Rhabdomyolysis: An evidence-based approach

2021 ◽  
pp. 175114372110507
Author(s):  
Sarah Burgess
Keyword(s):  
Fluid Overload ◽  
Kidney Injury ◽  
Community Acquired Pneumonia ◽  
Evidence Based ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Urine Dipstick ◽  
The Past ◽  
Acting Insulin ◽  
History Of

A 76-year-old lady was found on the floor following a fall at home. She was uninjured, but unable to get up, and had been lying on the floor for roughly 18 hours before her son arrived. She had been unwell for the past 3 days with a cough and shortness of breath. She had a past medical history of diabetes, hypertension, hypercholesterolaemia and atrial fibrillation (AF). On examination, she was alert but distressed, clinically dehydrated, febrile and tachycardic. She was treated for community acquired pneumonia with co-amoxiclav and was fluid resuscitated with Hartmann’s solution. Her hyperkalaemia was treated with 50 mL of 50% glucose containing 10 units of rapid-acting insulin. Her creatinine kinase (CK) on admission was 200,000, and she had an acute kidney injury (AKI). Urine dipstick was positive for blood. However, her renal function continued to deteriorate over the succeeding 48 h, when she required renal replacement therapy (RRT) due to fluid overload and anuria.

scholarly journals Ossification of the Posterior Longitudinal Ligament

2003 ◽  
Vol 30 (1) ◽  
pp. 61-62
Author(s):  
A.P. Mitha ◽  
J.H. Wong ◽  
S.J. du Plessis
Keyword(s):  
Diabetes Mellitus ◽  
Neck Pain ◽  
Type Ii Diabetes ◽  
Posterior Longitudinal Ligament ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Past Medical History ◽  
The Past ◽  
Chinese Descent ◽  
History Of

A 51-year-old gentleman of Chinese descent presented for neurological evaluation following a two-year history of cervical neck pain associated with left arm numbness. His symptoms were initially stable, but had progressed over the past six months to include weakness of his entire left arm and leg and symptoms of bladder urgency. Two weeks prior to presentation, he suffered repeated falls due to worsening gait difficulties. The past medical history was significant for type II diabetes mellitus.

scholarly journals Summary of Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Disease Society and the Canadian Thoracic Society

2000 ◽  
Vol 11 (5) ◽  
pp. 237-248 ◽  
Author(s):  
Lionel A Mandell ◽  
Thomas J Marrie ◽  
Ronald F Grossman ◽  
Anthony W Chow ◽  
Robert H Hyland ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Community Acquired Pneumonia ◽  
Evidence Based ◽  
Mixed Infections ◽  
Joint Effort ◽  
Initial Management ◽  
Serious Illness ◽  
The Past ◽  
Nursing Home Patients ◽  
Current Guidelines

Community-acquired pneumonia (CAP) is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in the knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity againstStreptococcus pneumoniaehas been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Diseases Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.

scholarly journals Acute Renal Injury: Revisited

2020 ◽  
Vol 10 (4) ◽  
pp. 221-224
Author(s):  
Kamel El-Reshaid ◽  
Shaikha Al-Bader
Keyword(s):  
Serum Creatinine ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Hydration Status ◽  
Acute Renal Injury ◽  
Potassium Accumulation ◽  
Life Threatening ◽  
History Of ◽  
Stage 1 ◽  
Morbid Conditions

Acute kidney injury (AKI) indicates its abrupt deterioration and is defined as an increase in serum creatinine more than the baseline by > 26 umol/L within 48 hours or > 50% within 1 week.  The latter since glomerular failure is the life-threatening one with: (a) uremic intoxication, (b) water and salt retention with fluid overload, and (c) potassium accumulation with cardiac arrest.  The etiology can be pre-renal, post-renal or intrinsic.  Diagnosis is established by history of new insults, physical examination for hydration status, systemic stability and manifestations of autoimmune diseases/infections as well as an initial laboratory testing for renal function (serum creatinine, electrolytes and urine routine) and kidney ultrasound.  Additional specific tests are indicated to assess etiology of AKI and its associated co-morbid conditions that interacts with its management.  Severity of AKI ranges from mild (stage 1) to advanced (stage 5) that requires dialytic support.  Moreover, it depends on the type and duration of the insult.  Prognosis depends on etiology of AKI, its co-morbid conditions and the timely interventions by the supportive medical team.  Keywords: acute, causes, epidemiology, injury, kidney, management.

