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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 Knee Injuries: Use of Decision Rules for Selective Radiograph Ordering - American...

Dec 1, 1999 - Family physicians often encounter patients with acute knee trauma. Radiographs of injured knees are commonly ordered, even though fractures are found in only 6 percent of such patients and emergency department physicians can usually discriminate clinically between fracture and ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1201/p2599.html

Adolescent Health Screening and Counseling - American Family Physician

Dec 15, 2012 - Serious health problems, risky behavior, and poor health habits persist among adolescents despite access to medical care. Most adolescents do not seek advice about preventing leading causes of morbidity and mortality in their age group, and physicians often do not find ways to provide ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1215/p1109.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

Allergy Testing: Common Questions and Answers - American Family Physician

Jul 1, 2018 - An estimated 10% to 30% of the global population has an allergic disease. Clinical presentations of allergic diseases, respiratory infections, and autoimmune conditions have similar features. Allergy and immunologic testing can help clarify the diagnosis and guide treatment. Immediate ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p34.html

An Approach to Interpreting Spirometry - American Family Physician

Mar 1, 2004 - Spirometry is a powerful tool that can be used to detect, follow, and manage patients with lung disorders. Technology advancements have made spirometry much more reliable and relatively simple to incorporate into a routine office visit. However, interpreting spirometry results can be ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0301/p1107.html

An Office-Based Approach to Influenza: Clinical Diagnosis and Laboratory Testing - ...

Jan 1, 2003 - Vaccination is the primary measure for preventing morbidity and mortality from influenza. During the influenza season, family physicians must distinguish influenza from the common cold and other flu-like illnesses. Signs and symptoms of influenza include abrupt onset of fever, severe ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0101/p111.html

Anterior Hip Pain - American Family Physician

Oct 15, 1999 - Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1015/p1687.html

Applying HIV Testing Guidelines in Clinical Practice - American Family Physician

Dec 15, 2009 - An estimated one fourth of persons with human immunodeficiency virus (HIV) are not aware they are infected. Early diagnosis of HIV has the potential to ensure optimal outcomes for infected persons and to limit the spread of the virus. Important barriers to testing among physicians ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1441.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

Approach to the Adult Patient with Fever of Unknown Origin - American Family Physician

Dec 1, 2003 - Fever of unknown origin (FUO) in adults is defined as a temperature higher than 38.3 degrees C (100.9 degrees F) that lasts for more than three weeks with no obvious source despite appropriate investigation. The four categories of potential etiology of FUO are classic, nosocomial, ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1201/p2223.html

Assessing Breast Cancer Risk in Women - American Family Physician

Dec 15, 2008 - Understanding modifiable and nonmodifiable factors that increase or decrease breast cancer risk allows family physicians to counsel women appropriately. Nonmodifiable factors associated with increased breast cancer risk include advanced age, female sex, family history of breast cancer, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1361.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

Asthma Update: Part I. Diagnosis, Monitoring, and Prevention of Disease Progression - ...

Sep 1, 2004 - Despite increased scientific knowledge about asthma and improved therapeutic options, the disease continues to cause significant morbidity and mortality. The National Asthma Education and Prevention Program Expert Panel has updated its clinical guidelines on asthma medications, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0901/p893.html

Asymptomatic Microscopic Hematuria in Adults: Summary of the AUA Best Practice Policy ...

Mar 15, 2001 - The American Urological Association (AUA) convened the Best Practice Policy Panel on Asymptomatic Microscopic Hematuria to formulate policy statements and recommendations for the evaluation of asymptomatic microhematuria in adults. The recommended definition of microscopic hematuria is ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0315/p1145.html

Atypical Presentations of Gastroesophageal Reflux Disease - American Family Physician

Aug 15, 2008 - Gastroesophageal reflux disease typically manifests as heartburn and regurgitation, but it may also present with atypical or extraesophageal symptoms, including asthma, chronic cough, laryngitis, hoarseness, chronic sore throat, dental erosions, and noncardiac chest pain. Diagnosing ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0815/p483.html

Audiometry Screening and Interpretation - American Family Physician

Jan 1, 2013 - The prevalence of hearing loss varies with age, affecting at least 25 percent of patients older than 50 years and more than 50 percent of those older than 80 years. Adolescents and young adults represent groups in which the prevalence of hearing loss is increasing and may therefore ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0101/p41.html

Bleeding and Bruising: A Diagnostic Work-up - American Family Physician

Apr 15, 2008 - Primary care physicians are often asked about easy bruising, excessive bleeding, or risk of bleeding before surgery. A thorough history, including a family history, will guide the appropriate work-up, and a physical examination may provide clues to diagnosis. A standardized bleeding ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1117.html

Breast Cancer Screening Update - American Family Physician

Feb 15, 2013 - Breast cancer is the most common non–skin cancer and the second leading cause of cancer death in North American women. Mammography is the only screening test shown to reduce breast cancer–related mortality. There is general agreement that screening should be offered at least biennially ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p274.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

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

Cardiovascular Screening of Student Athletes - American Family Physician

Aug 15, 2000 - Each year, a number of children and adolescents die suddenly from cardiac problems that are associated with a small subgroup of disorders and high-risk behaviors. While sudden cardiac death in any child or adolescent is distressing, it can be particularly devastating when it occurs in a...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p765.html

Cerebrospinal Fluid Analysis - American Family Physician

Sep 15, 2003 - Lumbar puncture is frequently performed in primary care. Properly interpreted tests can make cerebrospinal fluid (CSF) a key tool in the diagnosis of a variety of diseases. Proper evaluation of CSF depends on knowing which tests to order, normal ranges for the patient's age, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1103.html

Childhood Eye Examination - American Family Physician

Aug 15, 2013 - Vision screening in children is an ongoing process, with components that should occur at each well-child visit. The purpose is to detect risk factors and visual abnormalities that necessitate treatment and to identify those patients who require referral to an ophthalmologist skilled in ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0815/p241.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 Musculoskeletal Pain in Children: Part I. Initial Evaluation - American Family ...

