Cardiology
Management of risk factors for cardiovascular disease prevention, and early diagnosis and intervention for the established disease are important elements of a cardiologist.
Diseases typically seen by a cardiologist include:
- Coronary artery disease
- Ischemic heart disease
- Pericardial diseases
- Cardiomyopathies
- Endocarditis
- Dysrhythmias
- Valvular heart disease
- Congenital heart disease in adults
- Disorders of the veins, arteries, and pulmonary circulation
Endocrinology
- Hypothalamic disorders (abnormal sodium and water balance)
- Pituitary diseases (tumors, over- or under-production of pituitary hormones)
- Parathyroid abnormalities (hypercalcemia, hypocalcemia)
- Thyroid diseases (hyperthyroidism, hypothyroidism, goiter, nodules)
- Adrenal cortex dysfunction (mineralocorticoid, glucocorticoid, sex hormone abnormalities)
- Gonadal disease (hypogonadism and reproductive disorders)
- Pancreatic endocrine disease (diabetes mellitus)
- Bone metabolism (osteoporosis)
- Lipid metabolism
- Iatrogenic effect of glucocorticoids
Gastroenterology
Gastroenterology is the subspecialty of internal medicine that focuses on the evaluation and treatment of disorders of the gastrointestinal tract. Gastroenterologists are involved in the diagnosing, and treating of the diseases of the entire gastrointestinal tract, including the esophagus, stomach, small intestine, liver, gall bladder, pancreas, colon, and rectum.
Hematology
Hematology is the subspecialty of internal medicine that focuses on the care of patients with disorders of the blood, bone marrow, and lymphatic systems.
Clinical issues managed by hematologists include:
- Anemias
- Hematological malignancies and other clonal processes
- Congenital and acquired disorders of hemostasis, coagulation, and thrombosis
Infectious Disease
Infectious disease is the subspecialty of internal medicine that focuses on diagnosing and managing infections. Although general internists and other specialty physicians treat most common infections, infectious disease specialists are trained to managing difficult, unusual, or complicated infections including bacterial, viral, fungal, and parasitic infections occuring in humans and how they present clinically, as well as knowledge about antimicrobial agents, antibiotic resistance, vaccines, and other immunobiological agents.
Nephrology
Nephrology is the subspecialty of internal medicine that focuses on the diagnosis and treatment of diseases of the kidney. Nephrologists maintain expertise is in primary kidney disorders, but also the management of the systemic consequences of kidney dysfunction. Nephrologist input is recommended for primary kidney disorders such as glomerular diseases (such as glomerulonephritis or the nephrotic syndrome), tubulointerstitial kidney diseases, tubular defects, and the effects of toxins on the kidney, including various diagnostic and therapeutic agents. Conditions related the disorders of the kidney vasculature (such as renal artery stenosis), infections and neoplasms of the kidney, and abnormalities of the kidney, collecting system and bladder (such as nephrolithiasis) are important aspects of nephrology practice. Other conditions with involvement of the kidneys such as systemic diseases (such as vasculitis or heart failure) may require expert consultations in maintaining blood pressure, help in managing fluid, electrolyte, and acid-base disturbances, particularly those occurring in advanced kidney disease. A major role of nephrology is the oversight of dialysis (including hemodialysis and peritoneal dialysis) in patients requiring renal replacement therapy, and participation in the kidney transplant process, if indicated.
Medical Oncology
Oncology is frequently coupled with training in hematology in a combined hematology-oncology fellowship program. Medical oncology is the internal medicine subspecialty which involves the diagnosis and management of benign and malignant neoplasms. Oncologist typically assist general internists and other physicians in identifying individuals at risk for malignancy and investigating clinical symptoms and syndromes suggestive of underlying cancer. In patients with a diagnosed neoplasm, oncologists frequently undertake the care of patients with solid and hematologic tumors to attempt a cure or to prolong life and/or palliate symptoms.
Oncologist are actively involved in giving cancer directed therapies to patinet disgnosed with solid organ or hematological malignancies.
This dual training prepares an internist to diagnose, treat, and manage a wide range of related diseases.
