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Bronson Healthcare Midwest Epic Review of Systems 10.3
Bronson HealthCare Midwest Epic Review of Systems 10.3 Constitution Endocrine Activity Change Y N Cold intolerance Y N Appetite Change Y N Heat intolerance Y N Chills Y N Polydipsia Y N Diaphoresis Y N Polyuria Y N Fatigue Y N GU Fever Y N Difficulty urinating Y N Unexpctd wt chnge Y N Dyspareunia Y N HENT Dysuria Y N Facial Swelling Y N Enuresis Y N Neck pain Y N Flank pain Y N Neck stiffness Y N Frequency Y N Ear Discharge Y N Genital Sore Y N Hearing loss Y N Hematuria Y N Ear pain Y N Menstrual problem Y N Tinnitus Y N Pelvic pain Y N Nosebleeds Y N Urgency Y N Congestion Y N Urine decreased Y N Rhinorrhea Y N Vaginal bleeding Y N Postnasal drip Y N Vaginal discharge Y N Sneezing Y N Vaginal pain Y N Sinus Pressure Y N Musc Dental problem Y N Arthralgias Y N Drooling Y N Back pain Y N Mouth sores Y N Gait problem Y N Sore throat Y N Joint swelling Y N Trouble swallowing Y N Myalgias Y N Voice Change Y N Skin Eyes Color change Y N Eye Discharge Y N Pallor Y N Eye itching Y N Rash Y N Eye pain Y N Wound Y N Last Name: ___________________________________ First Name: ______________________________________ Date of Birth: _____________________________ Today’s Date: __________________________________________ Bronson HealthCare Midwest Epic Review of Systems 10.3 Eye redness Y N Allergy/Immuno Photophobia Y N Env allergies Y N Visual disturbance Y N Food Allergies Y N Respiratory Immunocompromised Y N Apnea Y N Neurological Chest tightness Y N Dizziness Y N Choking Y N Facial asymmetry Y N Cough Y N Headaches Y N Shortness of breath Y N Light-headedness -
A Pocket Manual of Percussion And
r — TC‘ B - •' ■ C T A POCKET MANUAL OF PERCUSSION | AUSCULTATION FOB PHYSICIANS AND STUDENTS. TRANSLATED FROM THE SECOND GERMAN EDITION J. O. HIRSCHFELDER. San Fbancisco: A. L. BANCROFT & COMPANY, PUBLISHEBS, BOOKSELLEBS & STATIONEB3. 1873. Entered according to Act of Congress, in the year 1872, By A. L. BANCROFT & COMPANY, Iii the office of the Librarian of Congress, at Washington. TRAN jLATOR’S PREFACE. However numerou- the works that have been previously published in the Fi 'lish language on the subject of Per- cussion and Auscultation, there has ever existed a lack of a complete yet concise manual, suitable for the pocket. The translation of this work, which is extensively used in the Universities of Germany, is intended to supply this want, and it is hoped will prove a valuable companion to the careful student and practitioner. J. 0. H. San Francisco, November, 1872. PERCUSSION. For the practice of percussion we employ a pleximeter, or a finger, upon which we strike with a hammer, or a finger, producing a sound, the character of which varies according to the condition of the organs lying underneath the spot percussed. In order to determine the extent of the sound produced, we may imagine the following lines to be drawr n upon the chest: (1) the mammary line, which begins at the union of the inner and middle third of the clavicle, and extends downwards through the nipple; (2) the paraster- nal line, which extends midway between the sternum and nipple ; (3) the axillary line, which extends from the centre of the axilla to the end of the 11th rib. -
Health History – Surgical Associates, Pc 575 S
HEALTH HISTORY – SURGICAL ASSOCIATES, PC 575 S. 70th Street, Suite 310 Lincoln, NE 68510 Date:_______________________________________ Name _____________________________________________________________ Age _______ Gender: M / F Family Doctor:____________________________________ Sent to our office by:____________________________________ Reason for seeing doctor: Problem/Symptoms: ____________________________________________________________ _______________________________________________________________________________________________________________ Currently Treated/Chronic Medical Problems: Acid Reflux Anxiety Asthma (type_________) Afib BPH (Benign Prostatic Hyperplasia) Coronary Artery Disease Cancer (type_________) CHF (Congestive Heart Failure) Chronic Migraines COPD Crohn’s CVA (Cerebral Infarction) Depression Diverticulitis Emphysema Factor 5 Leiden Mutation GERD Hepatitis Hypertension/High Blood Pressure High Cholesterol HIV Hypothyroid IBS (Irritable Bowel Syndrome) Joint Pain (joint_______) Back Pain Malignant Hyperthermia Morbid Obesity Obstructive Sleep Apnea PCOS Pneumonia Psychological Illness Renal Disease Sleep Apnea Type I diabetes Type II diabetes Ulcerative Colitis Urinary Incontinence Weight related injury (specify _____________________) Pregnant (week gestation ______) Other: _____________________________________________________________________________ Prior Surgeries & Approximate Date: (please circle or fill in blanks, dates can be written in below the procedure) Adenoidectomy -
