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Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment - ...

Oct 1, 2018 - Abdominal wall pain is often mistaken for intra-abdominal visceral pain, resulting in expensive and unnecessary laboratory tests, imaging studies, consultations, and invasive procedures. Those evaluations generally are nondiagnostic, and lingering pain can become frustrating to the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p429.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

Hemolytic Anemia: Evaluation and Differential Diagnosis - American Family Physician

Sep 15, 2018 - Hemolytic anemia is defined by the premature destruction of red blood cells, and can be chronic or life-threatening. It should be part of the differential diagnosis for any normocytic or macrocytic anemia. Hemolysis may occur intravascularly, extravascularly in the reticuloendothelial ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p354.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

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

May 15, 2021 - Clinical hypothyroidism affects one in 300 people in the United States, with a higher prevalence among female and older patients. Symptoms range from minimal to life-threatening (myxedema coma); more common symptoms include cold intolerance, fatigue, weight gain, dry skin, constipation,...

American Family Physician : Article

https://www.aafp.org/afp/2021/0515/p605.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

Kidney Stones: Treatment and Prevention - American Family Physician

Apr 15, 2019 - Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. During an episode of renal colic, the first priority is to rule out conditions requiring immediate referral to an emergency department, then to alleviate pain, preferably with a nonsteroidal ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p490.html

Abnormal Uterine Bleeding in Premenopausal Women - American Family Physician

Apr 1, 2019 - Abnormal uterine bleeding is a common symptom in women. The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p435.html

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

Jun 1, 2021 - Tinnitus is the sensation of hearing a sound in the absence of an internal or external source and is a common problem encountered in primary care. Most cases of tinnitus are benign and idiopathic and are strongly associated with sensorineural hearing loss. A standard workup begins with ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0601/p663.html

Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Apr 15, 2020 - Chronic diarrhea is defined as a predominantly loose stool lasting longer than four weeks. A patient history and physical examination with a complete blood count, C-reactive protein, anti-tissue transglutaminase immunoglobulin A (IgA), total IgA, and a basic metabolic panel are useful ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p472.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

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

Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention - American Family ... Restricted content. Login required.

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

Erythema Multiforme: Recognition and Management - American Family Physician

Jul 15, 2019 - Erythema multiforme is an immune-mediated reaction that involves the skin and sometimes the mucosa. Classically described as target-like, the erythema multiforme lesions can be isolated, recurrent, or persistent. Most commonly, the lesions of erythema multiforme present symmetrically on...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p82.html

High Blood Pressure in Children and Adolescents - American Family Physician

Oct 15, 2018 - High blood pressure in children and adolescents is a growing health problem that is often overlooked. Children should be screened for elevated blood pressure annually beginning at three years of age or at every visit if risk factors are present. In children younger than 13 years, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p486.html

Mobility Assistive Device Use in Older Adults - American Family Physician Restricted content. Login required.

Jun 15, 2021 - Many individuals need a mobility assistive device as they age. These devices include canes, crutches, walkers, and wheelchairs. Clinicians should understand how to select the appropriate device and size for individual patients (or work with a physical therapist) and prescribe the device...

American Family Physician : Article

https://www.aafp.org/afp/2021/0615/p737.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

Urinary Retention in Adults: Evaluation and Initial Management - American Family Physician

Oct 15, 2018 - Urinary retention is the acute or chronic inability to voluntarily pass an adequate amount of urine. The condition predominantly affects men. The most common causes are obstructive in nature, with benign prostatic hyperplasia accounting for 53% of cases. Infectious, inflammatory, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p496.html

Peripheral Neuropathy: Evaluation and Differential Diagnosis - American Family Physician Restricted content. Login required.

Dec 15, 2020 - Peripheral neuropathy, a common neurologic problem encountered by family physicians, can be classified clinically by the anatomic pattern of presenting symptoms and, if indicated, by results of electrodiagnostic studies for axonal and demyelinating disease. The prevalence of peripheral ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1215/p732.html

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

Jun 1, 2021 - Polycythemia vera is one of three stem-cell–derived myeloid malignancies commonly known as myeloproliferative neoplasms. It is characterized by erythrocytosis, often with associated leukocytosis and thrombocytosis. It has a significant negative impact on overall mortality and morbidity ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0601/p680.html

Acne Vulgaris: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

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

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

Amenorrhea: A Systematic Approach to Diagnosis and Management - American Family Physician

Jul 1, 2019 - Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p39.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

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

Anemia in Older Adults - American Family Physician

Oct 1, 2018 - Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p437.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

Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders - American ... Restricted content. Login required.

