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Criteria for the Classification of Wegener’s Granulomatosis (WG)

Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is a rare form of vasculitis. In this disorder, small-sized blood vessels in the nose, sinuses, ears, lungs and kidneys become inflamed and damaged. Continue reading “Criteria for the Classification of Wegener’s Granulomatosis (WG)”

Criterios Diagnóstico para Vértigo Posicional Paroxístico Benigno

Diagnostic Criteria for Benign Paroxysmal Positional Vertigo

  • Vertigo associated with a characteristic mixed torsional and vertical nystagmus provoked by the Dix-Hallpike test
  • A latency (typically of 1 to 2 seconds) between the completion of the Dix-Hallpike test and the onset of vertigo and nystagmus
  • Paroxysmal nature of the provoked vertigo and nystagmus (i.e., an increase and then a decline over a period of 10 to 20 seconds)
  • Fatigability (i.e., a reduction in vertigo and nystagmus if the Dix-Hallpike test is repeated)

Common Causes of Vertigo

Otologic disorders

  • Benign paroxysmal positional vertigo
  • Meniere´s disease (hydrops endolymphayic)
  • Vestibular neuronitis (labyrinthitis)

Neurologic disorders

  • Migraine-associated dizziness
  • Vertebrobasilar insufficiency
  • Panic disorders

Dix-Hallpike Maneover for Positional Nystagmus

Peripheral disorder Central disorder
Latent period before onset of positional nystagmus 2 to 20 seconds None
Duration of nystagmus Less than 1 minute Greater than 1 minute
Fatigability Fatiguing with repetition Nonfatiguing
Direction of nystagmus Only one type, usually horizontal/rotatory May change direction with a given head position
Intensity of vertigo Severe Less severe, sometimes none

 

References:

  1. Furman JM, Cass SP. Benign paroxysmal positional vertigo. N Engl J Med. 1999 Nov 18;341(21):1590-6. [Medline]

 

Created: Dic 23, 2005

 

Electrocardiographic Diagnosis of Left Ventricular Hypertrophy (LVH)

Sokolow-Lyon index:

There are two criteria with these widely used indices:

* Sum of S wave in V1 and R wave in V5 or V6 >/= 3.5 mV (35 mm)

and/or

* R wave in aVL >/= 1.1 mV (11 mm)

Continue reading “Electrocardiographic Diagnosis of Left Ventricular Hypertrophy (LVH)”

TIMI Risk Score for ST-Elevation Myocardial Infarction (STEMI)

The TIMI risk score, based upon data from 15,000 patients with an ST segment elevation myocardial infarction eligible for fibrinolytic therapy, is a simple arithmetic sum of eight independent predictors of mortality.

Continue reading “TIMI Risk Score for ST-Elevation Myocardial Infarction (STEMI)”

Indications and Contraindications for Tilt Table Testing

Indications

  • Recurrent syncope or single syncopal episode accompanied by physical injury or motor vehicle crash or occurring in a high-risk setting (for example, pilot, surgeon, commercial vehicle driver) and no evidence of structural cardiovascular disease; or presence of structural cardiovascular disease, but other causes of syncope ruled out by diagnostic testing

  • Syncope induced by or associated with exercise

  • Further evaluation of patients in whom an apparent specific cause of syncope has been established (for example, asystole, high atrioventricular block) but susceptibility to neurocardiogenic syncope may affect treatment plan

Continue reading “Indications and Contraindications for Tilt Table Testing”

Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis

The Wells Clinical Prediction Rule is a diagnostic tool used during review of systems to identify possible pulmonary embolism (PE) and deep vein thrombosis (DVT). Continue reading “Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis”

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