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A Primary Care Approach to the Patient with Claudication - American Family Physician

Feb 15, 2000 - Peripheral arterial occlusive disease occurs in about 18 percent of persons over 70 years of age. Usually, patients who have this disease present with intermittent claudication with pain in the calf, thigh or buttock that is elicited by exertion and relieved with a few minutes of rest. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1027.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

Acute Stroke Diagnosis - American Family Physician

Jul 1, 2009 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of ischemic stroke diagnosis. The most common presenting symptoms for ischemic stroke are ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p33.html

Allergy Testing - American Family Physician

Aug 15, 2002 - Percutaneous and intradermal skin tests and laboratory assays of specific IgE antibodies may be useful in selected cases of allergy management. Percutaneous testing kits are available from various manufacturers. A number of common allergens are available in standardized preparations. ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0815/p621.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

Assessing Oral Malignancies - American Family Physician

Apr 1, 2002 - Oral cancers account for approximately 3 percent of all cases of cancer in the United States. An estimated 30,000 people will be diagnosed with oral cancer this year, and about one half of them will eventually die of the disease. The most common type of oral cancer is squamous cell ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0401/p1379.html

Assessment of Microscopic Hematuria in Adults - American Family Physician

May 15, 2006 - Microscopic hematuria, a common finding on routine urinalysis of adults, is clinically significant when three to five red blood cells per high-power field are visible. Etiologies of microscopic hematuria range from incidental causes to life-threatening urinary tract neoplasm. The lack ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0515/p1748.html

Breast Cyst Aspiration - American Family Physician

Nov 15, 2003 - The breast mass is a clinical problem commonly encountered by family physicians. Fine-needle and core biopsy techniques require training and cytopathologist support. In contrast, breast cyst aspiration using a 21- or 22-gauge needle is a simple, cost-effective, minimally invasive ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1115/p1983.html

Brief Screening Instruments for Dementia in Primary Care - Point-of-Care Guides - ...

Mar 15, 2009 - In addition to identifying patients who may benefit from pharmacotherapy, early detection of dementia helps families anticipate the patient’s needs and helps physicians identify those in need of additional support.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2009/0315/p497.html

Cancer Screening in Older Patients - American Family Physician

Apr 15, 2016 - Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p659.html

Cancer Screening in the Older Patient - American Family Physician

Dec 15, 2008 - Although there are clear guidelines that advise at what age to begin screening for various cancers, there is less guidance concerning when it may be appropriate to stop screening. The decision to stop screening must take into account patients' age; overall health and life expectancy; ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1369.html

Causes and Evaluation of Mildly Elevated Liver Transaminase Levels - American Family ...

Nov 1, 2011 - Mild elevations in levels of the liver enzymes alanine transaminase and aspartate transaminase are commonly discovered in asymptomatic patients in primary care. Evidence to guide the diagnostic workup is limited. If the history and physical examination do not suggest a cause, a stepwise...

American Family Physician : Article

https://www.aafp.org/afp/2011/1101/p1003.html

Cervical Colposcopy: Indications and Risk Assessment - American Family Physician

Jul 1, 2020 - The practice of colposcopy, a diagnostic procedure to evaluate for vaginal, vulvar, and cervical dysplasia, has evolved to incorporate patient risk factors for high-grade cervical intraepithelial neoplasia (CIN) and cancer. Changes in cervical cancer screening and guidelines, human ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p39.html

Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ...

Apr 15, 2020 - Chronic diarrhea is defined as a predominantly loose stool lasting longer than four weeks. A patient history and physical examination with a complete blood count, C-reactive protein, anti-tissue transglutaminase immunoglobulin A (IgA), total IgA, and a basic metabolic panel are useful ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p472.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

Chronic Obstructive Pulmonary Disease: Diagnostic Considerations - American Family ...

Feb 15, 2006 - Chronic obstructive pulmonary disease is characterized by the gradual progression of irreversible airflow obstruction and increased inflammation in the airways and lung parenchyma that is generally distinguishable from the inflammation caused by asthma. Most chronic obstructive ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p669.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

Colonoscopy Surveillance After Polypectomy and Colorectal Cancer Resection - American ...

