Showing 581-600 of 809 for: Essential Evidence Topics Back
- 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
- Persistent depressive disorder (formerly dysthymia)
Essential Evidence Topics, 17-Dec-2021
Overall Bottom Line: The most prominent characteristic is at least 2 years of persistently depressed mood (one year for children and adolescents). Chronic symptoms lead to significant distress or cumulative functional impairment. Only half of patients
- Personality disorders
Essential Evidence Topics, 1-Nov-2022
Overall Bottom Line: Suspect personality disorder in difficult patients who have long-standing biopsychosocial issues. Conduct a comprehensive biopsychosocial interview and consider referring for psychological testing with the Minnesota Multiphasic Pers
- 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
- Phenylketonuria
Essential Evidence Topics, 27-May-2021
Overall Bottom Line: All newborns should be screened for phenylketonuria (PKU) between 24 and 168 hours of life. A low-phenylalanine diet should be started upon diagnosis and continued throughout life.
- Pheochromocytoma
Essential Evidence Topics, 23-Jul-2022
Overall Bottom Line: Pheochromocytomas are rare chromaffin cell tumors typically arising in the adrenal glands. They are characterized by excessive production of catecholamines, often leading to elevated blood pressure and symptoms of catecholamine exce
- Phimosis and paraphimosis
Essential Evidence Topics, 26-Dec-2022
Overall Bottom Line: Most cases of phimosis are physiologic and no intervention is needed. In boys with phimosis, a 4-week trial of medium potency steroid cream may be considered. Patients with scarring of the prepuce, painful erections, or who are 15
- Pigmented villonodular synovitis
Essential Evidence Topics, 11-Apr-2023
Overall Bottom Line: Because of the low incidence of this locally aggressive but benign proliferative disease of the synovium, a high index of suspicion is necessary to make the diagnosis of pigmented villonodular synovitis (PVNS). MRI is the imaging st
- Pityriasis alba
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Suspect pityriasis alba in atopic school-age children presenting with irregular hypopigmented patches and macules with fine scale of the face and extremities, accentuated by sun exposure. Reassure parents that pityriasis alba is a c
- Pityriasis rosea
Essential Evidence Topics, 28-Sep-2020
Overall Bottom Line: Diagnosis is based on clinical criteria. Look for herald patch preceding elliptical rash along Langer lines. Pityriasis rosea is distinguished by a collarette of scale just inside the erythematous border of the patch. A collarette
- Placenta previa and placenta accreta
Essential Evidence Topics, 3-Aug-2021
Overall Bottom Line: Obstetric ultrasound should be performed for placental localization in women who present with painless vaginal bleeding in late pregnancy. Placenta previa (placenta covers or overlaps the cervical os) diagnosed in the second trimest
- Plague
Essential Evidence Topics, 13-Jul-2021
Overall Bottom Line: Suspect plague when clinical symptoms, including fever and lymphadenopathy, are present in a person who resides in or has recently traveled to a plague-endemic area. Antibiotics should be initiated without delay in suspected cases o
- Plantar and flat warts
Essential Evidence Topics, 7-Feb-2022
Overall Bottom Line: Eventual spontaneous resolution is normal for immunocompetent patients, so expectant management is a reasonable option. Treatment with topical salicylic acid and/or cryotherapy produces cure rates between 50% and 60% within weeks to
- Plantar fasciitis
Essential Evidence Topics, 1-Oct-2021
Overall Bottom Line: Diagnosis of plantar fasciitis is based on characteristic history and physical examination findings. Standard therapies, including orthotics and night splints, are minimally more effective than stretching exercises or no treatment a
- 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
