John Murtagh's General Practice Companion Handbook

Cover
Title
Copyright
Contents
Preface
About the authors
Laboratory reference values
Normal values: diagnostic guidelines
Abbreviations
A
	ABC of general practice
	A diagnostic perspective
	Abdominal pain
		Abdominal pain in children
			Infantile ‘colic’ (period of infant distress)
			Intussusception
			Drugs
			Mesenteric adenitis
			Recurrent abdominal pain
		Specific causes of acute abdominal pain
			Abdominal aortic aneurysm (AAA)
			Mesenteric artery occlusion
			Acute retention of urine
			Acute appendicitis
			Small bowel obstruction
			Large bowel obstruction
			Perforated peptic ulcer
			Peritonitis
			Ureteric colic
			Biliary pain
			Acute pancreatitis
			Chronic pancreatitis
			Acute diverticulitis
		Lower abdominal pain in women
			Ectopic pregnancy
			Ruptured ovarian (Graafian) follicle (Mittelschmerz)
			Ruptured ovarian cyst
			Acute torsion of ovarian cyst
			Pelvic adhesions
	Acne
		Some topical treatment regimens
		Oral antibiotics
		Other therapies
	Acute allergic reactions
		Anaphylaxis and anaphylactic reactions
		Angioedema and acute urticaria
	Acute coronary syndromes (ACS)
	Addison disease (adrenal insufficiency)
	Adolescent health
		Depression, parasuicide and suicide
	Alcohol problems
	Alopecia areata (patchy hair loss)
		Androgenetic alopecia (male pattern baldness)
	Amnesia (loss of memory)
		Transient global amnesia
	Anaemia
		Classification of anaemia
		Microcytic anaemia—MCV ≤ 80 fL
			Iron-deficiency anaemia
			Thalassaemia
		Macrocytic anaemia—MCV > 100 fL
			Vitamin B12 deficiency (pernicious anaemia)
			Folic acid deficiency
	Angina pectoris
	Anorectal disorders
		Anorectal pain
			Anal fissure
			Proctalgia fugax
			Perianal haematoma
			Strangulated haemorrhoids
			Perianal abscess
		Anorectal lumps
			Skin tags
			Perianal warts
			Internal haemorrhoids
			Rectal prolapse
		Anal (faecal) incontinence
		Anorectal bleeding
	Anticoagulants
	Anxiety disorders
		Generalised anxiety disorder
		Panic disorder
		Phobic disorders
		Obsessive–compulsive disorder
		Acute stress disorder
		Post-traumatic stress disorder
	Aphthous ulcers (canker sores)
	Arm and hand pain
		Pulled elbow
		Tennis elbow
		Olecranon bursitis
		Trigger finger/thumb
		Game keepers thumb (skiers thumb)
		Raynaud phenomenon and disorder
		Chilblains
		Carpal tunnel syndrome
	Arthritis
		Osteoarthritis
		Rheumatoid arthritis
		Connective tissue disorders
		Crystal arthritis
		The spondyloarthropathies
		Viral arthritis
		Lyme disease and lyme like disease
		The vasculitides
	Asthma
		Pharmacological agents to treat asthma
			Maintenance plan for persistent asthma—adult (example)
			Asthma action plan (example)
			The acute asthma attack
			Asthma in children
B
	Back pain
	Low back pain (LBP)
		Vertebral dysfunction with non-radicular pain (non-specific LBP)
		Chronic LBP (pain > 3 mths)
		Vertebral dysfunction with radiculopathy (sciatica)
		Lumbar spondylosis
		Spondylolisthesis
		The spondyloarthritides
	Thoracic back pain
		Scheuermann disorder
		Idiopathic adolescent scoliosis
		Kyphosis
		Dysfunction of the thoracic spine
	Bad news (breaking bad news)—guidelines
		Bereavement and coping with loss
	Balanitis (balanoposthitis)
	Bed sores (pressure injury)
	Belching (aerophagia)
	Bell (facial nerve) palsy
	Benzodiazepine problems
		Benzodiazepine withdrawal syndrome
