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LabsCBCFerritinIron studiesTSHDHEA-sulfateTestosteroneZinc EtiologiesAlopocia areata patchy or diffuse Treatment: Dermovate lotion AAA twice dailyTriamcinolone acetonide
Clarify what the patient is askingSometimes we say things we may not mean: Think about a time when you had severe pain and/or discomfort, you may have expressed wishes that were never meant to materialize. Begin with Valid
http://www.medisave.ca/ Medisave.ca is better covers more drugs while having a decent interface than these other popular sites recently tested:http://www.pharmacycompass.ca/ <-- does not include some common drugshttp://www.pharmac
Download Harmony Brochure as PDF [672 KB] Source: https://www.dynacare.ca/DYN/media/DYN/eng/Whats%20Next/Harmony-Brochure-EN-2017DE20.pdf
Source: Academic Life in Emergency Medicine
General
Migraine (complicated)
Tension headache
Cluster headache
Caffeine or analgesic withdrawal
Hypertension
Depression
Infec
http://www.4s-dawn.com/HAQ/HAQ-DI.html
See also:Cough/shortness of breath Ddx2021 CCS/CHFS Heart Failure Guidelines Update -- HFrEF ClassificationNYHA functional classesEtiologyStage in development & progressionLeft ventricular ejection fraction LVE
A multi-organ system disease
Etiology
Primary (genetic)
Secondary
Blood disorders
Hemolytic anemias
Thala
ParameterFormulaNormal rangeStroke volume 60-100 mL/beatCardiac outputHR x SR4-8 L/minCardiac indexCO/BSA2.5-4 L/minRAP/CVP 0-8 mmHg
Hx
Usually have been apparent through most of the patient's life
Ddx
Sickle cell anemia
Thalassemia
Hemoglobin C disease
See also:
Anemia Ddx
Labs to order when a patient doesn't know if they've had Hepatitis A and/or Hepatitis B immunization:HBsAb normal/protective is >= 10 IU/LHAV IgG normal/protective is "Reactive" If patient lacks immunity to
The Canadian Liver Foundation Recommends screening ALL adults born between 1945-1975 and those with risk factors.Hepatitis C risk factorsIllicit injection or intranasal drug use or shared drug paraphernalia past or presentBorn or resid
See also:Ataxia DDxAtaxia by Time Course Used to assess acute vestibular syndrome AVS, defined as acute onset and persistent vertigo, gait instability, nausea/vomiting, nystagmus, and head motion intolerance.
Source: AFP 2009 Hoarseness in Adults See Figure 1 for good anatomical imageSee also: Croup vs Epiglottitis Hoarseness: Abnormal vocal quality breathy, strained, rough, raspy, high or l
EstrogenStarting: 0.5 mg oral estradiol&asympCE 0.300 mg oral tablet&asymp25 mcg transdermal 17-beta estradiol.May increase to: 37.5 mcg transdermal 17-beta estradiol.May increase to: 1 mg oral estradiol&asympCE 0.625 mg oral tabl
13 Week Taper Off 0.625 mg Conjugated EstrogenRequires 46.5 x 0.625 mg tablets and a pill cutter SundayMondayTuesdayWednesdayThursdayFridaySaturdayWeek 10.625 mg0.
Etiologies
Hyperparathyroidism is the most common cause in ambulatory patients
80% are solitary parathyroid adenomas
Parathyroid hyperplasia
Source: http://www.easternhealth.ca/Professionals.aspx?d=2&id=2010&p=1507
See also: Hyperkalemia Management Ddx Medication side-effect Nonselective beta-blockers Interferes with beta-2-mediated intracellular potassium uptake &n
Source: Academic Life in Emergency MedicinePotassium regulation1. Internal K shift: modulated by insulin, catecholamines, acid-base status2. Total body K elimination: By kidney 95% and gut 5% Adverse effects of hyperkalemia
From http://guidelines.hypertension.ca/chep-resources/ 2017 Hypertension Canada Guidelines of Adult Hypertension PDF2017 Hypertension Canada Guidelines of Pediatric Hypertension PDF2017 Hypertension Canada Guideline
A true medical emergency
Can cause coma and death over hours
Encephalopathy from hypertension is more likely reversible than hypertension from other causes (e.g. hypertensive stroke)
Mgmt
Avoid overzealous blood pressure lowering is
Hypertensive urgencyBP >=180/120 with NO symptoms except possibly isolated headacheManage with oral meds, follow up in hours to daysNifedipine IR 10 mg PO usually causes BP to drop within 10-20 minutes, may then switch to extended rele
Source: https://www.uptodate.com/contents/diagnosis-of-hyperthyroidism
Pathophysiology
Interventricular septal hypertrophy
Hx
More common in African Americans
Autosomal dominant inheritance
Sx
Syncope (possibly multifactorial)
Causes includeMental health concerns e.g. stress, anxiety, past sexual abuseRelationship conflictInadequate stimulationBehavioral factors such as alcohol and smokingHPA dysfunction see investigations, belowDrug side effects
Source: http://www.easternhealth.ca/Professionals.aspx?d=2&id=2010&p=1507
Source: http://www.hindawi.com/journals/ije/2012/625434/Relevant 15 minute CME podcast on ReachMD: https://reachmd.com/activity/7072/
Note: electrolyte disturbances often occur together, check others Ca^2+, Mg^2+, PO4^2-Medications Associated with HypokalemiaAdapted from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357351/ClassExamplesMechani