Signs and symptoms Resources

Pernicious anaemia is a rare condition which is classed as an autoimmune disease. It is most frequently diagnosed in those over the age of 60, but can occur at any age. It presents with variable symptoms, many of which are shared with those of other diseases, making the condition difficult to diagnose, leading to missed diagnosis and a greater risk of
complications. This article gives an overview of its diagnosis, management, and  complications, with the aim of helping general practice nurses (GPNs) and non-medical prescribers recognise symptoms and get early treatment, reducing the risk of long-term adverse effects and improving quality of life for all those affected by this complex disease.

Occupation-related lung diseases can be defined as diseases that are caused or made worse by the work environment. These are usually as a result of long-term and repeated exposures, although a single major exposure can result in lung damage. The symptoms of occupation-related lung diseases may be similar to those of other conditions, therefore as clinicians, taking both a past and current occupational history is important to assist in determining the possibility of workrelated lung disease/damage. It should be remembered that occupational lung disease may not only affect the individual who is exposed to the cause at his/her work, but also those who are exposed to the cause in their home. A well-recognised example of this type of exposure is asbestos-related disease, where an individual may be exposed to the pollutant by contact with the worker’s clothes, for example by washing them, and may also suffer the effects of asbestos exposure. The Health and Safety at Work Act (HSW Act) published in 1974 established a foundation principal; that those who create the risk are those who should control the risk. The challenge as clinicians, is that many of the lung-related diseases identified are a consequence of exposure prior to the HSW act. This does not mean occupational exposure after the publication of the HSW Act in 1974 is safe, but it did become the basis for improving occupational health and safety. This article explores some of the recognised occupation-related lung diseases.

Endometriosis is a disease which presents with a number of signs and symptoms, often confusing clinicians who may easily mistake them for other conditions with similar symptoms. Diagnosis is therefore often confirmed a number of years after the initial onset of symptoms, resulting in reduced quality of life, particularly for those whose symptoms are severe. This article hopes to raise awareness among general practice nurses (GPNs) and non-medical prescribers, enabling them to suspect the condition and hopefully give women the opportunity to get their condition diagnosed at an earlier stage with subsequent earlier intervention and improved health and wellbeing in those affected by this unpleasant condition.

There are many different causes of liver disease and current estimates suggest that as many as one in 10 people have problems with their liver at some time in their life (Foundation for Liver Research, 2020). Perhaps most worrying is the fact that incidence of liver disease is increasing, with the number of deaths reported to have increased by 400% since 1970 (British Liver Trust, 2020). Most liver diseases are asymptomatic early on, frequently resulting in late diagnosis, potentially leading to a higher risk of poor outcomes. Many of the well-known liver diseases are preventable and this article, which covers fatty liver disease, hepatitis A, B and C and liver cancer, hopes to raise awareness of risk factors, recognition, causes and treatment of these conditions, and give general practice nurses (GPNs) and non-medical prescribers more confidence when caring for patients with these illnesses.

Pelvic organ prolapse (POP) and urinary incontinence are common problems experienced by women of all ages. With the publication of Seizing the opportunity to improve patient care: Pelvic floor services in 2021 and beyond (Pelvic Floor Society, 2021) comes recognition of how common pelvic floor disorders are but how little investment has been put into these services. Such publications highlight the need for services to be provided which encourage women to come forward to be assessed and treated. This article, the first in a two-part series, discusses the signs and symptoms of POP and urinary incontinence. It details important issues to consider and remember when assessing a patient with either of these conditions in primary care. The second article will explore treatment options which should be started in primary care before considering onward referral.

Bronchiectasis, formally known as non-cystic fibrosis bronchiectasis, is the dilation of the small airways resulting in persistent cough, sputum production and recurrent chest infection, and develops as a result of insult and damage to the airways. The disease is more common in women than men and has an increasing incidence and prevalence. Early recognition of the signs and symptoms of bronchiectasis will support prompt investigations and management to reduce disease progression. This article gives an overview of bronchiectasis, its causes, treatment and management. It also discusses the role of general practice nurses (GPNs) in identifying and treating patients with the condition.