The Pfizer/Biontech COVID-19 Vaccine: What You Need to Know
Vaccine Information Statement • Pfizer/BioNTech COVID-19 Vaccine • When administering vaccine use EUA Fact Sheet date for VIS date in Plummer Chart • Created and distributed by Mayo Clinic VACCINE INFORMATION STATEMENT Mayo Clinic created this Vaccine The Pfizer/BioNTech COVID-19 Information Statement for use temporarily until the official CDC Vaccine: What You Need to Know versions are available. Why get vaccinated The Pfizer/BioNTech 1 against COVID-19? 2 COVID-19 vaccine This COVID-19 vaccine can prevent COVID-19 The Pfizer/BioNTech COVID-19 vaccine provides infection. protection against COVID-19 infection. It is one of several vaccines developed to protect against The COVID-19 infection (also called coronavirus COVID-19 infection. disease 2019) is caused by the SARS-CoV-2 virus. Symptoms can range from no symptoms at all to In a randomized, controlled trial involving severe acute respiratory syndrome. Most common over 40,000 volunteers, the vaccine prevented symptoms include fever, cough, loss of smell or COVID-19 in 95% of people vaccinated. The 95% taste and fatigue. prevention rate was about the same no matter the age, sex, ethnicity or race of the people who Symptoms usually appear 2 to 14 days after received it. infection. Early symptoms may include a loss of taste or smell. Other symptoms include shortness The Pfizer/BioNTech COVID-19 vaccine is of breath or difficulty breathing, muscle aches, recommended for people 12 years of age and chills, sore throat, runny nose, headache and older. The vaccine is given in two doses. The chest pain. Some people have experienced rash, second dose is given 21 days after the first. -
PHARYNGITIS- Management Considerations
PHARYNGITIS: Management Considerations NICE’18, BMJ’17, IDSA’12 www.RxFiles.ca © Aug 2021 PEARLS for the MANAGEMENT of PHARYNGITIS SHOULD ANTIBIOTICS BE USED TO TREAT PHARYNGITIS? The majority of pharyngitis cases do NOT require antibiotics as they are viral infections 80-90% of adults (>70% of children) do NOT require antibiotics as infection likely viral. (80-90% in adults, >70% in children). Patients with a positive throat swab should receive an antibiotic to the risk of Pharyngitis is typically self-limiting (often 3-7 days; up to 10 days). complications. See modified Centor score on left column, & antibiotic table below. A validated clinical decision rule e.g. modified Centor score can help identify low risk patients The turn-around-time for throat swab results can take a few days. However, antibiotics who do not require diagnostic testing (see below) or antibiotics. started within 9 days of symptom onset in confirmed GAS will prevent rheumatic fever. For confirmed Group A Streptococcus (GAS) pharyngitis, penicillin for 10 days is the drug Some possible strategies: watchful waiting, or empiric antibiotic (stop if throat swab negative). of choice. There is no documented GAS resistance to penicillin. MOST COMMON BACTERIAL PATHOGEN Advise on treatments that will provide symptomatic relief: NSAIDs, acetaminophen, Group A Streptococcus (GAS) medicated throat lozenges, topical anesthetics, warm liquids. EMPIRIC DRUG REGIMENS OF CHOICE & SUSCEPTIBILITY CONCERNS Patients should see their prescriber if: ❶ symptoms worsen, ❷ symptoms take longer FIRST LINE than 3 to 5 days to resolve, &/or ❸ unilateral neck swelling develops. - Majority of cases are viral. - See Symptom Management PRE-TREATMENT CONSIDERATIONS No antibiotic - Only use antibiotics in confirmed following page. -
Sore Throats