Apr 1, 2008 - This article describes a joint update of guidelines by the American Cancer Society and the U.S. Multi-Society Task Force on Colorectal Cancer delineating evidence-based surveillance recommendations for patients after polypectomy and colorectal cancer resection. Although there are some ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0401/p995.html

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

Colorectal Cancer Screening and Surveillance - American Family Physician

Jan 15, 2015 - Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0115/p93.html

Colorectal Cancer: A Summary of the Evidence for Screening and Prevention - American ...

Dec 15, 2008 - Colorectal cancer causes significant morbidity and mortality in the United States. The incidence of colorectal cancer can be reduced with increasing efforts directed at mass screening of average-risk adults 50 years and older. Currently, fecal occult blood test and flexible ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1385.html

Computed Tomography After Minor Head Injury - Point-of-Care Guides - American Family ...

Jun 15, 2006 - Minor head injury is commonly seen in the primary care and emergency department settings. Minor head injury typically includes brief loss of consciousness or other symptoms of concussion. Several clinical decision rules have been developed and validated to help identify patients who ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2006/0615/p2205.html

Dermal Electrosurgical Shave Excision - American Family Physician

May 1, 2002 - The dermal electrosurgical shave excision is a fast and inexpensive method of removing epidermal and dermal lesions. The procedure is ideally suited for pedunculated lesions raised above the level of the surrounding skin. It consists of repetitive, unidirectional, horizontal slicing of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0501/p1883.html

Detecting Celaic Disease in Your Patients - American Family Physician

Mar 1, 1998 - Celiac disease is a genetic, immunologically mediated small bowel enteropathy that causes malabsorption. The immune inflammatory response to gluten frequently causes damage to many other tissues of the body. The condition is frequently underdiagnosed because of its protean ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0301/p1023.html

Detection and Evaluation of Chronic Kidney Disease - American Family Physician

Nov 1, 2005 - Chronic kidney disease affects approximately 19 million adult Americans, and its incidence is increasing rapidly. Diabetes and hypertension are the underlying causes in most cases of chronic kidney disease. Evidence suggests that progression to kidney failure can be delayed or prevented...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1723.html

Diagnosing Lumbar Spinal Stenosis - Point-of-Care Guides - American Family Physician

Nov 15, 2009 - Lumbar spinal stenosis is an important cause of pain and disability, and surgery is beneficial for appropriately selected patients. Therefore, it is important for primary care physicians to distinguish patients with spinal stenosis from those with musculoskeletal low back pain, ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2009/1115/p1145.html

Diagnosing Rotator Cuff Tears - Point-of-Care Guides - American Family Physician

Apr 15, 2005 - As with many conditions, single physical examination maneuvers rarely are sensitive enough to rule out disease when absent or specific enough to rule in disease when present. By themselves, these maneuvers increase or decrease the likelihood of disease slightly, and it remains up to the...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2005/0415/p1587.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Oct 15, 2009 - Adnexal masses represent a spectrum of conditions from gynecologic and nongynecologic sources. They may be benign or malignant. The initial detection and evaluation of an adnexal mass requires a high index of suspicion, a thorough history and physical examination, and careful attention ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1015/p815.html

Diagnosis and Management of Gestational Diabetes Mellitus - American Family Physician

Jul 1, 2009 - Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p57.html

Diagnosis and Treatment of Acute Uncomplicated Cystitis - American Family Physician

Oct 1, 2011 - Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p771.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

Diagnosis of Anxiety Disorders in Primary Care - Point-of-Care Guides - American Family...

Aug 15, 2008 - Generalized anxiety disorder leads to considerable morbidity and affects approximately 3 percent of patients in primary care practices.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2008/0815/p501.html

Diagnosis of Appendicitis: Part I. History and Physical Examination - Point-of-Care ...

Mar 15, 2008 - Appendicitis is a relatively uncommon, but potentially serious, cause of abdominal pain in the primary care setting. An accurate diagnosis is important to prevent unnecessary surgery and avoid complications.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2008/0315/p828.html

Diagnosis of Appendicitis: Part II. Laboratory and Imaging Tests - Point-of-Care Guides...

Apr 15, 2008 - Although individual signs and symptoms are of limited value in the diagnosis of appendicitis, the Alvarado (also known as the MANTRELS [Migration of pain to the right lower quadrant, Anorexia, Nausea/vomiting, Tenderness in the right lower quadrant, Rebound pain, Elevation of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2008/0415/p1153.html

Diagnosis of Eating Disorders in Primary Care - American Family Physician

Jan 15, 2003 - Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant causes of morbidity and mortality among adolescent females and young women. Eating disorders are associated with devastating medical and psychologic consequences, including death, osteoporosis, growth ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0115/p297.html

Diagnosis of Gastroesophageal Reflux Disease - Point-of-Care Guides - American Family ...

