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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

Acne Vulgaris: Diagnosis and Treatment - American Family Physician

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

Acupuncture for Pain - American Family Physician

Jul 15, 2019 - Acupuncture has been increasingly used as an integrative or complementary therapy for pain. It is well-tolerated with little risk of serious adverse effects. Traditional acupuncture and nontraditional techniques, such as electroacupuncture and dry needling, often result in reported pain...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p89.html

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 Hand Infections - American Family Physician

Feb 15, 2019 - Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p228.html

Acute Kidney Injury: Diagnosis and Management - American Family Physician

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

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

Adhesive Capsulitis: Diagnosis and Management - American Family Physician

Mar 1, 2019 - Adhesive capsulitis, also known as frozen shoulder, is a common shoulder condition characterized by pain and decreased range of motion, especially in external rotation. Adhesive capsulitis is predominantly an idiopathic condition and has an increased prevalence in patients with diabetes...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p297.html

Adolescent Idiopathic Scoliosis: Common Questions and Answers - American Family Physician

Jan 1, 2020 - Adolescent idiopathic scoliosis affects 1% to 3% of U.S. adolescents. It is defined by a lateral curvature of the spine (Cobb angle) of at least 10 degrees in the absence of underlying congenital or neuromuscular abnormalities. Adolescent idiopathic scoliosis may be detected via the ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p19.html

Adolescent Substance Use and Misuse: Recognition and Management - American Family ...

Jun 1, 2019 - Adolescent use of illicit substances imposes an enormous burden on individuals, families, and communities. The types of illicit substances adolescents are using have changed drastically over the past decade with decreases in alcohol use (including binge alcohol use) offset by increases ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p689.html

Amblyopia: Detection and Treatment - American Family Physician

Dec 15, 2019 - Amblyopia is the leading cause of monocular vision loss in children. Early recognition and treatment are important to prevent vision loss. The U.S. Preventive Services Task Force recommends vision screening for all children at least once between three and five years of age to detect the...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p745.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

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

Anticoagulation: Updated Guidelines for Outpatient Management - American Family Physician

Oct 1, 2019 - Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p426.html

Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones - American ...

May 15, 2019 - Apophysitis and osteochondrosis are common causes of pain in growing bones but have differing etiologies and required management. Apophysitis results from a traction injury to the cartilage and bony attachment of tendons in children and adolescents. Most often it is an overuse injury in...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p610.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

Bartholin Duct Cyst and Gland Abscess: Office Management - American Family Physician

Jun 15, 2019 - The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland does not affect lubrication. Ductal blockage of these typically pea-sized structures can result in enlargement of the ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p760.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

Benign Anorectal Conditions: Evaluation and Management - American Family Physician

Jan 1, 2020 - Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p24.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

Care of the Military Veteran: Selected Health Issues - American Family Physician

Nov 1, 2019 - According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans receive care at a Veterans Health Administration or military treatment facility, leaving most to receive services from...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p544.html

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.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

Cirrhosis: Diagnosis and Management - American Family Physician

Dec 15, 2019 - Cirrhosis is the 12th leading cause of death in the United States. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. Only one in three people with cirrhosis knows they have it. Most patients with cirrhosis remain ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p759.html

Clinically Relevant Drug-Drug Interactions in Primary Care - American Family Physician

May 1, 2019 - Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p558.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

Common Breast Problems - American Family Physician

Apr 15, 2019 - Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p505.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

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

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Depression in Children and Adolescents: Evaluation and Treatment - American Family ...

Nov 15, 2019 - The prevalence of major unipolar depression in children and adolescents is increasing in the United States. In 2016, approximately 5% of 12-year-olds and 17% of 17-year-olds reported experiencing a major depressive episode in the previous 12 months. Screening for depression in ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p609.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.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...

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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

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