- Hepatic cirrhosis and chronic liver disease
Essential Evidence Topics, 17-Dec-2021
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 (alcohol-induced)
Essential Evidence Topics, 26-Oct-2021
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, 26-Aug-2021
Overall Bottom Line: Hepatitis A vaccination is recommended for all children age 12 to 23 months and in adults with risk factors (see Table 1). Hepatitis A infection most commonly presents with jaundice, dark urine, pale stools, abdominal pain, fatigu - Hepatitis B
Essential Evidence Topics, 20-Feb-2022
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 - Hepatitis C
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Recommend one-time screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years. All pregnant persons should be screened for HCV during each pregnancy. Offer periodic HCV screening to all persons with persistent ris - Hepatocellular cancer
Essential Evidence Topics, 20-Jun-2022
Overall Bottom Line: Screen all cirrhotic patients for hepatocellular carcinoma (HCC) with a semiannual liver ultrasound. A good quality observational study in patients with hepatitis B or C found significantly lower rates of hepatocellular carcinoma (N - Hepatorenal syndrome
Essential Evidence Topics, 18-Jun-2021
Overall Bottom Line: The diagnosis of hepatorenal syndrome in a patient with acute or chronic liver disease is based on elevated creatinine levels or reduced creatinine clearance after excluding other forms of underlying intrinsic kidney disease. Patien - Hereditary spherocytosis
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Although most patients with mild disease are asymptomatic, those with severe disease have significant anemia, jaundice, splenomegaly, and an increased risk of pigment gallstones. Hereditary spherocytosis (HS) may be diagnosed on the - Herpangina
Essential Evidence Topics, 9-Jul-2021
Overall Bottom Line: Patients typically present with 1- to 4-mm papulovesicular lesions with an erythematous base in the oropharynx. Symptomatic treatment with oral and topical analgesic medications is recommended. Fever usually resolves within 4 days - Herpes simplex (oral)
Essential Evidence Topics, 8-Mar-2022
Overall Bottom Line: Consider the diagnosis of oral herpes simplex in patients presenting with recurrent, painful vesiculopustules, erosions, ulcers, and crust of the lips and oral cavity. Oral herpes simplex is a clinical diagnosis but in cases of unce - Herpes simplex virus
Essential Evidence Topics, 8-Jul-2021
Overall Bottom Line: Herpes simplex virus (HSV) cell culture is the preferred diagnostic test for patients who present with recent-onset genital vesicles or ulcers. Serologic testing can provide guidance for patients who have a history consistent with her - Herpes zoster (shingles)
Essential Evidence Topics, 10-Dec-2021
Overall Bottom Line: Typically herpes zoster is characterized by unilateral dermatomal pain and rash. Initiating treatment within 72 hours with appropriate antivirals will significantly decrease the incidence of acute pain but does not decrease the freq - 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 - Hidradenitis suppurativa
Essential Evidence Topics, 8-Jul-2022
Overall Bottom Line: Suspect hidradenitis suppurativa (HS) in patients with tender nodular skin lesions in regions of skin folds especially with a history of recurrent symptoms, family history of HS, smoking, or female. Topical clindamycin improves heal - Hip pain
Essential Evidence Topics, 7-Sep-2021
Overall Bottom Line: Order imaging in adults with acute trauma, those with suspicion of malignancy (eg, age, history of cancer, weight loss), and patients with persistent symptoms after conservative treatment. MRI is the preferred study if clinical susp - Hirschsprung’s disease
Essential Evidence Topics, 25-Nov-2021
Overall Bottom Line: Rectal biopsy provides the definitive diagnosis of Hirschsprung’s disease. If less than 3 years old, get suction rectal biopsy. If greater than 3 years old, get barium enema and/or anorectal manometry. Surgery is required to remov - Hirsutism
Essential Evidence Topics, 24-Jun-2019
Overall Bottom Line: Hirsutism is excessive male pattern hair growth in females. Most often it is due to polycystic ovarian syndrome (PCOS) but may be idiopathic. Serum androgen assays (beginning with plasma free testosterone) are the mainstay of diagno - 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 - HIV infection and AIDS
Essential Evidence Topics, 20-Jun-2022
Overall Bottom Line: The United States Preventative Task Force (USPTF) recommends screening everyone with risk factors for contracting Human Immunodeficiency Virus (HIV) and anyone requesting HIV testing annually, and all adults and adolescents age 15 to - 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
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