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U-M Department of Family Medicine
Clinical Procedures
No-Scalpel Vasectomy
Pre-Test
Unit Contents
Objectives
Introduction to No-Scalpel Vasectomy
Pre-Vasectomy Counseling
Pre-Vasectomy Examination
Review of Anatomy
Instruments & Anesthetic Agents
Procedural Steps
Step I
Step II
Step III
Step IV
Step V
Step VI
Step VII
Final Steps
Post-Procedure Patient Instructions
Documentation of the Procedure
Follow-up Care
Complications
Materials, Templates, and Forms
References
Photo Attributions
Post-Test
Skin Surgery
Pre-Test
Objectives
Indications for Skin Surgery
Choosing the Right Technique
Patient Preparation
Skin Lines
Choosing the Right Technique
Informed Consent
Patient Position and Skin Preparation
Sterile Technique
Local Anesthesia
Techniques
Shave Excision
Skin Lines
Prep with Alcohol
Administer Local Anesthesia
Spread Skin
Bend Razor
Remove Lesion
Obtain Hemostasis
Dress Wound
Give Discharge Instructions
Send Tissue to Pathology
Punch Biopsy
Identify Skin Lesion
Skin Preparation
Administer Local Anesthesia
Spread Skin
Apply Skin Punch
Hemostasis and Wound Closure
Dress Wound
Discharge Instructions
Send Tissue to Pathology
Elliptical Excision
Measure Skin Lesion
Mark Ellipse
Prepare Skin
Local Anesthesia
Make Incision
Close Wound
Dress Wound
Discharge Instructions
Tissue to Pathology
Patient Discharge
Wound Dressing
Discharge Instructions
Suture Removal
Coding and Billing
Send Tissue to Pathology
Documentation
Shave Excision Documentation
Punch Biopsy Documentation
Elliptical Excision Documentation
Key Points
Post-Test
Photo Attributions
Integrative Medicine: Body-Based Therapies
Acupuncture
Pre-Test
History
Medical Treatises
Acupuncture - European History
Chinese Medicine
Chi
Meridians
Acupuncture Points
Organs
Acupuncture in the U.S.
Medical Literature
Mechanism of Action
Indications
Conditions Articles
Patient Evaluation
History Taking
Pulse Diagnosis
Tongue Diagnosis
Treatment Experience
Patient Experience
Needle Characteristics
Needle Stimulation
Post-Treatment Instructions
Treatment Side Effects
Training and Referrals
Physician Training: AAMA
Non-Physician Training
Referral Considerations
Reimbursement
Post-Test
Photo Attributions
Manual Medicine
Pre-Test
Try This Breathing Exercise
Objectives
History and Background
Philosophy and Principles
Types of Manual Medicine
High Velocity Low Amplitude (HVLA)
Strain-Counterstrain
Cranial Sacral
Muscle Energy
Lymphatic Technique
Myofascial Release
Trigger Point Release
Who Will Benefit?
Side Effects
Research Evidence
Sample Cases
Sample Case 1: Hip Pain
Sample Case 2: Headaches
Sample Case 3: Chest Wall Pain
Practitioners of Manual Medicine
Certified Athletic Trainers
Chiropractors
Doctors of Osteopathic Medicine (D.O.)
Physiatrists (Physical Medicine and Rehabilitation)
Physiotherapists / Physical Therapists
Massage Therapists
Contraindications for Manual Medicine
Contraindication for Lymphatic Technique
Contraindications for High Velocity Low Amplitude (HVLA)
Insurance Coverage
Post-Test
Photo Attributions
Massage Therapy
Pre-Test
Objectives
Background and History
Definitions
Evidence for Use
Musculoskeletal Conditions
Chronic Disease
Hospital and End-of-Life Care
Infant Massage
Contraindications and Safety
Common Experiences
Insurance and Cost Issues
Referral and Credentials
Cases Overview
Case #1
Case #1 Discussion
Case #2
Case #2 Discussion
Case #3
Case #3 Discussion
Resources
Post-Test
Acknowledgements and Permissions
Integrative Medicine: Mind-Body Therapies
Guided Imagery
Clinical Applications
Clinical Case #1
Clinical Case #2
Details and Exceptions
Imagery-Evoking Language
Indications and Contraindications
Mechanism of Action
Music and Imagery
Objectives
Post-Test
Pre-Test
Research Evidence
Resources
The "Relaxation Response"
Unit Evaluation
What is Guided Imagery?
