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Acute Chest Pain in Adults: Outpatient Evaluation - American Family Physician Restricted content. Login required.

Dec 15, 2020 - Approximately 1% of primary care office visits are for chest pain, and 2% to 4% of these patients will have unstable angina or myocardial infarction. Initial evaluation is based on determining whether the patient needs to be referred to a higher level of care to rule out acute coronary ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1215/p721.html

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

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

American Family Physician : Article

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

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

Acute Respiratory Distress Syndrome: Diagnosis and Management - American Family Physician

Jun 15, 2020 - Acute respiratory distress syndrome (ARDS) is noncardiogenic pulmonary edema that manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Diagnostic criteria include onset within one week of a known insult or new or worsening respiratory symptoms, profound hypoxemia, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p730.html

ADHD in Children: Common Questions and Answers - American Family Physician Restricted content. Login required.

Nov 15, 2020 - Attention-deficit/hyperactivity disorder (ADHD) is a multidimensional chronic neurodevelopmental condition that affects 8.4% of U.S. children between two and 17 years of age and may pose long-term morbidity if untreated. The evaluation for ADHD begins when parents or caregivers present ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1115/p592.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

Asymptomatic Bacteriuria - American Family Physician Restricted content. Login required.

Jul 15, 2020 - Asymptomatic bacteriuria, defined as the presence of bacteria in the urine in the absence of urinary symptoms, is a common clinical finding that often warrants a decision about whether to initiate antimicrobial therapy. There are few indications to treat asymptomatic bacteriuria, and ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0715/p99.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

Back Pain in Children and Adolescents - American Family Physician Restricted content. Login required.

Jul 1, 2020 - Back pain is a relatively common presenting symptom in children and adolescents. Typical causes include muscle strain or spasm, spinal deformities (e.g., Scheuermann kyphosis, adolescent idiopathic scoliosis), spondylolysis, bulging or herniated intervertebral disks, apophysitis of the ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p19.html

Basal Cell and Cutaneous Squamous Cell Carcinomas: Diagnosis and Treatment - American ... Restricted content. Login required.

Sep 15, 2020 - Keratinocyte carcinoma, traditionally referred to as nonmelanoma skin cancer, includes basal cell and cutaneous squamous cell carcinoma and is the most common skin cancer malignancy found in humans. The U.S. Preventive Services Task Force recommends counseling about minimizing exposure ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p339.html

Blood Product Transfusion in Adults: Indications, Adverse Reactions, and Modifications ... Restricted content. Login required.

Jul 1, 2020 - Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in patients with or at high risk of developing symptomatic anemia. Restrictive transfusion thresholds with lower hemoglobin ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p30.html

Breast Cancer Screening: Common Questions and Answers - American Family Physician Restricted content. Login required.

Jan 1, 2021 - Breast cancer is the most common nonskin cancer in women and accounts for 30% of all new cancers in the United States. The highest incidence of breast cancer is in women 70 to 74 years of age. Numerous risk factors are associated with the development of breast cancer. A risk assessment ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0101/p33.html

Cerebral Palsy: An Overview - American Family Physician Restricted content. Login required.

Feb 15, 2020 - Cerebral palsy, which occurs in two to three out of 1,000 live births, has multiple etiologies resulting in brain injury that affects movement, posture, and balance. The movement disorders associated with cerebral palsy are categorized as spasticity, dyskinesia, ataxia, or mixed/other. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p213.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

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

Chronic Dyspnea: Diagnosis and Evaluation - American Family Physician Restricted content. Login required.

May 1, 2020 - Dyspnea is a symptom arising from a complex interplay of diseases and physiologic states and is commonly encountered in primary care. It is considered chronic if present for more than one month. As a symptom, dyspnea is a predictor for all-cause mortality. The likeliest causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p542.html

Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments - American ... Restricted content. Login required.

Oct 15, 2020 - Chronic low back pain, neck pain, hip and knee osteoarthritis, and fibromyalgia are the most common types of chronic musculoskeletal pain. Because no individual therapy has consistent benefit, a multimodal treatment approach to chronic musculoskeletal pain is recommended. Many ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p465.html

Chronic Wounds: Evaluation and Management - American Family Physician Restricted content. Login required.

Feb 1, 2020 - Chronic wounds are those that do not progress through a normal, orderly, and timely sequence of repair. They are common and are often incorrectly treated. The morbidity and associated costs of chronic wounds highlight the need to implement wound prevention and treatment guidelines. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p159.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

Coccidioidomycosis (Valley Fever) in Primary Care - American Family Physician Restricted content. Login required.

Feb 15, 2020 - Primary pulmonary coccidioidomycosis (valley fever) is caused by inhaling airborne spores of the fungus Coccidioides immitis or Coccidioides posadasii. Residing in or traveling to areas endemic for Coccidioides is required for the diagnosis; no person-to-person or zoonotic contagion ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p221.html

Common Benign Chronic Vulvar Disorders - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p550.html

Cutaneous Cryosurgery for Common Skin Conditions - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Cryosurgery is the application of freezing temperatures to achieve the destruction of tissue. Cutaneous cryosurgery has become a commonly performed outpatient procedure because of the combination of its safety, effectiveness, low cost, ease of use, lack of need for injectable ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p399.html

Degenerative Cervical Myelopathy: Recognition and Management - American Family Physician Restricted content. Login required.

Dec 15, 2020 - Degenerative cervical myelopathy encompasses a collection of pathologic conditions that result in progressive spinal cord dysfunction secondary to cord compression. Patients are typically male (3: 1 male-to-female ratio), and the average age of presentation is 64 years. The exact ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1215/p740.html

Diagnostic Imaging: Appropriate and Safe Use - American Family Physician Restricted content. Login required.

