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Pulmonary Medicine

Chemotherapy-Related Drug-Induced Lung Injury

What every physician needs to know Chemotherapeutic agents are widely used to treat solid and hematologic malignancies, and are increasingly used for immunosuppression in the context of autoimmune disease. The first chemotherapy drugs, nitrogen mustards, were developed after the observation in World War I that soldiers who survived inhalation of poison gases often developed cytopenias…
Pulmonary Medicine

Nonthrombotic Pulmonary Embolism (Air, Amniotic Fluid, Fat, Tumor)

What every physician needs to know Nonthrombotic pulmonary embolism (NTPE) is embolization to the pulmonary circulation of different cell subtypes (adipocytes, hematopoietic, amniotic, trophoblastic or tumor), bacteria, fungi, foreign material, or gas. It is less common than pulmonary thromboembolism (Figure 1). Figure 1. Nonthrombotic pulmonary embolism (NTPE) is characterized as embolization to the pulmonary circulation…
Infectious Diseases

Chronic Pneumonia (not TB)

OVERVIEW: What every practitioner needs to know Are you sure your patient has chronic pneumonia? What should you expect to find? Chronic pneumonia is a pulmonary parenchymal process that can be infectious or non-infectious and that has been present for weeks to months rather than days. Chronic pneumonia is manifested by abnormal chest radiographic findings…
Cardiology

Evaluation and Treatment of AV Block and Intraventricular Conduction Disturbances

I. AV Block and Intraventricular Conduction Disturbances. What every physician needs to know. AV block, or atrioventricular block, is a major cause of significant bradyarrhythmias. To diagnose and manage AV block, it is important to have a basic understanding of the anatomy of the conduction system of the heart. The AV node lies at the…
Dermatology

Tuberous Sclerosis Complex (Bourneville Disease, Bourneville Phakomatosis)

Are You Confident of the Diagnosis? What you should be alert for in the history Tuberous sclerosis complex (TSC) is an autosomal dominant genetic condition characterized by hypomelanotic macules (Figure 1), hamartomas, and intellectual disability in 50% of those affected, as well as infantile spasms and/or seizure disorder in approximately 80% of affected individuals. Figure…
Critical Care Medicine

Fever/Leukocytosis

Fever and Leukocytosis Also known as: Fever: pyrexia, fever of unknown origin, pyrexia of unknown origin Leukocytosis: elevated white blood cell count, granulocytosis, neutrophilia Related Conditions: Fever: hyperthermia, post-operative fever, central fever Leukocytosis: leukemoid reaction, bandemia, extreme leukocytosis 1. Description of the problem What every clinician needs to know Fever and leukocytosis are common findings…
Hospital Infection Control

Yeast/molds – Aspergillus

What are the key principles of preventing yeast/molds – Aspergillus? The key principles regarding the prevention of invasive aspergillosis (IA) involve prevention of exposure to spores and prevention of disease in patients at risk. Successful implementation of preventive efforts rely on education of health care personnel as to the importance of prevention and their role…
Gastroenterology Hepatology

Cystic neoplasms and IPMN

Introduction Cystic neoplasms of the pancreas are being increasingly identified, due to the increased use of cross sectional imaging like CT or MRI. These neoplasms include intraductal papillary mucinous neoplasms (IPMNs) as well as mucinous cystic neoplasms (MCNs) and other more rare cystic tumors (e.g cystic islet cell tumors). The understanding of IPMN of the…
Infectious Diseases

Bacterial Meningitis

OVERVIEW: What every practitioner needs to know Are you sure your patient has bacterial meningitis? What should you expect to find? Patients usually present with fever (which may be absent in patients receiving immunosuppressive agents) accompanied by meningeal symptoms and the physical findings indicative of meningitis. Headache. A generalized headache is the rule. A more…
Shoulder and Elbow

Chronic Glenohumeral Dislocation: Anterior and Posterior

The Problem Chronic glenohumeral dislocations represent a therapeutic challenge for the orthopaedic surgeon. Patients with a chronic glenohumeral dislocation often present with a complex combination of pathologic findings, all of which impact the treatment strategy and ultimate prognosis. These include injuries to the humeral head articular surface, the glenoid, the rotator cuff, and the capsulolabral…
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