Hypertension
Contraindications
Details and Exceptions
Determining the Most Appropriate Recommendation
Nutrition
Personality
Physical Activity
Sleep
Spirit
Forms of Meditation
Agency for Healthcare Research Quality (AHRQ)
Mindfulness
Body Scan
Related Publications
Relaxation Response
Practice of Relaxation Response
Transcendental Meditation (TM)
Mantra
Meta-Analysis Citation
Introduction to the Patient
Benefits
Conventional Perspective
Problems
Meditation
Mind-Body Interventions
Mind-Body Practices
Movement System Practice for Hypertension
Photo Attributions
Post-Test
Pre-Test
Treatment Planning with Jim
Additional Recommendations
Preferred Choice
RR Choice
Unit Evaluation
Overview
Benefits of MBTs
Insomnia
Systematic Reviews
Clarifying Terminology
Common Mind-Body Terms
Prayer in NCCAM Classification Scheme
Clinical Care Implications
Encourage Your Patient's Efforts
Inquire About Patient Use of Mind-Body Practices
Recommended Mind-Body Therapies
Teaching Mind-Body Practices
Details and Exceptions
Effects of Stress: Chronic Health Conditions
Effects of Stress: Warning Signals
Executive Function of the Brain
Photo Attributions
Post-Test
Pre-Test
Prevalence
Chart on MBT Usage
Survey Results
Purpose
Relaxation Response
Relaxation Response Technique
Resources
Journal Articles and Books
Online Resources
Popular Books
Training Organizations
Science Behind Mind-Body Therapies
What is Allostasis?
Stress Response
Allostatic Load
HPA Axis
Physiology of Stress
Unit Evaluation
What Are Mind-Body Therapies?
Mind-Body Practices and Definitions
Joint Injection
Introduction to Joint Injection and Aspiration
Carpal Tunnel Injection
de Quervain's Tenosynovitis Injection
Details and Exceptions
Evidence Grades
Facts and Uses
First Carpal Metacarpal Joint Injection
First Metatarsophalangeal Joint Injection
Greater Trochanteric Bursa Injection
Knee Anatomy
Knee Injection
Lateral Epicondyle Injection
Objectives
Post-Test
Pre-Test
Preparation
Steroids
Subacromial Bursa Injection
Summary
Unit Evaluation
Musculoskeletal Examinations
Elbow Examination
Anterior Elbow Pain
Biceps Tendon Rupture
Biceps Tendonopathy
Elbow Arthritis
Details and Exceptions
Documentation of Examination
Evaluation of the Elbow (肘の評価)
Exam Maneuvers
Cozen's Test
Maudsley's Test
Medial and Lateral Collateral Ligament Stability
Tinel's Test of the Cubital Tunnel
Instructions on Use
Lateral Elbow Pain
Elbow Arthritis
Lateral Epicondylitis
Osteochondritis (OCD) of the Capitellum
Posterior Interosseous Nerve Impingement Syndrome
Radial Head Fracture
License
Medial Elbow Pain
Cubital Tunnel Syndrome
Elbow Arthritis
Medial Collateral Ligament Injury
Medial Epicondylitis
Post-Test
Posterior Elbow Pain
Olecrenon Bursitis
Olecrenon Fracture
Triceps Tendinopathy
Pre-Test
References
Unit Evaluation
Hand and Wrist Examination
Pre-Test
Instructions on Use
Evaluation of the Hand and Wrist (手と手首の評価)
Dorsal Surface Hand Pain
Arthritis
Extensor Tendon Injuries (Boutonniere and Mallet Finger)
Finger Fractures
Metacarpal Fractures
Paronychia
Palmar Surface Hand Pain
Arthritis
Dupuytren’s Disease
Felon
Finger Fractures
Flexor Tendon Injuries
Metacarpal Fractures
Trigger Finger
Radial Wrist Pain
Arthritis
Carpal Metacarpal Osteoarthritis
De Quervain's Tenosynovitis
Distal Radius Fracture
Ganglion Cyst
Intersection Syndrome
Scaphoid Wrist Fracture
