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Outpatient Management of COVID-19: Rapid Evidence Review - American Family Physician

Oct 15, 2020 - Common presenting symptoms of coronavirus disease 2019 include fever, dry cough, shortness of breath, and fatigue. However, patients may have a wide range of symptoms representing a spectrum of mild to severe illness. Symptoms in children tend to be milder and may include fever, cough, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p478.html

Gout: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Gout is caused by monosodium urate crystal deposition in joints and tissues. Risk factors include male sex; obesity; hypertension; alcohol intake; diuretic use; a diet rich in meat and seafood; chronic kidney disease; a diet heavy in fructose-rich food and beverages; being a member of ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p533.html

Management of Hypertriglyceridemia: Common Questions and Answers - American Family ... Restricted content. Login required.

Sep 15, 2020 - Hypertriglyceridemia, defined as fasting serum triglyceride levels of 150 mg per dL or higher, is associated with increased risk of cardiovascular disease. Severely elevated triglyceride levels (500 mg per dL or higher) increase the risk of pancreatitis. Common risk factors for ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p347.html

Atopic Dermatitis: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

May 15, 2020 - Atopic dermatitis (atopic eczema) is a chronic relapsing and remitting inflammatory skin disease affecting one in 10 people in their lifetime. Atopic dermatitis is caused by a complex interaction of immune dysregulation, epidermal gene mutations, and environmental factors that disrupts ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p590.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

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

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

Dec 1, 2017 - Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p709.html

Postpartum Hemorrhage: Prevention and Treatment - American Family Physician

Apr 1, 2017 - Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p442.html

Acute and Chronic Urticaria: Evaluation and Treatment - American Family Physician

Jun 1, 2017 - Urticaria commonly presents with intensely pruritic wheals, sometimes with edema of the subcutaneous or interstitial tissue. It has a lifetime prevalence of about 20%. Although often self-limited and benign, it can cause significant discomfort, continue for months to years, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p717.html

Acne Vulgaris: Diagnosis and Treatment - American Family Physician

Oct 15, 2019 - Acne vulgaris is the most prevalent chronic skin disease in the United States, affecting nearly 50 million people per year, mostly adolescents and young adults. Potential sequelae of acne, such as scarring, dyspigmentation, and low self-esteem, may result in significant morbidity. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1015/p475.html

Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Managing Hypertension Using Combination Therapy - American Family Physician Restricted content. Login required.

Mar 15, 2020 - More than 70% of adults treated for primary hypertension will eventually require at least two antihypertensive agents, either initially as combination therapy or as add-on therapy if monotherapy and lifestyle modifications do not achieve adequate blood pressure control. Four main ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p341.html

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Acute Kidney Injury: Diagnosis and Management - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Acute kidney injury is a clinical syndrome characterized by a rapid decline in glomerular filtration rate and resultant accumulation of metabolic waste products. Acute kidney injury is associated with an increased risk of mortality, cardiovascular events, and progression to chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p687.html

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management - American ...

Nov 1, 2017 - Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p582.html

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.html

Vitamin B12 Deficiency: Recognition and Management - American Family Physician

Sep 15, 2017 - Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Screening average-risk adults for vitamin B12 deficiency is not recommended. Screening may be warranted in patients with one or more risk factors, such...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p384.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

Functional Dyspepsia: Evaluation and Management - American Family Physician Restricted content. Login required.

Jan 15, 2020 - Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. Symptoms of functional dyspepsia include postprandial fullness, early satiety, and epigastric pain or...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p84.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Laceration Repair: A Practical Approach - American Family Physician

May 15, 2017 - The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p628.html

Diagnosis and Treatment of Polycystic Ovary Syndrome - American Family Physician

Jul 15, 2016 - Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. Although the pathophysiology of the syndrome is complex and there is no single defect from which it is known to result, it is ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p106.html

Frequent Headaches: Evaluation and Management - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Most frequent headaches are typically migraine or tension-type headaches and are often exacerbated by medication overuse. Repeated headaches can induce central sensitization and transformation to chronic headaches that are intractable, are difficult to treat, and cause significant ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p419.html

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

Office Spirometry: Indications and Interpretation - American Family Physician Restricted content. Login required.

Mar 15, 2020 - High-quality, office-based spirometry provides diagnostic information as useful and reliable as testing performed in a pulmonary function laboratory. Spirometry may be used to monitor progression of lung disease and response to therapy. A stepwise approach to spirometry allows for ease ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p362.html

Specific Learning Disabilities: The Family Physician's Role - American Family Physician

Nov 15, 2019 - Academic underachievement, such as failing a class and the threat of being held back because of academic issues, is common. Family physicians can provide support and guidance for families as they approach their child’s unique academic challenges. Specific learning disabilities are a ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p628.html

Amenorrhea: An Approach to Diagnosis and Management - American Family Physician

Jun 1, 2013 - Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p781.html

Thyroid Nodules: Advances in Evaluation and Management - American Family Physician Restricted content. Login required.

