Additional Information
Book Details
Abstract
Suspected premature menopause
• New patient asking for a benzodiazepine prescription
• Management of recurrent gout
• Asthma unresponsive to simple treatment in a child
• Haemochromatosis
• Smoking cessation
• Otalgia
• Fungal nail infection
• Chronic diarrhoea in a teenager
• Atrial fibrillation
• Sleep disorder (insomnia)
• Memory problems in an older person
• Genital warts
• Request for slimming tablets
• Raised blood glucose concentration
• Haematuria
• Reduced sexual desire in women
• Herpes zoster ophthalmicus
• Exacerbation of atopic eczema in children
• Acute anterior uveitis
• Hirsutism
• Thyroid swellings
• Non-alcoholic fatty liver disease
• Aphthous ulcers
• Acne vulgaris
• Transient ischaemic attack
• Tennis elbow
• Malignant melanoma
• Hoarse voice
• My baby keeps bringing up his feeds!
• Chalazion
• Female stress urinary incontinence
• Pollen food syndrome in a teenage student
• Acute cough in adults
• Vitamin B-12 deficiency
• Sexual health consultation for men who have sex with men
• Stridor in children
• Gout
• Macromastia (large breasts): request for breast reduction
• Hallux valgus
• Frequent exacerbations in chronic obstructive pulmonary disease
• Epididymo-orchitis
• Gilbert's syndrome
• Osgood-Schlatter disease
• Measles, mumps, and rubella vaccination in a child with suspected
egg allergy
• Funny turn
• Hypoglycaemia
• Otitis media with effusion ("glue ear")
• The Watery Eye
• Sexual dysfunction in cardiovascular disease
• Chronic chilblains
• Malaria
• Otorrhoea
• The Hajj
• Dyspepsia
• Varicose veins
• Epistaxis
• Reviewing a patient with coeliac disease
• A scaly rash on the hands
• A child with neck swelling
• Tick bite and early Lyme borreliosis
• Blepharitis
• Blood stained nappy
• Otitis externa
• Dry eye
• Adult trigger finger
• Minor incised traumatic laceration
• Vasectomy
• Hearing loss in adults
• Abnormal vaginal discharge
• Young people who self harm by cutting
• Tremor
• Assessment and management of renal colic
• A pain in the bottom
• Umbilical hernia
• Thrombocytopenia in an adult
• Atrial fibrillation
• Phimosis in childhood
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Book Cover | C | ||
| Title | i | ||
| Copyright | ii | ||
| About the publisher | iii | ||
| About The BMJ | iii | ||
| Contents | iv | ||
| About the editors | ix | ||
| Introduction to 10 Minute Consultations | x | ||
| Assessing the risk of diabetes | 1 | ||
| What you should cover | 1 | ||
| What should you do next? | 1 | ||
| Bariatric surgery | 3 | ||
| What you should cover | 3 | ||
| What you should do | 3 | ||
| Breast lumps | 5 | ||
| What you should cover | 5 | ||
| Examination | 5 | ||
| What you should do | 6 | ||
| Red flags | 6 | ||
| Diagnosing chronic obstructive pulmonary disease | 7 | ||
| What you should cover | 7 | ||
| Elicit risk factors— See box 1 | 7 | ||
| What you should do | 7 | ||
| Examination | 7 | ||
| Investigations | 7 | ||
| Spirometry | 7 | ||
| Other investigations | 7 | ||
| Predict disability | 7 | ||
| Management | 7 | ||
| Referrals | 8 | ||
| Double vision | 9 | ||
| What you should cover | 9 | ||
| Assessment | 9 | ||
| Examination | 9 | ||
| What you should do | 10 | ||
| Urgent, same day referral | 10 | ||
| Foot drop | 11 | ||
| Medical history | 11 | ||
| What you should do | 11 | ||
| Physical examination | 11 | ||
| Advice and treatment | 12 | ||
| Gastro-oesophageal reflux disease in children: NICE guidance | 13 | ||
| Recommendations | 13 | ||
| Initial management of gastro-oesophageal reflux and GORD | 15 | ||
| Pharmacological treatment of GORD | 15 | ||
