Showing 181-200 of 803 for: Essential Evidence Topics Back
- Cutaneous T-cell lymphomas: mycosis fungoides and Sézary syndrome
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Suspect cutaneous T-cell lymphoma (CTCL) in patients with persistent skin rash in the form of patches, plaques, or erythroderma, which may be localized or widespread. Patients frequently have been previously (incorrectly) diagnosed wi
- Cyanide poisoning
Essential Evidence Topics, 1-Mar-2021
Background: Cyanide can cause rapidly fatal poisoning following exposure by the oral, inhalation, and dermal routes. Only acute cyanide poisoning is considered in this chapter.
- Cyclospora
Essential Evidence Topics, 20-Apr-2020
Overall Bottom Line: Cyclospora cayetanensis is an uncommon cause of infectious diarrhea that should be considered in those with diarrhea during known outbreaks, who travel to endemic areas, or who are immunosuppressed with persistent diarrhea. Standard
- Cystic fibrosis
Essential Evidence Topics, 23-Jun-2020
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, 25-Nov-2020
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
- Decubitus ulcer and pressure sores
Essential Evidence Topics, 8-Jul-2019
Overall Bottom Line: Prevent pressure ulcers by recognizing high risk patients and situations. Avoid further damage from disinfectants such as alcohol, peroxide and iodine. Provide a moist environment to promote healing. Nutritional supplementation
- Deep vein thrombosis
Essential Evidence Topics, 27-Apr-2021
Overall Bottom Line: Use a validated clinical rule like the Wells score for an estimation of the pretest probability of deep vein thrombosis (DVT) to assist with the diagnostic process. Compression ultrasonography is the best initial imaging test for de
- Dehydration (adult)
Essential Evidence Topics, 23-Aug-2019
Overall Bottom Line: The recommended daily intake of fluids should not be less than 1600 mL/24 h in order to ensure adequate hydration in older adults. A fluid intake sheet and urine specific gravity might be the best methods of monitoring daily fluid.
- Delayed gastric emptying
Essential Evidence Topics, 25-Mar-2021
Overall Bottom Line: Suspect delayed gastric emptying when patients present with nausea, vomiting, early satiety, and abdominal pain (especially in the setting of diabetes, scleroderma, and neurologic disorders). After a mechanical obstruction is ruled
- Delirium and acute confusional states
Essential Evidence Topics, 6-Apr-2020
Overall Bottom Line: Delirium occurs in at-risk individuals with environmental stressors as precipitants. The risk of developing delirium can be predicted using a clinical decision rule. One-third of delirium cases can be prevented by reducing risk fa
- Dementia (Alzheimer’s disease)
Essential Evidence Topics, 12-Jan-2021
Overall Bottom Line: A combination of appropriate history from a reliable informant and cognitive testing is most valuable for determining the need to work up the patient for Alzheimer’s disease (AD). Consider neuroimaging with MRI, CT, or PET scan. Vit
- Dementia (diagnosis)
Essential Evidence Topics, 20-Jan-2021
Overall Bottom Line: The diagnosis rests on clinical criteria but evaluation should include a validated brief cognitive test and laboratory tests focused on treatable causes. Brief cognitive tests for dementia appropriate for office practice include the
- Dementia (Lewy body dementia)
Essential Evidence Topics, 4-Nov-2020
Overall Bottom Line: Dementia with Lewy bodies should be suspected in patients presenting with dementia accompanied by hallucinations, fluctuating cognition, and parkinsonism. Cholinesterase inhibitors are first-line therapy. Avoid typical neuroleptic
- Dementia (multi-infarct)
Essential Evidence Topics, 5-Feb-2021
Overall Bottom Line: In patients suspected of having dementia with vascular risk factors or atherosclerotic disease, neuroimaging showing evidence of brain infarction is highly suggestive of multi-infarct dementia (MID). Cholinesterase inhibitors offer
- Demyelinating diseases of CNS (PML)
Essential Evidence Topics, 11-Jan-2021
Overall Bottom Line: Suspect progressive multifocal leukoencephalopathy (PML) in immunocompromised patients with gait disorder, limb weakness, visual symptoms, altered mental status, or other neurologic symptoms. If clinically suspected, the diagnosis
- Dengue fever
Essential Evidence Topics, 18-Aug-2020
Overall Bottom Line: DF is characterized by acute febrile illness of 2 to 7 days associated with headache, myalgias, rash, and capillary fragility. Dengue fever (DF) is self-limited, while dengue hemorrhagic fever (DHF) is distinguished by hemorrhagic m
- Depression
Essential Evidence Topics, 4-May-2021
Background: OVERALL BOTTOM LINE No significant difference in performance of screening instruments, so choose a tool most practical for the clinical setting. Best diagnostic tool is a detailed history performed by the practitioner in context of Diagnosti
- Dermatitis herpetiformis
Essential Evidence Topics, 31-Oct-2019
Overall Bottom Line: Suspect dermatitis herpetiformis (DH) clinically if the patient presents with pruritic grouped papulovesicular lesions distributed symmetrically in classical extensor areas or buttocks. Establish a definitive diagnosis of DH by biop
- Dermatomyositis and polymyositis
Essential Evidence Topics, 3-Jul-2020
Overall Bottom Line: DM and PM are autoimmune inflammatory myopathies associated with symmetric proximal muscle weakness, and can be associated with cutaneous findings (specifically DM), elevated muscle enzymes, findings of myopathy on EMG, and inflammati
- Developmental and intellectual delay (pediatric)
Essential Evidence Topics, 22-Oct-2020
Overall Bottom Line: Adhere to standard recommendations regarding prenatal and perinatal screening and prenatal, perinatal, and postnatal prevention of mental retardation. The diagnostic yield of clinical assessment ranges from 17.2% to 34.2%. For patie