	Bites and stings
		Bite wounds
			Snake bites
			Spider bites
			Human bites and clenched fist injuries
			Dog bites (non-rabid)
			Cat bites
			Bed bug bites
			Sandfly (biting midges) bites
			Mollusc bite (blue-ringed octopus, cone shell)
		Stings
			Bee stings
			Centipede and scorpion bites/stings
			Box jellyfish or sea wasp (Chironex fleckeri)
			Irukandji (carukia barnesi) syndrome
			‘Blue bottle’ and other stinging jellyfish
			Stinging fish
			Other bites and stings
		Black named disorders
		Bladder cancer
		Bladder dysfunction (in women during night)
		Blepharitis
		Body odour
		Boils (recurrent)
		Breast lumps
			Carcinoma of the breast
			Fibrocystic disease
			Breast cyst
			Lactation cysts (galactoceles)
			Fibroadenoma
			Fat necrosis
			Mammary duct ectasia
			Phyllodes tumour
		Breast pain (mastalgia)
			Cyclical mastalgia
			Non-cyclical mastalgia
			Costochondritis (Tietze syndrome)
			Mastitis
			Inflammatory breast cancer (mastitis carcinomatosa)
			Breast abscess
		Breath-holding attacks
		Bronchiolitis
		Bronchitis
			Acute bronchitis
			Chronic bronchitis
		Bruising and bleeding
			Purpura
			Vascular disorders
			Platelet disorders
			Coagulation disorders
		Bruxism (teeth grinding)
		Burning feet syndrome
		Burns
			Burns to hands
		Buruli (aka Bairnsdale) ulcer: Mycobacterium ulcerans
C
	Calf pain
	Cancer
		Diagnostic triads/tetrads for specific cancers
		Metastatic tumours
	Cannabis (marijuana)
	Cardiopulmonary resuscitation (CPR)
	‘Cellulite’
	Cellulitis
	Central nervous system infections (incl. meningitis, encephalitis, abcess)
		Bacterial meningitis
		Viral meningitis
		Encephalitis
		Brain abscess
		Spinal subdural or epidural abscess
		Prion transmitted diseases
		Poliomyelitis
	Cervical cancer screening
		Performing a cervical screening test
	Chest pain
		Site, radiation and features of chest pain syndromes
			Acute coronary syndromes (ACS)
			Key features
			Aortic dissection
			Pulmonary embolism
			Acute pericarditis
			Spontaneous pneumothorax
			Psychogenic pain
	Chilblains
	Children: normal developmental milestones
	Children: developmental disorders
		Growth and puberty problems
			Short stature
			Tall stature
			Growing pains (benign nocturnal limb pain)
			Delayed puberty
			Precocious puberty
			Premature thelarche
			Premature adrenarche
			Pubertal breast hyperplasia
		Intellectual disability
			Cerebral palsy
			Down syndrome
			Fragile X syndrome (FXS)
			Prader–Willi syndrome
			Fetal alcohol syndrome (FAS)
			Williams syndrome
		Specific learning disabilities (SLDs)
			Dyslexia
			Autism spectrum disorders
	Child abuse
	Childhood: common infectious diseases
		Skin eruptions
			Measles
			Rubella
			Scarlet fever
			Viral exanthema (fourth syndrome)
			Erythema infectiosum (fifth syndrome)
			Roseola infantum (exanthema subitum or sixth syndrome)
			Chickenpox (varicella)
			Hand, foot and mouth (HFM) disease
			Kawasaki disease
		Others
			Mumps (epidemic parotitis)
			Pertussis (whooping cough)
	Children: special observations
		The child as a barometer of the family
		Failure to thrive (FTT)
	Children’s behaviour disorders
		Attention deficit hyperactivity disorder
		Breath-holding attacks
		Conduct disorders
		Crying and fussing in infants
		Habit cough
		Head banging or rocking
		Oppositional defiant disorder
		Parasomnias (night terrors, sleep talking and walking)
		Poor eating
