Category: Emergency Medicine
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Book Review: Symptom Based Radiology by Donald L. Renfrew MD (2011)
Choosing the wrong imaging study leads to unnecessary costs, complications, and side effects (no citation needed!). Yet many seasoned clinicians sometimes have trouble with knowing what imaging study to order. I think the author was correct in stating: “I wrote Symptom Based Radiology to help primary care providers make better use of radiology services. The…
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Hematologic Emergencies
White cell disorders Tumor lysis syndrome → allopurinol, hemodialysis Leukostasis (leukemia patient with very high white cell count and neurological changes) → leukophoresis Acute hyperviscosity syndrome (in Waldenström macroglobulinemia) → plasmapheresis Red blood cell disorders Methemoglobinemia → oxygen, methylene blue Sickle cell emergencies: Acute calculous cholecystitis → antibiotics, consider surgical intervention Acute splenic sequestration crisis (shock, LUQ pain, acute…
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Book Review: Brain CT Scans in Clinical Practice
Brain CT Scans in Clinical Practice by Usiakimi Igbaseimokumo MD is concise, sharp, brilliantly written, practice changing, and full ofnumerous helpful clinical pearls. In places, the advice is extremely straightforward: blood clots or tumours in the brain deep to the pia mater are called intraaxial and those outside the pia are called extra axial. (P. 26-27)…
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Toxic Hepatitis and Jaundice
Here are some important causes of toxic hepatitis and jaundice (notorious ones are in bold): Hepatocellular (elevated ALT and AST only): acarbose, acetaminophen, allopurinol, amiodarone, aspirin (in Reye’s syndrome), baclofen, bupropion, fluoxetine, HAART drugs, isoniazid, ketoconazole, lisinopril, losartan, methotrexate, NSAIDs, omeprazole, paroxetine, pyrazinamide, rifampin, risperidone, sertraline, statins, tetracyclines, trazodone, trovafloxacin, valproic acid, Vitamin A. Herbals…
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Electrocardiography: A Curriculum for Self-Guided Learners
“If you think there’s another specialist who has all the answers, someone else who’s going to bail you out of trouble every time you have a question about ECGs, you are mistaken. That person may just as likely be wrong, so YOU must strive to become THE expert.” Amal Mattu MD, ECG Interpretation of STEMI:…
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How to distinguish pericarditis from STEMI
The Problem Diffuse, convex (up) ST segment elevations with or without PR-segment depressions can be seen in both pericarditis or ST-segment Elevation Myocardial Infarction (STEMI), particularly if the patient has a wraparound LAD which supplies the inferior wall. So how can one reliably distinguish pericarditis from STEMI? The Solution If any of the following are present, a STEMI…
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Book Review: Cope’s Early Diagnosis of the Acute Abdomen
“You cannot be a real general surgeon without reading this book.” – Schein (p. 27) Cope’s Early Diagnosis of the Acute Abdomen is one of the most famous, if not the most famous, single subject book in all of medicine. Now in its twenty-second edition, it remains an excellent monograph about the history and physical examination…