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MEDICAL / Endocrinology & Metabolism
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A child or adolescent with type 1 diabetes in primary health care
The care of a child with type 1 diabetes requires specialist management. If a diabetic child pres...
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A lump in the neck
When assessing the aetiology, take into account possible symptoms of infection, the patient&rsquo...
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Abnormal menstrual bleeding
A detailed history of menstrual bleeding is often more important than the pelvic examination. Dif...
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Acute abdominal symptoms in children
Most abdominal symptoms in children can be treated by the general practitioner. The most common o...
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Addison's disease and other conditions inducing hypocortisolism
The symptoms of insufficient levels of cortisol include weight loss, fatigue and hypotension. Ski...
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Alkaline phosphatase (ALP)
the origin of an increased plasma ALP concentration is usually either the liver or the ...
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Amenorrhoea
In primary amenorrhoea, the patient has never had a menstruation. In secondary amenorrhoea, menst...
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Assessment of an obese patient
Determine the degree of obesity. In adults the body mass index (BMI) is a suitable measure. Mild ...
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Bariatric surgery (obesity surgery)
The long-term results of bariatric surgery are usually significantly better than those achieved w...
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Blood gas analysis and acid-base balance
The blood specimen should be examined as soon as possible after sampling
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Contraception: initiation, choice of method and follow-up
The time when a young woman starts with contraception provides a good opportunity to influence he...
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Crohn’s disease
The most common symptoms are abdominal pain, diarrhoea, fever, weight loss and blood in the stool...
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Cushing's syndrome
Cushing’s syndrome may be behind the patient's hypertension or metabolic syndrome . Dia...
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Diabetes: definition, differential diagnosis and classification
The diagnosis of diabetes is based on elevated fasting glucose level (plasma glucose = 7.0 mmol/l...
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Diabetic ketoacidosis
Always remember to measure plasma/blood glucose in insulin-treated diabetic patients showing symp...
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Diabetic nephropathy
Patients with diabetes should be screened annually for microalbuminuria and eGFR (estimated glome...
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Diabetic neuropathy
The diagnosis of diabetic neuropathy is based on the diagnosis of diabetes, typical symptoms and ...
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Diabetic retinopathy
Screening for diabetic retinopathy prevents blindness and visual impairment and offers a good cos...
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Diagnosis and treatment of childhood hypercholesterolaemia
Identify and guide to treatment children with hereditary dyslipidaemia, especially familial hyper...
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Doping in sports
The aim of the anti-doping work is to prevent the use of substances and methods that are hazardou...
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Erectile dysfunction (impotence)
Erectile dysfunction is often of organic origin. However, problems in self confidence and couple ...
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Examining a patient with a thyroid complaint
The assessment of thyroid function is primarily based on the symptoms, on clinical examination an...
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Excessive hair growth (hirsutism)
Hirsutism is defined as excessive male-pattern body hair growth in women. In about half of the c...
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Graves’ ophthalmopathy
Graves’ ophthalmopathy is an autoimmune disorder of the orbital tissues. It affects some of...
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Gynaecomastia
Differentiate physiological breast enlargement and "normal variant" from pathological c...
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Haemochromatosis
In hereditary haemochromatosis, disturbed regulation of iron absorption causes accumulation of ir...
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Hormonal contraception
The majority of women using hormonal contraception use low-dose preparations (containing 20&ndash...
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Hypercalcaemia and hyperparathyroidism
In primary hyperparathyroidism, the parathyroid glands produce an excess of parathyroid hormone (...
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Hyperglycaemic hyperosmolar syndrome
Manage an acutely ill patient with hyperglycaemia before he/she enters coma. Do not confuse this ...
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Hyperthyroidism
In a hyperthyroid patient, serum TSH concentration is below reference range (often unmeasurable),...
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Hypocalcaemia, hypoparathyroidism and vitamin D deficiency
It must be ensured that the patient does not have pseudohypocalcaemia caused by hypoalbuminaemia....
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Hypoglycaemia in a diabetic patient
The possibility of hypoglycaemia should be considered with every unconscious diabetic patient, es...
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Hypokalaemia and hyperkalaemia
The potassium level of patients using diuretics, particularly the elderly, should be monitored (t...
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Hyponatraemia and hypernatraemia
In hyponatraemia, the concentration of sodium in the plasma decreases to below 135 mmol/l, and th...
