Otorrhoea

2020 ◽  
Vol 13 (5) ◽  
pp. 281-288
Author(s):  
Mark Newton ◽  
Paraskevi Tsirevelou
Keyword(s):  
Primary Care ◽  
Cerebrospinal Fluid ◽  
Physical Examination ◽  
Hospital Admission ◽  
Secondary Care ◽  
Common Causes ◽  
Management Guidance ◽  
Throat Symptom ◽  
The Common ◽  
Nose And Throat

The discharging ear, also known as otorrhoea, is a common ear, nose and throat symptom and defined as drainage or flow exiting the ear. The discharge can be wax, blood, pus, mucus, or cerebrospinal fluid. The underlying cause can usually be determined from the history and physical examination. Most patients with otorrhoea can be managed within primary care and do not require referral or hospital admission. This article considers the common causes of a discharging ear, appropriate management, guidance for referral of patients to secondary care and some key take home points.

Rectal bleeding

2018 ◽  
Vol 11 (3) ◽  
pp. 143-146
Author(s):  
Rodrick Babakhanlou
Keyword(s):  
Primary Care ◽  
Rectal Bleeding ◽  
Secondary Care ◽  
Common Presentation ◽  
Common Causes ◽  
Bleeding Per Rectum ◽  
The Common

Bleeding per rectum is defined as the passage of blood from the anus. It is a common presentation in adults of all ages and the majority of cases can be managed in primary care. This article will focus on the common causes of rectal bleeding, its assessment and management, including guidance for referral pathways to secondary care.

Fever of Unknown Origin

2012 ◽  
pp. 237-243
Author(s):  
Mary J. Kasten
Keyword(s):  
Physical Examination ◽  
Laboratory Tests ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Definitive Diagnosis ◽  
Radiographic Testing ◽  
Common Causes ◽  
The Common ◽  
Definition Of ◽  
Comprehensive History

Classic definition of fever of unknown origin (FUO) is a fever for more than 3 weeks, a temperature of 38.3 C or higher on several occasions, and no definitive diagnosis after 1 week of hospital evaluation. Recent series have used other criteria instead of 1 week of hospital evaluation: 1 week of intensive outpatient evaluation, 3 outpatient visits, or a battery of laboratory tests. A comprehensive history should be obtained and a physical examination and basic laboratory and radiographic testing should be performed before stating that a patient has FUO. There is no clear consensus in the literature for defining the minimal diagnostic evaluation. The common causes of FUO are infection, cancer, rheumatologic or autoimmune disorders, and miscellaneous hematologic conditions. Treatment is empirical if a cause is not found.

Postmenopausal bleeding

2018 ◽  
Vol 11 (7) ◽  
pp. 387-390
Author(s):  
Freya Ridley-Davies
Keyword(s):  
General Practice ◽  
Endometrial Cancer ◽  
Secondary Care ◽  
Vaginal Bleeding ◽  
Menstrual Period ◽  
Last Menstrual Period ◽  
Postmenopausal Bleeding ◽  
Common Causes ◽  
The Common

Postmenopausal bleeding (PMB) is defined as any vaginal bleeding occurring at least 12 months after the last menstrual period, in a woman who is of menopausal age. PMB is a common problem presenting in general practice, and accounts for 5% of secondary care referrals. Although PMB usually has a benign cause, it is important to exclude endometrial cancer, which is detected in approximately 10% of women presenting with PMB. This article offers an outline for the history, examination and initial investigations of PMB, as well as an overview of the common causes and how these are subsequently managed.

Primary care

2018 ◽  
Author(s):  
Philippa Edwards
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Holistic Approach ◽  
Professional Relationship ◽  
Respiratory Problems ◽  
Diagnostic Skills ◽  
The Family ◽  
The Common ◽  
The Uk ◽  
William Osler

General practitioners (GPs) are the gatekeepers of the National Health Service in the UK, and virtually all referrals to secondary care are made through them. The breadth and depth of the discipline can at times seem overwhelming, although the old adage ‘common things occur commonly’ still holds. GPs need to be confident in the diagnosis and management of conditions from birth to the grave, and to know their boundaries of competence and when to refer to secondary care. The complexity of the GP consultation includes the following two points: 1. Many conditions present in a relatively undifferentiated form to the GP, whose job it is to try to identify whether the condition is normal or abnormal, and whether it is serious or minor. 2. GPs develop a close professional relationship with many of their patients and may also be the point of contact for other members of the family, neighbours, and friends of the patient. This knowledge is an important aspect of their holistic approach to medicine and is much valued by their patients. As the nineteenth-century physician Sir William Osler (1849–1919) said, ‘The good physician treats the disease; the great physician treats the patient who has the disease.’ The commonest presentations to GPs in the UK are for respiratory problems, chronic disease management, musculoskeletal disorders, and psychological problems. Health promotion, in particular smoking cessation and the management of obesity, is also important in preventing chronic illness. Although many presentations are minor and self-limiting, serious illnesses also occur, and GPs need to be able to recognize them, sometimes in the early stages. The questions in this chapter will assess your knowledge in the common areas that present, testing diagnostic skills and reasoning. They also test negotiating skills to ensure patient compliance, teamworking within the primary care setting, and risk management.

Management of spasticity in adults

2020 ◽  
Vol 13 (10) ◽  
pp. 574-581
Author(s):  
Asha Mary Thomas ◽  
Alexander P Joseph
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Brain Injury ◽  
Secondary Care ◽  
Late Presentation ◽  
Motor Neurone ◽  
The Common ◽  
Timely Referral

Spasticity is one of the most common and disabling impairments seen in patients with an upper motor neurone disorder such as stroke, brain injury and multiple sclerosis. It is increasingly accepted that spasticity remains an unrecognised and underdiagnosed impairment in primary care. This is worrying, as untreated spasticity leading to permanent contractures can be a late presentation in many conditions. There is an onus on GPs to recognise the common symptoms of spasticity and initiate management. This article will focus on practical aspects in the management of spasticity including timely referral to secondary care.

