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A Practical Approach to Hypercalcemia - American Family Physician

May 1, 2003 - Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often is made incidentally in asymptomatic patients. Clinical manifestations affect the neuromuscular, gastrointestinal, renal, skeletal, and cardiovascular systems. The most common causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0501/p1959.html

Addison Disease: Early Detection and Treatment Principles - American Family Physician

Apr 1, 2014 - Primary adrenal insufficiency, or Addison disease, has many causes, the most common of which is autoimmune adrenalitis. Autoimmune adrenalitis results from destruction of the adrenal cortex, which leads to deficiencies in glucocorticoids, mineralocorticoids, and adrenal androgens. In ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0401/p563.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

Are Long-acting Insulin Analogues Better Than Isophane Insulin? - Cochrane for ...

Feb 15, 2008 - Based on poor quality evidence, this review suggests that insulin glargine and insulin detemir have no advantage over isophane insulin in reducing A1C levels. In one study, isophane insulin reduced A1C levels slightly more than insulin detemir. However, patients on insulin glargine and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0215/p447.html

Charcot Foot: The Diagnostic Dilemma - American Family Physician

Nov 1, 2001 - Primary care physicians involved in the management of patients with diabetes are likely to encounter the diagnostic and treatment challenges of pedal neuropathic joint disease, also known as Charcot foot. The acute Charcot foot is characterized by erythema, edema and elevated ...

American Family Physician : Article

https://www.aafp.org/afp/2001/1101/p1591.html

Congenital Adrenal Hyperplasia: Not Really a Zebra - American Family Physician

Mar 1, 1999 - Congenital adrenal hyperplasia was once considered a rare inherited disorder with severe manifestations. Mild congenital adrenal hyperplasia, however, is common, affecting one in 100 to 1,000 persons in the United States and frequently eluding diagnosis. Both classic and nonclassic ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0301/p1190.html

Controlling Hypertension in Patients with Diabetes - American Family Physician

Oct 1, 2002 - Hypertension and diabetes mellitus are common diseases in the United States. Patients with diabetes have a much higher rate of hypertension than would be expected in the general population. Regardless of the antihypertensive agent used, a reduction in blood pressure helps to prevent ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1001/p1209.html

Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - American Family ...

Sep 1, 2000 - The most common endogenous cause of Cushing's syndrome is Cushing's disease. Frequent clinical findings include weight gain, truncal obesity, striae, hypertension, glucose intolerance and infections. Cranial nerve II may be affected by enlarging pituitary adenomas in Cushing's disease; ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0901/p1119.html

Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Diabetic Foot Infection - American Family Physician

Jul 1, 2008 - Foot infections are common in patients with diabetes and are associated with high morbidity and risk of lower extremity amputation. Diabetic foot infections are classified as mild, moderate, or severe. Gram-positive bacteria, such as Staphylococcus aureus and beta-hemolytic ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p71.html

Diabetic Foot Infections - American Family Physician

Aug 1, 2013 - Diabetic foot infection, defined as soft tissue or bone infection below the malleoli, is the most common complication of diabetes mellitus leading to hospitalization and the most frequent cause of nontraumatic lower extremity amputation. Diabetic foot infections are diagnosed clinically...

American Family Physician : Article

https://www.aafp.org/afp/2013/0801/p177.html

Diabetic Ketoacidosis - American Family Physician

May 1, 2005 - A diagnosis of diabetic ketoacidosis requires the patient's plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7.30, and the bicarbonate level to be 18 mEq per L or less. Beta-hydroxybutyrate is a better measurement ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1705.html

Diabetic Ketoacidosis: Evaluation and Treatment - American Family Physician

Mar 1, 2013 - Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0301/p337.html

Diagnosis and Management of Galactorrhea - American Family Physician

Aug 1, 2004 - After infancy, galactorrhea usually is medication-induced. The most common pathologic cause of galactorrhea is a pituitary tumor. Other causes include hypothalamic and pituitary stalk lesions, neurogenic stimulation, thyroid disorders, and chronic renal failure. Patients with the latter...