Sore Throats Insight into relief for a sore throat • What causes a sore throat? • What are my treatment options? • How can I prevent a sore throat? • and more... Infections from viruses or bacteria are the main cause of sore throats and can make it difficult to talk and breathe. Allergies and sinus infections can also contribute to a sore throat. If you have a sore throat that lasts for more than five to seven days, you should see your doctor. While increasing your liquid intake, gargling with warm salt water, or taking over-the-counter pain relievers may help, if appropriate, your doctor may write you a prescription for an antibiotic. What are the causes and symptoms of a sore throat? Infections by contagious viruses or bacteria are the source of the majority of sore throats. Viruses: Sore throats often accompany viral infections, including the flu, colds, measles, chicken pox, whooping cough, and croup. One viral infection, infectious mononucleosis, or “mono,” takes much longer than a week to be cured. This virus lodges in the lymph system, causing massive enlargement of the tonsils, with white patches on their surface. Other symptoms include swollen glands in the neck, armpits, and groin; fever, chills, and headache. If you are suffering from mono, you will likely experience a severe sore throat that may last for one to four weeks and, sometimes, serious breathing difficulties. Mono causes extreme fatigue that can last six weeks or more, and can also affect the liver, leading to jaundice-yellow skin and eyes. Bacteria: Strep throat is an infection caused by a particular strain of streptococcus bacteria. -
Getting to the Bottom of Pain
What’s Your Diagnosis? GettingGetting toto thethe BottomBottom ofof PainPain By Daniel S. Mishkin, MDCM; and Barry V. Mishkin, MD 36-year-old female patient presents to your office with intermittent rectal pain and a A sensation of incomplete evacuation over the past eight months. This pain is sensed as an uncomfortable sensation of pressure that is worse after prolonged sitting, and is slowly relieved with walking around. Its frequency varies from one to four times per week and it usually lasts between two and four hours. The patient denies any melena, hematochezia, constipation, diarrhea, or any constitutional symptoms. She has had no relief with the use of NSAIDs, a sitz bath or “hemorrhoidal” cream. She has consulted a gastroenterologist who performed a flexible sigmoidoscopy, which was normal to the splenic flexure. She was told there was nothing abnormal and that her discomfort was most likely related to a psychiatric problem. She now comes to you for help and advice. What’s Your Diagnosis? On examination, she appears healthy and in no apparent distress. Her blood pressure is 120/68 mmHg with a pulse of 72 beats per minute and an oral temperature of 37.2 C. The head and neck, respiratory, cardiac, abdominal, and musculoskeletal exams are all within normal limits. Rectal exam is diffusely tender, grossly normal sphincter tone and the stool is negative for occult blood. Dr. Daniel S. Mishkin is a gastroenterologist at the Albert Dr. Barry V. Mishkin is a gastroenterologist at the Albert Einstein College of Medicine and Montefiore Medical Centre, Einstein College of Medicine and Montefiore Medical Centre, Bronx, New York. -
Review of Sympathetic Blocks Anatomy, Sonoanatomy, Evidence, and Techniques
CHRONIC AND INTERVENTIONAL PAIN REVIEW ARTICLE Review of Sympathetic Blocks Anatomy, Sonoanatomy, Evidence, and Techniques Samir Baig, MD,* Jee Youn Moon, MD, PhD,† and Hariharan Shankar, MBBS*‡ Search Strategy Abstract: The autonomic nervous system is composed of the sympa- thetic and parasympathetic nervous systems. The sympathetic nervous sys- We performed a PubMed and MEDLINE search of all arti- tem is implicated in situations involving emergent action by the body and cles published in English from the years 1916 to 2015 using the “ ”“ ”“ additionally plays a role in mediating pain states and pathologies in the key words ultrasound, ultrasound guided, sympathetic block- ”“ ”“ body. Painful conditions thought to have a sympathetically mediated com- ade, sympathetically mediated pain, stellate ganglion block- ”“ ” “ ” ponent may respond to blockade of the corresponding sympathetic fibers. ade, celiac plexus