Essential Primary Care

Essential Primary Care aims to provide undergraduate students with a comprehensive overview of the clinical problems encountered in primary care. It covers the structure of primary care in the UK, disease prevention and the management of common and important clinical presentations from infancy to old age. Case studies are used in every chapter to illustrate key learning points. The book provides practical advice on how to consult with patients, make sense of their symptoms, explain things to them, and manage their problems.

Essential Primary Care:
• Is structured in five sections:
 - The building blocks of primary care: its structure and connection with secondary care, the consultation, the process of making a diagnosis, prescribing, and ethical issues
 - Health promotion
 - Common and important presenting problems in roughly chronological order
 - Cancer
 - Death and palliative care
• Gives advice on how to phrase questions when consulting with patients and how to present information to patients
• Provides advice on how management extends to prescribing - often missing from current textbooks
• Contains case studies within each chapter which reflect the variety of primary care and provide top tips and advice for consulting with patients
• Supported by a companion website at www.wileyessential.com/primarycare featuring MCQs, EMQs, cases and OSCE checklists

Jessica Buchan is a General Practitioner and a Teaching Fellow, University of Bristol.

contributors viii

Foreword ix

Preface x

How to use your textbook xi

About the companion website xii

Part 1: The key features of primary care

1 The structure and organisation of primary care 3
Andrew Blythe

2 The GP consultation 10
Jessica Buchan

3 Making a diagnosis 22
Barbara Laue

4 Prescribing 30
Andrew Blythe

5 The interface with secondary care 42
Sarah Jahfar

6 The everyday ethics of primary care 50
Trevor Thompson

Part 2: Healthy living and disease prevention

7 Behaviour change 59
Jessica Buchan

8 Alcohol and drug misuse 68
Andrew Blythe

9 Preventing cardiovascular disease 77
Andrew Blythe

10 Caring for people with learning disabilities 85
Andrew Blythe

Part 3: Common presenting problems

11 Tiredness 95
Andrew Blythe

Childhood

12 Child health in primary care 111
Jessica Buchan

13 Managing the feverish and ill child in primary care 120
Alastair Hay, Lucy Jenkins and Jessica Buchan

14 Managing common conditions in infancy 134
Jessica Buchan

15 Managing chronic conditions in childhood 139
Lucy Jenkins, Alastair Hay, Matthew Ridd and Jessica Buchan

16 Teenage and young�]adult health 147
Jessica Buchan and David Kessler

Early adulthood

17 Respiratory tract infections 157
Lucy Jenkins

18 Low back pain 163
Jessica Buchan

19 Heartburn and dyspepsia 170
Jessica Buchan

20 Diarrhoea and rectal bleeding 177
Andrew Blythe

21 Common skin conditions 184
Matthew Ridd

22 Headache 194
Andrew Blythe

23 Fits, faints and funny turns 201
Andrew Blythe

24 Depression, anxiety and self�]harm 210
David Kessler

25 Sexual health and dysuria 219
Lucy Jenkins

26 Menstrual problems, contraception and termination of pregnancy 231
Jessica Buchan

27 Pregnancy 241
Jessica Buchan

28 Domestic violence and abuse 254
Gene Feder

Middle and old age

29 Cardiovascular disease 265
Andrew Blythe

30 Breathlessness 275
Jessica Buchan

31 Joint pains and stiffness 287
Andrew Blythe

32 Urinary problems and prostate disease 294
Simon Thornton

33 The menopause 302
Jessica Buchan

34 Multimorbidity and polypharmacy 307
Polly Duncan and Andrew Blythe

35 Falls and fragility fractures 314
Andrew Blythe

36 Visual and hearing loss 322
Andrew Blythe

37 Dementia 331
Andrew Blythe

Part 4: Cancer

38 Spotting patients with cancer 343
Andrew Blythe

39 Looking after patients with cancer 352
Andrew Blythe

Part 5: Palliative care and death

40 Palliative care and death 361
Andrew Blythe

Index 371

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