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Hypertension Evaluation Exam

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1. Exam Series: Guide to the Back Exam

Exam Series: Guide to the Back Exam Exam Series: Guide to the Back Exam - CanadiEM Exam Series: Guide to the Back Exam In , by Kathryn Chan July 23, 2018 A 67-year-old male presents to your emergency room with back pain. He has a history of intermittent back pain that typically responds to NSAIDs, however this particular episode has been much more severe. He now feels sharp pain that radiates into this left foot with certain movements, which causes weakness when walking. His past medical (...) history is significant for a right hemicolectomy, hypertension, type II diabetes, and smoking. He has no history of IV drug use and has no infectious symptoms. Background Back pain is one of the most common presentations in the emergency department. The majority of these cases are musculosketal in nature, potentially involving a muscle sprain, ligament strain, or compression of nerve roots, although a specific diagnosis cannot be made is an estimated 85% of patients 1 . True back pain emergencies

2018 CandiEM

2. Hypertension Evaluation Exam

Hypertension Evaluation Exam Hypertension Evaluation Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hypertension Evaluation Exam (...) Hypertension Evaluation Exam Aka: Hypertension Evaluation Exam From Related Chapters II. Goals Identify end organ damage Identify signs Identify reversible exacerbating factors Document progression III. Exam: Vitals Consider arm to leg systolic BP measurements (difference >20 mmHg suggests ) Assess for Weight and Height or BMI (assess for ) IV. Exam: Head See increased in V. Exam: Neck exam s Neck vein exam VI. Exam: Chest signs Palpable intercostal pulses VII. Exam: Cardiovascular rhythm (decreased LV

2018 FP Notebook

3. The HINTS Exam to Differentiate Central from Peripheral Vertigo

, hearing changes, focal weakness or numbness, or speech changes. His past medical history includes hypertension and diabetes, controlled with amlodipine, metformin, and glyburide. On exam, he has horizontal beating nystagmus. Cerebellar exam - including finger to nose, heel to shin, and rapid alternating movements ‐ is otherwise normal. He has an abnormal Rom ­‐ berg’s and is unable to stand or ambulate unassisted. The remainder of his neurologic exam is normal. Head CT, ECG, and labs are all normal (...) wondering if there are any aspects of the physical exam that can differentiate between peripheral and central causes of vertigo. A quick search of the literature identiFies something referred to as the “HINTS” exam, which involves oculomotor testing. SpeciFically, this test includes evaluation of horizontal Head Impulse testing, the direction of Nystagmus, and Test of ocular Skew deviation. You begin delving deeper to determine if this is something you should be using in your practice… PICO Question

2014 Washington University Emergency Medicine Journal Club

4. June Wash U Nephrology Webisode - Clinical Exam of Hemodialysis Vascular Access

June Wash U Nephrology Webisode - Clinical Exam of Hemodialysis Vascular Access Renal Fellow Network: June Wash U Nephrology Webisode - Clinical Exam of Hemodialysis Vascular Access | | | | | Thursday, June 1, 2017 June Wash U Nephrology Webisode - Clinical Exam of Hemodialysis Vascular Access The June web episode features a special guest who was visiting St. Louis - Dr. Dirk Hentschel, Assistant Prrofessor and Director of Interventional Nephrology at Brigham and Women's/Harvard Medical School (...) Get notified of new RFN posts by email Partner A nice repository of landmark articles and reviews in the field of nephrology at . are also included. Partner Endorsed by Follow RFN on Twitter NephJC The Online Nephrology Journal Club The Glomerular Disease Study & Trial Consortium (GlomCon) Endorsed Educational Resource Subscribe to the Concepts in Hypertension Newsletter Blog Archive (78) (2) (5) (6) (4) (7) (5) (15) (26) (8) (76) (6) (6) (4) (9) (5) (5) (5) (6) (8) (7) (7) (8) (48) (7) (3) (3) (2

