NationMaster - Encyclopedia: Internal Medicine

Doctors of internal medicine ("internists") are medical specialists who focus on adult medicine and have had special study and training focusing on the prevention and treatment of adult diseases. At least three of their seven or more years of medical school and postgraduate training are dedicated to learning how to prevent, diagnose, and treat diseases that affect adults. Internists are sometimes referred to as the "doctor's doctor," because they are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems.^{[citation needed]} While the name "internal medicine" may lead one to believe that internists only treat "internal" problems, this is not the case. Doctors of internal medicine treat the whole person, not just internal organs. A medical specialist is someone who specializes in a particular field of medicine. ... It has been suggested that Refractory disease be merged into this article or section. ...

Definition of an internist

Doctors of internal medicine may also be referred to as "internists" or "general internists". They are not to be confused with "Medical interns," who are doctors in their first year of residency training. Although internists may act as primary care physicians, they are not "family physicians," "family practitioners," or "general practitioners", whose training is not just concentrated on adults, they work with children also, and may include surgery, obstetrics and pediatrics. General internists practice medicine from a primary care perspective but they can treat and manage many ailments.

Internal medicine subspecialists may also practice general internal medicine, but usually focus their practice on their particular subspecialty (like cardiology or pulmonology).

In the USA, Adult Primary care is usually provided by either Family practice or general internal medicine physicians. The primary care of adolescents is provided by Family practice, internists and pediatricians. The primary care of children and infants is provided by Family Practice or Pediatricians. Thus, there is overlap.

Internists are specially trained to solve puzzling diagnostic problems and handling severe chronic illnesses and situations where several different illnesses may strike at the same time. They also bring to patients an understanding of preventative medicine, men's and women's health, substance abuse, mental health, as well as effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Subspecialties of internal medicine

Internists can choose to focus their practice on general internal medicine, or may take additional training to "subspecialize" in one of 13 areas of internal medicine, generally organized by organ system. Cardiologists, for example, are doctors of internal medicine who subspecialize in diseases of the heart. The training an internist receives to subspecialize in a particular medical area is both broad and deep. Subspecialty training (often called a "fellowship") usually requires an additional one to three years beyond the standard three year general internal medicine residency. (Residencies come after a student has graduated from medical school.)

In the United States, there are two organizations responsible for certification of subspecialists within the field, the American Board of Internal Medicine, and the American Osteopathic Board of Internal Medicine.

The following are the subspecialties recognized by the American Board of Internal Medicine [1]. The American Board of Internal Medicine (ABIM) is a non-profit, independent physician organization in the U.S. that certifies physicians who practice in internal medicine and its subspecialties. ...

The ABIM also recognizes additional qualifications in the following areas Cardiology is the branch of medicine dealing with disorders of the heart and blood vessels. ... The heart and lungs, from an older edition of Grays Anatomy. ... The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Endocrinology is a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones. ... Major endocrine glands. ... Hormone is also the NATO reporting name for the Soviet/Russian Kamov Ka-25 military helicopter. ... Gastroenterology or gastrology is the medical specialty concerned with digestive diseases. ... All diseases that pertain to the gastrointestinal tract are labelled as digestive diseases. ... Hematology is the branch of medicine that is concerned with blood and its disorders. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... This false-colored electron micrograph shows a malaria sporozoite migrating through the midgut epithelia. ... Groups I: dsDNA viruses II: ssDNA viruses III: dsRNA viruses IV: (+)ssRNA viruses V: (-)ssRNA viruses VI: ssRNA-RT viruses VII: dsDNA-RT viruses A virus is a microscopic particle (ranging in size from 20 - 300 nm) that can infect the cells of a biological organism. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... A parasite is an organism that spends a significant portion of its life in or on the living tissue of a host organism and which causes harm to the host without immediately killing it. ... Oncology is the medical subspecialty dealing with the study and treatment of cancer. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Nephrology is the branch of internal medicine dealing with the study of the function and diseases of the kidney. ... It has been suggested that Renal anomalies and Renal plasma threshold be merged into this article or section. ... Neurology is a branch of medicine dealing with disorders of the nervous system. ... In animals, the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ... In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the lungs and the respiratory tract. ... The heart and lungs (from an older edition of Grays Anatomy) The lung is an organ belonging to the respiratory system and interfacing to the circulatory system of air-breathing vertebrates. ... In humans the respiratory tract is the part of the anatomy that has to do with the process of respiration or breathing. ... Rheumatology, a subspecialty of internal medicine, is devoted to the diagnosis and therapy of rheumatic diseases. ...

