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Subclinical Hypothyroidism: Deciding When to Treat - American Family Physician

Feb 15, 1998 - While screening patients for thyroid disease, physicians often find increased thyrotropin-stimulating hormone (TSH) levels in patients whose free thyroxine (T4) levels are not below normal. This state, termed

American Family Physician : Article

https://www.aafp.org/afp/1998/0215/p776.html

Anemia in the Elderly - American Family Physician

Oct 1, 2000 - Anemia should not be accepted as an inevitable consequence of aging. A cause is found in approximately 80 percent of elderly patients. The most common causes of anemia in the elderly are chronic disease and iron deficiency. Vitamin B12 deficiency, folate deficiency, gastrointestinal ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1001/p1565.html

Management of Diabetic Ketoacidosis - American Family Physician

Aug 1, 1999 - Diabetic ketoacidosis is an emergency medical condition that can be life-threatening if not treated properly. The incidence of this condition may be increasing, and a 1 to 2 percent mortality rate has stubbornly persisted since the 1970s. Diabetic ketoacidosis occurs most often in ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0801/p455.html

Epstein-Barr Virus Infectious Mononucleosis - American Family Physician

Oct 1, 2004 - Infectious mononucleosis should be suspected in patients 10 to 30 years of age who present with sore throat and significant fatigue, palatal petechiae, posterior cervical or auricular adenopathy, marked adenopathy, or inguinal adenopathy. An atypical lymphocytosis of at least 20 percent...

American Family Physician : Article

https://www.aafp.org/afp/2004/1001/p1279.html

Vasomotor Rhinitis - American Family Physician

Sep 15, 2005 - Vasomotor rhinitis affects millions of Americans and results in significant symptomatology. Characterized by a combination of symptoms that includes nasal obstruction and rhinorrhea, vasomotor rhinitis is a diagnosis of exclusion reached after taking a careful history, performing a ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0915/p1057.html

Orthostatic Hypotension - American Family Physician

Dec 15, 2003 - Orthostatic hypotension is a physical finding defined by the American Autonomic Society and the American Academy of Neurology as a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing. The ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1215/p2393.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

Evaluation of Syncope - American Family Physician

Oct 15, 2005 - Though relatively common, syncope is a complex presenting symptom defined by a transient loss of consciousness, usually accompanied by falling, and with spontaneous recovery. Syncope must be carefully differentiated from other conditions that may cause a loss of consciousness or ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1015/p1492.html

Acute Knee Effusions: A Systematic Approach to Diagnosis - American Family Physician

Apr 15, 2000 - Knee effusions may be the result of trauma, overuse or systemic disease. An understanding of knee pathoanatomy is an invaluable part of making the correct diagnosis and formulating a treatment plan. Taking a thorough medical history is the key component of the evaluation. The most ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0415/p2391.html

Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - American Family ...

Sep 1, 2000 - The most common endogenous cause of Cushing's syndrome is Cushing's disease. Frequent clinical findings include weight gain, truncal obesity, striae, hypertension, glucose intolerance and infections. Cranial nerve II may be affected by enlarging pituitary adenomas in Cushing's disease; ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0901/p1119.html

Chronic Pelvic Pain in Women - American Family Physician

Jun 1, 2008 - The etiology of chronic pelvic pain in women is poorly understood. Although a specific diagnosis is not found in the majority of cases, some common diagnoses include endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis. The initial history and physical ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0601/p1535.html

Chronic Pancreatitis - American Family Physician

Dec 1, 2007 - Chronic pancreatitis is the progressive and permanent destruction of the pancreas resulting in exocrine and endocrine insufficiency and, often, chronic disabling pain. The etiology is multifactorial. Alcoholism plays a significant role in adults, whereas genetic and structural defects ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1201/p1679.html

Imaging for Suspected Appendicitis - American Family Physician

Jan 1, 2005 - Acute appendicitis is the most common reason for emergency abdominal surgery and must be distinguished from other causes of abdominal pain. Family physicians play a valuable role in the early diagnosis and management of this condition. However, the overall diagnostic accuracy achieved ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0101/p71.html

