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hypertension

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Health Maintenance in School-Aged Children: Part I. History, Physical Examination, ...

Aug 15, 2019 - The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. During the visit, the physician should address patient and parent/caregiver concerns and ask about ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p213.html

Amenorrhea: A Systematic Approach to Diagnosis and Management - American Family Physician

Jul 1, 2019 - Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p39.html

Primary Care for Persons Who Inject Drugs - American Family Physician

Jan 15, 2019 - More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p109.html

The Adult Well-Male Examination - American Family Physician

Dec 15, 2018 - The adult well-male examination should provide evidence-based guidance toward the promotion of optimal health and well-being. The medical history should focus on tobacco and alcohol use, risk of human immunodeficiency virus and other sexually transmitted infections, and diet and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p729.html

Anemia in Older Adults - American Family Physician

Oct 1, 2018 - Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p437.html

Well-Child Visits for Infants and Young Children - American Family Physician

Sep 15, 2018 - The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. A complete history during the well-child visit includes information about birth history; prior screenings; diet; sleep; dental care; and medical,...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p347.html

Hemolytic Anemia: Evaluation and Differential Diagnosis - American Family Physician

Sep 15, 2018 - Hemolytic anemia is defined by the premature destruction of red blood cells, and can be chronic or life-threatening. It should be part of the differential diagnosis for any normocytic or macrocytic anemia. Hemolysis may occur intravascularly, extravascularly in the reticuloendothelial ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p354.html

Rheumatologic Tests: A Primer for Family Physicians - American Family Physician

Aug 1, 2018 - Patients with a suspected connective tissue disorder should undergo serologic testing to confirm the diagnosis and, in some cases, to monitor disease activity and predict flares. Patients with suspected systemic lupus erythematosus should be tested for antinuclear antibodies. However, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0801/p164.html

Vitamin D Screening and Supplementation in Community-Dwelling Adults: Common Questions ...

Feb 15, 2018 - Measurement of vitamin D levels and supplementation with oral vitamin D have become commonplace, although clinical trials have not demonstrated health benefits. The usefulness of serum 25-hydroxyvitamin D levels to assess adequate exposure to vitamin D is hampered by variations in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p254.html

Noninfectious Penile Lesions - American Family Physician

Jan 15, 2018 - Noninfectious penile lesions are classified by clinical presentation as papulosquamous (e.g., psoriasis), inflammatory (e.g., lichen sclerosus, lichen nitidus, lichen planus), vascular (e.g., angiokeratomas), or neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p102.html

Ear Pain: Diagnosing Common and Uncommon Causes - American Family Physician

Jan 1, 2018 - Otalgia (ear pain) is a common presentation in the primary care setting with many diverse causes. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis media and otitis externa. Examination of the ear usually reveals abnormal findings in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p20.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Dec 15, 2017 - Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p776.html

Secondary Hypertension: Discovering the Underlying Cause - American Family Physician

Oct 1, 2017 - Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p453.html

Health Maintenance in Postmenopausal Women - American Family Physician

May 1, 2017 - Cardiovascular disease is the leading cause of death and disability in postmenopausal women older than 50 years. Clinicians should use the pooled cohort risk assessment equations or another risk calculator every three to five years to estimate a woman’s 10-year risk of atherosclerotic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p561.html

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.html

Proteinuria in Children: Evaluation and Differential Diagnosis - American Family Physician

Feb 15, 2017 - Although proteinuria is usually benign in the form of transient or orthostatic proteinuria, persistent proteinuria may be associated with more serious renal diseases. Proteinuria may be an independent risk factor for the progression of chronic kidney disease in children. Mechanisms of ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p248.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.html

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.html

Acute Monoarthritis: Diagnosis in Adults - American Family Physician

Nov 15, 2016 - Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities....

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p810.html

Clinical Evaluation of Bleeding and Bruising in Primary Care - American Family Physician

Feb 15, 2016 - Bleeding and bruising are common symptoms in the primary care setting. The patient history can help determine whether the bruising or bleeding is abnormal. The International Society on Thrombosis and Hemostasis has developed a bleeding assessment tool that can be used to indicate ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0215/p279.html

Diabetes Mellitus: Screening and Diagnosis - American Family Physician

Jan 15, 2016 - Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p103.html

Evaluation of Patients with Leukocytosis - American Family Physician

Dec 1, 2015 - An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal ranges for the white blood cell count. A repeat complete blood count with peripheral smear may provide helpful ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1201/p1004.html

