General Internal Medicine (Geriatrics, Dermatology, Psychiatry, Women's Health, Preventive Care)
Geriatrics
Any acute change in cognition or function in an older adult is delirium until proven otherwise. Search for drugs, pain, urinary retention, constipation, dehydration, infection, and sensory deprivation; use non-pharmacologic measures first and reserve antipsychotics for danger to self or others. Review medications against the Beers criteria, and start low, go slow. Screen for falls (orthostatics, gait, vision, sedatives) and address advance care planning early.
Psychiatry
Screen with PHQ-2/9 and assess suicide risk directly. Serotonin syndrome (clonus, hyperreflexia, agitation) differs from neuroleptic malignant syndrome (rigidity, hyperthermia, elevated CK). Treat alcohol withdrawal with symptom-triggered benzodiazepines and always give thiamine with glucose. First-line pharmacotherapy for alcohol use disorder includes naltrexone and acamprosate.
Dermatology
Apply ABCDE criteria to pigmented lesions. Differentiate cellulitis (unilateral, warm, tender, sharp margins) from stasis dermatitis (bilateral, chronic, hemosiderin). Drug reactions range from morbilliform eruptions to SJS/TEN, which requires immediate drug withdrawal and burn-unit care.
Women's health and prevention
Age-appropriate cervical cancer screening, mammography, and bone density per guidelines; HRT is for symptom management, not prevention. Age 50–80 with a 20-pack-year history who currently smokes or quit within 15 years qualifies for annual low-dose CT lung screening. Screen for HIV and hepatitis C once in adults, and for colorectal cancer from age 45. Recommend statins per risk score.