Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds
The gold standard for diagnosis of PNES is Inpatient video-electroencephalography (vEEG) monitoring. Things that have been used but are unreliable: presence or absence of self-injury and incontinence, the ability to induce seizures by suggestion, psychologic tests,...
Clinic A/P, Peds, Hospital A/P, Peds
Treatment Nonpharmacologic: First do a trial of psychotherapy (CBT). Pharmacologic: Fluoxetine is 1st-line. Monitor the patient weekly for side effects for a month after starting fluoxetine. Counsel about FDA’s black box warning and other side effects....
Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds
Get Urine Drug Screen. Illicit drug use is the most common medical cause of acute psychosis. Further Reading. Am Fam Physician. 2015 Jun 15;91(12):856-863. Recognition and Differential Diagnosis of Psychosis in Primary Care.
Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds
Common presentation: a premenopausal woman with amenorrhea, headache, and vision changes (bitemporal hemianopsia). Diagnostic testing -MRI of the brain. Background “Pituitary adenomas are the most common disorder of the pituitary gland and are responsible for...
Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds
Diabetic kidney disease is the most common cause of hypoglycemia in a previously stable, well-controlled diabetic patient who has not changed their diet or insulin dosage. Common presentation: A diabetic patient whose been taking insulin for several years to decades...
Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds
“The euthyroid sick syndrome refers to alterations in thyroid function tests seen frequently in hospitalized patients, and abnormal thyroid function tests may be seen early in sepsis. These changes are statistically much more likely to be secondary to the...
