Table of Contents

Contents

ABC  of general practice 1

A diagnostic perspective 1

Abdominal pain 5

Acne 19

Acute allergic reactions 21

Addison disease 22

Adolescent health 22

Alcohol problems 24

Alopecia areata (patchy hair loss) 26

Amnesia (loss of memory) 27

Anaemia 27

Angina pectoris 30

Anorectal disorders 31

Anorectal bleeding: diagnostic strategy model 33

Anticoagulants 35

Anxiety disorders 35

Aphthous ulcers (canker sores) 38

Arm and hand pain 39

Asthma 47

Back pain 54

Bad news (breaking bad news)—guidelines 62

Balanitis (balanoposthitis) 63

Bed sores (pressure injury) 64

Belching (aerophagia) 65

Bell (facial nerve) palsy 65

Benzodiazepine problems 65

Bites and stings 66

Bladder cancer 70

Bladder dysfunction (in women during night) 71

Blepharitis 71

Body odour 71

Boils (recurrent) 72

Breast lumps 72

Breast pain (mastalgia) 76

Breath-holding attacks 78

Bronchiolitis 79

Bronchitis 79

Bruising and bleeding 80

Bruxism (teeth grinding) 83

Burning feet syndrome 83

Burns 83

Calf pain 85

Cancer 85

Cannabis (marijuana) 87

Cardiopulmonary resuscitation (CPR) 88

‘Cellulite’ 89

Cellulitis 89

Central nervous system infections (incl. meningitis,

encephalitis, abcess) 89

Cervical cancer and the Pap test 93

Chest pain 95

Chilblains 100

Children: normal developmental milestones 101

Children: developmental disorders 101

Child abuse 107

Childhood: common infectious diseases 110

Children: special observations 113

Children’s behaviour disorders 115

Children: surgical problems 119

Children: neonatal leg and foot abnormalities 123

Children: special senses 125

Optimal times for surgery/intervention in early children’s

disorders 126

Children’s emergencies 127

Children’s skin and hair disorders 131

Chloasma 134

Chronic obstructive pulmonary disease 134

Cold sores 137

Common cold (acute coryza) 137

Communication and consulting skills (or how to prevent litigation) 138

Concussion 140

Conjunctivitis 140

Constipation 143

Contact dermatitis 146

Contraception 147

Cough 150

Counselling skills 156

Court appearance 157

‘Cracked’ skin 157

Cramps (nocturnal cramps in legs) 158

Cranial nerves 159

Croup 159

Dandruff 161

Deafness and hearing loss 161

Depression 164

Dermatitis/eczema 168

Diabetes mellitus 171

Diarrhoea 177

Difficult, demanding and angry patients 184

Diplopia 184

Disturbed patients 185

Diverticular disease 190

Dizziness/vertigo 191

Domestic (intimate partner) violence 195

Drugs—illicit substance abuse 197

Dry eyes 197

Dry hair 197

Dry mouth 199

Dry skin 199

Dyslipidaemia 200

Dysmenorrhoea (primary) 202

Dyspareunia 202

Dyspepsia (indigestion) 203

Stomach cancer 207

Dysphagia 207

Dyspnoea 208

Dystonia 213

Dysuria and frequency 214

Ear pain 216

Ectropion 222

Elderly patients 222

Emergency management of key medical conditions 224

Encopresis (faecal incontinence in children) 225

Endocarditis 226

Endocrine—overview of conditions 227

Endometriosis 228

Entropion 229

Enuresis (bed-wetting) 229

Epilepsy 230

Epistaxis: treatment techniques 235

Erectile dysfunction 235

Erysipelas 236

Eye: dry 236

Eye pain and redness 236

Eyelashes: ingrowing (trichiasis) 242

Eyelid ‘twitching’ or ‘jumping’ 243

Eyes: flash burns 243

Facial pain 244

Fatty liver 249

Fever and chills 249

Fibroids (leiomyoma) 252

Fibromyalgia syndrome 253

Flatus: excessive 254

Floaters and flashers of eyes 254

Folliculitis 255

Foot odour (smelly and sweaty feet) 255

Foot pain (podalgia) 256

Freckles and lentigines (sun spots) 260

Frostbite 260

Gambling 262

Ganglion 262

Gastroenteritis 263

Gastroparesis (gastropathy) in adults 265

Genetic disorders 265

Genital herpes 268

Genital warts 269

Geographical tongue (erythema migrans) 269

Gingivitis 269

Glandular fever 270

Globus hystericus 270

Gout (monosodium urate crystal disease) 271

Granuloma annularae 272

Growing pains 272

Grover disease 273

Guillain–Barre syndrome 273

Haematemesis and melaena 274

Haematuria 276

Haemochromatosis 277

Haemorrhoids 277

Hair disorders 277

Halitosis 281

Hangover 281

Hay fever (seasonal allergic rhinitis) 282

Head banging or rocking in toddlers 282

Headache 282

Head injury and unconsciousness 288

Heartburn (dyspepsia) 291

Heart failure 291

Heel pain 295

Hepatitis 298

Herpes simplex 302

Herpes zoster (shingles) 303

Hiccoughs (hiccups) 305

Hip pain 305

Hirsutism (hirsuties) 309

Hives (papular urticaria) 309

Hoarseness 309

Human immunodeficiency virus infection 310

Hypertension 312

Hyperventilation 314

Hypoglycaemia 315

Immunisation 316

Impetigo 317

Incontinence of urine 317

Infantile colic 318

Infertility/subfertility 318

Influenza 319

Ingrowing toenails 320

Injectable contraceptives 321