blockade, , lumbar sympathetic blockade, “ ” “ ” The paravertebral sympathetic chain has been targeted for various painful hypogastric plexus blockade, and ganglion impar blockade. conditions. Although initially injected using landmark-based techniques, In order to capture the breadth of available evidence, because there fluoroscopy and more recently ultrasound imaging have allowed greater were only a few controlled trials, case reports were also included. visualization and facilitated injections of these structures. In addition to There were an insufficient number of reports to perform a system- treating painful conditions, sympathetic blockade has been used to improve atic review. Hence, we elected to perform a narrative review. perfusion, treat angina, and even suppress posttraumatic stress disorder symptoms. This review explores the anatomy, sonoanatomy, and evidence DISCUSSION supporting these injections and focuses on ultrasound-guided/assisted tech- nique for the performance of these blocks. -
Reactive Arthritis Following Tonsillitis
Grand Rounds Vol 5 pages 8–9 Speciality: Otolaryngology; rheumatology; general medicine Article Type: Case Report DOI: 10.1102/1470-5206.2005.0004 c 2005 e-MED Ltd GR Reactive arthritis following tonsillitis Urmi Bapat and Antony Narula St. Mary’s Hospital, London, UK Corresponding address: Mrs Urmi Bapat, 123 Tumey Road, London SE21 7JB, UK Tel.: +44-7788-453148; Fax: c/o +44-20-7886-1847; E-mail: [email protected] Date accepted for publication 10 December 2004 Abstract Reactive arthritis following upper respiratory tract infections is well known. The usual age group is young adults and management of the arthritis with anti-inflammatory medication is the mainstay of treatment. We present a case of reactive arthritis following tonsillitis, which was successfully treated by tonsillectomy. Keywords Reactive arthritis; tonsillitis; tonsillectomy. Case report A 35-year-old man was referred to the ENT Department from the rheumatologists with a history of recurrent sore throats for the last 5–6 years. He had been suffering from reactive large and small joint polyarthritis (especially his wrists, the small joints of his hands, knees and feet) but no spondyloarthropathy for the last 2 years following each sore throat. His arthritis improved following antibiotics for the sore throat. ENT examination revealed chronically inflamed tonsils. Investigations included throat swabs and various blood tests. The throat swabs were always negative; liver function tests were slightly deranged, erythroctye sedimentation rate (ESR) and C-reactive protein (CRP) levels were high on two occasions (11 mm, 16 mg/ml and 18 mm, 27 mg/ml, respectively) and anti-streptococcal antibody titre (ASOT) was positive on three separate occasions, rising each time (400 IU/ml, 800 IU/ml and 1000 IU/ml). -
Misdiagnosed Chronic Pelvic Pain: Pudendal Neuralgia Responding to a Novel Use of Palmitoylethanolamide
Pain Medicine 2010; 11: 781–784 Wiley Periodicals, Inc. Case Reports Misdiagnosed Chronic Pelvic Pain: Pudendal Neuralgia Responding to a Novel Use of Palmitoylethanolamidepme_823 781..784 Rocco Salvatore Calabrò, MD, Giuseppe Gervasi, frequency, erectile dysfunction, and pain after sexual Downloaded from https://academic.oup.com/painmedicine/article/11/5/781/1843389 by guest on 23 September 2021 MD, Silvia Marino, MD, Pasquale Natale Mondo, intercourse). MD, and Placido Bramanti, MD Patients typically present with pain in the labia or penis, IRCCS Centro Neurolesi “Bonino-Pulejo,” Messina, Italy perineum, anorectal region, and scrotum, which is aggra- vated by sitting, relieved by standing, and absent when Reprint requests to: Rocco Salvatore Calabrò, MD, via recumbent or when sitting on a lavatory seat. In the Palermo, Cda Casazza, Messina. Tel: 390903656722; absence of pathognomonic imaging, laboratory, and elec- Fax: 390903656750; E-mail: roccos.calabro@ trophysiology criteria, the diagnosis of PN remains primarily centroneurolesi.it. clinical [1], and it is often delayed. Furthermore, this condi- tion is frequently misdiagnosed and sometimes results in unnecessary surgery. Here in we describe a 40-year-old man presenting with chronic pelvic pain due to pudendal Abstract nerve