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Verified User Primary Care Comments Off on Hydrocarbon Poisoning 2626 views

Hydrocarbons are a heterogeneous group of organic substances that are primarily composed of carbon and hydrogen molecules. They are quite abundant in modern society. Some of the most commonly ingested hydrocarbons include gasoline, lubricating oil, motor oil, mineral spirits, lighter fluid/naphtha, lamp oil, and kerosene. [1] Other common sources of hydrocarbons include dry cleaning solutions, paint, spot remover, rubber cement, and solvents. In addition, many volatile substances that contain hydrocarbons (eg, glue, propellants) are commonly abused for their euphoric effects.[1] EPIDEMIOLOGY Hydrocarbon ingestion accounts ...

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Verified User Primary Care , USMLE Step 2 Comments Off on Abdominal Adhesions 2219 views

Abdominal adhesions are pathological bands of scar tissue that forms between two previously separated structures within an abdomen. They may be between omentum, abdominal wall or intestinal loops. ETIOLOGY - Congenital or Acquired - Iotragenic; trauma, surgery or postinflammatory RISK FACTORS - Emergent surgeries - Lower GI procedures - H/o abdominal abscess, surgery or trauma CLINICAL FINDINGS - Crampy abdominal pain - Nausea and/or vomiting - Minimal to no flatus - Borborygmi (loud bowel sounds) - Abdominal distention and tenderness - Vitals: fever, tachycardia - Peritoneal signs; guarding, rebound and rigidity INVESTIGATIONS - WBC, Lactate, Electrolytes, BUN/Cr - ...

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Evidence based approach to diagnosing Migraines

Verified User Primary Care Comments Off on Evidence based approach to diagnosing Migraines 3197 views

The pretest probability of a patient presenting to a PCP with a complain of headache to be migraine is 6-15%. A meta analysis identified nausea, photophobia, phonophobia and exacerbation with physical activity to be best individual symptoms for ruling in or out migraine. The best predictor was nausea. Headache with nausea = increases likelihood of headache being migraine to 90% 5 Item ...

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Verified User Primary Care Comments Off on HPV vaccination for adults 27 to 45yrs 4793 views

FDA has recently approved the HPV vaccine (Gardasil 9) for adults, both men and women, aged 27 to 45 yrs. Dr Marks who is the director of FDA states that the vaccine has the potential to prevent more than 90% cases of cancers caused every year from the virus. CDC statistics report 14 million americans are affected every year; of which 12,000 are diagnosed and 4000 die from cervical cancer. The effectiveness of Gardasil was studied by a study of approximately ...

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Verified User Primary Care Comments Off on Acromegaly 3467 views

Definition: It is a Hormonal Disorder that develops due to hypersecretion of GH in adulthood, after the epiphyseal closure of bones, which cause an increase in size (girth) of bones, including that of face, hands and feet Incidence: Annual incidence= 3-4cases/million population Prevalence= 60-70 cases/million population Male=female Mean age of presentation Males-42yrs, Females-44yrs Pathogenesis: There are several reasons for overproduction of GH. ...

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Verified User Primary Care Comments Off on Using POC BNP to rule out Heart failure 2426 views

A meta analysis was recently done to assess the diagnostic accuracy of POC BNP testing in patients with chronic heart failure, especially in an ambulatory setting. This was against any relevant standard of care interventions like ECHO, clinical examination or combination of both. At thresholds of >100 pg/ml the sensitivity of BNP was 0.95. At levels <100, it ranged from 0.46 to 0.97 and specificity of 0.31 to 0.98. So ...

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Verified User Primary Care Comments Off on High Dose PPI + Aspirin in Barrett’s Esophagus 1681 views

Esophageal carcinoma is the 6th most common cause of cancer with Barrett’s esophagus contributing to be the biggest risk factor. A randomized trial performed studied role of high-dose PPI and aspirin for  improving outcomes in patients with Barrett’s esophagus. Patients with 1 cm or more of Barrett’s esophagus at 84 different centers in UK and Canada  were randomized 1:1:1:1  using a computerized schedule to receive high-dose ( 40 mg ...

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Verified User Primary Care Comments Off on APGAR score 3170 views

APGAR score stands for Appearance, Pulse, Grimace, Activity and Respiration. An APGAR score of <7 at 5 mins requires repeated scoring every 5 mins for upto 20 mins to check for improvement.

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