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Hypothyroidism
Identify the possibility of hypothyroidism when the patient's symptoms include fatigue, const...
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Incidental glucosuria in children
Detect possible insulin-dependent diabetes mellitus as the cause of incidental glucosuria and arr...
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Infertility
Approximately 15% of all couples suffer from infertility at some point during their lives. In mos...
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Insulin therapy in type 2 diabetes
Glucose control in type 2 diabetes can be improved with additional insulin, self-monitoring of bl...
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Lifestyle education in type 2 diabetes
Every primary care unit should be prepared to provide lifestyle education (either as a group or i...
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Magnesium deficiency
Magnesium is a participant in many metabolic processes. Its concentration in the body is regulate...
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Male hypogonadism and hormone replacement
Primary and secondary hypogonadism must be differentiated from each other; in secondary hypogonad...
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Menopausal complaints
Climacterium is the entire period during which the function of the ovaries diminishes (ovula...
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Metabolic syndrome
Early detection and treatment of the metabolic syndrome (MBS) aims at primary and secondary preve...
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Newly diagnosed type 1 diabetes in a child
The signs and symptoms should be recognised early: thirst and frequent urination, enuresis in a p...
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Newly diagnosed type 2 diabetes
Explain the permanent nature and severity of the illness to the patient – the condition is ...
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Nipple discharge and mastitis in a non-lactating woman
Rule out a tumour of the breast by sufficient investigations in all cases with serous unilateral ...
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Oral antidiabetic drugs and GLP-1 analogues in the treatment of type 2 diabetes
Oral medication should be introduced at an early stage. In the absence of contraindications, medi...
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Osteoporosis
The aim in the prevention and treatment of osteoporosis is to prevent fractures.In prevention of ...
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Overweight and obesity in children
The prevention and management of childhood obesity is important since obesity in childhood is pre...
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Paget's disease of bone (osteitis deformans)
Paget’s disease is a chronic metabolic disorder of unknown aetiology that affects the skele...
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Pituitary tumours
The majority of pituitary tumours are benign adenomas.The tumours may be hormonally active and be...
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Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome is not purely a gynaecological problem. Diagnosis can be made if the pa...
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Polyuria
Establish whether the patient has true polyuria with excessive amounts of dilute urine, or does h...
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Postcoital contraception
Hormonal contraception, Postcoital contraception during breastfeeding, An intrauterine ...
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Postmenopausal hormone replacement therapy
Tell the patient the basic facts, the advantages and disadvantages of the hormone therapy as well...
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Primary aldosteronism (Conn's syndrome)
Measure serum potassium concentration in hypertensive patients as an initial investigation. Suspe...
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Primary and follow-up examinations in type 1 diabetes
Cinical examination, laboratory tests, visit to physician and follow-up
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Primary care follow-up of thyroid cancer after initial treatment
The follow-up of papillary or follicular thyroid cancer can be transferred to primary health care...
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Pubertal development and its disturbances
The first signs of central puberty are enlargement of the testes in boys and growth of the breast...
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Rare endocrine tumours
Tumours that earlier were called carsinoids are according to the new WHO classification called...
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Rickets
Rickets is a disorder of bone mineralization usually caused by vitamin D deficiency.Risk groups i...
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Secondary hypertension
Approximately 5% of patients with hypertension are diagnosed with a secondary cause to the condit...
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Steroid doping
Remember the possibility of anabolic steroid use when a young competitive athlete or a recreation...
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Systemic diseases in pregnancy
Poorly treated or untreated systemic disease impairs fertility; adequate management effectively r...
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Transsexualism
Transsexualism refers to the most extreme form of incongruity between an individual's gender ...
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Treatment and follow-up in type 2 diabetes
The main objective is to prevent the development or worsening of arterial disease, retinopathy, n...
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Treatment of chronic renal failure
Treatment aims at slowing down the deterioration of renal function and at prevention of organ com...
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Treatment of dyslipidaemias
Preventing the progress of arterial disease in those already affected (the most important patient...
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Treatment of obesity
Effective methods are available for the treatment of obesity . Realistic target weights should be...
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Treatment of the diabetic foot
The diabetic patient's feet should be examined and the risk category recorded annually. Patie...
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Type 1 diabetes: dietary therapy and exercise
The diet recommended for patients with type 1 diabetes does not differ from the general recommend...
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Type 1 diabetes: insulin treatment
The missing insulin production of the pancreas is replaced by individual administration of differ...
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