Ebook Murtach''s general practice (7/E): Part 1

TableofContents
1. Frontmatter
1. Halftitle
2. Dedication
3. Titlepage
4. Copyright
5. Theauthors
1. ProfessorJohnMurtaghAM
2. DrJillRosenblatt
3. DrJustinColeman
4. DrClareMurtagh
6. Foreword
7. Contents
8. Acknowledgments
1. Photocredits
9. Preface
10. Makingthemostofyourbook
1. Diagnosticstrategymodels
2. Keyfactsandcheckpoints
3. ThestaffofAsclepius
4. Redandyellowflags
5. Clinicalframework
6. Sevenmasqueradeschecklist
7. Diagnostictriads
8. Evidence-basedresearch
9. Extensivecoverageofpaediatricandgeriatriccare,pregnancy
andcomplementarytherapies
10. Practicetips
11. Clinicalphotos
12. Fullcolourillustrations

13. Significantlyenhancedindex
14. Patienteducationresources
11. Reviewers
1. Contentconsultants
2. Surveyrespondents


12. Laboratoryreferencevalues
13. Normalvalues:worthknowingbyheart
14. Abbreviations
2. Part1:Thebasisofgeneralpractice
1. Introduction
3. Chapter1:Thenature,scopeandcontentofgeneralpractice
1. Introduction
2. Definitions
3. Uniquefeaturesofgeneralpractice
1. Holisticapproachtomanagement
4. Continuingcare
1. Homevisits
5. Commonpresentingproblems
1. Mostfrequentpresentingsymptomsintheauthor’spractice
6. Symptomsandconditionsrelatedtolitigation
7. Chronicdiseasemanagement
8. References
9. Resources
4. Chapter2:Thefamily
1. Introduction
2. Characteristicsofhealthyfamilies
3. Familiesincrisis
1. Theeffectofillness

2. Guidelinesforthedoctor
4. Significantpresentationsoffamilydysfunction
5. Thepatientandfamilydynamics
1. Howtoevaluatethefamilydynamics
1. Thegenogram
6. Thefamilylifecycle
1. Familyassessment
2. Thequestionnaire1
3. Assessmentbasedonthequestionnaire
7. Family-basedmedicalcounselling
1. TheBATHEtechnique9
1. Background
2. Affect
3. Trouble
4. Handling


5. Empathy
8. Stepstobringaboutbehaviourchange
9. Maritaldisharmony
10. Basiccounsellingofcouples
1. Someimportantfacts
2. Positiveguidelinesforsuccess(summary)10
3. Makinglists—apracticaltask
4. Pitfalls1
5. Otherpitfalls
6. Possiblesolutionstoavoidpitfalls1
11. References
12. Resources
5. Chapter3:Consultingskills

1. Introduction
2. Theskillsofgeneralpractice
3. Modelsoftheconsultation
4. Phasesoftheconsultation
5. Thehistory
1. Goodquestions
2. Basicinterviewingtechniques
1. Questions
2. Theopen-endedquestion
3. Informationfromothersources
4. Problemdefinition
5. Touchingthepatient
6. Thephysicalandmentalexamination
7. Medicolegalguidelinesforexaminations
8. Investigations
9. Managementphaseoftheconsultation
1. Thesequenceofthemanagementinterview4
2. Closingthesession
3. Apatientmanagementstrategy
1. Prescriptions
2. Referral
4. The‘gatekeeper’roleoftheGP
5. Thehealingartofthedoctor
10. References
6. Chapter4:Communicationskills


1. Introduction
2. Communication
1. Communicationintheconsultation3,4

2. Prepare
3. Open
4. Gather
5. Non-verbalcommunication
6. Interpretingbodylanguage
7. Thepatient’sperspective
8. Communicatingduringthephysicalexaminationorprocedure
9. Negotiateandagreeonaplan
10. Close
11. Useofrelationship-buildingskills
12. Otherrapport-buildingtechniques
1. Mirroring
2. Pacing
3. Vocalcopying
4. Manageflow
3. References
7. Chapter5:Counsellingskills
1. Introduction
2. TheGPasaneffectivecounsellor
3. Featuresofcounselling
4. Aproblem-solvingapproach
5. Counsellingmodels
1. ThePLISSITmodel
2. TheColagiuriandCraigmodel
6. Thevalueofpatient-centredcounselling
7. Basicsofcounsellingandpsychotherapy
1. Counsellingstrategies4,7
2. Whatcounsellingisnot
3. Cautions1
8. Patientsunlikelytobenefit

