycemia,261for management of obstructive sleep apnea,163–164
QTc prolongation and torsades de pointes produced by,334Antiemetics, associated with serotonin syndrome,356Antiepileptic drugs (AEDs)interactions between psychotropic medications and,78mental illness and epilepsy,69
Antifungalsas cause of abnormal liver function tests,305Antihistaminesadverse effects and QTc prolongation and torsades de pointes with,333
with increased risk in the elderly,479for management of obstructive sleep apnea,164
for treatment of nausea and vomiting,197Antihypertensive medicationsabrupt discontinuation of,16
implicated in drug-related fever and hyperthermia,8Antimicrobial/antimalarial drugsadverse effects and QTc prolongation and torsades de pointes with,333–334
as cause of transient neutropenia,369Antineoplastic/immunosuppressive drugs, as cause of abnormal liver function tests,306Antiparkinsonian medications, as cause of orthostatic hypotension,31Antipsychotic medicationsassociated with a higher risk of seizure,76associated with hyponatremia,270black box warning for the elderly,473
as cause of abnormal liver function tests,305as cause of constipation,203
as cause of orthostatic hypotension,31as cause of transient neutropenia,369causing urinary incontinence and/or retention,225hypotension and,29
for management of delirium,408–409
neuroleptic malignant syndrome and,10
for treatment of nausea and vomiting,197Antipyretics, during diagnostic testing,11
Antiretroviral therapy, for treatment of HIV,461
Antirheumatic medications, as cause of transient neutropenia,369Antiseizure medications, implicated in drug-related fever and hyperthermia,8Antithyroid medications, as cause of transient neutropenia,369Antituberculosis drugs, as cause of abnormal liver function tests,305Antiviral agents, as cause of abnormal liver function tests,305Anxiety, clinical presentation of,103–104
Aortic dissectionchest pain and,119
shortness of breath and,132
Aplastic anemia,370Aprepitant, for treatment of nausea and vomiting,197ARFID.
See Avoidant/restrictive food intake disorder
Aripiprazolein cardiopulmonary emergencies,389
weight gain and,448
Arrhythmias, shortness of breath and,130
ASAM.
See American Society of Addiction Medicine
Assessment and management, in psychiatric settingsof abdominal pain and heartburn,176–182
of acute urinary retention,228, 229
of agitation,402–403,
404of alcohol withdrawal syndrome,435–439
of bradycardia,47
of cardiopulmonary emergencies,393–396
of chest pain,122, 124
of delirium,408–409
algorithm for,410of eating disorders, in adolescents,447–448
of edema,150
of the elderly,474–481,
475of eye pain,244
of falls,89–94, 98–99
after the fall,90, 92
before the fall,89–90,
91follow-up after a fall,92, 94,
93of fever,11
of headache,55–64
algorithm for assessment of headache,58risk stratification of,59of hyperglycemia,255–257
of hypernatremia,271
of hypertension,18–20
of hyperthyroidism,292–293
of hypoglycemia,261–262
of hypokalemia,275–277,
277of hypomagnesemia,280–281
of hyponatremia,267,
268, 269
of hypotension,26–28,
27of hypothyroidism,289–290
of kidney injury, acute,321–326,
315,
322,
323of liver function,309–310
of myocarditis and cardiomyopathy,345–347
of nausea and vomiting,193–196
of neutropenia/agranulocytosis,372–374
of NMS,353–354
of orthostasis,28–31
of QTc prolongation and torsades de pointes,338–339
of red eye,242
of rhabdomyolysis,362–363
of seizures,78, 82,
80of serotonin syndrome,357–358
of shortness of breath,136–139,
137of tachycardia,42–43
of thyroid storm,294
of urinary incontinence,217,
219–
222,
222,
223,
224, 226
of venous thromboembolism,380–383,
382,
383,
384of visual acuity, changes in,237
of weight gain and obesity, in adolescents,450–451
Asthma, shortness of breath and,132
Asymptomatic bacteriuria,215, 229
ATA.
See American Thyroid Association
ATN.
See Acute tubular necrosis
Atrial fibrillation,40,
41clinical presentation of,94–95
with rapid ventricular response,40
Atrial flutter,40
Atrioventricular blocks,44–46
Atrioventricular reentrant tachycardia (AVNRT),40–41
Atypical anorexia nervosa (AAN),445, 446
AUR.
See Acute urinary retention
Automated external defibrillator (AED), use in cardiopulmonary emergencies,389, 393, 395
AVNRT.
See Atrioventricular reentrant tachycardia
Avoidant/restrictive food intake disorder (ARFID),445
Azithromycinfor treatment of chancroid,457
for treatment of chlamydia,460
for treatment of gonorrhea,460
Azoles, for treatment of vulvovaginal candidiasis,458
Bacillus cereus,188
Baclofen, for treatment of GERD,182Bacterial infectionsas cause of rhabdomyolysis,361as cause of transient neutropenia,369Bacterial vaginosis, in adolescents,458–459
Baker’s cyst, ruptured, as condition associated with unilateral edema and,149Bariatric surgery, in adolescents,451
Barthel Index,475Barth syndrome,370Basal-bolus insulin regimen,256
Beck Depression Inventory,155
Beers Criteria for Potentially Inappropriate Medication Use in Older Adults,477
Behaviorinterventions for alcohol withdrawal syndrome,436–438
management of weight gain and obesity, in adolescents,450
Behavioral and psychological symptoms of dementia (BPSD),472
BEN.
See Benign ethnic neutropenia
Benign ethnic neutropenia (BEN),368
Benzodiazepinesassociated with hyponatremia,270causing urinary incontinence and/or retention,225for management of delirium,409
for treatment of alcohol withdrawal,435,
436,
437Berlin Questionnaire,157,
159Beta-blocker, for treatment of thyrotoxicosis,293
Biguanides, for management of diabetes mellitus,258Bipolar disorderclinical presentations,23
of headaches and,53–54
ECT and,413
shortness of breath and,129–130
Bladderdecompression of,227, 230
overactive,222
Blepharitis,241Blindness,7
Blood, in the stooldifferential diagnosis of,205–207
frank,205–206
occult,205–206
risk stratification and assessment and management in psychiatric settings,209
BN.
See Bulimia nervosa
Bowel habit changesclinical presentation of,201–202
differential diagnosis of,202–206
blood in the stool,205–206
constipation,203–205,
205diarrhea,202–203,
204risk stratification and assessment and management in psychiatric settings,206–209
algorithm for management of psychiatric patients with constipation,210algorithm for treatment of,208blood in the stool,209
constipation,207–209
BPSD.
See Behavioral and psychological symptoms of dementia
Bradycardiaatrioventricular blocks,44–46
causes of,45clinical presentation of,43–44
definition of,44
differential diagnosis of,44–46
first-degree atrioventricular block,44–45
indications for cardiac pacing,49interventions and management of,48risk stratification of,46–47,
46,
47second-degree atrioventricular block,45–46
sinus bradycardia,44
symptoms associated with,48third-degree atrioventricular block,46
treatment and management in psychiatric settings,47
Brain.
See also Cognition
abscess as cause of headache,61
Breast cancer, shortness of breath and,129–130
Breathing disorders, sleep-related,156–157
“Broken-heart syndrome,” shortness of breath and,132
Bulimia nervosa (BN),445
Caffeine, for management of headache,60
Calcium, as cause of constipation,205
Calcium channel blockers, causing urinary incontinence and/or retention,225Candida albicans,458
Cannabinoid hyperemesis syndrome,191, 196
Capacity, description of,480–481
Captodiame, for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437Carbamazepine, for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437Cardiac arrest rhythms,391Cardiac ischemia, chest pain and,121
Cardiac medicationswith increased risk in the elderly,478–
479Cardiac pacing, indications for,49Cardiac tamponade, chest pain and,119
Cardiomyopathyassessment and management in psychiatric settings,345–347
clinical presentation of,343–344
description of,345
differential diagnosis of,344
findings supporting diagnosis of suspected clozapine-induced myocarditis or,346risk stratification of,344
Cardiopulmonary emergencies.
See also Emergency department
assessment and management in psychiatric settings,393–396
clinical presentation of,389–391
cardiac arrest rhythms,391CPR in,393–394
differential diagnosis of,391–392
life support sequence,394risk stratification of,392–393
Cardiopulmonary resuscitation (CPR), in cardiac emergencies,393–394
Cardiovascular drugs, as cause of abnormal liver function tests,305Cardiovascular syncope,105–106,
108Cartilage-hair hypoplasia,370Catatonia, versus NMS,352
CDC.
See Centers for Disease Control and Prevention
Ceftriaxonefor treatment of chancroid,457
for treatment of gonorrhea,460
Celiac sprue,302Cellulitisconditions associated with unilateral edema and,149edema and,147
Centers for Disease Control and Prevention (CDC),455
Central pontine myelinolysis,267
Central sleep apnea syndrome,156–157
Cervicitis,216CFS.
See Chronic fatigue syndrome, in adolescents
Chalazion,241Chancroid, in adolescents,457
Chédiak-Higashi syndrome,370Chemotherapy.
