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Internal Medicine Residency Readings: July - Dec 2015
Information resources to support questions and discussion from resident report/morning report.
Winger J, Michelfelder A. Diagnostic approach to the patient with jaundice. Prim Care. 2011 Sep;38(3):469-82; viii. doi: 10.1016/j.pop.2011.05.004. Review. PubMed PMID: 21872092.
Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014 Dec 6;384(9959):2053-63. doi: 10.1016/S0140-6736(14)60220-8. Epub 2014 Jun 18. Review. PubMed PMID: 24954675.
Roberts PF, Waller TA, Brinker TM, Riffe IZ, Sayre JW, Bratton RL. Henoch-Schönlein purpura: a review article. South Med J. 2007 Aug;100(8):821-4. Review. PubMed PMID: 17713309.
"Experimental studies have demonstrated that the infectious agent may be present in many body tissues...CSF, liver, lymph node, kidney, lung, and spleen are considered low risk because of poor success with experimental transmission and no epidemiologic evidence of infection."
From: Thomas JG, Chenoweth CE, Sullivan SE. Iatrogenic Creutzfeldt-Jakob disease via
surgical instruments. J Clin Neurosci. 2013 Sep;20(9):1207-12. doi:
10.1016/j.jocn.2013.01.007. Epub 2013 Jul 27. Review. PubMed PMID: 23896549.
Natsis K, Piagkou M, Skotsimara A, Protogerou V, Tsitouridis I, Skandalakis P. Horseshoe kidney: a review of anatomy and pathology. Surg Radiol Anat. 2014
Aug;36(6):517-26. doi: 10.1007/s00276-013-1229-7. Epub 2013 Nov 1. Review. PubMed PMID: 24178305.
O'Brien J, Buckley O, Doody O, Ward E, Persaud T, Torreggiani W. Imaging of horseshoe kidneys and their complications. J Med Imaging Radiat Oncol. 2008 Jun;52(3):216-26. doi: 10.1111/j.1440-1673.2008.01950.x. Review. PubMed PMID: 18477115.
Dawson D. Essential principles: tracheostomy care in the adult patient. Nurs Crit Care. 2014 Mar;19(2):63-72. doi: 10.1111/nicc.12076. PubMed PMID: 24529106.
warfarin is reasonable for patients with a CHA2DS2-VASc score ≥ 2 and end-stage chronic kidney disease (creatinine clearance < 15 mL/minute) or are on hemodialysis (ACC/AHA Class IIa, Level B)
treatment with reduced doses of direct thrombin or factor Xa inhibitors (dabigatran, rivaroxaban, or apixaban) may be considered for patients with nonvalvular atrial fibrillation and moderate-to-severe chronic kidney disease and a CHA2DS2-VASc score = 2, but safety and efficacy have not been established (ACC/AHA Class IIb, Level C)
direct thrombin inhibitors (dabigatran or the factor Xa inhibitor rivaroxaban) not recommended for patients with end-stage chronic kidney disease or on hemodialysis due to lack of evidence from clinical trials regarding the balance of risks and benefits (ACC/AHA Class III, Level C)
In order to relieve assisting physicians on board of any medicolegal worries that could hinder them in the provision of aid, the cabin crew often issues a declaration of assumption of liability, according to which the physician is insured for any claims arising from his or her actions on board except in the case of deliberate harm or gross negligence. This insurance is a compo- nent of the insurance of the aircraft for personal injury claims; it covers medical interventions even by persons whose medical qualifications are not generally recog- nized in the country under whose jurisdiction the aircraft or airline operates.
-covered only if no monetary or equivalent recompense accepted.
Sanofi US is voluntarily recalling all Auvi‑Q® (epinephrine injection, USP). The recall involves all Auvi‑Q currently on the market and includes both the 0.15 mg and 0.3 mg strengths for hospitals, retailers and consumers. This includes lot numbers 2081278 through 3037230, which expire October 2015 through December 2016. The products have been found to potentially have inaccurate dosage delivery, which may include failure to deliver drug.
Pawlowski SW, Warren CA, Guerrant R. Diagnosis and treatment of acute or persistent diarrhea. Gastroenterology. 2009 May;136(6):1874-86. doi:
10.1053/j.gastro.2009.02.072. Epub 2009 May 7. Review. PubMed PMID: 19457416; PubMed Central PMCID: PMC2723735.