9. Typesofpsychotherapy
1. Cognitivebehaviourtherapy
2. Mindfulness
10. Specificareasofcounselling
11. Crisismanagement


1. Aimsofcrisisintervention
2. Principlesofmanagement
3. Tenrulestohelpthoseindistress
12. Bereavement
1. Stagesofnormalbereavement
2. Pathologicalbereavement
1. TheGPascounsellor1
2. Long-termcounselling
13. Breakingbadnews
1. Sharingbadnewswithapatient
2. Basicguidelines
3. Management
4. Copingwithpatientresponses
5. Children
6. Unexpecteddeath
1. Guidelinesforthedoctor
14. Thedepressedpatient
15. Chronicpain
16. Problemgambling
1. Dangers
2. Keywarning
3. Othertelltalesigns
4. First-linemanagement

5. Counsellingapproach
17. Patienteducationresources
18. References
8. Chapter6:Difficult,demandingandangrypatients
1. Introduction
2. Managementstrategies
1. Complaints
2. A‘heartsink’survivalkit
3. Theangrypatient
1. Whatisanger?
2. Consultingstrategies10
3. Analysingtheresponses
4. Recognisingdistresssignals
5. Questionstouncoverthetruesourceofanger
1. Rapportbuilding


2. Confrontation
3. Facilitation,clarification
4. Searching
6. Thedrug-dependentdoctorshopper12
7. Management
4. References
9. Chapter7:Healthpromotionandpatienteducation
1. Introduction
2. Healtheducation
3. Illnesseducation
4. Healthpromotioningeneralpractice
5. Opportunistichealthpromotion
1. Methods

6. Healthgoalsandtargets
7. Promotinghealthylifestyleingeneralpractice
1. TheSNAPguide6
2. TheNEATguide
8. Psychosocialhealthpromotion
9. Patienteducation/hand-outs
10. References
10. Chapter8:Theelderlypatient
1. Introduction
2. Ageinganddisease
1. Deteriorationinhealthandthe‘masquerades’
2. The‘classic’triad4
3. Changesinsensorythresholdsandhomeostasis
4. Establishingrapportwiththeelderlypatient
5. Lonelinessintheelderly
6. Doctorbehaviourthatcanirritateandconfuseelderlypatients
7. Assessmentoftheelderlypatient
1. History
2. Physicalexamination
1. Practicenurse
2. Doctor
3. ‘Rulesof7’forassessmentofthenon-copingelderlypatient
4. Themini-mentalstateexamination
1. Theclock-facedrawingtest
5. Laboratoryinvestigations


8. Behaviouralchangesintheelderly
9. Elderabuse
10. Depressionanddementia

1. Dementia(chronicorganicbrainsyndrome)13
1. Managementofsuspecteddementia
2. Managementofdementia
3. Driving
4. Comorbidity/associatedproblems15
5. DementiaandParkinsondisease
6. Medication15
7. AvailabledrugsforAlzheimerdisease
8. Cholinesteraseinhibitors
9. Aspartate(NMDA)antagonist
10. Complementarytherapy15
11. Dementiapreventionstrategies
12. Causesofmildneurocognitiveimpairment
13. Benignsenescentforgetfulness
14. Latelifedepressionandsuicide
15. Paraphrenia
16. Sarcopenia
17. Fallsintheelderly
1. Assessment
2. Managementandprevention
18. Prescribingandadversedrugreactions
1. Factorspredisposingtoadversedrugreactionsintheelderly1
2. Riskfactorspredisposingtomedicine-relatedproblems
3. Startingmedications15
4. Minimisingmedicationproblems
5. Othertipsformedicationintheelderly
19. References
20. Resources
11. Chapter9:Preventioningeneralpractice
1. Introduction