See also Medications
implicated in drug-related fever and hyperthermia,8nausea and vomiting with,191
CHEST guideline,382–383
Chest pain.
See also Pain
assessment and management in psychiatric settings,122, 124
clinical presentation of,117
differential diagnosis of,118–122,
120presenting findings of acute myocardial infarction, by sex,118risk stratification of,122
ECG findings that prompt an immediate visit to the ED,125findings in patients complaining of associated diagnoses and,123–
124life-threatening conditions presenting with,126Children.
See also Adolescents
QTc prolongation and torsades de pointes in,337
Chlamydia, in adolescents,459–460
Chlamydia trachomatis,459–460
Chloral hydrate, adverse effects and QTc prolongation and torsades de pointes with,333
Chlorpromazine, adverse effects and QTc prolongation and torsades de pointes with,332
Cholesterol reduction drugs, as cause of abnormal liver function tests,305Chronic dyspnea,135
Chronic fatigue syndrome (CFS), in adolescents,454–455
Chronic obstructive pulmonary disorder, shortness of breath and,129–130, 132
Chronic systolic congestive heart failure, shortness of breath and,129–130
Chronic venous insufficiency, conditions associated with unilateral edema and,149CIGH.
See Clozapine-induced gastrointestinal hypomotility
Ciprofloxacin, for treatment of chancroid,457
Cirrhosis, differential diagnosis of edema and,145Citalopramadverse effects and QTc prolongation and torsades de pointes with,333
QTc prolongation produced by,334CIWA-Ar.
See Clinical Institute Withdrawal Assessment for Alcohol—Revised
Clinical Institute Withdrawal Assessment for Alcohol—Revised (CIWA-Ar),433, 435
Clinical presentationsof abdominal pain and heartburn,169–170
of abnormal fever,3–4
of abnormal hypertension,15–16
of acute urinary retention,226
of adverse events associated with ECT,413–414
of agitation,399–400
of alcohol withdrawal syndrome,429–431
of Alzheimer’s dementia,403–404
of anxiety,103–104
of atrial fibrillation,94–95
atypical, in older adults,467
of bowel habit changes,201–202
of bradycardia,43–44
of cardiopulmonary emergencies,389–391
of chest pain,117
of delirium,403–405
of dementia,85
of dysuria and urinary frequency associated with urinary tract infection,213–214
of eating disorders, in adolescents,444
of edema,143–144
of eye pain,243
of falls,85
of fatigue, in adolescents,451–452
of geriatric medicine,465–470
of headache,53–55
of head trauma,94–95
of hyperglycemia,251–254
of hypernatremia,269
of hyperthyroidism,291
of hypoglycemia,257, 259–260
of hypokalemia,271, 273
of hypomagnesemia,277,
278of hyponatremia,265–266
of hypotension,23–24, 26–28,
27of hypothyroidism,285–286
of kidney injury, acute,313–314,
315of liver function,299–300
of myocarditis and cardiomyopathy,343–344
of nausea and vomiting,187–188
of neutropenia/agranulocytosis,367–368
of NMS,350–352
of obstructive sleep apnea,153–156
of psychosis,67–68, 85
of QTc prolongation and torsades de pointes,331–332
of red eye,240
of rhabdomyolysis,358–359
of seizures,67–69
of serotonin syndrome,354–356
of shortness of breath,129–130
of STIs in adolescents,455–456
of syncope,103–104
of tachycardia,37–38
of urinary incontinence,218–219
of venous thromboembolism,377–378
of visual acuity, changes in,235
of weight gain and obesity, in adolescents,448
Clomipramine, adverse effects and QTc prolongation and torsades de pointes with,333
Clostridium difficile, as cause of diarrhea,207
Clozapineassociation with hypertension,16
as cause of AIN,318
drug-induced neutropenia/agranulocytosis,368
fever as side effect of,7–8
fever induced by,13
findings supporting diagnosis of clozapine-induced myocarditis or cardiomyopathy,346myocarditis/cardiomyopathy and,347
Clozapine-induced gastrointestinal hypomotility (CIGH), as cause of constipation,205
Cluster headachedescription of, 6464treatment for,64
Cochrane review,436, 437
Cognition.
See also Brain
decline in,399–400
deficits in,226
ECT and delirium,415
in the elderly,467
elderly assessment of,475Cognitive-behavioral therapy, for fatigue in an adolescent,451–452
Cohen syndrome,370Colchicine, causing rhabdomyolysis,360Compartment syndrome, associated with unilateral edema and,149Computed tomography (CT) scan,4
use of contrast for specific causes of abdominal pain,179Confusion Assessment Method,475Congestive heart failuredifferential diagnosis of edema and,145shortness of breath and,130, 132
Conjunctivitis,240,
241, 246
Constipationalgorithm for management of psychiatric patients with,210causes of,211
definition of,202
differential diagnosis of,203–205,
205normal-transit,209
risk stratification and assessment and management in psychiatric settings,207–209
treatment of,211
Continuous positive airway pressure (CPAP),155
for treatment of obstructive sleep apnea,162–163
Corneachanges in visual acuity and,238damage to,242,
245Coronary artery disease, shortness of breath and,129–130
Coronary vasospasm, chest pain and,119
Corticosteroidsthat can cause rhabdomyolysis,360for treatment of inflammatory/vasculitic headache,60
for treatment of nausea and vomiting,197CPAP.
See Continuous positive airway pressure
CPR.
See Cardiopulmonary resuscitation
Crackles,138
C-reactive protein (CRP),8–9
CRP.
See C-reactive protein
CT.
See Computed tomography scan
Cyamemazine, for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437Cyclosporine, that can cause rhabdomyolysis,360Dacryocystitis, characteristics and treatment of,245Deathfrom falls,95
sudden cardiac,392–393
Decongestants, for treatment of sinusitis,61
Deep vein thrombosis (DVT)conditions associated with unilateral edema and,149edema and,147
Delirium.
See also Agitation
assessment and management in psychiatric settings,408–409
algorithm for,410clinical presentation of,403–405
definition of,473
versus dementia,404–405
differential diagnosis of,405–407
DSM-5 definition of,404
in the elderly,473
etiologies to be considered,406as risk factor for falls,87
risk stratification of,408
factors in development of delirium,409Dementiaclinical presentations of,85, 214, 240, 399–400
versus delirium,404–405
in the elderly,471–473
Dental workas cause of fever,6
good oral hygiene to prevent neutropenia,372
Deprescribing,477,
480Depressionclinical presentationsof abdominal pain and heartburn in patient with,169–170
of abnormal visual acuity and,235
of eye pain,243
with prolonged QTc and,331–332
of weight gain and obesity in an adolescent,448
in the elderly,465, 470–471
late-life,470
Desipramine, adverse effects and QTc prolongation and torsades de pointes with,333
Detemir, for management of diabetes mellitus,257Dexamethasone, for treatment of nausea and vomiting,196,
197Diabetes mellitus type2, 214
clinical presentations of,251–254, 399–400
nausea and vomiting in a patient with,187–188
commonly used medications for management of,258medications with increased risk in the elderly,479Diabetic agents, as cause of abnormal liver function tests,305Diabetic ketoacidosis (DKA),252
characteristics of,253shortness of breath and,133
Dialysis,275.
See also Potassium
DIAPPERS,229
Diarrheaacute episode of,202
causes of,209,
204chronic,202
differential diagnosis of,202–203,
204reasons for transfer to ED,211
Differential diagnosesof abdominal pain and heartburn,170–174
of acute urinary retention,226–227,
227of agitation,400,
401of alcohol withdrawal syndrome,431
of bowel habit changes,202–206,
204,
205of bradycardia,44–46
of cardiopulmonary emergencies,391–392
of chest pain,118–122,
120of delirium,405–407
of dysuria and urinary frequency associated with urinary tract infection,215–216,
216of eating disorders, in adolescents,445
of edema,144–150
of eye pain,244,
245of fatigue, in adolescents,452–455
of fever,4–10
in geriatric medicine,470–474
of headache,55,
56of head trauma,95–96
of hyperglycemia,254
of hypernatremia,270–271
of hypertension,16–17
of hyperthyroidism,291
of hypokalemia,273–275
of hypomagnesemia,278–280
of hyponatremia,266–267
of hypotension,24–26
of hypothyroidism,286,
287of kidney injury, acute,314–320,
316,
317of liver function,300–308
of myocarditis and cardiomyopathy,344
of nausea and vomiting,188–192,
189–
190of neutropenia/agranulocytosis,368–371,
369,
370of NMS,352–353,
353of obstructive sleep apnea,156–157
of QTc prolongation and torsades de pointes,332–335
of red eye,240,
241of rhabdomyolysis,360
of seizures,69–74
of serotonin syndrome,357
of shortness of breath,130–135,
131–
132of STIs in adolescents,456–461
of syncope,104–105
of tachycardia,38–41,
42of venous thromboembolism,378,
379of visual acuity, changes in,237,
238of weight gain and obesity, in adolescents,449
Dihydroergotamine, for treatment of migraine headache,62
DILI,309
Dimenhydrinate (Dramamine), for treatment of nausea and vomiting,197Dipeptidyl peptidase–4 inhibitors, for management of diabetes mellitus,
258Diphenhydramine (Benadryl), for treatment of nausea and vomiting,197Diphenhydramine, for management of obstructive sleep apnea,164
Direct oral anticoagulants (DOACs),382
Distal esophageal spasm, chest pain and,121
Diuretics, causing urinary incontinence and/or retention,225DKA.
