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Hospital Medicine

Cushing's

I. Definition. Cushing’s syndrome is a clinical condition resulting from prolonged exposure to excessive glucocorticoids, either from endogenous or exogenous sources. Therapeutic administration of exogenous glucocorticoids is the most common cause of Cushing’s syndrome. The most common endogenous cause of Cushing’s syndrome is Cushing’s disease. Cushing’s disease is Cushing’s syndrome caused by an adrenocorticotropic hormone…
Infectious Diseases

Native valve Endocarditis (NV-IE), Non-IVDA

OVERVIEW: What every practitioner needs to know about native valve endocarditis  Are you sure your patient has native valve endocarditis? Native valve endocarditis (NV-IE) is one of the most important life-threatening infectious diseases, and its timely diagnosis, antibiotic treatment, and management of complications is critical to optimal outcomes. Typical symptoms are variable and depend on the…
Obstetrics and Gynecology

Polycystic Ovary Syndrome

Polycystic ovarian syndrome, PCOS, PCO 1. What every clinician should know Polycystic ovarian syndrome is a medical condition associated with ovulatory dysfunction, hyperandrogenism, and polycystic ovaries. The diagnosis is made by considering a spectrum of signs and symptoms, rather than by a single test result. Although there is no universally accepted definition of PCOS, there…
Hospital Medicine

Complications of Diabetes Mellitus

I. Problem/Condition. In the United States, the estimated prevalence of diabetes mellitus (DM) is between 4.4-17.9 %. While diabetes has a major impact on quality of life and economics, the associated vascular complications result in approximately 14 % of US health care expenses. The complications of DM are divided into macrovascular (coronary artery disease, stroke…
Pediatrics

Overdose – Common Medications

Overview: What every practitioner needs to know Are you sure your patient has overdosed on common medications? What are the typical findings for this disease? Acetaminophen toxicity Acetaminophen is commonly used in the pediatric population for many different indications including for its antipyretic properties and its analgesic properties. The therapeutic dose of acetaminophen is 15-20…
Dermatology

Cellulitis and Erysipelis

Are You Confident of the Diagnosis? Cellulitis is a diffuse acute inflammatory infectious process that involves the dermal and subcutaneous layers of the skin. Erysipelas is a specific varient of cellulitis with characteristic features that is generally superficial and caused by beta-hemolytic streptococci. The spectrum of cellulitis also includes cellulitis with gangrene or necrosis, and…
Cardiology

CAD and Noncardiac Surgery

I. Coronary Artery Disease: What every physician needs to know. Approximately 27 million patients undergo noncardiac surgical procedures each year in the U.S. Of those patients, 50,000 will suffer from a myocardial infarction (MI) and 20,000 patients will die due to cardiovascular causes in the perioperative setting. With more than 6 million surgical procedures being…
Gastroenterology Hepatology

Crohn's disease

How can I be sure that the patient has Crohn's disease? Crohn’s disease (CD) is chronic, affecting the intestinal mucosal in a focal, asymmetric, transmural, granulomatous inflammatory disease that can involve any portion of the digestive tract from the mouth to the anus. The transmural nature of CD leads to potential complications of intestinal strictures,…
Cardiology

Use of the Echocardiogram to Define the Presence, Extent, and Etiology of Cardiac Dysfunction

Indications and patient selection Introduction Heart failure (HF) is a clinical syndrome characterized by breathlessness and fatigue. Hemodynamically, HF is caused by the inability to generate adequate cardiac output to meet end organ and peripheral perfusion demands, or to do so only at the expense of elevated cardiac filling pressure. The diagnosis of HF is…
Nephrology Hypertension

Hypertension: Secondary Hypertension

Does this patient have secondary hypertension? Secondary hypertension (HTN) can be defined as HTN that has a specific cause, and thus is potentially curable. Although this has not been carefully evaluated in the literature, it represents about 10-15% of all patients with HTN. Common causes Renal Parenchymal Disease: Chronic kidney disease (CKD), any etiology of…
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