Diagnosing renal disease

2021 ◽  
pp. 175573802110530
Author(s):  
Ikenna Anderson Aneke
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Renal Disease ◽  
Physical Examination ◽  
Secondary Care ◽  
Diagnostic Tools ◽  
Or Management ◽  
Detailed History ◽  
Diagnostic Pathway ◽  
High Index Of Suspicion

Making clear diagnoses of renal disease can prove challenging for the general practitioner considering the limitations in consulting time and diagnostic tools in primary care. In addition, many of these diseases are asymptomatic and a high index of suspicion is needed to make a diagnosis. As always, the diagnostic pathway begins with a detailed history, physical examination and relevant investigations. This will help determine whether the patient requires emergency referral to secondary care, referral on the cancer pathway or management within the community.

scholarly journals Chronic Cough in Thymoma

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
K K Agrawal ◽  
SS Dhakal ◽  
N Bhatta ◽  
B Pradhan ◽  
RK Chaurasia ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Cough ◽  
Primary Care Physicians ◽  
Symptomatic Treatment ◽  
Anterior Mediastinum ◽  
Medical Attention ◽  
Common Symptom ◽  
Common Causes ◽  
The Common ◽  
Lung Infections

Cough is one of the most common symptom for which patients seek medical attention from primary care physicians and pulmonologists. Although tuberculosis and other lung infections are common throughout the developing world, they are not among the most common causes of chronic cough. We report a case of a 23 years old male who presenting to the outpatient clinic with chronic cough not responding to regular and symptomatic treatment that was diagnosed to have thymoma. After all the common causes for chronic cough have been ruled out, unusual causes should also be considered in the differential diagnosis. KEYWORDS: Chronic cough, Thymoma, Anterior Mediastinum.

Transient Vision Loss

2019 ◽  
pp. 83-88
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Physical Examination ◽  
Vision Loss ◽  
Internal Carotid Artery Stenosis ◽  
Management Approach ◽  
Common Causes ◽  
Transient Loss ◽  
The Common ◽  
Afferent Visual System

Transient vision loss is common and often results from a transient loss of blood supply to the afferent visual system, although there are many other potential causes. In this chapter, we begin by listing the common causes of transient vision loss. We next discuss the approach to transient vision loss. We emphasize the importance of the history, since physical examination and workup may be unrevealing. We then review the diagnostic evaluation, with a focus on investigations for transient vision loss that is vascular in etiology. Lastly, we discuss the management approach for patients with a cardiac source of embolism or internal carotid artery stenosis.

scholarly journals Adult hip pain

2019 ◽  
Vol 13 (1) ◽  
pp. 21-27
Author(s):  
Aman Jain ◽  
Katie Clamp
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Secondary Care ◽  
Management Strategies ◽  
Hip Pain ◽  
Good Knowledge ◽  
Musculoskeletal Conditions ◽  
Urgent Referral ◽  
Common Causes ◽  
Anatomy Of The Hip

Hip pain is one of the most common musculoskeletal presentations in general practice. There are multiples causes of hip pain, ranging from acute to chronic and traumatic to atraumatic. In general practice, it is important to identify the cause of hip pain, as management strategies vary depending on pathology. Some diagnoses need urgent referral to secondary care, whereas others can be managed in primary care. According to the RCGP, an estimated 1-in-5 consultations are for musculoskeletal conditions, so a good knowledge of management is important. In this article, we will discuss the anatomy of the hip, the most common causes of hip pain and their management.

scholarly journals The quality of e-fit notes issued in secondary care

2020 ◽  
Vol 70 (6) ◽  
pp. 394-399
Author(s):  
S Harrison ◽  
S Dorrington ◽  
V Parsons ◽  
S G S Shah ◽  
I Madan
Keyword(s):  
Primary Care ◽  
Thematic Analysis ◽  
Functional Ability ◽  
Secondary Care ◽  
Free Text ◽  
Anonymized Data ◽  
Primary Care Practitioners ◽  
Few Data ◽  
Nose And Throat

Abstract Background Few data are available on the pattern of use of fit notes issued in secondary care settings. Aims To evaluate the pattern and quality of e-fit notes issued in an NHS Trust. Methods Anonymized data on patients admitted to Guy’s and St Thomas’ NHS Foundation Trust (London, UK) who had an e-fit note issued from 1 January to 31 August 2017 were analysed using descriptive statistical methods. Thematic analysis was used to group the free-text comments into distinct categories and themes. Results A total of 815 fit notes were issued during the study period. A total of 659 (81%) fit notes advised that patients were ‘not fit’ for work, whilst 156 (19%) advised that they ‘may be fit’ for work. The specialty with the highest proportion of patients assessed as may be fit was plastic surgery 46/104 (44%), whilst the lowest was ear, nose and throat surgery 0/57 (0%). The majority 151/156 (97%) of fit notes which advised that patients may be fit for work used the tick-box sections on the fit note to recommend work modifications. Of the free-text comments in section 4 of the ‘may be fit’ e-fit notes issued, 91/114 (80%) were related to the functional ability of patients. Conclusions Our study suggests that doctors in secondary care are more willing to use the ‘may be fit’ option on the fit note than primary care practitioners. Most fit notes, which advised that a patient may be fit for work, suggested workplace modifications.

Sign in / Sign up

Export Citation Format

Share Document