See Diabetic ketoacidosis
DOACs.
See Direct oral anticoagulants
Dolasetron, for treatment of nausea and vomiting,197Dopamine receptor antagonists, for treatment of nausea and vomiting,197Doxepinfor management of obstructive sleep apnea,164
QTc prolongation produced by,334Doxycycline, for treatment of chlamydia,460
Doxylamine, for management of obstructive sleep apnea,164
DRESS,345
Dronabinol, for treatment of cannabinoid hyperemesis syndrome,196
Droperidoladverse effects and QTc prolongation and torsades de pointes with,332
for treatment of nausea and vomiting,197Drug fever,7
Drug-related fever, drugs implicated in,8Drugs.
See Medications; individual drug names
DSM-5definition of delirium,404
diagnostic criteria for eating disorders,461–462
Duloxetine, QTc prolongation produced by,334DVT.
See Deep vein thrombosis
Dyskeratosis congenita,370Dyspneaacute,135
acute on chronic,135
assessment of patient with,137chronic,135
differential diagnosis of,130–135,
131–
132Dysuria.
See Urinary tract infection, dysuria and urinary frequency associated with
EARS.
See Employee Assistance Resource Services Recovery Program
Eating disorders, in adolescentsclinical presentation of,444
differential diagnosis of,445
DSM-5 diagnostic criteria for,461–462
management of,447–448
prognosis of,448
risk stratification of,445–447
ECG.
See Electrocardiogram
ECT.
See Electroconvulsive therapy, adverse events associated with
ED.
See Emergency department
Edemaassessment and management in psychiatric settings,150
clinical presentation of,143–144
description of,150
differential diagnosis of,144–150
conditions associated with,149drugs known to induce edema,148generalized/bilateral edema,144–147,
145–
146localized/unilateral edema,147–150
etiology of,144risk stratification of,150,
151Elderly.
See also Agitation; Delirium; Geriatric medicine, topics for the mental health practitioner
abuse in,473–474
advanced planning for,481
falls and,86, 89–90
frailty in,470
medical considerations for,481
medical outcomes of patients in psychiatric settings,466
nonpharmacological approach to depression in,472–473
normal aging,467
“orphans,”467
physiological changes due to aging,468prevalence of orthostatic hypotension in,28–29
QTc prolongation and torsades de pointes in,337–338
red eye in,240
transitions of care in,477, 480
urinary tract infection in men,215
Electrocardiogram (ECG)for evaluation of hypotension,26
findings that prompt an immediate visit to the ED,125flowchart for categorizing types based on features of,39Electroconvulsive therapy (ECT), adverse events associated withclinical presentation of,413–414
effects and complications of,417medical evaluation prior to ECT,415, 418–420
medications continued during ECT,424mortality with,415
physiology and,414–415,
416–
417risk- and morbidity-related issues during course of ECT,425risk optimization prior to and during course of ECT,421, 423–424
risk stratification of,420–421,
421algorithm for risk assessment prior to ECT,422Electrolytes, abnormal.
See Hypernatremia; hypokalemia; Hypomagnesemia; Hyponatremia
Emergency department (ED).
See also Cardiopulmonary emergencies
bowel habit changes and reasons for transfer to,211
ECG findings that prompt an immediate visit to the ED,125for evaluation of syncope,106
nausea and vomiting requiring transfer to,194Employee Assistance Resource Services (EARS) Recovery Program,438
n1
Encephalitis, as cause of headache,61
Endocrine disorders, as cause of fever,5Endophthalmitis,242characteristics and treatment of,245End-organ damage,17
Enterococcus faecalis,6
Environmentas cause of unresponsiveness,110safe environment for the agitated patient,402–403, 411
Epilepsymedical disorders confused with,71–
72psychiatric disorders confused with,74signs and symptoms differentiating psychogenic nonepileptic seizures from epileptic seizures,74Epinephrine, for management of shortness of breath,138
Episcleritis,241Epworth Sleepiness Scale,157,
159Erythrocyte sedimentation rate (ESR),7
Erythromycin, for treatment of chancroid,457
Escherichia coli,214
ESR.
See Erythrocyte sedimentation rate
Essential hypertension, description of,17–18
Eye lens, changes in visual acuity and,238Eyelids, changes in visual acuity and,238Eye pain.
See also Pain
clinical presentation of,243
differential diagnosis of,244,
245management in psychiatric settings,244
risk factors and interventions of,236risk stratification of,244
Factitious disease, as cause of fever,6, 9
Factitious edema,150
Falls.
See also Head trauma
assessment and management in psychiatric settings,89–94
after the fall,90, 92
before the fall,89–90,
91follow-up after a fall,92,
93, 94
clinical presentation of,85
as complication of ECT,419–420
death from,95
in the elderly,86, 89–90
etiology,86,
87risk stratification of,86–88
risk factors leading to hospitalization with schizophrenia spectrum disorder,89risk factors most consistently associated with falls,88Famciclovir, for treatment of genital herpes,457
Familial Mediterranean fever,6Fanconi anemia,370Fatigue, in adolescentsclinical presentation of,451–452
differential diagnosis of,452–455
chronic fatigue syndrome,454–455
medical and psychological causes of,453
sleep deficits,452–453
sleep disorders,454
Felty’s syndrome,371
Fever.
See also Vital signs, abnormal
as abnormal vital sign,3–14
See also Infections
approach to acute febrile episodes in psychiatric patients,12assessment and management in psychiatric settings,11
clinical presentation of,3–4
common causes of,5–
6differential diagnosis of,4–10
drugs implicated in drug-related fever and hyperthermia,8risk stratification of,10
Fever of unknown origin (FUO),4, 7
First-degree atrioventricular block,44–45
5-2-1-0 program,450
Fluconazole, for treatment of vulvovaginal candidiasis,458
Fludrocortisone, for treatment of orthostatic hypotension,32Fluoxetine, QTc prolongation produced by,334“Focal to bilateral tonic-clonic seizure,”69
FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols),181
Foreign bodies, in the eye,243,
245Frailty, in the elderly,470
Frustration,402.
See also Agitation
FUO.
See Fever of unknown origin
Gardnerella vaginalis,458, 459
Gastroesophageal reflux disease (GERD)alarm symptoms for,183chest pain and,118
treatment of,181–182,
182GCS.
See Glasgow Coma Scale
Generalized/bilateral edema,144–147, 151,
145–
146GERD.
See Gastroesophageal reflux disease
Geriatric Depression Scale,475Geriatric medicine, topics for the mental health practitioner.
See alsoElderly
assessment and management in psychiatric settings,474–481,
475advanced care planning/family meeting,481
informed consent,480–481
polypharmacy,476–477,
478–
479steps of deprescribing,480transitions of care,477, 480
atypical presentations in older adults,467
clinical presentation of,465–470
demographics,466
differential diagnosis of,470–474
Alzheimer’s disease and related dementias,471–473
delirium,473
depression in the elderly,470–471
elder abuse,473–474
substance use disorders,474
suicide,471
geriatric syndromes,470
medical outcomes of elderly patients in psychiatric settings,466
normal aging,467
physiological changes due to aging,468–
469Geriatric syndromes,470
Glargine, for management of diabetes mellitus,257Glasgow Coma Scale (GCS),96,
97Glucagon-like peptide–1 agonists, for management of diabetes mellitus,
258Glycogen storage disease, type1B,
370Gonorrhea, in adolescents,460
Granisetron, for treatment of nausea and vomiting,197Graves’ disease,291–292,
294Griscelli syndrome, type2,
370Guillain-Barré syndrome, shortness of breath and,134
Haemophilus ducreyi,457
Haemophilus influenzae,6
Hallucinations, seizures and,73
Haloperidoladverse effects and QTc prolongation and torsades de pointes with,332
for treatment of agitation,403
for treatment of nausea and vomiting,197Hamilton Rating Scale for Depression,155
Hashimoto’s hypothyroidism,285
Headache.
See also Head trauma
assessment and management in psychiatric settings,55–64
algorithm for assessment of headache,58attributed to substance use or withdrawal,61
clinical presentation of,53–55
cluster,64
differential diagnosis of,55,
56due to decreased intracranial pressure,60
due to increased intracranial pressure,59–60
due to intracranial hemorrhage,59
due to mass lesion,58–59
ECT and,425infectious causes of,61
inflammatory/vasculitic,60
migraine,62–63
posttraumatic,60
prevalence of,54
primary,62–64
risk stratification of,55,
57,
59secondary,57–61
tension-type,63
HEADSS (Home & Environment, Education & Employment, Activities, Drugs, Sexuality, Suicide/Depression) assessment,122
Head trauma.
See also Falls; Headache
assessment and management in psychiatric settings,98–99
clinical presentation of,94–95
differential diagnosis of,95–96
Glasgow Coma Scale,96,
97risk stratification of,96–97
subdural hemotomas and,95–96
Heartburn.