| Surgery for GORD | 17 | ||
| Overcoming barriers | 17 | ||
| Gradual loss of vision in adults | 19 | ||
| What you should cover | 19 | ||
| History | 19 | ||
| Examination | 19 | ||
| What you should do | 19 | ||
| High INR on warfarin | 21 | ||
| What you should cover | 21 | ||
| What you should do | 21 | ||
| Advice and follow-up | 21 | ||
| Nipple discharge | 23 | ||
| What you should cover | 23 | ||
| History | 23 | ||
| Examination | 23 | ||
| Inspection | 23 | ||
| Palpation | 23 | ||
| Red flags based on NICE guidelines for suspected cancer 4 | 23 | ||
| What you should do | 23 | ||
| Pain at the base of the thumb | 25 | ||
| What you should cover | 25 | ||
| Alternative or concomitant diagnoses to consider | 25 | ||
| What you should do | 25 | ||
| Examination | 25 | ||
| Investigations | 25 | ||
| Treatment options | 25 | ||
| Pelvic pain | 27 | ||
| What you should cover | 27 | ||
| History | 27 | ||
| Examination | 27 | ||
| What you should do | 27 | ||
| Reducing the risk of diabetes | 29 | ||
| What you should cover | 29 | ||
| What you should do | 29 | ||
| Teenagers with back pain | 31 | ||
| What you should cover | 31 | ||
| History | 31 | ||
| Examination | 31 | ||
| What you should do | 31 | ||
| When to refer | 32 | ||
| The drooling child | 33 | ||
| What issues you should cover | 33 | ||
| Ear, nose, and throat examination | 33 | ||
| What you should do | 33 | ||
| Atrial fibrillation | 35 | ||
| What you should cover | 35 | ||
| What you should do | 35 | ||
| Initial assessment | 35 | ||
| Stroke risk assessment | 35 | ||
| Investigations | 35 | ||
| Management | 35 | ||
| When to refer to cardiologist (or cardiac rhythm management specialist if available) | 35 | ||
| Rate control | 35 | ||
| Stroke risk reduction | 35 | ||
| Diagnosis and management of chronic heart failure | 37 | ||
| What you should cover | 37 | ||
| Ask about | 37 | ||
| Clinical examination | 37 | ||
| What you should do | 37 | ||
| Talk to the patient | 37 | ||
| Establish the diagnosis | 37 | ||
| Blood tests | 37 | ||
| Other tests | 37 | ||
| Make a management plan | 37 | ||
| Drug treatment | 37 | ||
| Treatment of comorbidities | 38 | ||
| Long term health promotion and rehabilitation | 38 | ||
| Tick bite and early Lyme borreliosis | 39 | ||
| What you should cover | 39 | ||
| What you should do | 39 | ||
| Dyspepsia | 41 | ||
| What you should cover | 41 | ||
| What you should do | 41 | ||
| When to refer | 41 | ||
| Thrombocytopenia in an adult | 43 | ||
| What issues you should cover? | 43 | ||
| Pointers to diagnosis | 43 | ||
| What you should do? | 43 | ||
| Outcome | 44 | ||
| Osgood-Schlatter disease | 45 | ||
| What you should cover | 45 | ||
| History | 45 | ||
| What you should do | 45 | ||
| Examination and treatment | 45 | ||
| Funny turn | 47 | ||
| What you should cover | 47 | ||
| Assessing symptoms | 47 | ||
| Associated symptoms | 47 | ||
| Timing and onset | 47 | ||
| What you should do | 47 | ||
| Examination | 47 | ||
| ABCD 2 score | 47 | ||
| Investigations | 47 | ||
| Referral | 47 | ||
| Driving | 48 | ||
| Vitamin B-12 deficiency | 49 | ||
| What you should cover | 49 | ||
| Assess clinical evidence of B-12 deficiency | 49 | ||
| What you should do | 49 | ||
| Consider the cause | 49 | ||
| Consider referral | 49 | ||
| Treatment | 49 | ||
| Monitoring | 49 | ||
| A pain in the bottom | 51 | ||
| What you should cover | 51 | ||
| History | 51 | ||
| Examination | 51 | ||
| What you should do | 51 | ||
| Anal fissures | 51 | ||
| Haemorrhoids | 51 | ||
| Functional anorectal pain | 51 | ||
| Adult acute rhinosinusitis | 53 | ||
| What you should cover | 53 | ||