		Sleep disorders
		Stealing
		Stuttering and stammering
		Temper tantrums
		Tics (habit spasm)
		Tourette disorder
	Children: surgical problems
		Plagiocephaly (flat head syndrome)
		Ear, nose, face and oral cavity
			Prominent bat/shell ears
			Facial deformity
			External angular dermoid
			Cleft lip and cleft palate
			Nasal disorders
			Tongue tie
			Pre-auricular sinus
			Branchial sinus/cyst/fistula
		Eyes
			Strabismus (squint)
			Blocked nasolacrimal duct
		Neck lumps
			Sternomastoid tumour/fibrosis
			Thyroglossal cyst
			Lymphatic malformation/cystic hygroma
			Cervical lymphadenopathy
			MAIS (Mycobactyerium AIS) lymphadenitis
		Congenital heart disorders
			Ventricular septal defect
			Atrial septal defect
			Patent ductus arteriosus
			Coarctation of aorta
		Hernias and genital disorders
			Hernias
			Hydroceles
			Hypospadias
			Foreskin and circumcision
	Children: neonatal leg and foot abnormalities
		Developmental dysplasia of hip
		Club foot (congenital talipes equinovarus)
		Flat feet (pes plano valgus)
		Curly toes
	Children: special senses
		Visual problems
			Amblyopia
			Strabismus (squint)
		Hearing problems
	Optimal times for surgery/intervention in early children’s disorders
	Children’s emergencies
		Meningitis or encephalitis
		Acute epiglottitis
		Acute heart failure
		Poisoning
		Swallowed foreign objects
		Inhaled foreign bodies with choking
		Management of other emergencies
		Collapse in children
		Pulse oximetry and oxygen saturation
	Children’s skin and hair disorders
		Neonatal period and early infancy
			Toxic erythema of newborn
			Transient neonatal pustular dermatosis
			Naevus flammeus (salmon patch)
			Capillary malformation (port wine stain)
			Infantile haemangioma (strawberry naevus)
			Sebaceous hyperplasia
			Naevus sebaceous
			Congenital naevi
			Benign juvenile melanoma
			Milia
			Miliaria (‘sweat rash’)
			Sucking blisters
			Umbilical granuloma
			Breast hyperplasia
			Frey’s syndrome
		Common childhood skin problems
		Hair disorders
			Loose anagen (growing hair) syndrome
			Traction alopecia
			Trichotillomania (hair pulling)
			Localised alopecia areata
			Tinea capitis
	Chloasma
	Chronic obstructive pulmonary disease
	Cold sores
	Common cold (acute coryza)
	Communication and consulting skills (or how to prevent litigation)
	Concussion
	Conjunctivitis
		Bacterial conjunctivitis
		Viral conjunctivitis
		Primary herpes simplex infection
		Allergic conjunctivitis
		Chlamydia trachomatis conjunctivitis (trachoma)
	Constipation
		Idiopathic (functional) constipation
		Colorectal cancer (CRC)
	Contact dermatitis
	Contraception
	Cough
		Key features
		Cough in children
		Bronchial carcinoma
		Bronchiectasis
		Tuberculosis
		Symptomatic treatment of cough
	Counselling skills
		Cognitive behaviour therapy (CBT)
	Court appearance
	‘Cracked’ skin
		Cracked and dry lips
		Cracked hands and fingers
		Cracked heels
	Cramps (nocturnal cramps in legs)
	Cranial nerves
	Croup
		Crying baby
D
	Dandruff
	Persistent dandruff
		Deafness and hearing loss
	Deafness in children
		Otosclerosis
		Noise-induced hearing loss
		Presbyacusis
		Wax impaction
	Depression
		Notes about antidepressants
	Dermatitis/eczema
		Atopic dermatitis (eczema)
		Other types of atopic dermatitis
			Nummular (discoid) eczema
			Pityriasis alba
			Lichen simplex chronicus
			Dyshydrotic dermatitis (pompholyx)
