Showing 41-60 of 74 for: Essential Evidence Topics > Respiratory 
- Lung cancer
Essential Evidence Topics, 10-Aug-2022
Overall Bottom Line: USPSTF recommends screening with low dose CT for high risk smokers (age 50-80 years, 20 pack years, and still smoking or quit within 15 years). It is most cost-effective for current smokers in their 60's with 35 pack years. Although
- Mediastinal enlargement
Essential Evidence Topics, 27-Apr-2021
Overall Bottom Line: Mediastinal enlargement is defined as a total width of more than 8 cm at the level of the aortic arch or a mediastinal to chest width ratio of more than 0.25. The most common mediastinal mass is lymphoma. Rare but important causes
- Mesothelioma
Essential Evidence Topics, 1-Nov-2022
Overall Bottom Line: Consider mesothelioma in patients with a history of asbestos exposure and typical symptoms (shortness of breath, chest pain, dullness to percussion). Thoracoscopy with pleural biopsy is recommended for diagnosis. Patients should be
- Neck mass
Essential Evidence Topics, 17-Jul-2022
Overall Bottom Line: A neck mass in an adult should be considered cancer until ruled out. Initial evaluation of a neck mass begins with the determination of whether it is congenital, infectious/inflammatory, or possibly neoplastic ( and ). If neoplasm
- Opioid overdose and intoxication
Essential Evidence Topics, 8-Nov-2022
Overall Bottom Line: Classic toxidrome of opiod overdose respiratory depression, stupor and miosis, but it is not always consistently present. Hypoventilation is invariably present in opioid overdose. Miosis is helpful in diagnosis, but may be absent be
- Peritonsillar abscess
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: Peritonsillar abscess is a suppurative complication of acute tonsillitis usually seen in children through young adults. Typical presentation consists of severe throat pain, trismus, and tender submandibular lymphadenopathy. Diagnosi
- Pertussis (whooping cough)
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: A 5-dose series of acellular pertussis vaccine is recommended for children , and the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) booster is recommended once for adolescents at ages 11 to 12 years, and fo
- Pharyngitis
Essential Evidence Topics, 20-Mar-2022
Overall Bottom Line: Combinations of symptoms in a clinical decision rule are useful to guide testing and antibiotic use in patients with pharyngitis. A rapid detection antigen test (RADT) can be used to rule out strep throat in patients with intermedia
- Pleural effusion
Essential Evidence Topics, 21-Jan-2022
Overall Bottom Line: Patients with a parapneumonic effusion greater than 1 cm on lateral decubitus chest x-ray should have a thoracentesis performed for diagnostic (and therapeutic) purposes. Customarily, an effusion is exudative if: (1) the ratio of pr
- Pleuritic chest pain and pleurisy
Essential Evidence Topics, 27-Aug-2021
Overall Bottom Line: Low risk young patients generally do not need an extensive evaluation if pleuritic pain is an isolated symptom. After a careful history and physical, use validated decision rules to evaluate for risk of pulmonary embolism and cardio
- Pneumocystis jiroveci pneumonia
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: A definitive diagnosis of Pneumocystis pneumonia (PCP) requires identification of Pneumocystis jiroveci in an induced sputum or bronchioalveolar lavage (BAL) specimen. CXR is the preferred initial imaging study; order high-resoluti
- Pneumonia (aspiration)
Essential Evidence Topics, 11-Jun-2020
Overall Bottom Line: Aspiration pneumonia is a clinical diagnosis made when a patient at risk for aspiration presents with signs and symptoms consistent with pneumonia. Treat suspected aspiration pneumonia as an outpatient with amoxicillin-clavulanate o
- Pneumonia (chlamydia)
Essential Evidence Topics, 20-Feb-2023
Overall Bottom Line: No single clinical or radiographic finding or constellation of findings accurately differentiates community-acquired pneumonia (CAP) caused by Chlamydophila pneumoniae (formerly Chlamydia pneumoniae ) from any other cause. No accur
- Pneumonia (community acquired)
Essential Evidence Topics, 22-Feb-2023
Overall Bottom Line: Consider pneumonia in patients with cough, dyspnea, or sputum production, especially if accompanied by fever, altered breath sounds, or rales. Perform a CXR to confirm the diagnosis. Determine prognosis using a validated clinical pr
- Pneumonia (eosinophilic)
Essential Evidence Topics, 20-Feb-2023
Overall Bottom Line: Evaluate for secondary causes of eosinophilic pneumonia (EP) once an initial diagnosis is made. Idiopathic acute eosinophilic pneumonia (IAEP) presents as acute lung injury or acute respiratory distress syndrome (ARDS); peripheral e
- Pneumonia (Legionnaires')
Essential Evidence Topics, 28-Sep-2021
Overall Bottom Line: Consider Legionnaires' disease (LD) in patients with community-acquired pneumonia (CAP); urine antigen assay is the recommended diagnostic test. Fluoroquinolones are the drug of choice; macrolides and tetracyclines are alternative
- Pneumonia (mycoplasma)
Essential Evidence Topics, 7-Jan-2022
Overall Bottom Line: Mycoplasma pneumoniae and other atypical organisms account for approximately 15% of community-acquired pneumonias (CAPs). A prediction rule based on age and duration of fever helps to identify children with pneumonia at increased r
- Pneumonia (pediatric)
Essential Evidence Topics, 23-Jul-2022
Overall Bottom Line: Pneumonia is suggested in children with fever, tachypnea, hypoxia, retractions, and nasal flaring, but no single sign or symptom can determine if a child has pneumonia. Children with suspected bacterial pneumonia should be treated w
- Pneumonia (ventilator-associated or hospital-acquired)
Essential Evidence Topics, 11-Apr-2023
Overall Bottom Line: Clinical criteria for ventilator-associated pneumonia (VAP) include new lung infiltrate in a ventilated patient and at least two of the following: temperature >38°C, leukopenia or leukocytosis, and purulent secretions. Semi-quant
- Pneumothorax
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: The classic presentation of pneumothorax (PTX) is dyspnea and pleuritic chest pain. Radiologic findings are crucial to the diagnosis and management of PTX. Management is determined by PTX size, severity of symptoms, presence of ai