scholarly journals Drugs as diagnostic tools

2016 ◽  
Vol 85 (1) ◽  
pp. 43-45
Author(s):  
Nicole Arseneau ◽  
Carlos Muzlera
Keyword(s):  
Illicit Drugs ◽  
Diagnostic Tools ◽  
Past Medical History ◽  
Fat Pad ◽  
Mild Depression ◽  
Family History Of Diabetes ◽  
The Past ◽  
Multivitamin Supplement ◽  
History Of ◽  
Alcoholic Drinks

Mr Simon, age 36, presents to his family physician with concerns about his weight. He has gained 20 kg in the past 4 months, and has developed purple striae on his abdomen. His body mass index (BMI) is currently 34, and on physical examination, he is found to have a rounded face, a large dorsal fat pad, and a waist circumference of 112 cm. His blood pressure is elevated at 145/95 mmHg, while all other vitals are normal. He also mentions worsening acne on his face, shoulders, and upper back, as well as mild depression for the past 3 months. His past medical history is significant only for an appendectomy at age 10. He has no family history of diabetes, obesity, or cardiac disease. The only medication he has been on for the past 3 years is a multivitamin supplement. He does not smoke, drinks approximately 5 alcoholic drinks per week, and does not take any illicit drugs.

The Source of the Problem

2019 ◽  
Vol 18 (1) ◽  
pp. 33-33
Author(s):  
Peter Moffitt ◽  
◽  
Adam Williamson ◽  
Peter Stenhouse ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical History ◽  
General Malaise ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Focus Of Infection ◽  
History Of

58-year-old lady presented to the Emergency Department with a two-day history of shortness of breath and confusion, on a background of one week’s history of general malaise, vomiting, fevers and chills. Her past medical history was unremarkable except for a large, benign goitre. Systemic enquiry revealed no symptoms to suggest a focus of infection.

scholarly journals Inappropriate Sinus Tachycardia Following Viral Illness

2021 ◽  
Vol 11 (2) ◽  
pp. 219-222
Author(s):  
Khalid Sawalha ◽  
Fuad Habash ◽  
Srikanth Vallurupalli ◽  
Hakan Paydak
Keyword(s):  
Viral Infection ◽  
Medical History ◽  
Sinus Tachycardia ◽  
Esophageal Disease ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Inappropriate Sinus Tachycardia ◽  
Laboratory Findings ◽  
Viral Illness ◽  
History Of

A 67-year-old female patient with a past medical history of menopause, migraines, and gastro-esophageal disease presented with palpitation, fatigue, and shortness of breath. One month prior to her presentation, she reported having flu-like symptoms. Her EKG showed sinus tachycardia with no other abnormality. Laboratory findings, along with imaging, showed normal results. The event monitor failed to detect any arrythmias. We report a case of inappropriate sinus tachycardia secondary to viral infection as a diagnosis of exclusion.

scholarly journals Chronic lymphocytic leukemia; an incidental finding in a COVID-19 patient.

2021 ◽  
Author(s):  
Shazaf Masood Sidhu ◽  
Fabiha Ghulam Muhammad ◽  
Ainan Arshad
Keyword(s):  
Acute Kidney Injury ◽  
Chronic Lymphocytic Leukemia ◽  
Incidental Finding ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Functional Class ◽  
Lymphocytic Leukemia ◽  
Shortness Of Breath ◽  
Tumor Lysis ◽  
History Of

Abstract We report a case of 57 years old male, with no prior comorbids functional class I, presented with a history of fever for one week along with shortness of breath and cough for 5 days. Upon workup his baseline CBC reported bicytopenia along with marked lymphocytosis which raised the suspicion and to confirm the diagnosis, his acute leukemia comprehensive panel was done which reported an incidental finding of Chronic lymphocytic leukemia along with concomitant COVID PCR positive. This patient also presented with Tumor Lysis Syndrome and Acute kidney Injury.

scholarly journals December 2020 Pulmonary Case of the Month: Resurrection or Medical Last Rites?