Jan 1, 2021 - The use of diagnostic radiography has doubled in the past two decades. Image Gently (children) and Image Wisely (adults) are multidisciplinary initiatives that seek to reduce radiation exposure by eliminating unnecessary procedures and offering best practices. Patients with an estimated...

American Family Physician : Article

https://www.aafp.org/afp/2021/0101/p42.html

Dysphagia: Evaluation and Collaborative Management - American Family Physician Restricted content. Login required.

Jan 15, 2021 - Dysphagia is common but may be underreported. Specific symptoms, rather than their perceived location, should guide the initial evaluation and imaging. Obstructive symptoms that seem to originate in the throat or neck may actually be caused by distal esophageal lesions. Oropharyngeal ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0115/p97.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

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

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

American Family Physician : Article

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

Endometrial Biopsy: Tips and Pitfalls - American Family Physician Restricted content. Login required.

May 1, 2020 - Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p551.html

Esophageal Motility Disorders - American Family Physician Restricted content. Login required.

Sep 1, 2020 - Esophageal motility disorders can cause chest pain, heartburn, or dysphagia. They are diagnosed based on specific patterns seen on esophageal manometry, ranging from the complete absence of contractility in patients with achalasia to unusually forceful or disordered contractions in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0901/p291.html

Eye Emergencies - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Central retinal artery occlusions, chemical injuries, mechanical globe injuries, and retinal detachments are eye emergencies that can result in permanent vision loss if not treated urgently. Family physicians should be able to recognize the signs and symptoms of each condition and be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1101/p539.html

Fetal Aneuploidy: Screening and Diagnostic Testing - American Family Physician Restricted content. Login required.

Apr 15, 2020 - Aneuploidy is the presence of one or more extra chromosomes or the absence of one or more chromosomes. The risk of fetal aneuploidy rises with increasing maternal age. Because fetal aneuploidy can affect any pregnancy, all pregnant women should be offered screening. First-trimester ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p481.html

Foreign Bodies in the Skin: Evaluation and Management - American Family Physician Restricted content. Login required.

Jun 15, 2020 - Foreign bodies may be introduced into the skin through lacerations and soft tissue wounds. Long-term complications of retained foreign bodies include chronic pain and neurovascular impairment. Wound exploration and initial imaging with radiography or ultrasonography should be considered...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p740.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

Genital Ulcers: Differential Diagnosis and Management - American Family Physician Restricted content. Login required.

Mar 15, 2020 - Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. Herpes simplex virus is the most common cause of genital ulcers in the United States. A diagnosis of genital herpes simplex virus infection is made through ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p355.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

Henoch-Schönlein Purpura (IgA Vasculitis): Rapid Evidence Review - American Family ... Restricted content. Login required.

Aug 15, 2020 - Henoch-Schönlein purpura, now called immunoglobulin A (IgA) vasculitis, is a systemic, immune complex–mediated, small-vessel leukocytoclastic vasculitis characterized by nonthrombocytopenic palpable purpura, arthritis, and abdominal pain. It is the most common vasculitis in children but...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p229.html

Hip Pain in Adults: Evaluation and Differential Diagnosis - American Family Physician Restricted content. Login required.

Jan 15, 2021 - Adults commonly present to their family physicians with hip pain, and diagnosing the cause is important for prescribing effective therapy. Hip pain is usually located anteriorly, laterally, or posteriorly. Anterior hip pain includes referred pain from intra-abdominal or intrapelvic ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0115/p81.html

House Calls - American Family Physician Restricted content. Login required.

Aug 15, 2020 - The demand for house calls is increasing because of the aging U.S. population, an increase in patients who are homebound, and the acknowledgment of the value of house calls by the public and health care industry. Literature from current U.S. home-based primary care programs describes ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p211.html

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

Oct 15, 2020 - Groin hernias are caused by a defect of the abdominal wall in the groin area and comprise inguinal and femoral hernias. Inguinal hernias are more common in men. Although groin hernias are easily diagnosed on physical examination in men, ultrasonography is often needed in women. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p487.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

Labor Dystocia in Nulliparous Women - American Family Physician Restricted content. Login required.

Jan 15, 2021 - Dystocia (abnormally slow or protracted labor) accounts for 25% to 55% of primary cesarean deliveries. The latent phase of labor begins with onset of regular, painful contractions and continues until 6 cm of cervical dilation. Current recommendations are to avoid admission to labor and ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0115/p90.html

Management of Fever in Infants and Young Children - American Family Physician Restricted content. Login required.

Jun 15, 2020 - Despite dramatic reductions in the rates of bacteremia and meningitis since the 1980s, febrile illness in children younger than 36 months continues to be a concern with potentially serious consequences. Factors that suggest serious infection include age younger than one month, poor ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p721.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

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

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

Nerve Blocks: Part I. Upper Extremity - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Procedural anesthesia is administered by family physicians for a variety of conditions, including neuropathies, fracture reduction, foreign body removals, and complex wound management. A nerve block may be preferred because it provides effective regional anesthesia with less anesthetic....

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p654.html

Nerve Blocks: Part II. Lower Extremity - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Family physicians use anesthesia to provide diagnostic and procedural analgesia for conditions such as neuropathies, fracture reduction, foreign body removals, and complex wound management. Local infiltration of anesthetics is commonly used in this setting because of the ease of use, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p669.html

Newborn Circumcision Techniques - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Newborn male circumcision is a common elective surgical procedure for the removal of foreskin covering the glans penis. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the American Academy ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p680.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

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

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