Foreword xi
Preface to 1st Edition xii
Preface to 2nd edition xiv
About the author xv
Acknowledgements xvi
Selected useful resources xvii
The focused consultation 1
Focused clinical assessment 3
Useful consultation tools 8
Red flags in general practice 12
Undifferentiated and miscellaneous presentations 15
Suspected cancer 17
Weight loss 24
Tiredness 29
Dizziness 35
Chronic pain 41
Sudden collapse and syncope 45
Frequent attenders 50
Medication review and polypharmacy 54
Medically unexplained symptoms 58
Insomnia 63
Irritability and 'stress' 67
Domestic violence 71
Homelessness 75
Paediatrics and adolescent health 81
The sick and/or feverish child 83
Suspected meningococcal meningitis and septicaemia 90
Neonatal jaundice 95
Faltering growth 99
Headache and migraine in children 104
Head injury in children 108
Suspected cancer in children and adolescents 113
Abdominal pain in children 118
Hearing loss in children 124
Childhood cough 128
Childhood wheeze 133
Constipation in children 138
Childhood obesity 142
Suspected child abuse and neglect 148
Nocturnal enuresis 153
Knee problems in children 158
Hip problems in children 163
Adolescent health problems 167
Self-harm in teenagers 171
Eating disorders 175
Autism-spectrum disorder 180
Cardiovascular 183
Chest pain 185
Palpitations 191
Cardiovascular risk assessment 195
Hypertension 200
Atrial fibrillation 205
Heart failure 209
Peripheral vascular disease 215
Respiratory 221
Shortness of breath 223
Haemoptysis 228
Suspected lung cancer 233
Asthma 237
Chronic obstructive pulmonary disease 242
Suspected pneumonia 248
Pleural effusion 252
Pulmonary embolism 256
Endocrine and metabolic 261
Diabetes review 263
Obesity 268
Hirsutism in women 273
Hypothyroidism 277
Hyperthyroidism 281
Hyponatraemia 285
Hypernatraemia 289
Hypokalaemia 292
Hyperkalaemia 296
Hypocalcaemia 299
Hypercalcaemia 302
Gastrointestinal 307
Nausea and vomiting 309
Dysphagia 313
Dyspepsia and reflux 317
Upper gastrointestinal bleeding and melaena 321
Abdominal pain 326
Constipation 332
Diarrhoea 336
Rectal bleeding and suspected bowel cancer 341
Abnormal liver function tests 346
Irritable bowel syndrome 351
Inflammatory bowel disease 356
Coeliac disease 361
Infectious diseases 365
Fever of unknown origin 367
Fever and illness in the returning traveller 372
HIV infection and AIDS 377
Tuberculosis 383
Rheumatic fever 388
Haematology 393
Iron-deficiency anaemia 395
Macrocytic anaemia (B12 and folate deficiency) 400
Bleeding disorders 405
Myeloma 409
Musculoskeletal 413
Soft-tissue injury 415
Acute hot and swollen joint 420
Chronic musculoskeletal pain 424
Polyarthralgia 429
Neck pain 435
Back pain 440
Shoulder and arm problems 446
Elbow problems 452
Hand problems 456
Hip pain 461
Groin problems 466
Leg pain and/or swelling 470
Knee pain 476
Foot and ankle problems 483
Gout 489
Osteoporosis 493
Neurology 499
Headache 501
Transient ischaemic attack and stroke 508
Head injury in adults 514
Suspected or confirmed brain tumour 519
Tremor 524
Motor neurone disease 528
Peripheral neuropathy 533
Multiple sclerosis 538
Gynaecology 543
Combined oral contraception 545
Menorrhagia 549
Amenorrhoea 553
Breast lumps 557
Loss of libido 561
Polycystic ovary syndrome 565
Suspected ovarian cancer 570
Obstetrics 575
Routine antenatal care 577
Bleeding in early pregnancy 582
Abdominal pain in pregnancy 586
Pre-eclampsia 591
Urology and renal medicine 595
Suspected urinary tract infection in women 597
Lower urinary tract symptoms in men 601
Urinary incontinence 606
Urethral discharge in men 612
Scrotal and testicular problems 616
Erectile dysfunction 621
Renal or ureteric colic (kidney stones) 626
Haematuria 631
Chronic kidney disease 635
Mental health 641
Depression 643
Self-harm and harm to others 648
Anxiety phobias and panic disorder 653
Alcohol screening 657
Alcohol dependence 662
Illicit drug misuse 667
Obsessive-compulsive disorder 672
Mania 675
Schizophrenia 679
Skin 685
Moles and malignant melanoma 687
Pressure ulcers 690
Ophthalmology 695
Eye injuries 697
The acute red eye 701
Gradual painless visual disturbance 706
Sudden painless visual disturbance 710
Eye problems in older people 715
Ear nose and throat 719
Neck swelling 721
Sore throat 725
Ear pain 730
Hearing loss in adults 734
Tinnitus 738
Sinusitis and facial pain 742
Problems in older people 747
General health assessment in older people 749
Cognitive problems and dementia 755
Falls in older people 760
Delirium and acute confusional state 766
Depression in older people 772
Palliative and end-of-life care 777
Parkinson's disease 781
Index 785