1. Primaryprevention
2. Secondaryprevention
3. Tertiaryprevention
4. Relationshipbetweentypesofprevention
2. Thepracticeofpreventivemedicine


3. Optimalopportunitiesforprevention
4. Mortalityandmorbidityconsiderations
5. Aglobalstrategyforgoodhealth
1. Behaviourmodification
6. Vasculardisease
7. Malignantdisease
1. UpdatedimportantfactsaboutcancerinAustralia*(currentand
immediatefuture)
2. Theroleofimmunityincancer
8. Asthmaandotherrespiratorydiseases
9. Periodichealthexamination
1. Aimsofscreening
10. Thehistory
11. Screeningforchildren
1. Generaldevelopment
12. Screeningintheelderly
13. Screeningforadults
14. Immunisation
15. Adverseeffectsofvaccination
1. Thecaseforvaccines
16. Neonatalscreening
1. Geneticscreening
17. Keycheckpoints

1. Resource:
18. References
12. Chapter10:Nutritioninhealthandillness
1. Introduction
2. Protein
1. Protein
1. Energymalnutrition
2. Marasmus
3. Kwashiorkor
3. Carbohydrates
1. Theglycaemicindex(GI)
4. Fat
5. Nutritionalassessment
6. Thegeneralprinciplesofoptimalnutrition
1. Whatisaserving?2
7. TheLyonHeartStudy


8. Antioxidants
1. Primesourcesofantioxidantsinfood9
2. Folate-containingfoods
9. Vitamindeficiencydisorders
10. Gout
11. Dietarycontrolofdiabetes
1. Obesity
12. Anaemiaandiron
13. Guidelinesforsafeconsumptionofalcohol(currentNH&MRC
recommendations
1. Healthymalesandfemales
2. Youngpeople

3. Pregnancyandbreastfeeding
14. Coeliacdisease
15. Foodsassociatedwithmigraine
16. Nutritionandchronicsimpleconstipation
17. Recurrenturinarycalculi
18. Iodinedeficiency
19. DietaryguidelinesforchildrenandadolescentsinAustralia(NHMRC)
20. DietaryguidelinesforAustralianadults(NHMRC)
21. Patienteducationresources
1. Resource
22. References
13. Chapter11:Palliativecare
1. Introduction
2. Thediseases
3. Thespecialroleofthefamilydoctor
4. Supportforpatientsandcarers
5. TheGoldStandardsFramework(UK)
6. Symptomcontrol
1. Commonsymptoms
2. Thegriefreaction
1. Paincontrolincancer
3. Useofanalgesics7
1. Step1:Mildpain
2. Step2:Moderatepain
3. Step3:Severepain
4. Guidelines


5. Opioidrotation
6. Parenteralmorphine

7. Adjuvanttreatment
1. Paincontrol
8. Continuoussubcutaneousinfusionofmorphine
1. Practicalaspects
9. Spinalmorphine
7. Commonsymptomcontrol
1. Anorexia
2. Constipation6,7,9
3. Noisybreathingandsecretions7,11
4. Dyspnoea
5. Terminaldistress/restlessness7,11,12
6. Nauseaandvomiting
7. Wounddressings
8. Cerebralmetastases
9. Paraplegia
10. Hiccoughs7,9
11. Depression11
12. Weaknessandweightloss
13. Delirium
14. Hypercalcaemia
8. ThepatientwithAIDS
9. Palliativecareinchildren
1. Principlesofmanagement
10. Dyingandgrieving
1. Communicatingwiththedyingpatient
2. Spiritualissues1
3. Advancedcareplanning(ACP)
4. Thequestionofeuthanasia
11. References
12. Resources

14. Chapter12:Painanditsmanagement
1. Introduction
2. Definitions
1. Originsofpain1
2. Componentsofpain1
3. Categoriesofpain


4.

5.
6.

7.

