Hospital Medicine
Inhalation exposure to asbestos causes malignant as well as non-malignant diseases of the chest. The spectrum of pleural diseases associated with exposure can range from pleural plaques to effusion and malignancy. Despite major awareness and enormous effort to control exposure, asbestos related diseases will continue because of disease latency and ongoing exposure. In this chapter,…
Hospital Medicine
I. Problem/Condition. Inadequate perfusion to the extremities refers to decreased arterial blood flow to the extremities. This can be due to a sudden embolic event obstructing arterial flow, or a chronic obstructive process leading to decreased arterial flow to the extremities. II. Diagnostic Approach. A. What is the differential diagnosis for this problem? A useful…
Hospital Medicine
Appendicitis I. What every physician needs to know. Appendicitis—acute inflammation of vermiform appendix—is one of the most common and treatable causes of acute abdominal pain. Estimated lifetime risk of appendicitis is about 7 to 8 percent. Its cause remains poorly understood until this day. Infections, environmental, and genetic factors have been implicated in the recent…
Hospital Medicine
Mesenteric Adenitis I. What every physician needs to know. Right lower quadrant (RLQ) pain is a common initial presenting complaint with acute appendicitis as the most frequent cause. Mesenteric adenitis, also known as mesenteric lymphadenitis, is caused by inflamed mesenteric lymph nodes and is the second most common cause of acute RLQ abdominal pain. Mesenteric…
Hospital Medicine
I. Definitions and background Factitious disorder Factitious disorder is a condition in which a patient falsifies symptoms of illness for the purpose of assuming the sick role. Factitious disorder is a psychiatric diagnosis, and according to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV-TR), patients must meet the following…
Hospital Medicine
Peripheral Arterial Disease I. What every physician needs to know. Peripheral arterial disease (PAD) is a condition of blood vessels that result in narrowing of arteries and diminished perfusion to the tissues supplying the brain, visceral organs and limbs. This chapter primarily discusses lower extremity PAD. PAD and peripheral vascular disease are used interchangeably. PAD…
Hospital Medicine
I. Problem/Challenge. Hospitalists are often asked to consult on or co-manage patients undergoing orthopedic procedures. The scope can be general, such as pre-operative risk stratification or management of chronic medical problems. More challenging, specific problems include management of perioperative anticoagulation, diagnosis and management of perioperative delirium, fever, hypoxia, or fluid and electrolyte derangement. In the…
Hospital Medicine
Abdominal aortic aneurysm I. What every physician needs to know. Abdominal aortic aneurysm (AAA) is defined as a permanent dilatation of all three layers of the abdominal aortic wall with a diameter measuring 3 cm or larger. By comparison, a pseudoaneursym is defined as communication of blood between the layers of the arterial wall, without…
Hospital Medicine
I. What every physician needs to know. Melanoma is a malignant tumor of melanocytes which are normally found in the basal layer of the epidermis. Unlike other skin cancers which appear mostly in sun-exposed areas, melanoma can occur anywhere on the body including the mucous membranes. Melanoma is primarily a skin cancer of adults and…
Hospital Medicine
OVERVIEW: What every practitioner needs to know Are you sure your patient has nocardiosis? What are the typical findings for this disease? Nocardiosis refers to the disease entities caused by Nocardia species. Nocardia are Gram-positive, partially acid-fast, branched, filamentous environmentally ubiquitous aerobic rods. The most commonly isolated species in the United States are N. nova,…