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Gastroenterology Hepatology

Chronic pancreatitis

How can I be sure that the patient has chronic pancreatitis? There are a number of clinical presentations of chronic pancreatitis. The disease usually is initially considered based on imaging findings or on symptoms. Abdominal pain is usually the earliest, most frequent, and most characteristic symptom. In many patients, the pain is often episodic early…
Anesthesiology

Cesarean Delivery, Spinal, Epidural or Combined Spinal-Epidural (CSE) Anesthesia

What the Anesthesiologist Should Know before the Operative Procedure Whether a neuraxial technique is the appropriate anesthetic choice for cesarean delivery will depend on the urgency of the procedure based on fetal or maternal issues, the presence of any significant maternal comorbidities or instability, and on occasion, whether a functioning labor epidural is already in…
Anesthesiology

ORIF of ankle fracture

What the Anesthesiologist Should Know before the Operative Procedure The anesthesiologist should know the patient’s medical conditions (including additional injuries for patients who have a high-energy mechanism of injury) as well as the surgical plan. 1. What is the urgency of the surgery? What is the risk of delay in order to obtain additional preoperative…
Pulmonary Medicine

Paraneoplastic Syndromes Associated with Lung Cancer (ectopic Cushing’s syndrome, SIADH, hypercalcemia of malignancy,Lambert-Eaton myasthenic syndrome (LEMS), paraneoplastic limbic encephalitis, paraneoplastic cerebellar degeneration, paraneoplastic opsoclonus-myoclonus, dermatomyositis)

What every physician needs to know: Lung cancer symptoms usually arise from the direct effects of tumor on the lungs or contiguous structures by compression, obstruction, or invasion of other organs. However, another important form of clinical presentation is paraneoplastic syndromes. Paraneoplastic syndromes are defined as symptoms and signs distant to the primary tumor site…
Gastroenterology Hepatology

Endoscopic diagnosis and therapy of biliary diseases

General description of procedure, equipment, and endoscopic technique Endoscopic retrograde cholangiopancreatography (ERCP) has assisted in the care of patients with pancreaticobiliary diseases for almost four decades. This technique involves passing a specially designed endoscope into the second portion of the duodenum. There, its side-viewing optics allow for identification of the major duodenal papilla. Through its…
Anesthesiology

Cystic fibrosis

What every physician needs to know: Cystic fibrosis (CF) is a relatively common disease that is inherited in an autosomal recessive pattern and results in a shortened average life span. CF affects all exocrine glands of the body, but abnormalities in the lungs and pancreas usually dominate the clinical picture. CF lung disease is a…
Cardiology

Managing the Patient with a Ventricular Assist Device

General description of procedure, equipment, technique Traditional management of heart failure (HF) includes medical therapy, implantable cardiac defibrillators (ICDs), and biventricular pacemakers. Despite such advances, HF continues to carry high morbidity and mortality. Five-year mortality for all patients with HF is estimated to be 50%. For those who have progressed to end-stage HF, the 1-year…
Infectious Diseases

Mediastinitis

OVERVIEW: What every practitioner needs to know Are you sure your patient has mediastinitis? What should you expect to find? Acute mediastinitis is an uncommon but potentially devastating infection involving the structures of the mediastinum. This infection can arise from perforation of the esophagus or spread from an oropharyngeal source, but most commonly occurs as…
Infectious Diseases

Hepatitis C Virus (HCV)

OVERVIEW: What every clinician needs to know Pathogen name and classification The Hepatitis C virus (HCV) is a single stranded, positive sense, RNA virus belonging to the family Flaviviridae and is the only member of the genus Hepacivirus. What patients should be treated? The FDA approval of multiple direct-acting antiviral regimens for HCV has ushered…
Pediatrics

Congenital anomalies/polycystic kidney disease

Overview: What every practitioner needs to know Are you sure your patient has congenital anomalies/polycystic kidney disease? What are the typical findings for this disease? Congenital anomalies of the kidney and urinary tract (CAKUT) occur in 1 in 500 births, account for the most cases of pediatric end-stage kidney disease (ESKD), and predispose an individual…
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