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A1c to average blood glucose
Posted by dkwinter
A1c %Estimated average blood glucosemg/dLmmol/L612676.51407.871548.67.51699.4818310.1
ABCDE of melanoma
Posted by dkwinter
ABCDE&rsquoSIf you notice one or more of the following ABCDE&rsquos below, please speak to you health care provider.When spotted early, melanoma has a cure rate of 85%. Check your skin monthly.ASYMMETRYThe two halves of the mole have diff
ABG Interpretation
Posted by dkwinter
Source: http://www.aliem.com/paucis-verbis-card-abg-interpretation/ABG InterpretationHaber RJ. A practical approach to acid-base disorders. West J Med 1991 155:146-51. RULES OF THUMB:1. Look at pH. Whichever side of 7.4 the pH
ABG vs VBG vs CBG
Posted by dkwinter
Arterial Blood Gas ABGstandard nomenclature: pH / PaCO2 / PaO2 / HCO3 / O2Sat / BEnormal valuespH: 7.35-7.45PaCO2: 33 - 45 mmHgPaO2: 80 - 100 mmHgHCO3: 21 - 27 mEq/LO2Sat: 95-100%BE +/- 2 mEq/L Co
ACE inhibitor and Angiotensin Receptor Blocker ARB equivalence table
Posted by dkwinter
All Approximately Equivalent Doses Reasonable for Substitution in Most Cases Benazapril 10 mg PO DAILY max dose 40 mg PO DAILYCaptopril 12.5 mg PO TID max dose 50 mg PO TIDCilazapril 2.5 mg PO DAILY max dose 10 mg PO DAILY
ACLS 2010 Algorithm for Cardiac Arrest
Posted by dkwinter
Source: http://www.aliem.com/paucis-verbis-acls-2010-cardiac-arrest-flowchart/
ACLS megacode bare bones review
Posted by dkwinter
PulselessIf VF/pVT->compressions, defibrillate 200J, give epi then amioIf PEA->compressions, give epiPulseBradyif stable->atropineIf unstable->pacing, if pacing doesn't work then epi or dopamine infusion
ACR Thyroid Imaging Reporting and Data System ACR TI-RADS
Posted by dkwinter
More info: https://radiopaedia.org/articles/acr-thyroid-imaging-reporting-and-data-system-acr-ti-rads
Acute Angle Closure Glaucoma Treatment
Posted by dkwinter
Call ophtho! Diamox 500 mg PO then 250 mg PO q6hPilocarpine i drop q5minutesCombigan i drop q5minutesPrednisolone i drop q5minutes If still healthy, pupil size reduces within ~30 minutes then pressure drops with some
Acute Colitis
Posted by dkwinter
ImagingCT may show diffuse thickening and edema of large bowel loops associated with peri-colonic fat stranding. There may be enlarged LNs in the mesentery and/or retroperitoneal region. DdxInfectious or inflammatory. Trea
Acute pericarditis
Posted by dkwinter
EtiologyViral or idiopathicAutoimmune diseases e.g. SLEUremia acute of CKDPost-myocardial infarctionEarly: Per-infarction pericarditis usual onset is less than 4 days following acute MILate: Dressler syndrome usual onset i
Adenosine for Supraventricular Tachycardia
Posted by dkwinter
See also:Paroxysmal supraventricular tachycardia Adenosine is indicated in the ACLS algorithm "[Adult] Tachycardia With a Pulse" for patients withstable tachycardia and narrow QRS complexstable tachycardia and
Adjunctive non-pharmacologic treatment of depression
Posted by dkwinter
Psychotherapy: Cognitive Behavioral Therapy CBT has evidence for mood and anxiety and is considered first-line treatment. Acceptance and Committment therapy can also be of benefit. Supportive counselling can also be helpful.Investigations of possib
Adult ADHD Self-Report Scale v1.1 ASRS Calculator
Posted by dkwinter
Static PDF Version [47 KB]\$jsmodules/adult_adhd_self-report_scale.html/
Advanced Health Care Directives
Posted by dkwinter
Current Legislation in NL see section 10 for determination of substitute decision maker in cases of no AHCD
Adverse Reaction and Medical Device Problem Reporting Canada
Posted by dkwinter
http://www.hc-sc.gc.ca/dhp-mps/medeff/report-declaration/index-eng.php
Age-specific PSA reference ranges
Posted by dkwinter
40 to 49 years: 0 to 2.5 ng/mL50 to 59 years: 0 to 3.5 ng/mL60 to 69 years: 0 to 4.5 ng/mL70 to 79 years: 0 to 6.5 ng/mL See also: http://www.uptodate.com/contents/screening-for-prostate
AGMA mnemonic, improved
Posted by dkwinter
Impressive bed mnemonic for anion-gap metabolic acidosis:A CAT MUDPILE AspirinCyanide, carbon monoxide Acetaminophen Theophylline Methanol, metformin Uremia Diabetic ketoacidosis or alcoholic ketoacidosis Prop
Akbari Algorithm--Detection, Monitoring & Referral of Chronic Kidney Disease
Posted by dkwinter
