More articles from 1-Minute Consult
- Should urine antigen testing for Legionella pneumophila be ordered for all hospitalized patients with community-acquired pneumonia?
Testing is recommended if the pneumonia is severe, if there has been recent travel, and if there is currently an outbreak of legionnaires disease.
- Celiac disease: Who should I test, and how?
First-degree relatives of patients with celiac disease and patients with dermatitis herpetiformis, type 1 diabetes mellitus, and autoimmune thyroid disease are among those for whom testing is advisable.
- What is the optimal approach to infiltration and extravasation of nonchemotherapy medications?
The immediate response is warm or cold compression and assessment of the severity.
- Should my elderly hospitalized patient with acute onset of altered mental status undergo stat head CT?
Clinical acumen and use of delirium scoring tools help narrow the range of possible causes for the individual patient and guide decisions on the need for further testing and imaging.
- 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.
- 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.
- 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?
- 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.