Showing 181-200 of 807 for: Essential Evidence Topics Back
- Cutaneous drug reaction
Essential Evidence Topics, 7-Jul-2021
Overall Bottom Line: Avoid unnecessary use of medications that may cause cutaneous drug eruptions, especially antibiotics. Make the diagnosis based on history and physical examination. Avoid repeat exposures for patients with Type 1 reactions or Steve
- Cutaneous larva migrans
Essential Evidence Topics, 21-Jul-2021
Overall Bottom Line: Obtain travel history pertaining to exposure to potentially contaminated soil or sand, particularly in warmer climates. Patients typically present with pruritic, reddish brown, serpiginous lesions, which advance several millimeters
- Cutaneous T-cell lymphomas: mycosis fungoides and Sézary syndrome
Essential Evidence Topics, 24-Jun-2022
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, 7-Apr-2022
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, 4-Oct-2021
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. Standar
- 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
- Decubitus ulcer and pressure sores
Essential Evidence Topics, 29-Jun-2021
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, 25-Apr-2022
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-Jul-2021
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, 27-Dec-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, 31-Mar-2022
Overall Bottom Line: The diagnostic evaluation for suspected dementia should include a validated brief cognitive test, laboratory tests focused on reversible causes, functional screening, and ideally an informant questionnaire. Brief cognitive tests for
- Dementia (Lewy body dementia)
Essential Evidence Topics, 28-Jul-2021
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, 10-Jul-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, 19-Jul-2022
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, 29-Dec-2021
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, 27-Jun-2022
Background: OVERALL BOTTOM LINE There is no significant difference in performance of screening instruments, so choose a tool most practical for the clinical setting. The best diagnostic tool is a detailed history performed by the practitioner in the con
- Dermatitis herpetiformis
Essential Evidence Topics, 8-Sep-2021
Overall Bottom Line: Suspect dermatitis herpetiformis (DH) in patients presenting with pruritic grouped papulovesicles distributed symmetrically in classical extensor areas, buttocks, back, or scalp. After an initial lesional biopsy demonstrating histop
