General Practice at a Glance

Paul Booton is Professor of General Practice and Primary Care at St George’s, University of London, and formerly Director of Primary Care Education, Imperial College, LondonCarol Cooper is Honorary Teaching Fellow, Department of Primary Care and Public Health at Imperial College Medical School, London, and a General PractitionerGraham Easton is Deputy Director of Primary Care Education, Department of Primary Care and Public Health at Imperial College Medical School, London, and a General PractitionerMargaret Harper is Honorary Teaching Fellow, Department of Primary Care and Public Health at Imperial College Medical School, London, and a General Practitioner

• Contributors 6Preface 7Acknowledgements 8Abbreviations 9Introduction: how to make the most of your GP attachment 11Part 1 The essence of general practice1 The 10-minute consultation: taking a history 122 The 10-minute consultation: managing your patient 143 Continuity of care and the primary healthcare team 164 Why do patients consult? 185 Preventive medicine 206 Significant event analysis, audit and research 227 Communication between primary and secondary care 248 Principles of good prescribing in primary care 269 Prescribing in children and the elderly 2810 Law and ethics 3011 Child abuse, domestic violence and elder abuse 32Part 2 Common presentations in general practice Child health12 The febrile child 3413 Cough and wheeze 3614 Asthma 3715 Abdominal problems 3816 Common behaviour problems 4017 Childhood rashes 4218 Child health promotion 4419 Musculoskeletal problems in children 46Sexual health20 Common sexual problems 4921 Sexually transmitted infections and HIV 5222 Contraception 5423 Subfertility 56Women’s health24 Termination of pregnancy 5825 Menstrual disorders 6026 The menopause 6227 Common gynaecological cancers 6328 Breast problems 64The pregnant woman29 Antenatal care 6630 Bleeding and pain in pregnancy 6831 Other pregnancy problems 70Care of the elderly32 Acute confusional state and dementia 7233 Fits, faints, falls and funny turns 74Cardiovascular problems34 Chest pain 7635 Stroke 7836 Peripheral vascular disease and leg ulcers 7937 Preventing cardiovascular disease 80Respiratory problems38 Breathing diffi culties 8239 Cough, smoking and lung cancer 8440 Asthma and chronic obstructive pulmonary disease 86Endocrine problems41 Diabetes 8842 Thyroid disease 90Gastrointestinal problems43 Acute diarrhoea and vomiting in adults 9244 Dyspepsia and upper gastrointestinal symptoms 9445 Lower gastrointestinal symptoms 9646 The acute abdomen 98Musculoskeletal problems47 Back pain 10048 Hip and lower limb 10249 Neck and upper limb 10450 Inflammatory arthritis, rheumatism and osteoarthritis 106Eyes and ENT51 Upper respiratory tract infection (including sore throat) 10852 Ear symptoms 11053 The red eye 11254 Loss of vision and other visual symptoms 114Dermatology55 Eczema, psoriasis and skin tumours 11656 Other common skin problems 118Mental health57 Depression 12058 Anxiety, stress and panic disorder 12259 Alcohol and drug misuse 12460 Eating disorders 12661 Psychosis and severe mental illness 128Other common conditions62 Headache 13063 Tiredness and anaemia 13264 Insomnia 13465 Allergy and hay fever 13666 Urinary tract disorders 13867 Chronic pain 140Further reading and resources 142Index 146

“A comprehensive guide on history taking, diagnosis and treatment in primary care, useful for written and clinical examinations alike. In particular, the use of high yield schematics throughout - from contraceptive methods and ear and eye symptoms, to the acute abdomen and gynaecological cancer epidemiology - differentiates this text from the rest." (Mobolaji O. Ajekigbe, Imperial College London) “This is a valuable book for young clinicians and students of all disciplines. It is intuitive and provides much teaching material for patients.” (Doody’s)“It will help you develop an understanding of the nature and structure of primary care.” (Student BMA News) “I think it is a fantastic book. I will be recommending it to medical students and other GP registrars. It is a lovely summary of general practice. The authors are obviously very experienced and have managed to distil the real ‘need to know’ facts in a highly reader friendly and engaging way. I would recommend every practice should have a copy of this text. Medical students will find it really useful for exam revision and not just during a GP placement. It’s a really reader-friendly, clear book. It does not scrimp on the medical facts or lose anything by being so slim and lightweight. I think it is priced perfectly for its intended market. The diagrams and illustrations are particularly good and relevant: it’s an excellent revision text for students. It is very difficult to pick out any weaknesses based on its intended audience. I was thoroughly impressed with this book. I though from the style it was going to be a little too basic but it certainly is not. Particularly noteworthy are the illustrations which are highly relevant and clear. The inclusion of photographs makes this text stand out from other similar texts on the market. A far more engaging and informative read than other stodgy textbooks on the same topic. I would have no hesitation in recommending this to medical and GP registrars.” (2013 BMA Medical Book Awards)