1. Acutepain
2. Chronicpain
Assessingandmeasuringpain
1. Thehistory
2. Useofbodycharts
3. Measurementofpain
1. Unidimensionalscales
2. Multidimensionalscales
Theholisticapproachtopainmanagement
Analgesicprescribing
1. Analgesicsincommonuse1
1. Paracetamol
2. NSAIDs
3. Aspirin
4. Opioidanalgesics4

5. Codeine
6. Oxycodone
7. Dextropropoxyphene
8. Morphine
9. Tapentadol
10. Methadone5
11. Pethidine
12. Fentanyl1
13. Hydromorphone
14. Tramadol
15. Buprenorphine
16. Combinedanalgesics
17. Ketamine
18. Methoxyflurane
2. Prescribingguidelinesforopioids4,6
Paininchildren
1. Guidingprinciples7
2. Assessmentofpain
3. Analgesiainchildren1,8
1. Paracetamol(acetaminophen)
2. Aspirin
3. NSAIDs
4. Opioidanalgesics


8. Analgesicsintheelderly
1. Somegeneralrulesandtips1,9
9. PrescribingNSAIDs
1. NSAIDsandtheelderly
2. Prescribingrecommendations

10. Neuropathicpain
1. Clinicalfeatures1,14
2. Treatment14
1. Someguidingrules1
2. Evidencebase
3. Painfuldiabeticneuropathy18
11. Somatoformpaindisorder
12. References
15. Chapter13:Researchandevidence-basedmedicine
1. Introduction
2. Whydoresearch?
3. Whoshoulddoresearch?
1. Askingquestions
4. Researchonwhat?
5. Understandingterminology
1. Validityandreliability
2. Sensitivity,specificityandpredictivevalues
3. Incidenceandprevalence
4. Bias
5. Confounding
6. Chance
6. Howistheresearchundertaken?
7. Researchdesign
1. Hypothesisdevelopment
2. Selectingarepresentativesampleofappropriatesize
8. Typesofresearch
1. Qualitativeresearch12
1. Commonqualitativeapproaches
2. Phenomenology
3. Ethnography(ethnos=anation)

4. Groundedtheory
2. Quantitativeresearch
3. Meta-analysis


9. Evidence-basedmedicine
10. Criticalappraisalofpublishedresearch
11. References
12. Resources
16. Chapter14:Travelmedicine
1. Introduction
2. Principlesofpre-travelhealthcare
3. Gastrointestinalinfections
1. Traveller’sdiarrhoea
1. Treatment3
2. Milddiarrhoea
3. Moderatediarrhoea3
4. Severediarrhoea(patienttoxicandfebrile)
2. Persistentdiarrhoea
1. Treatment
3. Preventiveadvice
4. Malaria
5. Generalaspects
6. Malariariskassessment
7. Malariaprevention
8. Importantconsiderationsinmalariaprophylaxis
9. Drugprophylaxis
1. Guidelines
4. Specificinfectiousdiseasesandimmunisation
5. Compulsoryimmunisations

1. Yellowfever
2. Meningococcalinfection
6. Voluntaryimmunisation
1. HepatitisA,B
1. Prevention
2. Typhoid
3. Cholera
4. JapaneseBencephalitis
5. Rabies
6. Plague
7. Specialproblems
1. Preventionofsexuallytransmittedinfections
2. ExposuretoSTIs


3. Drugs
8. Pregnancyandtravel
9. Childrenandtravel
10. Airtravel
1. Jetlag
2. Factorsinfluencingjetlag
3. Howtominimisetheproblem(advicetopatients)
1. Beforetheflight
2. Duringtheflight
3. Atthedestination
4. Roleofmelatonin10
4. Whoisfittofly?
5. PreventionofDVT
11. Travelsickness
1. Medicationfortravelsickness

2. Recommendedmedications
1. Cartravel:adultpassengersandchildren
2. Seatravel
3. Severeseasickness
4. Theaged
12. Altitudesickness
1. Forms
1. Clinicalfeatures
2. Prevention
3. Treatment
13. Travellers’medicalkit
1. Materials
2. Topicalitems
3. Medicationchecklist
14. Patienteducationresources
15. References
16. Resources
17. Chapter15:Tropicalmedicineandthereturnedtraveller
1. Introduction
2. Problemsinthereturnedtropicaltraveller
1. Gastrointestinalsymptoms
1. Milddiarrhoea
2. Moderateorprolonged(>3weeks)diarrhoea
3. Persistentabdominaldiscomfort


