- Jaundice
Essential Evidence Topics, 4-Jan-2021
Overall Bottom Line: Extrahepatic obstruction accounts for 40% of adult patients who present with jaundice as the primary symptom and 20% of those with new-onset jaundice. Ultrasound of the abdomen is the most appropriate initial study to evaluate patie - Juvenile idiopathic arthritis
Essential Evidence Topics, 4-Oct-2019
Overall Bottom Line: Children suspected of having juvenile idiopathic arthritis (JIA) should be referred to a subspecialist (pediatric rheumatologist or orthopedist) as early as possible. Children with JIA are at risk for asymptomatic uveitis and should - Kaposi's sarcoma
Essential Evidence Topics, 8-Jul-2021
Overall Bottom Line: Kaposi's sarcoma (KS) is a low-grade multifocal vascular tumor; typical skin lesions are multifocal, asymmetrically distributed, and nonpruritic. For a patient newly diagnosed with KS, exclude underlying human immunodeficiency virus - Kawasaki disease
Essential Evidence Topics, 30-Nov-2020
Overall Bottom Line: No gold standard test exists for diagnosis of Kawasaki disease (KD). Diagnosis must be made based on clinical features and, if there is atypical presentation, include supportive laboratory work and echocardiogram. Treatment for the - Keloid scarring
Essential Evidence Topics, 5-Aug-2019
Overall Bottom Line: Identify at-risk patients by obtaining personal and family history of keloid formation. Also consider age, race and anantomic area. At risk patient should be treated with silicone sheet or intralesional steroid injections. Recurre - Klinefelter syndrome
Essential Evidence Topics, 5-Jun-2019
Overall Bottom Line: The range of presentation is highly variable, and many patients present as adults with infertility. Klinefelter syndrome is underdiagnosed, and clinicians should be mindful of the syndrome when examining well children and adults. Th - Knee injection (procedure)
Essential Evidence Topics, 6-Jan-2021
Indications for Procedure: Anesthetic/Corticosteroid Combination Injecting an anesthetic/corticosteroid solution may provide prompt, focal pain relief from noninflammatory, inflammatory, and crystal arthritides. Candidates for injection include patients w - Knee injury (ligamentous)
Essential Evidence Topics, 27-Aug-2021
Overall Bottom Line: McMurray maneuver and joint line testing can be helpful in detecting meniscal injuries. Patients with meniscal injuries should be given a trial of nonsurgical treatment, because no randomized trials have compared surgical versus non - Knee pain (diagnostic evaluation)
Essential Evidence Topics, 23-Jul-2020
Overall Bottom Line: Aspirate a swollen knee that is warm or erythematous and send the fluid for cell count, crystals, and culture. Initial imaging for patients not responding to conservative therapy should include at a minimum AP and lateral radiograph - Laceration repair (procedure)
Essential Evidence Topics, 9-Feb-2020
Indications for Procedure: Primary closure of clean, well vascularized, full-thickness skin wound (e.g. head, face) to be performed less than 24 hours after injury. Primary closure of clean full thickness laceration to body and extremeties to be performed - Lactose intolerance
Essential Evidence Topics, 15-Mar-2021
Overall Bottom Line: Suspect lactose intolerance (LI) if symptoms of abdominal pain, diarrhea, bloating, and/or flatulence occur after the ingestion of lactose or lactose-containing products. The diagnosis of LI can be confirmed by hydrogen breath analy - Laryngeal cancer
Essential Evidence Topics, 27-Jul-2021
Overall Bottom Line: Patients who have hoarseness, vocal changes, or difficulty swallowing for more than 2 weeks should be evaluated for laryngeal cancer. The preferred initial test is laryngoscopy. Surgery and radiation therapy remain the first choic - Laryngitis
Essential Evidence Topics, 19-Mar-2019
Overall Bottom Line: Patients typically present with hoarseness, usually accompanied by other symptoms of viral Upper respiratory tract infection (URI). Symptoms typically resolve without treatment in about a week. Antibiotics are not helpful. Laryngo - Lead poisoning
Essential Evidence Topics, 17-Jul-2019
Overall Bottom Line: Take a thorough environmental history to assess risk. Pay special attention to the condition of current housing and to occupational exposures. Follow state and local regulations (which vary) regarding screening in children. Venous b - Leg cramps
Essential Evidence Topics, 19-Jan-2021
Overall Bottom Line: The patient's medications should be reviewed carefully because they are a common cause of leg cramps. Quinine is effective in treating leg cramps, but severe adverse reactions have been reported and most preparations have been banne - Legg-Calve-Perthes disease
Essential Evidence Topics, 5-Jul-2021
Overall Bottom Line: Consider Legg-Calve-Perthes disease (LCPD) in a child that presents with a limp, hip pain, referred pain to the knee, limited range of motion in hip abduction and internal rotation, or antalgic gait. Obtain plain anteroposterior (AP) - Leishmaniasis
Essential Evidence Topics, 8-Jul-2021
Overall Bottom Line: Suspect cutaneous (CL), mucocutaneous (MCL) or mucosal (ML) leishmaniasis in patients with a history of a painless, non-healing skin, nasal, or oral lesion after exposure in an endemic region. Diagnosis is made by sampling affected ti - Leptospirosis
Essential Evidence Topics, 11-Jun-2020
Overall Bottom Line: Leptospirosis is an acute febrile illness that can progress rapidly with severe sequelae. Since leptospirosis is an emerging zoonotic disease widespread in animals, a high index of suspicion is needed in patients with a history sugg - Leukemia (acute lymphoblastic)
Essential Evidence Topics, 30-Jun-2021
Overall Bottom Line: Suspect acute lymphoblastic leukemia (ALL) in patients with symptoms and signs related to cytopenias. Initial diagnostic testing should include CBC, chemistries, coagulation studies, and bone marrow with cytochemistry and immunophen - Leukemia (acute myelogenous)
Essential Evidence Topics, 22-Mar-2021
Overall Bottom Line: Acute myelogenous leukemia (AML) is the most common form of acute leukemia in adults. Patients present with insidious symptoms related to variable degrees of bone marrow failure. The diagnosis of AML is demonstrated by increased num
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