Am Fam Physician. 2022;106(4):379
What is the preferred first-line treatment for children with functional constipation?
Polyethylene glycol (Miralax) is first-line treatment for functional constipation in children.
What is the preferred treatment for chlamydia?
Treat chlamydia preferentially with doxycycline, 100 mg twice per day for seven days; azithromycin (Zithromax), 1 g, is an acceptable alternative, is preferred in pregnancy, and may be more appropriate for patients with confidentiality concerns or those unable to adhere to seven-day regimens.
What is the preferred treatment for gonorrhea?
Treat gonorrhea with a single intramuscular dose of ceftriaxone, 500 mg (in patients weighing less than 300 lb [136 kg]) or 1,000 mg (in patients weighing more than 300 lb); cotreatment with azithromycin (Zithromax) or doxycycline is no longer required.
Does reducing dietary salt intake lower blood pressure or albuminuria in patients with chronic kidney disease?
In patients with chronic kidney disease, reducing dietary salt intake by approximately 4.2 g per day (73.5 mmol or 1,690 mg of sodium) lowers mean systolic blood pressure by 6.9 mm Hg (95% CI, 5.0 to 8.8 mm Hg) and diastolic blood pressure by 3.9 mm Hg (95% CI, 3.0 to 4.8 mm Hg) compared with patients on a higher salt diet. In patients with chronic kidney disease who do not have end-stage renal disease, a low-salt diet decreases mean albuminuria by 36% (95% CI, 26% to 44%) compared with a higher salt diet.
What initial evaluation should be performed for patients with cerebellar symptoms that are concerning for posterior circulation stroke?
Patients who present with cerebellar symptoms such as gait ataxia, limb ataxia, or vertigo should be evaluated with a HINTS (head-impulse, nystagmus, test of skew) examination and diffusion-weighted magnetic resonance imaging. Negative early magnetic resonance imaging may need to be repeated in three to seven days or followed up with a bedside HINTS examination.
What are clinical signs of soft tissue masses with increased risk of malignancy?
Signs that increase the risk of malignancy include a tumor size of 5 cm or larger, location on or below the fascia, masses matted to surrounding structures, and rapid growth.
Additional Online Only AFP Clinical Answers
What can be done to prevent recurrent seizures after a first seizure in adults?
Approximately one-third of adults experience a second seizure within one year of an initial unprovoked seizure, and nearly one-half experience a second seizure within two years. Anti-seizure medications are recommended for patients with a high risk of seizure recurrence (e.g., patients with nighttime seizures, electroencephalography abnormalities, history of brain insult, brain imaging abnormalities) after risks and benefits of treatment have been considered. Anti-seizure medications reduce the risk of seizure recurrence by more than one-third at two years after a seizure. Recurrence rates are similar with or without medications after three years.
What is the best approach to evaluating children in suspected cases of abuse?
A trauma-informed approach to evaluating, diagnosing, and treating child abuse within a multidisciplinary team is recommended. A trauma-informed approach to care requires that team members be mindful of the potential for traumatic stress, recognize and appropriately respond to the symptoms and signs of trauma, and prevent retraumatization.
Is bariatric surgery for adult obesity an effective treatment option for type 2 diabetes mellitus?
Yes. Remission of type 2 diabetes mellitus occurs in approximately 70% of metabolic surgery patients, and about 38% of surgical patients maintain remission at 10 years.
Tip for Using AFP at the Point of Care
Are you looking for more clinical questions and evidence-based answers? You can find AFP's collection of Cochrane for Clinicians at https://www.aafp.org/afp/cochrane. All department collections are accessible from the AFP home page at https://www.aafp.org/afp.
A collection of AFP Clinical Answers published in AFP is available at https://www.aafp.org/afp/answers.