May 15, 2010 - Diagnosis of GERD may be clinical (presentation with typical symptoms, such as heartburn); physiologic (evidence of abnormal pH levels in the distal esophagus); anatomic (evidence of esophagitis on endoscopy); or functional (clinical response to antacid medications). However, the ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2010/0515/p1278.html

Diagnosis of Lyme Disease - American Family Physician

Jul 15, 2005 - The use of serologic testing and its value in the diagnosis of Lyme disease remain confusing and controversial for physicians, especially concerning persons who are at low risk for the disease. The approach to diagnosing Lyme disease varies depending on the probability of disease (based...

American Family Physician : Article

https://www.aafp.org/afp/2005/0715/p297.html

Diagnosis of Migraine Headache - Point-of-Care Guides - American Family Physician

Dec 15, 2006 - Headache is a common reason for primary care office visits and is a complaint in more than 1 percent of patient visits. The prevalence of migraine headache in the general population is approximately 6 percent in men and 15 percent in women, peaking at 40 years of age and then declining.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2006/1215/p2087.html

Diagnosis of Streptococcal Pharyngitis - Point-of-Care Guides - American Family Physician

Jun 15, 2014 - Sore throat was the chief symptom in 1.3% of all outpatient office visits in 2010, and is even more common in primary care practice. An Australian study found that among families with at least one child three to 12 years of age, the incidence of sore throat was 33 and 14 episodes per ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2014/0615/p976.html

Diagnosis of Urinary Tract Infections in Children - Point-of-Care Guides - American ...

Feb 15, 2018 - A recent observational study found that 2.2% of acutely ill children younger than five years met criteria for a UTI when their urine was cultured. However, in the same study, overall clinician impression that a UTI was present (fairly to very certain) identified only 28 out of 60 ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0215/p273.html

Diagnostic Approach to Palpitations - American Family Physician

Feb 15, 2005 - Palpitations-sensations of a rapid or irregular heartbeat-are most often caused by cardiac arrhythmias or anxiety. Most patients with arrhythmias do not complain of palpitations. However, any arrhythmia, including sinus tachycardia, atrial fibrillation, premature ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p743.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

Diagnostic Approach to Pleural Effusion - American Family Physician

Jul 15, 2014 - Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy. Pleural effusion occurs when fluid collects between the parietal and visceral pleura. Processes causing a distortion in ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p99.html

Diagnostic Approach to Tinnitus - American Family Physician

Jan 1, 2004 - Tinnitus is a common disorder with many possible causes. Most cases of tinnitus are subjective, but occasionally the tinnitus can be heard by an examiner. Otologic problems, especially hearing loss, are the most common causes of subjective tinnitus. Common causes of conductive hearing ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0101/p120.html

Diagnostic Evaluation of Erectile Dysfunction - American Family Physician

Jan 1, 2000 - Erectile dysfunction, the persistent inability to attain or maintain penile erection sufficient for sexual intercourse, affects millions of men to various degrees. The majority of cases have an organic etiology, most commonly vascular disease that decreases blood flow into the penis. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0101/p95.html

Dizziness: A Diagnostic Approach - American Family Physician

Aug 15, 2010 - Dizziness accounts for an estimated 5 percent of primary care clinic visits. The patient history can generally classify dizziness into one of four categories: vertigo, disequilibrium, presyncope, or lightheadedness. The main causes of vertigo are benign paroxysmal positional vertigo, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p361.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

Down Syndrome: Prenatal Risk Assessment and Diagnosis - American Family Physician

Aug 15, 2000 - Down syndrome (trisomy 21) is the most commonly recognized genetic cause of mental retardation. The risk of trisomy 21 is directly related to maternal age. All forms of prenatal testing for Down syndrome must be voluntary. A nondirective approach should be used when presenting patients ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p825.html

Dyspareunia in Women - American Family Physician

Oct 1, 2014 - Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. Dyspareunia can have a significant impact on a woman’s mental and physical health, body image, relationships with ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1001/p465.html

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