Depression and Sexual Desire - American Family Physician

Aug 15, 2000 - Decreased libido disproportionately affects patients with depression. The relationship between depression and decreased libido may be blurred, but treating one condition frequently improves the other. Medications used to treat depression may decrease libido and sexual function. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p782.html

Normocytic Anemia - American Family Physician

Nov 15, 2000 - Anemia is a common problem that is often discovered on routine laboratory tests. Its prevalence increases with age, reaching 44 percent in men older than 85 years. Normocytic anemia is the most frequently encountered type of anemia. Anemia of chronic disease, the most common normocytic ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1115/p2255.html

Food Allergies: Detection and Management - American Family Physician

Jun 15, 2008 - Family physicians play a central role in the suspicion and diagnosis of immunoglobulin E-mediated food allergies, but they are also critical in redirecting the evaluation for symptoms that patients are falsely attributing to allergies. Although any food is a potential allergen, more ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1678.html

Abnormal Uterine Bleeding - American Family Physician

Oct 1, 1999 - The most probable etiology of abnormal uterine bleeding relates to the patient's reproductive age, as does the likelihood of serious endometrial pathology. The specific diagnostic approach depends on whether the patient is premenopausal, perimenopausal or postmenopausal. In ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1371.html

COPD: Management of Acute Exacerbations and Chronic Stable Disease - American Family ...

Aug 15, 2001 - Acute exacerbations of chronic obstructive pulmonary disease (COPD) are treated with oxygen (in hypoxemic patients), inhaled beta2 agonists, inhaled anticholinergics, antibiotics and systemic corticosteroids. Methylxanthine therapy may be considered in patients who do not respond to ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0815/p603.html

Evaluating Dysphagia - American Family Physician

Jun 15, 2000 - Dysphagia is a problem that commonly affects patients cared for by family physicians in the office, as hospital inpatients and as nursing home residents. Familiar medical problems, including cerebrovascular accidents, gastroesophageal reflux disease and medication-related side effects, ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0615/p3639.html

Evaluating Obesity and Cardiovascular Risk Factors in Children and Adolescents - ...

Nov 1, 2008 - Obesity continues to be a growing public health problem. According to the 2003-2004 National Health and Nutrition Examination Survey, 17 percent of persons two to 19 years of age are overweight. The number of obese children and adolescents has tripled in the past 20 years. Obesity in ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1101/p1052.html

Initiating Hormonal Contraception - American Family Physician

Jul 1, 2006 - Most women can safely begin taking hormonal birth control products immediately after an office visit, at any point in the menstrual cycle. Because hormonal contraceptives do not accelerate cervical neoplasia or interfere with cervical cytology, women who have not had a recent ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0701/p105.html

The Physical Therapy Prescription - American Family Physician

Dec 1, 2007 - Numerous guidelines recommend physical therapy for the management of musculoskeletal conditions. However, specific recommendations are lacking concerning which exercises and adjunct modalities to use. Physical therapists use various techniques to reduce pain and improve mobility and ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1201/p1661.html

Treatment of Panic Disorder - American Family Physician

Feb 15, 2005 - Panic disorder with or without agoraphobia occurs commonly in patients in primary care settings. This article assesses multiple evidence-based reviews of effective treatments for panic disorder. Antidepressant medications successfully reduce the severity of panic symptoms and eliminate ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p733.html

Diagnosis and Initial Management of Kidney Stones - American Family Physician

Apr 1, 2001 - The diagnosis and initial management of urolithiasis have undergone considerable evolution in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected renal colic is one major advance. The superior sensitivity and specificity of helical CT...