			Asteatotic dermatitis (‘winter itch’)
			Dermatitis of hands
	Diabetes mellitus
		Type 1 diabetes mellitus
		Type 2 diabetes mellitus
		Hypoglycaemia
		Diabetic ketoacidosis
	Diarrhoea
		Specific conditions
			Pseudomembranous colitis (antibiotic-associated diarrhoea)
			Ischaemic colitis in the elderly
		Diarrhoea in children
			Acute gastroenteritis
			Toddlers diarrhoea (‘cradle crap’)
			Chronic diarrhoea in children
		Acute gastroenteritis in adults
			Traveller’s diarrhoea
			Inflammatory bowel disease
	Difficult, demanding and angry patients
	Diplopia
		Cranial nerves in general (with function)
	Disturbed patients
		Dementia (chronic organic brain syndrome)
		The acutely disturbed patient
		Delirium (acute organic brain syndrome)
		The acute psychotic patient
		Bipolar disorder
	Diverticular disease
	Dizziness/vertigo
		Vertigo
		Giddiness
		Syncopal episodes
		Disequilibrium
		Specific causes of dizziness
			Drugs
			Cervical spine dysfunction
			Acute vestibulopathy (vestibular failure)
			Benign paroxysmal positional vertigo
			Ménière syndrome
			Vestibular migraine (migrainous vertigo)
			Recurrent vestibulopathy
			Dizzy turns in elderly women
			Dizzy turns in girls in late teens
	Domestic (intimate partner) violence
	Drugs—illicit substance abuse
	Dry eyes
	Dry hair
	Dry mouth
	Dry skin
	Dyslipidaemia
	Dysmenorrhoea (primary)
	Dyspareunia
	Dyspepsia (indigestion)
		Dyspepsia in children
			Gastro-oesophageal reflux
		Dyspepsia in adults
			Gastro-oesophageal reflux disease (GORD)
			Functional (non-ulcer) dyspepsia
			Peptic ulcer disease
			NSAIDs and peptic ulcers
	Dysphagia
	Dyspnoea
		Key investigations for dyspnoea
		Pulmonary function tests
		Interstitial lung diseases
			Sarcoidosis
			Idiopathic pulmonary fibrosis
			Hypersensitive pneumonitic (extrinsic allergic alveolitis)
		Occupational pulmonary disease
			Acute respiratory distress syndrome (ARDS)
			Severe acute respiratory syndrome (SARS)
		Dystonia
		Dysuria and frequency
E
	Ear pain
	Key features
	Otitis media in children
	Otitis media in adults
	Otitis externa
	Furunculosis
	Perichondritis
	Infected earlobe
	Otic barotrauma
	Ectropion
	Elderly patients
		‘Rules of 7’ for assessment of the non-coping elderly patient
		The mini-mental state examination
		Falls in the elderly
		Electrolyte/metabolic disorders
	Emergency management of key medical conditions
	Encopresis (faecal incontinence in children)
	Endocarditis
	Endocrine—overview of conditions
		Triads/tetrads for syndromes related to pituitary hormones
			Thyroid
			Adrenal
			Pituitary
			Other endocrine related
	Endometriosis
	Entropion
	Enuresis (bed-wetting)
		Nocturnal enuresis
	Epilepsy
		Tonic-clonic seizures
		Absence seizure
		Complex partial seizures
		Simple partial seizures
		Status epilepticus
	Epistaxis: treatment techniques
	Erectile dysfunction
	Erysipelas
	Eye: dry
	Eye pain and redness
		Red eye in children
			Neonatal conjunctivitis (ophthalmia neonatorum)
			Trachoma
			Blocked nasolacrimal duct
			Orbital cellulitis
		Red eye in adults
			Conjunctivitis
			Episcleritis and scleritis
			Uveitis (iritis)
			Acute glaucoma
			Herpes zoster ophthalmicus
			Flash burns
		Eyelid and lacrimal disorders
			Stye
			Chalazion (meibomian cyst)
			Blepharitis
			Dacryocystitis
			Dacroadenitis
		Eyelashes: ingrowing (trichiasis)
		Eyelid ‘twitching’ or ‘jumping’
		Eyes: flash burns
F
	Facial pain
