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Gastroenterology Hepatology

Evaluation of a patient with a liver mass

Evaluation of a patient with liver mass The differential diagnosis of a mass in the liver is broad but can be easily narrowed down based on two factors that are usually known at the time of presentation: (1) suspected or proven chronic liver disease and (2) solid or cystic lesion. Also known as : Liver…
Obstetrics and Gynecology

Operative Vaginal Delivery

Operative Vaginal Delivery Introduction Unfortunately, obstructed labor still complicates thousands of deliveries worldwide, claiming hundreds of maternal and fetal/neonatal lives and causing significant morbidities in the survivors (such as is the case with obstetric fistulas) that could have been otherwise prevented with timely obstetrical interventions. Obstetrical forceps and vacuums refer both to a heterogeneous group…
Gastroenterology Hepatology

Endoscopic diagnosis and therapy of biliary diseases

General description of procedure, equipment, and endoscopic technique Endoscopic retrograde cholangiopancreatography (ERCP) has assisted in the care of patients with pancreaticobiliary diseases for almost four decades. This technique involves passing a specially designed endoscope into the second portion of the duodenum. There, its side-viewing optics allow for identification of the major duodenal papilla. Through its…
Hospital Medicine

Pre-excitation syndrome (WPW)

Pre-Excitation Syndrome I. What every physician needs to know. Ventricular pre-excitation is a condition in which some or all of the ventricular muscle of the heart undergoes electrical activation (or depolarization) earlier in relation to atrial events than would be expected had the electrical impulses travelled normally by way of the atrioventricular (AV) conduction system.…

Sickle cell disease

OVERVIEW: What every practitioner needs to know Are you sure your patient has sickle cell disease? What are the typical findings for this disease? Sickle cell disease (SCD) is the name for a group of related blood disorders caused by an abnormal hemoglobin (Hb) called sickle Hb (Hb S). Although SCD is primarily a blood…

Diagnosis and Management of Mitral Stenosis

I. Mitral Stenosis: What every physician needs to know. Mitral stenosis (MS) results in obstruction to left ventricular (LV) inflow and is defined by a diastolic pressure gradient between the left atrium (LA) and ventricle. Rheumatic fever following infection with group A beta-hemolytic strep (GABS) is by far the most common etiology. Other causes of…
Gastroenterology Hepatology

Approach to the patient with intestinal obstruction

Are you confident of the diagnosis? the lumen prevents normal flow of luminal contents. In a simple obstruction there is a single point of obstruction, whereas a closed-loop obstruction is caused by two distinct points of obstruction. A complete obstruction is present if there is no passage of intestinal contents beyond the point of obstruction,…
Infectious Diseases

Infections of the oral cavity, neck, and head

OVERVIEW: What every practitioner needs to know This is a broad subject area. The topics to be covered include odontogenic orofacial “space” infections; suppurative parotitis; peritonsillar abscess; and deep neck space infections, including submandibular (Ludwig’s angina), lateral pharyngeal, and retropharyngeal space infections. Although rare in the post-antibiotic era, deep space infections of the head and…
Gastroenterology Hepatology

Crohn's disease

How can I be sure that the patient has Crohn's disease? Crohn’s disease (CD) is chronic, affecting the intestinal mucosal in a focal, asymmetric, transmural, granulomatous inflammatory disease that can involve any portion of the digestive tract from the mouth to the anus. The transmural nature of CD leads to potential complications of intestinal strictures,…
Obstetrics and Gynecology

Vulvar Cancer

Vulvar Cancer 1. What every clinician should know Are you sure your patient has disease? What should you expect to find? Vulvar cancer is a relatively rare cancer that affects approximately 3,500 women annually in the United States. It is usually a relatively indolent cancer that presents with pruritis and a visible lesion. The majority…
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