- Coronavirus SARS-CoV1 infection (SARS)
Essential Evidence Topics, 30-Mar-2022
Overall Bottom Line: The most common presenting symptoms of the SARS-CoV1 in 2003 were fever, chills, myalgia, malaise, and cough. Test patients for SARS-CoV1 using PCR only if no other cause of pneumonia can be found 72 hours after starting a workup and - Cough (subacute and chronic)
Essential Evidence Topics, 25-Oct-2021
Overall Bottom Line: Ninety percent of patients with chronic cough have gastroesophageal reflux disease (GERD), postnasal drip (PND) syndrome, and/or asthma; nearly two-thirds of patients will have more than one of these contributing to their cough. Pat - Croup
Essential Evidence Topics, 10-May-2019
Overall Bottom Line: Clinical symptoms include seal-like barky cough, inspiratory stridor, and hoarseness. Give oral dexamethasone (dose 0.15-0.6 mg/kg) to any patient who presents with croup symptoms. Nebulized epinephrine can be given to patients wi - Cystic fibrosis
Essential Evidence Topics, 27-Dec-2021
Overall Bottom Line: Screen newborns for cystic fibrosis (CF) using an IRT-based protocol. The sweat chloride test is the gold standard to confirm the diagnosis, in conjunction with DNA testing (see ). Initiate pancreatic enzyme replacement in patient - Cytomegalovirus infection (adult and child)
Essential Evidence Topics, 27-Feb-2022
Overall Bottom Line: Order a strep test, monospot, and CBC in febrile patients with pharyngitis, adenopathy, and fatigue. Cytomegalovirus (CMV) may be asymptomatic or cause a mononucleosis-like syndrome in immunocompetent hosts. Most CMV infections in - Diphtheria
Essential Evidence Topics, 12-Jun-2019
Overall Bottom Line: Suspect diphtheria in patients with severe sore throat, difficulty swallowing, low-grade fever, and a grayish adherent membrane on the nasopharynx. If diphtheria is clinically suspected, take swabs of the nasopharynx and culture on - Drowning and near-drowning
Essential Evidence Topics, 22-Aug-2019
Overall Bottom Line: Order a CBC electrolytes, glucose, coagulation studies, CPK, urinalysis, and urine drug screen. Provide active cardiopulmonary resuscitation in the order airway-breathing-circulation, remembering that special circumstances may be pr - Epiglottitis
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Suspect epiglottitis in any child or adult with abrupt onset of rapidly progressive sore throat, fever, dysphagia, and muffled voice. Diagnosis depends on clinical suspicion, confirmed by direct visualization of the epiglottis. Ai - Epistaxis and nosebleeds
Essential Evidence Topics, 13-Apr-2021
Overall Bottom Line: Simple measures are helpful in stopping most nosebleeds: nose blowing to clear clots, pinching the nose for 5-15 minutes and topical decongestants. Cauterizing visible bleeding vessels with AgNO3 or electrocautery are equally effec - 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 - Hiccups
Essential Evidence Topics, 31-Jul-2021
Overall Bottom Line: Most hiccups are of the benign self-limiting type lasting less than 24 hours, and these require no investigation. The initial treatment of hiccups involves respiratory maneuvers. Patients with chronic or intractable hiccups should - Histoplasmosis
Essential Evidence Topics, 15-Jul-2021
Overall Bottom Line: Infection with histoplasmosis is exceedingly rare outside of endemic areas. Typical symptoms are nonspecific and include fever, productive cough, malaise. Diagnosis can be accomplished by the use of urinary antigen testing, serolo - Hoarseness
Essential Evidence Topics, 22-Nov-2021
Overall Bottom Line: Hoarseness is a symptom; a careful and thorough history is necessary to diagnose the possible underlying causes. Improvement after empiric treatment of gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with tw - Hypersensitivity pneumonitis (including bronchiolitis obliterans)
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: Suspect hypersensitivity pneumonitis in patients with pulmonary symptoms associated with recent exposure to a possible antigen (ie, birds, mold). Initial evaluation should include CXR, pulmonary function tests (PFTs), and antibodies - Hyperventilation
Essential Evidence Topics, 2-Aug-2021
Overall Bottom Line: Suspect hyperventilation in patients presenting with rapid breathing, dyspnea, chest pain, paresthesias, and repeated sighing. ABG, CXR, and blood glucose are recommended initial tests; rule out intrinsic lung disease, heart disease - Idiopathic pulmonary fibrosis
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: The diagnosis of idiopathic pulmonary fibrosis (IPF) can be made based on clinical symptoms, pulmonary function tests (PFTs) or CXR consistent with restrictive lung disease, exclusion of other interstitial lung disease (ILD) and typic - Infectious mononucleosis
Essential Evidence Topics, 16-Sep-2021
Overall Bottom Line: Obtain a white blood cell count with differential in patients between ages 10 and 30 years with sore throat, fever, and at least one of the following: significant anterior cervical adenopathy, fatigue, posterior cervical adenopathy, i - Influenza
Essential Evidence Topics, 19-Apr-2021
Overall Bottom Line: Yearly influenza vaccination is recommended by ACIP (US) for persons over the age of 6 months. Patients classically present with rapid onset of fever, cough, chills or rigors, sore throat, and myalgias. A clinical decision rule can - 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 - Laryngitis
Essential Evidence Topics, 19-Mar-2019
Overall Bottom Line: Patients typically present with hoarseness, usually accompanied by other symptoms of viral Upper respiratory tract infection (URI). Symptoms typically resolve without treatment in about a week. Antibiotics are not helpful. Laryngo
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