| Ask about | 53 | ||
| Examination | 53 | ||
| What you should do | 53 | ||
| When to refer immediately | 54 | ||
| Flashes, floaters, and a field defect | 55 | ||
| What you should cover | 55 | ||
| Ask about | 55 | ||
| What you should do | 55 | ||
| Hypoglycaemia | 57 | ||
| What you should cover | 57 | ||
| What you should do | 57 | ||
| Examination and investigations | 57 | ||
| Treatment and advice | 57 | ||
| Follow-up | 58 | ||
| Varicose veins | 59 | ||
| What you should cover | 59 | ||
| What you should do | 59 | ||
| An adult with a neck lump | 61 | ||
| What you should cover | 61 | ||
| History | 61 | ||
| Examination | 61 | ||
| What you should do | 61 | ||
| Dental pain | 63 | ||
| What you should cover | 63 | ||
| Nature and severity of the pain | 63 | ||
| History | 63 | ||
| What you should do | 63 | ||
| Examination | 63 | ||
| Extra-orally | 63 | ||
| Intra-orally | 63 | ||
| Consider referral | 64 | ||
| Medication | 64 | ||
| New patient asking for a benzodiazepine prescription | 65 | ||
| What issues you should cover | 65 | ||
| Is it appropriate to prescribe diazepam to this patient? | 65 | ||
| Is it safe to prescribe? | 65 | ||
| What should you prescribe? | 65 | ||
| What you should do | 65 | ||
| Measles, mumps, and rubella vaccination in a child with suspected egg allergy | 67 | ||
| What you should cover | 67 | ||
| What you should do | 67 | ||
| Otitis media with effusion (“glue ear”) | 69 | ||
| What you should cover | 69 | ||
| What you should do | 69 | ||
| Reviewing a patient with coeliac disease | 71 | ||
| What you should cover | 71 | ||
| What you should do | 71 | ||
| Clinical examination | 71 | ||
| Blood tests | 71 | ||
| Management | 71 | ||
| Longer term aspects of management | 72 | ||
| Phimosis in childhood | 73 | ||
| What is phimosis? | 73 | ||
| What you should cover | 73 | ||
| History | 73 | ||
| Examination | 73 | ||
| What you should do | 73 | ||
| Chronic chilblains | 75 | ||
| What you should cover | 75 | ||
| What you should do | 75 | ||
| Hearing loss in adults | 76 | ||
| What you should cover | 76 | ||
| Hearing difficulties | 76 | ||
| Associated ear, nose, and throat (ENT) symptoms | 76 | ||
| Risk factors for otological disease | 76 | ||
| Red flags | 76 | ||
| What you should do | 76 | ||
| Examination | 76 | ||
| Referrals | 76 | ||
| Pointers to diagnosis of hearing loss | 76 | ||
| Conductive loss (unilateral) | 76 | ||
| Conductive loss (bilateral) | 76 | ||
| Sensorineural loss (bilateral and gradual) | 77 | ||
| Sensorineural loss (unilateral) | 77 | ||
| Tremor | 78 | ||
| What you should cover | 78 | ||
| History | 78 | ||
| Medical history | 78 | ||
| Drug history | 78 | ||
| Social history and lifestyle | 78 | ||
| Family history | 78 | ||
| Examination | 78 | ||
| What you should do | 78 | ||
| Management of recurrent gout | 80 | ||
| What issues you should cover | 80 | ||
| What you should do | 80 | ||
| During the consultation | 80 | ||
| Reducing the risk of further attacks | 80 | ||
| Drug treatment | 80 | ||
| Ongoing care | 80 | ||
| Gout | 82 | ||
| What you should cover | 82 | ||
| What you should do | 82 | ||
| Otorrhoea | 84 | ||
| What you should cover | 84 | ||
| What is the link between otorrhoea and otalgia? | 84 | ||
| Risk factors | 84 | ||
| Prevalence and incidence | 84 | ||
| Examination | 84 | ||
| What you should do | 84 | ||
| Referral to an ear, nose, and throat specialist | 85 | ||
| Adult trigger finger | 86 | ||
| What you should cover | 86 | ||
| History | 86 | ||
| What you should do | 86 | ||
| Examination | 86 | ||
| Treatment options | 86 | ||
| Management | 86 | ||
