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Evaluating the Child with Purpura - American Family Physician

Aug 1, 2001 - Purpura is the result of hemorrhage into the skin or mucosal membrane. It may represent a relatively benign condition or herald the presence of a serious underlying disorder. Purpura may be secondary to thrombocytopenia, platelet dysfunction, coagulation factor deficiency or vascular ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0801/p419.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 Management of Corneal Abrasions - American Family Physician

Jan 15, 2013 - Corneal abrasions are commonly encountered in primary care. Patients typically present with a history of trauma and symptoms of foreign body sensation, tearing, and sensitivity to light. History and physical examination should exclude serious causes of eye pain, including penetrating ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0115/p114.html

Evaluation and Management of Galactorrhea - American Family Physician

Jun 1, 2012 - Galactorrhea is commonly caused by hyperprolactinemia, especially when it is associated with amenorrhea. Hyperprolactinemia is most often induced by medication or associated with pituitary adenomas or other sellar or suprasellar lesions. Less common causes of galactorrhea include ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0601/p1073.html

Evaluation and Management of Infants and Young Children with Fever - American Family ...

Oct 1, 2001 - A practice guideline for the management of febrile infants and children younger than three years of age sparked controversy when it was published in 1993. Surveys indicate that many office-based physicians do not agree with recommendations for venipuncture and bladder catheterization in...

American Family Physician : Article

https://www.aafp.org/afp/2001/1001/p1219.html

Evaluation and Management of Neck Masses in Children - American Family Physician

Mar 1, 2014 - Neck masses in children usually fall into one of three categories: developmental, inflammatory/reactive, or neoplastic. Common congenital developmental masses in the neck include thyroglossal duct cysts, branchial cleft cysts, dermoid cysts, vascular malformations, and hemangiomas. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p353.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

Evaluation and Management of the AGUS Papanicolaou Smear - American Family Physician

Jun 1, 2001 - Atypical glandular cells on Papanicolaou smears are an unusual but important cytologic diagnosis. The Bethesda system classifies atypical glandular cells of undetermined significance (AGUS) as glandular cells that demonstrate nuclear atypia appearing to exceed reactive or reparative ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0601/p2239.html

Evaluation and Management of the Patient with Difficult-to-Control or Resistant ...

May 15, 2009 - High blood pressure is often difficult to control. Resistant hypertension is blood pressure above goal despite adherence to a combination of at least three antihypertensive medications of different classes, optimally dosed and usually including a diuretic. The approach to blood pressure...

American Family Physician : Article

https://www.aafp.org/afp/2009/0515/p863.html

Evaluation and Mangement of Intestinal Obstruction - American Family Physician

Jan 15, 2011 - Acute intestinal obstruction occurs when there is an interruption in the forward flow of intes- tinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often vary based on the level of obstruction. Intestinal ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p159.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

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

Feb 1, 2006 - Constipation in children usually is functional and the result of stool retention. However, family physicians must be alert for red flags that may indicate the presence of an uncommon but serious organic cause of constipation, such as Hirschsprung's disease (congenital aganglionic ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0201/p469.html

Evaluation and Treatment of Endometriosis - American Family Physician

Jan 15, 2013 - Endometriosis, which affects up to 10 percent of reproductive-aged women, is the presence of endometrial tissue outside of the uterine cavity. It is more common in women with pelvic pain or infertility (25 to 40 percent and 70 to 90 percent, respectively). Some women with endometriosis ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0115/p107.html

Evaluation and Treatment of Enuresis - American Family Physician

Aug 15, 2008 - Enuresis is defined as repeated, spontaneous voiding of urine during sleep in a child five years or older. It affects 5 to 7 million children in the United States. Primary nocturnal enuresis is caused by a disparity between bladder capacity and nocturnal urine production and failure of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0815/p489.html

Evaluation and Treatment of Galactorrhea - American Family Physician

May 1, 2001 - Galactorrhea, or inappropriate lactation, is a relatively common problem that occurs in approximately 20 to 25 percent of women. Lactation requires the presence of estrogen, progesterone and, most importantly, prolactin. Stress, suckling, sleep, sexual intercourse and medications may ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0501/p1763.html

Evaluation and Treatment of Hematospermia - American Family Physician

Dec 15, 2009 - Hematospermia can be a distressing symptom for patients, but most cases are effectively managed by a primary care physician. Although the condition is usually benign, significant underlying pathology must be excluded by history, physical examination, laboratory evaluation, and, in ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1421.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