Pulmonary medicine
Pulmonary medicine is the subspecialty of internal medicine that focuses on the diagnosis and management of disorders of the respiratory system, including the lungs, upper airways, thoracic cavity, and chest wall. Pulmonogist opinions are frequently seeked to help diagnose unknown disorders and assist in managing difficult, unusual, or complicated diseases of the respiratory system.
Pulmonologists have expertise in structural, inflammatory, infectious, and neoplastic disorders of the lung parenchyma, pleura and airways, pulmonary vascular disease and its effect on the cardiovascular system, and detection and prevention of occupational and environmental causes of lung disease. Diseases commonly evaluated and treated by pulmonologists include asthma, chronic obstructive lung disease (COPD), emphysema, lung cancer, interstitial and occupational lung diseases, complex lung and pleural infections including tuberculosis, pulmonary hypertension,cystic fibrosis and sleep apnea or sleep related disorders.
They with training in critical care medicine (intensivist) are at the forefront in managing critically ill patients in intensive care unit with respiratory failure and manage complex interventions such as mechanical ventilation.
Rheumatology
Rheumatology is the subspecialty of internal medicine that focuses on the diagnosis and treatment of medical diseases of the joints, muscles, and connective tissues. Rheumatologist provide expert input to help in diagnosing and managing more complex and systemic disease like in rheumatoid arthritis, osteoarthritis, crystalline diseases (such as gout), the spondyloarthropathies, vasculitis (such as giant cell arteritis or polyarteritis nodosa), polymyalgia rheumatica, systemic lupus erythematosus, inflammatory muscle diseases (such as polymyositis and dermatomyositis), systemic sclerosis (scleroderma), Sjögren disease, polychondritis, osteoporosis, fibromyalgia, and common musculoskeletal and sports injuries.
Allergy and immunology
Allergy and immunology involves the management of disorders related to the immune system. These conditions range from the very common to the very rare, spanning all ages and encompassing various organ systems. Diseases typically seen by an allergist/immunologist (often referred to simply as an “allergist”) include:
- Allergic diseases of the eye, such as allergic conjunctivitis
- Respiratory tract-related conditions such as allergic rhinitis, sinusitis, asthma, hypersensitivity pneumonitis and occupational lung diseases
- Gastrointestinal disorders caused by immune responses to foods, including eosinophilic esophagitis or gastroenteritis, and food protein-induced enteropathies
- Skin-related allergic conditions such as atopic dermatitis, contact dermatitis, acute and chronic urticaria, or angioedema
- Adverse reactions to foods, drugs, vaccines, stinging insects and other agents
- Diseases primarily affecting the immune system, including primary immune deficiencies such as severe combined immune deficiency syndromes, antibody deficiencies, complement deficiency, phagocytic cell abnormalities, or other impairments in innate immunity and acquired immune deficiency
- Systemic diseases including anaphylaxis and systemic diseases involving mast cells or eosinophils
- Stem cell, bone marrow and/or organ transplantation
Geriatric medicine
Geriatric medicine is a type of practice within internal medicine that focuses on the care of older patients. Those who practice geriatric medicine (“geriatricians”) are specifically trained in the normal and abnormal physiologic and psychosocial changes associated with aging, and to recognize the differences in presentation of disease relative to normal aging. Geriatricians also recognize the importance of maintaining functional independence in older patients and focus on providing preventive interventions.
Women’s Health
Women’s Health focuses on developing expertise in health issues that are unique to women, are more common in women, or may present differently in women. Women’s Health training programs are highly variable in focus but frequently provide more advanced expertise beyond that gained in usual internal medicine training, including:
- In-depth understanding of the physical, psychological, social, and sexual development of adolescent and young women
- Routine gynecologic care, including preventive counseling, breast examination, and breast cancer screening, pelvic examination and cervical cancer screening
- Family planning, including prescription of a variety of contraceptive options, preconception counseling, and post-partum care
- Management of menstrual dysfunction
- Evaluation of vaginitis and sexually transmitted infections in women
- Management of issues associated with perimenopause and menopause, including hormone replacement therapy
- Management of issues associated with perimenopause and menopause, including hormone replacement therapy
- Identification and management of specific psychosocial issues that disproportionately affect women, including domestic violence, sexual trauma, and post-partum depression