Sep 1, 2020 - Thyroid nodules can be detected by ultrasonography in up to 68% of the general population. They are typically benign and are often discovered incidentally. The primary goal of thyroid nodule evaluation is to determine whether it is malignant. After thyroid ultrasonography has been ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0901/p298.html

Type 2 Diabetes Mellitus: Outpatient Insulin Management - American Family Physician

Jan 1, 2018 - In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p29.html

Peritonsillar Abscess - American Family Physician

Apr 15, 2017 - Peritonsillar abscess is the most common deep infection of the head and neck, occurring primarily in young adults. Diagnosis is usually made on the basis of clinical presentation and examination. Symptoms and findings generally include fever, sore throat, dysphagia, trismus, and a hot ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p501.html

Early Recognition and Management of Sepsis in Adults: The First Six Hours - American ...

Jul 1, 2013 - Sepsis is a complication of severe infection characterized by a systemic inflammatory response. Mortality rates from sepsis range between 25% to 30% for severe sepsis and 40% to 70% for septic shock. The clinical presentation of sepsis is highly variable depending on the etiology. The ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0701/p44.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

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

Hypertensive Disorders of Pregnancy - American Family Physician

Jan 15, 2016 - Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks’ gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks’ gestation), preeclampsia, or preeclampsia superimposed on chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p121.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

Common Questions About Recurrent Urinary Tract Infections in Women - American Family ...

Apr 1, 2016 - Recurrent urinary tract infections (UTIs) are common in women, including healthy women with normal genitourinary anatomy. Recurrent UTI is typically defined as three or more UTIs within 12 months, or two or more occurrences within six months. The same species that caused previous ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0401/p560.html

Depression in Children and Adolescents: Evaluation and Treatment - American Family ...

Nov 15, 2019 - The prevalence of major unipolar depression in children and adolescents is increasing in the United States. In 2016, approximately 5% of 12-year-olds and 17% of 17-year-olds reported experiencing a major depressive episode in the previous 12 months. Screening for depression in ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p609.html

Urinary Tract Infections in Young Children and Infants: Common Questions and Answers - ... Restricted content. Login required.

Sep 1, 2020 - Urinary tract infections (UTIs) are common in children and are associated with significant short- and long-term morbidity. They have a high recurrence rate and are associated with anatomic and functional abnormalities. The decision to test for UTI is based on risk factors and the ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0901/p278.html

Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention - American Family ...

Sep 15, 2019 - Pelvic inflammatory disease (PID) is an infection of the upper genital tract occurring predominantly in sexually active young women. Chlamydia trachomatis and Neisseria gonorrhoeae are common causes; however, other cervical, enteric, bacterial vaginosis–associated, and respiratory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p357.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

Urinary Incontinence in Women: Evaluation and Management - American Family Physician

Sep 15, 2019 - Urinary incontinence is a common problem among women worldwide, resulting in a substantial economic burden and decreased quality of life. The Women’s Preventive Services Initiative is the only major organization that recommends annual screening for urinary incontinence in all women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p339.html

Diagnosis and Management of Common Types of Supraventricular Tachycardia - American ...

Nov 1, 2015 - Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. The condition is caused by reentry phenomena or automaticity at or above the atrioventricular node, and includes atrioventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p793.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

Onychomycosis: Current Trends in Diagnosis and Treatment - American Family Physician

Dec 1, 2013 - Onychomycosis is a fungal infection of the nails that causes discoloration, thickening, and separation from the nail bed. Onychomycosis occurs in 10% of the general population, 20% of persons older than 60 years, and 50% of those older than 70 years. It is caused by a variety of ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1201/p762.html

Uterine Fibroids: Diagnosis and Treatment - American Family Physician

Jan 15, 2017 - Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. Fibroids can cause abnormal uterine bleeding, pelvic pressure, bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p100.html

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.html

Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention - American ...