Phin N, Parry-Ford F, Harrison T, Stagg HR, Zhang N, Kumar K, Lortholary O,
Zumla A, Abubakar I. Epidemiology and clinical management of Legionnaires'
disease. Lancet Infect Dis. 2014 Oct;14(10):1011-21. doi:
10.1016/S1473-3099(14)70713-3. Epub 2014 Jun 23. Review. PubMed PMID: 24970283.
Wilkins T, Khan N, Nabh A, Schade RR. Diagnosis and management of upper gastrointestinal bleeding. Am Fam Physician. 2012 Mar 1;85(5):469-76. Review. PubMed PMID: 22534226.
European Association for the Study of the Liver (EASL) recommendations for spontaneous bacterial peritonitis prophylaxis in patients without gastrointestinal bleeding(6)
in patients with severe liver disease and ascitic fluid protein level < 15 g/L, consider long-term prophylaxis with norfloxacin (EASL Strong recommendation, High-quality evidence); severe liver disease defined in the supporting trial as Child-Pugh score ≥ 9 points with serum bilirubin level ≥ 3 mg/dL (51.3 mcmol/L) or impaired renal function (serum creatinine level ≥ 1.2 mg/dL [106.1 mcmol/L], blood urea nitrogen level ≥ 25 mg/dL [8.9 mmol/L], or serum sodium level ≤ 130 mEq/L [130 mmol/L])
Fanara B, Manzon C, Barbot O, Desmettre T, Capellier G. Recommendations for the intra-hospital transport of critically ill patients. Crit Care. 2010;14(3):R87. doi: 10.1186/cc9018. Epub 2010 May 14. Review. PubMed PMID: 20470381; PubMed Central PMCID: PMC2911721
Halsey NA. Discussion of Immunization Practices Advisory Committee/American
Academy of Pediatrics recommendations for universal infant hepatitis B vaccination. Pediatr Infect Dis J. 1993 May;12(5):446-9. PubMed PMID: 8327314.
Chu C, Selwyn PA. Diagnosis and initial management of acute HIV infection. Am Fam Physician. 2010 May 15;81(10):1239-44. Review. PubMed PMID: 20507048.
Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014 Dec 6;384(9959):2053-63. doi: 10.1016/S0140-6736(14)60220-8. Epub 2014 Jun 18. Review. PubMed PMID: 24954675.
Silva MM. Neurologic complications of HIV in the HAART era: where are we? Braz J Infect Dis. 2012 Jul-Aug;16(4):373-8. doi: 10.1016/j.bjid.2012.06.021. Review. PubMed PMID: 22846127.
No: Dr. Churg was a Polish Jew who immigrated to the U.S. in 1936. Dr. Strauss was German, completed medical school in Italy in 1937, and immigrated to the U.S. in 1938.
de Campos, F. P. F., & Geller, S. A. (2013). Churg-Strauss Syndrome: a syndrome described on clinical observation and autopsy findings. Autopsy and Case Reports, 3(2), 1-4.
albuminocytologic disassociation, which is an elevated CSF protein level greater than 0.55 g/L with normal white blood cell count (<5–10 × 106 cells/L).
Rossi R, Balagtas D, Cuccurullo S (2015). Neurorehabilitation. In Maitin I.B., Cruz E (Eds), CURRENT Diagnosis & Treatment: Physical Medicine & Rehabilitation.
Harder N. Temporal arteritis: an approach to suspected vasculitides. Prim
Care. 2010 Dec;37(4):757-66, vi-ii. doi: 10.1016/j.pop.2010.07.005. Review.
PubMed PMID: 21050956.
Ness, T., Bley, T. A., Schmidt, W. A., & Lamprecht, P. (2013). The Diagnosis and Treatment of Giant Cell Arteritis. Deutsches Aerzteblatt International, 110(21), 376-386 11p. doi:10.3238/arztebl.2013.0376
Ramos-Casals M, Brito-Zerón P, García-Carrasco M, Font J. Sarcoidosis or Sjögren syndrome? Clues to defining mimicry or coexistence in 59 cases. Medicine (Baltimore). 2004 Mar;83(2):85-95. Review. PubMed PMID: 15028962.
McNamara R, Dean AJ. Approach to acute abdominal pain. Emerg Med Clin North Am. 2011 May;29(2):159-73, vii. doi: 10.1016/j.emc.2011.01.013. Review. PubMed PMID: 2115174.
