Guest thinePA Posted February 20, 2006 Share Posted February 20, 2006 Sarcoidosis skin test: I'm not too sure about the anergy testing, but the one I was looking for is the Kveim test. Here's a bit about it: Kveim test A Kveim test (also known as a Kveim-Siltzbach test) is a skin test that was designed specifically for diagnosing sarcoidosis. It involves collecting lymph node or spleen samples. The sample is processed to eliminate infectivity and is injected into the patient's skin. Approximately 4 weeks later a skin biopsy is performed; specific histological changes are considered confirmatory for sarcoidosis. The test is poorly standardized and is rarely used in the United States. It may have a role in atypical cases where tissue is difficult or impossible to obtain, such as in neurosarcoidosis. Great fun!! Quote Link to comment Share on other sites More sharing options...
Monica Posted February 21, 2006 Share Posted February 21, 2006 Mother brings in her 1 yo son because she noticed that his skin color has changed recently. On physical exam you note that the baby's skin is yellowish in color. The child is otherwise healthy, active, and there are no other significant findings in your H/P. The kiddo looks great but you are ready to order a bilirubin level and suspect that it is a hemolytic process that is affecting the child's liver. Your preceptor hears the chief complaint stops you and asks "What does he eat & what does his sclera look like?" Why are these questions important? Quote Link to comment Share on other sites More sharing options...
xxbowiexx Posted February 21, 2006 Share Posted February 21, 2006 Mother brings in her 1 yo son because she noticed that his skin color has changed recently. On physical exam you note that the baby's skin is yellowish in color. The child is otherwise healthy, active, and there are no other significant findings in your H/P. The kiddo looks great but you are ready to order a bilirubin level and suspect that it is a hemolytic process that is affecting the child's liver. Your preceptor hears the chief complaint stops you and asks "What does he eat & what does his sclera look like?" Why are these questions important? i'm guessing the question is to rule out jaundice *sclera* and some food allergic reaction possibly. Quote Link to comment Share on other sites More sharing options...
merseur Posted February 21, 2006 Share Posted February 21, 2006 Diffentiate between liver and food etiology. Kids who eat mostly carrots will have yellow skin appearance mimicking jaudince. Icterus is secondary to liver dysfunction. Quote Link to comment Share on other sites More sharing options...
Monica Posted February 21, 2006 Share Posted February 21, 2006 Good job. Kiddos who eat a large amount of yellow, orange, or red veggies/fruits can develop keratodermia (carotene) and/or lycopenemia (red foods like tomatoes). In these cases, there is no scleral icterus & the serum bilirubin levels are WNL. Quote Link to comment Share on other sites More sharing options...
Guest lisnek Posted March 12, 2006 Share Posted March 12, 2006 varices....high mortality. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 28, 2006 Moderator Share Posted March 28, 2006 New One- What Is Superior Mesenteric Artery Syndrome? Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted March 30, 2006 Share Posted March 30, 2006 What are the five most common causes of tachycardia? Quote Link to comment Share on other sites More sharing options...
amanquee Posted March 30, 2006 Share Posted March 30, 2006 fever dehydration drug induced How am I doing LA? Amanda Quote Link to comment Share on other sites More sharing options...
Monica Posted March 30, 2006 Share Posted March 30, 2006 feverdehydration drug induced How am I doing LA? Amanda Never forget hyperthyroidism Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 30, 2006 Moderator Share Posted March 30, 2006 Never forget hyperthyroidism Although not a common cause always consider P.E. in the differential of anyone with unexplained tachycardia....has saved my backside a few times..... Quote Link to comment Share on other sites More sharing options...
Guest lisnek Posted March 31, 2006 Share Posted March 31, 2006 variceal bleed elevated BUN acute encephalopathy coma death massive hemorrhage ~great q's!!!!!!! Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted March 31, 2006 Share Posted March 31, 2006 1. fever (yea, Amanda!) 2. 3. 4. dehydration (Amanda), variceal bleed and massive hemmorhage (lisnek) cause ------? {A more general term that encompasses these specific conditions} 5. PE (yea, E!) My EM attending said PEis a more common cause of tachycardia than hyperthyroidism, Mon, but I didn't ask what his source was. But definitely a good one to keep in mind! Lisnek, I think death is actually one of the most common causes of asystole, not tachycardia ;) Quote Link to comment Share on other sites More sharing options...
rcdavis Posted March 31, 2006 Share Posted March 31, 2006 y'al,l thinking too hard about this.. think...what do you think of when you see a tachy patient? Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted March 31, 2006 Share Posted March 31, 2006 ummmmmmm anemia, shock, Quote Link to comment Share on other sites More sharing options...
MedicPA Posted March 31, 2006 Share Posted March 31, 2006 Shock, anxiety/emotional stress, side effect of sympathomimetics, too much cocaine ;o) Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted March 31, 2006 Share Posted March 31, 2006 1. fever 2. fear/anxiety (MedicPA :) ) 3. 4. shock is close... but not all shock causes tachycardia. Goes along with dehydration & hemmorhage... 5. PE Quote Link to comment Share on other sites More sharing options...
merseur Posted March 31, 2006 Share Posted March 31, 2006 what about anemia? Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted March 31, 2006 Share Posted March 31, 2006 1. fever2. fear/anxiety (MedicPA :) ) 3. 4. shock is close... but not all shock causes tachycardia. Goes along with dehydration & hemmorhage... 5. PE Im sorry let me qualify my previous answers... septic/hypovolemic/hemmorhagic/and septic shock all cause tachy Quote Link to comment Share on other sites More sharing options...
MedicPA Posted March 31, 2006 Share Posted March 31, 2006 What about electrolyte imbalances, hypoglycemia, hypoxemia, hypovolemia, hyperthermia, cardiac tamponade, tension pneumo ... (hmm, someone sounds like they're recerting their ACLS soon ;)) Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted March 31, 2006 Share Posted March 31, 2006 Know those Hs & Ts, Medic! :D 1. fever 2. fear/anxiety 3. 4. volume depletion (due to dehydration, hemorrhage, third-spacing, etc) 5. PE I think anemia would fit in with #4... isn't tachycardia more common in acute anemias than chronic, and the most common cause of acute anemia is blood loss? #3 is extremely common.... we ask almost every pt about it, and if it is present we ask several quanititative & qualitative questions..... some would consider it a vital sign........... :confused: Quote Link to comment Share on other sites More sharing options...
Guest pac4hire Posted March 31, 2006 Share Posted March 31, 2006 DOE? SOB? Pain? Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted March 31, 2006 Share Posted March 31, 2006 Pain would be the last one (yea pac4hire!). I'm not sure where the doc got the info; some might disagree with these being the top 5 causes.... but I really liked the question because tachycardia is so common, plus it got the brain working. To recap: 5 MCC of tachycardia 1. fever 2. fear/anxiety 3. pain 4. volume depletion 5. PE Quote Link to comment Share on other sites More sharing options...
andersenpa Posted March 31, 2006 Share Posted March 31, 2006 What are the five most common causes of tachycardia? LA- the more approriate question is what are the most common causes of SINUS tachycardia.............. Afib, flutter, SVT, VT, we're in a different box with these....... Quote Link to comment Share on other sites More sharing options...
andersenpa Posted March 31, 2006 Share Posted March 31, 2006 Another good way to ask this question is based on the clinical setting. A postop open AAA is way more likely to be tachy from hypovolemia than fever. The patients you'll be seeing and worrying about present with associated conditions, not in exam questions! (well, after you pass the PANCE)..... Quote Link to comment Share on other sites More sharing options...
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