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General Practice at a Glance


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Table of Contents

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 Infl ammatory 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

About the Author

Paul Booton is Professor of General Practice andPrimary Care at St George s, University of London, andformerly Director of Primary Care Education, Imperial College,London Carol Cooper is Honorary Teaching Fellow, Department ofPrimary Care and Public Health at Imperial College MedicalSchool, London, and a General Practitioner Graham Easton is Deputy Director of Primary CareEducation, Department of Primary Care and Public Health at ImperialCollege Medical School, London, and a General Practitioner Margaret Harper is Honorary Teaching Fellow, Departmentof Primary Care and Public Health at Imperial College MedicalSchool, London, and a General Practitioner


A comprehensive guide on history taking, diagnosis andtreatment in primary care, useful for written and clinicalexaminations alike. In particular, the use of high yield schematicsthroughout - from contraceptive methods and ear and eye symptoms,to the acute abdomen and gynaecological cancer epidemiology -differentiates this text from the rest." (Mobolaji O. Ajekigbe,Imperial College London) This is a valuable book for young clinicians and students ofall disciplines. It is intuitive and provides much teachingmaterial for patients. (Doody s) It will help you develop an understanding of the natureand structure of primary care. (Student BMA News) I think it is a fantastic book. I will be recommending it tomedical students and other GP registrars. It is a lovely summary ofgeneral practice. The authors are obviously very experienced andhave managed to distil the real need to know facts ina highly reader friendly and engaging way. I would recommend everypractice should have a copy of this text. Medical students willfind it really useful for exam revision and not just during a GPplacement. It s a really reader-friendly, clear book. It doesnot scrimp on the medical facts or lose anything by being so slimand lightweight. I think it is priced perfectly for its intendedmarket. The diagrams and illustrations are particularly good andrelevant: it s an excellent revision text for students. It isvery difficult to pick out any weaknesses based on its intendedaudience. I was thoroughly impressed with this book. I though fromthe style it was going to be a little too basic but it certainly isnot. Particularly noteworthy are the illustrations which are highlyrelevant and clear. The inclusion of photographs makes this textstand out from other similar texts on the market. A far moreengaging and informative read than other stodgy textbooks on thesame topic. I would have no hesitation in recommending this tomedical and GP registrars. (2013 BMA Medical BookAwards)

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