Essential Primary Care (eBook)

Andrew Blythe, Jessica Buchan (Herausgeber)

eBook Download: PDF

2016
John Wiley & Sons (Verlag)
978-1-118-86760-0 (ISBN)

Infos

Essential Primary Care aims to provide undergraduate students with a comprehensive overview of the clinical problems encountered in primary care. It covers the structure of primary care in the UK, disease prevention and the management of common and important clinical presentations from infancy to old age. Case studies are used in every chapter to illustrate key learning points. The book provides practical advice on how to consult with patients, make sense of their symptoms, explain things to them, and manage their problems.
Essential Primary Care:
• Is structured in five sections:
 - The building blocks of primary care: its structure and connection with secondary care, the consultation, the process of making a diagnosis, prescribing, and ethical issues
 - Health promotion
 - Common and important presenting problems in roughly chronological order
 - Cancer
 - Death and palliative care
• Gives advice on how to phrase questions when consulting with patients and how to present information to patients
• Provides advice on how management extends to prescribing - often missing from current textbooks
• Contains case studies within each chapter which reflect the variety of primary care and provide top tips and advice for consulting with patients
• Supported by a companion website at www.wileyessential.com/primarycare featuring MCQs, EMQs, cases and OSCE checklists

Andrew Blythe is a General Practitioner at Gaywood House Surgery, Bristol, and Senior Teaching Fellow, University of Bristol.

Jessica Buchan is a General Practitioner and a Teaching Fellow, University of Bristol.