2020 ◽  
Vol 21 (6) ◽  
pp. 128-135
Author(s):  
Lewis Wesselius ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Chronic Atrial Fibrillation ◽  
Community Acquired Pneumonia ◽  
Bypass Grafting ◽  
The Past ◽  
History Of ◽  
Artery Disease

No abstract available. Article truncated after the first page. History of Present Illness An 88-year-old man who has been short of breath and febrile up to 101.5° F for the past day presented on October 20, 2020. He has no known sick contacts or exposure to COVID-19. PMH, SH, and FH • No reported pulmonary history although he had a Xopenex MDI which he rarely used. • Coronary artery disease with prior coronary artery bypass grafting (1978); multiple subsequent stents; chronic atrial fibrillation; pacemaker (Micra) • Stage 3-4 CKD (creatinine 1.95) • Chronically on warfarin Physical Examination • Temp 37.3, Sat 92% on RA, 95% on 2 lpm, • Lungs: Few crackles in right upper chest • CV: regular, no murmur • Ext: 1 to 2+ edema (chronic, uses TED hose) Which of the following is/are the most likely diagnosis? 1. Community-acquired pneumonia 2. Congestive heart failure 3. COVID-19 4. 1 and 3 5. Any of the above …

A Chest X-Ray causing confusion

2019 ◽  
Vol 18 (2) ◽  
pp. 120-120
Author(s):  
Timea Novak ◽  
◽  
Catherine Strait ◽  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Alendronic Acid ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Medical Unit ◽  
X Ray ◽  
Acute Medical Unit ◽  
History Of ◽  
Chest X Ray ◽  
Irritable Bowel

A 91-year old female presented to Acute Medical Unit with a 2 week history of shortness of breath and haemoptysis. Her past medical history included osteoporosis, depression, irritable bowel syndrome, asthma, cataracts, and a colonic polypectomy. Her medications: Citalopram 10 mg, Co-codamol, Beclomethasone 200 mcg inhaler, Salbutamol MDI inhaler, Omeprazole 20 mg and Alendronic acid. She was an ex-smoker with a 20-pack year history who had stopped smoking 40-years ago. She did not drink alcohol and lived alone independently.

Successful management of subglottic stenosis in pregnancy

2021 ◽  
Vol 14 (3) ◽  
pp. e236466
Author(s):  
Shenghao Fang ◽  
Poonam Pai B H
Keyword(s):  
Multidisciplinary Approach ◽  
Postoperative Management ◽  
Subglottic Stenosis ◽  
Routine Practice ◽  
Shortness Of Breath ◽  
Successful Management ◽  
The Past ◽  
Surgical History ◽  
History Of ◽  
In Pregnancy

Evaluation and management of subglottic stenosis in pregnancy is challenging. It often is not only a multidisciplinary approach between obstetricians, otolaryngologists (ENT surgeons) and anesthesiologists, but also requires a thorough understanding of possible foreseen complications by the patient as well. Hence, whenever we are presented with a challenging case requiring multidisciplinary approach involving team of physicians from different specialties, it is routine practice to huddle regarding the preoperative, intraoperative and postoperative management and care. We present a case of a 37-year-old woman with a known history of idiopathic subglottic stenosis, 16 weeks’ pregnant, G4P1, with a surgical history significant for two previous subglottic dilations in the past and who now presented with an audible stridor and shortness of breath on activity. We highlighted the unique challenges encountered and the corresponding management adopted. This is a case of successful management of symptomatic worsening of subglottic stenosis managed during pregnancy.

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