Patients presenting with headaches need to be screened for primary vs secondary etiologies. “Red flags” associated with secondary headaches are crucial to identify. Physical examination should be completed with careful assessment of clues obtained during the history. It should include blood pressure measurements, assessment of mental status, and cranial nerve (CN) examination including but not limited to fundoscopic examination, gait, and facial strength.
The CDR is a clinically based, semistructured interview, which rates impairment level in 6 cognitive domains: memory, orientation, judgment/problem solving, community affairs, home and hobbies, and personal care. Continue reading “Clinical Dementia Rating (CDR) Scale”
Chronic pancreatitis is an irreversible disease of exocrine pancreas characterized by progressive destruction of pancreatic parenchyma and remodeling processes leading to the replacement of the exocrine parenchyma by extensive fibrosis. These changes result in malabsorption, diabetes mellitus and severe and chronic abdominal pain.
Moreover, it is possible the development of several complications which will determine the clinical course developing in some cases pancreatic pseudocyst (25-30%), bile duct strictures (40-50%), even pancreatic cancer (1-3%). The mainstay is detecting early pancreatic changes and treating its related complications. Continue reading “Rosemont Criteria for Chronic Pancreatitis”
Human herpesvirus-8 (HHV-8)–negative, idiopathic multicentric Castleman disease (iMCD) is a rare and life-threatening disorder involving systemic inflammatory symptoms, polyclonal lymphoproliferation, cytopenias, and multiple organ system dysfunction caused by a cytokine storm often including interleukin-6. Accurate diagnosis is challenging, because no standard diagnostic criteria or diagnostic biomarkers currently exist, and there is significant overlap with malignant, autoimmune, and infectious disorders. Continue reading “Diagnostic Criteria for Idiopathic Multicentric Castleman Disease (iMCD)”
Lipedema is a chronic progressive disease characterized by abnormal fat distribution resulting in disproportionate, painful limbs. It almost exclusively affects women, leading to considerable disability, daily functioning impairment, and psychosocial distress. Continue reading “Diagnostic Criteria of Lipedema”
The Endocrine Society guidelines on the diagnosis and treatment of Acute Adrenal Insufficiency (AAI) defines an adrenal crisis as a medical emergency with hypotension, abdominal symptoms and laboratory abnormalities requiring emergency treatment.
Continue reading “Diagnostic Criteria of Acute Adrenal Insufficiency”
Typically, peripartum cardiomyopathy occurs in the first 4 months postpartum; fewer than 10% of cases occur prepartum. Common symptoms include dyspnea, cough, orthopnea, hemoptysis, and paroxysmal nocturnal dyspnea. Most affected patients have New York Heart Association (NYHA) class III or IV function. Additional symptoms include nonspecific fatigue, malaise, palpitations, chest and abdominal discomfort, and postural hypotension. Diagnosis requires a high degree of suspicion, because symptoms of peripartum cardiomyopathy can be confused with physiologic changes associated with advanced pregnancy. Continue reading “Diagnostic Criteria for Peripartum Cardiomyopathy”
Cannabis use induces a variety of acute psychological and physiological effects that vary in intensity and duration according to the dose, the route of administration, and the degree of tolerance in the user. Acute psychological effects include euphoria (“high”), relaxation, and sedation (usually desired by persons who use cannabis recreationally), increased appetite (“munchies”) and impaired short-term memory, concentration, and psychomotor coordination. Some people experience increased anxiety, panic attacks, or paranoia, especially at higher doses. Psychotic symptoms, such as perceptual alterations, hallucinations, and delusions, are less common. Acute physical effects include impaired motor coordination, slurred speech, dry mouth, conjunctival injection (“red eye”), tachycardia, orthostatic hypotension, and horizontal nystagmus. Smoked cannabis induces cough, wheezing, and dyspnea; increases sputum production; and exacerbates asthma. Continue reading “Diagnostic Criteria for Cannabis Use Disorder”
The Psoriasis Area Severity Index (PASI) is a tool used to measure the severity of psoriasis, a chronic autoimmune skin condition characterized by red, scaly patches on the skin. PASI takes into account the extent of psoriatic involvement (area) as well as the severity of erythema (redness), induration (thickness), and desquamation (scaling) present within the involved regions. It provides a quantitative assessment of psoriasis severity and is commonly used in clinical trials and practice to monitor disease progression and treatment efficacy. Continue reading “Psoriasis Area Severity Index (PASI) Score”
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