Evaluation and Treatment of Patients with Suicidal Ideation - American Family Physician

Mar 15, 1999 - Suicidal ideation is more common than completed suicide. Most persons who commit suicide have a psychiatric disorder at the time of death. Because many patients with psychiatric disorders are seen by family physicians and other primary care practitioners rather than by psychiatrists, it...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1500.html

Evaluation and Treatment of Swallowing Impairments - American Family Physician

Apr 15, 2000 - Swallowing disorders are common, especially in the elderly, and may cause dehydration, weight loss, aspiration pneumonia and airway obstruction. These disorders may affect the oral preparatory, oral propulsive, pharyngeal and/or esophageal phases of swallowing. Impaired swallowing, or ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0415/p2453.html

Evaluation and Treatment of Urinary Tract Infections in Children - American Family ...

Apr 1, 1998 - Urinary tract infections (UTIs) are among the most common bacterial infections encountered by primary care physicians. Although UTIs do not occur with as great a frequency in children as in adults, they can be a source of significant morbidity in children. For reasons that are not yet ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0401/p1573.html

Evaluation and Treatment of Weight Loss in Adults with HIV Disease - American Family ...

Sep 1, 1999 - Weight loss late in the course of human immunodeficiency virus (HIV) disease is common and often multifactorial. Increased energy expenditure in response to opportunistic disease, as well as to HIV infection itself, can lead to protein-calorie malnutrition similar to that observed in ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p843.html

Evaluation and Treatment of Women with Hirsutism - American Family Physician

Jun 15, 2003 - Hirsutism is a common disorder, often resulting from conditions that are not life-threatening. It may signal more serious clinical pathology, and clinical evaluation should differentiate benign causes from tumors or other conditions such as polycystic ovary syndrome, late-onset adrenal ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0615/p2565.html

Evaluation of Acute Abdominal Pain in Adults - American Family Physician

Apr 1, 2008 - Acute abdominal pain can represent a spectrum of conditions from benign and self-limited disease to surgical emergencies. Evaluating abdominal pain requires an approach that relies on the likelihood of disease, patient history, physical examination, laboratory tests, and imaging ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0401/p971.html

Evaluation of Acute Pelvic Pain in Women - American Family Physician

Jul 15, 2010 - Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p141.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

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 Back Pain in Children and Adolescents - American Family Physician

Dec 1, 2007 - Back pain is fairly prevalent in healthy children and adolescents. When children or adolescents seek medical care for back pain, it is highly likely that underlying pathology will be identified. Common causes of back pain include nonspecific pain or muscle strain, herniated disk, ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1201/p1669.html

Evaluation of Chest Pain in Primary Care Patients - Point-of-Care Guides - American ...

Mar 1, 2011 - Chest pain can be caused by conditions that range from benign and self-limited (e.g., chest wall pain) to serious (e.g., anxiety disorder) or life-threatening (e.g., unstable angina, aortic dissection, pulmonary embolism). Accurate identification of life-threatening and serious causes ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2011/0301/p603.html

Evaluation of Chronic Diarrhea - American Family Physician

Nov 15, 2011 - Chronic diarrhea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Watery diarrhea may be subdivided into osmotic, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1119.html

Evaluation of Chronic Dyspnea - American Family Physician

Apr 15, 2005 - Chronic dyspnea is defined as dyspnea lasting more than one month. In approximately two thirds of patients presenting with dyspnea, the underlying cause is cardiopulmonary disease. Establishing an accurate diagnosis is essential because treatment differs depending on the underlying ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0415/p1529.html

Evaluation of Dysuria in Adults - American Family Physician

Apr 15, 2002 - Dysuria, defined as pain, burning, or discomfort on urination, is more common in women than in men. Although urinary tract infection is the most frequent cause of dysuria, empiric treatment with antibiotics is not always appropriate. Dysuria occurs more often in younger women, probably ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0415/p1589.html

Evaluation of Elevated Serum Transaminase Levels - FPIN's Clinical Inquiries - American...

Oct 15, 2012 - The evaluation of patients with elevated transaminase levels should be individualized based on the presence of symptoms or physical examination findings that suggest serious disease or hepatic decompensation.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/1015/od4.html

Evaluation of Epigastric Discomfort and Management of Dyspepsia and GERD - Practice ...

