More articles from 1-Minute Consult
- What diagnostic tests should be done after discovering clubbing in a patient without cardiopulmonary symptoms?
Computed tomography of the patient’s chest is indicated based on the robust association between clubbing and intrathoracic malignancy.
- Does my adult patient need a measles vaccine?
Possibly. Adults without acceptable presumptive evidence of immunity to measles should receive 1 dose of the measles-mumps-rubella vaccine, and 2 doses are recommended for adults in special situations.
- Do I need to treat supine hypertension in my hospitalized patient?
Inpatients with an elevated supine blood pressure should be evaluated for orthostatic changes before treatment is considered.
- Should glucagon-like peptide 1 receptor agonists be withheld during the preoperative period?
Clinical judgment should guide this decision, taking into account patient symptoms and the presence of factors that may delay gastric emptying and increase risk for aspiration.
- Can my patient with a ‘sulfa allergy’ receive celecoxib or other nonantimicrobial sulfonamides?
There is no cross-reactivity between antimicrobial and nonantimicrobial sulfonamides, and patients with a history of immunoglobulin E–mediated reaction to a sulfonamide antibiotic can receive nonantimicrobial sulfonamides.
- Which patients with presumed acute infectious diarrhea in an outpatient setting should undergo gastrointestinal pathogen panel testing?
Use of a gastrointestinal pathogen panel is warranted in certain individuals, such as those with fever, visible blood in the stool, sepsis, or a compromised immune system.
- How can I better recognize and manage delirium in my hospitalized patients?
By knowing common precipitants and mimickers of delirium and considerations for workup, clinicians can implement nonpharmacologic preventive strategies, better identify patients experiencing delirium, and optimize symptom management.
- How do I manage my patients with thyrotoxicosis until they see the endocrinologist?
Primary care physicians can start beta-blockers promptly for symptomatic relief, obtain radioactive iodine uptake and scan, and start methimazole if high uptake is noted.
- What are options for my patients with erectile dysfunction who have an unsatisfactory response to PDE5 inhibitors?
Alternative therapies include intracavernosal injection, vacuum erection devices, and penile prosthesis implantation.
- Should every patient with an unprovoked venous thromboembolism have a hypercoagulable workup?
In the absence of consensus guidelines addressing this question, an individualized approach that considers personal and family history is needed.