By Tilak Shah MD
Organized by means of subspecialty, this case-based overview covers all of the details scholars are anticipated to profit in the course of their inner medication clerkship. each one subject starts off with a quick sufferer historical past and a query concerning the probably analysis or subsequent step in administration by way of a dialogue of other diagnoses and administration concepts. The elementary method comprises a variety of algorithms, photos, mnemonics, and tables.
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Tearing chest pain and pulse deficits should always raise suspicion for aortic dissection, particularly if the patient has a history of longstanding HTN or aortic aneurysm. The CXR demonstrates the characteristic features of a dissected thoracic aorta (widened mediastinum and tracheal deviation). CXR is not a sensitive test to detect aortic aneurysm or dissection, so further testing is necessary if CXR is nondiagnostic and these diagnoses are suspected. 70% of patients with aortic dissection have a history of HTN.
What should you tell him? Xanthomas and xanthelasmas usually resolve with treatment. If they are refractory, consider probucol. This antioxidant does not affect LDL but helps resolve xanthomas. 2 The patient is a 32-year-old woman who presents with nausea, vomiting, and acute epigastric pain radiating to the back. Amylase and lipase levels are elevated, and acute pancreatitis is diagnosed in the patient. She recently initiated oral contraceptive pills (OCP). She does not drink alcohol, and right upper quadrant ultrasound does not show any gallstones.
Pharmacologic therapy can reduce but not completely eliminate symptoms. What pharmacologic options exist to decrease symptoms of nicotine withdrawal? 1. Nicotine replacement: Available in five forms (see Table 1-10). All five forms are equally effective, so patient preference decides which method to use. Nicotine pharmacotherapy reduces rate of relapse by 50%. 2. Bupropion (Zyban): Bupropion inhibits dopamine and norepinephrine reuptake in the central nervous system. Bupropion is as effective as nicotine at reducing relapse.