Internists may also specialize in allergy and immunology. The American Board of Allergy, Asthma, and Immunology is a conjoint board between internal medicine and pediatrics. Adolescent medicine is a medical subspecialty that focuses on care of patients who are in the adolescent period of development. ... Clinical cardiac electrophysiology (also referred to as cardiac electrophysiology or electrophysiology), is a branch of the medical specialty of cardiology concerned with the study and treatment of rhythm disorders of the heart. ... Intensive care medicine or critical care medicine is concerned with providing greater than ordinary medical care and observation to people in a critical or unstable condition. ... Geriatrics is the branch of medicine that focuses on health promotion and the prevention and treatment of disease and disability in later life. ... Interventional cardiology is a branch of the medical specialty of cardiology that deals specifically with the mechanical treatment of heart diseases. ... Sports medicine or sport medicine is an interdisciplinary subspecialty of medicine which deals with the treatment and preventive care of athletes, both amateur and professional. ...

The American College of Osteopathic Internists recognizes the following subspecialties.[2]

This article deals specifically with IgE-mediated hypersensitivity. ... Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. ... Cardiology is the branch of medicine dealing with disorders of the heart and blood vessels. ... Intensive care medicine or critical care medicine is concerned with providing greater than ordinary medical care and observation to people in a critical or unstable condition. ... Endocrinology is a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones. ... Gastroenterology or gastrology is the medical specialty concerned with digestive diseases. ... Geriatrics is the branch of medicine that focuses on health promotion and the prevention and treatment of disease and disability in later life. ... Hematology is the branch of medicine that is concerned with blood and its disorders. ... Oncology is the medical subspecialty dealing with the study and treatment of cancer. ... This false-colored electron micrograph shows a malaria sporozoite migrating through the midgut epithelia. ... Shown above is the bone scintigraphy of a young woman. ... Nephrology is the branch of internal medicine dealing with the study of the function and diseases of the kidney. ... In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the lungs and the respiratory tract. ... Rheumatology, a subspecialty of internal medicine, is devoted to the diagnosis and therapy of rheumatic diseases. ...

Principles of diagnosis

The main tools of the doctor are the medical history and the physical examination, but this holds particularly true for internal medicine. Subtle descriptions of disease (e.g. cyclic shallow and deep breathing, as in Cheyne-Stokes's respiration, or persistently deep breathing as in Kussmaul's) or physical signs (e.g. clubbing in many internal diseases) are important tools in guiding the diagnostic process. In the medical history, the "Review of Systems" serves to pick up symptoms of disease that a patient might not normally have mentioned, and the physical examination typically follows a structured fashion. In medicine, the physical examination or clinical examination is the process by which the physician investigates the body of a patient for signs of disease. ... Clubbing is also used to refer to the activity of gathering socially at nightclubs. ...

At this stage, a doctor is generally able to generate a differential diagnosis, or a list of possible diagnoses that can explain the constellation of signs and symptoms. Occam's razor dictates that, when possible, all symptoms should be presumed to be manifestations of the same disease process, but often multiple problems are identified. In medicine, differential diagnosis (sometimes abbreviated DDx or Î”Î”) is the systematic method physicians use to identify the disease causing a patients symptoms. ... In medicine, a sign is a feature of disease as detected by the doctor. ... The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... William of Ockham Occams razor (also spelled Ockhams razor) is a principle attributed to the 14th-century English logician and Franciscan friar William of Ockham. ...

In order to "narrow down" the differential diagnosis, blood tests and medical imaging are used. They can also serve screening purposes, e.g. to identify anemia in patients with unrelated complaints. Commonly performed screening tests, especially in older patients, are an X-ray of the chest, a full blood count, basic electrolytes, renal function and blood urea nitrogen. Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Medical imaging designates the ensemble of techniques and processes used to create images of the human body (or parts thereof) for clinical purposes (medical procedures seeking to reveal, diagnose or examine disease) or medical science (including the study of normal anatomy and function). ... Anemia (AmE) or anaemia (BrE), from the Greek () meaning without blood, refers to a deficiency of red blood cells (RBCs) and/or hemoglobin. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... A full blood count (FBC) or complete blood count (CBC) is a test requested by a doctor or other medical professional that gives information about the cells in a patients blood. ... An electrolyte is a substance containing free ions which behaves as an electrically conductive medium. ... In medicine (nephrology) renal function is an indication of the state of the kidney and its role in physiology. ... The blood urea nitrogen (BUN) test is a measure of the amount of nitrogen in the blood that comes from urea. ...

At this stage, the physician will often have already arrived at a diagnosis, or maximally a list of a few items. Specific tests for the presumed disease are often required, such as a biopsy for cancer, microbiological culture etc. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... A microbiological culture is a way to determine the cause of infectious disease by letting the agent multiply (reproduce) in predetermined media. ...

Treatment

Medicine is mainly focused on the art of diagnosis and treatment with medication, but many subspecialties administer surgical treatment: Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ...