Sep 1, 2017 - The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p314.html

Intrapartum Fetal Monitoring - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Continuous electronic fetal monitoring was developed to screen for signs of hypoxic-ischemic encephalopathy, cerebral palsy, and impending fetal death during labor. Because these events have a low prevalence, continuous electronic fetal monitoring has a false-positive rate of 99%. The ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p158.html

Otitis Media: Rapid Evidence Review - American Family Physician

Sep 15, 2019 - Acute otitis media (AOM) is the most common diagnosis in childhood acute sick visits. By three years of age, 50% to 85% of children will have at least one episode of AOM. Symptoms may include ear pain (rubbing, tugging, or holding the ear may be a sign of pain), fever, irritability, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p350.html

Erectile Dysfunction - American Family Physician

Nov 15, 2016 - Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is common, affecting at least 12 million U.S. men. The five-question International Index of Erectile Function allows rapid clinical assessment of ED. The ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p820.html

Clostridioides difficile Infection: Update on Management - American Family Physician Restricted content. Login required.

Feb 1, 2020 - Guidelines for the diagnosis and treatment of Clostridioides difficile infection have recently been updated. Risk factors include recent exposure to health care facilities or antibiotics, especially clindamycin. C. difficile infection is characterized by a wide range of symptoms, from ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p168.html

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Dec 15, 2015 - A solitary pulmonary nodule is a common radiologic finding that is often discovered incidentally and may require significant workup to establish a definitive diagnosis. A solitary pulmonary nodule is a well-circumscribed round lesion measuring up to 3 cm in diameter and surrounded by ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1084.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.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

Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders ...

Jun 15, 2016 - An occupational illness is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition. If an occupational disorder is suspected, a directed history should be taken with particular attention to establishing a temporal ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p1000.html

Diagnosis and Treatment of Temporomandibular Disorders - American Family Physician

Mar 15, 2015 - Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, and surrounding musculature and osseous components. TMD affects up to 15% of adults, with a peak incidence at 20 to 40 years of age....

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p378.html

Acute Pericarditis: Diagnosis and Management - American Family Physician

Apr 1, 2014 - Acute pericarditis, inflammation of the pericardium, is found in approximately 5% of patients admitted to the emergency department for chest pain unrelated to acute myocardial infarction. It occurs most often in men 20 to 50 years of age. Acute pericarditis has a number of potential ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0401/p553.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

Multiple Myeloma: Diagnosis and Treatment - American Family Physician

Mar 15, 2017 - Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. In 2015, an estimated 28,850 new cases of multiple myeloma were diagnosed in the United States, and the disease caused more than 11,000 deaths. Patients older ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p373.html

Anaphylaxis: Recognition and Management - American Family Physician Restricted content. Login required.

Sep 15, 2020 - Anaphylaxis is a life-threatening systemic reaction, normally occurring within one to two hours of exposure to an allergen. The incidence of anaphylaxis in the United States is 2.1 per 1,000 person-years. Most anaphylactic reactions occur outside the hospital setting. Urticaria, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p355.html

Diagnosis and Management of Kawasaki Disease - American Family Physician

Mar 15, 2015 - Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p365.html

Urine Drug Tests: Ordering and Interpreting Results - American Family Physician

Jan 1, 2019 - Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p33.html

Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults - American Family ...

Jan 15, 2017 - Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p78.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

Preventing Falls in Older Persons - American Family Physician

Aug 15, 2017 - The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p240.html

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.html

Hidradenitis Suppurativa: Rapid Evidence Review - American Family Physician

Nov 1, 2019 - Hidradenitis suppurativa is a chronic folliculitis affecting intertriginous areas. Onset generally occurs in young adulthood to middle adulthood (18 to 39 years of age). Females and blacks are more than twice as likely to be affected. Additional risk factors include family history, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p562.html

Ectopic Pregnancy: Diagnosis and Management - American Family Physician Restricted content. Login required.

May 15, 2020 - Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p599.html

Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children - American ...

Oct 15, 2015 - Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p705.html

Evaluation and Management of Orthostatic Hypotension - American Family Physician

Sep 1, 2011 - Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p527.html

Heat-Related Illnesses - American Family Physician

Apr 15, 2019 - Heat-related illnesses comprise a spectrum of syndromes resulting from disruption of thermoregulation in people exposed to high environmental heat. Symptoms range from heat edema and exercise-associated muscle cramps to exercise-associated collapse, heat exhaustion, and life-threatening...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p482.html

Myocardial Infarction: Management of the Subacute Period - American Family Physician

Nov 1, 2013 - Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p581.html

Hoarseness in Adults - American Family Physician

Dec 1, 2017 - Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p720.html

Screening and Counseling Adolescents and Young Adults: A Framework for Comprehensive ... Restricted content. Login required.

