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Practice Guidelines

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Evaluation and Treatment of the Suicidal Patient - American Family Physician

Mar 15, 2012 - Evaluation and treatment of a suicidal patient are challenging tasks for the physician. Because no validated predictive tools exist, clinical judgment guides the decision-making process. Although there is insufficient evidence to support routine screening, evidence shows that asking ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0315/p602.html

Evaluation of a First Seizure - American Family Physician

May 1, 2007 - Seizure is a common presentation in the emergency care setting, and new-onset epilepsy is the most common cause of unprovoked seizures. The patient history and physical examination should direct the type and timing of laboratory and imaging studies. No single sign, symptom, or test ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0501/p1342.html

Evaluation of Asymptomatic Microscopic Hematuria in Adults - American Family Physician

Sep 15, 1999 - In patients without significant urologic symptoms, microscopic hematuria is occasionally detected on routine urinalysis. At present, routine screening of all adults for microscopic hematuria with dipstick testing is not recommended because of the intermittent occurrence of this finding ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0915/p1143.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Evaluation of the Patient with Chronic Cough - American Family Physician

Oct 15, 2011 - Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. Patients who are taking an angiotensin-converting enzyme inhibitor should switch to a ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p887.html

Evaluation of the Patient with Chronic Cough - American Family Physician

May 1, 2004 - Patients with chronic cough should avoid exposure to irritants that can trigger cough, and those who smoke should stop smoking. Patients who develop chronic cough in association with angiotensin-converting enzyme inhibitor therapy should be switched to an agent from another drug class. ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2159.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

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Oct 15, 2009 - Solitary pulmonary nodules are common radiologic findings, typically discovered incidentally through chest radiography or computed tomography of the neck, chest, and abdomen. Primary care physicians must decide how to pursue an evaluation of a nodule once it has been identified. The ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1015/p827.html

Fetal Chromosomal Abnormalities: Antenatal Screening and Diagnosis - American Family ...

Jan 15, 2009 - Pregnant women of all ages should be offered screening and invasive diagnostic testing for chromosomal abnormalities before 20 weeks' gestation. New developments in screening methods have increased the number of options for patients. Diagnostic options include chorionic villus sampling ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0115/p117.html

General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues - ...

May 15, 2018 - Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p642.html

Guidelines for the Use of Antibiotics in Acute Upper Respiratory Infections - American ...

Sep 15, 2006 - To help physicians with the appropriate use of antibiotics in children and adults with upper respiratory tract infection, a multidisciplinary team evaluated existing guidelines and summarized key practice points. Acute otitis media in children should be diagnosed only if there is abrupt...

American Family Physician : Article

https://www.aafp.org/afp/2006/0915/p956.html

Hepatitis A - American Family Physician

Jun 15, 2006 - The introduction of hepatitis A vaccines in 1995 led to a drop in the number of reported cases of hepatitis A and a shift to a higher percentage of cases occurring in older age groups. The hepatitis A virus survives for extended periods in the environment. Transmission primarily is ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0615/p2162.html

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Hepatitis C: Part II. Prevention Counseling and Medical Evaluation - American Family ...

Jan 15, 1999 - An estimated 3.9 million Americans are infected with hepatitis C virus (HCV), and most do not know that they are infected. This group includes persons who are at risk for HCV-associated chronic liver disease and who also serve as reservoirs for transmission of HCV to others. Because ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0115/p349.html

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Jun 15, 2011 - Herpes zoster (shingles) is diagnosed clinically by recognition of the distinctive, painful vesicular rash appearing in a unilateral, dermatomal distribution. An estimated 1 million cases occur in the United States each year, and increasing age is the primary risk factor. Laboratory ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1432.html

Identification and Evaluation of Mental Retardation - American Family Physician

Feb 15, 2000 - Mental retardation in young children is often missed by clinicians. The condition is present in 2 to 3 percent of the population, either as an isolated finding or as part of a syndrome or broader disorder. Causes of mental retardation are numerous and include genetic and environmental ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1059.html

Interventions to Facilitate Smoking Cessation - American Family Physician

Jul 15, 2006 - Tobacco use, primarily cigarette smoking, is the leading cause of preventable morbidity and mortality in the United States, and nearly one third of those who try a cigarette become addicted to nicotine. Family physicians, who see most of these patients in their offices every year, have ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0715/p262.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

Lung Cancer: Diagnosis, Treatment Principles, and Screening - American Family Physician

Feb 15, 2015 - Lung cancer is classified histologically into small cell and non–small cell lung cancers. The most common symptoms of lung cancer are cough, dyspnea, hemoptysis, and systemic symptoms such as weight loss and anorexia. High-risk patients who present with symptoms should undergo chest ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p250.html

Management of Falls in Older Persons: A Prescription for Prevention - American Family ...

