BMJ Best Practice update

Best Practice will soon include a new symptom search feature  to provide a list of differential diagnoses based on a patient’s presenting symptoms, age and gender.  Search results will link you directly to the relevant condition in Best Practice – helping you to consider a wider range of differentials as part of the patient consultation process.

Due out in June, the search box will appear at the top of every Best Practice screen.

Featured updated topic: Renal artery stenosis

Renal artery stenosis is typically due to atherosclerotic disease or fibromuscular dysplasia. It often presents with accelerated or difficult-to-control hypertension. Worsening kidney function, especially after initiation of renin-angiotensin blockade, and recurrent flash pulmonary oedema are common features. Renal artery stenosis, renovascular hypertension, and ischaemic nephropathy are various manifestations of this process. Definitive diagnosis is with imaging. Patients may already be receiving treatment with multiple antihypertensive medications; therapy of this disorder includes additions to and adjustments of antihypertensive agents in order to achieve target control of blood pressure.  Secondary prevention measures such as aspirin, a statin, or smoking cessation may be required. This topic also discusses the role of non-medical therapy (e.g., percutaneous intervention) for renal artery stenosis.  “

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