See also Abdominal pain and heartburn
approach to the patient with,183,
184Hemochromatosis,303Hemothorax, shortness of breath and,134
Hepatitisdifferential diagnosis of,302serological testing for the diagnosis of viral hepatitis,307Hepatobiliary iminodiacetic acid scan,4
Hermansky-Pudlak syndrome, type2,
370Herpes zoster, chest pain and,121
Herpes simplex, in adolescents,456–457
HHS.
See Hyperosmolar hyperglycemic state
Histamine type-2 blocker, for treatment of GERD,182HIV, in adolescents,461
Hormones. as cause of abnormal liver function tests,305HPV.
See Human papillomavirus infection, in adolescents
Human papillomavirus (HPV) infection, in adolescents,456
Hunter Serotonin Toxicity Criteria,364
Hyperbilirubinemia, common etiologies of,304Hyperglycemiaassessment and management in psychiatric settings,255–257
commonly used diabetes medications,258pharmacokinetics of insulin preparations,257rapid-acting insulin dosing for correction of hyperglycemia,256weight-based calculation of insulin requirements,257clinical presentation of,251–254
characteristics of DKA and HHS,253diagnostic features of prediabetes and diabetes mellitus,252differential diagnosis of,254
ECT and,425risk stratification of,254–255
Hyper-IgM syndrome,370Hyperkalemia, ECT and,425Hypernatremiaapproach to,272assessment and management in psychiatric settings,271
clinical presentation of,269
differential diagnosis and risk stratification of,270–271
symptoms of,269
Hyperosmolar hyperglycemic state (HHS),252
characteristics of,253Hyperpyrexia, description of,4
Hypertension.
See also Vital signs, abnormal
as abnormal vital sign,13–22
assessment and management in psychiatric settings,18–19
clinical presentations of,15–16, 218, 299–300
description of,15–16
differential diagnosis of,16–17
levels as defined in American College of Cardiology/American Heart Association guidelines,18pharmacological management of arterial hypertension,21“resistant,”155
risk stratification of,17–18
Hypertensive crisis, description of,17
Hypertensive emergency, description of,17
Hypertensive urgency, definition of,17
Hyperthermiaas cause of fever,6description of,4
drug-induced,7, 10
drugs implicated in drug-related fever and,8Hyperthermia syndrome,10
Hyperthyroidismassessment and management in psychiatric settings,292–293
clinical presentation of,291
differential diagnosis of,291
etiologies of,294physical signs of,293risk stratification of,291–292
symptoms of,292Hypertonic hyponatremia,266
Hypoglycemiaalgorithm for management of hypoglycemia,262assessment and management in psychiatric settings,261–262
clinical presentation of,257, 259–260
psychotropic drugs increasing risk of,261risk stratification of,261
symptoms of,260Hypokalemia.
See also Potassium
assessment and management in psychiatric settings,275–277,
277clinical presentation of,271, 273
definition of,271
differential diagnosis of,273–275
laboratory investigations of,276
risk stratification of,275
treatment of,276–277
Hypomagnesemiaassessment and management in psychiatric settings,280–281
clinical presentation of,277,
278common causes of,279differential diagnosis of,278–280
risk stratification of,280
treatment of,281
Hyponatremiaassessment and management in psychiatric settings,267,
268, 269
clinical presentation of,265–266
differential diagnosis and risk stratification of,266–267
psychiatric medications associated with,270symptoms associated with,266
Hypopnea,154
Hypotensionas abnormal vital sign,23–35
algorithm for assessment and treatment of,27assessment and management in psychiatric settings,26–28,
27causes of shock and,32,
25clinical presentation of,23–24
definition of,23–24, 32
differential diagnosis of,24–26
hemodynamic compromise and,49
symptoms of,24
Hypothyroidismassessment and management in psychiatric settings,289–290
clinical presentation of,285–286
definition of,286
description of,296
differential diagnosis of,286,
287edema and,145myxedema coma,290
physical signs of,287risk stratification of,286–289,
288symptoms of,286Hypotonic hyponatremia,266–267
Hypovolemia, as cause of hypotension,24
I-131.
See Radioactive iodine
Ibuprofen, for treatment of rheumatoid arthritis,23
ILAE.
See International League Against Epilepsy
Illicit drugs, as cause of abnormal liver function tests,305Imipramine, QTc prolongation produced by,334Immune disorders, as cause of transient neutropenia,369Immunosuppressants, adverse effects and QTc prolongation and torsades de pointes with,334
IMPROVE VTE calculator,384
Infections,4.
See also Sexually transmitted infections, in adolescents
as cause of fever,5as cause of headache,61
as cause of rhabdomyolysis,361as cause of transient neutropenia,374,
369as cause of unresponsiveness,110shortness of breath and,132–133
Inflammatory/vasculitic headache,60
Informed consent,480–481
Insomnia.
See also Obstructive sleep apnea
in adolescents,454
pharmacological management of,163–164
Insulinbasal-bolus insulin regimen,256
pharmacokinetics of insulin preparations,257rapid-acting dosing for correction of hyperglycemia,256weight-based calculation of requirements for hyperglycemia,257International Headache Society, diagnostic criteria,63
International League Against Epilepsy (ILAE), classification of seizure types,68–69
Intracranial hemorrhage, headache due to,59–60
algorithm for evaluation of,325evaluation of,323Intrinsic acute kidney injury,316–320,
317algorithm for evaluation of,325evaluation of,323Iron, as cause of constipation,205
Ischemic heart disease,63
Isolated neutropenia,370Isotonic hyponatremia,266
Janeway lesions,6
Jaundice,308
JNC.
See Joint National Committee
Joint National Committee (JNC8), 17, 18
Kidney injury, acuteassessment in psychiatric settings,321–323
laboratory investigations,321–322,
322,
323radiological evaluation,322–323
classification of,314,
315clinical presentation of,313–314,
315definition of,314
differential diagnosis of,314–320
acute glomerulonephritis,319
acute interstitial nephritis,318–319,
319intrinsic acute kidney injury,316–318,
317postrenal acute kidney injury,320
prerenal acute kidney injury,314–315,
316vascular injury,319–320
management in psychiatric settings,323–326
algorithm for evaluation of,325renal replacement therapy,326
risk factors for,321
risk stratification of,320–321
treatment of,324
Kussmaul breathing,133–134
Laboratory findings, abnormalelectrolyte abnormalitiesassessment and management in psychiatric settings,280–281
hypernatremiaapproach to,272assessment and management in psychiatric settings,271
clinical presentation of,269
differential diagnosis and risk stratification of,270–271
hypokalemiaassessment and management in psychiatric settings,275–277,
277clinical presentation of,271, 273
differential diagnosis of,273–275
risk stratification of,275
hypomagnesemiaclinical presentation of,277,
278common causes of,279differential diagnosis of,278–280
hyponatremiaassessment and management in psychiatric settings,267, 269,
268clinical presentation of,265–266
differential diagnosis and risk stratification of,266–267
psychiatric medications associated with,270risk stratification of,280
hyperglycemiaassessment and management in psychiatric settings,255–257
commonly used diabetes medications,258pharmacokinetics of insulin preparations,257rapid-acting insulin dosing for correction of hyperglycemia,256weight-based calculation of insulin requirements,257clinical presentation of,251–254
characteristics of DKA and HHS,253diagnostic features of prediabetes and diabetes mellitus,252differential diagnosis of,254
risk stratification of,254–255
hypoglycemiaassessment and management in psychiatric settings,261–262
algorithm for management of hypoglycemia,262clinical presentation of,257, 259–260
psychotropic drugs increasing risk of,261risk stratification of,261
symptoms of,260kidney injury, acuteassessment in psychiatric settings,321–323
laboratory investigations,321–322,
322,
323radiological evaluation,322–323
clinical presentation of,313–314,
315differential diagnosis of,314–320
acute glomerulonephritis,319
acute interstitial nephritis,318–319,
319intrinsic acute kidney injury,316–318,
317postrenal acute kidney injury,320
prerenal acute kidney injury,314–315,
316vascular injury,319–320
management in psychiatric settings,323–326
algorithm for evaluation of,325renal replacement therapy,326
risk stratification of,320–321
liver functionassessment and management in psychiatric settings,309–310
clinical presentation of,299–300
differential diagnosis of,300–308
common etiologies of hyperbilirubinemia,304drugs that can cause abnormal liver function tests,304,
305–
306elevated serum transaminases,301–
303serological testing for the diagnosis of viral hepatitis,307
risk stratification of,308
thyroid functionhyperthyroidismassessment and management in psychiatric settings,292–293
clinical presentation of,291
differential diagnosis of,291
etiologies of,294physical signs of,293risk stratification of,291–292
symptoms of,292hypothyroidismassessment and management in psychiatric settings,289–290
clinical presentation of,285–286
differential diagnosis of,286,
287myxedema coma,290
physical signs of,287risk stratification of,286–289,
288symptoms of,286thyroid stormapproach to evaluation and management of,295diagnostic criteria for,295–
296management,294–296
overview,294
risk stratification and assessment of,294
Laryngospasm, shortness of breath and,133
Late-life depression, definition of,470
Lesions, headache due to,58–59
Levothyroxine (LT4, for treatment of hypothyroidism,289, 296
Lewy body disease,407
LFTs.
