CURRENT Essentials of Medicine, Fourth Edition (LANGE by Lawrence Tierney, Sanjay Saint, Mary Whooley

By Lawrence Tierney, Sanjay Saint, Mary Whooley

The fitting fast reference at the wards and within the health center! The well-known "one disorder in keeping with web page" layout! present necessities of drugs is a realistic, point-of-care pocket guide that provides "nutshell" info at the analysis and therapy of greater than 500 scientific issues noticeable in either fundamental care and sanatorium settings. excellent as a brief reference at the wards or in a hectic health center, this is often the single pocket advisor to provide sickness necessities in a one-disease-per-page bulleted structure. functional pearls, for which the authors are renowned, are provided for the majority stipulations. positive aspects To-the-point details at the analysis and therapy of greater than 500 of the commonest illnesses visible in medical perform handy one-disease-per web page presentation Bulleted information for every affliction overlaying necessities of analysis, Differential analysis, remedy, Pearl, and Reference Encompasses either ambulatory and inpatient medication contains inner drugs, plus specialties similar to obstetrics/gynecology, surgical procedure, and pediatrics up-to-date medical manifestations, diagnostic assessments, and therapy concerns all through

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Extra resources for CURRENT Essentials of Medicine, Fourth Edition (LANGE CURRENT Essentials)

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N Engl J Med 2006;355:2125. [PMID: 17108344] Chapter 2 Pulmonary Diseases 41 Allergic Bronchopulmonary Mycosis (Formerly Allergic Bronchopulmonary Aspergillosis) 2 ■ Essentials of Diagnosis • • • • • ■ Differential Diagnosis • • • • • ■ Asthma Bronchiectasis Invasive aspergillosis Churg-Strauss syndrome Chronic obstructive pulmonary disease Treatment • • • • ■ Caused by allergy to antigens of Aspergillus species or other fungi colonizing the tracheobronchial tree Recurrent dyspnea, unmasked by corticosteroid withdrawal, with history of asthma; cough productive of brownish plugs of sputum Physical examination as in asthma Peripheral eosinophilia, elevated serum IgE level, precipitating antibody to Aspergillus antigen present; positive skin hypersensitivity to Aspergillus antigen Infiltrate (often fleeting) and central bronchiectasis by chest radiography Oral corticosteroids often required for several months Inhaled bronchodilators as for attacks of asthma Treatment with itraconazole (for 16 weeks) improves disease control Complications include hemoptysis, severe bronchiectasis, and pulmonary fibrosis Pearl One of at least three ways this fungus causes illness—all different pathophysiologically.

Severe community-acquired pneumonia in adults: current antimicrobial chemotherapy. Expert Rev Anti Infect Ther 2009;7:69. [PMID: 19622058] 37 38 Current Essentials of Medicine Acute Pulmonary Venous Thromboembolism 2 ■ Essentials of Diagnosis • • • • • • • • • • ■ Differential Diagnosis • • • ■ Seen in immobilized patients, congestive heart failure, malignancies, hypercoagulable states, and after pelvic trauma or surgery Abrupt onset of dyspnea and anxiety, with or without pleuritic chest pain, cough with hemoptysis; syncope rare Tachycardia, tachypnea most common; loud P2 with right-sided S3 characteristic but unusual Acute respiratory alkalosis and hypoxemia Elevations in brain natriuretic peptide (eg, BNP > 100 pg/mL) and/or troponins portend a worse prognosis and should prompt an echocardiographic evaluation of right ventricular function Quantitative D-dimer has excellent negative predictive value in patients with low clinical pretest probability CT angiogram is the new gold standard and essentially rules out clinically significant pulmonary embolism A ventilation-perfusion scan can be done in patients who cannot tolerate contrast dye; results rely on pretest probability Lower-extremity ultrasound demonstrates deep venous thrombosis (DVT) in half of patients Rarely, pulmonary angiography required Pneumonia; myocardial infarction Any cause of acute respiratory distress Systemic inflammatory response syndrome (SIRS) Treatment Anticoagulation: Acutely with heparin, start warfarin concurrently and continue for a minimum of 6 months (for reversible cause) to lifelong (unprovoked or irreversible cause) • Thrombolytic therapy in selected patients with hemodynamic compromise • Intravenous filter placement for selected patients; consider temporary filter if risk of anticoagulation is time-limited • ■ Pearl Ten percent of pulmonary emboli originate from upper-extremity veins; there is more endothelial thromboplastin activity than in the leg veins.

Orphanet J Rare Dis 2006;1:25.

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