| Young people who self harm by cutting | 88 | ||
| What you should cover | 88 | ||
| History and her feelings | 88 | ||
| Examination | 88 | ||
| What you should do | 88 | ||
| What not to miss | 89 | ||
| Hallux valgus | 90 | ||
| What you should cover | 90 | ||
| What you should do | 90 | ||
| Frequent exacerbations in chronic obstructive pulmonary disease | 92 | ||
| What you should cover | 92 | ||
| What you should do | 92 | ||
| Consider alternative diagnoses | 92 | ||
| Optimise therapy | 92 | ||
| Support and palliative care | 92 | ||
| Gilbert’s syndrome | 94 | ||
| What you should cover | 94 | ||
| What you should do | 94 | ||
| History and examination | 94 | ||
| Investigations | 94 | ||
| Diagnosis | 94 | ||
| Patient advice and education | 94 | ||
| Epistaxis | 96 | ||
| What you should cover | 96 | ||
| What you should do | 96 | ||
| First aid | 96 | ||
| Treatment | 96 | ||
| Follow-up | 96 | ||
| The Watery Eye | 98 | ||
| What you should cover | 98 | ||
| History | 98 | ||
| What you should do | 98 | ||
| Examination | 98 | ||
| Management | 98 | ||
| A feeling of a lump in the throat | 100 | ||
| What you should cover | 100 | ||
| Examination | 100 | ||
| What you should do | 101 | ||
| Abnormal vaginal discharge | 102 | ||
| What you should cover | 102 | ||
| What you should do | 102 | ||
| Examination | 102 | ||
| Management | 102 | ||
| When to consider referral to genitourinary medicine | 102 | ||
| Infective (non-sexually transmitted infection) | 102 | ||
| Infective (sexually transmitted infection) | 102 | ||
| Personal hygiene and advice | 103 | ||
| Eustachian tube dysfunction in adults | 104 | ||
| What is eustachian tube dysfunction? | 104 | ||
| What you should cover | 104 | ||
| History | 104 | ||
| Preceding symptoms and precipitating factors | 104 | ||
| Examination | 104 | ||
| Primary care | 104 | ||
| Consider if available in primary care | 104 | ||
| Treatment in primary care | 104 | ||
| Auto-inflation devices (Otovent, Ear Popper) | 104 | ||
| Intranasal preparations | 104 | ||
| Referral to ENT services | 104 | ||
| Secondary care | 105 | ||
| Further investigations | 105 | ||
| Treatment | 105 | ||
| A scaly rash on the hands | 106 | ||
| What issues you should cover | 106 | ||
| Pointers to diagnosis | 106 | ||
| What you should do | 106 | ||
| Follow-up | 107 | ||
| Transient ischaemic attack | 108 | ||
| What issues you should cover | 108 | ||
| General points | 108 | ||
| Assessing symptoms | 108 | ||
| What you should do | 108 | ||
| Eyelid lumps and lesions | 110 | ||
| What you should cover | 110 | ||
| History | 110 | ||
| Examination | 110 | ||
| Red flags | 110 | ||
| What you should do | 110 | ||
| Conservative management | 110 | ||
| Routine referral | 110 | ||
| Urgent referral | 111 | ||
| Baby with an abnormal head | 112 | ||
| What you should cover | 112 | ||
| What you should do | 112 | ||
| Management of positional plagiocephaly | 113 | ||
| Acute cough in adults | 114 | ||
| What you should cover | 114 | ||
| What you should do | 114 | ||
| Advice and treatment | 114 | ||
| Sexual dysfunction in cardiovascular disease | 116 | ||
| What you should cover | 116 | ||
| What you should do | 116 | ||
| Management options | 116 | ||
| Consider referral | 117 | ||
| Acne vulgaris | 118 | ||
| What issues you should cover | 118 | ||
| What you should do | 118 | ||
| First line treatments | 118 | ||
| Second line treatments | 118 | ||
| Assessment and management of renal colic | 120 | ||
| What you should cover | 120 | ||
| Important features of the examination include | 120 | ||
| What you should do | 120 | ||