See also:Alberta--Chronic Kidney Disease CKD Clinical PathwayKidneyWise Algorithm Ontario Health  
Alberta--Chronic Kidney Disease CKD Clinical Pathway
Posted by dkwinter
See also:Akbari Algorithm--Detection, Monitoring & Referral of Chronic Kidney DiseaseKidneyWise Algorithm Ontario Health The Chronic Kidney Disease CKD Clinical Pathway is a resource for primary care providers to
Alternatives to PO bisphosphonates
Posted by dkwinter
Aclasta Zoledronic acid 5 mg IV once yearlyProlia Denosumab 60 mg sc q6months
AMI and EKG Geography
Posted by dkwinter Source Academic Life in Emergency Medicine
By Dr. Tor Ercleve see also: http://lifeinthefastlane.com/the-art-of-infarct-localisation/
AMMI Use of antiviral drugs for seasonal influenza: Foundation document for practitioners--Update 2019
Posted by dkwinter
AMMI Association of Medical Microbiology and Infectious Disease Canada GuidelinesDownload PDF: Use of antiviral drugs for seasonal influenza 2019.pdf [1.69 MB]Selected figures:
Anemia workup
Posted by dkwinter
First lineCBC w/diffRetic countRenal functionFerritinIron studiesB12TSHFolateColon cancer screeningUrinalysis Second lineSPEPIgG, IgA, IgMSerum free light chains Third line
Antidepressant cheat sheet
Posted by dkwinter
  
Aortic stenosis
Posted by dkwinter
Severe aortic stenosis diagnostic criteriaRequiredAortic jet velocity >=4.0 m/sORMean transvalvular pressure gradient >=40 mmHgOptionalValve area usually <=1.0cm^2 Indications
Arthritis workup
Posted by dkwinter
HistoryJoint distributionInflammationExtra inflammatory features PhysicalAnatomic sites, activity vs damage "Make up your mind after H&P, use labs to confirm your diagnosis" Lab
ASA Physical Status Classification System
Posted by dkwinter
See also: General Anesthesia Normal ASA Physical Status 1 - A normal healthy patient ASA Physical Status 2 - A patient with mild systemic disease ASA Physical Status 3 -
Abdominal pain Ddx
Posted by dkwinter
Hx     Location     Quality     Intensity     Duration     Radiation     Timing relation to meals     Associated sx    &nbs
Abortion classification
Posted by dkwinter
See also: Vaginal bleeding Ddx Medical abortion Hx Pregnant patient Lower abdominal pain Vaginal bleeding Workup Pelvic ex
Accidental Hypothermia
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Acetaminophen Toxicity
Posted by dkwinter
Source: http://www.aliem.com/paucis-verbis-acetaminophen-toxicity/ 
Acetaminophen overdose
Posted by dkwinter
Dx The first data point on the Rumack-Matthew nomogram is at 4 hours The decision of whether or not to administer the antidote can be made after four hours, based on the acetaminophen level. As long as it is admini
Acne
Posted by dkwinter
Source: http://siouxlookoutareadocs.libsyn.com/acne Remember to seek a secondary cause:PCOS esp if irregular periodsHigh-androgen OCP consider switchingPregnancyAnabolic steroid usePrimary hormonal acne, which may r
Acromegaly
Posted by dkwinter
Sx     Uncontrolled HTN     Increase in ring size/hand size/feet size     Sweaty hands/increased oiliness of skin     Headaches     Visual changes    &nb
Acute HIV infection/acute retroviral syndrome
Posted by dkwinter
See also: Sore throat Ddx Hx IV drug use Risky sexual practices Sx Sore throat Fever Rash Weight loss Workup &nb
Acute Limb Ischemia
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Acute Myocardial Infarction
Posted by Anil
Acute MI 2 out of 3 criteria130 minutes retrosternal pain - must R/O MI, PE, Aortic dissection2Cardiac enzymes elevated3ECG changes Unstable Angina -Chest pain at rest - cardiac ischemia w/o ECG changes MI Causes
Acute Pancreatitis
Posted by dkwinter
See also: Abdominal pain Ddx Pathophysiology Premature activation of pancreatic enzymes causing autodigestion of the pancreas. Release of lipolytic enzymes from the pancreas causes significant inflammation o
Acute Vestibular Syndrome vs Stroke
Posted by dkwinter
Source: Academic Life in Emergency Medicine Gaze-Evoked NystagmusFrom: http://www.medscape.com/viewarticle/422863_3Action. Ask the patient to gaze at a target placed 20 to 30 degrees to the left and right of center for
Acute arthritis
Posted by dkwinter
Ddx, most likely Flare-up of osteoarthritis Crystal arthritis Gout Pseudogout Bacterial arthritis
Acute cholecystitis
Posted by dkwinter
