Hospital Medicine
Chest Pain I. Problem/Condition. Chest pain accounts for approximately 5 million emergency department visits annually, and can be a difficult diagnostic challenge. II. Diagnostic Approach. A. What is the differential diagnosis for this problem? Cardiac causes of chest pain Ischemia – stable angina, unstable angina, acute myocardial infarction*, coronary artery spasm, aortic stenosis Non ischemia…
Hospital Medicine
What every physician needs to know: Pulmonary alveolar proteinosis (PAP) is a rare lung syndrome characterized by an accumulation of surfactant within the alveoli, leading to pulmonary symptoms, increased infection risk, and in severe cases, hypoxic respiratory failure. The most common type is autoimmune PAP, which is associated with autoantibodies to granulocyte-macrophage colony-stimulating factor (GM-CSF)…
Hospital Medicine
Von Willebrand Disease I. What every physician needs to know. Von Willebrand factor (VWF) is important for primary and secondary hemostasis. VWF is a multifunctional protein that serves as a link between a damaged vessel wall and platelets, and is also a carrier for Factor VIII (FVIII). In primary hemostasis it binds to the platelet…
Hospital Medicine
At a Glance Thyroid storm is an acute and severe hypermetabolic episode that can include fever, tachycardia, hypertension, diarrhea, neurologic abnormalities, and death. Profound and rapid thyroid hormone release leads to severe hypermetabolism with these clinical manifestations. What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?…
Hospital Medicine
I. Problem/Condition. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the first defense against bacterial infections. Neutropenia is a reduction in the number of white blood cells, specifically neutrophils, resulting in immunosuppression and thereby putting patients at risk for infection. Neutropenia is defined as an absolute neutrophil count of less…
Hospital Medicine
What every physician needs to know: Cystic fibrosis (CF) is a relatively common disease that is inherited in an autosomal recessive pattern and results in a shortened average life span. CF affects all exocrine glands of the body, but abnormalities in the lungs and pancreas usually dominate the clinical picture. CF lung disease is a…
Hospital Medicine
Diabetic Ketoacidosis I. What every physician needs to know. Diabetic ketoacidosis (DKA) is a serious, life-threatening complication of diabetes mellitus. DKA is characterized by the triad of hyperglycemia, anion gap metabolic acidosis, and ketonemia. It is part of a spectrum of hyperglycemia on which lies hyperosmolar hyperglycemic state (HHS). Though the two are distinct entities,…
Hospital Medicine
OVERVIEW: What every practitioner needs to know Tumor lysis syndrome (TLS) is defined as the combination of hyperuricemia, hyperphosphatemia, hyperkalemia, and acute kidney injury that results from lysis of cancer cells when treatment is initiated. The syndrome can lead to fatal cardiac dysrhythmias and acute kidney injury, so all patients potentially at risk for TLS…
Hospital Medicine
Hepatorenal Syndrome (HRS) I. What every physician needs to know. Hepatorenal syndrome (HRS) is a potentially reversible form of renal failure seen in patients with advance liver disease and occasionally in acute fulminant liver failure. HRS is a diagnosis of exclusion and it is diagnosed when all other causes of renal failure have been ruled…