| Pain management | 120 | ||
| Reasons to refer a patient immediately to hospital | 120 | ||
| Initial investigations if patient is not admitted | 121 | ||
| Dry eye | 122 | ||
| What you should cover | 122 | ||
| History | 122 | ||
| Examination | 122 | ||
| What you should do | 122 | ||
| Macromastia (large breasts): request for breast reduction | 124 | ||
| What issues you should cover | 124 | ||
| Medical or social history | 124 | ||
| Physical examination | 124 | ||
| Physical issues | 124 | ||
| Psychological issues | 124 | ||
| What you should do | 124 | ||
| Give advice on conservative treatment | 124 | ||
| Refer to a plastic surgeon | 125 | ||
| Umbilical hernia | 126 | ||
| What you should consider during the consultation | 126 | ||
| Asymptomatic umbilical hernias | 126 | ||
| Symptomatic umbilical hernias | 126 | ||
| What you should do | 126 | ||
| Surgery | 127 | ||
| Follow-up | 127 | ||
| Fungal nail infection | 128 | ||
| What issues you should cover | 128 | ||
| What you should do | 128 | ||
| Examination and diagnosis | 128 | ||
| Explanation and reassurance | 128 | ||
| Treatments | 128 | ||
| Preventing further infections | 129 | ||
| A child with neck swelling | 130 | ||
| What you should cover | 130 | ||
| Important features in the history | 130 | ||
| Important features of the examination | 130 | ||
| General examination | 130 | ||
| Neck examination: lymphadenomatous swellings | 130 | ||
| Neck examination: findings suggestive of non-lymphadenomatous swellings | 130 | ||
| Causes of massive neck swelling (refer urgently to hospital) | 131 | ||
| What you should do | 131 | ||
| Aphthous ulcers | 132 | ||
| What issues you should cover | 132 | ||
| What you should do | 132 | ||
| The Hajj | 134 | ||
| What you should cover | 134 | ||
| Explore his understanding of the Hajj | 134 | ||
| Does he experience angina? | 134 | ||
| Does he appreciate the possible effects of heat, physical exertion, crowds, and altered routine on his health? | 134 | ||
| Has he been vaccinated? | 134 | ||
| Will he be travelling elsewhere after the Hajj? | 134 | ||
| What you should do | 134 | ||
| Malaria | 136 | ||
| What you should cover | 136 | ||
| What you should do | 136 | ||
| Epididymo-orchitis | 138 | ||
| What you should cover | 138 | ||
| Taking history | 138 | ||
| What you should do | 138 | ||
| Treatment | 138 | ||
| Tennis elbow | 140 | ||
| What issues you should cover | 140 | ||
| What you should do | 140 | ||
| History | 140 | ||
| Examination and treatment | 140 | ||
| Hoarse voice | 141 | ||
| What you should cover | 141 | ||
| History taking | 141 | ||
| Examination | 141 | ||
| What you should do | 141 | ||
| Memory problems in an older person | 143 | ||
| What issues you should cover | 143 | ||
| What you should do | 143 | ||
| Hirsutism | 144 | ||
| What issues you should cover | 144 | ||
| What you should do | 144 | ||
| Otitis externa | 146 | ||
| What you should cover | 146 | ||
| What you should do | 146 | ||
| Treatment | 146 | ||
| Malignant melanoma | 148 | ||
| What issues you should cover | 148 | ||
| What you should do | 148 | ||
| Blepharitis | 149 | ||
| What you should cover | 149 | ||
| History | 149 | ||
| Examination | 149 | ||
| What you should do | 149 | ||
| Chalazion | 151 | ||
| What you should cover | 151 | ||
| What you should do | 151 | ||
| Genital warts | 152 | ||
| What issues you should cover | 152 | ||
| What you should do | 152 | ||
| Blood stained nappy | 154 | ||
| What you should cover | 154 | ||
| Was it blood? | 154 | ||
| Bleeding and blood | 154 | ||
| Stools | 154 | ||
| Explore the feeds | 154 | ||
| What you should do | 154 | ||
