Sections
Index
Symptoms
Cardiovascular Disorders
Clinical Pharmacology
Critical Care Medicine
Dental Disorders
Dermatologic Disorders
Ear, Nose, and Throat Disorders
Endocrine and Metabolic Disorders
Eye Disorders
Gastrointestinal Disorders
Genitourinary Disorders
Geriatrics
Gynecology and Obstetrics
Hematology and Oncology
Hepatic and Biliary Disorders
Immunology; Allergic Disorders
Infectious Diseases
Injuries; Poisoning
Musculoskeletal and Connective Tissue Disorders
Neurologic Disorders
Nutritional Disorders
Pediatrics
Psychiatric Disorders
Pulmonary Disorders
Special Subjects
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Abdominal Pain, Acute
Abdominal pain, Chronic
Alopecia
Amenorrhea
Amnesia
Anosmia
Bleeding, Excessive
Breast Lumps
Chest Pain
Constipation in Adults
Constipation in Children
Cough in Adults
Cough in Children
Crying
Diarrhea in Adults
Diarrhea in Children
Diplopia
Dizziness
Dry Mouth
Dysmenorrhea
Dyspepsia
Dysphagia
Dyspnea
Dysuria
Earache
Ear Discharge
Edema
Edema During Late Pregnancy
Epistaxis
Erectile dysfunction
Eyelid Swelling
Eye Pain
Fever
Fever, Acute, in Adults
Fever, Chronic (FUO)
Fever in Infants and Children
Floaters
Gas
Gastrointestinal Bleeding
Halitosis
Headache
Hearing Loss
Hearing Loss: Sudden Deafness
Hematospermia
Hematuria
Hemoptysis
Hiccups
Hirsutism
Insomnia and Excessive Daytime Sleepiness
Itching
Itching, Anal
Jaundice in Adults
Jaundice in Neonates
Joint Pain, Monarticular
Joint Pain, Polyarticular
Knee pain
Lump in Throat
Nasal Congestion and Rhinorrhea
Nausea and Vomiting During Early pPregnancy
Nausea and Vomiting in Adults
Nausea and Vomiting in Infants and Children
Neck and Back Pain
Neck Mass
Nipple Discharge
Orthostatic Hypotension
Pain
Pain, Chronic
Palpitations
Pelvic Pain
Pelvic Pain During Early Pregnancy
Polyuria
Priapism
Red Eye
Scrotal Pain
Sore Throat
Stomatitis
Stridor
Syncope
Tearing
Tinnitus
Toothache
Tremor
Urinary Frequency
Urinary Incontinence in Adults
Urinary Incontinence in Children
Urinary Retention
Urticaria
Vaginal Bleeding
Vaginal Bleeding During Early Pregnancy
Vaginal Bleeding During Late Pregnancy
Vaginal Itching and Discharge
Vision, Blurred
Vision Loss, Acute
Weakness, Generalized
Wheezing
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Sections
in
Health Care Professionals
Cardiovascular Disorders
Clinical Pharmacology
Critical Care Medicine
Dental Disorders
Dermatologic Disorders
Ear, Nose, and Throat Disorders
Endocrine and Metabolic Disorders
Eye Disorders
Gastrointestinal Disorders
Genitourinary Disorders
Geriatrics
Gynecology and Obstetrics
Hematology and Oncology
Hepatic and Biliary Disorders
Immunology; Allergic Disorders
Infectious Diseases
Injuries; Poisoning
Musculoskeletal and Connective Tissue Disorders
Neurologic Disorders
Nutritional Disorders
Pediatrics
Psychiatric Disorders
Pulmonary Disorders
Special Subjects
Merck Manual
>
Health Care Professionals
>
Geriatrics
Geriatrics
Approach to the Geriatric Patient
Introduction
Physical Changes With Aging
Evaluation of the Elderly Patient
Multiple disorders
Missed or delayed diagnosis
Polypharmacy
Caregiver problems
History
Interview
Medical history
Drug history
Alcohol, tobacco, and recreational drug use history
Nutrition history
Mental health history
Functional status
Social history
Key Points
Physical Examination
Vital Signs
Skin
Head and Neck
Face
Nose
Eyes
Ears
Mouth
Temporomandibular joint
Neck
Chest and Back
Breasts
Heart
GI System
Male GU System
Female Reproductive System
Musculoskeletal System
Feet
Neurologic System
Cranial nerves
Motor function
Muscle strength
Coordination
Gait and posture
Reflexes
Sensation
Mental status
Nutritional Status
Key Points
Comprehensive geriatric assessment
Assessment Domains
Unusual Presentations of Illness in the Elderly
Drug Therapy in the Elderly
Introduction
Pharmacokinetics in the Elderly
Absorption
Distribution
Hepatic metabolism
Renal elimination
Pharmacodynamics in the Elderly
Drug-Related Problems in the Elderly
Reasons for Drug-Related Problems
Inappropriate drugs
Overdosage
Underprescribing
Drug-disease interactions
Drug-drug interactions
Inadequate monitoring
Poor communication
Lack of patient adherence
Prevention
Before starting a new drug
After starting a drug
Ongoing
Drug Categories of Concern in the Elderly
Analgesics
Anticoagulants
Antidepressants
Antihyperglycemics
Antihypertensives
Antiparkinsonian drugs
Antipsychotics
Anxiolytics and hypnotics
Digoxin
Diuretics
Prevention of Disease and Disability in the Elderly