See Liver function tests
Lifestylechanges in the elderly,470–471
interventions in patients with prediabetes,255
modifications for treatment of constipation,211
modifications for treatment of hypertension,19–20
Life support sequence,394Liothyronine sodium (LT3), for treatment of hypothyroidism,289
Lipedema, differential diagnosis of edema and,146Lispro, for management of diabetes mellitus,257Listeria monocytogenes,6
Lithiumadverse effects and QTc prolongation and torsades de pointes with,333
myocarditis/cardiomyopathy and,345, 347
Liver, abnormal function ofassessment and management in psychiatric settings,309–310
clinical presentation of,299–300
differential diagnosis of,300–308
common etiologies of hyperbilirubinemia,304drugs that can cause abnormal liver function tests,304,
305–
306elevated serum transaminases,301–
303serological testing for the diagnosis of viral hepatitis,307liver function tests,300
risk stratification of,308
Liver function tests (LFTs),300
medications as cause of,309,
305–
306Localized/unilateral edema,144, 147–150, 151
Long QT syndrome (LQTS),335
Lorazepam, for treatment of agitation,403
LQTS.
See Long QT syndrome
LT3.
See Liothyronine sodium
LT4.
See Levothyroxine
Lubben Social Network Scale–6,
475Lymphedema,218
conditions associated with unilateral edema and,149edema and,148
Magnesiumgastrointestinal losses of,278
renal losses of,278–280
Malignant hyperthermia, fever and,10
Malnutrition, severe, differential diagnosis of edema and,145Medications.
See also Antiarrhythmic medications; Antihypertensive medications; Antipsychotic medications; Antiseizure medications; Chemotherapy; Seizures
associated with rhabdomyolysis,360associated with serotonin syndrome,356as cause of constipation,203–204
as cause of transient neutropenia,369as cause of unresponsiveness,109as cause of urinary incontinence and/or retention,225commonly used oral diabetes medications,258continued during ECT,424drug-induced neutropenia,373–374
drug-related issues with agitation,401edema and,151,
148implicated in AIN,319implicated in drug-related fever and hyperthermia,8with increased risk of adverse drug events in the elderly,478–
479interactions between antiepileptic drugs and psychotropic medications,78for management of delirium,408–409
for management of obstructive sleep apnea,163–164
obstructive sleep apnea and,163–164
pharmacological intervention for alcohol withdrawal intervention,435–436,
436,
437pharmacological management of arterial hypertension,21polypharmacy in the elderly,476–477,
478–
479psychiatric medications associated with hyponatremia,270psychotropic medications causing orthostatic hypotension,31QTc prolongation and torsades de pointes with,333,
334reconciliation,480
steps of deprescribing,480that can cause abnormal liver function tests,304,
305–
306that can cause rhabdomyolysos,360for treatment of nausea and vomiting,191
for treatment of orthostatic hypotension,32for weight gain and obesity, in adolescents,450–451
Meglitinides, for management of diabetes mellitus,258Melatoninfor management of delirium,411
for management of obstructive sleep apnea,164
Menpresenting findings of AMI,118prostatitis in,216urinary tract infection in,215–216,
219Meningitis, as cause of headache,61
Mental health disordersadolescent topics for the mental health practitioner,443–444
obstructive sleep apnea and,155–156
Mental health practitioneradolescent medicine topics for,443–444
geriatric medicine topics for,465–481
Mental statusaltered,94–95
decompensation of,350
nausea and vomiting with altered state,193
Metabolic encephalopathy, as cause of unresponsiveness,109Metforminfor management of diabetes mellitus,251
for treatment of obese children and adolescents,450–451
Methimazole, for treatment of thyrotoxicosis,293
N-methyl-D-aspartate receptor antibody–associated limbic encephalitis,73
Metoclopramidefor treatment of GERD,182for treatment of nausea and vomiting,196
Midodrine, for treatment of orthostatic hypotension,32Migraine headache,62–63
characterization of,62
preventive treatment for,63
without aura,62
Mini-Cog,475Mini-Mental State Examination,475Mirtazapine, for management of obstructive sleep apnea,164
Montreal Cognitive Assessment,475Mood disorders, hypothyroidism and,288
associated with a higher risk of seizure,76associated with hyponatremia,270increasing risk of hypoglycemia,261Multiple sclerosis, shortness of breath and,134
Myasthenia gravis, shortness of breath and,134
Myelodysplasia,370Myocarditisassessment and management in psychiatric settings,345–347
clinical presentation of,343–344
description of,345
differential diagnosis of,344
findings supporting diagnosis of suspected clozapine-induced cardiomyopathy or,346risk stratification of,344
signs and symptoms of,347
Myonecrosis,317
MyPlate guidelines,450
Myxedemacoma,290
differential diagnosis of edema and,145NAATS.
See Nucleic acid amplification tests
Narcolepsy, in adolescents,454
Narcotics Anonymous,437
National Epidemiologic Survey on Alcohol and Related Conditions III,430
National Institute for Clinical Excellence,472
Nausea and vomitingassessment and management in psychiatric settings,193–196
diagnostic investigations,195–196
clinical presentation of,187–188
description of,188
differential diagnosis of,188–192,
189–
190ECT and,425risk stratification of,193
alarm signs for patients with nausea and vomiting,195features requiring transfer to the ED,194treatment of,196,
197Near-syncope,104
Neisseria gonorrhoeae,460
Neisseria meningitidis,6, 240
Neoplastic disease, as cause of fever,5, 7
Nephrotic syndromedifferential diagnosis of edema and,145Neurocardiogenic (neurally mediated) syncope,104–105,
106Neuroleptic malignant syndrome (NMS),4
assessment and management in psychiatric settings,353–354
clinical presentation of,350–352
as complication of treatment with antipsychotic rugs,10
diagnosis of,351
differential diagnosis of,352–353, 363,
353risk stratification of,353
Neutral protamine Hagedorm (NPH)for management of diabetes mellitus,257Neutropeniaadverse effects of drugs andassessment and management in psychiatric settings,372–374
clinical presentation of,367–368
differential diagnosis of,368–371
cause of transient neutropenia,369causes of chronic neutropenia,370preventive measures of,372–373
risk stratification of,371–372
assessment and management in psychiatric settings,373
drug-induced,373–374
fever and,7, 371, 373, 374
Neutropenic fever,371, 373, 374
Nightmares,155
NMS.
See Neuroleptic malignant syndrome
Nonbenzodiazepine agentsfor management of obstructive sleep apnea,153
Noninfectious inflammatory diseases, as cause of fever,7,
5Nonpitting edema,143
Nonsteroidal anti-inflammatory drugs, causing urinary incontinence and/or retention,225Nortriptylineadverse effects and QTc prolongation and torsades de pointes with,333
QTc prolongation produced by,334NPH.
See Neutral protamine Hagedorm
Nucleic acid amplification tests (NAATs),459
Nutritiondeficiencies and chronic neutropenia,370
management of weight gain and obesity, in adolescents,450
nausea and vomiting with food overconsumption,192
for rhabdomyolysis,363
Obesity.
See also Adolescents, weight gain and obesity
clinical presentations of,235, 377–378
Obesity-hypoventilation syndrome (OHS),156
Obstructive sleep apnea (OSA)assessment and management in psychiatric settings,162–164
effects of medications and substances,163–164
treatment considerations,162–163
clinical presentation of,153–156
differential diagnosis of,156–157
epidemiology of,154–155
mental health disorders and,155–156
morbidity and mortality with,164
other sleep-related breathing disorders,156–157
risk stratification of,157
referral for objective testing,157,
160–
161screening questionnaires,157,
159Obstructive sleep apnea–hypopnea syndrome (OSAHS),154
Octreotide, for treatment of orthostatic hypotension,32OH.
See Orthostatic hypotension
OHS.
See Obesity-hypoventilation syndrome
Olanzapinediabetes medications and,251
for management of delirium,409
for management of edema,143
for treatment of nausea and vomiting,197Ondansetron, for treatment of nausea and vomiting,197Opiates, causing urinary incontinence and/or retention,225Opioids, obstructive sleep apnea and,163
Opioid receptor antagonists (PAMORA),209
Optic nerve, changes in visual acuity and,239Optic neuritis, characteristics and treatment of,245Orbital cellulitis,242characteristics and treatment of,245Orthostasis.
See also Orthostatic hypotension
approach to a patient with orthostatic hypotension in an ambulatory setting,33assessment and management in psychiatric settings,28–31
etiologies of,30medications used to treat orthostatic hypotension,32nonpharmacological interventions to alleviate orthostatic hypotension,32as normal vital sign,23–35
psychotropic medications as cause of orthostatic hypotension,31Orthostatic hypotension (OH).
See also Orthostasis
approach to a patient in an ambulatory setting,33definition of,28, 33
etiologies of,30medications for treatment of,32nonpharmacological interventions to alleviate,32prevalence in older patients,28–29
symptoms of,29
syncope due to,105,
107treatment,31, 34
OSA.