Thumb Fracture
Thumb Ulnar Collateral Ligament Injury
Ulnar Wrist Pain
Arthritis
Ganglion Cyst
Triangular Fibrocartilage Complex Injury
Ulnar Nerve Entrapment
Palmar Surface Wrist Pain
Arthritis
Carpal Tunnel Syndrome
Distal Radius Fracture
Ganglion Cyst
Kienbock's Disease
Scaphoid Fracture
Scapholunate Dissociation
Dorsal Surface Wrist Pain
Arthritis
Distal Radius Fracture
Ganglion Cyst
Intersection Syndrome
Kienbock's Disease
Scaphoid Fracture
Scapholunate Dissociation
Specific Hand and Wrist Exam Maneuvers
Axial Grind Test
Boyes' Test
Carpal Compression Test
Elson's Test
Finger Collateral Ligament Stress Test
Finkelstein's Test
Flexor Digitorum Profundus Test
Frommet's Sign
OK Sign
Phalen's Test
Shuck Test
Thumb Ulnar Collateral Ligament Stress Test
Tinel's Test of the Carpal Tunnel
Tinel's Test of the Ulnar Tunnel
Ulnar Compression Test
Watson's Test
Documentation of Examination
References
Anatomic Landmarks
Details and Exceptions
Post-Test
Unit Evaluation
Hip Examination
Anterior Hip Pain
Avascular Necrosis Osteonecrosis of the Hip
Femoral Shaft Fracture
Hip Dislocation
Hip Fracture Proximal Femur Fracture
Hip Strain
Inflammatory Arthritis of the Hip
Inguinal Hernia
Osteitis Pubis Pubic Symphysitis
Osteoarthritis of the Hip
Pelvis Fracture
Proximal Quadriceps Strain
Septic Arthritis of the Hip
Snapping Hip Syndrome
Sports Hernia (Athletica Pubalgia)
Stress Fractures of the Hip
Details and Exceptions
Documentation of the Hip Exam
Evaluation of the Hip (股関節の評価)
Instructions on Use
Lateral Hip Pain
Greater Trochanteric Bursitis
Lateral Femoral Cutaneous Nerve Syndrome (Meralgia Paresthetica)
Snapping Hip Syndrome
Post-Test
Posterior Hip and Gluteal Pain
Lumbar Radiculaopathy (Sciatica)
Pelvis Fracture
Piriformis Syndrome
Proximal Hamstring Strain
Sacroiliac Dysfunction
Pre-Test
References
Specific Examination Maneuvers of the Hip
Ely's Test
Faber (Patrick) Test
Femoral Log Roll and Heel Strike Test
Fulcrum Test
Hamstring Flexibility Testing
Leg Length Discrepancy Test
Ober's Test
Piriformis Test
Seated Flexion Test
Standing Flexion Test
Stork Test
Straight Leg Raise Test
Thomas Test
Trendelenberg Test
Unit Evaluation
Knee Examination
Anatomic Landmarks
Anterior Knee Pain
Bipartite Patella
Fat Pad Syndrome
Hip Osteoarthritis
Knee Osteoarthritis
Osgood Schlatter
Osteochondral Defect (Osteochondritis Dessecans)
Patella Fracture
Patellar Instability/Extensor Mechanism Injury
Patellar Tendinopathy
Patellar Tendon Rupture
Patellofemoral Syndrome
Prepatellar Bursitis
Quadriceps Tendinopathy
Quadriceps Tendon Rupture
Sinding Larsen Johansson Syndrome
Synovial Plica
Documentation of Exam
Evaluation of Effusion
Anterior Cruciate Ligament Injury
Baker's Cyst
Inflammatory Arthritis
Intra-articular Fracture
Knee Osteoarthritis
Malignancy
Pigmented Villonodular Synovitis
Posterior Cruciate Ligament Injury
Septic Knee
Evaluation of the Knee
Instructions On Use
Lateral Knee Pain
Iliotibial Band Syndrome
Knee Osteoarthritis
Lateral Collateral Ligament (LCL) Injury
Lateral Meniscal Injury
Proximal Fibular Fracture
License
Medial Knee Pain
Knee Osteoarthritis
Medial Collateral Ligament Injury (MCL)
Medial Meniscal Injury
Pes Anserine Bursitis
Tibial Plateau Fracture
Post-Test
Posterior Knee Pain
Baker's Cyst
Deep Venous Thrombosis
Pre-Test
References
Specific Knee Exam Maneuvers
