Differentiating Conversion vs Factitious vs Malingering Disorders – Hughes

Difficulty is that these cannot be differentiated by self-report only; the clinician HAS to investigate other sources of information. CONVERSION Symptoms or deficits affecting voluntary motor or sensory functioning Actually very rare Commonly recurs (25% in the first year) Risk factors:  maladaptive personality traits (borderline, histrionic traits), history of childhood abuse/neglect, stressful life events may… Continue reading Differentiating Conversion vs Factitious vs Malingering Disorders – Hughes

Chronic Low Back Pain: What does and does not work (according to current evidence)

DOES WORK: Keeping moving Physical therapy or manipulation therapies Acupuncture, tai chi (clinician should emphasize possible benefits - likely enhances the placebo effect!) NSAIDs - lowest effective dose for shortest period - 1st line pharmacotherapy Can try APAP in those with NSAID contraindications, but unlikely to help Duloxetine (other SNRIs may work, but evidence lacking)… Continue reading Chronic Low Back Pain: What does and does not work (according to current evidence)

Evaluation and EKG Findings with Palpitations – Primary Care RAP

Copied from Primary Care RAP March podcast - an excellent overview of the workup and "red flags" on EKG. Palpitations are a common symptom seen in the outpatient setting. While most are benign, it is important to rule out more serious and potentially deadly causes. A family history of sudden cardiac death and certain EKG… Continue reading Evaluation and EKG Findings with Palpitations – Primary Care RAP