Health Decision Guides

Welcome to this symptom guide about itching. We're sorry to hear you have this problem!

Itching is a common symptom and it can be caused by a number of different conditions. This guide will cover some of the most common, but it is not exhaustive -- rarer causes will not be covered. Itching, also called pruritus, is often associated with a rash, as with poison ivy. But this guide is about itching without a rash.

This guide is not intended to replace a face-to-face meeting with your doctor about these symptoms. In fact, many causes of itching require an in-person examination and testing. However, this guide may be particularly helpful while awaiting a visit to your doctor or after your initial evaluation.

Okay, let's get started.

Along with itching, do you have any of the following?

- Trouble breathing

- Unintentional weight loss

- Enlarging lumps (or "glands") under the skin

- Reduced urination

- Yellow tinge to the eyes or skin

Yes, I have one or more of those.

Nope, I have none of those.

Good, that makes some of the more serious causes of itching less likely. For example, people with severe allergic reactions or kidney disease can have itching without rash along with one or more of those symptoms.

Okay, the next question deals with the possibility of a mild allergic reaction.

Have you recently started a new medicine or had exposure to something new on your skin (such as a new soap, perfume, or lotion)?

Yes, I have.

No, I haven't.

Welcome to our health decision guide for people with new leg swelling, also called "lower extremity edema." We're sorry to hear you have this problem!

You may have noticed new swelling in any part of one or both legs, this includes feet and ankles. If you've had foot, ankle, and/or leg swelling for a while, this guide may still be useful, but the focus will be on new symptoms.

There are a number of causes of lower extremity edema. This guide will cover some of the most common, but it is not exhaustive; rarer causes will not be covered. In addition, keep in mind that there could be more than one cause of swelling.

This guide is not intended to replace a face-to-face meeting with your doctor about your symptoms. Many causes of leg and foot swelling require an in-person examination and testing to diagnose. However, this guide may be particularly helpful while awaiting a visit to your doctor or after your initial evaluation.

Okay, let's get started.

The reasons for swelling in just one leg are not the same as the causes of swelling in both legs.

Do you have swelling of just one foot, ankle, and/or leg? (Also answer yes if one side is much more swollen than the other side.)

Yes, the swelling is just on one side.

No, both sides are swollen.

Welcome to this symptom guide about ankle and leg swelling during pregnancy.

Almost every pregnant woman has some extra fluid in the tissues. Usually this will be most obvious during the later part of pregnancy, especially if a woman is on her feet for a long period of time.

However, sometimes leg swelling can indicate a complication of pregnancy or be caused by an unrelated problem.

This guide is not intended to replace a face-to-face meeting with a health care professional about your symptoms. Many causes of leg and foot swelling require an in-person examination and testing to diagnose. However, this guide may be particularly helpful while awaiting an office visit or after your initial evaluation.

Okay, let's get started.

The reasons for swelling in just one leg are not the same as the causes of swelling in both legs.

Do you have swelling of just one foot, ankle, and/or leg? (Also answer yes if one side is much more swollen than the other side.)

Yes, the swelling is just on one side.

No, both sides are swollen.

Welcome.

People say they feel dizzy when describing a variety of sensations. This guide is designed to address one type of dizziness, a feeling of lightheadedness when you stand up that gets better when you lie down. You will be asked a short series of questions that will lead you to information pertinent to your symptoms.

A lightheaded feeling may vary from a vague sense that your brain is "not clear" to the dramatic symptom of feeling like you will faint when you stand up.

Normally when you stand up, your blood pressure falls for a few seconds, but then rises to make sure that your brain gets enough blood flow. Becoming lightheaded when moving from a lying position to sitting or standing usually means that your blood pressure has fallen inappropriately. Doctors call this postural hypotension.

If your dizziness does not fit this description, then please visit our guide titled New Onset Dizziness.

Let's get started.

Have any of the episodes of lightheadedness resulted in fainting, blacking out, or losing consciousness?

Yes, my lightheadedness has resulted in fainting, blacking out, or losing consciousness.

No, my lightheadedness has not resulted in fainting, blacking out, or losing consciousness.

Welcome. Nausea and vomiting can make life miserable. When they occur during pregnancy, they can feel like they steal the magic and fun out of being pregnant. It probably won't make you feel any better, but you have lots of company — most women experience some nausea during pregnancy. Although this is sometimes called morning sickness, it can actually occur at any time during the day.

By answering a short series of questions, you can figure out whether your nausea and vomiting are related to your pregnancy or if they might be caused by something else.

Let's get started.

Repeated episodes of vomiting can deplete you of fluids and electrolytes, no matter what the cause.

Have you been vomiting so much that you feel lightheaded or very weak?

Yes, I have.

No, I am not lightheaded or especially weak.

Many women experience crampy pain around the time of menstrual periods. Painful menstrual cramps, also called "dysmenorrhea," usually involves the area around the lower abdomen or pelvis, but can be felt in other areas such as the lower back, hips or upper thighs.

Menstrual cramps can be mild to moderately severe, usually lasting one to three days. About ten percent of women with painful periods have such severe pain that they cannot work, exercise or play for several hours to several days each month. Fortunately, most women find relief or control of their symptoms with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.

For many women, painful menstrual cramps have been a part of their lives for years.

This Decision Guide is designed to help women who have more recent onset of painful menstrual cramps or whose cramps have become worse in the last several months. The guide consists of a series of questions. You answers will lead to information pertinent to your menstrual cramps and tips on how to manage your cramps.

Please note that this guide should be used for informational purposes and is not intended to replace the evaluation and advice of your health care provider.

Click here to begin.