Anterior Drawer Test
Apley's Compression Test
Bounce Test
Lachman Test
Lateral Collateral Ligament Stability Test
McMurray's Test
Medial Collateral Ligament Stability Test
Noble's Test
Ober's Test
Patellar Apprehension Test
Patellar Ballottement
Patellar Grind Test
Patellar Inhibition Test
PCL Sag Test
Posterior Drawer Test
Unit Evaluation
Shoulder Examination
Anterior Shoulder Pain
Acromioclavicular Separation
Adhesive Capsulitis
Cervical Radiculopathy
Clavicle Fracture
Labral Injury
Multidirectional Instability
Proximal Biceps Tendon Injuries
Proximal Humerus Fracture
Rotator Cuff Injuries
Shoulder Arthritis
Shoulder Dislocation
Sternoclavicular Injuries
Thoracic Outlet Syndrome
Details and Exceptions
Documentation of the Shoulder Exam
Evaluation of the Shoulder (肩の評価)
Instructions on Use
Lateral Shoulder Pain
Adhesive Capsulitis
Cervical Radiculopathy
Labral Injury
Multidirectional Instability
Proximal Humerus Fracture
Rotator Cuff Injuries
Thoracic Outlet Syndrome
Post-Test
Posterior Shoulder Pain
Cervical Radiculopathy
Labral Injuries
Multidirectional Instability
Proximal Humerus Fracture
Rotator Cuff Injuries
Scapular Fracture
Shoulder Arthritis
Shoulder Dislocation
Pre-Test
References
Shoulder Exam Maneuvers
Adson's Test
Apley Scratch Test of External Rotation
Apley Scratch Test of Internal Rotation
Apprehension and Relocation Test
Biceps Load Test
Biceps Tension Test
Costoclavicular Maneuver
Crank Test
Cross Arm Test
Drop Arm Test
Empty Can Test
Hawkin's Test
Load and Shift Test
Neer's Test
O'Brien's Test
Push-Off Test
Roos' Test
Speed's Test
Spurling's Test
Sulcus Sign
Yergason's Test
Unit Evaluation
膝の検査 (Knee Examination)
事前テスト
参考文献
本単元の使用にあたって
膝の内側の痛み
内側側副靭帯（MCL）損傷
内側半月板損傷
脛骨プラトー骨折
膝の骨関節炎
鵞足滑液包炎
膝の前側の痛み
オズグッドシュラッター病
シングディングラーセンヨハンセン症候群
二分膝蓋骨（分裂膝蓋骨）
大腿四頭筋腱付着部炎（ジャンパー膝)
大腿四頭筋腱断裂
滑膜ひだ
股関節の骨関節炎
膝の骨関節炎
膝蓋下脂肪体炎
膝蓋前滑液包炎
膝蓋大腿症候群
膝蓋腱障害（ジャンパー膝）
膝蓋骨の不安定性／伸筋損傷
膝蓋骨の骨折
膝蓋骨腱断裂
骨軟骨欠損（離断性骨軟骨炎）
膝の外側の痛み
外側側副靭帯（LCL）損傷
外側半月板損傷
腓骨近位端骨折
腸脛靭帯症候群（腸脛靭帯炎、ランナー膝）
膝の骨関節炎
膝の後側の痛み
ベーカー嚢胞
深部静脈血栓症
膝の特異的検査法
アプレーの圧迫テスト
オーベルテスト
ノブレーテスト
マックマレーテスト
ラックマンテスト
内側側副靭帯安定性テスト
前方引き出しテスト
外側側副靭帯安定性テスト
後十字靭帯(PCL)サグテスト
後方引き出しテスト
膝蓋骨アプリヘンションテスト
膝蓋骨圧迫テスト
膝蓋骨抑制テスト
膝蓋骨跳動テスト
跳ね返りテスト
膝の評価
解剖学的ランドマーク
詳細と例外はこちら
関節浸出液の評価
ベーカー嚢胞
前十字靭帯損傷
化膿性膝関節炎
後十字靭帯損傷
悪性腫瘍
炎症性関節炎
膝の骨関節炎
色素性絨毛結節性滑膜炎
関節内骨折
Obstetrics
Neonatal Circumcision I
Background
Details and Exceptions
Indications and Contraindications
Disease Conditions
General
Indications
Penile Abnormalities
Informed Consent & Documents
Benefits
Brief Description of the Procedure
Immediate Short-Term Risks
Long-Term Risks
Potential Reasons Against Circumcision
Potential Reasons for Circumcision
Risks of Penile Nerve Block
Objectives
Post-Test
Pre-Test
Neonatal Circumcision II
Pre-Test
Preparation
Time Out Procedure
Calculate Amount of Lidocaine
Draw Up Proper Amount of Lidocaine
Restraint
Comfort
Prepare for Penile Nerve Block Analgesia
Technique of Penile Analgesia
Penile Nerve Block Analgesia
Anatomy of Dorsal Penile Nerves
Dorsal Penile Nerve Block: Initial Approach
Potential Errors
Dorsal Penile Nerve Block: Completion
Anatomy of Ventral Glans Innervation
Ventral Subcutaneous Injection Technique
Subcutaneous Ring Block
Circumcision with Gomco Clamp
Choosing Size of Gomco Clamp
Sterile Preparation of the Penis
Inspection of Circumcision Surgical Tray
Gomco Clamp Inspection