Feb 1, 2020 - Healthy development is likely to occur when an adolescent’s risk factors are limited and when protective factors are fostered. Healthy development is further encouraged when youth feel valued, empowered, and form healthy social connections. Threats to the well-being of adolescents ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p147.html

Diagnosis and Management of Acute Diverticulitis - American Family Physician

May 1, 2013 - Uncomplicated diverticulitis is localized diverticular inflammation, whereas complicated diverticulitis is diverticular inflammation associated with an abscess, phlegmon, fistula, obstruction, bleeding, or perforation. Patients with acute diverticulitis may present with left lower ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0501/p612.html

Recurrent Urinary Tract Infections in Women: Diagnosis and Management - American Family...

Sep 15, 2010 - Recurrent urinary tract infections, presenting as dysuria or irritative voiding symptoms, are most commonly caused by reinfection with the original bacterial isolate in young, otherwise healthy women with no anatomic or functional abnormalities of the urinary tract. Frequency of sexual ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0915/p638.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

Evaluation and Treatment of Infertility - American Family Physician

Mar 1, 2015 - Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0301/p308.html

Right Care for Children: Top Five Do's and Don'ts - American Family Physician

Mar 15, 2019 - Underuse and overuse of medical interventions, failure to use interventions known to be effective, and provision of tests or interventions in which benefits do not exceed harms are types of low-value care. The Lown Institute’s Right Care Alliance Children’s Health Council identified ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p376.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

Evaluation of Anemia in Children - American Family Physician

Jun 15, 2010 - Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes vary by age. Most children with anemia are asymptomatic, and the condition is detected on screening laboratory evaluation. Screening is recommended only for high-risk children. Anemia is classified ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0615/p1462.html

Bladder Cancer: Diagnosis and Treatment - American Family Physician

Oct 15, 2017 - Bladder cancer is the sixth most prevalent malignancy in the United States and causes more than 16,000 deaths annually. The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1015/p507.html

Common Questions About Developmental Dysplasia of the Hip - American Family Physician

Dec 15, 2014 - Developmental dysplasia of the hip is a common musculoskeletal condition in newborns. Infants with developmental dysplasia of the hip, whether treated or untreated, have a higher incidence of early-onset hip osteoarthritis in adulthood. Evidence to support universal screening by ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1215/p843.html

Localized Prostate Cancer: Treatment Options - American Family Physician

Jun 15, 2018 - In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. The National Comprehensive ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p798.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

Treatment and Prevention of Kidney Stones: An Update - American Family Physician

Dec 1, 2011 - Kidney stones are associated with chronic kidney disease. Preventing recurrence is largely specific to the type of stone (e.g., calcium oxalate, calcium phosphate, cystine, struvite [magnesium ammonium phosphate]), and uric acid stones); however, even when the stone cannot be retrieved,...

American Family Physician : Article

https://www.aafp.org/afp/2011/1201/p1234.html

Diagnosis and Treatment of Acne - American Family Physician

Oct 15, 2012 - Acne is a chronic inflammatory skin disease that is the most common skin disorder in the United States. Therapy targets the four factors responsible for lesion formation: increased sebum production, hyperkeratinization, colonization by Propionibacterium acnes, and the resultant ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1015/p734.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

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

Evaluation and Management of Abnormal Uterine Bleeding in Premenopausal Women - ...

Jan 1, 2012 - Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0101/p35.html

Evaluation and Treatment of Constipation in Children and Adolescents - American Family ...

Jul 15, 2014 - Childhood constipation is common and almost always functional without an organic etiology. Stool retention can lead to fecal incontinence in some patients. Often, a medical history and physical examination are sufficient to diagnose functional constipation. Further evaluation for ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p82.html

Acute Lower Gastrointestinal Bleeding: Evaluation and Management - American Family ... Restricted content. Login required.

Feb 15, 2020 - Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p206.html

Obsessive-Compulsive Disorder: Diagnosis and Management - American Family Physician

Nov 15, 2015 - Obsessive-compulsive disorder (OCD) is a chronic illness that can cause marked distress and disability. It is a complex disorder with a variety of manifestations and symptom dimensions, some of which are underrecognized. Early recognition and treatment with OCD-specific therapies may ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p896.html

Nonspecific Low Back Pain and Return To Work - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Nonspecific low back pain refers to a condition without a distinct etiology to explain its associated symptoms. This pain may become chronic and is a major cause of work loss around the world. Without a specific explanation for a patient’s symptoms, the family physician is charged with ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p697.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.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

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Smell and Taste Disorders in Primary Care - American Family Physician

Dec 15, 2013 - Smell and taste disorders can be challenging to diagnose because of the large number of potential etiologies. Patients are often unable to provide a clear history of symptoms, because they frequently cannot distinguish between difficulties with smell and taste. Standardized ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1215/p852.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.html

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