See also: Abdominal pain Ddx Biliary disease Pathophysiology May be caused by undiagnosed hereditary spherocytosis Hx Pain that is triggered by eating fatty food Sx &nb
Acute confusional state
Posted by dkwinter
Sx Attention deficit common to all confusional states Organic-causes Acute onset Abnormal vital signs Fluc
Adenosine
Posted by dkwinter
Diagnostic action Abolishes conduction through the AV node E.g. PSVT Terminates some re-entrant type tachycardias Dose 3-12 mg rapid IV push
Age-appropriate Pediatric Fever Without a Source workup
Posted by dkwinter
See also: Pediatric fever Ddx Terms:Fever without a source FWS: No adequate explanation for fever after H&P.Fever of unknown origin FUO: No adequate explanation for fever lasting at least 8 days' duration, af
Alcoholism
Posted by dkwinter
Sx Poor nutrition Labs Low thiamine levels due to poor nutrition Low glucose due to suppression of gluconeogenesis by alcohol (give thiamine first to prevent precipitating Wernicke's encep
Alprazolam (Xanax)
Posted by dkwinter
A BDZ, the #1 prescribed mental health drug Mechanism Binds GABA-alpha receptors Enhances the affinity of GABA for the receptor, allows increased opening of the GABA-alpha channel Indications  
Amenorrhea Ddx
Posted by dkwinter
Hx Primary vs. secondary Duration Possible pregnancy Associated sx Headache Decreased peripheral vis
Amiodarone
Posted by dkwinter
Treats Atrial arrhythmias (+/- heart failure) Ventricular tachycardia (+/- heart failure) 5 common side effects of amiodarone: 1. Pulmonary toxicity: Amiodarone lung toxicity is associated wit
Anaphylaxis
Posted by dkwinter
Source: Academic Life in Emergency Medicine 
Anaphylaxis treatment
Posted by dkwinter
First line: 1. Epinephrine 0.01 mg/kg (use 1:1000 sol) q5-15min IM (max dose 0.3 mg in kids or 0.5 mg in adults) 1. Methylprednisolone (Solumedrol) 1-2mg/kg/day IV (all ages) (usual dose is 125mg IV for most adults) 1. Benadryl 50 mg IV/
Angina
Posted by dkwinter
See also: Joint/limb pain Ddx Hx Left arm pain that starts during exercise Pain relieved by rest Workup EKG CK-MB, troponin CBC
Angioedema
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Ankle Fractures
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Ankle sprain classification and management
Posted by dkwinter
Anorexia nervosa
Posted by dkwinter
See also: Amenorrhea Ddx Hx Significant weight loss Vigorous exercise Cold intolerance Amenorrhea Workup CBC TSH
Anterior spinal artery occlusion
Posted by dkwinter
The perfusion territory of the anterior spinal artery includes the anterior horn cells and part of the pain and temperature pathways. Thrombosis of this artery causes flaccid paralysis, loss of bowel and bladder function and loss of pain and temperature se
Antibiotic Sensitivity Table
Posted by Anil
Antibiotic regimens
Posted by dkwinter
HEENT Otitis externa Initial treatment in otherwise healthy people Cipro/Dexamethasone otic <-can be used with perforated TM
Antibiotics for Uncomplicated Cystitis & Pyelonphritis in Women
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Anticholinergics
Posted by dkwinter
Impede ACh signaling at nicotinic and/or muscarinic receptors. Treat Parkinson's disease (e.g. Trihexphenidyl) Attempt to reduce acetylcholine signaling to match reduced dopamine signaling Drug
Anticoagulation
Posted by dkwinter
See CHADS2 for guidance for patients with atrial fibrillation Indications Acute coronary syndrome Low-molecular weight heparins Atrial fibrillation  
Anticoagulation in Atrial Fibrillation
Posted by dkwinter Source Academic Life in Emergency Medicine
Anticoagulation in Atrial Fibrillation Waldo AL. Cardiol Clin 2009; 27:125-35. Atrial Fibrillation (AF) = 5x risk for CVA and increases with age Stroke risk stratification for patients with AF:
Anticoagulation in Atrial Fibrillation
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Anticoagulation in OR patients
Posted by dkwinter
all fractures Lovenox, only while inpatients all joint replacements hips-Xarelto 35 days knees-Xarelto 14 days all gen surg low risk-Heparin 5000 U SC bid
Antivirals
Posted by dkwinter
Treat Influenza pneumonia Oseltamivir Zanamivir CMV infections Ganciclovir HIV  
Aortic Dissection
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Aortic aneurysm
Posted by dkwinter
Descending aortic aneurysms are usually fusiform and due to atherosclerosis.