	Cervical spinal dysfunction
	Dental disorders
	Alveolar osteitis (dry tooth socket)
	Pain from paranasal sinuses
	Temporomandibular joint (TMJ) dysfunction
	Trigeminal neuralgia
	Glossopharyngeal neuralgia
	Facial migraine (lower half headache)
	Chronic paroxysmal hemicrania
	Herpes zoster and postherpetic neuralgia
	Atypical facial pain
	Fatty liver
	Fever and chills
		Fever of less than 3 days duration
		Fever present for 4–14 days
	Fever in children
		Febrile convulsions
	Fever of undetermined origin (FUO)
	Fibroids (leiomyoma)
	Fibromyalgia syndrome
	Flatus: excessive
	Floaters and flashers of eyes
	Folliculitis
	Foot odour (smelly and sweaty feet)
	Foot pain (podalgia)
		Vascular causes
		Complex regional pain syndrome 1
		Osteoid osteoma
		Osteochondritis/aseptic necrosis
		Skin disorders
		Arthritic conditions
		Foot strain
		Plantar fasciitis
		Metatarsalgia
		Stress fractures
		Morton neuroma
		Foot ache
		Callus, corn and wart
		Turf toe
		Ingrowing toenails
		Paronychia
	Freckles and lentigines (sun spots)
	Frostbite
G
	Gambling
	Ganglion
	Gastroenteritis
	Gastroparesis (gastropathy) in adults
	Genetic disorders
		Familial cancer
	Genital herpes
	Genital warts
	Geographical tongue (erythema migrans)
	Gingivitis
	Glandular fever
		Epstein–Barr mononucleosis (EBM)
	Globus hystericus
	Gout (monosodium urate crystal disease)
	Granuloma annularae
	Growing pains
	Grover disease
	Guillain–Barre syndrome
H
	Haematemesis and melaena
	Haematuria
	Haemochromatosis (primary hereditary)
	Haemorrhoids
	Hair disorders
		Androgenic alopecia
		Alopecia areata, alopecia totalis and alopecia universalis
		Scarring alopecia
		Telogen effluvium
		Anagen effluvium
		Trichotillomania (hair pulling)
	Hair disorders in children
	Hirsuties
		Hypertrichosis
		Dry hair
		Oily hair
	Halitosis
	Hangover
	Hay fever (seasonal allergic rhinitis)
	Head banging or rocking in toddlers
	Headache
		Tension-type headache
		Migraine
		Transformed migraine
		Cluster headache
		Cervical dysfunction/spondylosis–cervicogenic headache
		Combination headache
		Temporal arteritis
		Frontal sinusitis
		Subarachnoid haemorrhage (SAH)
		Hypertension headache
		Benign intracranial hypertension (pseudotumour cerebri)
	Head injury and unconsciousness
		Extradural haematoma
		Subdural (epidural) haematoma
	Heartburn (dyspepsia)
	Heart failure
		Diastolic heart failure
		Acute severe heart failure
	Heel pain
		Achilles tendon bursitis
		Plantar fasciitis
		Achilles tendonopathy/peritendonitis
		Partial rupture of Achilles tendon
		Complete rupture of Achilles tendon
	Hepatitis
		Hepatitis A
		Hepatitis B (HBV)
		Hepatitis C (HCV)
	Herpes simplex
		Herpes labialis (classical cold sores)
		Genital herpes
		Eczema herpeticum
		Herpetic whitlow
		Herpes simplex keratitis
	Herpes zoster (shingles)
		Postherpetic neuralgia
	Hiccoughs (hiccups)
	Hip pain
		Key features: hip and buttock pain
	Hip pain in children
		Developmental dysplasia of the hip (DDH)
		Perthes disease
		Transient synovitis
		Slipped capital femoral epiphysis
		Septic arthritis
	Hip and buttock pain in the elderly
		Osteoarthritis of the hip
		Greater trochanteric pain syndrome
	Hirsutism
	Hives (papular urticaria)
	Hoarseness
	Human immunodeficiency virus infection
	Hypertension
	Hyperventilation
	Hypoglycaemia
I
	Immunisation
	Impetigo
	Incontinence of urine
	Infantile colic
	Infertility/subfertility
		Referral
