- Gastrointestinal hemorrhage (lower)
Essential Evidence Topics, 25-Oct-2021
Overall Bottom Line: Diverticulosis is by far the most common cause of lower GI bleeding. Assess the patient's hemodynamic status and initiate resuscitation if needed at the time of initial evaluation and assessment. Perform upper GI endoscopy to rule - Hematuria
Essential Evidence Topics, 31-Dec-2021
Overall Bottom Line: The United States Preventive Services Task Force and Canadian Task Force on the Periodic Health Examination do not recommend routine screening of urine for microscopic hematuria. Evaluation of hematuria depends on whether it is micr - Hemoptysis
Essential Evidence Topics, 29-Apr-2021
Overall Bottom Line: Mild hemoptysis is often associated with a respiratory tract infection and can be managed on an outpatient basis with close follow-up. The volume and frequency of blood loss is helpful in management decisions but does not indicate t - Hepatocellular cancer
Essential Evidence Topics, 27-Feb-2022
Overall Bottom Line: Screen all cirrhotic patients for hepatocellular carcinoma (HCC) with a semiannual liver ultrasound. If a liver nodule is noted on ultrasound, follow-up imaging with helical CT or MRI should be performed. Adopt an early multidisci - Hypercalcemia
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: The majority of asymptomatic patients with hypercalcemia have primary hyperparathyroidism. Primary hyperparathyroidism with mild hypercalcemia is a benign disease and may not require therapy. Initial treatment of symptomatic or sev - Hypopituitarism
Essential Evidence Topics, 26-Jan-2022
Overall Bottom Line: Signs and symptoms of hypopituitarism are nonspecific; they represent a composite of the signs and symptoms of the target hormone deficiencies caused by the syndrome. Measure the functioning of each pituitary axis independently with - Insulinoma
Essential Evidence Topics, 22-Mar-2021
Overall Bottom Line: Consider insulinoma in patients who have an overnight fasting glucose level of less than 45 mg/dL (2.5 mmol/L) and symptoms of hypoglycemia that are relieved by glucose. Confirm diagnosis with serum insulin, proinsulin, high C-pepti - Kaposi's sarcoma
Essential Evidence Topics, 8-Jul-2021
Overall Bottom Line: Kaposi's sarcoma (KS) is a low-grade multifocal vascular tumor; typical skin lesions are multifocal, asymmetrically distributed, and nonpruritic. For a patient newly diagnosed with KS, exclude underlying human immunodeficiency virus - Laryngeal cancer
Essential Evidence Topics, 27-Jul-2021
Overall Bottom Line: Patients who have hoarseness, vocal changes, or difficulty swallowing for more than 2 weeks should be evaluated for laryngeal cancer. The preferred initial test is laryngoscopy. Surgery and radiation therapy remain the first choic - Leukemia (acute lymphoblastic)
Essential Evidence Topics, 30-Jun-2021
Overall Bottom Line: Suspect acute lymphoblastic leukemia (ALL) in patients with symptoms and signs related to cytopenias. Initial diagnostic testing should include CBC, chemistries, coagulation studies, and bone marrow with cytochemistry and immunophen - Leukemia (acute myelogenous)
Essential Evidence Topics, 22-Mar-2021
Overall Bottom Line: Acute myelogenous leukemia (AML) is the most common form of acute leukemia in adults. Patients present with insidious symptoms related to variable degrees of bone marrow failure. The diagnosis of AML is demonstrated by increased num - Leukemia (chronic myelocytic)
Essential Evidence Topics, 28-Jul-2021
Overall Bottom Line: Chronic myelogenous leukemia (CML) is a myeloproliferative disorder characterized by the presence of the Philadelphia (Ph) chromosome and the Bcr-Abl mutant gene. Patients with CML typically present with vague symptoms, such as fatigu - Leukemia (hairy cell)
Essential Evidence Topics, 22-Nov-2021
Overall Bottom Line: Obtain a peripheral smear to evaluate for abnormal lymphocytes with fine, hair-like projections in a patient who presents with pancytopenia and splenomegaly. The bone marrow is typically inaspirable, but the biopsy is essential for - Lipoma
Essential Evidence Topics, 14-Nov-2019
Overall Bottom Line: Lipomas have a characteristic soft, doughy feel on examination. If malignancy is suspected, MRI is the imaging modality of choice. Treatment is unnecessary unless there is concern for cosmesis, compression of neighboring structure - Lung cancer
Essential Evidence Topics, 24-Dec-2021
Overall Bottom Line: USPSTF recommends screening with low dose CT for high risk smokers (age 50-80 years, 20 pack years, and still smoking or quit within 15 years). It is most cost-effective for current smokers in their 60's with 35 pack years. Although - Lymphoma (Hodgkin's)
Essential Evidence Topics, 4-Mar-2021
Overall Bottom Line: Common symptoms include lymph node swelling, fever, night sweats, and weight loss. Open biopsy of enlarged lymph nodes to show the presence of Hodgkin's or Reed-Sternberg cells is mandatory. For staging, or extent of disease, perf - Lymphoma (non-Hodgkin's)
Essential Evidence Topics, 24-Dec-2021
Overall Bottom Line: Non-Hodgkin's lymphomas (NHLs) are grouped as either aggressive lymphoma or as indolent lymphoma; about 85% of NHL occur in B cells. Open biopsy of enlarged lymph nodes is mandatory for diagnosis. Chemotherapy is the main treatmen - Merkel cell carcinoma
Essential Evidence Topics, 28-Jul-2021
Overall Bottom Line: Examine closely any asymptomatic flesh-colored, pink, red, or blue lesion that a patient states is changing in size, shape, symptoms (itching, tenderness) and is growing rapidly on sun-exposed skin. Perform a full-thickness excision - Mesothelioma
Essential Evidence Topics, 3-Dec-2021
Overall Bottom Line: Consider mesothelioma in patients with a history of asbestos exposure and typical symptoms (shortness of breath, chest pain, dullness to percussion). Thoracoscopy with pleural biopsy is recommended for diagnosis. Data showing benef - Multiple endocrine neoplasia (MEN) type 1
Essential Evidence Topics, 2-Aug-2021
Overall Bottom Line: Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant disorder with high penetrance characterized by parathyroid hyperplasia/adenomas, enteropancreatic neuroendocrine tumors, and pituitary adenomas. Primary hyperpara
Essential Evidence is a powerful, one-stop, state-of-the-art reference that includes best-evidence answers to your most important clinical questions concerning symptoms, diseases, and treatment. Its concise, highly structured content is tightly integrated and hyperlinked to thousands of calculators, articles, and evidence summaries within Essential Evidence Plus to make searching for answers quick and seamless. Each topic has a “strength of evidence” rating for every recommendation, a “Bottom-line” summary that introduces each section, and a broad array of helpful algorithms.