American Family Physician : Article

https://www.aafp.org/afp/2004/0801/p543.html

Disorders of Puberty: An Approach to Diagnosis and Management - American Family Physician

Nov 1, 2017 - Disorders of puberty can profoundly impact physical and psychosocial well-being. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Patients with early isolated pubertal changes, prepubertal linear growth, and no worrisome ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p590.html

Evaluation and Treatment of Galactorrhea - American Family Physician

May 1, 2001 - Galactorrhea, or inappropriate lactation, is a relatively common problem that occurs in approximately 20 to 25 percent of women. Lactation requires the presence of estrogen, progesterone and, most importantly, prolactin. Stress, suckling, sleep, sexual intercourse and medications may ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0501/p1763.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

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

Sep 1, 2008 - Children and adolescents whose heights and growth velocities deviate from the normal percentiles on standard growth charts present a special challenge to physicians. Height that is less than the 3rd percentile or greater than the 97th percentile is deemed short or tall stature, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0901/p597.html

Gastrointestinal Complications of Diabetes - American Family Physician

Jun 15, 2008 - Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1697.html

Glucose Management in Hospitalized Patients - American Family Physician

Nov 15, 2017 - Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p648.html

Gynecomastia - American Family Physician

Apr 1, 2012 - Gynecomastia is defined as benign proliferation of glandular breast tissue in men. Physiologic gynecomastia is common in newborns, adolescents, and older men. It is self-limited, but can be treated to minimize emotional distress and physical discomfort. Nonphysiologic gynecomastia may ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0401/p716.html

HAIR-AN Syndrome: A Multisystem Challenge - American Family Physician

Jun 15, 2001 - HAIR-AN syndrome is an acronym for an unusual multisystem disorder in women that consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). The precipitating abnormality is thought to be insulin resistance, with a secondary increase in insulin levels and ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0615/p2385.html

Hereditary Hemochromatosis - American Family Physician

Feb 1, 2013 - Hereditary hemochromatosis is an autosomal recessive disorder that disrupts the body’s regulation of iron. It is the most common genetic disease in whites. Men have a 24-fold increased rate of iron-overload disease compared with women. Persons who are homozygous for the HFE gene ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0201/p183.html

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.html

Hirsutism in Women - American Family Physician

Feb 15, 2012 - Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0215/p373.html

Hyperosmolar Hyperglycemic State - American Family Physician

Dec 1, 2017 - Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p729.html

Hyperosmolar Hyperglycemic State - American Family Physician

May 1, 2005 - Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose, hyperosmolarity, and little or no ketosis. With the dramatic increase in the prevalence of type 2 diabetes and the aging population, this condition may be encountered more ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1723.html

Hyperparathyroidism - American Family Physician

Jan 15, 2004 - Primary hyperparathyroidism is the most frequent cause of hypercalcemia in ambulatory patients. The condition is most common in postmenopausal women, although it can occur in persons of all ages, including pregnant women. If symptoms are present, they are attributable to hypercalcemia ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p333.html

Hyperthyroidism: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p363.html

Hypothyroidism: An Update - American Family Physician

Aug 1, 2012 - Hypothyroidism is a clinical disorder commonly encountered by the primary care physician. Untreated hypothyroidism can contribute to hypertension, dyslipidemia, infertility, cognitive impairment, and neuromuscular dysfunction. Data derived from the National Health and Nutrition ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0801/p244.html

IDSA Releases Guidelines on the Diagnosis and Treatment of Diabetic Foot Infections - ...

Apr 1, 2005 - Guidelines for the diagnosis and treatment of diabetic foot infections have been developed by the Infectious Diseases Society of America (IDSA). In persons with diabetes, foot infections can cause substantial morbidity and are the most common nontraumatic cause of amputations.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2005/0401/p1429.html

Insulin Therapy for Type 2 Diabetes: Rescue, Augmentation, and Replacement of Beta-Cell...

Aug 1, 2004 - Type 2 diabetes is characterized by progressive beta-cell failure. Indications for exogenous insulin therapy in patients with this condition include acute illness or surgery, pregnancy, glucose toxicity, contraindications to or failure to achieve goals with oral antidiabetic ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0801/p489.html

Management of Blood Glucose in Type 2 Diabetes Mellitus - American Family Physician

Jan 1, 2009 - Evidence-based guidelines for the treatment of type 2 diabetes mellitus focus on three areas: intensive lifestyle intervention that includes at least 150 minutes per week of physical activity, weight loss with an initial goal of 7 percent of baseline weight, and a low-fat, ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0101/p29.html

Management of Blood Glucose with Noninsulin Therapies in Type 2 Diabetes - American ...

Jul 1, 2015 - A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p27.html

Management of Diabetic Ketoacidosis - American Family Physician

Aug 1, 1999 - Diabetic ketoacidosis is an emergency medical condition that can be life-threatening if not treated properly. The incidence of this condition may be increasing, and a 1 to 2 percent mortality rate has stubbornly persisted since the 1970s. Diabetic ketoacidosis occurs most often in ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0801/p455.html

Management of Hospitalized Patients with Type 2 Diabetes Mellitus - American Family ...

