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, London

Carol Cooper is Honorary Teaching Fellow, Department of Primary Care and Public Health at Imperial College Medical School, London, and a General Practitioner

Graham Easton is Deputy Director of Primary Care Education, Department of Primary Care and Public Health at Imperial College Medical School, London, and a General Practitioner

Margaret Harper is Honorary Teaching Fellow, Department of Primary Care and Public Health at Imperial College Medical School, London, and a General Practitioner

Contributors 6

Preface 7

Acknowledgements 8

Abbreviations 9

Introduction: how to make the most of your GP attachment 11

Part 1 The essence of general practice

1 The 10-minute consultation: taking a history 12

2 The 10-minute consultation: managing your patient 14

3 Continuity of care and the primary healthcare team 16

4 Why do patients consult? 18

5 Preventive medicine 20

6 Significant event analysis, audit and research 22

7 Communication between primary and secondary care 24

8 Principles of good prescribing in primary care 26

9 Prescribing in children and the elderly 28

10 Law and ethics 30

11 Child abuse, domestic violence and elder abuse 32

Part 2 Common presentations in general practice Child health

12 The febrile child 34

13 Cough and wheeze 36

14 Asthma 37

15 Abdominal problems 38

16 Common behaviour problems 40

17 Childhood rashes 42

18 Child health promotion 44

19 Musculoskeletal problems in children 46

Sexual health

20 Common sexual problems 49

21 Sexually transmitted infections and HIV 52

22 Contraception 54

23 Subfertility 56

Women's health

24 Termination of pregnancy 58

25 Menstrual disorders 60

26 The menopause 62

27 Common gynaecological cancers 63

28 Breast problems 64

The pregnant woman

29 Antenatal care 66

30 Bleeding and pain in pregnancy 68

31 Other pregnancy problems 70

Care of the elderly

32 Acute confusional state and dementia 72

33 Fits, faints, falls and funny turns 74

Cardiovascular problems

34 Chest pain 76

35 Stroke 78

36 Peripheral vascular disease and leg ulcers 79

37 Preventing cardiovascular disease 80

Respiratory problems

38 Breathing diffi culties 82

39 Cough, smoking and lung cancer 84

40 Asthma and chronic obstructive pulmonary disease 86

Endocrine problems

41 Diabetes 88

42 Thyroid disease 90

Gastrointestinal problems

43 Acute diarrhoea and vomiting in adults 92

44 Dyspepsia and upper gastrointestinal symptoms 94

45 Lower gastrointestinal symptoms 96

46 The acute abdomen 98

Musculoskeletal problems

47 Back pain 100

48 Hip and lower limb 102

49 Neck and upper limb 104

50 Inflammatory arthritis, rheumatism and osteoarthritis 106

Eyes and ENT

51 Upper respiratory tract infection (including sore throat) 108

52 Ear symptoms 110

53 The red eye 112

54 Loss of vision and other visual symptoms 114

Dermatology

55 Eczema, psoriasis and skin tumours 116

56 Other common skin problems 118

Mental health

57 Depression 120

58 Anxiety, stress and panic disorder 122

59 Alcohol and drug misuse 124

60 Eating disorders 126

61 Psychosis and severe mental illness 128

Other common conditions

62 Headache 130

63 Tiredness and anaemia 132

64 Insomnia 134

65 Allergy and hay fever 136

66 Urinary tract disorders 138

67 Chronic pain 140

Further reading and resources 142

Index 146