If your menstrual cramps have developed recently this may indicate a new medical problem or a change in your hormones. For example, painful cramps that have had their start within the past six weeks may be caused by infection or pregnancy. Cramps that started more than six weeks ago are less likely to be from one of these problems.

Did your cramps begin within the last six weeks?

Yes, my cramps started less than six weeks ago.

No, my cramps started more than six weeks ago.

Welcome to this Decision Guide about persistent knee swelling. We're sorry to hear you have this problem!

The goal of this guide is to provide information while awaiting evaluation with your doctor for persistent knee swelling or for additional information after you have seen him or her. Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor.

First, some background information about this guide and about knee swelling:

Knee swelling may develop for a number of reasons. If you have new, unexplained knee swelling that followed a significant injury or you have fever, this guide is not the best place to start! See your doctor first. Ligament tears, cartilage damage and fracture can follow trauma and may require urgent treatment; this is particularly true if you are unable to bear weight.

This decision guide will focus on persistent knee swelling -- that is, knee swelling lasting more than two or three weeks.

You'll be asked a series of questions and depending on your answers, information will be provided and additional questions asked until the conclusion.

So, let's get started.

Would you like to get information related to your own situation? Or would you rather start with some general information about knee swelling?

General information about knee swelling

Information specific to my situation

In general, one or both knees may be swollen due to

• increased joint fluid

• blood in the joint

• enlargement of the bones near the knee joint

• swelling near the knee joint (without an actual joint problem)--for example, bursitis can cause swelling directly on top of the kneecap

• fluid behind the knee, called a Baker's cyst.

Each of these will be briefly reviewed. There are other, rarer, causes that will not be covered here.

Let's start with Increased Joint Fluid:

Normally, there is a tiny amount of fluid in the knee which serves as a lubricant and to deliver nutrition to the cartilage that lines the joint. When there is any type of arthritis present, fluid may accumulate in the joint. This is sometimes called "water on the knee." In addition to arthritis, structural problems in the knee (such as torn cartilage or ligament injury) may stimulate extra fluid formation.

Your doctor may recommend a procedure (called arthrocentesis, or joint aspiration) in which a sample of fluid is removed from the knee and analyzed for the presence of white blood cells, red blood cells, infection, or crystals.

This is helpful because certain diseases can be suggested or even proven by the results of this analysis:

• high white blood cell count in joint fluid suggests the presence of marked inflammation (making infection a larger concern).

• a large number of red blood cells suggests there's been bleeding into the joint.

• many common bacterial joint infections can be identified by analysis of the fluid.

• gout or pseudogout, the most common forms of "crystal-induced" arthritis, can be proven by seeing the appropriate crystal (uric acid crystals in gout; calcium crystals in pseudogout).

Would you like to continue learning about other causes of joint swelling (next up: blood in the joint) or would you prefer to move on to questions about your particular situation?

Blood in the joint

Information specific to my situation

Welcome to our Decision Health Guide on Persistent Cough. This guide is designed for people who have been coughing for at least 3 weeks.

Anyone with a persistent cough should be evaluated by a health care provider.

This guide will provide you with the likely possibilities for your persistent cough. You can use this guide either before or after you have been evaluated by a health care professional.

Click here to start.

Most people are not concerned about a cough when it first begins, since it is so common to have a cough from a cold or viral bronchitis. At the start of your cough, you may also have had a dripping or congested nose, sore throat, fever, muscle aches, nausea, ear pain, or pink eye. Sometimes bronchitis or other upper respiratory infections result in a long-lasting cough.

When your cough began, did you have any other symptoms that suggest that you had a cold, bronchitis or a viral illness?

Yes, I had some or all of these symptoms.

No, I didn't have any symptoms like that.

Many, many women who are pregnant find themselves short of breath at some point. One reason is that the uterus is expanding and pushing up into the abdomen. This squeezes the lungs a bit, reducing the space they have for oxygen exchange.

An even bigger cause for shortness of breath is progesterone, a hormone that increases during pregnancy. High progesterone levels cause pregnant women to breathe faster. The rise in progesterone begins early in pregnancy, and the shortness of breath it causes can come as a surprise.

While shortness of breath can be worrisome, most of the time it is harmless and due to the normal changes of pregnancy. That said, it's still a good idea to consider if there might be some other reason for it.

This guide will help you assess whether your shortness of breath is normal pregnancy-related shortness of breath or something else.

Let's get started.

Severe shortness of breath, shortness of breath that comes on suddenly, and shortness of breath accompanied by certain symptoms requires immediate medical attention. If you have one or more of the following symptoms, it is a medical emergency:

- Severe shortness of breath

- Difficulty talking in full sentences

- Chest pain with shortness of breath

- Swelling in the face or abdomen with shortness of breath (a possible allergic reaction)

- Shortness of breath that appears suddenly and unexpectedly

Do you have any of the symptoms listed above?

Yes, I have one or more of these symptoms.

No, I don't have any of these symptoms.

Welcome.

The two main reasons for blacking out are insufficient blood flow to the brain and abnormal electrical activity within the brain (a seizure).

While both of these sound scary, in reality most episodes of blacking out are not related to life threatening health problems.

This guide is designed to provide insight into why you passed out. It is not a diagnostic tool or a substitute for evaluation by a health professional.

The questions are ones your doctor is likely to ask you. Your answers provide a path to better understanding of the common reasons for losing consciousness.

Let's begin.

Certain situations demand emergency medical care.

Do any of the following apply to you?

- Chest pain or shortness of breath before or after you passed out

- Bloody or black stools

- Severe headache

- Recent blow to the head

- A heart condition

Yes, one of those applies to me.

No, none of those apply to me.