Stabilizing the Prepuce
Lysis of "Adhesions"
The Dorsal Clamp
The Dorsal Slit
Exposing the Glans Penis
Lysis of Residual "Adhesions"
Placement of Gomco Bell
Securing the Gomco Bell
Placement of Gomco Base Plate
Placement of the Rocker Arm
Adjustments to Gomco Clamp
Further Adjustments
Excision of Prepuce
Removal of Gomco Clamp
Removal of Gomco Bell
Postoperative Preparation of the Infant
Postoperative Care
Common Pitfalls and Problems
Inadequate Pain Control
Excessive Removal of Prepuce
Poor Cosmetic Result
Excessive Bleeding and Hemostasis
Treatment Measures for Hemostasis
Preputial Adhesions and Skin Bands
Circumcision of a Penis with Penile Torsion <90º
Use of a Defective Clamp
Review
Permissions and Acknowledgments
References
Post-Test
Patient Identity
Details and Exceptions
Photo Attributions
Uses and Insertion Techniques for Fetal Scalp Electrode (FSE) and Intrauterine Pressure Catheter (IUPC) in Labor
Details and Exceptions
Fetal Scalp Electrode
Advantages, Disadvantages, and Risks
Documentation
Indications and Contraindications
Placement Procedure
Removal
Things to Remember
Intrauterine Pressure Catheter
Advantages, Disadvantages, and Risks
Indications and Contraindications
Placement Procedure
Things to Remember
Objectives
Post-Test
Pre-Test
Principles of FSE and IUPC Placement
Review
Unit Evaluation
Palliative Care
Pain Management with Non-Opioids
Pre-Test
Objectives
Basic Principles of Pain Assessment
Pathophysiology of Pain
Physical Pain Related to Terminal Illness
Non-Physical Causes of Pain
Use of Adjuvant Drugs
Inflammation I
Classes of Medicine
Inflammation II
Bone Pain
Raised Intracranial Pressure
Visceral Pain
Neuropathic Pain
Muscular Pain
Non-Pharmacologic Methods
Summary
Post-Test
Pain Management with Opioids
Pre-Test
Objectives
Misconceptions About Opioids
Respiratory Depression
Addiction
Constipation
Nausea
Oral Efficacy
Effective Dosages
Rapid Tolerance
Euphoria
Mask Progression
Hastens Death
WHO Analgesia Ladder
Effective Starting Dosages
Opioid Titration
Treatment of Breakthrough Pain
Opioid Equivalents
Help with Dose Conversions
Practice Dose Conversion: Judy
Practice Dose Conversion: Michael
Practice Dose Conversion: Rebecca
Practice Dose Conversion: John
Special Populations
Drugs and Routes to Avoid
Adverse Side Effects
Constipation
Rotation to Methadone
Resources and References
Post-Test
Women's Health
Endometrial Biopsy
Completing the Procedure
Post-Procedure Patient Care
Preserving the Specimen
Tenaculum Removal
Complications
Inadequate Specimen
Patient Discomfort
Perforation of the Uterus
Post-Operative Bleeding
Post-Operative Infection
Unable to Obtain the Specimen
Vasovagal Reaction
Details and Exceptions
Documentation
Indications
Interpretation of the Pathologic Report
Atrophic Endometrium
Endometrial Hyperplasia
Inadequate Specimen
Materials
Objectives
Other Methods for Evaluating AUB
Dilatation and Curettage
Hysteroscopy
Saline Infusion Sonography
Transvaginal Ultrasound
Performing the Biopsy
Attempt After Sounding
Attempt with Tenaculum
Biopsy Without Instrumentation
Tenaculum Placement
Uterine Sounding
Post-Test
Pre-Test
Preparatory Steps
Anesthetic
Antiseptic
Bimanual Exam
Insert Speculum
Prepare and Consent
References
Summary
Troubleshooting
Unit Evaluation
Intrauterine Device (IUD)
Benefits and Risks
Candidates for IUD Use