	Influenza
	Ingrowing toenails
	Injectable contraceptives
	Insect stings
	Insomnia
	Intertrigo
		Groin rash
		Candida intertrigo
		Erythrasma
	Irritable bowel syndrome (IBS)
J
	Jaundice
	Key history
	Infective viral hepatitis
	Cholestatic jaundice (bile outflow obstruction)
	Jaundice in the infant
	Jet lag
	Jitters
	Jock itch
K
	Kawasaki disease (mucocutaneous lymph node syndrome)
	Keloid or hypertrophic scar
	Keratoacanthoma
	Keratoses (solar and seborrhoeic)
		Seborrhoeic keratoses
		Solar keratoses
	Keratosis pilaris
	Kidney disease
	Knee pain
		Osgood–Schlatter disorder
		Chondrocalcinosis of knee (pseudogout)
		Meniscal tears
		Anterior cruciate ligament rupture
		Medial collateral ligament rupture
		Patellofemoral pain syndrome
		Patellar tendonopathy (‘jumper’s knee’)
		Localised tendonopathy or bursitis
		Osteoarthritis
L
	Laryngitis
	Lead poisoning (plumbism)
	Leg pain
		Spinal causes of leg pain
		Vascular causes of leg pain
			Occlusive arterial disease
			Venous disorders
			Superficial thrombophlebitis
			Deep venous thrombosis (DVT)
			Cellulitis and erysipelas of legs
			Osteomyelitis and septic arthritis
			Nocturnal cramps
	Lice infestation
		Head lice
		Pubic lice
	Lichen planus
M
	Melanoma
	Melasma (chloasma)
	Ménière syndrome
	Menopause syndrome
	Menorrhagia (heavy menstrual bleeding)
		Dysfunctional uterine bleeding (DUB)
	Men’s health: an overview
	Metabolic syndrome
	Migraine attack
	Milker’s nodules
	Molluscum contagiosum
	‘Monkey muscle’ tear
	Morning sickness
	Mouth soreness
		Gingivitis
		Periodontitis
		Oral dysaesthesia
		Angular chelitis and fissures
		Bad taste
	Mouth ulcers
	Multiple sclerosis (MS)
	Myocardial infarction and NSTEACS
	The ECG and myocardial infarction
	Myoclonic jerks (periodic limb movement disorder)
N
	Nail disorders
	Onycholysis
	Onychomycosis
	Onychogryphosis
	Brittle nails
	Nail apparatus melanoma
	Paronychia
	Ingrowing toenails
	Subungual haematoma
	Nappy rash (diaper dermatitis)
	Narcotic (opioid) dependence
	Neck pain
		Cervical dysfunction
		Cervical spondylosis
		Acute torticollis
		Whiplash syndrome
	Needlesticks and sharps injuries
	Nightmares (dream anxiety)
	Nose
		Nasal fractures
		Nasal polyps
		Nasal vestibulitis
		Offensive smell from the nose
		Rhinophyma
		Senile rhinorrhoea
		Stuffy and running nose
		Snuffling infant
	Nutrition advice
O
	Obesity
	Obsessive–compulsive disorder
	Obstetric care
		Basic antenatal care
		Management of specific issues
			Nausea and vomiting in pregnancy
			Cramps
			Varicose veins
			Mineral supplements in pregnancy
			Pregnancy-induced hypotension
			Pregnancy-induced hypertension
			Physiological breathlessness of pregnancy
			Acute cystitis
		Transmissible infections in pregnancy
			Rubella
			Varicella (chickenpox)
			Parvovirus B-19
			Cytomegalovirus
			Hepatitis B
			Hepatitis C
			HIV
			Genital herpes
			Genital warts
			Syphilis
			Chlamydia/gonorrhoea
		Postnatal care
			After pains
			Oral contraception
			Insufficient milk supply
			Engorged breasts
			Lactation suppression
			Nipples: cracked
			Nipples: sore
			Postnatal depressive disorders
			Postpartum thyroid dysfunction
			Hair loss
	Oily hair
	Opioid (heroin) overdosage
	Orf
	Osteoporosis
	Otitis externa
	Otitis media
P
	Paget disease (osteitis deformans)
	Pain and its management
		Neuropathic pain
		Systematic approach to pain history
	Palliative care
