Practical General Practice

1. Practical General Practice : Guidelines for Effective Clinical Management - p. i 2. Cover image - p. i 3. Title page - p. ii 4. Table of Contents - p. iii 5. Copyright - p. iv 6. Preface - p. vii 7. The structure of the book - p. viii 8. Acknowledgements - p. ix 9. List of Contributors - p. xi 10. List of Illustrations - p. xiii 11. List of Tables - p. xiv 12. Section 1. Principles and Practice of Primary Care - p. xiv 13. 1.  Principles and practice of primary care - p. 1 14. 2.  Long-term conditions - p. 7 15. 3.  Communication skills - p. 12 16. 4.  Disability - p. 19 17. Section 2. Manual of Clinical Practice - p. 27 18. 5.  Childhood problems - p. 28 19. The child with a fever - p. 29 20. The child with a cough - p. 31 21. The child with wheeze - p. 32 22. The child with constipation - p. 33 23. The child with abdominal pain - p. 35 24. The child with diarrhoea - p. 36 25. The child with a murmur - p. 37 26. The child who collapses - p. 37 27. The child with chest pain - p. 38 28. The child who does not walk at age 15 months - p. 39 29. The child with a small head - p. 39 30. The child with a large head - p. 40 31. The child with a febrile seizure - p. 40 32. The child with seizures - p. 41 33. The child with headaches - p. 42 34. The child with a tic - p. 43 35. The child with dysuria and abdominal pain - p. 43 36. The child with bedwetting (nocturnal enuresis) - p. 44 37. The child with protein in their urine - p. 45 38. The child with blood in their urine - p. 46 39. The child with an itchy perineum - p. 47 40. The child with worms in their stool - p. 48 41. The child with a painful penis - p. 48 42. The child with a groin swelling - p. 49 43. The child with a painful scrotum - p. 49 44. The child with a nonblanching rash - p. 49 45. The child with cervical lymphadenopathy - p. 50 46. The child with pica - p. 51 47. The child who is short - p. 51 48. The child who is tall - p. 52 49. The child with precocious puberty - p. 53 50. The child with excess body hair - p. 53 51. The child with a painful limp - p. 54 52. The infant who screams or vomits when feeding - p. 54 53. The infant who has weight faltering in the first 6 months of life - p. 55 54. The infant who has weight faltering after 6 months of age - p. 56 55. The child who is suspected of having a nonaccidental injury - p. 57 56. Reference - p. 58 57. 6.  Cardiovascular problems - p. 59 58. Hypertension - p. 59 59. Chest pain of recent onset - p. 65 60. Unstable angina (acute coronary syndrome) - p. 65 61. Stable angina - p. 67 62. Heart failure - p. 69 63. Atrial fibrillation - p. 74 64. Prophylaxis of infective endocarditis - p. 79 65. Prevention of cardiovascular disease - p. 79 66. Familial hypercholesterolaemia - p. 82 67. References - p. 83 68. 7.  Respiratory problems - p. 88 69. 8.  Gastroenterologic problems - p. 111 70. Disorders of the upper gastrointestinal tract - p. 111 71. Gallstone disease - p. 115 72. Pancreatic disease - p. 116 73. Irritable bowel syndrome - p. 116 74. Inflammatory bowel disease - p. 117 75. Chronic diarrhoea - p. 122 76. Coeliac disease - p. 123 77. Iron-deficiency anaemia - p. 125 78. Weight loss - p. 126 79. Jaundice and abnormal liver function test results - p. 128 80. Special situations - p. 128 81. Chronic liver disease - p. 132 82. References - p. 134 83. 9.  Surgical problems - p. 140 84. 10.  Musculoskeletal problems - p. 151 85. Osteoarthritis - p. 152 86. Low back pain - p. 154 87. Neck pain - p. 157 88. Problems with upper limbs - p. 158 89. Problems with the lower limbs - p. 160 90. Problems with the feet - p. 162 91. Steroid injections in soft tissue lesions - p. 163 92. Oral nonsteroidal antiinflammatory drugs - p. 163 93. Monitoring patients taking disease-modifying antirheumatic drugs - p. 165 94. Biologic therapy monitoring - p. 165 95. Gout - p. 165 96. Rheumatoid arthritis - p. 167 97. Spondyloarthropathies - p. 168 98. Connective tissue diseases - p. 169 99. Osteoporosis - p. 170 100. Polymyalgia rheumatica - p. 173 101. Temporal arteritis - p. 174 102. Fibromyalgia - p. 175 103. Further reading - p. 175 104. References - p. 176 105. 11.  Neurologic problems - p. 178 106. 12.  Women’s health - p. 199 107. 13.  Obstetric problems - p. 219 108. 14.  Older people - p. 241 109. 15.  