Physician-informed medical book reviews and clinical education resources.
Introduction Vertigo is a sensation of spinning, either of the patient or of his or her environment. There are four types of vertigo that you must consider in a patient who complains of a spinning sensation: Toxic vertigo Central nervous system vertigo Peripheral nervous system vertigo Hematologic vertigo (hyperviscosity syndrome) Toxic Vertigo Salicylates and anticonvulsants, … Read more
Introduction You can solve triple acid-base problems with basic arithmetic and straightforward logic. As an example, let’s work through the following rather classic triple acid-base problem: An afebrile, atraumatic 26-year-old male with no past medical history is brought to the emergency department because of a three hour history of altered mental status, vomiting and vertigo. The physical examination is … Read more
Introduction A high anion gap metabolic acidosis can be a very dangerous acid-base abnormality. The “gap” itself is just a number – it isn’t harmful per se. Rather, the danger is from the acidosis and from the process that is generating the abnormal and excessive organic acid load. The most common screening test for high anion gap … Read more
I’ve been looking at Acid-Base Case Studies (2004) by Ira Kurtz MD for a long time now, at least since I’ve written several months ago, wrongly, that a solid book with a case-based approach to acid-base disorders does not exist. It does in fact exist, and this is it. The book presents the reader with dozens of clinical … Read more
The following is a comprehensive differential diagnosis and workup for seizures. The workup is (obviously!) not something that you have to do for every patient. You can, however, use the information below for standardized test preparation and to guide your thought process as you work up patients with seizures. Please let me know if there’s anything that you … Read more