Fotiadis C, Tsekouras DK, Antonakis P, Sfiniadakis J, Genetzakis M, Zografos GC. Gardner's syndrome: a case report and review of the literature. World J Gasrtoenterol. 2005 Sep 14;11(34):5408-11. Review. PubMed PMID: 16149159.
"The sensitivity of IHC testing, regardless of the MMR gene involved, is 83% and the specificity is 89%."
Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW; American College of Gastroenterology. ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol. 2015 Feb;110(2):223-62; quiz 263. doi: 10.1038/ajg.2014.435. Epub 2015 Feb 3. Review. PubMed PMID: 25645574.
Mellstedt H. Clinical signs and symptoms at diagnosis and its differential diagnosis. Ann Oncol. 2007 Jan;18 Suppl 1:i14-i21. Review. PubMed PMID: 17311816.
Motyckova G, Steensma DP. Why does my patient have lymphadenopathy or
splenomegaly? Hematol Oncol Clin North Am. 2012 Apr;26(2):395-408, ix. doi:
10.1016/j.hoc.2012.02.005. Epub 2012 Mar 9. Review. PubMed PMID: 22463834.
Sarno J. Prevention and management of tumor lysis syndrome in adults with malignancy. J Adv Pract Oncol. 2013 Mar;4(2):101-6. Review. PubMed PMID: 25031988; PubMed Central PMCID: PMC4093415.
See table 1 for prophylaxis recommendations based on risk.
Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011 May 12;364(19):1844-54. doi: 10.1056/NEJMra0904569. Review. PubMed PMID: 21561350; PubMed Central PMCID: PMC3437249.
Wilkin T. CLINICAL PRACTICE. Primary Care for Men Who Have Sex with Men. N Engl J Med. 2015 Aug 27;373(9):854-62. doi: 10.1056/NEJMcp1401303. Review. PubMed PMID: 26308686.
LeFevre ML; U.S. Preventive Services Task Force. Screening for Chlamydia and gonorrhea: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Dec 16;161(12):902-10. doi: 10.7326/M14-1981. PubMed PMID: 25243785.
Weant KA, Baker SN. Review of human rabies prophylaxis and treatment. Crit Care Nurs Clin North Am. 2013 Jun;25(2):225-42. doi: 10.1016/j.ccell.2013.02.001. epub 2013 Mar 1. Review. PubMed PMID: 23692940.
Mills B, Yepes A, Nugent K. Synthetic Cannabinoids. Am J Med Sci. 2015 Jul;350(1):59-62. doi: 10.1097/MAJ.0000000000000466. Review. PubMed PMID: 26132518.
van Amsterdam J, Brunt T, van den Brink W. The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects. J
Psychopharmacol. 2015 Mar;29(3):254-63. doi: 10.1177/0269881114565142. Epub 2015 Jan 13. Review. PubMed PMID: 25586398.
Hess C, Stockhausen S, Kernbach-Wighton G, Madea B. Death due to diabetic
ketoacidosis: Induction by the consumption of synthetic cannabinoids? Forensic Sci Int. 2015 Aug 29. pii: S0379-0738(15)00356-4. doi:
10.1016/j.forsciint.2015.08.012. [Epub ahead of print] PubMed PMID: 26363623.
Pavlidis N, Khaled H, Gaafar R. A mini review on cancer of unknown primary site: A clinical puzzle for the oncologists. J Adv Res. 2015 May;6(3):375-82.
doi: 10.1016/j.jare.2014.11.007. Epub 2014 Nov 21. Review. PubMed PMID: 26257935; PubMed Central PMCID: PMC4522587.
Moseley RH, Manoogian B, Shehab T, Saint S. Clinical problem-solving. An intricate interplay. N Engl J Med. 2012 Oct 4;367(14):1342-7. doi: 10.1056/NEJMcps1011784. PubMed PMID: 23034023.
Runfola JK, House J, Miller L, Colton L, Hite D, Hawley A, Mead P, Schriefer M, Petersen J, Casaceli C, Erlandson KM, Foster C, Pabilonia KL, Mason G, Douglas JM Jr; Centers for Disease Control and Prevention (CDC). Outbreak of Human Pneumonic Plague with Dog-to-Human and Possible Human-to-Human Transmission--Colorado, June-July 2014. MMWR Morb Mortal Wkly Rep. 2015 May 1;64(16):429-34. PubMed PMID: 25928467.