2. Rash/otherskinlesions
3. Fever
4. Malaria
1. Clinicalfeatures

2. Otherfeatures
3. Treatment5,6
5. Typhoidfever
1. Clinicalfeatures
2. Diagnosis
3. Treatment
6. Cholera
1. Clinicalfeatures
2. Diagnosis
3. Treatment
4. VIRALHAEMORRHAGICFEVERS
7. Yellowfever
8. Lassafever,Ebolavirus,Marburgvirus,Hantavirus
1. Ebola
9. Denguefever7
1. Clinicalfeatures
2. Diagnosis
3. Treatment
4. Prevention
10. Zikavirus
11. Chikungunya
1. Diagnosis
12. Encephalitis
13. Melioidosis
1. Clinicalfeatures
2. Diagnosis
3. Treatment(adults)8
4. Prevention
14. Plague
1. Clinicalfeatures

2. Diagnosis
3. Treatment
15. Rabies
1. Clinicalfeatures


2. Diagnosis
3. Treatment
16. Ciguatera
17. Hansen’sdisease(leprosy)
1. Clinicalfeatures
2. Diagnosis
3. Treatment
18. Scrubtyphus
1. Clinicalfeatures
2. Diagnosis
3. Treatment
19. Queenslandticktyphus
3. Tropicalparasiticinfections
1. Africantrypanosomiasis(sleepingsickness)
1. Clinicalfeatures
2. Diagnosis
3. Treatment
4. Prevention
2. Leishmaniasis
3. Visceralleishmaniasis(kala-azar)
1. Clinicalfeatures
2. Diagnosis
4. Cutaneousleishmaniasis
1. Clinicalfeatures

2. Diagnosis
3. Treatment
5. Schistosomiasis(bilharzia)
1. Clinicalfeatures
2. Diagnosis
3. Treatment
4. Prevention
6. Amoebiasis
7. Amoebicliverabscess
1. Clinicalfeatures
2. Diagnosis
3. Treatment
8. Giardiasis
1. Clinicalfeatures
2. Diagnosis


3. Treatment
9. Cutaneousmyiasis
10. WORMS(HELMINTHS)
11. Pinworm
1. Clinicalfeatures(usuallyasymptomatic)
2. Diagnosis
3. Treatment
12. Humanroundworm
1. Diagnosis
2. Treatment
13. Whipworm
1. Diagnosis
2. Treatment

14. Hookworm
1. Clinicalfeatures
2. Diagnosis
3. Treatment
4. Prevention
15. Humanthreadworm(Strongyloides)
1. Diagnosis
2. Treatment
16. Cutaneouslarvamigrans
1. Diagnosis
2. Treatment
3. Prevention
17. Filariasis
18. Hydatiddisease
1. Clinicalfeatures
2. Diagnosis
3. Treatment
19. Dracunculusmedinensis(Guineaworm)
1. Clinicalfeatures
2. Treatment
4. References
18. Chapter16:Inspectionasaclinicalskill
1. Introduction
2. Firstimpressions
3. Physiognomy
4. Thefaceasamirrorofdisease


5. Diagnosticfacies
1. Acromegalic

2. Adenoidal
3. Alcoholic(duetochronicuse)
4. Bird-like(systemicsclerosis:CRESTsyndrome)
5. Chipmunk(thalassaemiamajor)
6. Choleric
7. Cushingoid
8. Facialnervepalsy
9. Hippocratic
10. Marfanoid(Marfansyndrome)
11. Mitral(mitralvalvedisease,especiallymitralstenosis)
12. Mongoloid(Downsyndrome)
13. Myopathic(myopathy/myastheniagravis)
14. Myotonic(dystrophiamyotonia)
15. Myxoedemic(hypothyroidism)
16. Obese
17. Pagetic(Pagetdisease)
18. Parkinsonian
19. Peutz–Jeghers
20. Risussardonicus
21. Smoker’s
22. Thyrotoxic(hyperthyroidism)
23. Turnersyndrome
24. Uraemic
25. Otherclassicfacies(similes)
6. Specificcharacteristics
1. Butterfly‘rash’
2. Chloasma/melasma
3. Malarflush
4. Spidernaevi
5. Enlargedtongue

