More articles from 1-Minute Consult
- Fundic gland polyps: Should my patient stop taking PPIs?
Of the 2 types of these polyps, the sporadic type is linked to proton pump inhibitor use, whereas the syndromic type occurs on a background of familial adenomatous polyposis—a key distinction.
- What is the rationale for the laboratory workup for suspected pheochromocytomas and paragangliomas?
The decision to test is best guided by clinical suspicion. Test results should be interpreted with careful consideration of how the samples were collected.
- What are the treatment options for myasthenia gravis if first-line agents fail?
From 5% to 20% of patients may have a suboptimal response or prohibitive adverse effects over a period of a few weeks to 3 months.
- What are my obligations to my incarcerated patient?
A court order authorizes a blood transfusion, but the incarcerated patient refuses the transfusion. As the caregiver, am I obligated to follow the court order against the patient’s wishes?
- Which patients hospitalized with alcohol withdrawal syndrome should receive high-dose parenteral thiamine?
The authors briefly outline risk factors for Wernicke encephalopathy and when high-dose parenteral thiamine is indicated.
- Does my patient need to be screened or treated for a urinary tract infection?
When patients present with symptoms that suggest but are not clearly diagnostic of urinary tract infection, urine studies should be obtained.
- When should antithrombotic therapy be resumed after gastrointestinal bleeding?
The timing should be individualized after considering factors related to the bleeding event, thromboembolic risk, and patient comorbidities.
Atrial fibrillation: Rate control or rhythm control?Rate control has been preferred as the primary approach, but the pendulum is swinging in favor of rhythm control.
- How do I interpret and use quantitative buprenorphine and norbuprenorphine urine levels?
Confirmatory testing of urine samples can be useful in outpatient settings where buprenorphine dosing is not directly observed. But retaining and engaging the patient in effective treatment should be the ultimate goals of testing.
- How do we maximize diuresis in acute decompensated heart failure?
The initial goal is to maximize loop diuretic therapy using urine output or urinary sodium for guidance. Combination therapy can be used when patients respond poorly to escalating loop diuretic doses.