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Hematology

Clonal and non-clonal mast cell activation disorders

Clonal and non-clonal mast cell activation disorders What every physician needs to know: Mast cell activation disorders are a heterogeneous group in which patients present with signs and symptoms of disease mediated by the synthesis and release of activation products such as reformed vasoactive amines, newly generated arachidonic acid derived mediators, and induced cytokines. Mast…
Hospital Medicine

Sickle cell anemia

Sickle cell anemia I. What every physician needs to know. Sickle cell disease is a term used to describe a variety of genotypes and disease states associated with the hemoglobin sickle cell (HbS) gene and the sickling of red blood cells (RBCs). The HbS gene develops from a mutation in the sixth codon of the…
Hospital Medicine

Guillain-Barré Syndrome (Acute Inflammatory Demyelinating Polyneuropathy)

I. What every physician needs to know. Classic Guillain-Barré syndrome (GBS) is an acute to sub-acute onset ascending, flaccid, symmetric, areflexic weakness syndrome, often associated with autonomic instability, typically occurring within days to weeks of an antecedent infection. The majority of patients will recover, but there is a notable 2-10% case mortality rate, and a…
Hospital Medicine

Environmental exposures

Environmental Exposures I. Problem/Condition. Exposure to environmental forces that dramatically alter normal human physiology and can result in significant morbidity and mortality. Diagnoses include the following: 1. Hypothermia 2. Hyperthermia 3. Near-Drowning 4. Burns/Radiation Exposure 5. Electrical Injury 6. Stinging insect hypersensitivity 7. Carbon Monoxide 8. Smoke Inhalation 9. Drug overdose and poisoning II. Diagnostic…
Nephrology Hypertension

Chronic Kidney Disease: Cognitive Dysfunction in Chronic Kidney Disease

Does this patient have cognitive dysfunction in chronic kidney disease? Cognitive impairment increases in prevalence with chronic kidney disease (CKD) severity, potentially affecting up to 60% of CKD patients. There may also be specific domains of cognition that are impaired for patients with CKD, such as executive cognitive function. Similar to the general population, a…
Pediatrics

Hemolytic uremic syndrome

Overview: What every practitioner needs to know Are you sure your patient has hemolytic uremic syndrome? What are the typical findings for this disease? Hemolytic Uremic Syndrome [HUS] is defined by the almost simultaneous onset of acute renal failure, acute hemolytic anemia with fragmented erythrocytes and thrombocytopenia. The most frequent type of HUS is associated…
Anesthesiology

Vitreoretinal Surgery – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Anesthesia management plays a pivotal role in vitreoretinal surgery. Unexpected patient movement during delicate microscopic intraocular surgery can lead to increased intraocular pressure (IOP), choroidal hemorrhage, extrusion of intraocular contents, and loss of vision. Therefore, the avoidance of movement, coughing, and straining is essential during vitreoretinal…
Critical Care Medicine

Acid-base imbalance, Abnormal blood pH

Acid-base Disorders Synonym Abnormal blood pH Related Conditions Metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis, mixed acid-base disorders 1. Description of the problem Derangements in blood pH result from increased intake, altered production or impaired/excessive excretion of acid or base. With time, respiratory and renal adjustments correct the pH towards normal by altering the…
Critical Care Medicine

GI Hemorrhage

Gastrointestinal (GI) Hemorrhage 1. Description of the problem Gastrointestinal (GI) hemorrhage occurs anywhere throughout the GI tract. Classically it was differentiated into upper and lower GI bleeding, with the point of division being proximal or distal to the ligament of Treitz respectively. However, new insights into the pathology of bleeding and therapeutic strategies have led…
Rheumatology

CPPD Arthropathy

Does this patient have calcium pyrophosphate dihydrate crystal deposition disease? Definitions Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is an umbrella term encompassing all instances of calcium pyrophosphate dihydrate (CPP) crystal precipitation in connective tissues seen in asymptomatic patients or associated with several clinical syndromes. The names traditionally used to describe CPPD crystal deposition disease…
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