Copper-Releasing IUD Insertion Technique
Details and Exceptions
Difficulties with IUD Insertion and Removal
Equipment
General Insertion Technique
Objectives
Post-Procedure Patient Care
Post-Test
Pre-Test
Progestin-Releasing IUD Insertion Technique
References
Summary
Types of IUDs
Unit Evaluation
Osteoporosis Prevention
Bone Mineral Density Measurement
Bone Physiology and Primary Prevention
Details and Exceptions
DEXA Scan
DEXA Limitations
Medicare Payment for DEXA
Vertebral X-rays and Vertebral Fracture Analysis
Exercise and Fall Prevention
Fragility Fractures
FRAX
Objectives
Pharmacologic Therapies
Bisphosphonates
Calcitonin
Calcium
Combination Therapy
Denosumab (Prolia)
Estrogen Replacement Therapy (HRT)
Raloxifene
Teriparatide
Testosterone Replacement Therapy
Vitamin D
Post-Test
Pre-Test
References
Risk Factors
Summary
Unit Evaluation
What is Osteoporosis?
Who to Treat
Work-Up of Secondary Causes
Full List of Topics
Videos Available in Spanish
日本語字幕付き動画一覧 (Videos Available in Japanese)
Archived Modules
Asthma
Pre-Test
Objectives
General Characteristics of Asthma
Primary Care Considerations
New Thinking in Pathophysiology
Asthma Triggers
Integrative Treatment Strategies
Environment
Nutrition
Exercise
Breathing Techniques
Vitamins and Supplements
Botanicals
Biomechanical Approaches
Therapeutic Summary
References and Resources
Biomechanical Approach References
Botanicals
Probiotic References
Vitamin and Supplement References
Photo Attributions
Post-Test
Depression
Pre-Test
Objectives
Background
Prevalence
Evidence For Antidepressants
Efficacy of Antidepressants
Types of Depression
Exercise
Evidence for Exercise
Pedometers
Other Exercise Options
Nutrition
Omega-3s
B Vitamins
Vitamin D
Herbs and Supplements
St. John's Wort
Evidence
Dosage
Safety
Side Effects
SAMe
Evidence
Dosage
Safety
Side Effects
5-HTP
Evidence
Dosage
Safety
Side Effects
Psychological Therapy
Cognitive Behavioral Therapy (CBT)
Interpersonal Therapy (IPT)
Brief Psychodynamic Therapy (BPT)
Behavioral Activation
Relaxation
Meditation
Progressive Muscle Relaxation (PMR)
Deep Breathing
Light Therapy
Evidence
Instructions For Use
Precautions
Types of Lights
Blue/Green Wavelength Lights
Dawn Simulators
Full Spectrum Light
Summary
References
Appendix I
Assesssment
Prescription
Followup
Appendix II
Mindfulness Meditation
Mantra Meditation
Walking Meditation
Christian Meditation
Post-Test
Photo Attributions
Astm (Asthma)
Obiective
Caracteristicile Generale ale Astmului
Consideraţii despre Asistenţa Primară
Abordare Nouă în Fiziopatologie
Declanşatorii Astmului
Strategii de Tratament Integrativ
Mediu
Nutriție
Exerciții
Tehnici de Respirație
Vitamine şi Suplimente
Plante Medicinale
Abordări Biomecanice
Rezumat Terapeutic
Referințe şi Resurse
Referințele Abordării Biomecanice
Plante Medicinale
Referințe Probiotice
Referințe Vitamine şi Suplimente
Atribuții Foto
Diabetes Type 2
Pre-Test
Objectives
Prevention
Nutrition
Glycemic Index
Fiber
Fats
Protein
Mediterranean Diet
Physical Activity
Physical Activity vs. Exercise
Evidence
Recommendations
Prescription
Follow Up
Botanicals Overview
Ginseng
Gymnema Sylvestre
Ayurvedic
Fenugreek
Cinnamon
Supplements
Vitamin D
Magnesium
Chromium Piccolinate
Omega-3 Fatty Acids
Alpha-lipoic Acid
Mental and Spiritual Health
Stress Reduction
Biofeedback
Prayer/Spiritual Practice
How to Integrate?
