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New Issue: Neck Pain, Intrapartum Fetal Monitoring, Acute Pyelonephritis

An editorially independent, peer-reviewed journal of the American Academy of Family Physicians.

 
 

AUGUST 1, 2020

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All AAFP websites will be unavailable beginning at 6 p.m. CT on Aug. 13 as we prepare to bring you a new AAFP website and mobile app on Aug. 17. Members or subscribers who need assistance during this time can contact the Member Resource Center at [email protected] or 800-274-2237.  about what's in store and the steps to take to ensure that you're ready to access the new features. Your next AFP email table of contents will arrive a few days later than normal.


 

The broad differential diagnosis for neck pain requires an efficient but global assessment. Emphasis is typically placed on red flags that can assist in the early recognition and treatment of more concerning diagnoses, such as traumatic injuries, infection, malignancy, vascular emergencies, and other inflammatory conditions.

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Continuous electronic fetal monitoring was developed to screen for signs of hypoxic-ischemic encephalopathy, cerebral palsy, and impending fetal death during labor; it is appropriately used in high-risk labor. Structured intermittent auscultation can be used in low-risk labor and can lower operative vaginal and cesarean deliveries; however, structured intermittent auscultation remains difficult to implement because of perceived barriers in nurse staffing and physician oversight.

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Acute pyelonephritis is a bacterial infection of the kidney and renal pelvis. Urine culture should direct therapy. Outpatient management is appropriate for uncomplicated cases, and extended emergency department stays are appropriate for patients who initially cannot tolerate oral antibiotics. In cases of concurrent urinary tract obstruction, referral for urgent decompression is warranted. Pregnant patients should be admitted to the hospital and treated with parenteral therapy.

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Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Find out which patients can be diagnosed clinically, when to order a biopsy, and how to treat each of these conditions.

CME credit for this article will be available when it is published in print.

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