| Haemochromatosis | 155 | ||
| What you should cover | 155 | ||
| What is haemochromatosis? | 155 | ||
| Who gets it? | 155 | ||
| What are the signs, symptoms, and sequelae? | 155 | ||
| How do you diagnose hereditary haemochromatosis? | 155 | ||
| What you should do | 155 | ||
| Vasectomy | 156 | ||
| What you should cover | 156 | ||
| How it works | 156 | ||
| Aftercare | 156 | ||
| Thyroid swellings | 158 | ||
| What issues you should cover | 158 | ||
| What you should do | 158 | ||
| Examination | 158 | ||
| Management | 158 | ||
| Otalgia | 159 | ||
| Case history | 159 | ||
| What you should cover | 159 | ||
| History | 159 | ||
| Examination | 159 | ||
| What you should do | 159 | ||
| Herpes zoster ophthalmicus | 161 | ||
| What issues you should cover | 161 | ||
| What is it and why has she got it? | 161 | ||
| Have I got the right diagnosis? | 161 | ||
| Can I predict who will get eye problems? | 161 | ||
| What are the possible ocular complications? | 161 | ||
| What you should do | 161 | ||
| Eye examination | 161 | ||
| Treatment and management | 161 | ||
| Referral | 162 | ||
| Suspected premature menopause | 163 | ||
| What issues you should cover | 163 | ||
| What you should do | 163 | ||
| Sexual health consultation for men who have sex with men | 164 | ||
| What you should cover | 164 | ||
| What you should do | 164 | ||
| Female stress urinary incontinence | 165 | ||
| What issues you should cover | 165 | ||
| What you should do | 165 | ||
| Examination | 165 | ||
| Investigations | 165 | ||
| Management | 165 | ||
| Stridor in children | 167 | ||
| What issues you should cover | 167 | ||
| How long has the stridor been present? | 167 | ||
| Associated features | 167 | ||
| History | 167 | ||
| What you should do | 167 | ||
| Physical examination | 167 | ||
| Management | 167 | ||
| Exacerbation of atopic eczema in children | 169 | ||
| What issues you should cover | 169 | ||
| What you should do | 169 | ||
| Asthma unresponsive to simple treatment in a child | 171 | ||
| What issues you should cover | 171 | ||
| What you should do now | 171 | ||
| Chronic diarrhoea in a teenager | 172 | ||
| What issues you should cover | 172 | ||
| What is the risk of underlying disease? | 172 | ||
| History | 172 | ||
| Examination | 172 | ||
| What you should do | 172 | ||
| Minor incised traumatic laceration | 174 | ||
| What you should cover | 174 | ||
| Medical history | 174 | ||
| What you should do | 174 | ||
| Physical examination and wound cleansing | 174 | ||
| Wound closure | 174 | ||
| Sutures | 174 | ||
| Adhesive glue | 174 | ||
| Wound dressing, patient advice, and follow-up | 175 | ||
| Pollen food syndrome in a teenage student | 176 | ||
| What issues you should cover | 176 | ||
| Detailed history is the cornerstone of diagnosis | 176 | ||
| How does the problem affect her? | 176 | ||
| Ask about related co-morbidities, particularly hay fever and asthma | 176 | ||
| What treatments, if any, has she tried and with what effect? | 176 | ||
| What you should do | 176 | ||
| Examination | 176 | ||
| Confirmatory testing | 176 | ||
| Food avoidance | 176 | ||
| Advice on botanical relations | 176 | ||
| Treatments | 176 | ||
| Information and support | 176 | ||
| Acute anterior uveitis | 178 | ||
| What issues you should cover | 178 | ||
| What you should do | 178 | ||
| More titles in The BMJ Series | 179 | ||
| More titles in The BMJ Easily Missed? Series | 180 | ||
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| More titles in The BMJ Research Methods and Reporting Series | 182 | ||
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