Dysuria: Evaluation and Differential Diagnosis in Adults - American Family Physician

Nov 1, 2015 - The most common cause of acute dysuria is infection, especially cystitis. Other infectious causes include urethritis, sexually transmitted infections, and vaginitis. Noninfectious inflammatory causes include a foreign body in the urinary tract and dermatologic conditions. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p778.html

Diagnosing Common Benign Skin Tumors - American Family Physician

Oct 1, 2015 - Patients will experience a wide range of skin growths and changes over their lifetime. Family physicians should be able to distinguish potentially malignant from benign skin tumors. Most lesions can be diagnosed on the basis of history and clinical examination. Lesions that are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1001/p601.html

The Preparticipation Sports Evaluation - American Family Physician

Sep 1, 2015 - The preparticipation physical evaluation is a commonly requested medical visit for amateur and professional athletes of all ages. The overarching goal is to maximize the health of athletes and their safe participation in sports. Although studies have not found that the preparticipation ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0901/p371.html

Evaluation of Short and Tall Stature in Children - American Family Physician

Jul 1, 2015 - Short stature is defined as a height more than two standard deviations below the mean for age (less than the 3rd percentile). Tall stature is defined as a height more than two standard deviations above the mean for age (greater than the 97th percentile). The initial evaluation of short ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p43.html

Recognition and Differential Diagnosis of Psychosis in Primary Care - American Family ...

Jun 15, 2015 - Psychosis is a symptom complex that may include hallucinations, delusions, disorders of thought, and disorganized speech or behavior. Acute psychosis is primary if it is symptomatic of a psychiatric disorder, or secondary if caused by a specific medical condition. Patients with primary ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p856.html

Evaluation of Neck Masses in Adults - American Family Physician

May 15, 2015 - Neck masses are often seen in clinical practice, and the family physician should be able to determine the etiology of a mass using organized, efficient diagnostic methods. The first goal is to determine if the mass is malignant or benign; malignancies are more common in adult smokers ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p698.html

Diagnosis of Acute Stroke - American Family Physician

Apr 15, 2015 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p528.html

Unintentional Weight Loss in Older Adults - American Family Physician

May 1, 2014 - Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. The most common etiologies are malignancy, nonmalignant gastrointestinal disease, and psychiatric conditions. Overall, nonmalignant diseases are more common causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0501/p718.html

A Stepwise Approach to the Interpretation of Pulmonary Function Tests - American Family...

Mar 1, 2014 - Office-based pulmonary function testing, also known as spirometry, is a powerful tool for primary care physicians to diagnose and manage respiratory problems. An obstructive defect is indicated by a low forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio, which...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p359.html

Update on Prenatal Care - American Family Physician

Feb 1, 2014 - Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor....

American Family Physician : Article

https://www.aafp.org/afp/2014/0201/p199.html

Diagnostic Approach to Patients with Tinnitus - American Family Physician

Jan 15, 2014 - Tinnitus, a common symptom encountered in family medicine, is defined as the perception of noise in the absence of an acoustic stimulus outside of the body. Because tinnitus is a symptom and not a disease, its underlying cause must be determined to best help patients. Although tinnitus ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0115/p106.html

Assessment of Asymptomatic Microscopic Hematuria in Adults - American Family Physician

Dec 1, 2013 - Although routine screening for bladder cancer is not recommended, microscopic hematuria is often incidentally discovered by primary care physicians. The American Urological Association has published an updated guideline for the management of asymptomatic microscopic hematuria, which is ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1201/p747.html

Recognition and Evaluation of Nontraumatic Subarachnoid Hemorrhage and Ruptured ...

Oct 1, 2013 - Swift diagnosis and treatment are critical for good outcomes in patients with nontraumatic subarachnoid hemorrhage, which is usually caused by a ruptured aneurysm. This type of stroke often results in death or disability. Rates of misdiagnosis and treatment delays for subarachnoid ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1001/p451.html

When to Order Contrast-Enhanced CT - American Family Physician

Sep 1, 2013 - Family physicians often must determine the most appropriate diagnostic tests to order for their patients. It is essential to know the types of contrast agents, their risks, contraindications, and common clinical scenarios in which contrast-enhanced computed tomography is appropriate. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p312.html

Signs and Symptoms of Childhood Cancer: A Guide for Early Recognition - American Family...