Aortic regurgitation
Posted by dkwinter
PE Early diastolic murmur in mild cases Holodiastolic murmur in severe cases Hyperdynamic "Water-hammer" pulse Abrupt rise in systolic blood pressu
Appendicitis: ACEP Clinical Policy
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Approach to Increased Osmolal Gap
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Arterial Insufficieny/Occlusion
Posted by Anil
ASAS Classification Criteria for Axial Spondyloarthritis
Posted by dkwinter
 Adapted from Choosing Wisely NL Practice Points Volume 3 2018 
Ascites assessment with paracentesis
Posted by dkwinter
Source: Academic Life in Emergency Medicine  
Aspirated foreign body/aspirated food
Posted by dkwinter
Path Due to its wider diameter and the fact it forms a more obtuse take-off angle with the trachea, the right mainstem bronchus is a more likely site of aspiration than the left mainstem bronchus in adults. Dx Mor
Aspirin (Salicylate) intoxication
Posted by dkwinter
Effects Characteristically causes metabolic acidosis mixed with a respiratory alkalosis Stimulates respiratory center -> Tachypnea -> RESPIRATORY ALKALOSIS Anion-gap METABOLIC ACIDOSIS by
Asthma
Posted by dkwinter
See also: Cough/shortness of breath Ddx Asthma exacerbation Hx Shortness of breath Cough Wheezing Worse in cold air  
Asthma Classification
Posted by dkwinter
Source: Academic Life in Emergency Medicine
Asthma Exacerbation
Posted by dkwinter
See also: COPD Exacerbation Epidemiology More common in male children than female children More common in female adults than male adults Higher prevalence in African-Americans than Triggers
Asymmetric arm blood pressures
Posted by dkwinter
Ddx Coarctation BP in arm(s) greater than legs BP in R arm greater than L arm Subclavian artery atherosclerosis &
Ataxia by Time Course
Posted by dkwinter
See also:Ataxia DDxHINT exam for localizing the source of ataxia Acute hours to daysHypovolemiaInfectionsICHCVAMSToxinsDrug side-effect Antineoplastics, antiepileptics, antiarrhythics e.g. Amiodarone
Ataxia DDx
Posted by dkwinter
 See also:Ataxia by Time CourseHINT exam for localizing the source of ataxia VestibularAtaxia+vertigo+tinnitus+nystagmusPeripheralBPPVMeniere'sLabyrinthitisVestibular n
ATLS Primary Survey
Posted by dkwinter
What&rsquos your name? What happened?100% O2 non-rebreather, pulse ox, cardiac monitor, BP, two large bore IVsPage lab, routine trauma labs including type & screen Airway        Open or close
ATLS Spinal Levels Key Myotomes and Dermatomes
Posted by dkwinter
Key myotomesC5 deltoidC6 wrist extensors biceps, extensor carpi radialis longus and brevisC7 elbow extensors tricepsC8 finger flexors to the middle fingerT1 small finger abductors abductor digiti minimiL2 hip flexors iliopsoasL3,L
Atrial fibrillation
Posted by dkwinter
Hx     A common complication of CABGDx     Absence of P waves     Irregularly irregular rhythmClassifications     Duration          Paroxysmal <7 days du
Audiograms
Posted by dkwinter
PresbycusisSource link Noise-induced Hearing LossSource link or Download 3.52 MB PDF <-- a good summary of other conditions affecting hearing
Autoimmune anemias
Posted by dkwinter
Tend to be hemolytic and tend to have normal appearing erythrocytes on peripheral smear; autoagglutination of red cells may be seen in some types. Ddx Lupus See also: Anemia
AWLS Evacuation Guide Quick reference
Posted by dkwinter
Source: Wilderness Medical Society WMS, Advanced Wilderness Life Support AWLS