Apr 15, 2021 - Hypermobile Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders are the most common symptomatic joint hypermobility conditions seen in clinical practice. The 2017 International Classification of the Ehlers-Danlos syndromes replaced previous terms for symptomatic joint ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0415/p481.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

Neck Pain: Initial Evaluation and Management - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p150.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

Initiating Hormonal Contraception - American Family Physician Restricted content. Login required.

Mar 1, 2021 - Most patients can safely begin using hormonal contraception at any point in their menstrual cycle. An evidence-based, flexible, patient-centered approach to initiating contraception promotes health and enhances patients’ reproductive autonomy. A recent Papanicolaou test is not necessary...

American Family Physician : Article

https://www.aafp.org/afp/2021/0301/p291.html

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Jan 15, 2020 - Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p95.html

Intestinal Obstruction: Evaluation and Management - American Family Physician

Sep 15, 2018 - Acute intestinal obstruction occurs when the forward flow of intestinal contents is interrupted or impaired by a mechanical cause. It is most commonly induced by intra-abdominal adhesions, malignancy, and herniation. The clinical presentation generally includes nausea, emesis, colicky ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p362.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

Acute Pyelonephritis in Adults: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Acute pyelonephritis is a bacterial infection of the kidney and renal pelvis and should be suspected in patients with flank pain and laboratory evidence of urinary tract infection. Urine culture with antimicrobial susceptibility testing should be performed in all patients and used to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p173.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

Gas, Bloating, and Belching: Approach to Evaluation and Management - American Family ...

Mar 1, 2019 - Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p301.html

Crohn's Disease: Diagnosis and Management - American Family Physician

Dec 1, 2018 - Crohn’s disease is a chronic inflammatory condition that affects the gastrointestinal tract. It can cause lesions from mouth to anus and may result in extraintestinal complications. The prevalence of Crohn’s disease is increasing in adults and children. Genetic predispositions to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p661.html

Eating Disorders in Primary Care: Diagnosis and Management - American Family Physician Restricted content. Login required.

Jan 1, 2021 - Eating disorders are potentially life-threatening conditions characterized by disordered eating and weight-control behaviors that impair physical health and psychosocial functioning. Early intervention may decrease the risk of long-term pathology and disability. Clinicians should ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0101/p22.html

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

May 1, 2021 - Urethritis refers to inflammation of the urethra and is classified as gonococcal (caused by Neisseria gonorrhoeae) or nongonococcal in origin (most commonly caused by Chlamydia trachomatis, Mycoplasma genitalium, or Trichomonas vaginalis). The most common signs and symptoms include ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0501/p553.html

Shoulder Dystocia: Managing an Obstetric Emergency - American Family Physician Restricted content. Login required.

Jul 15, 2020 - Shoulder dystocia is an obstetric emergency in which normal traction on the fetal head does not lead to delivery of the shoulders. This can cause neonatal brachial plexus injuries, hypoxia, and maternal trauma, including damage to the bladder, anal sphincter, and rectum, and postpartum ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0715/p84.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

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

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

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

Nonalcoholic Fatty Liver Disease: Common Questions and Answers on Diagnosis and ... Restricted content. Login required.

Nov 15, 2020 - Nonalcoholic fatty liver disease (NAFLD) is the most common form of liver disease in the United States, affecting up to 30% of adults. There are two forms of NAFLD: nonalcoholic fatty liver (NAFL), defined as 5% or greater hepatic steatosis without hepatocellular injury or fibrosis, and...

American Family Physician : Article

https://www.aafp.org/afp/2020/1115/p603.html

Cervical Colposcopy: Indications and Risk Assessment - American Family Physician Restricted content. Login required.

Jul 1, 2020 - The practice of colposcopy, a diagnostic procedure to evaluate for vaginal, vulvar, and cervical dysplasia, has evolved to incorporate patient risk factors for high-grade cervical intraepithelial neoplasia (CIN) and cancer. Changes in cervical cancer screening and guidelines, human ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p39.html

Current Concepts in Concussion: Initial Evaluation and Management - American Family ...

Apr 1, 2019 - Mild traumatic brain injury, also known as concussion, is common in adults and youth and is a major health concern. Concussion is caused by direct or indirect external trauma to the head resulting in shear stress to brain tissue from rotational or angular forces. Concussion can affect a...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p426.html

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

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

Parkinson Disease - American Family Physician Restricted content. Login required.

Dec 1, 2020 - Parkinson disease is a progressive neurodegenerative disorder with significant morbidity and mortality. Most patients consult with their primary care physician about Parkinson disease symptoms before seeking care from a specialist. The diagnosis of Parkinson disease is clinical, and key...

American Family Physician : Article

https://www.aafp.org/afp/2020/1201/p679.html

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