Am Fam Physician. 2025;112(6):606
How does ambulatory ECG monitoring compare with echocardiography in investigating palpitations?
Ambulatory electrocardiography (ECG) monitoring for 2 weeks has the highest diagnostic yield-to-cost ratio in the evaluation of palpitations of unknown etiology. Echocardiography is recommended in patients whose history, physical examination, or ECG results raise concern for structural heart disease.
What are the initial recommended tests for evaluating suspected bleeding disorders?
Initial laboratory evaluation of suspected bleeding disorders should assess complete blood cell count, prothrombin time, activated partial thromboplastin time, peripheral blood smear, and fibrinogen level, with additional consideration for von Willebrand disease analysis.
What initial imaging modality is recommended to evaluate jaundice in adults?
Ultrasonography or computed tomography with contrast are typically preferred for initial evaluation of jaundice because of their noninvasive nature, lower cost, and convenience.
Is intermittent dosing of SSRIs an acceptable alternative to continuous dosing in premenstrual disorders?
According to the American College of Obstetricians and Gynecologists clinical practice guidelines, intermittent use of selective serotonin reuptake inhibitors (SSRIs) daily starting 1 week before menses onset and ending 3 days after onset is effective and can be used instead of continuous dosing.
How should suspected acute bacterial arthritis in children be initially evaluated and managed?
Initial evaluation of suspected acute bacterial arthritis in children should include blood cultures before any antimicrobial treatment, plain radiography of the potentially affected joint, and consideration of a C-reactive protein level for monitoring treatment response. Serum procalcitonin level or erythrocyte sedimentation rate should not be measured. In ill-appearing children, antibiotic treatment should not be delayed for a joint aspiration procedure.
Do all anaphylactic reactions treated with epinephrine require emergency medical services?
No. According to the Joint Task Force on Allergy-Immunology Practice Parameters, conservative care can be considered after complete or near-complete symptom resolution if anaphylaxis is not severe and symptoms do not return or worsen. After stabilization, patients should be observed for at least 1 hour to monitor for recurrent symptoms from a biphasic reaction. Patients should follow up with their primary care physician to document the allergy history, obtain epinephrine autoinjectors, and implement prevention strategies.
Tip for Using AFP at the Point of Care
Do you need to refresh your procedural skills? The AFP video collection includes short, educational videos that are freestanding or accompany AFP articles. All videos are peer-reviewed. Available at: https://www.aafp.org/afp/videos.html.
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