The Medical Media Review
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Shock and Hypotension: An Expanded Differential Diagnosis
The following is an expanded differential diagnosis of shock. Please let me know if you’d consider adding anything to the list! Cardiogenic Arrhythmias Impaired contractility (volume overload, ischemia, drugs, toxins, electrolyte disorders) Structural problems (valvular abnormalities, etc.) Obstructive Endovascular: pulmonary embolus, atrial myxoma or thrombus Exo-vascular: cardiac tamponade, hypertrophic cardiomyopathy, tension pneumothorax, tension mediastinum, breath…
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Hematuria: An Approach
Etiology Traumatic: exercise, Foley catheterization, nephrolithiasis, coitus Infectious: urinary tract infections Malignant: bladder, kidney, prostate Vascular: renal infarct, renal vein thrombosis, sickle cell disease and trait Toxic: cyclophosphamide, antiplatelet agents, anticoagulants, NSAIDS Spurious: menses Workup Step 1: discontinue offenders Anticoagulants and antiplatelet agents Hemorrhagic cystitis: isophosphamide, cyclophosphamide, radiation therapy, methotrexate stone forming agents: loop diuretics, anticonvulsants,…
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Book Review: Symptom Based Radiology by Donald L. Renfrew MD (2011)
Choosing the wrong imaging study leads to unnecessary costs, complications, and side effects (no citation needed!). Yet many seasoned clinicians sometimes have trouble with knowing what imaging study to order. I think the author was correct in stating: “I wrote Symptom Based Radiology to help primary care providers make better use of radiology services. The…
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Hematologic Emergencies
White cell disorders Tumor lysis syndrome → allopurinol, hemodialysis Leukostasis (leukemia patient with very high white cell count and neurological changes) → leukophoresis Acute hyperviscosity syndrome (in Waldenström macroglobulinemia) → plasmapheresis Red blood cell disorders Methemoglobinemia → oxygen, methylene blue Sickle cell emergencies: Acute calculous cholecystitis → antibiotics, consider surgical intervention Acute splenic sequestration crisis (shock, LUQ pain, acute…
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Book Review: Brain CT Scans in Clinical Practice
Brain CT Scans in Clinical Practice by Usiakimi Igbaseimokumo MD is concise, sharp, brilliantly written, practice changing, and full ofnumerous helpful clinical pearls. In places, the advice is extremely straightforward: blood clots or tumours in the brain deep to the pia mater are called intraaxial and those outside the pia are called extra axial. (P. 26-27)…
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Book Review: Atlas of Tropical Medicine and Parasitology (2007)
Atlas of Tropical Medicine and Parasitology (2007) by Wallace Peters and Geoffrey Pasvol offers a bleak and sometimes depressing window into the state of health, or lack thereof, of underdeveloped countries, particularly those in Africa. The names of the diseases and symptoms are fearsome and sometimes curious: dengue, blackwater fever, rabies, leprosy, bubonic plague and more. The…
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Weakness: An Approach
As a first step, neuromuscular weakness should be distinguished from its mimics, which are: Mental fatigue bradykinesia Decreased range of motion Depression Movement limited by pain. “Abnormal fatigability of striated muscle is the cardinal manifestation of disorders of the neuromuscular junction. Exercise-dependent weakness often affects the extraocular muscles first, causing ptosis or diplopia, as the…
Got any book recommendations?