ACEIs Before Surgery: Know When to Hold 'em
ACEI-related intraoperative hypotension can, on occasion, be unresponsive to typical corrective maneuvers. So, are these drugs out in the perioperative period? It’s not quite that simple. (Source: Consultant Live)
Source: Consultant Live - September 18, 2013 Category: Primary Care Source Type: news
Ecchymoses and Erosion on Fragile Skin
These wounds occurred when this 77-year-old woman fell when chasing her dog. Such wounds — a combination of ecchymoses and erosion caused by blunt and sheering forces on fragile skin— are common in the elderly, even after relatively mild trauma. Simple interventions will promote healing. (Source: Consultant Live)
Source: Consultant Live - September 17, 2013 Category: Primary Care Source Type: news
Tumors (skin and GI) and Rhabdomyolysis
Which of these GI and skin lesions should you worry about most? Is rhabdomyolysis usually the result of infection? See how well you do with this week’s questions. . . (Source: Consultant Live)
Source: Consultant Live - September 17, 2013 Category: Primary Care Source Type: news
Striae (Stretch Marks)
These classic linear, wide-mouthed, red to purple, atrophic patches are classic for stretch marks (striae distensae). The patient was in the middle of his growth spurt. (Source: Consultant Live)
Source: Consultant Live - September 16, 2013 Category: Primary Care Source Type: news
Cat nip in an immunocompromised owner
A large, red, tender plaque developed after a cat bite in a woman with Crohn disease. What now? (Source: Consultant Live)
Source: Consultant Live - September 13, 2013 Category: Primary Care Source Type: news
What Alternative to Penicillin in the Allergic Patient?
Cross-reactivity can make it a challenge to effectively treat the patient with allergy to penicillin. A suggestion is offered, here. Is it appropriate? (Source: Consultant Live)
Source: Consultant Live - September 13, 2013 Category: Primary Care Source Type: news
Too Much Medicine Is Bad for Our Health
Curing medical excess will not be easy. Harmful overtesting and overtreating is promoted and protected by the enormous economic and political power of the medical industrial complex. Here's just a beginning list of what needs to be done . . . (Source: Consultant Live)
Source: Consultant Live - September 13, 2013 Category: Primary Care Source Type: news
Bed Bug Bites
The patient assumed that the itchy rash was due to insect bites. The shape, size, color, and presence of 6 legs of the insect he captured were consistent with bedbugs and bedbug bites. (Source: Consultant Live)
Source: Consultant Live - September 13, 2013 Category: Primary Care Source Type: news
New Labeling Required for Long-Acting Opioids: What Does it Mean for Clinicians?
With this change in language, the FDA seeks to narrow the range of patients for whom the long-acting/extended-release opioids are prescribed. Dr Steven King wonders which clinicians they hope to reach. (Source: Consultant Live)
Source: Consultant Live - September 13, 2013 Category: Primary Care Source Type: news
Developmental Disorders in Children—A Photo Quiz
Early identification of childhood disorders is essential for achieving the best possible outcomes. This week’s photo quiz tests your ability to recognize some of the possible presentations. (Source: Consultant Live)
Source: Consultant Live - September 13, 2013 Category: Primary Care Source Type: news
Subclinical Atrial Fibrillation in Type 2 Diabetes: Silent Menace
When compared to healthy, age-matched controls, persons with type 2 diabetes demonstrated a higher incidence of silent atrial fibrillation events. (Source: Consultant Live)
Source: Consultant Live - September 12, 2013 Category: Primary Care Source Type: news
Lesions, Markers, Metastases, and Prognosis
Angiofibromas and neoplasms? CRP as a marker of depression? Colorectal metastases? Can you answer all 5 of this week’s questions? (Source: Consultant Live)
Source: Consultant Live - September 12, 2013 Category: Primary Care Source Type: news
Bilateral Corpus Callosum Stroke
Bilateral strokes of the corpus callosum are uncommon because of the rich blood supply of this structure from 3 main arterial systems. Also, it is a dense white matter tract and so less sensitive to ischemic injury than gray matter. (Source: Consultant Live)
Source: Consultant Live - September 12, 2013 Category: Primary Care Source Type: news
Lichenoid Keratosis
Diagnostic possibilities for this asymptomatic “red spot” included squamous cell carcinoma in-situ, superficial basal cell carcinoma, lichenoid keratosis, and insect bite. This case underscores the importance of a biopsy when the diagnosis is in doubt. (Source: Consultant Live)
Source: Consultant Live - September 11, 2013 Category: Primary Care Source Type: news
Is Screening for Asymptomatic Atrial Fibrillation Indicated?
So-called silent atrial fibrillation was found among 3 percent of individuals in a cohort with an average age of 75 to 76 years. Widespread screening in high-risk populations may have important implications. (Source: Consultant Live)
Source: Consultant Live - September 11, 2013 Category: Primary Care Source Type: news
