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🆓 Educational notes to medical students, interns, family physicians & any health-care worker who is interested in helping patients efficiently
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67-year-old man with progressive lower extremity pain that occurs when he is walking and relieved by bending forward at the waist or sitting down to rest. What is the most likely diagnosis?
📣 DM neuropathy can be painFUL or painLESS!
that’s why every DM patient should be EXAMINED for neuropathy by 10g monofilament, at least annually
+1🆕 FDA approved Empagliflozin to ↓ risk for decline in eGFR, ESRD, CV death, and hospitalization in adults with CKD
🔷 Most acute rhinosinusitis are due to VIRAL 🦠 infections (aka Abx are NOT required)
🔷 When to suspect BACTERIAL rhinosinusitis?
🤒 Fever and symptom >10 days 🦷 Maxillary toothache ⤵️ Initial symptom improvement and then worsening of symptoms ⤵️
👃 Cacosmia (sense of bad odor in the nose)
💥 Unilateral facial pain
Females with recurrent post-coital cystitis (UTI) should have Single dose Abx immediately after intercourse:
💊 Nitrofurantoin 100 mg (also preferred in penicillin allergy)
💊 TMP-SMX 80mg/400 mg
💊 Cephalexin 250 mg
Females with recurrent post-coital cystitis (UTI)
Post-coitol antibiotics: Single dose immediately after intercourse: 100 mg
TMP-SMX 80mg/400 mg
Trimethoprim 100 mg
Cephalexin 250 mg
Here is a lot of lesions to comment on, however, I meant to refer to hypopyon sign
DDx:
Pemphigus vulgaris
Bullous impetigo
+1🆕 NO link between PPI use & dementia or cognitive decline
post hoc analysis of (ASPREE) study, including 18,934 community-based adults ≥65
[Gastroenterology 2023;165:564–572]
🔗 https://www.gastrojournal.org/article/S0016-5085(23)00873-9/fulltext
🔷 When to refer DM patient to a nephrologist?
• GFR <30
• Urine Alb/Cr ratio >300 mg/d (nephrotic range)
• Rapid decline ↓ in eGFR >3 mL/min/1.73 m2 per year
• Inflammatory kidney disease (eg, hematuria and/or sterile pyuria)
• If the cause of the kidney disease is unclear
• Difficult-to-manage complications of CKD (eg, HYPERkalemia, anemia)