		Pain control
		Symptom control
	Palpitations
	Panic attack
	Parkinson disease
		Pharmacological management
	Paronychia
		Acute
		Chronic
	Pelvic inflammatory disease (females)
		Clinical features
		Investigations
		Treatment of PID (sexually acquired)
		Non-sexually acquired PID
	Pelvic pain
		Chronic pelvic pain in women
	Perioral dermatitis
	Peripheral neuropathy
		Guillain–Barre syndrome
	Personality disorders
	Perspiration: excessive (hyperhidrosis)
	Phimosis
	Photoageing/wrinkles
	Pityriasis rosea
	Pityriasis versicolor (tinea versicolor)
	Plantar warts
	Pneumonia
		Typical pneumonia
		The atypical pneumonias
		Antibiotic treatment for CAP according to severity
		Pneumonia in children
	Polycystic ovarian syndrome (PCOS)
	Polymyalgia rheumatica and giant cell arteritis
	Premature ejaculation
	Premenstrual syndrome (PMS)
	Prickly heat (miliaria/heat rash)
	Prostate disorders
		Benign prostatic hyperplasia
		Carcinoma of the prostate
	Pruritus (generalised)
	Pruritus ani
	Pruritus vulvae
	Psoriasis
		Treatment options
	Purpura
R
	Rectal bleeding
	Refugee health
	Restless legs (Ekbom syndrome)
	Reye syndrome and aspirin
	Rhinosinusitis
		Acute URTI rhinosinusitis
		Rhinitis medicamentosa
		Vasomotor rhinitis
	Ringworm
	Rosacea
	Ross River and Barmah Forest infection
S
	Sarcopenia
	Scabies
	Scrotal pain
		Torsion of the testis versus epididymo-orchitis
		Acute epididymo-orchitis
	Seborrhoeic dermatitis
	Septicaemia (sepsis)
	Sexually transmitted infections
		Syphilis
		Urethritis
	Shingles
	Shoulder pain
		Tendonopathy syndromes, subacromial bursitis and adhesive capsulitis
	Sinusitis
	Skin cancer
		Basal cell carcinoma
		Squamous cell carcinoma
		Bowen disorder (intradermal carcinoma)
		Malignant melanoma
	Skin eruptions
		Acute skin eruptions in children
		Secondary syphilis
		Primary HIV infection
		Guttate psoriasis
		Drug eruptions
		Erythema multiforme
		Stevens–Johnson syndrome/toxic epidermal necrolysis
		Erythema nodosum
		Hand, foot and mouth (HFM) disease
	Sleep disorders
		Primary insomnia
		Periodic limb movements
		Restless legs syndrome
		Narcolepsy
		Sleep paralysis
		Sleep apnoea
		Parasomnias
		Sleep disorders in children
	Smoking/nicotine
	Snapping or clinking hip
	Snoring
	Sore throat
		Streptococcal tonsillopharyngitis
		Quinsy
		Diphtheria (may be seen in recent overseas travellers)
		Candida pharyngitis
	Spinal dysfunction
		Cervical spinal dysfunction
		Thoracic spinal dysfunction
		Lumbar spinal dysfunction
	Splenectomy patients
	Sprained ankle
	Stinging fish
	Stitch in side (precordial catch, Texidor twinge)
	Stool/faeces—diagnostic pointers
	Stress disorders
	Stroke and TIAs (transient ischaemic attacks)
		Stroke
		Transient ischaemic attacks
		Atrial fibrillation and TIAs
	Stuttering
	Stye in eye
	Subconjunctival haemorrhage
	Sudden unexpected infant death syndrome (SIDS) and ALTE
		Apparent life-threatening episode (ALTE)
	Sunburn
	Sweating
		General hyperhidrosis
		Axillary hyperhidrosis
		Specialist treatments
	Syphilis
T
	Tampon toxic shock syndrome
	Tearduct (nasolacrimal duct) blockage in child
	Teething
	Temporomandibular joint dysfunction
	Tennis elbow
	Tension-type headache
	Testicular tumours
	Tetanus
	Thrombotic disorders and anticoagulation
		Thrombophilia
		Warfarin
		Direct oral anticoagulants (DOACs)
	Thrush (candidiasis) of mouth
	Thumb sucking
	Thyroid disorders
		Hypothyroidism (myxoedema)
