Pediatrics: Bronchiolitis vs. Croup

While the first is a disease of bronchioles and lower airway with resulting wheezing and crakles, the second one is inflammation of the larynx, causing stridor and braking cough. Both are caused mainly by a viral infection and both may present at the ED with rhinorrea, coughing, fever and signs of increased work of breathing….

Myelitis vs. Guillain Barré vs. MS

Let’s take a very quick review of these demyelinating diseases. Patient comes to the ED because of limb weakness and sensory alterations. If there’s a clearly defined level with no cranial nerve and no brainstem symptoms, we may be in front of transverse myelitis. If there is in fact oculomotor weakness with dyplopia or weakness…

Meralgia paresthetica

Check the following illustrations out. A patient comes for your help due to thigh pain. It hurts in a clearly demarcate area on the anterior and lateral region of her thigh. Pain is of a burning quality. Numbness is also felt. No motor abnormalities. Patient is overweight and has been wearing a very tight belt…

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 II: vascular abnormalities.

Upper GI also happens due to vascular abnormalities in the gastric and duodenal mucosa. Let’s review three: 1. Angiodysplasia (most common), 2. Dieulafoy’s lesion (associated with cardiovascular disease and NSAID use) and 3. GAVE -gastric antral vascular ectasia, associated with congestive gastropathy (due to portal hypertension, for example). Hope you enjoy learning and reviewing from…

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.

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…

Infective endocarditis diagnostic criteria / Endocarditis infecciosa, criterios diagnósticos.

Criteria can be quickly summarized in: Major clinical criteria (or pathological criteria) – Evidence of either valve damage or evidence of microorganisms within the bloodstream: Positive ecocardiography for infective endocarditis: vegetation, abscess, dehiscence of prosthetic valve. 2 separated positive blood cultures for typical IE microorganisms, or a single one for Cox. Burnetti. Minor clinical criteria…