Aug 1, 2013 - Although cancer in children is rare, it is the second most common cause of childhood mortality in developed countries. It often presents with nonspecific symptoms similar to those of benign conditions, leading to delays in the diagnosis and initiation of appropriate treatment. Primary ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0801/p185.html

Approach to Acute Headache in Adults - American Family Physician

May 15, 2013 - Approximately one-half of the adult population worldwide is affected by a headache disorder. The International Headache Society classification and diagnostic criteria can help physicians differentiate primary headaches (e.g., tension, migraine, cluster) from secondary headaches (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0515/p682.html

Evaluation and Diagnosis of Wrist Pain: A Case-Based Approach - American Family Physician

Apr 15, 2013 - Patients with wrist pain commonly present with an acute injury or spontaneous onset of pain without a definite traumatic event. A fall onto an outstretched hand can lead to a scaphoid fracture, which is the most commonly fractured carpal bone. Conventional radiography alone can miss up ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0415/p568.html

Outpatient Diagnosis of Acute Chest Pain in Adults - American Family Physician

Feb 1, 2013 - Approximately 1 percent of primary care office visits are for chest pain, and 1.5 percent of these patients will have unstable angina or acute myocardial infarction. The initial goal in patients presenting with chest pain is to determine if the patient needs to be referred for further ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0201/p177.html

Health Maintenance in Women - American Family Physician

Jan 1, 2013 - The health maintenance examination is an opportunity to focus on disease prevention and health promotion. The patient history should include screening for tobacco use, alcohol misuse, intimate partner violence, and depression. Premenopausal women should receive preconception counseling ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0101/p30.html

Revised AAP Guideline on UTI in Febrile Infants and Young Children - American Family ...

Nov 15, 2012 - In 2011, the American Academy of Pediatrics released a revision of its 1999 clinical practice guideline on urinary tract infections in febrile infants and young children two to 24 months of age. The new clinical practice guideline has several important updates based on evidence ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1115/p940.html

Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism - American Family Physician

Nov 15, 2012 - Venous thromboembolism manifests as deep venous thrombosis (DVT) or pulmonary embolism, and has a mortality rate of 6 to 12 percent. Well-validated clinical prediction rules are available to determine the pretest probability of DVT and pulmonary embolism. When the likelihood of DVT is ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1115/p913.html

When to Suspect a Genetic Syndrome - American Family Physician

Nov 1, 2012 - Family physicians should be able to recognize findings on physical examination and history that suggest the presence of a genetic syndrome to aid in the diagnosis and treatment of potentially affected patients, as well as subspecialty referral. General themes that can alert family ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1101/p826.html

Transient Ischemic Attack: Part I. Diagnosis and Evaluation - American Family Physician

Sep 15, 2012 - Transient ischemic attack is defined as transient neurologic symptoms without evidence of acute infarction. It is a common and important risk factor for future stroke, but is greatly underreported. Common symptoms are sudden and transient, and include unilateral paresis, speech ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p521.html

Evaluation of First Nonfebrile Seizures - American Family Physician

Aug 15, 2012 - Nonfebrile seizures may indicate underlying disease or epilepsy. The patient history can often distinguish epileptic seizures from nonepileptic disorders by identifying the events directly preceding the convulsion, associated conditions, and details of the seizure, including triggers, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0815/p334.html

Causes and Evaluation of Chronic Dyspnea - American Family Physician

Jul 15, 2012 - Chronic dyspnea is shortness of breath that lasts more than one month. The perception of dyspnea varies based on behavioral and physiologic responses. Dyspnea that is greater than expected with the degree of exertion is a symptom of disease. Most cases of dyspnea result from asthma, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0715/p173.html

Diagnosis and Evaluation of Heart Failure - American Family Physician

Jun 15, 2012 - Heart failure is a common clinical syndrome characterized by dyspnea, fatigue, and signs of volume overload, which may include peripheral edema and pulmonary rales. Heart failure has high morbidity and mortality rates, especially in older persons. Many conditions, such as coronary ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0615/p1161.html

The Adult Well Male Examination - American Family Physician

May 15, 2012 - The adult well male examination should incorporate evidence-based guidance toward the promotion of optimal health and well-being, including screening tests shown to improve health outcomes. Nearly one-third of men report not having a primary care physician. The medical history should ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0515/p964.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Nov 15, 2011 - Chronic kidney disease affects an estimated 27 million adults in the United States, and is associated with significantly increased risk of cardiovascular disease and stroke. Patients should be assessed annually to determine whether they are at increased risk of developing chronic kidney...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1138.html

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