Resources and Acknowledgements
Details and Exceptions
Post-Test
Gastroesophageal Reflux Disease (GERD)
Pre-Test
Objectives
Case Presentation
Pathophysiology
Suggested Lifestyle Modifications
Botanical Therapies
Licorice
Marshmallow
Slippery Elm
Ginger
Apple Cider Vinegar
Other Therapies
Risks of Medical Therapies
Summary
References
Photo Attributions
Post-Test
Headache
Pre-Test
Classification
Lifestyle Modification
Herbal Approaches
Nutritional Approaches
Homeopathic Remedies
Manual Therapies
Craniosacral Therapy
Acupuncture
Reflexology
Biofeedback
References
Post-Test
Menopause
Pre-Test
Objectives
Overview
Patient Education
Regulating Body Temperature
Dealing with Vaginal Dryness
Lifestyle
Sleep
Exercise
Nutrition
Stress Management
Bioidentical Hormones
Phytoestrogens
Soy
Flax
Herbs and Supplements
Black Cohosh
Other Supplements
Body-Based Therapies
Summary
Post-Test
References
Photo Attributions
Prenatal Care
Pre-Test
Objectives
The Integrative Approach
Nutrition
The Basics
Omega-3 Fatty Acids
Folic Acid
Vitamin D
Environmental Exposures to Consider
Integrative Modalities
Massage Therapy
Acupuncture
Exercise and Yoga
Relaxation and Hypnosis
Use of Doulas
Perineal Massage
Common Symptoms and Remedies
Nausea and Vomiting
Nausea and Vomiting Recommended Remedies
Back and Pelvic Pain
Back and Pelvic Pain Recommended Remedies
Heartburn
Heartburn Recommended Remedies
Headache
Headache Recommended Remedies
Insomnia
Insomnia Recommended Remedies
Peripheral Edema
Peripheral Edema Recommended Remedies
Urinary Tract Infection
Urinary Tract Infection Recommended Remedies
Post-term Pregnancy
Post-term Pregnancy Recommended Remedies
Breastfeeding
Take Home Messages
References
Photo Attributions
Post-Test
Obesity and Weight Loss
Pre-Test
Objectives
Epidemiology (U.S.)
Epidemiology (Michigan)
Definitions
Rationale for Treatment
Treatment Stratification
Diets
Mediterranean Diet
Low-Calorie Diet
Low-Fat Diet
Low-Carbohydrate Diet
Exercise
Behavior Therapy
Pharmaceuticals
Orlistat (Xenical™)
Sibutramine (Meridia™)
Metformin (Glucophage)
Supplements
Ephedra
Ephedra-Free Products
Chitosan
Conjugated Linoleic Acid (CLA)
Green Tea
Hoodia
Summary
Post-Test
Photo Attributions
Upper Respiratory Infection (URI)
Pre-Test
Objectives
Clinical Presentation
Early Symtoms
Zinc
Echinacea
Vitamin C
Treating a Cough
Codeine/Hydrocodone
Treatments for Rhinorrhea
Antibiotics
Vitamin C for Prevention
Summary
Post-Test
Photo Attributions
Foot and Ankle Examination
Anterior Hindfoot and Ankle Pain
Osteochondral Defect
Syndesmotic Ankle Sprains
Details and Exceptions
Documentation of Exam
Dorsum of Forefoot Pain
Base of the Fifth Metatarsal Fracture
Ganglion Cyst
Metatarsal Stress Fracture
Evaluation of the Foot and Ankle (足と足首の評価)
Foot and Ankle Exam Maneuvers
Anterior Drawer Test
Calcaneal Squeeze Test
Kleiger's Test
Midfoot Torsion Test
Mulder's Test
Squeeze Test
Talar Tilt Test
Thompson's Test
Tinel's Test of the Tarsal Tunnel
Heel Pain
Calcaneal Apophysitis/Sever's Disese
Calcaneal Fracture and Stress Fracture
Heel Fat Pad Syndrome
Plantar Fasciitis
Instructions on Use