American Family Physician : Article

https://www.aafp.org/afp/2001/0401/p1329.html

Lung Cancer: Diagnosis and Management - American Family Physician

Jan 1, 2007 - Lung cancer is the leading cause of cancer-related death in the United States, with an average five-year survival rate of 15 percent. Smoking remains the predominant risk factor for lung cancer. Lung cancers are categorized as small cell carcinoma or non-small cell carcinoma (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0101/p56.html

Diagnosis and Management of Galactorrhea - American Family Physician

Aug 1, 2004 - After infancy, galactorrhea usually is medication-induced. The most common pathologic cause of galactorrhea is a pituitary tumor. Other causes include hypothalamic and pituitary stalk lesions, neurogenic stimulation, thyroid disorders, and chronic renal failure. Patients with the latter...

American Family Physician : Article

https://www.aafp.org/afp/2004/0801/p543.html

Thyroiditis - American Family Physician

May 15, 2006 - Thyroiditis is an inflammation of the thyroid gland that may be painful and tender when caused by infection, radiation, or trauma, or painless when caused by autoimmune conditions, medications, or an idiopathic fibrotic process. The most common forms are Hashimoto's disease, subacute ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0515/p1769.html

Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading ...

Feb 1, 2004 - A large number of taxonomies are used to rate the quality of an individual study and the strength of a recommendation based on a body of evidence. We have developed a new grading scale that will be used by several family medicine and primary care journals (required or optional), with ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0201/p548.html

End-of-Life Care: Guidelines for Patient-Centered Communication - American Family ...

Jan 15, 2008 - When patients are diagnosed with cancer, primary care physicians often must deliver the bad news, discuss the prognosis, and make appropriate referrals. When delivering bad news, it is important to prioritize the key points that the patient should retain. Physicians should assess the ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0115/p167.html

Acute Dyspnea in the Office - American Family Physician

Nov 1, 2003 - Respiratory difficulty is a common presenting complaint in the outpatient primary care setting. Because patients may first seek care by calling their physician's office, telephone triage plays a role in the early management of dyspnea. Once the patient is in the office, the initial goal...

American Family Physician : Article

https://www.aafp.org/afp/2003/1101/p1803.html

Preoperative Cardiac Risk Assessment - American Family Physician

Nov 15, 2002 - Heart disease is the leading cause of mortality in the United States. An important subset of heart disease is perioperative myocardial infarction, which affects approximately 50,000 persons each year. The American College of Cardiology (ACC) and American Heart Association (AHA) have ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1115/p1889.html

Falls in the Elderly - American Family Physician

Apr 1, 2000 - Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0401/p2159.html

An Algorithm for the Evaluation of Peripheral Neuropathy - American Family Physician

Feb 15, 1998 - The diagnosis of peripheral neuropathies can be frustrating, time consuming and costly. Careful clinical and electrodiagnostic assessment, with attention to the pattern of involvement and the types of nerve fibers most affected, narrows the differential diagnosis and helps to focus the ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0215/p755.html

Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - American ...

Sep 1, 2006 - Major complications of cirrhosis include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal bleeding, and hepatorenal syndrome. Diagnostic studies on ascitic fluid should include a differential leukocyte count, total protein level, a ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p767.html

Digoxin Therapy for Heart Failure: An Update - American Family Physician

Aug 15, 2006 - Digoxin therapy has long been used to treat heart failure; however, its effectiveness was not completely known until recently. Results of the Digitalis Investigation Group trial showed that adding digoxin to standard heart failure therapy had no effect on mortality. However, adding ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0815/p613.html

Hyperparathyroidism - American Family Physician

Jan 15, 2004 - Primary hyperparathyroidism is the most frequent cause of hypercalcemia in ambulatory patients. The condition is most common in postmenopausal women, although it can occur in persons of all ages, including pregnant women. If symptoms are present, they are attributable to hypercalcemia ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p333.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

Clostridium difficile-Associated Diarrhea - American Family Physician

Mar 1, 2005 - Clostridium difficile infection is responsible for approximately 3 million cases of diarrhea and colitis annually in the United States. The mortality rate is 1 to 2.5 percent. Early diagnosis and prompt aggressive treatment are critical in managing C. difficile-associated diarrhea. ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p921.html