Ulu-Kilic A, Doganay M. An overview: tularemia and travel medicine. Travel Med Infect Dis. 2014 Nov-Dec;12(6 Pt A):609-16. doi: 10.1016/j.tmaid.2014.10.007. ePub 2014 Oct 18. Review. PubMed PMID: 25457302.
Mandel J, Poch D. In the clinic. Pulmonary hypertension. Ann Intern Med. 2013 May 7;158(9):ITC5-1 -16. doi: 10.7326/0003-4819-158-9-201305070-01005. Review. PubMed PMID: 23648959.
Jamilloux Y, Gerfaud-Valentin M, Henry T, Sève P. Treatment of adult-onset Still's disease: a review. Ther Clin Risk Manag. 2014 Dec 22;11:33-43. doi:
10.2147/TCRM.S64951. eCollection 2015. Review. PubMed PMID: 25653531; PubMed Central PMCID: PMC4278737.
CDC (2015). Health Information for Travelers to Uganda Clinician View from Traveler's Health. Available at: http://wwwnc.cdc.gov/travel/destinations/clinician/none/uganda?s_cid=ncezid-dgmq-travel-single-002
Johnson BA, Kalra MG. Prevention of malaria in travelers. Am Fam Physician. 2012 May 15;85(10):973-7. Erratum in: Am Fam Physician. 2012 Aug 1;86(3):222. Dosage error in article text. PubMed PMID: 22612048.
Perlman R.L., Heung M, Ix J.H. (2013). Renal Disease. In Hammer G.D., McPhee S.J. (Eds), Pathophysiology of Disease: An Introduction to Clinical Medicine, Seventh Edition.
LeBlond R.F., Brown D.D., Suneja M, Szot J.F. (2015). Principles of Diagnostic Testing. In LeBlond R.F., Brown D.D., Suneja M, Szot J.F. (Eds), DeGowin’s Diagnostic Examination, 10e. Retrieved August 05, 2015 from http://accessmedicine.mhmedical.com.proxygw.wrlc.org/content.aspx?bookid=1192&Sectionid=68671649.
Martin C (2014). Chapter 3. Epidemiology, Biostatistics, and Surveillance. In Markle W.H., Fisher M.A., Smego R.A., Jr. (Eds), Understanding Global Health, 2e. Retrieved August 05, 2015 from http://accessmedicine.mhmedical.com.proxygw.wrlc.org/content.aspx?bookid=710&Sectionid=46796904.
MacMahon, H., Austin, J., Gamsu, G., Herold, C., Jett, J., Naidich, D., & ... Swensen, S. (2005). Guidelines for management of small pulmonary nodules detected on CT scans: A statement from the Fleischner Society. Radiology, 237(2), 395-400
Weant KA, Baker SN. Review of human rabies prophylaxis and treatment. Crit Care Nurs Clin North Am. 2013 Jun;25(2):225-42. doi: 10.1016/j.ccell.2013.02.001. epub 2013 Mar 1. Review. PubMed PMID: 23692940.
: Mehndiratta M, Nayak R, Garg H, Kumar M, Pandey S. Appraisal of Kernig's and Brudzinski's sign in meningitis. Ann Indian Acad Neurol. 2012 Oct;15(4):287-8.doi: 10.4103/0972-2327.104337. PubMed PMID: 23349594; PubMed Central PMCID: PMC3548367.
Van Amsterdam J, Brunt T, van den Brink W. The adverse health effects of
synthetic cannabinoids with emphasis on psychosis-like effects. J
Psychopharmacol. 2015 Mar;29(3):254-63. doi: 10.1177/0269881114565142. Epub 2015 Jan 13. Review. PubMed PMID: 25586398.
Brewer TL, Collins M. A review of clinical manifestations in adolescent and
young adults after use of synthetic cannabinoids. J Spec Pediatr Nurs. 2014
Apr;19(2):119-26. doi: 10.1111/jspn.12057. Epub 2013 Dec 10. Review. PubMed PMID:
24320158.
Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ, Svensson PJ, Veenstra DL, Crowther M, Guyatt GH; American College of Chest Physicians. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e152S-84S. doi: 10.1378/chest.11-2295. Review. PubMed PMID: 22315259; PubMed Central PMCID: PMC3278055.
The definition of ‘correction’ varies from laboratory to laboratory because of differences in the PTT and PT methods used. Some thromboplastin reagents are more sensitive than others. Attempts to standardize across laboratories have been generally unsuccessful. Consultation with the particular laboratory involved or someone experienced in interpreting its results may be helpful, particularly when partial correction occurs.
