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Intoxication with Ethanol

At a Glance Ethanol intoxication should be considered in any patient in whom there is unexplained loss of consciousness, altered sensorium, or onset of seizures. A toxic dose is 5g/kg in an adult and 3 g/kg in a child. Ingestion of ethanol is common and is estimated to be responsible for some 600,000 emergency department…
Hospital Medicine


I. Problem/Condition. Ataxia is a syndrome characterized by a disturbance of coordination and balance; the effects may result in abnormal stance and gait, limb incoordination, oculomotor disturbances, and issues related to swallowing and speech. Truncal ataxia, limb ataxia, and sensory ataxia are further descriptive terms that are important to recognize, as an accurate understanding of…

Chronic Substance abuse

OVERVIEW: What every practitioner needs to know Are you sure your patient has this condition? What are the typical findings for this condition? What are the stages of substance abuse? From a developmental perspective, adolescents do not always fit neatly into the criteria for substance abuse and dependence formerly defined by the Diagnostic and Statistical…
Critical Care Medicine

Toxin-induced metabolic acidosis

1. Description of the problem What every clinician needs to know Metabolic acidosis is a common and serious presentation of several toxins. Toxin-induced metabolic acidosis can be due to multiple diverse pathways and can become become evident at various stages and time-frames of the poisoning. These include organic acid production through metabolic pathways, exogenous acid…
Nephrology Hypertension

Acid/Base Disorders: Metabolic Acidosis

Does this patient have metabolic acidosis? Metabolic acidosis is generally defined by the presence of a low serum bicarbonate concentration (normal range 22-28 mEq/L), although occasionally states can exist where the serum bicarbonate is normal with an elevated anion gap (e.g., patients with a lactic acidosis who have received a bicarbonate infusion or patients on…

Overdose – Drugs of Abuse

OVERVIEW: What every practitioner needs to know Are you sure your patient has overdosed? What are the typical findings for this condition? Stimulants Stimulants are a class of compounds that accelerate neuronal and/or physical activity. These include a number of both prescription and recreational drugs such as cocaine, amphetamines, anticholinergics, and sympathomimetics. In general, they…
Hospital Medicine

Chronic pancreatitis

. Traditionally, chronic pancreatitis (CP) is considered a progressive inflammatory disorder of the pancreas in which normal parenchymal morphology is irreversibly damaged and replaced by fibrosis and chronic inflammatory cell infiltrates. Clinical value of this histological definition is limited because some patients with histological definition of CP have no symptoms, histological features seen in CP…
Hospital Medicine

Peripheral neuropathy

Peripheral neuropathies are syndromes, seen in association with a variety of anatomic or physical, metabolic, toxic, ischemic, nutritional, inflammatory (e.g., autoimmune, infectious), paraneoplastic, or inherited processes. They may be present as mononeuropathies, polyneuropathies, autonomic neuropathies, or polyneuropathies associated with autonomic neuropathies. Additionally, they may be further characterized by: Frequency of occurrence (common causes: diabetes, alcohol,…


Are You Confident of the Diagnosis? Hemochromatosis is a condition in which the absorption of iron from the intestinal mucosa is in excess of the loss of iron or of an individual’s need. It is a progressive disease, usually affecting adults, which leads to retention and damage in parenchymal tissues including the liver, heart, pancreas…
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