This chapter focuses on the approach to medical symptoms that commonly occur among geriatric patients on inpatient psychiatric units and provides general guidance for psychiatrists who will be called first to assess the patient and initiate medical management. This chapter is not intended to be a comprehensive review of medical diagnosis and treatment, and for this, the reader is encouraged to consult a textbook of medicine or geriatrics, or to utilize an accessible online reference, such as UpToDate® (www.uptodate.com). The amount of work-up and management of medical complaints on a psychiatric unit should be tailored to the psychiatrist’s level of comfort in this role, as well as the skills and comfort of staff to carry out needed monitoring and treatment. The on-call psychiatrist may be faced with atypical presentation of illness, as well as inadequate or misleading history from the patient. Suggested approaches to selected geriatric and general medical conditions are provided.