Category: Toxicology
Keywords: zolpidem, benzodiazepines, eszopiclone (PubMed Search)
Posted: 2/28/2008 by Fermin Barrueto
(Updated: 10/9/2024)
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Both dealing with the adverse effects from therapeutic administration, like when you order it on the floors or take yourself - to the overdose setting. Here is a brief list of the common sleep aids, MOA and toxicity. (Zolpidem or Ambien gets the award for most entertaining adverse effect of "Sleep Eating")
Category: Neurology
Keywords: dizzy, head and neck examination, heent (PubMed Search)
Posted: 2/28/2008 by Aisha Liferidge, MD
(Updated: 10/9/2024)
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Be sure to perform a thorough head and neck examination in the dizzy patient, as the etiologic source is often due to ear, nose, and throat pathology, such as structural abnormalities, some of which may even signal a more widespread process
Such common physical examination findings may include the following:
Category: Critical Care
Keywords: d-dimer (PubMed Search)
Posted: 2/26/2008 by Mike Winters, MBA, MD
(Updated: 10/9/2024)
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D-Dimer in the Critically Ill
Crowther MA, et al. Neither baseline tests of molecular hypercoagulability nor D-dimer levels predict deep venous thrombosis in critically ill medical-surgical patients. Intensive Care Med 2005;31(1):48-55.
Category: Vascular
Keywords: BP, Hypertension, Angioedema (PubMed Search)
Posted: 2/26/2008 by Rob Rogers, MD
(Updated: 10/9/2024)
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Direct Renin Inhibitor-Aliskiren (Tekturna)
This drug is the 1st in a new class of antihypertensives called direct renin inhibitors-1st approved in 2007. This drug, along with three others being developed, inhibits the entire Renin-Angiotensin-Aldosterone System (RAAS) which has been shown to lead to definitive 24 hour blood pressure control.
Why should emergency physicians care, you ask?
J Hypertension March 2007
Category: Cardiology
Keywords: acute myocardial infarction, stress test (PubMed Search)
Posted: 2/24/2008 by Amal Mattu, MD
(Updated: 10/9/2024)
Click here to contact Amal Mattu, MD
Just a reminder, after a recent case of a patient that had a large AMI the day after a negative dobutamine stress test...
Neither stress testing nor coronary angiography are definitive for ruling out unstable/vulnerable plaques. If the HPI for your patient is very concerning, don't obviate your concern just because of a recent negative stress test or angiography. These tests are good at identifying large occlusions, but they tell us nothing about recent rupture or about composition of the plaques, and we now know that it is the composition that determines plaque instability. Size doesn't always matter...
Category: Obstetrics & Gynecology
Keywords: Ultrasound, ectopic, pregnancy (PubMed Search)
Posted: 2/24/2008 by Michael Bond, MD
(Updated: 10/9/2024)
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Ultrasound in Pregnancy
Category: Pediatrics
Keywords: DKA, Cerebral Edema, Mannitol, Risk Factors (PubMed Search)
Posted: 2/22/2008 by Sean Fox, MD
(Updated: 10/9/2024)
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Cerebral Edema in Patients with DKA
Category: Toxicology
Keywords: influenza, tamiflu, oseltamivir (PubMed Search)
Posted: 2/21/2008 by Fermin Barrueto
(Updated: 10/9/2024)
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Category: Neurology
Keywords: Romberg Test, proprioception, dorsal columns, balance (PubMed Search)
Posted: 2/20/2008 by Aisha Liferidge, MD
(Updated: 10/9/2024)
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Category: Critical Care
Keywords: central venous pressure (PubMed Search)
Posted: 2/19/2008 by Mike Winters, MBA, MD
(Updated: 10/9/2024)
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Category: Airway Management
Keywords: Asthma (PubMed Search)
Posted: 2/18/2008 by Rob Rogers, MD
(Updated: 10/9/2024)
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Care of the Crashing Asthma Patient
Several things should be considered in the crashing asthmatic:
Category: Cardiology
Keywords: adenosine, ventricular tachycardia (PubMed Search)
Posted: 2/17/2008 by Amal Mattu, MD
(Updated: 10/9/2024)
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Adenosine should never be used in the setting of a wide complex regular tachycardia as a diagnostic maneuver. Adenosine will convert some types of VT, and this may mislead the health care provider into thinking that the WCT is an SVT. The electrophysiology literature is rife with reports of "adenosine-sensitive VT," and these patients are often young and without prior history of CAD...the very patients that we'd most be inclinded to assume have SVT.
The bottom line is that one should always assume that a regular WCT (without obvious evidence of sinus tachycardia) is VT, and treat the tachydysrhythmia as such.
Category: Infectious Disease
Keywords: Dermatology, Rash, (PubMed Search)
Posted: 2/17/2008 by Michael Bond, MD
(Updated: 10/9/2024)
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Category: Pediatrics
Keywords: Ferbrile Seizures, Bacteremia, Fever (PubMed Search)
Posted: 2/15/2008 by Sean Fox, MD
(Updated: 10/9/2024)
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Febrile Seizures
Category: Toxicology
Posted: 2/14/2008 by Fermin Barrueto
(Updated: 10/9/2024)
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Here are a couple of herbals touted as aphrodesiac's and the toxcity associated with them (the price of love):
Chan Su or "Love Stone" - A chinese herbal that is suppose to be topically applied, unfortunately all of the instructions are in chinese and those who ingest it will die a digoxin-like death. It has a compound that is essentially a potent digoxin-like substance.
Yohimbine - herbals that contain this can cause priapism - shocker
Category: Neurology
Keywords: brainstem, cranial nerves (PubMed Search)
Posted: 2/14/2008 by Aisha Liferidge, MD
(Updated: 10/9/2024)
Click here to contact Aisha Liferidge, MD
Category: Critical Care
Keywords: spontaneous pneumomediastinum (PubMed Search)
Posted: 2/12/2008 by Mike Winters, MBA, MD
(Updated: 10/9/2024)
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Spontaneous Pneumomediastinum
Category: Vascular
Keywords: AAA, aneurysm (PubMed Search)
Posted: 2/12/2008 by Rob Rogers, MD
(Updated: 10/9/2024)
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AAA...be afraid, be very afraid
Abdominal Aortic Aneurysm (AAA) is known as the great masquerader in the elderly for good reason....
Category: Cardiology
Keywords: acute coronary syndrome, history (PubMed Search)
Posted: 2/10/2008 by Amal Mattu, MD
(Updated: 10/9/2024)
Click here to contact Amal Mattu, MD
The 5 most important factors at predicting the presence of ACS in a patient presenting with chest pain (in order of importance):
1. nature of anginal symptoms (i.e. the HPI)
2. prior history of CAD
3. male gender
4. older age
5. increasing number of traditional risk factors
Notice this means that the MOST important factor is the HPI...the OLDCAAAR. If the patient has a concerning HPI, NEVER drop your concerns just because the patient is young or has minimal other risk factors.
Category: Obstetrics & Gynecology
Keywords: Rhogam, Pregnancy (PubMed Search)
Posted: 2/9/2008 by Michael Bond, MD
(Updated: 10/9/2024)
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Rhogam
Dosing:
Trivial Fact: Rhogam is Pregnancy Class C