Lateral Hindfoot and Ankle Pain
Anterior Process of Calcaneous Fracture
Chronic Ankle Instability
Impingement Syndrome
Lateral Ankle Ligament Injury
Lateral Malleolar Fracture
Lateral Process of Talus Fracture
Osteochondral Defect
Peroneal Tendonopathy/Subluxation
Medial Hindfoot and Ankle Pain
Deltoid Ligament Injury
Medial Malleolar Fracture
Posterior Tibial Tendonopathy/Dysfunction
Tarsal Tunnel Syndrome
Midfoot Pain
Accessory Navicular (Os Tibiale Externum)
Kohler’s Disease (Osteochondrosis of the Navicular Bone)
Lisfranc Injury
Midfoot Fracture or Stress Fracture
Post-Test
Posterior Hindfoot and Ankle Pain
Achilles Tendon Rupture
Achilles Tendonopathy
Haglund Deformity
Os-Trigonum/Posterior Ankle Impingement Syndrome
Retrocalcaneal Bursitis
Pre-Test
References
Sole of Forefoot Pain
Metatarsalgia
Morton's Neuroma
Sesamoiditis
Toe Pain
Claw Toe
Hallux Rigidus
Hallux Valgus/Bunion (or Bunionette)
Hammer Toe
Mallet Toe
Turf Toe
Unit Evaluation
Parenting
Sign With Your Baby
Five Reasons to Sign with Your Baby
Learn 12 Signs
Frequently Asked Questions (FAQs)
ベビーサイン（赤ちゃんと手で会話）をしよう
Details and Exceptions
よくある質問 (FAQs)
ベビーサインをやってみよう
ベビーサイン（赤ちゃんと手で会話）をするとよい５つの理由
Quality Improvement
Meeting Management
Conducting the Meeting
Conflict Management
Creating a Meeting Agenda
Decision Making
Details and Exceptions
End of Meeting Actions
Establishing Ground Rules
Facilitation Skills
Group Decision Making
Group Problems
Guidelines for Engagement
Introduction to Meeting Management
Meeting Planner's Checklist
Meeting Planning
Meeting Set Up
Objectives
Observation
Post-Test
Pre-Test
References
Sample Meeting Notification
Stages of Team Growth
Summary
Typical Agenda Items
Unit Contents
Unit Evaluation
Contraception
避妊法 (Contraception)
Post-Test
Pre-Test
Unit Evaluation
ホルモン剤による避妊法
IUD (プロゲスチン放出型)
インプラント
ピル 経口避妊薬
患者の相談
注射法
症例2
症例2の答え
症例１の答えはこちら
皮膚貼付薬（パッチ)
腟リング (NuvaRing®)
ホルモン剤以外による避妊法
IUD (銅付着型)
コンドーム
ペッサリー: ダイアフラム、サービカルキャップ
殺精子剤
症例3
症例3の答え
避妊手術
不適切な方法
写真出所
参考文献
概要
細目および例外事項
緊急避妊法
症例4
症例4の答え
避妊効果の一覧表
避妊法の選択
Introduction to Nutrition
Acknowledgements
Carbohydrates
Choosing Healthy Carbs
Fiber
Glycemic Index
Description of Module
Fats
Good Fats
Fatty Acid Mixtures
Monounsaturated
Omega-3 Fats
Omega-6 Fats
Polyunsaturated
Saturated Fats
Trans Fats
Fruits and Vegetables
Benefits
Cardiovascular Health
Eye Health
Gastrointestinal Health
Prostate Health
Helpful Tips for Increasing Consumption
Purchasing and Preparation
Recommended Daily Intake
Goals and Objectives
License
Meal Planning Guides
Harvard's Healthy Living Pyramid
Popular Diets
Atkins Diet
South Beach Diet
Weight Watchers
The Great Plate
U-M's Healing Foods Pyramid
Post-Test
Pre-Test
Protein
How Much Protein?
Protein Quality
Quinoa
Protein Sources
Dairy
Eggs
Fish and Seafood
Grains
Lean Meat
Legumes and Soy
Seeds and Nuts
References
Useful Resources
Referring Patients
Weight Loss
Family Medicine Education Modules
症例3の答え
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このような、経妊婦であれば、避妊効果が高く長期間有効な（ピルなどのように毎日内服する必要がない）IUDがおすすめです。
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