Showing 321-340 of 803 for: Essential Evidence Topics Back
- Hearing loss in adults (diagnostic approach)
Essential Evidence Topics, 30-Mar-2021
Overall Bottom Line: The United States Preventive Services Task Force (USPSTF) found insufficient evidence to assess the balance of benefits and harms of screening for hearing loss in asymptomatic adults aged 50 years or older. In any patient with a comp
- Heart failure with preserved ejection fraction (diastolic heart failure)
Essential Evidence Topics, 27-Apr-2021
Overall Bottom Line: Patients with diastolic heart failure (also called heart failure with preserved ejection fraction or HFpEF) have typical signs and symptoms of heart failure (exertional dyspnea, fatigue, pulmonary or peripheral fluid accumulation) but
- Heart failure with reduced ejection fraction (systolic heart failure)
Essential Evidence Topics, 27-Apr-2021
Overall Bottom Line: Heart failure is a syndrome resulting from a variety of cardiac pathologies, but typified by elevated cardiac filling pressures and/or a reduction in cardiac output. The absence of classical signs and a normal chest X-ray do not exc
- Heart murmurs (child)
Essential Evidence Topics, 21-Nov-2020
Overall Bottom Line: Screen for heart murmurs in childhood and as a part of the preparticipation examination for young athletes. Heart murmurs in childhood are common, and the great majority are benign. Most, but not all, congenital heart defects caus
- Heatstroke and hyperthermia
Essential Evidence Topics, 10-Jul-2019
Overall Bottom Line: Initiate cooling immediately in any patient suspected of heatstroke. Rapid recognition and treatment of heat stroke is essential to controlling morbidity and mortality. Consider other causes of pyrexia and mental status change in he
- HELLP syndrome
Essential Evidence Topics, 18-Aug-2020
Overall Bottom Line: In any pregnant woman >20 weeks gestation with hypertension, obtain hemoglobin, hematocrit, platelets, AST, ALT, LDH, creatinine, 24-hour urine for protein and uric acid, as well as a complete fetal ultrasound and NST to evaluate f
- Hemangioma and vascular skin tumors
Essential Evidence Topics, 8-Apr-2020
Overall Bottom Line: Infantile hemangiomas (IHs) are common benign vascular tumors of the skin. History and physical examination are sufficient to diagnose 95% of IHs. It is important to differentiate IHs from other vascular anomalies (see ). Most IHs
- Hematuria
Essential Evidence Topics, 1-Mar-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
- Hemochromatosis
Essential Evidence Topics, 15-Mar-2021
Overall Bottom Line: Patients may be asymptomatic or may present with nonspecific symptoms, elevated hepatic transaminases, chronic liver disease, or diabetes. An elevated fasting transferrin saturation of greater than 60% (for men) or greater than 50%
- Hemolytic disease of the fetus and newborn
Essential Evidence Topics, 6-Oct-2020
Overall Bottom Line: Screen all pregnant women by checking blood type, RhD status, and antibody screen at the first prenatal visit. Administer 300 μg of RhD immunoglobulin to all unsensitized RhD-negative women at 24 to 28 weeks’ gestation, after any po
- Hemolytic uremic syndrome
Essential Evidence Topics, 1-Mar-2021
Overall Bottom Line: Suspect hemolytic uremic syndrome (HUS) in patients with hemolysis, thrombocytopenia, and renal failure. If HUS is suspected, evaluate for antecedent infection by Shiga toxin-producing organisms or invasive Streptococcus pneumoniae
- Hemophilia
Essential Evidence Topics, 15-Mar-2021
Overall Bottom Line: Approximately 80% of patients with hemophilia present with hemarthroses. All patients with hemophilia treated with clotting factor concentrate prior to 1985 should be screened for hepatitis B, hepatitis C and HIV infections. Patie
- 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
- Hemorrhagic fevers
Essential Evidence Topics, 28-Apr-2020
Overall Bottom Line: Isolate any traveler with acute febrile illness and hemorrhagic manifestations who is returning from an endemic area and obtain blood for virus isolation and serology. Administer ribavirin to patients with severe hemorrhagic fever u
- Hemorrhoids
Essential Evidence Topics, 27-Jan-2021
Overall Bottom Line: Patients most often will complain of painless rectal bleeding, fecal soilage, and/or itching with defecation. Higher risk patients with rectal bleeding () warrant further evaluation with colonoscopy or flexible sigmoidoscopy combine
- Henoch-Schonlein purpura
Essential Evidence Topics, 14-Nov-2019
Overall Bottom Line: Suspect Henoch-Schonlein purpura (HSP) in children with palpable purpura and abdominal pain, joint pain, proteinuria, or hematuria. Routine testing should include vital signs, CBC, urinalysis, and stool for occult blood; consider ab
- Hepatic cirrhosis and chronic liver disease
Essential Evidence Topics, 9-Nov-2020
Overall Bottom Line: Order liver function tests, hepatitis serology, a CBC with platelets, and a prothrombin time (PT) test if a liver abnormality is suspected. Additional testing may include alpha-1-antitrypsin studies, transferrin saturation and total i
- Hepatitis (alcoholic)
Essential Evidence Topics, 6-Jan-2020
Overall Bottom Line: Alcoholic hepatitis is a clinical diagnosis that is supported by laboratory findings, but there is no pathognomonic examination finding or serologic test for the disease. The AST/ALT ratio is 2 or more times the upper limit of norma
- Hepatitis A
Essential Evidence Topics, 13-Apr-2020
Overall Bottom Line: Hepatitis A infection most commonly presents with jaundice, dark urine, pale stools, abdominal pain, fatigue, fever, nausea, and vomiting with elevated AST/ALT and bilirubin. Positive anti-HAV IgM, in the clinical setting of acute h
- Hepatitis B
Essential Evidence Topics, 1-Mar-2021
Overall Bottom Line: Screen all pregnant women for hepatitis B during their first prenatal visit, and screen persons at high risk for HBV infection, including those born in a high-prevalence country, HIV-positive persons, injection drug users, household