See Obstructive sleep apnea
OSAHS.
See Obstructive sleep apnea—hypopnea syndrome
Osler nodes,6
Osmotic demyelination syndrome,267
Overflow incontinencedescription of,222
management of,226
“Overlap syndrome,”156
Pacemaker,423
Pain.
See also Abdominal pain and heartburn; Chest pain; Eye pain
colicky,173
duration of,173
in the lower back,117
Pain medicationsimplicated in drug-related fever and hyperthermia,8with increased risk in the elderly,478PAMORA.
See Opioid receptor antagonists
Panic disordersseizures and,73
treatment for,403
ParoxetineQTc prolongation produced by,334for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437PAWSS.
See Prediction of Alcohol Withdrawal Severity Scale
PD.
See Purging disorder
PE.
See Pulmonary embolism
Pearson syndrome,370Pediculosis pubis, in adolescents,457–458
Pelvic inflammatory disease,216Penicillin G, for treatment of syphilis,461
Pericarditis, chest pain and,119
Permethrin, for treatment of pediculosis pubis and scabies,457
Pharmacokinetics.
See also Medications
of insulin preparations,257Phenothiazines, for treatment of nausea and vomiting,196
Pimozide, adverse effects and QTc prolongation and torsades de pointes with,332
Pitting edema,143
PNES.
See Psychogenic nonepileptic seizures
Pneumoniachest pain and,120
shortness of breath and,132–133
Pneumothoraxchest pain and,120
shortness of breath and,133
POCUS.
See Point-of-care ultrasound
Point-of-care ultrasound (POCUS),380
Polysomnography (PSG), obstructive sleep apnea and,160–
161Postrenal acute kidney injuryalgorithm for evaluation of,325evaluation of,323Posttraumatic stress disorder (PTSD),155
Posttraumatic headache,60
Potassium.
See also Dialysis; Hypokalemia
deficit in,274
intracellular shift of,274
replacement of,276–277,
277PPI.
See Proton pump inhibitor therapy
Prediabetes.
See Hyperglycemia
Prediction of Alcohol Withdrawal Severity Scale (PAWSS),433
Pregabalin, for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437Pregnancy.
See also Women
algorithm for initial treatment of patient with a seizure,81differential diagnosis of edema and,146thyroid screening and,286–287
Prerenal acute kidney injury,314–315,
316algorithm for evaluation of,325evaluation of,323Preseptal cellulitis,242characteristics and treatment of,245Presyncope,104
Prevotella spp.,458
Primary headache,62–64
definition of,62
Primary hypertension, description of,17–18
Primary hypothyroidism, definition of,296
Prinzmetal’s angina,63
Prochlorperazine, for treatment of nausea and vomiting,196,
197Promethazine, for treatment of nausea and vomiting,186,
197Prostatis,216Proton pump inhibitor therapy (PPI)chest pain and,124
for treatment of GERD,182“Pseudoseizures,”69, 72
Pseudosyncope,106
PSG.
See Polysomnography
Psychogenic nonepileptic seizures (PNES)differentiation from epileptic seizures,75Psychosis, clinical presentations of,67–68, 85
Psychotropic drugs, adverse effects ofassociated with a higher risk of seizure,76as cause of orthostatic hypotension,31as cause of syncope,111
discontinuation of,338
fever and,7
hypoglycemia and,261implicated in drug-related fever and hyperthermia,8interactions between antiepileptic drugs and,78myocarditis and cardiomyopathyassessment and management in psychiatric settings,345–347
clinical presentation of,343–344
differential diagnosis of,344
findings supporting diagnosis of suspected clozapineinduced myocarditis or cardiomyopathy,346risk stratification of,344
neuroleptic malignant syndromeassessment and management in psychiatric settings,353–354
clinical presentation of,350–352
differential diagnosis of,352–353,
353risk stratification of,353
neutropenia and agranulocytosisassessment and management in psychiatric settings,372–374
general approach to,372
neutropenic fever,373
clinical presentation of,367–368
differential diagnosis of,368–371
causes of chronic neutropenia,370causes of transient neutropenia,369drug-induced neutropenia,373–374
preventive measures of,372–373
risk stratification of,371–372
QTc prolongation and torsades de pointesassessment and management in psychiatric settings,338–339
in children and adolescents,337
clinical presentation of,331–332
differential diagnosis of,332–335
in the elderly,337–338
produced by antidepressants,334risk stratification of,335–338
clinical features that increase risk for torsades de pointes,336rhabdomyolysisassessment and management in psychiatric settings,362–363
clinical presentation of,358–359
common causes of,361differential diagnosis of,360
medications and toxins that can cause,360risk stratification of,360–361
serotonin syndromeassessment and management in psychiatric settings,357–358
clinical presentation of,354–356
differential diagnosis of,357
drugs associated with,356risk stratification of,357
venous thromboembolismassessment and management in psychiatric settings,380–383
pulmonary embolism ruleout criteria,381,
383Wells criteria, modified, for pulmonary embolism,382Wells criteria for deep venous thrombosis,384clinical presentation of,377–378
differential diagnosis of,378,
379prophylaxis for,384
risk stratification of,378–379
PTSD.
See Posttraumatic stress disorder
Pulmonary contusion, shortness of breath and,134
Pulmonary edema, shortness of breath and,133
Pulmonary embolism (PE)chest pain and,120
in the elderly,378
rule-out criteria,381,
383shortness of breath and,132
Purging disorder (PD),445
Pyelonephritis, management in women,220–
221Pyridostigmine, for treatment of orthostatic hypotension,32QRS complexabnormal,41–42
normal,42,
42QTc prolongation, torsades de pointes andassessment and management in psychiatric settings,338–339
in children and adolescents,337
clinical presentation of,331–332
definition of,332
differential diagnosis of,332–335
in the elderly,337–338
produced by antidepressants,334risk stratification of,335–338
clinical features that increase risk for torsades de pointes,336treatment of,339
Quality of life, in the elderly,472
Quetiapineassociation with thrombotic thrombocytopenic purpura,320
myocarditis/cardiomyopathy and,345, 347
Radioactive iodine (I-131), for treatment of thyrotoxicosis,293
Ramelteon, for management of delirium,411
Rapid eye movement (REM) sleep,156
Red eyeclinical presentation of,240
differential diagnosis of,240,
241management in psychiatric settings,242
risk stratification of,240,
241Reflex-mediated syncope,104–105
Reflex sympathetic dystrophy,148, 150
Regurgitation, description of,188
REM.
See Rapid eye movement sleep
Renal artery occlusion, as cause of AKI,319–320
Renal replacement therapy,326
Renal vein occlusion, as cause of AKI,320
Retching, description of,188
Retina, changes in visual acuity and,238–
239Revised Cardiac Risk Index,420
Rhabdomyolysisassessment and management in psychiatric settings,362–363
clinical presentation of,358–359
common causes of,359, 360
description of,359
differential diagnosis of,360
management of,362–363
medications and toxins that can cause,360risk stratification of,360–361
Rheumatoid arthritis, clinical presentation of,23
Risk stratificationof abdominal pain and heartburn,174–176
of acute urinary retention,227, 229
of adverse events associated with ECT,420–421,
421,
422of agitation,400–402
of alcohol withdrawal syndrome,431, 433
of bowel habit changes,206–209,
208,
210of bradycardia,46–47,
46,
47of cardiopulmonary emergencies,392–393
of chest pain,122
findings in patients complaining of chest pain and associated diagnoses,123–
124of delirium,408
of dysuria and urinary frequency associated with urinary tract infection,216–217
of eating disorders, in adolescents,445–447
of edema,150,
151of eye pain,244
factors in development of delirium,409of falls,86–88,
88,
89of fever,10
of headache,55,
57,
59of head trauma,96–97
of hyperglycemia,254–255
of hypernatremia,270–271
of hypertension,17–18
of hyperthyroidism,291–292
of hypoglycemia,261
of hypokalemia,275
of hypomagnesemia,280
of hyponatremia,266–267
of hypothyroidism,286–289,
288of kidney injury, acute,320–321
of liver function,308
of myocarditis and cardiomyopathy,344
of nausea and vomiting,193, 195
of neutropenia/agranulocytosis,371–372
of NMS,353
of obstructive sleep apnea,157,
159–
161of red eye,240,
241of rhabdomyolysis,360–361
of seizures,77–78
of serotonin syndrome,357
of shortness of breath,135–136
of thyroid storm,294
of unresponsiveness,108–110
of urinary incontinence,222–223
of venous thromboembolism,378–379
of visual acuity, changes in,237
of weight gain and obesity, in adolescents,449
Risperidone, for management of delirium,409
Roth spots,6
Rumination, description of,188
Rumination syndrome,196
RVR.
See Rapid ventricular response
Sarcoptes scabiei,458
Scabies, in adolescents,457–458
Schimke immuno-osseous dysplasia,370Schizoaffective disorder,243, 299–300, 350
obstructive sleep apnea and,153–154
Schizophreniaclinical presentations of,3, 15, 37–38, 201–202, 213–214, 265–266, 313–314, 343–344, 358–359, 367–368
risk factors for falls and fractures leading to hospitalization in people with,89Scleritis,242characteristics and treatment of,245Scopalamine, for treatment of nausea and vomiting,197SDB.
