Search Results

  Overview Diagnosis requires 2 major, 1 major with 3 minor, or 5 minor criteria from the modified Duke Criteria listed below: MAJOR CLINICAL CRITERIA: Persistently positive blood cultures with typical IE organisms. Bacteremia is continuous and high grade....

Rates Normal: 60-100 bpm Tachycardia: > 100 bpm Bradycardia: < 60 bpm Readings Count the number of large squares present within one R-R interval. Divide 300 by this number to calculate heart rate. OR Count the number of complexes on the rhythm strip ...

Syncope Rapid onset of transient loss of consciousness Inability to maintain postural tone It may be associated with a fall Resolves spontaneously and quickly without intervention Presyncope (Near-Syncope) Weakness, Dizziness, lightheadedness, or "grayin...

  Diagnosis DKA vs HHS:  DKA sugar ranges from 250 to 500 mg/dL HHS typically has sugars > 600 mg/dL Serum osmolality > 320 in HHS Neurologic symptoms such as stupor and coma are primarily seen in HHS, but can sometimes be seen in severe DKA. Little to ...

Definitions Type 1 DM: autoimmune. Patients require exogenous insulin to prevent DKA. Type 2 DM: insulin resistance and a relative insulin deficiency. Treatment may be with diet, exercise, oral meds, injectable meds, and/or insulin. With severe insulin d...

Etiology The site of bleeding is only suggested by the patient’s presentation and physical examination. Stool can turn black (melena) with as little as 50-100 cc of upper GI bleeding Pre-endoscopic clinical risk stratification Clinical judgment always come...

Definition Accumulation of peritoneal fluid Symptoms Abdominal Distention and discomfort Anorexia Nausea Early satiety Heartburn (Gastroesophageal Reflux) Flank Pain Respiratory distress Signs Umbilicus may evert Bulging flanks with the patient lyi...

Definition SBP is a bacterial infection of the ascitic fluid. Diagnosis: PMN count >= 250 cells/mm3 OR ascitic fluid WBC >= 500 cells/mm3 with a positive fluid culture. Diagnostic clinical signs: New onset fever, confusion or abdominal pain, hepatic enceph...

Definition indicates inflammation of the pancreas. Acute pancreatitis: results from the leakage of pancreatic enzymes into pancreatic tissue, leading to autodigestion. Chronic pancreatitis: causes are varied and lead to destruction of the pancreatic tissue....

 3 Histological Stages Simple steatosis (usually reversible w/ abstinence in 4-6 wks) Steatohepatitis (steatosis + neutrophil infiltration + Mallory-Denk bodies) Steato-fibrosis (extreme is cirrhosis) MELD SCORE [calculate with mdcalc] Model for End-Stage...

Nausea Nausea is the unpleasant sensation of about to vomit.  This can occur alone or with vomiting.  Many differentials are associated with nausea depending on patient's symptoms.   Always check patients electrolytes if they have been having severe vomiting...

Check if patient has Bowel Obstruction before giving anything PO Stool Softeners - Colace 100-250mg po qd or bid  Osmotic Laxatives   MiraLAX 17gm daily Lactulose 30ml q4hr until bowel movement Milk of Magnesia 30ml to 60ml qd Suppository - Dulcolax 10mg...

Anemia can be caused by many things but first we should get some basic labs such as CBC that will show MCV, and Reticulocyte count.  This table from UTD summarizes on the different causes of anemia depending on the MCV. Increased reticulocyte count (increa...

Sickled cells occlude arterioles and cause tissue infarction, resulting in recurrent painful episodes, and a variety of serious organ system complications that can lead to life-long disabilities and even death. Causes: Precipitated by infection, fever, dehydr...

Packed red blood cells (PRBC): - Consent: Always consent the patient or family member for transfusion of blood products on admission, unless emergent. - Dose effect: 1 unit PRBC (volume = 350 cc) should raise Hgb by about 1 g/dl - Leukocyte filtered/reduced...

For all reactions (except mild allergic/uricaria): STOP transfusion, send remaining blood product and fresh blood sample to blood bank) Acute Hemolysis (caused by ABO incompatibility) - Signs: fever/chills, hypotension, flushing, dyspnea, flank pain. Fever o...

General Principles Initiate empiric therapy based on severity of illness, likely pathogen, likelihood of drug resistance, host factors (allergy, poor renal function, immunocompromised) Initiate antibiotic therapy as soon as possible tailor antibiotic therap...

Objective The primary objectives of the medical evaluation of the first seizure are to establish whether the event was a seizure, and if so, whether it resulted from a correctable systemic process or whether the patient is at risk for developing further unpro...

Causes CNS insults, Systemic Infections, Metabolic Disturbances, Toxin Exposure, Medications, Chronic Systemic Diseases, Psychiatric conditions Definition Change in consciousness, appearance, behavior, mood, affect, motor activity or cognitive function Bes...

Common causes Streptococcus pneumoniae (pneumococcus) and respiratory viruses are the most frequently detected pathogens in patients with CAP Typical bacteria S. pneumoniae (most common bacterial cause) Haemophilus influenzae Moraxella catarrhalis Staphy...