Approach To Jaundice History and Examination

Physical Exam Hepatitis

The most important information in the diagnostic evaluation usually comes from the history. In patients presenting with jaundice, the history should be thorough and should include questions focused on identifying the common causes of jaundice. Specific information should include when the jaundice commenced and whether it is of acute or gradual onset. The presence of gastrointestinal symptoms, such as abdominal pain, nausea, vomiting, diarrhea, or changes in stool color can be significant....

Clinical Presentation

Fatigue, weakness, and dyspnea are symptoms that are commonly reported by elderly persons with anemia. These vague and nonspecific symptoms are often ignored by both patients and physicians as symptoms of old age. Anemia may result in worsening of symptoms of other underlying conditions. For example, the reduced oxygen-carrying capacity of the blood as a consequence of anemia may exacerbate dyspnea associated with congestive heart failure. Certain signs found on examination may prompt a work-up...

Vaginal Discharge Reveals Branching Hyphae Consistent With Candida

The first test performed on a woman with menstrual cycle irregularities should be a pregnancy test. A history of anovulatory cycles does not confer absolute protection against pregnancy. Ovulation may occur intermittently and irregularly. If the woman does not want to become pregnant, she should be counseled on contraceptive options. Albers JR. Hull SK. Wesley RM. Abnormal uterine bleeding. Am Fam Physician 2004 69 1915-1926. 1931 -1932. Carr BR. Bradshaw KD. Disorders of the ovary and female...

Urinalysis In Malignant Melanoma

The preventable risk factor common to all skin cancers is sun exposure. Recommend to your at-risk patients limiting exposure to sunlight in the middle of the day, wearing appropriate protective clothing, and using sun screen. Contrary to popular belief, the use of tanning beds is also a risk factor for skin cancer. There is no such thing as a healthy tan. Abbasi NR, Shaw HM. Rigel DS. el al. Early diagnosis of cutaneous melanoma revisiting ihe ABCD criteria. JAMA 2004 292 2771-2776. Fitzpatrick...

Click To Cure Cancer Clinical Cases

Adolescent healthcare is a complex issue. However, the clinician should attempt to administer confidential healthcare to minors seeking care for sensitive medical issues when it is safe and appropriate to do so. It is very important for clinicians to know the laws regarding consent and confidentiality when treating adolescent patients of the states in which they practice. Boonstra H. Nash E. Minors and the rights to consent to health care. The Guttmacher Report on Public Policy, Volume 3,...

Approach To Hematuria

Hematuria is divided into glomerular, renal nonglomerular . and urologic etiologies. Glomerular hematuria typically is associated with significant proteinuria, erythrocyte casts, and dysmorphic RBCs. Renal nonglomerular hematuria is secondary to tubulointerstitial. renovascular, and metabolic disorders. Like glomerular hematuria, it often is associated with significant proteinuria however, there are no associated dysmorphic RBCs or erythrocyte casts. Urologic causes of hematuria include tumors,...

Comprehension Questions

34.1 A 28-year-old male presents for evaluation of headaches. He has had several episodes of unilateral throbbing headaches that last 8-12 hours. When they occur, he gets nauseated and just wants to go to bed. Usually they are relieved after he lies down in a dark, quiet room for the remainder of the day. He is missing significant amounts of work because of the headaches. He has a normal examination today. Which of the following statements is true regarding this situation A. He needs a CT scan...