		Hashimoto’s thyroiditis (autoimmune thyroiditis)
		Neonatal hypothyroidism
		Hyperthyroidism (thyrotoxicosis)
		Subacute thyroiditis
	Tick bites
	Tics
	Tinea infections
		Tinea capitis
		Tinea cruris (jock itch)
		Tinea pedis (athlete’s foot)
		Tinea of toenails and fingernails (tinea unguium)
		Tinea corporis
		Tinea incognito
	Tinnitus
		Precautions
		Investigations
		Acute severe tinnitus
		Those for investigation
	Tiredness/fatigue
		Sleep-related disorders
		Narcolepsy
		Chronic fatigue syndrome (CFS)
	Tongue disorders
		Erythema migrans
		Black or hairy tongue
	Torticollis (acute wry neck)
	Travel medicine and tropical infections
		Malaria
	Fever in the returned traveller
		Traveller’s diarrhoea
		Typhoid fever
		Cholera
		Amoebiasis
		Giardiasis
		Dengue (‘breakbone’) fever and chikungunya
		Zika virus
		Melioidosis
		Malaria
		Japanese B encephalitis and meningococcal meningitis
		Schistosomiasis (bilharzia)
		African trypanosomiasis (sleeping sickness)
		Plague (‘black death’)
		Rabies (a rhabdovirus infection)
		Hansen’s disease (leprosy)
		Leishmaniasis
		Cutaneous myiasis
		Helminth (worm) infections
		Pinworms (also called threadworms)
		Human roundworm
		Viral haemorrhagic fevers (VHF)
	Travel sickness
	Tremor
		Classification
			Resting tremor—Parkinsonian
			Action or postural tremor
			Intention tremor (cerebellar disease)
			Flapping (metabolic tremor)
			Essential tremor
			Tropical ear
U
	Umbilical discharge
	Umbilical granuloma in infants
	Undescended testes
		The problem of non-descent
		Optimal time for assessment
		Refer
		Optimal time for surgery
		Hormone injections
	Unemployment
		Vulnerable groups
	Urethritis
		Chlamydia non-specific urethritis
		Gonococcal infection
	Urinary tract infection
		Acute uncomplicated cystitis
		Acute pyelonephritis
		Indications for investigation of UTI
		Investigations for recurrent UTI
		Urine color changes—diagnostic pointers
	Urticaria (hives)
		Check causes
V
	Vaginal discharge
	Vaginal thrush (candidal vulvovaginitis)
	Bacterial vaginosis
	Trichomonas vaginalis
	Atrophic vaginitis
	Venous ulcers
		Wound dressing
	Visual loss
		Amblyopia
		Retinoblastoma
		Cataracts
		Glaucoma
		Retinitis pigmentosa
		Acute and subacute painless loss of vision: diagnostic strategy model
		Amaurosis fugax
		Retinal migraine
		Retinal detachment
		Vitreous haemorrhage
		Central retinal artery occlusion
		Central retinal vein thrombosis
		Macular degeneration
		Temporal arteritis
		Posterior vitreous detachment
		Optic (retrobulbar) neuritis
	Vitiligo
	Vomiting
		Vomiting in infancy
		Cyclical vomiting
		Chronic idiopathic nausea and vomiting
		Symptomatic relief of vomiting
	Vulvar disorders
		Lichen sclerosus
		Chronic vulvovaginal candidiasis
		Vulvovaginitis in prepubertal girls
		Vulvodynia
W
	Warts
	Weight loss
		Failure to thrive
		Eating disorders in the adolescent
	Whiplash
	Whole-person approach to management
	Worms (helminths)
	Wounds: removal of non-absorbable sutures
	Wrinkles
	Writer’s cramp
Z Zoonoses
Appendixes
	Appendix 1 Dermatome chart
	Appendix 2 Mini-mental state examination
	Appendix 3 Snellen visual acuity chart (read from distance 140 cm)
	Appendix 4 School exclusion for childhood infectious diseases: minimum exclusion periods from school, preschool and childcare centres
	Appendix 5 BMI ready reckoner
	Appendix 6 Basic life support algorithm and CPR schedule