Contraception, sexual problems, and sexually transmitted infections - p. 259 110. Contraception - p. 259 111. Information for professionals - p. 260 112. Information for patients - p. 260 113. Hormonal contraception - p. 260 114. Nonhormonal methods of contraception - p. 272 115. Emergency contraception - p. 274 116. Contraception in special cases - p. 276 117. Termination of pregnancy - p. 277 118. Infertility - p. 278 119. Sexual problems - p. 279 120. Sexually transmitted infections and human immunodeficiency virus - p. 282 121. Specific management of sexually transmitted infections - p. 283 122. Further reading - p. 289 123. References - p. 290 124. 16.  Psychiatric problems - p. 293 125. Depression - p. 293 126. Management of depression - p. 294 127. Suicide and suicidal risk - p. 298 128. Stress reactions - p. 299 129. Anxiety disorders - p. 302 130. Self-harm - p. 305 131. Acute psychotic disorders - p. 306 132. Compulsory admission - p. 307 133. Chronic schizophrenia - p. 309 134. Bipolar affective disorder - p. 312 135. Dealing with violence - p. 313 136. Eating disorders - p. 313 137. Further reading - p. 316 138. References - p. 316 139. 17.  Urinary and renal problems - p. 320 140. 18.  Ear, nose, and throat - p. 334 141. 19.  Eye problems - p. 347 142. 20.  Skin problems - p. 358 143. Atopic eczema - p. 358 144. Contact dermatitis - p. 361 145. Seborrhoeic dermatitis - p. 362 146. Acne vulgaris - p. 363 147. Acne rosacea - p. 364 148. Psoriasis - p. 365 149. Lichen planus - p. 367 150. Infection and infestation - p. 367 151. Lesions and malignancies - p. 373 152. Venous or varicose eczema - p. 377 153. Leg ulcers - p. 377 154. Hidradenitis suppurativa or acne inversa - p. 378 155. Urticaria and angioedema - p. 380 156. Alopecia - p. 381 157. References - p. 381 158. 21.  Allergic problems - p. 382 159. 22.  Diabetes and endocrinology - p. 387 160. 23.  Persistent physical symptoms - p. 406 161. 24.  Palliative care and care of the dying patient - p. 410 162. Basic principles - p. 410 163. Emergencies - p. 411 164. Care in the last days of life - p. 437 165. Advanced neurologic disease - p. 440 166. End-stage renal failure - p. 443 167. End-stage respiratory disease - p. 446 168. End-stage heart failure - p. 447 169. Section 3. Appendices - p. 450 170. Appendix 1. UK routine schedule of immunisations - p. 451 171. Appendix 2. Incubation periods and infectivities of common diseases - p. 452 172. Appendix 3. Suggested immunisations for travel - p. 454 173. Appendix 4. Notification of infectious diseases - p. 455 174. Appendix 5. Child health promotion - p. 456 175. Appendix 6. Stages of child development - p. 458 176. Appendix 7. Stages of puberty - p. 461 177. Appendix 8. Predicted normal peak flow values in children (younger than 15 years of age) - p. 463 178. Appendix 9. Peak expiratory flow (PEF) in normal subjects - p. 464 179. Appendix 10. Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) - p. 465 180. Appendix 11A. Summary of management of asthma in adults - p. 467 181. Appendix 11B. Summary of management of asthma in children - p. 468 182. Appendix 11C. Management of acute asthma in adults in general practice - p. 469 183. Appendix 11D. Management of acute asthma in children in general practice - p. 471 184. Appendix 12. Guidance for disease-modifying antirheumatic drug prescribing - p. 473 185. Appendix 13. Dermatomes and myotomes - p. 475 186. Appendix 14. Testing peripheral nerves - p. 476 187. Appendix 15. Drug levels - p. 478 188. Appendix 16. Checklist to guide the review of a patient with multiple sclerosis - p. 479 189. Appendix 17. Medical management of patients with obesity - p. 480 190. Appendix 18. Immunisations in pregnancy (UK) - p. 482 191. Appendix 19. Edinburgh postnatal depression scale - p. 483 192. Appendix 20. Admission procedures for patients with mental health problems - p. 485 193. Appendix 21. Early warning form for use in psychotic illness - p. 486 194. Appendix 22. The alcohol use disorders identification test - p. 487 195. Appendix 23. The international prostate symptom score - p. 489 196. Appendix 24. Body mass index for adults - p. 491 197. Appendix 25. Reference ranges for young adults - p. 492 198. Appendix 26. Anaphylaxis - p. 494 199. Appendix 27. Problems associated with specific causes of disability - p. 496 200. Appendix 28. The community dependency index - p. 500 201. Appendix 29. The Nottingham extended activities of daily living questionnaire - p. 502 202. Appendix 30. Drug stabilities in syringe drivers - p. 503 203. Appendix 31. Suspected cancer: Recognition and referral - p. 505 204. Appendix 32. Opioid dose conversion chart - p. 508 205. Index - p. 509