Showing 541-560 of 803 for: Essential Evidence Topics Back
- Otitis media (acute)
Essential Evidence Topics, 5-Apr-2021
Overall Bottom Line: Three criteria are needed for the diagnosis of acute otitis media (AOM). They include: (1) acute onset of fever or ear pain, (2) middle ear fluid as demonstrated by exam or diagnostic testing, and (3) signs of middle ear inflammation
- Otitis media (chronic serous)
Essential Evidence Topics, 16-Feb-2021
Overall Bottom Line: Chronic serous otitis media (CSOM) is diagnosed via pneumatic otoscopy. The main goal of diagnosis and treatment is to identify children at risk for language delay, learning problems, or significant hearing loss. Drug therapy is n
- Otosclerosis
Essential Evidence Topics, 10-Dec-2019
Overall Bottom Line: Suspect otosclerosis in a patient between the ages of 15 years and 45 years who presents with gradual onset of hearing loss. Family history is usually positive. Audiologic evaluation is necessary to determine the extent and type of
- Ovarian cyst
Essential Evidence Topics, 6-Oct-2020
Overall Bottom Line: Ultrasound with cyst morphology and Doppler flow studies are helpful to distinguish benign cysts from ovarian malignancies. Oral contraceptives are not helpful for the treatment of ovarian cysts. They can prevent functional cysts in
- Ovarian teratoma
Essential Evidence Topics, 26-Apr-2021
Overall Bottom Line: Transvaginal ultrasound is the recommended initial imaging study for evaluation of ovarian masses. Most imaged teratomas have the classic dermoid cyst appearance whether they are benign or malignant. Surgical removal is first-line tr
- Ovarian tumor (benign)
Essential Evidence Topics, 23-Jun-2020
Overall Bottom Line: Any palpable adnexal mass in a postmenopausal female must be evaluated for malignancy. The initial study is transvaginal ultrasound; obtain CA-125 with masses larger than 5 cm or if changes occur in size or character at follow-up.
- Ovarian tumor (malignant)
Essential Evidence Topics, 9-Nov-2020
Overall Bottom Line: Women with a family history of BRCA gene mutations and a positive screening should be referred for genetic counselling. They should be counselled on the risks, benefits, and limitations of genetic screening. Routine screening is not
- Paget disease of the breast
Essential Evidence Topics, 2-Nov-2020
Overall Bottom Line: Suspect Paget disease of the breast (PDB) in patients presenting with erythema, ulceration, crusting, or scaling of the nipple. Perform full-thickness nipple biopsy, mammography, and breast ultrasonography if PDB is suspected. Consi
- Paget's disease of bone (osteitis deformans)
Essential Evidence Topics, 11-Jan-2021
Overall Bottom Line: Order plain radiographs at one or more sites to document the diagnosis, as well as a bone scan to document the extent of disease. In patients with radiographic evidence of disease, serum alkaline phosphatase is sufficiently sensitiv
- Pain management (chronic non-malignant)
Essential Evidence Topics, 10-Mar-2021
Overall Bottom Line: There is no test to measure pain. Imaging correlates poorly with symptoms. The patient’s report of pain is your guide. Consider the safest therapies first: acetaminophen, cognitive behavioral therapy, and exercise. Effective optio
- Pancreatic cancer
Essential Evidence Topics, 6-Oct-2020
Overall Bottom Line: Suspect pancreatic cancer in middle-aged or older patients with weight loss or jaundice. Initial imaging is with ultrasound or helical CT; confirm the diagnosis with endosonographic fine needle aspiration biopsy (FNAB). Pancreatic
- Pancreatitis (acute)
Essential Evidence Topics, 20-Feb-2020
Overall Bottom Line: Suspect acute pancreatitis in patients with acute upper abdominal or back pain. Order hepatic transaminases, alkaline phosphatase, serum lipase, and amylase (former is more specific for pancreatitis). Clinical rules have been deve
- Pancreatitis (chronic)
Essential Evidence Topics, 13-Nov-2019
Overall Bottom Line: Chronic pancreatitis is a chronic process of inflammation leading to impairment of pancreatic function. In comparison to acute pancreatitis, chronic pancreatitis is generally progressive and may be asymptomatic for a period of time.
- Panic disorder
Essential Evidence Topics, 25-Jan-2021
Overall Bottom Line: Complete a comprehensive history and focused physical examination; routine laboratory testing or imaging is not recommended unless suggested by history and physical. Use a validated screening instrument and confirm diagnosis using D
- Paraneoplastic syndromes
Essential Evidence Topics, 2-Apr-2019
Bottom Line: Overall Suspect paraneoplastic syndromes in patients with cancer who have fatigue, weakness, myalgias, or electrolyte abnormalities that cannot be explained by their condition or treatment. If you suspect a paraneoplastic syndrome, screen f
- Parkinson disease
Essential Evidence Topics, 30-Nov-2020
Overall Bottom Line: The cardinal physical signs of Parkinson disease (PD) are distal resting tremor, rigidity, bradykinesia, and asymmetric onset. Levodopa (L-dopa) is the primary treatment, but its long-term use is limited by motor complications and d
- Paronychia
Essential Evidence Topics, 16-Jan-2020
Overall Bottom Line: Patients typically present with tenderness, erythema, swelling, and sometimes fluctuance or induration of the proximal or lateral nail folds. Conservative measures such as warm soaks or compresses can be used. Oral antibiotics or
- Parvovirus B19 infection
Essential Evidence Topics, 13-Mar-2019
Overall Bottom Line: Suspect erythema infectiosum in children with prodromal fever, coryza, headache, and nausea followed by erythema of the cheeks. Consider confirmatory testing for immunocompetent pregnant patients with serum IgM enzyme immunoassay,
- Patellofemoral syndrome
Essential Evidence Topics, 9-Sep-2020
Overall Bottom Line: The diagnosis of patellofemoral pain syndrome is clinical and centered around a combination of key historical and physical exam findings. The mainstay of treatment includes education as well as a dedicated physical therapy program.
- Pediculosis (lice)
Essential Evidence Topics, 17-Mar-2020
Overall Bottom Line: Visualization of the live adult lice or nymphs in the hair or on clothing is diagnostic. Pediculicides are generally equivalent, and the choice among formulations () is based on local resistance patterns. Physical treatment method
