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 | ||
More titles in The BMJ Easily Missed? Series | 181 | ||
More titles in The BMJ Research Methods and Reporting Series | 182 | ||
More titles in The BMJ Research Methods and Reporting Series | 183 | ||
More titles in The BMJ Clinical Review Series | 184 | ||
More titles in The BMJ Clinical Review Series | 185 | ||
More titles from BPP School of Health | 186 | ||
More titles in The Progressing Your Medical Career Series | 187 | ||
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