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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…
Hospital Medicine

Nephrolithiasis

Nephrolithiasis I. What every physician needs to know Stones composed of calcium phosphate or calcium oxalate make up 85-90% of renal stones in the United States. Precipitation of calcium in urine causes these stones, and stones have been linked to hypercalciuria, high salt diets, obesity, hypertension, diabetes, genetic factors, and environmental factors. Uric acid, cystine,…
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…
Pulmonary Medicine

Malignant Pleural Effusion

What every physician needs to know: Malignant pleural effusion (MPE) is a common clinical problem that results in disabling breathlessness for patients with advanced malignancy. It represents disseminated disease and confers a poor prognosis. Patients often require multiple invasive procedures in order to gain a diagnosis and manage their symptomatic pleural effusions, which impacts their…
Gastroenterology Hepatology

Pancreatic adenocarcinoma

How can I be sure that the patient has pancreatic adenocarcinoma? Common signs and symptoms of pancreatic cancer include fatigue, abdominal pain often radiating to the back, jaundice, nausea with or without vomiting, anorexia, early satiety, and weight loss. Additionally, up to 80% of individuals with pancreatic cancer will be shown to have glucose intolerance…
Anesthesiology

Lumpectomy and mastectomy – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Breast cancer is the second leading cause of cancer death in women, and In the United States, over a lifetime, 1 in 8 women will be diagnosed with breast cancer and 1 in 35 will die from the disease. In contrast, male breast cancer is rare,…
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