Inhalt

Title Page 5
Copyright Page 6
Contents 7
Contributors 10
Foreword 11
Preface 12
How to use your textbook 13
About the companion website 14
Part 1 The key features of primary care 15
Chapter 1 The structure and organisation of primary care 17
What is primary care? 18
Organisation of primary care in the UK 19
What can be done in primary care? 22
References 23
Chapter 2 The GP consultation 24
The consultation in general practice 25
The effective consultation 26
Structuring a consultation (process and content) 27
Preparing for the consultation 28
Gaining rapport 28
Agreeing on the purpose of the consultation 30
Gaining knowledge about the issues through questioning 30
Gaining knowledge about the patient through examination 31
Gaining knowledge about the patient’s perspective 31
Gaining knowledge about the patient’s context 32
Understanding: what is going on and what do we do about it? 32
Reaching a shared decision and aiding the patient’s understanding 33
Reflecting on our consultation skills 34
Summary 34
References 34
Chapter 3 Making a diagnosis 36
What is a diagnosis? 37
Science and art in diagnosis 37
Diagnosis-making as ‘labelling’ 38
Models of diagnosis-making 38
Processes for reaching a diagnosis 39
Pitfalls of the diagnostic process 41
Preventing diagnostic errors 42
Learning to make a diagnosis 43
Summary 43
References 43
Chapter 4 Prescribing 44
Introduction 45
The cost of prescribing 45
Adherence 45
Safe prescribing using the 10 steps 48
Prescribing errors 53
Reporting adverse drug reactions 54
Summary 55
References 55
Chapter 5 The interface with secondary care 56
Introduction 57
Referring patients to secondary care 57
Admitting patients to hospital 60
Discharge from hospital 61
Summary 62
References 62
Chapter 6 The everyday ethics of primary care 64
Introduction 65
Concepts in medical ethics 65
Core values in primary care 65
Responsibilities of the GP 66
Approaching ethical issues 67
Five case studies in everyday ethics 68
Summary 70
References 70
Part 2 Healthy living and disease prevention 71
Chapter 7 Behaviour change 73
The role of the GP in health behaviour change 74
Barriers to health behaviour change 75
Assessing readiness to change 76
Brief motivational interviewing 77
Taking action: goal-setting 78
Relapse 80
Summary 80
References 81
Chapter 8 Alcohol and drug misuse 82
Identifying patients whose alcohol consumption is problematic 83
Helping people whose level of alcohol consumption is harmful 85
Detoxification and relapse 87
The role of the GP in helping people who misuse drugs 88
Summary 90
References 90
Chapter 9 Preventing cardiovascular disease 91
The burden of cardiovascular disease 92
Estimating the risk of a patient developing cardiovascular disease 92
Smoking cessation 93
Blood pressure 94
Cholesterol reduction 97
Summary 97
References 98
Chapter 10 Caring for people with learning disabilities 99
Types of learning disability 100
Inequalities of health experienced by those with a learning disability 101
Conducting a consultation with someone who has a learning disability 102
Common problems in people with a learning disability 103
Annual health checks for people with a learning disability 103
Supporting carers 105
Summary 105
References 106
Part 3 Common presenting problems 107
Chapter 11 Tiredness 109
Tired all the time 110
Thyroid disease 112
Type 2 diabetes mellitus 113
Anaemia 118
Chronic fatigue syndrome 120
Summary 120
References 120
Childhood 123
Chapter 12 Child health in primary care 125
The healthy child 126
Screening and developmental reviews 126
Immunisations 128
Consulting with children 129
Child health promotion 130
Vulnerable families and children at risk 131
Child abuse 131
Summary 132
References 133
Chapter 13 Managing the feverish and ill child in primary care 134
Assessment of the ill child in primary care 135
Red flags and assessing the likelihood of serious illness 135
Childhood fever 137
Dehydration in children 140
Antibiotic use and parental expectations 140
Coughs, colds and influenza 142
Sore throat in children 143
Earache in children 144
Urinary tract infections in children 144
Suspected cancer in children 144
Summary 146
References 146
Chapter 14 Managing common conditions in infancy 148
Introduction 149
Assessing growth in infants 149
Rashes, jaundice and skin problems 149
Feeding, vomiting and crying 150
Sleep and preventing sudden infant death 151
Prematurity 151
Summary 152
References 152
Chapter 15 Managing chronic conditions in childhood 153
Recurrent wheeze and asthma 154
Acute asthma in children 154
Eczema in children 155
Glue ear (chronic otitis media) 156
Recurrent abdominal pain and constipation 156
Bedwetting 157
Behavioural issues in children 158
Summary 159
References 159
Chapter 16 Teenage and young-adult health 161
Consulting with teenagers 162
Confidentiality and consent 162
Puberty 163
Drugs and alcohol 165
Mood 165
Eating disorders 167
Summary 168
References 168
Early adulthood 169
Chapter 17 Respiratory tract infections 171
Coughs and colds 172
Lower respiratory tract infections: bronchitis and pneumonia 173
Sinusitis 173
Sore throat: pharyngitis and tonsillitis 175
Glandular fever 175
Summary 176
References 176
Chapter 18 Low back pain 177
The burden of back pain 178
Assessing back pain in primary care 178
Nerve root pain (radiculopathy) assessment and management 181
Other causes of back pain 182
Managing chronic nonspecific back pain 182
Summary 183
References 183
Chapter 19 Heartburn and dyspepsia 184
Definition of heartburn and dyspepsia 185
Diagnosing and managing heartburn 185
Diagnosing and managing dyspepsia 187
Summary 190
References 190
Chapter 20 Diarrhoea and rectal bleeding 191
Causes of diarrhoea 192
Conducting a consultation about diarrhoea 193
Irritable bowel syndrome 195
Rectal bleeding 196
Summary 196
References 197
Chapter 21 Common skin conditions 198
Introduction 199
Inflammatory dermatoses 199
Psoriasis 199
Acne 201
Other inflammatory dermatoses 203
Pigmented lesions 203
Common skin infections 205
Summary 207
References 207
Chapter 22 Headache 208
Types of headache 209
Causes of headache that should not be missed 211
