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Biomedical subjects

J Murtagh

Publications and source records attributed to J Murtagh.

At least 163 records · Page 9Linked to original sources
PubMed1991

Jaundice.

Always take a full travel, drug and contact history in any patient presenting with jaundice. All drugs should be suspected as potential hepatotoxins. With hepatitis A the presence of IgM antibodies reflects recent infection, and IgG antibody indicates past infection and lifelong immunity. There is no chronic carrier state of hepatitis A and E. All patients with jaundice should be tested for hepatitis B surface antigen (HBsAg). Hepatitis B infection is usually benign and short lived, but it can be fatal if chronic hepatitis develops, which may lead later to cirrhosis and hepatocellular carcinoma. Up to 5 to 10 per cent of patients with hepatitis B will become chronic carriers (especially drug addicts and homosexuals). Such carriers are identified by persistent titres of HBsAg and possibly HBeAg, the latter indicating the presence of the whole virus and active replication and high infectivity. A raised gamma glutamyl transferase accompanied by a raised MCV is a good screening test for alcohol abuse.

Diagnosis, Differential↗
PubMed1990

Common problems. Headache.

In general practice, headache presents as a problem with many causes and is seen from a different perspective than in specialist practice. Common headaches include tension, cervical dysfunction and 'mixed' headache. Consideration of the diurnal patterns in the history is a key to diagnosis. Causes such as cerebrovascular accidents, space occupying lesions, temporal arteritis and meningitis must not be missed.

Diagnosis, Differential↗
PubMed1990

Acute sore throat.

The second common problem to be presented in this series is the acute sore throat. The common causes are viral pharyngitis and tonsillitis due to streptococcus pyogenes. Another important cause that warrants attention is Epstein Barr virus (infectious mononucleosis) so that prescribing of penicillins is carefully considered. The sore throat may be the presentation of serious and hidden systemic diseases, such as blood dyscrasias, AIDS and diabetes (due to moniliasis).

Acute Disease↗
PubMed1990

The painful arm.

The painful arm often presents a diagnostic challenge. The cause is often obvious, especially with regional pain syndromes including the carpal tunnel and the tennis elbows. However, pain reference syndromes can be confusing and it is advisable to first examine the cervical spine because it is a common and often overlooked cause of arm pain or paraesthesia. It is common for arm pain to cause sleep disturbances and in such cases it is worth considering cervical causes, carpal tunnel syndrome and the thoracic outlet syndromes. The working rule is: patients with thoracic outlet syndrome cannot fall asleep; a carpal tunnel lesion wakes the patient in the middle of the night; and cervical spondylosis wakes the patient with pain and stiffness that persists well into the day.

Aged↗
PubMed1990

Diagnosis of patellofemoral pain syndrome.

This syndrome, also known as chondromalacia patellae, is characterised by pain and crepitus around the patella during activities that require flexion of the knee under loading, for example, climbing stairs.

Femur↗
PubMed1990

Arthralgia: a diagnostic strategy.

For arthritis or arthralgia there is no simple system for diagnostic analysis, but whether it is polyarthritis or monoarthritis, acute or chronic in onset, some general rules apply. Common causes include osteoarthritis (primary and secondary) and viral infection. Drugs should be considered, including those inducing gout. It is still imperative not to miss rheumatic fever, sepsis and tuberculosis in assessment. We may encounter more cases of Lyme disease presenting as arthritis.

Arthritis↗
PubMed1990

Common problems. Tiredness.

When a patient presents with tiredness, the diagnostic model is a useful basis for considering the probable diagnosis. At the same time it is imperative not to overlook the serious, even life threatening, causes such as malignant disease or AIDS. Such an organised approach allows the practitioner to ask the correct questions because, as always, the quality of the history taking is vital in leading to the diagnosis of this difficult symptom.

Diagnosis, Differential↗
PubMed1990

Ron Elisha. General practitioner and playwright.

Australian Family Physician is privileged to present a regular feature on notable Australian doctors. We are aware that there are hundreds of doctors whose service to their patients and dedication to their vocation make then outstanding people and excellent role models. This feature will present profiles on doctors who have contributed something special in their careers whether it be excellence of service or an additional special skill or achievement other than medical. We hope that readers enjoy learning about their colleagues and invite you to let us know about any members of our profession who would be worthy inclusions in this feature.

Australia↗
PubMed1990

Constipation.

The author outlines a safe diagnostic strategy for the symptom of chronic constipation, conforming to Australian Family Physician's series on common problems in general practice. The constipation is most commonly idiopathic, especially the simple form related to inadequate dietary fibre and bad habit. It is vital not to miss colonic or anorectal carcinoma. Important causes to consider include drugs (self administered or prescribed), hypothyroidism and depression.

Clinical Protocols↗