Jul 1, 2006 - Musculoskeletal pain can be difficult for children to characterize. Primary care physicians must determine whether the pain may be caused by a systemic disease. Change in activity, constitutional symptoms such as fevers and fatigue, or abnormal examination findings without obvious ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0701/p115.html

Chronic Pelvic Pain in Women - American Family Physician

Mar 1, 2016 - Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p380.html

Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - American Family...

Sep 1, 2006 - Cirrhosis and chronic liver failure are leading causes of morbidity and mortality in the United States, with the majority of preventable cases attributed to excessive alcohol consumption, viral hepatitis, or nonalcoholic fatty liver disease. Cirrhosis often is an indolent disease; most ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p756.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

Clinical Utility of Common Serum Rheumatologic Tests - American Family Physician

Mar 15, 2002 - Serum rheumatologic tests are generally most useful for confirming a clinically suspected diagnosis. Testing for rheumatoid factor is appropriate when rheumatoid arthritis, Sjögren's syndrome or cryoglobulinemia is suspected. Antinuclear antibody testing is highly sensitive for ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0315/p1073.html

Clinical Utility of the Erythrocyte Sedimentation Rate - American Family Physician

Oct 1, 1999 - The erythrocyte sedimentation rate (ESR) determination is a commonly performed laboratory test with a time-honored role. However, the usefulness of this test has decreased as new methods of evaluating disease have been developed. The test remains helpful in the specific diagnosis of a ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1443.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 in Individuals at Increased Risk - ...

Jan 15, 2018 - Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. In general, these persons should undergo more ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p111.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

Common Breast Problems - American Family Physician

Aug 15, 2012 - A palpable mass, mastalgia, and nipple discharge are common breast symptoms for which patients seek medical attention. Patients should be evaluated initially with a detailed clinical history and physical examination. Most women presenting with a breast mass will require imaging and ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0815/p343.html

Common Hyperpigmentation Disorders in Adults: Part I. Diagnostic Approach, Cafe au Lait...

Nov 15, 2003 - The cause of hyperpigmentation usually is traced to the activity and presence of melanocytes. Cafe au lait macules may be solitary benign findings or may indicate the presence of neurofibromatosis with its associated complications. Diffuse hyperpigmentation should prompt a search for ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1115/p1955.html

Common Hyperpigmentation Disorders in Adults: Part II. Melanoma, Seborrheic Keratoses, ...

Nov 15, 2003 - Nevi, or moles, are localized nevocytic tumors. The American Cancer Society's ABCD rules are useful for differentiating a benign nevus from malignant melanoma. While acanthosis nigricans may signal an underlying malignancy (e.g., gastrointestinal tumor), it more often is associated with...

American Family Physician : Article

https://www.aafp.org/afp/2003/1115/p1963.html

Contemporary Management of Angina: Part I. Risk Assessment - American Family Physician

Dec 1, 1999 - Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1201/p2543.html

Depression: Screening and Diagnosis - American Family Physician

Oct 15, 2018 - Depression affects an estimated 8% of persons in the United States and accounts for more than $210 billion in health care costs annually. The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians recommend screening for depression in the general adult ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p508.html

Dermoscopy for the Family Physician - American Family Physician

Oct 1, 2013 - Noninvasive in vivo imaging techniques have become an important diagnostic aid for skin cancer detection. Dermoscopy, also known as dermatoscopy, epiluminescence microscopy, incident light microscopy, or skin surface microscopy, has been shown to increase the clinician’s diagnostic ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1001/p441.html

Detecting Elder Abuse and Neglect: Assessment and Intervention - American Family Physician

Mar 15, 2014 - Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0315/p453.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

Developmental Delay: When and How to Screen - American Family Physician

Jul 1, 2017 - An estimated 15% of children in the United States have at least one developmental delay, yet less than one-fifth of those children receive early intervention services before three years of age. Many barriers exist to implementing initial screening and referral, but screening tools can ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p36.html

Diabetes Mellitus: Diagnosis and Screening - American Family Physician

Apr 1, 2010 - Based on etiology, diabetes is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, latent autoimmune diabetes, maturity-onset diabetes of youth, and miscellaneous causes. The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0401/p863.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

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

Diagnosing Rhinitis: Allergic vs. Nonallergic - American Family Physician

May 1, 2006 - Allergic rhinitis, the most common type of rhinitis, generally can be differentiated from the numerous types of nonallergic rhinitis through a thorough history and physical examination. Allergic rhinitis may be seasonal, perennial, or occupational. The most common cause of nonallergic ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0501/p1583.html

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