Showing 1-20 of 809 for: Essential Evidence Topics Back
- Abdominal mass
Essential Evidence Topics, 30-Jul-2021
Overall Bottom Line: Perform a thorough history and physical examination to determine the location, physical findings and symptoms associated with the mass. For some masses (e.g., umbilical hernia and bladder distension), examination findings may be defin
- Abdominal pain (adult)
Essential Evidence Topics, 22-Nov-2020
Overall Bottom Line: Use clues from the history and physical examination to establish a presumptive diagnosis on which to base diagnostic testing. History and physical examination alone are often adequate to begin initial treatment for gastroesophageal
- Abdominal pain (pediatric)
Essential Evidence Topics, 13-Oct-2022
Overall Bottom Line: Differentiate abdominal from extra-abdominal etiology ( and ). When there is uncertainty regarding the pain's origin, ultrasound is the first step in evaluation. Early administration of pain medications provides relief to the pati
- Abnormal gait in children
Essential Evidence Topics, 26-Nov-2021
Overall Bottom Line:
- Abnormal liver function test evaluation
Essential Evidence Topics, 4-Oct-2021
Overall Bottom Line: Do not order serum liver chemistries to screen asymptomatic patients. Based on the American College of Gastroenterology guideline (2017), one should repeat the lab panel and/or perform a clarifying test (e.g., gamma-glutamyl transpe
- Abnormal uterine bleeding
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: For patients of reproductive age with irregular menses, order/perform a pregnancy test, thyroid-stimulating hormone (TSH) and serum prolactin levels, and an endometrial biopsy in those older than 45 years. Consider endometrial biops
- Abruptio placentae
Essential Evidence Topics, 21-Jan-2022
Overall Bottom Line: Vaginal bleeding (70%), abdominal pain (51%), blood-tinged amniotic fluid (50%), and fetal heart rate abnormalities (69%) are the most common manifestations. Definitive management should never be delayed for ultrasound evaluation be
- Acetaminophen toxicity
Essential Evidence Topics, 28-Sep-2022
Overall Bottom Line: Address basic life support first, and then obtain an accurate history of quantity, timing, type of ingestion and concomitant ingestions. If within 4 hours of ingestion give activated charcoal. Obtain a stat acetaminophen level and
- Achilles tendinitis
Essential Evidence Topics, 9-Jul-2021
Overall Bottom Line: Acute Achilles pain (symptoms less than 6 weeks in duration) is best treated with ice, stretching, and activity and footwear modification. Chronic Achilles tendinosis (more than 6 weeks in duration) should be treated with an eccentr
- Achilles tendon rupture
Essential Evidence Topics, 16-Feb-2021
Overall Bottom Line: A positive Thompson (calf squeeze) test is highly suggestive of achilles tendon rupture in the patient who presents with the acute onset of posterior heel pain and an appropriate mechanism of injury. Operative versus nonoperative ma
- Acne rosacea
Essential Evidence Topics, 3-Feb-2023
Overall Bottom Line: Consider a diagnosis of rosacea in adults over 30 years of age with fixed centrofacial erythema with periods of intensification or with phymatous changes. Diagnosis can also be made by the presence of two or more major features, which
- Acne vulgaris
Essential Evidence Topics, 4-Jan-2023
Overall Bottom Line: Classify acne as comedonal (primarily obstructive) or inflammatory (papules, pustules, nodules, and cysts). Topical retinoids are especially useful in preventing comedones and new acne lesions. For mild to moderate inflammatory ac
- Acoustic neuroma (vestibular schwannoma)
Essential Evidence Topics, 30-Mar-2022
Overall Bottom Line: Vestibular schwannoma (acoustic neuroma) is an important consideration in a patient presenting with asymmetric sensorineural hearing loss. Use auditory brainstem response (ABR) audiometry for the initial evaluation; however, if the
- Acromegaly
Essential Evidence Topics, 27-Jul-2021
Overall Bottom Line: Acromegaly carries significant risk of morbidity/mortality and a high index of suspicion should be maintained when considering biochemical screening. Serum IGF-1 level is the best initial biochemical test. If elevated (for age/sex),
- Actinic keratosis
Essential Evidence Topics, 20-Jul-2022
Overall Bottom Line: Suspect actinic keratosis (AK) in patients with rough, scaly patches of skin in sun-exposed areas. Consider biopsy when lesions are ulcerated, bleeding, or persistent despite adequate treatment, or if there are concerns for overt cuta
- Acute bronchitis
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: Acute bronchitis is an acute lower respiratory tract infection where community-acquired pneumonia has been excluded clinically or based on chest radiograph. Antibiotic treatment only minimally decrease the duration of symptoms and a
- Acute gastroenteritis and dehydration (child)
Essential Evidence Topics, 29-Jul-2022
Overall Bottom Line: Clinical history and physical examination should be the basis for diagnosing acute gastroenteritis and the degree of dehydration. Laboratory tests are not recommended for routine cases. Combinations of findings are most effective in
- Acute kidney injury
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: Adequate hydration, maintenance of adequate circulating volume (mean arterial pressure), and avoidance of nephrotoxins are the cornerstones of prevention. Specific prevention efforts are controversial. Best evidence for preventing c
- Acute respiratory distress syndrome (ARDS)
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: Brain natriuretic peptide (BNP) is helpful in differentiating acute respiratory distress syndrome (ARDS) from cardiogenic pulmonary edema. In patients with indeterminate levels of BNP, echocardiogram or pulmonary artery catheterizat
- Adrenal insufficiency
Essential Evidence Topics, 13-Oct-2022
Overall Bottom Line: Suspect primary adrenal insufficiency (AI) in a patient with fatigue, hypotension, and hyperpigmentation accompanied by hyponatremia and hyperkalemia. Also suspect primary adrenal insufficiency in any critically ill patient. Seconda
