Internal medicine

Tests, procedures & treatments

Treating a Broad Range of Internal Medicine Conditions

Internal medicine doctors diagnose, manage, and treat a very wide variety of conditions — from the common and simple to the rare and complex.

They include diseases, infections, injuries, and other conditions affecting the heart, blood, kidneys, joints, and the digestive, respiratory, and vascular systems, such as:

• Allergies, including allergic rhinitis; angioedema (“hives”), and food allergies

• Birth control, including emergency contraception

• Bleeding and clotting disorders, including hemophilia, sickle cell disease, thrombotic thrombocytopenic purpura (TTP), intravascular coagulation, and von Willebrand disease

• Cardiac (heart) issues, including coronary artery disease; angina; pericarditis; heart defects; heart failure; arrhythmias such as atrial fibrillation and tachycardia; and complications of heart attack, stroke, and transient ischemic attack (TIA)

• Cognitive concerns, including cognitive impairment and dementia

• Dermatologic (skin) issues, including abscesses; cysts; cellulitis; skin cancer; and acne 

• Ear, nose, and throat problems, including sinusitis; pharyngitis (sore throat); rhinitis; strep throat; otitis; and vertigo

• Endocrine conditions, including thyroid disease; electrolyte disorders; Cushing's syndrome; adrenal insufficiency; and diabetes and related complications, such as ketoacidosis and hyperglycemic state

• Gastrointestinal problems, including infections; bleeding; inflammatory bowel disease; colitis and Crohn’s disease; gastroenteritis; esophageal disease; ingested foreign bodies; food impaction; narrowing (stenosis) and blockages (ischemia); difficulty swallowing (dysphagia); anal fissure; acid peptic disease; diverticulitis and diverticulosis; peptic ulcers; pancreatitis; liver disease; cholecystitis; and cholangitis

• Hypertension (high blood pressure) and related complications, including hypertensive retinopathy and hypertensive encephalopathy

• Infections, including Lyme disease; infections of shunts and other implanted devices; soft-tissue infections; bacterial peritonitis; staphylococcal and streptococcal infections; toxic shock syndrome; non-HIV viral infections; and clostridioides difficile (“c. diff”)

• Kidney conditions, including chronic kidney disease; acute kidney injury; pre-renal disease; kidney stones; tubular necrosis; and hydronephrosis

• Liver disease, including cirrhosis; fatty liver; hepatitis; and hepatic encephalopathy

• Men’s health, including prostate disease and erectile dysfunction

• Metabolic conditions such as metabolic alkalosis; metabolic acidosis; and metabolic mineral and bone disease

• Neurologic conditions, including headaches; migraine; Bell’s palsy; meningitis; encephalitis; epilepsy; neuromuscular disease; and peripheral nerve and muscle diseases, such as neuropathies

• Non-surgical orthopedic issues, including strains, sprains, minor breaks, and other injuries; and joint pain and inflammation

• Pain, including acute pain; chronic pain; pain related to cancer and other conditions

• Pulmonary (lung and respiratory) issues, including bronchitis and other infections; asthma; pneumonia; trouble breathing; foreign bodies in the airway; chronic obstructive pulmonary disease (COPD); pneumothorax; and pulmonary embolism (blood clot)

• Urinary health, including urinary stones; bladder issues; and urinary tract infections

• Vascular (blood flow) conditions, including venous thrombosis; peripheral vascular disease; and syncope (fainting)

• Women’s health, including well-woman care and care for obstetric and gynecologic (OB/GYN) issues

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Internal Medicine Tests and Procedures

Internal medicine doctors, nurses, and other providers are trained to perform many types of tests and procedures — some to evaluate, diagnose, and monitor patients, others to manage or treat specific conditions.

Clinicians need experience, skill, and in many cases, additional training and medical credentials to perform these procedures — and to minimize patient discomfort, optimize outcomes, and reduce side effects.

Internal medicine specialists commonly perform and order tests and procedures that include:

• Venipuncture (“blood draw”) to test blood

• Arterial puncture to analyze blood gases

• Endotracheal intubation

• Flexible sigmoidoscopy

• Intravenous (IV) line insertion

• Nasogastric (NG) tube placement

• Urinary catheters placement

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Some internists have been trained in more complex and/or invasive diagnostic and therapeutic procedures, such as thoracentesis, lumbar puncture, and paracentesis.
Categories and other types of tests and procedures an internist might perform or order include:

• Allergy: Skin testing, rhinoscopy

• Cardiology: Cardiac stress testing, echocardiograms

• Endocrinology: Thyroid biopsy, dynamic hormone testing, bone density testing

• Oropharyngeal cancer screening

• Pulmonary: Intubation and ventilator management, bronchoscopy, chest tube thoracostomy, tracheostomy placement

• Rheumatology: Joint aspiration and therapeutic injection

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Internal medicine and many other medical specialties use ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) to guide invasive procedures. Flexible fiber-optic instruments may be used to access hard-to-reach areas of the body.