Cardiology is the branch of medicine dealing with disorders of the heart and blood vessels. ... This article or section does not adequately cite its references or sources. ... Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms. ... Radiofrequency ablation (RFA) uses radiofrequency energy to destroy abnormal electrical pathways in heart tissue. ... The Intra-aortic balloon pump (IABP) is a mechanical device that is used to increase myocardial oxygen supply and decrease myocardial oxygen demand as well as increase cardiac output. ... Gastroenterology or gastrology is the medical specialty concerned with digestive diseases. ... Endoscopic images of a duodenal ulcer Endoscopy means looking inside and refers to looking inside the human body for medical reasons. ... Endoscopic retrograde cholangiopancreatography (ERCP) is endoscopy of the biliary tree and the pancreatic duct. ... Nephrology is the branch of internal medicine dealing with the study of the function and diseases of the kidney. ... In medicine, dialysis is a type of renal replacement therapy which is used to provide an artificial replacement for lost kidney function due to renal failure. ... Intensive care medicine or critical care medicine is concerned with providing greater than ordinary medical care and observation to people in a critical or unstable condition. ... mechanical or forced ventilation is the use of powered equipment, e. ...

References

Content based on authoritative information from the Web sites of the American College of Physicians, ABIM, and ACOI. See links above.

See also

The Royal College of Physicians and Surgeons of Canada, (RCPSC) is a national, private, nonprofit organization established in 1929 by a special Act of Parliament to oversee the medical education of specialists in Canada. ...

External links

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Advance practice nursing - Audiology - Dentistry - Dietetics - Emergency medical services - Epidemiology - Medical technology - Midwifery - Nursing - Occupational therapy - Optometry - Osteopathic medicine - Pharmacy - Physical therapy (Physiotherapy) - Physician - Physician assistant - Podiatry - Psychology - Public health - Respiratory therapy - Speech and language pathology Health sciences are the group of disciplines of applied science dealing with human and animal health. ... medicines, see medication and pharmacology. ... Advanced practice nurses (APNs) are Registered Nurses with advanced education, knowledge, skills, and scope of practice. ... Audiology is the branch of science that studies hearing, balance, and their disorders. ... A Dentist and Dental Assistant perform surgery on a patient. ... Dietitians are experts in food and nutrition. ... The examples and perspective in this article or section may not represent a worldwide view. ... Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ... Category: Possible copyright violations ... // Midwifery is the term traditionally used to describe the art of assisting a woman through childbirth. ... Nursing is a profession focused on assisting individuals, families, and communities in attaining, re-attaining, and maintaining optimal health and functioning. ... Occupational therapy (OT) is rehabilitation of mentally and physically disabled persons by teaching them a skill or providing them with creative activity. ... Optometry (Greek: optos meaning seen or visible and metria meaning measurement) is the health care profession concerned with examination, diagnosis, and treatment of the eyes and related structures and with determination and correction of vision problems using lenses and other optical aids [1]. An optical refractor (also called a phoropter... Osteopathic medicine (formerly known as osteopathy) is [1] Outside the United States, osteopathic medicine is often used interchangeably with osteopathy. Doctors of Osteopathic Medicine, or D.O.s, apply the philosophy of treating the whole person (a holistic approach) to the prevention, diagnosis and treatment of illness, disease and injury... For other uses, see Pharmacy (disambiguation). ... Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ... The Doctor by Samuel Luke Fildes This article is about the term physician, one type of doctor; for other uses of the word doctor see Doctor. ... In the United States, Physician Assistants (PAs) are non-physician clinicians licensed to practice medicine with a physicians supervision. ... Podiatry or Podiatric Medicine is a field of healthcare devoted to the study and treatment of disorders of the foot, ankle, and sometimes knee, leg and hip (collectively known as the lower extremity). ... Psychology is an academic or applied discipline involving the scientific study of mental processes such as perception, cognition, emotion, personality, behavior, and interpersonal relationships. ... Public health is concerned with threats to the overall health of a community based on population health analysis. ... Respiratory therapy is categorized as an allied health profession in the United States and Canada. ... // The practice of speech-language pathology includes prevention, diagnosis, habilitation, and rehabilitation of communication, swallowing, or other upper aerodigestive disorders; elective modification of communication behaviors; and enhancement of communication. ...

