ABC of Medically Unexplained Symptoms by Christopher Burton PDF
By Christopher Burton
This fresh name addresses the advanced matters confronted through fundamental health and wellbeing care practitioners in treating and handling sufferers with ‘medically unexplained symptoms'. It goals to enhance directions and rules to aid determine sufferers with medically unexplained signs, as they're generally underdiagnosed, and to regulate signs extra successfully with lively sufferer involvement.
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Investigations and referral The appropriate investigation and management of dyspepsia of recent origin is well described in current guidelines. If the patient has persistent symptoms after a negative H. pylori test and endoscopy then you may need to consider alternative diagnoses. If there are no red ﬂags, and the history is not typical of biliary colic, there is a risk that requesting an ultrasound ‘just to be sure’ may turn up asymptomatic gallstones, which are a common coincidental ﬁnding and may lead to inappropriate surgery with poor outcome.
Although tension-type headache probably is not actually caused by muscle tension, the label is sometimes sufﬁcient for patients to raise their own concerns about psychosocial stress. • • • Has a headache limited your activities for a day or more in the past 3 months? Are you nauseated or sick to your stomach when you have a headache? Does light bother you when you have a headache? The examination Although the relationship between blood pressure and headache is contested, blood pressure and fundoscopy are minimum examinations at the ﬁrst presentation.
GP assessment GPs should consider dysfunctional breathing in patients where breathlessness is at odds with clinical ﬁndings – this may be in 25 the case of asthma or chronic obstructive pulmonary disease (COPD) where symptoms seem disproportionate to signs and lung function – or it may occur along with non-cardiac chest pain. However, it is important to remember that some organic causes of breathlessness (especially pulmonary embolism) can present with with intense breathlessness and few objective signs other than distress.