Dec 1, 2011 - Although falls are a common cause of injury in older persons, they are not just a normal part of the aging process. 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 ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1201/p1267.html

Management of Group A Beta-Hemolytic Streptococcal Pharyngitis - American Family Physician

Apr 15, 2001 - Bacteria are responsible for approximately 5 to 10 percent of pharyngitis cases, with group A beta-hemolytic streptococci being the most common bacterial etiology. A positive rapid antigen detection test may be considered definitive evidence for treatment; a negative test should be ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0415/p1557.html

Management of Normal Pressure Hydrocephalus - American Family Physician

Sep 15, 2004 - Gait instability, urinary incontinence, and dementia are the signs and symptoms typically found in patients who have normal pressure hydrocephalus. Estimated to cause no more than 5 percent of cases of dementia, normal pressure hydrocephalus often is treatable, and accurate recognition ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1071.html

Management of Patellofemoral Pain Syndrome - American Family Physician

Jan 15, 2007 - Patellofemoral pain syndrome (PFPS) is the most common cause of knee pain in the outpatient setting. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and extension, particularly with overloading of the joint. Risk factors include overuse, ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0115/p194.html

Managing Benign Prostatic Hyperplasia - American Family Physician

Jul 1, 2002 - Medical and surgical options for the treatment of benign prostatic hyperplasia have expanded in recent years. Saw palmetto, the most widely used complementary medication, is less effective than standard medical therapy but has fewer side effects. Although non-selective alpha blockers ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p77.html

Managing the Adverse Effects of Radiation Therapy - American Family Physician

Aug 15, 2010 - Nearly two thirds of patients with cancer will undergo radiation therapy as part of their treatment plan. Given the increased use of radiation therapy and the growing number of cancer survivors, family physicians will increasingly care for patients experiencing adverse effects of ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p381.html

Nephrotic Syndrome in Adults: Diagnosis and Management - American Family Physician

Nov 15, 2009 - Nephrotic syndrome may be caused by primary (idiopathic) renal disease or by a variety of secondary causes. Patients present with marked edema, proteinuria, hypoalbuminemia, and often hyperlipidemia. In adults, diabetes mellitus is the most common secondary cause, and focal segmental ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1115/p1129.html

Obsessive Compulsive Disorder: Diagnosis and Management - American Family Physician

Aug 1, 2009 - Obsessive-compulsive disorder is an illness that can cause marked distress and disability. It often goes unrecognized and is undertreated. Primary care physicians should be familiar with the various ways obsessive-compulsive disorder can present and should be able to recognize clues to ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0801/p239.html

Osteoarthritis: Diagnosis and Treatment - American Family Physician

Jan 1, 2012 - Osteoarthritis is a common degenerative disorder of the articular cartilage associated with hypertrophic bone changes. Risk factors include genetics, female sex, past trauma, advancing age, and obesity. The diagnosis is based on a history of joint pain worsened by movement, which can ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0101/p49.html

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

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

American Family Physician : Article

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

Outpatient Treatment of Systolic Heart Failure - American Family Physician

Dec 1, 2004 - Optimal outpatient treatment of systolic heart failure has three goals that should be pursued simultaneously: (1) control of risk factors for the development and progression of heart failure, (2) treatment of heart failure, and (3) education of patients. Control of risk factors includes...

American Family Physician : Article

https://www.aafp.org/afp/2004/1201/p2157.html

Overview of Histoplasmosis - American Family Physician

Dec 15, 2002 - Histoplasmosis is an endemic infection in most of the United States and can be found worldwide. The spectrum of this illness ranges from asymptomatic infection to severe disseminated disease. Life-threatening illness is usually associated with an immunocompromised state; however, 20 ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1215/p2247.html

Paget Disease of Bone for Primary Care - American Family Physician Restricted content. Login required.

