More articles from 1-Minute consult
- What is the utility of measuring the serum ammonia level in patients with altered mental status?
If you already know that the patient has decompensated liver disease, then measuring the ammonia level has little value.
- Who should receive the shingles vaccine?
The answer: Nearly everyone who is age 60 and older, immunocompetent, and without contraindications to it.
Does noninvasive positive pressure ventilation have a role in managing hypercapnic respiratory failure due to an acute exacerbation of COPD?Yes. In selected patients, this therapy reduces the need for endotracheal intubation, the hospital length of stay, and the risk of death.
- What are the caveats to using sodium phosphate agents for bowel preparation?
Although these preparations are generally safe and well tolerated, they can cause significant fluid shifts and electrolyte abnormalities. They should not be used in patients with electrolyte imbalances, renal or hepatic dysfunction, or a number of other comorbidities.
- Should patients on long-term warfarin take aspirin for heart disease?
The benefit of adding aspirin to warfarin (Coumadin) outweighs the risk in patients with acute coronary syndrome, mechanical heart valves, or coronary stents, but maybe not for patients who have stable coronary artery disease or who are at risk of coronary disease.
- Should all patients with chronic kidney disease take a statin?
Some patients should take a statin, particularly those not yet on dialysis who have low-density lipoprotein cholesterol levels higher than 100 mg/dL. However, relatively few studies have addressed this question.
- When should a methacholine challenge be ordered for a patient with suspected asthma?
This test is used if the diagnosis of asthma is in question, but it is currently not recommended for routine management of asthma.
- Should all patients with acute pericarditis be treated with colchicine?
Colchicine should be considered a first-line treatment for acute pericarditis and for preventing recurrent episodes.
- At what age should we discontinue colon cancer screening in the elderly?
In general, you should stop when you do not expect the patient to live 7 to 10 more years. However, the full answer is more complicated.