Category Archives: Diagnosis

EUH Dressler Conference: What is the clinical exam for pericardial tamponade?

The Bottom Line: Among patients with cardiac tamponade, a minority will not have dyspnea, tachycardia, elevated jugular venous pressure, or cardiomegaly on chest radiograph. A pulsus paradoxus greater than 10 mm Hg among patients with a pericardial effusion helps distinguish those … Continue reading

Posted in Diagnosis, EUH

EUH Morning Report: Delayed paracentesis and mortality risk with spontaneous bacterial peritonitis

The Bottom Line: In a study of hospitalized patients with spontaneous bacterial peritonitis (SBP), Kim et al (2014) concluded: Patients who receive delayed paracentesis (DP) had a higher in-hospital mortality (27% vs 13%) compared with those who received early paracentesis (EP). … Continue reading

Posted in Diagnosis, EUH, Therapy

EUH Morning Report: Diagnosing ascites

The Bottom Line: Three guidelines are most useful when determining if a patient has ascites (Williams and Simel, 1992, p.2648): The most useful findings for ruling out ascites are negative histories of ankle swelling or increased abdominal girth, and the inability  … Continue reading

Posted in Diagnosis, EUH

EUH Morning Report: Can PE be ruled out with a D-Dimer of less than 1000?

The Bottom Line: The YEARS algorithm simultaneously assesses three items – clinical signs of DVT, hemoptysis, and whether PE is the most likely diagnosis – as well as a D-dimer test threshold of 500 ng/mL in presence, and 1000 ng/mL in … Continue reading

Posted in Diagnosis, EUH

EUH Dressler Conference: What are HIV elite controllers and HIV long-term nonprogressors?

The Bottom Line: Long-term nonprogressors (LTNP) account for 1-5% of HIV-infected individuals characterized by documented infection for more than 7-10 years, a stable CD4+ T cell count over 500/mm3 and low viremia in the absence of antiretroviral treatment. They are able … Continue reading

Posted in Background question, Diagnosis, EUH, Intern toolbox, Teaching pearls

EUH Krakow Conference: What are the diagnostic criteria for Henoch-Schonlein purpura (HSP)?

The Bottom Line: European League Against Rheumatism/Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society (EULAR/PRINTO/PRES) criteria for diagnosis of HSP include both: purpura or petechiae not related to thrombocytopenia with lower limb predominance (or demonstration of immunoglobulin A [IgA] deposits … Continue reading

Posted in Background question, Diagnosis, EUH

EUH Krakow Conference: What are the causes of leukocytoclastic vasculitis?

The Bottom Line: About half of cases are idiopathic. The remainder are most often either drug induced or post infectious. Viral upper respiratory infection or streptococcal pharyngitis frequently precede the onset of IgA vasculitis by 1 to 2 weeks. 40% … Continue reading

Posted in Background question, Diagnosis, EUH