See Sleep-disordered breathing
Secondary headache,57–61, 64
Secondary hypertension, description of,18
Second-degree atrioventricular block,45–46
definition of,45
type I,45
type II,45
Seizures.
See also Electroconvulsive therapy, adverse events associated with; Medications
algorithm for initial treatment of patient with,81–
82assessment and management in psychiatric settings,78, 82
approach to management of patient with,80causes of,79classification of,70clinical presentations of,67–69
definition of,68
description of,68–69
diagnosis of,68
differential diagnosis of,69–74
drug effects and,74–77
interactions between antiepileptic drugs and psychotropic medications,78psychotropic drugs associated with a higher risk of seizure,76“focal to bilateral tonic-clonic seizure,”69
hallucinations and,73
medical disorders that may be confused with epilepsy or seizures,71–
72panic disorder and,73
psychiatric disorders that may be confused with epilepsy,74psychogenic nonepileptic seizures, differentiation from epileptic seizures,75risk stratification of,77–78
signs and symptoms differentiating psychogenic nonepileptic seizures from epileptic seizures,74Selective serotonin reuptake inhibitors (SSRIs), QTc prolongation produced by,334Sepsis,4,
302description of,6–7, 13
Septic shock, definition of,7
Serotonin antagonists, for treatment of nausea and vomiting,197Serotonin-norepinephrine reuptake inhibitors (SNRIs)QTc prolongation produced by,334for treatment of depression in the elderly,471
Serotonin syndrome,4
adverse effects of drugs associated with,356assessment and management in psychiatric settings,357–358
clinical presentation of,354–356
description of,363
differential diagnosis of,357
in the elderly,471
as life-threatening conditions,355–356
risk stratification of,357
symptoms of,355
Sertindole, adverse effects and QTc prolongation and torsades de pointes with,333
Sertraline, QTc prolongation produced by,334Sexually transmitted infections (STIs), in adolescentsclinical presentation of,455–456
differential diagnosis and management of,456–461
bacterial vaginosis,458–459
chancroid,457
chlamydia,459–460
gonorrhea,460
herpes simplex,456–457
HIV,461
human papillomavirus infection,456
pediculosis pubis and scabies,457–458
syphilis,460–461
trichomoniasis,459
vulvovaginal candidiasis,458
Shortness of breathassessment and management in psychiatric settings,136–139,
137assessment of stability with,136clinical presentation of,129–130
differential diagnosis of,130–135,
131–
132risk stratification of,135–136
Shwachman-Diamond syndrome,370SIADH.
See Syndrome of inappropriate antidiuretic hormone secretion
Sinus bradycardia,44
Sinusitis, as cause of headache,61
Sinus tachycardia,49,
40Sjögren’s syndrome, as cause of AIN,318
of fatigue, in adolescents,452–453
Sleep-disordered breathing (SDB),454
Sleep disorders.
See also Fatigue, in adolescents; Insomnia; Obstructive sleep apnea
of fatigue, in adolescents,454
hygiene for,408
Sleeping pills, with increased risk in the elderly,478Sleep-wake cycle,40
Slimepiride, for management of diabetes mellitus,251
Snellen eye chart,475SNRIs.
See Serotonin-norepinephrine reuptake inhibitors
Society for Post-Acute and LongTerm Care Medicine,472
Sodium-glucose cotransporter 2 inhibitorsfor management of diabetes mellitus,258Somatic symptomsabdominal pain and heartburnassessment and management in psychiatric settings,176–182
alarm symptoms for GERD,183algorithm for evaluation and management of a patient with abdominal pain,180CT and use of contrast for specific causes of abdominal pain,179recommended imaging studies based on location of abdominal pain,178treatment of GERD,182clinical presentation of,169–170
differential diagnosis of,170–174
serious conditions producing abdominal pain, by location,171–
172serious conditions producing abdominal pain, by timing of onset,175outpatient considerations,182–183
risk stratification of,174–176
acute urinary retentionclinical presentation of,226
differential diagnosis of,226–227
227management in psychiatric settings,229,
228risk stratification of,227, 229
bowel habit changesclinical presentation of,201–202
differential diagnosis of,202–206
blood in the stool,205–206
constipation,203–205,
205diarrhea,202–203,
204risk stratification and assessment and management in psychiatric settings,206–209
algorithm for management of psychiatric patients with constipation,210algorithm for treatment of,208blood in the stool,209
constipation,207–209
chest painassessment and management in psychiatric settings,122, 124
clinical presentation of,117
differential diagnosis of,118–122,
120life-threatening conditions presenting with,126presenting findings of acute myocardial infarction, by sex,118risk stratification of,122
ECG findings that prompt an immediate visit to the ED,125findings in patients complaining of chest pain and associated diagnoses,123–
124dysuria and urinary frequency associated with urinary tract infectionclassifications of,215clinical presentations of,213–214
differential diagnosis of,215–216,
216risk stratification of,216–217
urinary tract infection in men,215–216
edemaassessment and management in psychiatric settings,150
clinical presentation of,143–144
differential diagnosis of,144–150
conditions associated with edema,149drugs known to induce edema,147,
148generalized/bilateral edema,144–147,
145–
146localized/unilateral edema,147–150
etiology of,144risk stratification of,150,
151eye painclinical presentation of,243
differential diagnosis of,244,
245management in psychiatric settings,244
risk stratification of,244
fallsassessment and management in psychiatric settings,89–94
after the fall,90, 92
before the fall,89–90,
91follow-up after a fall,92, 94,
93clinical presentation of,85
etiology,86,
87risk stratification of,86–88
risk factors leading to hospitalization with schizophrenia spectrum disorder,89risk factors most consistently associated with falls,88headacheassessment and management in psychiatric settings,55–64
algorithm for assessment of headache,58risk stratification of,59attributed to substance use or withdrawal,61
clinical presentation of,53–55
cluster,64
differential diagnosis of,55,
56due to decreased intracranial pressure,60
due to increased intracranial pressure,59–60
due to intracranial hemorrhage,59
due to mass lesion,58–59
infectious causes of,61
inflammatory/vasculitic headache,60
migraine,62–63
posttraumatic,60
primary,62–64
risk stratification of,55,
57secondary,57–61, 64
tension-type,63
head traumaassessment and management in psychiatric settings,98–99
clinical presentation of,94–95
differential diagnosis of,95–96
Glasgow Coma Scale,96,
97risk stratification of,96–97
nausea and vomitingassessment and management in psychiatric settings,193–196
diagnostic investigations,195–196
clinical presentation of,187–188
differential diagnosis of,188–192,
189–
190risk stratification of,193
alarm signs for patients with nausea and vomiting,195features requiring transfer to the ED,194treatment of,196,
197obstructive sleep apneaassessment and management in psychiatric settings,162–164
effects of medications and substances,163–164
treatment considerations,162–163
clinical presentation of,153–156
differential diagnosis of,156–157
epidemiology of,154–155
mental health disorders and,155–156
other sleep-related breathing disorders,156–157
risk stratification of,157
referral for objective testing,157,
160–
161screening questionnaires,157,
159red eyeclinical presentation of,240
differential diagnosis of,240,
241management in psychiatric settings,242
risk stratification of,240,
241seizuresalgorithm for initial treatment of patient with,81–
82assessment and management in psychiatric settings,78, 82
approach to management of patient with,80causes of,79classification of,70clinical presentations of,67–69
differential diagnosis of,69–74
drug effects and,74–77
interactions between antiepileptic drugs and psychotropic medications,78psychotropic drugs associated with a higher risk of seizure,76medical disorders that may be confused with epilepsy or seizures,71–
72psychiatric disorders that may be confused with epilepsy,74risk stratification of,77–78
signs and symptoms differentiating psychogenic nonepileptic seizures from epileptic seizures,74shortness of breathassessment and management in psychiatric settings,136–139,
137assessment of stability with,136clinical presentation of,129–130
differential diagnosis of,130–135,
131–
132risk stratification of,135–136
syncopeclinical presentation of,103–104
differential diagnosis of,104–106
cardiovascular syncope,105–106,
108neurocardiogenic (neurally mediated) syncope,104–105,
106pseudosyncope,106
reflex-mediated syncope,104–105
syncope due to orthostatic hypotension,105,
107risk factors associated with increased morbidity and mortality,111unresponsivenessassessment and management in psychiatric settings,110–113
common causes of,109–
110description of,107–108
initial evaluation of loss of consciousness,112risk stratification of,108–110
urinary incontinenceclinical presentation of,218–219
irreversible causes of,223management in psychiatric settings,217,
219–
222, 222, 223, 224, 226
medications causing retention or,225risk stratification of,222–223
visual acuity, changes inapproach to evaluation of a patient with eye symptoms,234clinical presentation of,235
differential diagnosis of,237,
238–
239management in psychiatric settings,237
overview,233
risk factors and interventions,236–
237risk stratification of,237
Sonogram,4
SPICES screening,474,
475Spurious hypokalemia,273
SSRIs.
