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DECEMBER 15, 2020
| AFP’s COVID-19 Collection |
New topics include neurologic presentations of COVID-19, mental health disorders associated with COVID-19, and vaccine updates. in the collection that is open-access and frequently updated. Our collection of is also avalable.
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Approximately 1% of primary care office visits are for chest pain. Initial evaluation is based on determining whether the patient needs to be referred to a higher level of care to rule out acute coronary syndrome (ACS). Age, sex, and type of chest pain can predict the likelihood of coronary artery disease. Patients with suspicion of ACS should be transported to the emergency department. Those with low or intermediate risk can undergo outpatient testing. In those with low suspicion for ACS, consider costochondritis, gastroesophageal reflux disease, and anxiety states. Other less common considerations include acute pericarditis, pneumonia, and heart failure.
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Peripheral neuropathy is one of the most common neurologic problems encountered by family physicians. Common identifiable causes include diabetes mellitus, nerve compression or injury, alcohol use, toxin exposure, hereditary diseases, and nutritional deficiencies, although many cases are idiopathic. Diagnosis requires a comprehensive history, physical examination, and judicious laboratory testing.
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Mechanical compression of the spinal cord is the underlying cause of degenerative cervical myelopathy. The signs and symptoms of cervical myelopathy are variable and can mimic other conditions, but upper motor neuron findings are the hallmark of the disease. The treatment of severe, progressive degenerative cervical myelopathy is primarily surgical. Conservative therapy with monitoring for progression may be considered in patients with mild to moderate disease who are neurologically stable.
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