entrapment, misdiagnosed as chronic prostatitis. Background. Pudendal neuralgia is a cause of After different uneffective pharmacological therapies, chronic, disabling, and often intractable perineal the patient was treated with palmitoylethanolamide (PEA), pain presenting as burning, tearing, sharp shooting, an endogenous lipid with antinociceptive and anti- foreign body sensation, and it is often associated inflammatory properties [2,3] with significant improvement with multiple, perplexing functional symptoms. of his neuralgia. Case Report. We report a case of a 40-year-old man Case Report presenting with chronic pelvic pain due to pudendal nerve entrapment and successfully treated with A 40-year-old healthy man developed since 5 years a palmitoylethanolamide (PEA). -
Hurt Blocker the Next Big Pain Drug May Soothe Sensory Firestorms Without Side Effects by Rachel Ehrenberg June 30Th, 2012; Vol.181 #13 (P
Hurt Blocker The next big pain drug may soothe sensory firestorms without side effects By Rachel Ehrenberg June 30th, 2012; Vol.181 #13 (p. 22) Michael Morgenstern Among a small number of related families from northern Pakistan, some individuals never feel pain in any part of their bodies. Scientists studying six such children found that by the age of 4, they all had injuries to the lips or tongue from repeatedly biting themselves. Bruises, cuts and broken bones were common, though fractures were diagnosed only long after the fact, when weird, painless limping or the inability to use a limb called attention to the injury. Tests showed that the pain-free children perceived sensations of warm and cold, tickling and pressure. They could feel the prick of a needle, but it didn’t hurt. Two had been scalded — painlessly — by hot liquids. And one boy who performed street theater by putting knives through his arms and walking on hot coals died after jumping off a roof on his 14th birthday. Besides their inability to feel pain, the Pakistani individuals studied by the scientists had something else in common: mutations in a gene called SCN9A. That gene encodes the instructions for a protein that forms a passageway for letting sodium ions into nerve cells. Known as Nav1.7, this particular ion channel sits on pain-sensing nerves; when a nerve is stimulated enough to warrant sending a signal to the brain, a flood of sodium ions rush into the cell. Among the pain-free Pakistanis, various mutations in SCN9A altered the blueprints for Nav1.7 in different ways, but with the same result: The channel didn’t work. -
Streptococcal Pharyngitis (Strep Throat)
Streptococcal Pharyngitis (Strep Throat) Maria Pitaro, MD ore throat is a very common reason for a visit to a health care provider. While the major treatable pathogen is group A beta hemolytic Streptococcus (GAS), Sthis organism is responsible for only 15-30% of sore throat cases in children and 5-10% of cases in adults. Other pathogens that cause sore throat are viruses (about 50%), other bacteria (including Group C beta hemolytic Streptococci and Neisseria gonorrhea), Chlamydia, and Mycoplasma. In this era of increasing microbiologic resistance to antibiotics, the public health goal of all clinicians should be to avoid the inappropriate use of antibiotics and to target treatment to patients most likely to have infection due to GAS. Clinical Manifestations and chest and in the folds of the skin and usually Pharyngitis due to GAS varies in severity. The spares the face, palms, and soles. Flushing of the Streptococcal Pharyngitis most common presentation is an acute illness with cheeks and pallor around the mouth is common, (Strep Throat). sore throat, fever (often >101°F/38.3°C), tonsillar and the tongue becomes swollen, red, and mottled Inflammation of the exudates (pus on the tonsils), and tender cervical (“strawberry tongue”). Both skin and tongue may oropharynx with adenopathy (swollen glands). Patients may also have peel during recovery. petechiae, or small headache, malaise, and anorexia. Additional physical Pharyngitis due to GAS is usually a self-limited red spots, on the soft palate. examination findings may include petechiae of the condition with symptoms resolving in 2-5 days even Photo courtesy soft palate and a red, swollen uvula.