6. Cataracts:riskfactors
7. Telangiectasia
7. Cyanosis
1. Central
2. Peripheral
8. Clubbingoffingers
1. Features


2. Causes
9. Increasedgeneralpigmentation
1. Increasedmelanocyte-stimulatinghormone(MSH)
2. Metabolic
3. Drugs
4. Tumours
10. References
19. Chapter17:Asafediagnosticstrategy
1. Introduction
2. Theconceptofdiagnostictriads
3. Thebasicmodel
1. 1Theprobabilitydiagnosis
2. 2Whatseriousdisordersmustnotbemissed?
1. ConsiderM2I2
2. Redflags
3. 3Whatconditionsareoftenmissed?
4. 4Themasquerades(‘chameleons’)
5. 5Isthepatienttryingtotellmesomething?
4. Someexamplesofapplicationofthemodel
1. Hiccough
2. Halitosis

5. Patienteducationresources
6. References
20. Chapter18:Geneticconditions
1. Introduction
1. Epigenetics
2. Thespectrumofgeneticdisorders
3. Thegenogram
1. SPECIFICIMPORTANTGENETICDISORDERS
2. Haemochromatosis
1. Geneticprofile8
2. Clinicalfeatures
3. Diagnosis
4. Management
3. Thalassaemia
1. Geneticprofile8
2. Clinicalfeatures
3. Diagnosis9


4. Treatmentforthalassaemiamajor
4. Cysticfibrosis9
1. Geneticprofile7,11
2. Clinicalfeatures
3. Diagnosis
4. Treatment
5. Neurofibromatosis
1. ClinicalfeaturesofNF18
2. Generalrule
3. Management
6. Duchennemusculardystrophy(DMD)

1. Geneticprofile
2. Clinicalfeatures8
3. Diagnosis(initiateatfirstsuspicion)
4. Treatment
7. Spinalmuscularatrophy(SMA)
1. Geneticprofile
2. Clinicalfeatures
8. Dystrophiamyotonica
1. Clinicalfeatures
9. Familialperiodicparalysis
10. INHERITEDADULTONSETNEUROLOGICAL
DISORDERS11,12
11. Huntingtondisease9
1. Geneticprofile
2. Clinicalfeatures
3. Treatment
4. Genetictestingandcounselling
12. FamilialAlzheimerdisease(FAD)
13. Parkinsondisease
14. Motorneuronedisease(MND)(amyotrophiclateralsclerosis)
15. Mitochondrialdisorders
4. Theepilepsies
5. Psychiatricconditions
6. Hereditaryhaemoglobinopathies,haemolyticdisorders,andbleeding
andclottingdisorders
1. Sicklecelldisorders
2. Sicklecellanaemia


3.

4.
5.

6.

7.
8.
9.

10.

11.
12.

13.
14.

15.
16.
17.

1. Sicklecelltrait
Hereditaryspherocytosis
Bleedingdisorders
Thrombophilia
1. CHROMOSOMAL/MICRODELETIONSYNDROMES
(CHILDHOODEXPRESSION)9
Downsyndrome15
1. Facts
2. Associateddisorders

3. Management
Edwardsyndrome9
1. Clinicalfeatures
Patausyndrome9
1. Clinicalfeatures
FragileXsyndrome(FXS)15
1. Facts
2. Diagnosis
3. Associateddisorders16
4. Management
Prader–Willisyndrome
1. Clinicalfeatures
2. Management
Williamssyndrome
Marfansyndrome9
1. Geneticprofile
2. Clinicalfeatures
3. Management
Tuberoussclerosis(epiloia)
Noonansyndrome15
1. Clinicalfeatures15
2. Treatment
Angelmansyndrome
1. Clinicalfeatures(awidespectrum)
Progeria
1. SEXCHROMOSOMEABNORMALITIES
Klinefeltersyndrome9
1. Geneticprofile
2. Clinicalfeatures

