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

Ankle-Brachial Index

Helpful in diagnosis of peripheral arterial disease Also, decreased ABI associated with high-risk CAD, stroke, TIA, renal insufficiency and all-cause mortality. Normal:  0.9 - 1.3 > 1.3 = calcified, sclerotic vessels < 0.9 if occlusive arterial disease (95% sens, 100% spec) < 0.4 suggestive of multilevel disease (iliac, femoral, tibial) and associated with non-healing ulcers… Continue reading Ankle-Brachial Index

The Heckerling Score – H&P predictor of CXR findings

The Heckerling score:  1 point each for T > 37.8 C HR > 100/min crackles on auscultation diminished breath sounds absence of asthma Score of 4 or 5 highly suggestive of pneumonia (+LR = 8.2, increasing pre-test probability around 45%) Score of 0 or 1 suggestive of NO pneumonia (-LR = 0.3, decreasing pre-test probability… Continue reading The Heckerling Score – H&P predictor of CXR findings

Pediatric Headaches – Turner

Majority of children are diagnosed with viral illness or migraine in the ED/UC setting. DDx: Infection:  viral meningitis, bacterial meningitis, orbital or cerebral abscess. Tumor:  isolated headache is a rare manifestation of a brain tumor. Intracranial hemorrhage:  non-traumatic (not typically HA alone) Carbon monoxide poisoning Hypertension:  essential, pheo Common secondary causes: fever viral meningitis pharyngitis… Continue reading Pediatric Headaches – Turner

Eye Manifestations of Systemic Disease – Czarnecki

Lecture notes from presentation by Dr Scott Czarnecki, 04 January 2017: WHAT IS URGENT? Acute vision loss (<24h) Painful vision loss (<24h) Globe penetration (now) Flashes and floaters (<24h) Semi-urgent:  HSV conjunctivitis, zoster ophthalmicus (24-48h) Ptosis and blown pupil (now) Random ophtho pearls: For bacterial conjunctivitis, use Ocuflox or Polytrim.  Don't use tobra or gentamicin… Continue reading Eye Manifestations of Systemic Disease – Czarnecki