Primary Care

CLUSTER HEADACHE

Neuros Medical Verified User December 8, 2018 Primary Care Comments Off 1805 views

Cluster headaches are more common in middle aged men, with a ratio of 2:1 In women, it is usually seen earlier in life (in their 20s) ASSOCIATED WITH 1. Depression 2. Asthma 3. History of migraines 4. Sleep apnea CLINICAL PRESENTATION The diagnosis is clinical 1. Unilateral, recurrent periorbital pain that lasts from 15 min upto 3 hours 2. Usually at night time 3. Ipsilateral injection, lacrimation and nasal congestion 4. Neurological exam is normal PATHOPHYSIOLOGY Posterior hypothalamus activation > increased parasympathetic outflow The lacrimation, redness and congestion is due to parasympathetic hyperactivity The ptosis and ...

How much sleep should you get?

Neuros Medical Verified User November 27, 2018 Sleep Medicine Comments Off 1584 views

RECOMMENDATIONS BASED ON NATIONAL SLEEP FOUNDATION: AGE HOURS OF SLEEP 0-3 months 14-17 hours 4-11 months 12-15 hours 1-2 years 11-14 hours 3-5 years 10-13 hours 6-13 years 9-11 hours 14-17 years 8-10 hours 18-25 years 7-9 hours 26-64 years 7-9 hours 65+ years 7-8 hours Reference: National Sleep Foundation (Accessed ...

Pneumonia

Neuros Medical Verified User November 22, 2018 Primary Care Comments Off 1684 views

Pneumonia is the infection of the lower respiratory tract. There are 2 main types; Community acquired pneumonia (CAP) and Health care associated pneumonia (HCAP) EPIDEMIOLOGY - approx 4 million adults in the US are diagnosed with CAP every year ETIOLOGY - Viral (most common, 85% cases) - Common bacterial; S.pneumoniae, Hemophilus influenzae, Staph aureus, MRSA, Pseudomonas - Other; TB, fungi, legionella RISK FACTORS - Age (>65yrs) - Smoking, Alcohol use - Asthma, COPD - Previous h/o of pneumonia - Immunosuppression - Malnutrition PATHOLOGY BASED ON RISK FACTORS 1. Alcohol - S.pneumoniae, Klebsiella, S aureus, Anaerobes 2. ...

Adrenal Insufficiency

Neuros Medical Verified User November 13, 2018 Primary Care , USMLE Step 1 Comments Off 1759 views

Consists of 2 types; primary and secondary Primary adrenal insufficiency is also called Addison's disease ETIOLOGY Primary - Autoimmune (most common) - Hemorrhage; trauma, illness, pregnancy - Infections; HIV, CMV, TB - Amyloidosis and Hemochromatosis - Congenital - Drugs; ketoconazole, etomidate, mitotane Secondary - Iatrogenic CLINICAL FEATURES - Weakness, Fatigue - Weight loss - Nausea, Vomiting, Diarrhea, Abdominal pain - Orthostatic hypotension - Coma, Death - Hyper pigmentation of oral mucosa and palmar creases DIAGNOSIS - Blood work; BMP (hyponatremia, hyperkalemia) - Cortisol test - Cosyntropin stimulation test TREATMENT - Fludrocortisone, Hydrocortisone, Prednisone

Preventing Cold Injuries

Neuros Medical Verified User October 26, 2018 Primary Care Comments Off 1551 views

Treating & Preventing Cold Injuries: Exposure Risks: Risk factors are elevated for people who spend extended time working or recreating in cold environments. Many winter time injuries occur at the end of the work or recreational day when the temperature drops, surfaces get icy and slick, and people are fatigued and/or dehydrated. Complacency or lack of awareness, especially in warmer climates, can also heighten injury risk. Other contributing factors include: 1. Wearing inadequate or wet clothing. 2. Consuming substances that inhibit the body's response to cold and/or ...

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