Adverse Drug Reactions: Types and Treatment Options - American Family Physician

Nov 1, 2003 - Drug hypersensitivity results from interactions between a pharmacologic agent and the human immune system. These types of reactions constitute only a small subset of all adverse drug reactions. Allergic reactions to medications represent a specific class of drug hypersensitivity ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1101/p1781.html

Pruritus - American Family Physician

Sep 15, 2003 - Pruritus is a common manifestation of dermatologic diseases, including xerotic eczema, atopic dermatitis, and allergic contact dermatitis. Effective treatment of pruritus can prevent scratch-induced complications such as lichen simplex chronicus and impetigo. Patients, particularly ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1135.html

Metastatic Carcinoma of the Long Bones - American Family Physician

Nov 15, 2007 - Breast, prostate, renal, thyroid, and lung carcinomas commonly metastasize to bone. Managing skeletal metastatic disease can be complex. Pain is the most common presenting symptom and requires thorough radiographic and laboratory evaluation. If plain-film radiography is not sufficient ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1115/p1489.html

Management of Heatstroke and Heat Exhaustion - American Family Physician

Jun 1, 2005 - Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. Recent research has identified a cascade of inflammatory pathologic events that begins with mild heat exhaustion and, if uninterrupted, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0601/p2133.html

Treatment of Irritable Bowel Syndrome - American Family Physician

Dec 15, 2005 - Irritable bowel syndrome affects 10 to 15 percent of the U.S. population to some degree. This condition is defined as abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms. Irritable ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1215/p2501.html

Polycythemia Vera - American Family Physician

May 1, 2004 - Polycythemia vera is a chronic myeloproliferative disorder characterized by increased red blood cell mass. The resultant hyperviscosity of the blood predisposes such patients to thrombosis. Polycythemia vera should be suspected in patients with elevated hemoglobin or hematocrit levels, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2139.html

Conjunctivitis - American Family Physician

Feb 15, 1998 - Conjunctivitis refers to any inflammatory condition of the membrane that lines the eyelids and covers the exposed surface of the sclera. It is the most common cause of

American Family Physician : Article

https://www.aafp.org/afp/1998/0215/p735.html

Common Benign Skin Tumors - American Family Physician

Feb 15, 2003 - Benign skin tumors are commonly seen by family physicians. The ability to properly diagnose and treat common benign tumors and to distinguish them from malignant lesions is a vital skill for all family physicians. Any lesions for which the diagnosis is uncertain, based on the history ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0215/p729.html

Foreign Body Ingestion in Children - American Family Physician

Jul 15, 2005 - Because many patients who have swallowed foreign bodies are asymptomatic, physicians must maintain a high index of suspicion. The majority of ingested foreign bodies pass spontaneously, but serious complications, such as bowel perforation and obstruction, can occur. Foreign bodies ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0715/p287.html

Management of Active Tuberculosis - American Family Physician

Dec 1, 2005 - Although the overall incidence of tuberculosis has been declining in the United States, it remains an important public health concern, particularly among immigrants, homeless persons, and persons infected with human immunodeficiency virus. Patients who present with symptoms of active ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1201/p2225.html

Evaluating Fever of Unidentifiable Source in Young Children - American Family Physician

Jun 15, 2007 - Most children will have been evaluated for a febrile illness by 36 months of age. Although the majority will have a self-limited viral illness, studies done before the use of Haemophilus influenzae type b and Streptococcus pneumoniae vaccines showed that approximately 10 percent of ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0615/p1805.html

Club Drugs: MDMA, Gamma-Hydroxybutyrate (GHB), Rohypnol, and Ketamine - American Family...

Jun 1, 2004 - Club drugs are substances commonly used at nightclubs, music festivals, raves, and dance parties to enhance social intimacy and sensory stimulation. The most widely used club drugs are 3,4-methylenedioxymethamphetamine (MDMA), also known as ecstasy; gamma-hydroxybutyrate (GHB); ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2619.html

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