Differential Diagnosis in Primary Care

Formulating a diagnosis purely on the basis of clinical judgement can be fraught with difficulty and danger, yet this is the challenge faced every day by Primary Care physicians, who rarely have access to the diagnostic tools available to hospital-based colleagues.

Differential Diagnosis in Primary Care has been specifically written with the needs of the Primary Care physician in mind.

It examines the potential causes of common presentations and aims to help the physician differentiate between diseases, using history and examination alone.

Diseases are listed in descending order of prevalence, with the commonest causes first, while high-risk conditions are highlighted to ensure they are not overlooked. Its unique tabulated format ensures key information is easily accessible, and the user-friendly format ensures the book can be used during consultations, home visits, and on ward rounds.

Whether used by the undergraduate, postgraduate trainee or the experienced Primary Care physician, Differential Diagnosis in Primary Care is an invaluable tool designed to improve the reader's ability to diagnose on the basis of clinical judgement alone.

Acknowledgements vi

Preface vii

List of Abbreviations and Symbols viii

Chapter 1: Head and Neck 1

Chapter 2: Ophthalmology 7

Chapter 3: Ear, Nose and Throat 14

Chapter 4: Thorax 24

Chapter 5: Abdomen 37

Chapter 6: Urinary Tract 58

Chapter 7: Women’s Health 65

Chapter 8: Men’s Health 81

Chapter 9: Musculoskeletal 90

Chapter 10: Skin, Hair and Nails 109

Chapter 11: Mental Health 137

Chapter 12: Miscellaneous 144

Index 167

"I liked the layout as it is easy on the eye and simple to find what you are looking for if you are searching for a particular symptom. The index is searchable by symptom and by disease" (Royal College of General Practitioners, 1 May 2011)

“This is a highly useful book to keep readily available in the outpatient office as a memory aid when confronted with a less-than-textbook presentation of symptoms.” (Doody’s , August 2009)

Dr Mehmood Syed, MBBS DRCOG MRCGP, Private & NHS General Practitioner.

Dr Nairah Rasul, BSc (Hons) MBBS, Senior House Officer in Vocational Training for General Practice.

Background:
In General Practice, common disorders are usually distinguished from each other by good history taking and careful examination. In contrast, hospital doctors have easy access to many investigations and often rely more heavily on these, than their clinical skills.

The inability of GPs to access such immediate tests in making the diagnosis, is the most difficult challenge for new doctors to overcome. Furthermore keeping up to date on signs and symptoms of uncommon conditions is also a challenge for more experienced GPs.

The ability to differentiate between benign illnesses and serious conditions without investigations is therefore a critical skill which GPs must possess in order to practise safely.

Scope of the book:
The book will cover all common symptoms which present in General Practice and list their recognised causes in order of prevalence.

Reaching a provisional diagnosis is the most difficult part of any GP consultation. The formulation of a management plan thereafter is often straight forward. Therefore this book will focus solely on the formulation of likely diagnoses and will not attempt to cover the investigations and management of them. However, important points will be highlighted where appropriate.

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