Mar 1, 1998 - Subopitmal glycemic control in hospitalized patients with type 2 (non-insulin-dependent) diabetes mellitus can have adverse consequences, including increased neurologic ischemia, delayed wound healing and an increased infection rate. Poor glycemic control can also affect the outcome of ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0301/p1079.html

Osteoporosis: Part I. Evaluation and Assessment - American Family Physician

Mar 1, 2001 - Osteoporosis afflicts 75 million persons in the United States, Europe and Japan and results in more than 1.3 million fractures annually in the United States. Because osteoporosis is usually asymptomatic until a fracture occurs, family physicians must identify the appropriate timing and ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0301/p897.html

Parathyroid Disorders - American Family Physician

Aug 15, 2013 - Disorders of the parathyroid glands most commonly present with abnormalities of serum calcium. Patients with primary hyperparathyroidism, the most common cause of hypercalcemia in outpatients, are often asymptomatic or may have bone disease, nephrolithiasis, or neuromuscular symptoms. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0815/p249.html

Pharmacologic Management of Hypertension in Patients with Diabetes - American Family ...

Dec 1, 2008 - Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macrovascular and microvascular complications. Patients with diabetes should achieve a target blood pressure of less than 130/80 mm Hg. The use of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1277.html

Pituitary Adenomas: An Overview - American Family Physician

Sep 1, 2013 - Prolactinomas and nonfunctioning adenomas are the most common types of pituitary adenomas. Patients with pituitary adenomas may present initially with symptoms of endocrine dysfunction such as infertility, decreased libido, and galactorrhea, or with neurologic symptoms such as headache ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p319.html

Radiologic Bone Assessment in the Evaluation of Osteoporosis - American Family Physician

Apr 1, 2002 - Osteoporosis affects nearly 28 million elderly Americans. Its major clinical manifestation is fragility fractures of the spine, hip, and distal radius. Low bone mass is the most important risk factor for a fragility fracture. In 1994, the World Health Organization defined osteoporosis ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0401/p1357.html

Risk-Assessment Tools for Detecting Undiagnosed Diabetes - Point-of-Care Guides - ...

Jul 15, 2009 - Early intervention with lifestyle modifications or pharmacotherapy has been shown to effectively delay or prevent type 2 diabetes in adults.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2009/0715/p175.html

Screening, Diagnosis, and Management of Gestational Diabetes Mellitus - American Family...

Apr 1, 2015 - Gestational diabetes mellitus (GDM) affects approximately 6% of pregnancies in the United States, and it is increasing in prevalence. Pregnant women without known diabetes mellitus should be screened for GDM after 24 weeks of gestation. Treatment of GDM results in a statistically ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p460.html

Subclinical Hyperthyroidism: Controversies in Management - American Family Physician

Feb 1, 2002 - Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. The thyroid-stimulating hormone value ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0201/p431.html

Subclinical Hyperthyroidism: When to Consider Treatment - American Family Physician

Jun 1, 2017 - Subclinical hyperthyroidism is defined by a low or undetectable serum thyroid-stimulating hormone level, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (e.g., in Graves disease, toxic nodular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p710.html

Subclinical Hypothyroidism: Deciding When to Treat - American Family Physician

Feb 15, 1998 - While screening patients for thyroid disease, physicians often find increased thyrotropin-stimulating hormone (TSH) levels in patients whose free thyroxine (T4) levels are not below normal. This state, termed

American Family Physician : Article

https://www.aafp.org/afp/1998/0215/p776.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Thyroid Nodules - American Family Physician

Aug 1, 2013 - Thyroid nodules are a common finding in the general population. They may present with symptoms of pressure in the neck or may be discovered during physical examination. Although the risk of cancer is small, it is the main reason for workup of these lesions. Measurement of ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0801/p193.html

Thyroid Nodules - American Family Physician

Feb 1, 2003 - Palpable thyroid nodules occur in 4 to 7 percent of the population, but nodules found incidentally on ultrasonography suggest a prevalence of 19 to 67 percent. The majority of thyroid nodules are asymptomatic. Because about 5 percent of all palpable nodules are found to be malignant, ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0201/p559.html

Thyroiditis - American Family Physician

May 15, 2006 - Thyroiditis is an inflammation of the thyroid gland that may be painful and tender when caused by infection, radiation, or trauma, or painless when caused by autoimmune conditions, medications, or an idiopathic fibrotic process. The most common forms are Hashimoto's disease, subacute ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0515/p1769.html

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