Physician specialties: Anesthesiology - Dermatology - Emergency medicine - General practice (Family medicine) - Internal medicine - Neurology - Nuclear medicine - Occupational medicine - Pathology - Pediatrics - Physical medicine and rehabilitation (Physiatry) - Preventive medicine - Psychiatry - Radiation oncology - Radiology - Surgery Anesthesia (AE), also anaesthesia (BE), is the process of blocking the perception of pain and other sensations. ... Dermatology (from Greek derma, skin) is a branch of medicine dealing with the skin and its appendages (hair, nails, sweat glands etc). ... This article or section does not cite its references or sources. ... A general practitioner (GP) or family physician (FP) is a physician who provides primary care. ... Neurology is a branch of medicine dealing with disorders of the nervous system. ... Shown above is the bone scintigraphy of a young woman. ... // What is occupational medicine Occupational medicine is the branch of clinical medicine most active in the field of occupational health. ... Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... Clinical Examination Pediatrics (also spelled paediatrics) is the branch of medicine that deals with the medical care of infants, children, and adolescents (from newborn to age 16-21, depending on the country). ... Physical medicine and rehabilitation (PM&R) or physiatry is a branch of medicine dealing with functional restoration of a person affected by physical disability. ... A 1930 Soviet poster propagating breast care. ... Psychiatrist redirects here. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... Image A: A normal chest X-ray. ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ...

Medical subspecialties: Allergy and immunology - Cardiology - Endocrinology - Gastroenterology - Hematology - Infectious disease - Intensive care medicine (Critical care medicine) - Medical genetics - Nephrology - Oncology - Pulmonology - Rheumatology This article deals specifically with IgE-mediated hypersensitivity. ... Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. ... Cardiology is the branch of medicine dealing with disorders of the heart and blood vessels. ... Endocrinology is a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones. ... Gastroenterology or gastrology is the medical specialty concerned with digestive diseases. ... Hematology is the branch of medicine that is concerned with blood and its disorders. ... This false-colored electron micrograph shows a malaria sporozoite migrating through the midgut epithelia. ... Intensive Care Medicine or critical care medicine is a branch of medicine concerned with the provision of life support or organ support systems in patients who are critically ill who usually also require intensive monitoring. ... Medical Genetics is the application of genetics to medicine. ... Nephrology is the branch of internal medicine dealing with the study of the function and diseases of the kidney. ... Oncology is the medical subspecialty dealing with the study and treatment of cancer. ... In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the lungs and the respiratory tract. ... Rheumatology, a subspecialty of internal medicine, is devoted to the diagnosis and therapy of rheumatic diseases. ...

Surgical subspecialties: Andrology - Cardiac surgery - General surgery - Hand surgery - Interventional neuroradiology - Neurosurgery - Obstetrics and gynecology - Ophthalmology - Oral and maxillofacial surgery - Orthopaedic surgery - Otolaryngology (ENT) - Pediatric surgery - Plastic surgery - Surgical oncology - Thoracic surgery - Transplant surgery - Trauma surgery - Urology - Vascular surgery Andrology (from the Greek andros, man) is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. ... Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... A surgeon operating General surgery, despite its name, is a surgical specialty that focuses on surgical treatment of abdominal organs, e. ... The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand or upper extremity (commonly from the tip of the hand to the shoulder). ... Interventional Neuroradiology (INR) / Endovascular Surgical Neuroradiology (ESN) is an Accreditation Council for Graduate Medical Education (ACGME) accredited medical subspecialty centered on minimally invasive image-based technologies/procedures used to diagnosis and treat diseases of the head, neck, and spine. ... Insertion of an electrode during neurosurgery for Parkinsons disease. ... Obstetrics and gynaecology (often abbreviated Ob-Gyn in the US and O&G elsewhere) form a single medical specialty and have a combined postgraduate training program. ... This does not adequately cite its references or sources. ... Oral and Maxillofacial Surgery is a recognized international training course in specialised Medicine, which requires a minimum length of formation of 5 years for a basic medical training and 4 years for a basic medical and dental training, in the European Union. ... Orthopedic surgery or orthopedics (BE: orthopaedics) is the branch of surgery concerned with acute, chronic, traumatic and recurrent injuries and other disorders of the locomotor system, its musclular and bone parts. ... Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. ... Pediatric surgery (sometimes spelled paediatric surgery) is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults. ... â€œFacial reconstructionâ€ redirects here. ... Surgical Oncology is the branch of surgery which focuses on the surgical managment of malignant neoplasms (cancer). ... In medicine, the field of (cardio)thoracic surgery is involved in the surgical treatment of diseases affecting the heart (cardiovascular disease) and lungs (lung disease). ... An organ transplant is the transplantation of an organ (or part of one) from one body to another, for the purpose of replacing the recipients damaged or failing organ with a working one from the donor. ... It has been suggested that Traumatology be merged into this article or section. ... Urology is the field of medicine that focuses on the urinary tracts of males and females, and on the reproductive system of males. ... Vascular surgery is the branch of surgery that occupies itself with surgical interventions of arteries and veins, as well as conservative therapies for disease of the peripheral vascular system. ...