Aust Fam Physician
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Of the many causes of acute chest pain, it is important to delineate the life threatening causes, such as myocardial infarction, dissecting aneurysm and pulmonary embolism. It is important to consider the cause as 'myocardial infarction until proved otherwise'. Common causes in general practice are musculoskeletal disorders and functional problems. A diagnostic strategy is outlined.
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Our superb coastline attracts local tourists and overseas visitors seeking recreation. There is increasing contact with marine life. The unwary and unprepared holiday-maker can be at risk of serious injury from a number of common sea creatures.
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The painful ear is caused commonly by otitis media, otitis externa and temporomandibular joint dysfunction. Difficulty in visualising the tympanic membrane due to debris in the ear canal can make diagnosis difficult, especially when otitis externa and otitis media co-exist. Another problem is determining the origin of referred pain. Due to the complex innervation of the ear, referred pain can arise from most sites in the head and neck, especially the upper cervical spine, the teeth and the throat.
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It is not uncommon for patients with 'arthritis' to be presenting with a rheumatological manifestation of a systemic disease. Frequently the pain is not even of articular origin. The diagnostic challenge for the practitioner is to determine the nature of the underlying pathologic process. This article sets out to provide some guidelines for diagnosis.
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Scripts for the oral contraceptive pill are written by general practitioners every day, but how organised are their prescribing habits? The author describes the use of a supplementary insert to medical records to aid the busy general practitioner.