Aug 15, 2020 - Paget disease of bone is a benign disorder characterized by focal areas of increased bone turnover in one or more skeletal sites. It usually affects older adults, and men are at a higher risk than women. Any bone may be affected, but the disease has a high preference for the pelvis, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p224.html

Pediatric Urinary Tract Infection and Reflux - American Family Physician

Mar 15, 1999 - Urinary tract infections in children are sometimes associated with vesicoureteral reflux, which can lead to renal scarring if it remains unrecognized. Since the risk of renal scarring is greatest in infants, any child who presents with a urinary tract infection prior to toilet training ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1472.html

Pharmacologic Treatment of Hyperlipidemia - American Family Physician

Sep 1, 2011 - Pharmacologic treatment of hyperlipidemia in conjunction with therapeutic lifestyle changes can be used for both primary and secondary prevention of cardiovascular disease. Statins have the most convincing data for primary prevention, especially for higher risk patients. Therefore, risk...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p551.html

Pituitary Adenomas: An Overview - American Family Physician

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

American Family Physician : Article

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

Practical Steps to Smoking Cessation for Recovering Alcoholics - American Family Physician

Apr 15, 1998 - Smoking rates among persons with a history of alcohol abuse are triple that of the general public. Strong evidence indicates that the risk of cancer and cardiovascular disease is higher in recovering alcoholics than in peers who smoke, but do not drink alcohol. Yet these persons often ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0415/p1869.html

Preventing Cardiovascular Disease in Women - American Family Physician

Oct 15, 2006 - Cardiovascular disease (CVD) has been the primary cause of death in women for almost a century, and more women than men have died of CVD every year since 1984. Although CVD incidence can be reduced by adherence to a heart-healthy lifestyle and detection and treatment of major risk ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1331.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

Primary Care Issues in Patients with Mental Illness - American Family Physician

Aug 1, 2008 - Family physicians commonly care for patients with serious mental illness. Patients with psychotic and bipolar disorders have more comorbid medical conditions and higher mortality rates than patients without serious mental illness. Many medications prescribed for serious mental illness ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0801/p355.html

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence - American Family...

Aug 1, 2017 - Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p170.html

Pulmonary Rehabilitation in the Treatment of Chronic Obstructive Pulmonary Disease - ...

Sep 15, 2010 - Pulmonary rehabilitation is a nonpharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease. It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0915/p655.html

Recognition and Management of Hereditary Hemochromatosis - American Family Physician

Mar 1, 2002 - Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent. It is characterized by increased intestinal absorption of iron, with deposition of the iron in multiple organs. Previously, the classic description was combined diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p853.html

Recurrent Venous Thromboembolism - American Family Physician

Feb 1, 2011 - A previous venous thromboembolism is the most important risk factor for predicting recurrence of the condition. Several studies have shown that routine testing for inherited thrombophilias is not helpful in predicting the risk of recurrence or altering treatment decisions, and therefore...

American Family Physician : Article

https://www.aafp.org/afp/2011/0201/p293.html

Reducing Adverse Effects of Proton Pump Inhibitors - American Family Physician

Jul 1, 2012 - Proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. Proton pump inhibitors cause few adverse effects with short-term use; however, long-term use has been scrutinized for ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p66.html

Reducing the Risk of Adverse Drug Events in Older Adults - American Family Physician

Mar 1, 2013 - Adverse drug events occur in 15 percent or more of older patients presenting to offices, hospitals, and extended care facilities. These events are potentially preventable up to 50 percent of the time. Common serious manifestations include falls, orthostatic hypotension, heart failure, ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0301/p331.html

Respiratory Syncytial Virus Bronchiolitis in Children - American Family Physician

Jan 15, 2017 - Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p94.html

Respiratory Syncytial Virus Infection in Children - American Family Physician

Jan 15, 2011 - Respiratory syncytial virus (RSV) is an RNA virus that causes respiratory tract infections in children. In the North- ern Hemisphere, the peak infection season is November through April. By two years of age, most children will have had an RSV infection. Bronchiolitis, a lower ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p141.html

Role of the Primary Care Physician in Hodgkin Lymphoma - American Family Physician

Sep 1, 2008 - Approximately 8,200 new cases of Hodgkin lymphoma are diagnosed annually in the United States. Common presenting features include painless lymphadenopathy (usually above the diaphragm), cough, fever, night sweats, and weight loss. To decrease late complications, treatment has gradually ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0901/p615.html

Seasonal Affective Disorders - American Family Physician

Mar 15, 1998 - Seasonal affective disorder is a pattern of major depressive episodes that occur and remit with changes in seasons. It may be seen in major depressive or bipolar disorders, as described in the Diagnostic and Statistical. Manual of Mental Disorders (DSM-IV). The most recognized form of ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0315/p1340.html

Selecting Medications for the Treatment of Urinary Incontinence - American Family ...

Jan 15, 2005 - In response to the growing population of older patients with incontinence, pharmaceutical companies are developing new drugs to treat the condition. Before prescribing medications for incontinence, however, physicians should determine the nature and cause of the patient's incontinence. ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0115/p315.html

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