Anticholinergic poisoning

The following illustration reviews the famous mnemonic that helps to remember some of the feature signs and symptoms of anticholinergic poisoning. It’s important to remember that there are over 600 medications usually prescribed by physicians and over-the-counter that have anticholinergic components. These include antihistaminics, bronchodilators and psychotropics. Elderly population is in special risk due to…

Pulmonary embolism / Tromboembolismo pulmonar

Think about it whenever you have a patient who presents with abrupt unexplained shortness of breath, tachypnea and tachycardia, specially in the setting of deep venous thrombosis, recent surgery, having to wear a cast on the leg, prolonged immobilization (like after a long trip), or active cancer. After a careful examination, you may find out…

Acute calculous cholecystitis / Colecistitis aguda calculosa.

Acute cholecystitis (inflammation of the gallbladder) results from injury from a gallstone, like impactation or cystic duct obstruction. Sometimes inflammation occurs without gallstone disease due to infection of bile (acalculous cholecystitis). The main difference between a patient who complains from abdominal pain and suffers from uncomplicated gallstone disease and acute cholecystitis is the evidence of…

Abdominal pain in the ED / Dolor abdominal en urgencias.

While very common in the emergency department, abdominal pain can be challenging, since the causes range from functional disorders, non severe organic diseases up to bad acute abdomen real life threatening emergencies. Women and elderly patients represent an even more challenging population due to an expanded list of possible diseases and higher frequency of atypical…

Lower extremity vascular disease:

Peripheral artery disease vs. deep venous thrombosis: PERIPHERAL ARTERY DISEASE (PAD).- Due to arterial stenosis. Associated with heavy and prolonged tobacco use and atherosclerotic disease. Reduce blood flow will cause signs and symptoms such as weak pulses, pallor, cold skin, ulceration and of course lower extremity pain that increases with exertion up to the point…

Sepsis

The patient who becomes “septic” / El paciente séptico. Quick tips: This patient looks ill and has a “toxic appearance”, mental status may be altered, looks pale or cyanotic, is hypotensive (SBP < 100), cold or feverish, breathing heavily and with very weak pulses. Skin may present livedo reticularis and capillary refill time is prolonged….