Giant-cell arteritis (temporal arteritis) 213
Carbon monoxide poisoning 214
Summary 214
References 214
Chapter 23 Fits, faints and funny turns 215
Transient loss of consciousness 216
Epilepsy 218
Dizziness 220
Summary 222
References 223
Chapter 24 Depression, anxiety and self-harm 224
Introduction 225
Definition 225
Epidemiology 225
Diagnosis 226
Variations in presentation 227
Management 228
Controversies in depression and anxiety 230
Personality disorder, depressed mood and recurrent self-harm 231
Summary 231
References 232
Chapter 25 Sexual health and dysuria 233
Sexually transmitted infections: a historical perspective 234
Dysuria and urinary tract infections 234
Vaginal and penile discharge 236
Sexual health epidemiology and sexual health services 238
Taking a sexual history in primary care 240
The National Chlamydia Screening Programme 241
Other sexually transmitted infections 241
Bloodborne sexually transmitted infections 242
Summary 243
References 243
Chapter 26 Menstrual problems, contraception and termination of pregnancy 245
Introduction 246
The menstrual cycle 246
Taking a menstrual history 246
Common menstrual problems 246
Postponing menstruation 249
Assessing contraception needs 249
The combined oral contraceptive pill 250
Progesterone-only methods of contraception 252
Postcoital contraception 253
Termination of pregnancy 253
Summary 254
Referencess 254
Chapter 27 Pregnancy 255
Preconceptual advice 256
Subfertility in primary care 256
The antenatal screening programme 259
Common problems in the second and third trimesters 262
The onset of labour 265
Problems in the puerperium 265
Summary 266
References 267
Chapter 28 Domestic violence and abuse 268
What is domestic violence and abuse? 269
The scale of the problem 269
Health impact 269
Asking about domestic violence and abuse 272
Responding appropriately to disclosure 273
Offering referral 273
Children exposed to domestic violence and abuse 274
Summary 274
References 275
Middle and old age 277
Chapter 29 Cardiovascular disease 279
Introduction 280
Atrial fibrillation 280
Angina 281
Myocardial infarction 283
Strokes and transient ischaemic attacks 284
Peripheral arterial disease 285
Summary 287
References 287
Chapter 30 Breathlessness 289
Introduction 290
Acute breathlessness in primary care 290
Diagnosing and managing chronic asthma 292
Chronic breathlessness 294
Diagnosing and managing left ventricular failure 295
Diagnosing and managing chronic obstructive pulmonary disease 296
Summary 299
References 299
Chapter 31 Joint pains and stiffness 301
Osteoarthritis 302
Rheumatoid arthritis 303
Polymyalgia rheumatica 305
Summary 306
References 307
Chapter 32 Urinary problems and prostate disease 308
Haematuria 309
Haematospermia 310
Lower urinary tract symptoms in men 310
Urinary incontinence 312
Testicular problems 312
Erectile dysfunction 314
Summary 314
References 315
Chapter 33 The menopause 316
Symptoms of the menopause 317
Identifying the menopause 317
Managing menopausal symptoms 317
Hormone-replacement therapy preparations 319
Postmenopausal bleeding 320
Summary 320
References 320
Chapter 34 Multimorbidity and polypharmacy 321
Epidemiology of multimorbidity 322
The impact of multimorbidity on patients, GPs and the health system 323
Managing patients with multimorbidity 323
Polypharmacy 324
Summary 326
References 326
Chapter 35 Falls and fragility fractures 328
Falls 329
Osteoporosis and bone protection 330
Summary 334
References 334
Chapter 36 Visual and hearing loss 336
Identifying people with visual problems 337
Assisting people with visual loss 338
Common causes of visual loss 338
Conditions that require immediate action to prevent sight loss 340
Assessing someone who complains of poor hearing 341
Wax and ear-syringing 342
Conducting a consultation with someone who has a hearing loss 343
Summary 343
References 344
Chapter 37 Dementia 345
Diagnosing dementia 346
Finding the cause of dementia 350
Giving the diagnosis 351
Creating a power of attorney and a will 351
Supporting the family and carers of those with dementia 351
Creating the right environment at home 351
Medication for dementia 352
Monitoring patients with dementia 352
Summary 354
References 354
Part 4 Cancer 355
Chapter 38 Spotting patients with cancer 357
Introduction 358
The common risk factors for cancer 358
The role of screening 359
The National Awareness and Early Diagnosis Initiative 361
Defining the predictive value of symptoms, signs and tests 362
Rarer cancers 363
Missing a diagnosis of cancer in primary care 364
Summary 365
References 365
Chapter 39 Looking after patients with cancer 366
The role of the GP in the treatment of patients with cancer 367
Other problems encountered by patients with cancer 369
Cancer survivorship 370
Spotting patients who have a recurrence of their cancer 370
Surveillance of patients with cancer 371
Summary 372
References 372
Part 5 Palliative care and death 373
Chapter 40 Palliative care and death 375
What is palliative care? 376
Identifying those in need of palliative care 376
Symptom relief in palliative care 378
Allowing natural death 379
After death 380
Bereavement 382
Self-care 382
Summary 383
References 383
Index 385
EULA 403

Produkt-Details

• Erscheint lt. Verlag: 17.3.2016
• Reihe/Serie: Essentials
• Reihe/Serie: Essentials
• Reihe/Serie: Essentials
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Gesundheitswesen
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Allgemeinmedizin
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Medizinethik
• Themenwelt: Studium ► Querschnittsbereiche ► Geschichte / Ethik der Medizin
• Themenwelt: Studium ► Querschnittsbereiche ► Prävention / Gesundheitsförderung
• Schlagworte: Allgemeinpraxis, hausärztliche Praxis • Allgemeinpraxis, hausärztliche Praxis • Cancer • Childhood • Consultation • Disease • general practice • General Practice/Family Practice • GP • Lifespan • <p>Primary care • Medical • medical education • Medical Science • Medizin • Medizinische Grundversorgung • Medizinstudium • old-age • palliative</p> • Student • Symptoms
• ISBN-10: 1-118-86760-2 / 1118867602
• ISBN-13: 978-1-118-86760-0 / 9781118867600