Insect stings 321

Insomnia 321

Intertrigo 322

Irritable bowel syndrome (IBS) 324

Jaundice 326

Jet lag 328

Jitters 329

Jock itch 329

K Kawasaki’s disease (mucocutaneous lymph node syndrome) 330

Keloid or hypertrophic scar 330

Keratoacanthoma 331

Keratoses (solar and seborrhoeic) 331

Keratosis pilaris 332

Kidney disease 332

Knee pain 334

Laryngitis 339

Lead poisoning 339

Leg pain 340

Lice infestation 344

Lichen planus 345

Melanoma 346

Melasma (chloasma) 347

Ménière syndrome 347

Menopause syndrome 347

Menorrhagia 349

Men’s health: an overview 351

Metabolic syndrome 351

Migraine attack 352

Milker’s nodules 352

Molluscum contagiosum 352

‘Monkey muscle’ tear 352

Morning sickness 353

Mouth soreness 353

Mouth ulcers 355

Multiple sclerosis (MS) 355

Myocardial infarction and NSTEACS 356

The ECG and myocardial infarction 360

Myoclonic jerks (periodic limb movement disorder) 362

Nail disorders 363

Narcotic dependence 366

Neck pain 367

Needlesticks and sharps injuries 369

Nightmares (dream anxiety) 369

Nose 370

Nutrition advice 372

Obesity 375

Obsessive–compulsive disorder 376

Obstetric care 376

Oily hair 384

Opioid (heroin) overdosage 384

Orf 384

Osteoporosis 384

Otitis externa 385

Otitis media 385

Paget disease (osteitis deformans) 386

Pain and its management 386

Palliative care 388

Palpitations 390

Panic attack 393

Parkinson disease 393

Paronychia 395

Pelvic inflammatory disease (females) 395

Pelvic pain 396

Perioral dermatitis 397

Peripheral neuropathy 398

Guillain–Barre syndrome 399

Personality disorders 399

Perspiration: excessive (hyperhidrosis) 401

Phimosis 401

Photoageing/wrinkles 401

Pityriasis rosea 402

Pityriasis versicolor (tinea versicolor) 402

Plantar warts 403

Pneumonia 403

Polycystic ovary syndrome (PCOS) 405

Polymyalgia rheumatica and giant cell arteritis 406

Premature ejaculation 407

Premenstrual tension syndrome 407

Prickly heat (miliaria/heat rash) 408

Prostate disorders 408

Pruritus (generalised) 410

Pruritus ani 411

Pruritus vulvae 412

Psoriasis 412

Purpura: diagnostic strategy model 415

Rectal bleeding 416

Refugee health 418

Restless legs (Ekbom syndrome) 418

Reye syndrome and aspirin 419

Rhinitis 419

Ringworm 420

Rosacea 420

Ross River and Barmah Forest infection 421

Scabies 422

Scrotal pain 422

Seborrhoeic dermatitis 424

Septicaemia (sepsis) 425

Sexually transmitted infections 426

Shingles 427

Shoulder pain 428

Sinusitis 429

Skin cancer 430

Skin eruptions 431

Sleep disorders 434

Smoking/nicotine 436

Snapping or clinking hip 437

Snoring 438

Sore throat 438

Spinal dysfunction 441

Splenectomy patients 441

Sprained ankle 442

Stinging fish 443

Stitch in side (precordial catch, Texidor twinge) 443

Stress disorders 443

Stroke and TIAs (transient ischaemic attacks) 443

Stuttering 447

Stye in eye 447

Subconjunctival haemorrhage 447

Sudden infant death syndrome (SIDS) and ALTE 447

Sunburn 448

Sweating 449

Syphilis 449

Tampon toxic shock syndrome 450

Tearduct (nasolacrimal duct) blockage in child 450

Teething 450

Temporomandibular joint dysfunction 451

Tennis elbow 451

Tension-type headache 451

Testicular tumours 451

Tetanus 452

Thrombotic disorders and anticoagulation 453

Thrush (candidiasis) of mouth 455

Thumb sucking 455

Thyroid disorders 456

Tick bites 457

Tics 457

Tinea infections 458

Tinnitus 460

Tiredness/fatigue 461

Tongue disorders 462

Torticollis (acute wry neck) 463

Travel medicine and tropical infections 463

Travel sickness 472

Tremor 472

Tropical ear 474

Umbilical discharge 475

Umbilical granuloma in infants 475

Undescended testes 475

Unemployment 476

Urethritis 476

Urinary tract infection 477

Urticaria (hives) 480

Vaginal discharge 481

Venous ulcers 483

Visual loss 485

Vitiligo 487

Vomiting 488

Vulvar disorders 489

Warts 492

Weight loss 493

Whiplash 495

Whole-person approach to management 495

Worms (helminths) see Tropical infections 497

Wounds: removal of non-absorbable sutures 497

Wrinkles 497

Writer’s cramp 497

Z Zoonoses 498

Appendixes 500

 

 

About the Author

John Murtagh, AM, is Executive Director, Education at the Royal Australian College of General Practitioners and Adjunct Professor of General Practice at the Department of Community Medicine and General Practice , Monash University, Victoria, Australia. He is one of Australia's leading GPs and community educators. A Professor in General Practice in the School of Primary Health Care at Monash University in Melbourne, Professorial Fellow in the Department of General Practice at the University of Melbourne and Adjunct Clinical Professor in the Graduate School of Medicine at the University of Notre Dame, Fremantle.