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…

Bell’s Palsy

The following illustrations present a summary of what’s known as Bell’s Palsy. First described by Charles Bell in 1830, the diseased is defined as a peripheral facial paralysis due to many causes. The name “idiopathic facial palsy” may not be a synonym, since after a proper investigation, a cause is mostly found. Reference: uptodate.com. I…

Causes of upper gastrointestinal bleeding, part I

The following illustrations are a summary of some of the causes of upper GI in adults. Ulcer related, erosive and variceal (portal hypertensive related and non portal HT related) are included: The second part will include vascular causes, such as Deulafoy lesion and GAVE (gastric antral vascular ectasia). See ya next time! Augusto Saldaña M.D.

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…

Community acquired pneumonia / Neumonía adquirida en la comunidad.

Diagnosis will be based on the clinical presentation and the results from a plain chest x-ray. There are very sensitive and specific symptoms and signs that will form a “constellation” most associated with pneumonia. X-ray will then confirm the suspicion. Although, it must be said that older patients my have different signs and symptoms like…

Gallstone disease in adults / Cólico biliar en el adulto.

Abdominal pain is very common in the emergency department. Plenty of times patients complain of pain, but the physical examination results completely normal. Because of WHERE it hurts (upper right quadrant), suspicion of gallstone diseases rises. Things get tricky when lab results are normal, and the possibility of a final diagnosis in the ED disappears…

Cardiac tamponade / Taponamiento cardiaco.

A major complication of trauma and pericarditis, and a feared cause of hypotension and obstructive shock, cardiac tamponade occurs when there’s fluid in the pericardial space. This may be from effusion (pericarditis, serositis) or blood, such as in thoracic trauma. As the heart is “imprisoned” within its own pericardium, diastole is restricted, and ultimately systole…

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…