Sep 15, 2003 - The Institute for Clinical Systems Improvement (ICSI) recently published a guideline on the evaluation and management of dyspepsia and gastroesophageal reflux disease (GERD).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2003/0915/p1215.html

Evaluation of Fever in Infants and Young Children - American Family Physician

Feb 15, 2013 - Febrile illness in children younger than 36 months is common and has potentially serious consequences. With the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b, the epidemiology of bacterial infections causing fever has changed. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p254.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 Macrocytosis - American Family Physician

Feb 1, 2009 - Macrocytosis, generally defined as a mean corpuscular volume greater than 100 fL, is frequently encountered when a complete blood count is performed. The most common etiologies are alcoholism, vitamin B12 and folate deficiencies, and medications. History and physical examination, ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0201/p203.html

Evaluation of Microcytosis - American Family Physician

Nov 1, 2010 - Microcytosis is typically an incidental finding in asymptomatic patients who received a complete blood count for other reasons. The condition is defined as a mean corpuscular volume of less than 80 ┬Ám3 (80 fL) in adults. The most common causes of microcytosis are iron deficiency anemia ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1101/p1117.html

Evaluation of Nausea and Vomiting - American Family Physician

Jul 1, 2007 - A comprehensive history and physical examination can often reveal the cause of nausea and vomiting, making further evaluation unnecessary. Acute symptoms generally are the result of infectious, inflammatory, or iatrogenic causes. Most infections are self-limiting and require minimal ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0701/p76.html

Evaluation of Nausea and Vomiting: A Case-Based Approach - American Family Physician

Sep 15, 2013 - In the absence of acute abdominal pain, significant headache, or recent initiation of certain medications, acute nausea and vomiting is usually the result of self-limited gastrointestinal infections. Nausea and vomiting is also a common adverse effect of radiation therapy, chemotherapy,...

American Family Physician : Article

https://www.aafp.org/afp/2013/0915/p371.html

Evaluation of Occult Gastrointestinal Bleeding - American Family Physician

Mar 15, 2013 - Occult gastrointestinal bleeding is defined as gastrointestinal bleeding that is not visible to the patient or physician, resulting in either a positive fecal occult blood test, or iron deficiency anemia with or without a positive fecal occult blood test. A stepwise evaluation will ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0315/p430.html

Evaluation of Palpable Breast Masses - American Family Physician

May 1, 2005 - Palpable breast masses are common and usually benign, but efficient evaluation and prompt diagnosis are necessary to rule out malignancy. A thorough clinical breast examination, imaging, and tissue sampling are needed for a definitive diagnosis. Fine-needle aspiration is fast, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1731.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

Evaluation of Pregnant Women Exposed to Respiratory Viruses - American Family Physician

May 15, 2000 - Prenatal patients are often exposed to respiratory viruses at home and at work. Understandably, these patients may be concerned and want immediate answers and advice from their physicians. While most women who are exposed to chickenpox are immune, serologic testing can be performed and ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0515/p3065.html

Evaluation of Scrotal Masses - American Family Physician

May 1, 2014 - Scrotal masses are caused by a variety of disorders, ranging from benign conditions to those requiring emergent surgical intervention. Painful scrotal masses require urgent evaluation. Characteristics that suggest testicular torsion include rapid symptom onset, nausea and vomiting, high...

American Family Physician : Article

https://www.aafp.org/afp/2014/0501/p723.html

Evaluation of Scrotal Masses - American Family Physician

Nov 15, 2008 - Scrotal masses can represent a wide range of medical issues, from benign congenital conditions to life-threatening malignancies and acute surgical emergencies. Having a clear understanding of scrotal anatomy allows the examiner to accurately identify most lesions. Benign lesions such as...

American Family Physician : Article

https://www.aafp.org/afp/2008/1115/p1165.html

Evaluation of Short and Tall Stature in Children - American Family Physician

Jul 1, 2015 - Short stature is defined as a height more than two standard deviations below the mean for age (less than the 3rd percentile). Tall stature is defined as a height more than two standard deviations above the mean for age (greater than the 97th percentile). The initial evaluation of short ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p43.html

Evaluation of Short and Tall Stature in Children - American Family Physician

Sep 1, 2008 - Children and adolescents whose heights and growth velocities deviate from the normal percentiles on standard growth charts present a special challenge to physicians. Height that is less than the 3rd percentile or greater than the 97th percentile is deemed short or tall stature, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0901/p597.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

Evaluation of Syncope - American Family Physician

Sep 15, 2011 - Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p640.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

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