See Selective serotonin reuptake inhibitors
Staphylococcus aureus,6, 188
Statins, causing rhabdomyolysis,360Status epilepticus,77
Stimulant medications, implicated in drug-related fever and hyperthermia,8STIs.
See Sexually transmitted infections, in adolescents
STOP-BANG questionnaire,157,
159Stress incontinencedescription of,219, 222
management of,223
Streptococcus pneumoniae,6
Stroke, shortness of breath and,134
Stye,241characteristics and treatment of,245Subclinical hypothyroidismdefinition of,287–288
mood disorders and,288
Subconjunctival hemorrhage,241Subdural hematomas, head trauma and,95–96
Substance use/abuse.
See also Alcohol withdrawal syndrome
agitation and,400
as cause of rhabdomyolysis,360drugs as cause of abnormal liver function tests,305drugs increasing risk of hypoglycemia,261in the elderly,474
headache attributed to,61
NMS and,352–353
obstructive sleep apnea and,153–154
Suicideattempt,377–378
in the elderly,471
Sulfonylureas, for management of diabetes mellitus,258Suvorexant, for management of obstructive sleep apnea,164
Sympathomimetic drugs, causing urinary incontinence and/or retention,225Syncope.
See also Unresponsiveness
clinical presentation of,103–104
differential diagnosis of,104–106
cardiovascular syncope,105–106,
108due to benign etiologies,113
neurocardiogenic (neurally mediated) syncope,104–105,
106pseudosyncope,106
reflex-mediated syncope,104–105
syncope due to orthostatic hypotension,105,
107risk factors associated with increased morbidity and mortality,111Syndrome of inappropriate antidiuretic hormone secretion (SIADH),266, 267
Syphilis, in adolescents,460–461
Tachycardiaassessment and management in psychiatric settings,42–43
atrial fibrillation,40,
41atrial flutter,40
atrioventricular reentrant tachycardia,40–41
clinical presentation of,38, 47–48, differential diagnosis of, 40–41,
42flowchart for categorizing types based on ECG features,39narrow complex tachycardia,38–41
shortness of breath and,129–130
sinus tachycardia,39,
40wide complex tachycardias,41–42,
42Takotsubo cardiomyopathy, shortness of breath and,132
TCAs.
See Tricyclic antidepressants
Teen-LABS.
See Teen—Longitudinal Assessment of Bariatric Surgery Study Group
Teen—Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study Group,451
Temporal (giant cell) arteritis, description of,60
Tension-type headache,63
T4.
See Levothyroxine
Thionamides, for treatment of thyrotoxicosis,293
Third-degree atrioventricular block,46
Thrombocytopenia, ECT and,425Thrombotic thrombocytopenic purpura, association with AKI,320
Thyroidectomy,293–294
Thyroid function, abnormal.
See Hyperthyroidism; Hypothyroidism; Thyroid storm
Thyroiditis,292
Thyroid storm,4
approach to evaluation and management of,295description of,297
diagnostic criteria for,295–
296management,294–296
overview,294
risk stratification and assessment of,294
Thyrotoxicosis, treatment of,293
Tobacco abuse,377–378
Torsades de pointes,112.
See also QTc prolongation, torsades de pointes and
Toxic ingestion, shortness of breath and,133
Toxinsas cause of unresponsiveness,109that can cause rhabdomyolysis,360Traumaas cause of rhabdomyolysis,361shortness of breath and,134
Trazodone, for management of obstructive sleep apnea,164
Treponema pallidum,455, 460–461
Trichomonas,459
Trichomoniasis, in adolescents,459
Tricyclic antidepressants (TCAs)QTc prolongation and torsades de pointes with,332
for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437T3.
See Liothyronine sodium
Unresponsiveness.
See also Syncope
assessment and management in psychiatric settings,110–113
common causes of,109–
110description of,107–108
initial evaluation of loss of consciousness,112as a medical emergency,113
risk stratification of,108–110
Urethritis,216Urge incontinence (overactive bladder)description of,222
management of,223, 226
Urinary incontinence.
See also Acute urinary retention; Urinary tract infection, dysuria and urinary frequency associated with
clinical presentation of,218–219
definition of,219
irreversible causes of,223management in psychiatric settings,217,
219–
222, 222, 223,
224, 226
medications causing retention or,225risk stratification of,222–223
types of,219, 222
Urinary tract infection (UTI), dysuria and urinary frequency associated withclassifications of,215, 222
clinical presentations of,213–214
differential diagnosis of,215–216,
216in men,215–216,
219risk stratification of,216–217
uncomplicated,229
in women,220–
221Urine, frequency of.
See Urinary tract infection, dysuria and urinary frequency associated with
U.S. Preventive Services Task Force,470
UTI.
See Urinary tract infection, dysuria and urinary frequency associated with
characteristics and treatment of,245Vaginitis,216Valproate, for treatment of benzodiazepine discontinuation in chronic benzodiazepine users,437Valproic acid, for management of obstructive sleep apnea,164
Vascular injury, of the kidney,319–320
Venlaflaxine, QTc prolongation produced by,334Venous stasis, edema and,147
Venous thromboembolism (VTE)assessment and management in psychiatric settings,380–383
pulmonary embolism rule-out criteria,381,
383Wells criteria, modified, for pulmonary embolism,382Wells criteria for deep venous thrombosis,384clinical presentation of,377–378
differential diagnosis of,378,
379prophylaxis for,384
risk stratification of,378–379
Ventricular fibrillation (VF)description of,391
sudden death and,396
Ventricular tachycardia (VT), definition of,390–391
VF.
See Ventricular fibrillation
Video electroencephalographyfor differential diagnosis of seizures,83
Viral infectionsas cause of rhabdomyolysis,361as cause of transient neutropenia,369Vision testing,235
Visual acuity, changes inacute loss of vision,244
approach to evaluation of a patient with eye symptoms,234chemical injury,244
clinical presentation of,235
differential diagnosis of,237,
238–
239management in psychiatric settings,237
overview,233
risk factors and interventions,236–
237risk stratification of,237
Vital signs, abnormalabnormal heart ratebradycardiaatrioventricular blocks,44–46
causes of,45clinical presentation of,43–44
differential diagnosis of,44–46
first-degree atrioventricular block,44–45
indications for cardiac pacing,49risk stratification of,46–47,
46,
47second-degree atrioventricular block,45–46
sinus bradycardia,44
symptoms associated with,48treatment and management in psychiatric settings,47
risk stratification of,42
tachycardiaassessment and management in psychiatric settings,42–43
atrial fibrillation,40,
41atrial flutter,40
atrioventricular reentrant tachycardia,40–41
clinical presentation of,37–38,
38differential diagnosis of,38–41,
42flowchart for categorizing types based on ECG features,39narrow complex tachycardias,38–41
sinus tachycardia,39,
40wide complex tachycardias,41–42,
42fever,3–14
assessment and management in psychiatric settings,11
clinical presentation of,3–4
common causes of,5–
6differential diagnosis of,4–10
drugs implicated in drugrelated fever and hyperthermia,8risk stratification of,10
findings in patients complaining of chest pain and associated diagnoses,123–
124hypertension,13–22
assessment and management in psychiatric settings,18–20
clinical presentation of,15–16
differential diagnosis of,16–17
levels as defined in American College of Cardiology/American Heart Association guidelines,18pharmacological management of arterial hypertension,21risk stratification of,17–18
hypotension,23–35
assessment and management in psychiatric settings,26–28,
27clinical presentation of,23–24
differential diagnosis of,24–26
orthostasis,23–35
approach to a patient with orthostatic hypotension in an ambulatory setting,33assessment and management in psychiatric settings,28–31
etiologies of,30medications used to treat orthostatic hypotension,32nonpharmacological interventions to alleviate orthostatic hypotension,32psychotropic medications as cause of orthostatic hypotension,31Vitamin B12, as cause of chronic neutropenia,370Vitamin K antagonists (VKAs),382
Vitreous humor, changes in visual acuity and,238VKAs.
See Vitamin K antagonists
Vomiting.
See also Nausea and vomiting
description of,188
VTE.
See Venous thromboembolism; Ventricular tachycardia
Vulvovaginal candidiasis, in adolescents,458
Weight gain and obesity, in adolescentsclinical presentation of,448
differential diagnosis of,449
management of,450–451
bariatric surgery,451
behavioral management of,450
nutritional intervention,450
pharmacotherapy,450–451
risk stratification of,449
Weight loss drugs, associated with serotonin syndrome,356Wells score criteriafor deep venous thrombosis,384modified, for pulmonary embolism,382Wheezing,138
WHIM syndrome,370Wide complex tachycardias,41–42,
42Wilson’s disease,303Women.
See also Pregnancy
abdominal pain in,174
management of lower urinary tract infection and pyelonephritis in women,220–
221presenting findings of AMI,118pyelonephritis management in,220–
221testing for HPV,456
urinary tract infection management in,220–
221Yohimbine, for treatment of orthostatic hypotension,32Ziprasidoneadverse effects and QTc prolongation and torsades de pointes with,333
myocarditis/cardiomyopathy and,345, 347
for treatment of agitation,403