Overview of Prevention in the Elderly
Patient and caregiver issues
Prevention of Disease in the Elderly
Primary and Secondary Prevention
Tertiary Prevention
Arthritis
Osteoporosis
Diabetes
Vascular disorders
Heart failure
Chronic obstructive pulmonary disease (COPD)
Prevention of Frailty
Prevention of Injuries in the Elderly
Falls
Driving hazards
Home hazards
Prevention of Iatrogenic Complications in the Elderly
Risk Factors
Multiple chronic diseases
Multiple physicians
Multiple drugs (polypharmacy) and inappropriate drugs
Hospitalization
Prevention
Care management
Geriatric interdisciplinary team
Pharmacist consultation
Acute Care for the Elderly (ACE) units
Advance directives
Prevention of Psychosocial Problems in the Elderly
Aging and Quality Of Life
Quality of Life in the Elderly
Health-Related Quality of Life
Influences
Assessment
Barriers to assessment
Method
Therapeutic Objectives in the Elderly
Social Issues in the Elderly
Introduction
Family Caregiving for the Elderly
Effects
The Elderly Living Alone
Self–Neglect in the Elderly
Alternative Living Arrangements for the Elderly
Effects of Life Transitions on the Elderly
Intimacy and the Elderly
Religion and Spirituality in the Elderly
Benefits
Psychologic benefits
Health-promoting practices
Social benefits
Caregivers
Harmful Effects
Role of the Health Care Practitioner
Spiritual history
Referral to clergy
Support of patients' religious beliefs and practices
Religious interventions
Recommendation of religious activities
Patient and family information
Elder Abuse
Elder Abuse
Risk Factors
Diagnosis
History
Physical examination
Laboratory tests
Documentation
Prognosis
Treatment
Intervention
Nursing and social work issues
Reporting
Caregiver issues
Prevention
Provision of Care to the Elderly
Overview of Geriatric Care
Health care settings
Geriatric Interdisciplinary Teams
Patient and caregiver participation
Home Health Care
Reimbursement
Day Care for the Elderly
Reimbursement
Respite Care
Hospital Care and the Elderly
Emergency department care
Communication among practitioners
Disposition
Hospitalization
Improving outcomes
Adverse Drug Effects
Prevention
Bed Rest Effects
Prevention
Falls
Prevention
Incontinence
Mental Status Changes
Prevention
Pressure Ulcers
Prevention
Undernutrition
Prevention
Discharge Planning and Transfers
To home
To another health care facility
Nursing Homes
Supervision of care
Hospitalization
Costs
Problems related to reimbursement
Nursing home placement
Selection
Board-and-Care Facilities
Assisted-Living Programs
Life-Care Communities
Program of All-Inclusive Care for the Elderly
Pharmacists and the Elderly
Patient adherence
Settings
Falls in the Elderly
Falls in the Elderly
Etiology
Intrinsic factors
Extrinsic factors
Situational factors
Complications
Evaluation
History and physical examination
Performance tests
Laboratory tests
Prevention
Exercise
Assistive devices
Medical management
Environmental management
Gait Disorders in the Elderly
Gait Disorders in the Elderly
Normal Age-Related Changes in Gait
Abnormal Changes in Gait
Causes
Manifestations
Evaluation
History
Physical examination
Gait assessment
Testing
Treatment
Strength training
Balance training
Assistive devices
Prevention
The Older Driver
Overview of the Older Driver
Assessment
Key Points
Functional Assessment of the Older Driver
Visual function
Physical function
Cognitive function
Medical Assessment of the Older Driver
Falls
Cardiac disorders
Neurologic disorders
Diabetes mellitus
Sleep disorders
Drugs
Interventions with the Older Driver
Driving rehabilitation programs
Driving cessation
Reporting
Funding Health Care for the Elderly
Introduction
Medicare
Part A
Inpatient hospital care
Inpatient care in a skilled nursing facility
Home health care
Hospice services
Custodial care
Part B
Covered services
Physician reimbursement
Part C (Medicare Advantage Plans)
Part D
Covered drugs
Benefits and costs
Medicaid
Covered services
Eligibility
Medicaid estate recovery
Medicare Savings Programs
Other Federal Programs Affecting the Elderly
Veterans Health Administration
Tricare
Older Americans Act (OAA)
Social Security
Title XX of the Social Security Act
Private Insurance for the Elderly
Medigap
Long-term care insurance
Models for Comprehensive Health Care Coverage for the Elderly
Social health maintenance organizations (SHMOs)
Program of All-Inclusive Care for the Elderly (PACE)
Extended care communities
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