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Radial Access and Intervention

General description of procedure, equipment, technique Transradial angiography and intervention includes vascular procedures performed via radial arterial access. Because the radial artery is smaller in diameter compared with the femoral artery, and is more superficially located, hemostasis after transradial procedures is easily obtained. The body of evidence suggests a significant reduction in access-site bleeding and…
Hospital Medicine

Adrenal adenoma

At a Glance Adrenal adenomas are benign tumors of the adrenal glands. Most adrenal adenomas are spotted by chance at the time of computed tomography (CT) or magnetic resonance imaging (MRI) verifying some other symptoms. They are classified as either functional (hormone secreting) or nonfunctional (incidentalomas) and as either benign or malignant. The majority of…
Endocrinology Metabolism


Are You Sure the Patient Has a Craniopharyngioma? Craniopharyngiomas are benign tumors which develop in the sellar/suprasellar region adjacent to the pituitary gland. Patients may be diagnosed years after the onset of symptoms due to the nonspecific and insidious nature of symptoms. Adult patients will often complain of headache, visual deficits resulting from mass effect…
Dermatologic Look-Alikes

Large, Spreading Rash After Illness

The term morbilliform describes a rash that resembles measles, with erythematous, maculopapular lesions that may coalesce.
Hospital Medicine

Systemic lupus erythematosus

I. What every physician needs to know. Systemic lupus erythematosus (SLE) is an autoimmune disease that can present with a constellation of symptoms, most commonly including arthritis, rash, hematologic disease, kidney disease, and inflammation of the serosal surfaces of the heart and lungs. However, SLE may target nearly any tissue in the body and mimic…

Intrauterine fetal assessment and management of non-reassuring status

What the Anesthesiologist Should Know before the Operative Procedure Intrauterine fetal monitoring is used by the obstetrician to determine fetal status before and during labor. It is the anesthesiologist’s responsibility to understand and be aware of fetal status in order to optimize communication with their obstetric colleagues and respond to emergencies in a timely manner.…
Pulmonary Medicine

Aspiration Pneumonia and Lung Abscess

What every physician needs to know: Aspiration can lead to any of four distinct syndromes: pneumonitis (which is not discussed further in this chapter), necrotizing pneumonia, lung abscess, and empyema (which almost always overlaps with pneumonia or abscess formation). Pulmonary aspiration and its infectious complications are important causes of serious illness and death in hospitalized…
Gastroenterology Hepatology


Causes of ascites The most common cause is portal hypertension secondary to cirrhosis. This accounts for for 90% of cases. In 10% of cases, there is a nonhepatic cause such as malignancy, heart failure, constrictive pericarditis, tuberculosis, nephrotic syndrome, hemodialysis, pancreatitis, bile leak and other rare causes. Table 1 History and exam Ascites usually develops…
Gastroenterology Hepatology

Liver transplantation: indications/evaluation

How can I be sure that the patient has sufficient indications for liver transplantation? Patients that are candidates for liver transplantation have either acute or chronic end-stage liver disease. Manifestations of end-stage liver disease include synthetic dysfunction, inflammatory activity, and complications of portal hypertension. 1. Coagulopathy. Prolongation of the prothrombin time and international normalization ratio…
Hospital Medicine

Complications of Diabetes Mellitus

I. Problem/Condition. In the United States, the estimated prevalence of diabetes mellitus (DM) is between 4.4-17.9 %. While diabetes has a major impact on quality of life and economics, the associated vascular complications result in approximately 14 % of US health care expenses. The complications of DM are divided into macrovascular (coronary artery disease, stroke…
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