3. Diagnosis
4. Treatment
18. Turnersyndrome(gonadaldysgenesis)
1. Geneticprofile
2. ClinicalfeaturesoftypicalXOkaryotype
3. Treatment
7. Intersexstates
8. Congenitaladrenalhyperplasia
1. FETALALCOHOLSYNDROME(FAS)18
2. ClinicalfeaturesofFAS
3. Management
4. OTHERTYPESOFHEREDITARYDISORDERS
5. Glucose-6-phosphatedehydrogenasedeficiency
6. Hereditaryhaemorrhagictelangectasia
7. Gaucherdisease
8. Galactosaemia9
9. Phenylketonuria(PKU)9
10. Theporphyrias
1. Acuteintermittentporphyria
2. Clinicalfeatures
3. Diagnosis
4. Treatment
11. Glycogenstoragedisease(liverglycogenoses)
12. Tay–Sachsdisease
1. SINGLEGENECARDIACDISORDERS
13. CongenitallongQTsyndrome
14. Hypertrophiccardiomyopathy
1. Clinicalfeatures
15. Familialhyperlipoproteinaemia19

1. Familialcancer20
16. Featuresofbreast–ovariancancersyndrome8,9
1. Riskindicatorsforfamilialbreast–ovariancancer
17. Colorectalcancer20
1. Lynchsyndrome(hereditarynon-polyposiscolorectal
cancer)
2. Familialadenomatouspolyposis
3. Individualsatrisk
4. Othercancerswherefamilyhistoryissignificant


18. TheroleoftheGPinfamilialcancer20
9. Predictivegenetictesting
1. Reproductivegeneticscreening21
2. Newbornscreening
10. Prenatalscreeninganddiagnosisofgeneticdisorders
1. ScreeningforDownsyndrome
11. Consanguinity
12. Rarebuthelpfuldiagnostictips
13. References
21. Part2:Diagnosticperspectiveingeneralpractice
1. Introduction
22. Chapter19:Depression
1. Introduction
2. Classifications
1. Questionstoassesslevelofdepression
1. Depressionscales
2. Somatisation
3. Depressionintheelderly
4. Depressioninchildrenandadolescents

5. Perinataldepression
1. Recurrentbriefdepression
2. Seasonalaffectivedisorder
6. Managementofdepression
1. Suicideassessment
1. Lowrisk(fleetingthoughtsofself-harmorsuicidebutno
currentplanormeans):
2. Mediumrisk(suicidalthoughtsandintentbutnocurrent
planorimmediatemeans):
3. Highrisk(continual/specificsuicidalthoughts,intent,plan
andmeans):
7. Treatment
8. Whentorefer
9. Choiceoftreatment
10. Complementaryandalternativetherapies
11. Serotoninsyndrome
12. Continuingtreatment
13. References
23. Chapter20:Diabetesmellitus


1. Introduction
2. Diabetes:arealmasquerade
1. Clinicalfeatures
2. History
3. Examination
4. Investigations
5. Riskfactors
6. Screening(type2)5
7. Diagnosis

8. Prediabetes
3. Diabetesinchildren
4. Gestationaldiabetes
5. Diabetesintheelderly
6. Complicationsofdiabetes
1. Microvasculardisease
2. Nephropathy
3. Retinopathyandmaculopathy
4. Neuropathy
5. Infections
6. Diabeticmetaboliccomplications
7. Othercomplications
7. Preventionofdiabetes
8. Managementofdiabetesmellitus
9. Managementprinciples
1. Metabolicsyndrome8
2. Monitoringtechniques
3. Bloodglucosemonitoringathome
1. Howoftenandwhen?
4. Glycatedhaemoglobin
5. Type1diabetes
1. Insulinregimensfortype1diabetes5,8
2. Startinginsulin8
3. Methodsofgivinginsulininjections
4. Guidelinesforthepatient5
6. Type2diabetes8,16
1. Startinginsulinintype2diabetes14,18
2. Suggestedstepwiseapproach14,16
10. Theimportanceofdietandnutrition