TAILIEUCHUNG - Ebook John Murtagh's general practice (6th edition): Part 2

(BQ) Part 2 book "John Murtaghs general practice" presentation of content: Chronic disorders, continuing management, male health, sexual health, child and adolescent health, problems of the skin, women’s health, accident and emergency medicine, health of specific groups. | McGraw-Hill Create™ Review Copy for Instructor Harris. Not for distribution. 788 Murtaghs General Practice 66 Pain in the leg Thou cold sciatica Cripple our senators, that their limbs may halt As lamely as their manners. William Shakespeare ( – ), Timon of Athens Pain in the leg has many causes, varying from a simple cramp to an arterial occlusion. Overuse of the legs in the athlete can lead to a multiplicity of painful leg syndromes, ranging from simple sprains of soft tissue to compartment syndromes. A major cause of leg pain lies in the source of the nervous network to the lower limb, namely the lumbar and sacral nerve roots of the spine. It is important to recognise radicular pain, especially from L5 and S1 nerve roots, and also the patterns of referred pain, such as from apophyseal (facet) joints and sacroiliac joints (SIJs). Key facts and checkpoints • • • • • • • • • Always consider the lumbosacral spine, the SIJs and hip joints as important causes of leg pain. Hip joint disorders may refer pain around the knee only (without hip pain). Nerve root lesions may cause pain in the lower leg and foot only (without back pain). Nerve entrapment is suggested by a radiating burning pain, prominent at night and worse at rest. Older people may present with claudication in the leg from spinal canal stenosis or arterial obstruction or both. Think of the hip pocket wallet as a cause of sciatica from the buttocks down. Acute arterial occlusion to the lower limb requires relief within 4 hours (absolute limit of 6 hours). The commonest site of acute occlusion is the common femoral artery. Varicose veins can cause aching pain in the leg. A diagnostic approach A summary of the diagnostic strategy model is presented in TABLE . Table Pain in the leg: diagnostic strategy model Q. Probability diagnosis A. Muscle cramps Nerve root ‘sciatica’ Osteoarthritis (hip, knee) Exercise-related pain (. Achilles tendonitis), muscular injury (. hamstring) Q.

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• General practice
• Chronic disorders
• Continuing management
• Male health
• Sexual health
• Adolescent health
• Problems of the skin
• Emergency medicine
• The basis of general practice
• Diagnostic perspective
• Problem solving in general practice
• Nasal disorders
• Nausea and vomiting
• Gre Practice General Test 2003
• GRE
• practice general test
• BMC Musculoskeletal Disorders
• Incidence rate
• Danish general practice
• Activity related pain
• Mission IELTS 1
• General training supplement
• IELTS General Training Module
• General training practice test
• Bài thi IELTS
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• Murtachs general practice
• Patient education
• Angry patients
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• The disturbed patient
• Tthe painful ear
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• The painful knee
• BMC Pharmacology and Toxicology
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• Practice guidelines as topic
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• Emergency presentation
• Lung cancer
• Socio demographic characteristics
• Murtagh's General Practice
• Breaking bad news
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• Specific problems of children
• Child safety
• Diagnostic triads for children
• Colorectal cancer
• Faecal occult blood test
• Early diagnosis
• Immunochemical faecal occult blood test
• Delayed diagnosis
• Primary care
• Quality indictors
• Health care
• Fast track
• Cancer suspicion
• GP’s symptom interpretation
• Lumbosacral radicular syndrome
• Pain treatment
• Epidural injections
• Patients with type 2 diabetes
• Knowledge on the diet
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• Outpatients with type 2 diabetes
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• Low back pain
• Patient outcomes assessment
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• GRE general test
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• Antibacterial chemotherapy theory
• Problems and practice
• Antibiotic action—general principles
• Antibiotics—mechanisms of action
• Harmacokinetics applied to antimicrobials
• Harmacokinetics applied