From Transfusion Medicine and Hemostasis: Clinical and Laboratory Aspects (2nd Ed)
Prasad Kerlin M. In the clinic. Asthma. Ann Intern Med. 2014 Mar 4;160(5):ITC3
2-15; quiz ITC3 16-9. doi: 10.7326/0003-4819-160-5-201403040-01003. Review.
PubMed PMID: 24737276.
Recommended by Dr. Ahari
Busse WW. Asthma diagnosis and treatment: filling in the information gaps. J
Allergy Clin Immunol. 2011 Oct;128(4):740-50. doi: 10.1016/j.jaci.2011.08.014.
Epub 2011 Aug 27. Review. PubMed PMID: 21875745.
Lau TT, Zed PJ. Does ketamine have a role in managing severe exacerbation of asthma in adults? Pharmacotherapy. 2001 Sep;21(9):1100-6. Review. PubMed PMID: 11560199. Note: not available full-text; email Laura if you would like a copy.
LeBlond R.F., Brown D.D., Suneja M, Szot J.F. (2015). The Nervous System. In LeBlond R.F., Brown D.D., Suneja M, Szot J.F. (Eds), DeGowin’s Diagnostic Examination, 10e.
Molnar A, McGee S. Diagnosing and treating dizziness. Med Clin North Am. 2014 May;98(3):583-96. doi: 10.1016/j.mcna.2014.01.014. Review. PubMed PMID: 24758962.
LeBlond R.F., Brown D.D., Suneja M, Szot J.F. (2015). The Head and Neck. In LeBlond R.F., Brown D.D., Suneja M, Szot J.F. (Eds), DeGowin’s Diagnostic Examination, 10e.
Foden N, Mehta N, Joseph T. Sudden onset hearing loss--causes, investigations
and management. Aust Fam Physician. 2013 Sep;42(9):641-4. PubMed PMID: 24024225.
Greenberg DL. Evaluation and treatment of shoulder pain. Med Clin North Am.
2014 May;98(3):487-504. doi: 10.1016/j.mcna.2014.01.016. Epub 2014 Mar 22.
Review. PubMed PMID: 24758957.
Hamdan K, Somers S, Chand M. Management of late postoperative complications of bariatric surgery. The British Journal Of Surgery [serial online]. October 2011;98(10):1345-1355. Available from: MEDLINE Complete, Ipswich, MA. Accessed July 7, 2015.
John S, Thuluvath PJ. Hyponatremia in cirrhosis: pathophysiology and management. World J Gastroenterol. 2015 Mar 21;21(11):3197-205. doi:
10.3748/wjg.v21.i11.3197. Review. PubMed PMID: 25805925; PubMed Central PMCID: PMC4363748.
Lee JJ, Kilonzo K, Nistico A, Yeates K. Management of hyponatremia. CMAJ. 2014 May 13;186(8):E281-6. doi: 10.1503/cmaj.120887. Epub 2013 Dec 16. Review. PubMed PMID: 24344146; PubMed Central PMCID: PMC4016091.
if risk of antibiotic resistance or if failed initial therapy, use 1 of the following(2)
high-dose amoxicillin-clavulanate 2,000 mg/125 mg orally twice daily (IDSA Weak recommendation, Moderate-quality evidence)
levofloxacin 500 mg orally once daily
moxifloxacin 400 mg orally once daily
Gibson AM, Sommerkamp SK. Evaluation and management of oral lesions in the emergency department. Emerg Med Clin North Am. 2013 May;31(2):455-63. doi: 10.1016/j.emc.2013.02.004. Epub 2013 Mar 15. Review. PubMed PMID: 23601482.
for eye involvement
treat inflammatory eye disease affecting posterior segment with regimen that includes azathioprine and systemic corticosteroids (EULAR Category Ib, Grade A/D)
if severe eye disease (defined as > 2 lines of drop in visual acuity on 10/10 scale and/or retinal disease [retinal vasculitis or macular involvement]) (EULAR Category Ib/IIb, Grade C/D)
treat with either cyclosporine A or infliximab in combination with azathioprine and corticosteroids
alternatively use interferon alfa with or without corticosteroids
Mat, M. C., Goksugur, N., Engin, B., Yurdakul, S., & Yazici, H. (2006). The frequency of scarring after genital ulcers in Behçet's syndrome: a prospective study. International Journal Of Dermatology, 45(5), 554-556.