2017 Renal Fellow Network

5. Is the Funduscopic Exam Worthwhile For the General Practitioner?

system. It is also an exam of an organ that often has pathology in the general population. One study found that in a screening of a primary care population, 50% of 405 patients had ocular pathology [1]. Furthermore, some of the most common conditions such as diabetes and hypertension are associated with retinal pathology [1]. The funduscopic exam has the ability to reveal a broad range of systemic diseases, including accelerated hypertension, raised intracranial pressure, miliary tuberculosis (...) , and cytomegalovirus [5]. The funduscopic exam can reveal pathology in a wide variety of patients: 1. Evaluating neurologic structures such as the optic disc is useful, for example in patients with headaches, evolving neurologic status, or head trauma. Papilledema or a swollen optic nerve head indicates elevated intracranial pressure. Elevated intracranial pressure is not ruled out by an absence of papilledema, as it does not occur immediately, but is less likely if retinal venous pulsations are seen on exam [6

2014 Clinical Correlations

6. RNA Sequencing in the Framingham Heart Study Third Generation Cohort Exam 2

Sequencing in the Framingham Heart Study Third Generation Cohort Exam 2 The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03225183 Recruitment Status : Enrolling by invitation First Posted : July 21, 2017 Last Update Posted : March 26, 2019 Sponsor: National Heart, Lung, and Blood Institute (NHLBI (...) will be analyzed. Only certified researchers can access them. No study participants will be contacted in relation to this project. Condition or disease Cardiovascular Disease Hypertension Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 1700 participants Observational Model: Cohort Time Perspective: Retrospective Official Title: An RNA Sequencing Study in the Framingham Heart Study Third Generation Cohort Exam 2 Estimated Study Start Date : March 29, 2019

2017 Clinical Trials

7. Hypertensive emergencies

, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52. http://hyper.ahajournals.org/content/42/6/1206.full http://www.ncbi.nlm.nih.gov/pubmed/14656957?tool=bestpractice.com Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report (...) Hypertensive emergencies Hypertensive emergencies - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Hypertensive emergencies Last reviewed: February 2019 Last updated: April 2018 Summary If the clinical suspicion is high, treatment should be initiated immediately without waiting for further tests. BP must be lowered over minutes to hours with parenteral medications in an intensive care setting. The initial goal

2018 BMJ Best Practice

8. Essential hypertension

. The seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Aug 2004 [internet publication]. http://www.nhlbi.nih.gov/files/docs/guidelines/jnc7full.pdf Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-104. https://academic.oup.com/eurheartj/article/39/33/3021/5079119 http://www.ncbi.nlm.nih.gov/pubmed/30165516?tool=bestpractice.com James (...) Essential hypertension Essential hypertension - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Essential hypertension Last reviewed: February 2019 Last updated: March 2019 Summary Typically diagnosed by screening of an asymptomatic individual. Treatment of uncontrolled hypertension reduces the risks of mortality and of cardiac, vascular, renal, and cerebrovascular complications. Lifestyle changes are recommended

2018 BMJ Best Practice

9. Diagnosis & Assessment of Hypertension - Measuring Blood Pressure

is not performed, hypertension cases will remain undetected. Blood pressure screening frequency and timing may vary between patients and is left to the discretion of each practitioner. Periodic health exams, visits for assessment of other cardiovascular risk factors, urgent office visits for neurological or cardiovascular related issues, and medication renewal visits are examples of clinical visits considered appropriate for blood pressure measurement . Hypertension-related complications are more common (...) , Molebatsi N, Maseko MJ, Libhaber E, Libhaber C, Majane OH, et al. Nurse-recorded auscultatory blood pressure at a single visit predicts target organ changes as well as ambulatory blood pressure. J Hypertens 2009;27:287-97. Villegas I, Arias IC, Botero A, Escobar A. Evaluation of the technique used by health-care workers for taking blood pressure. Hypertension 1995;26:1204-6. McKay DW, Raju MK, Campbell NRC. Assessment of blood pressure measuring techniques. Med Educ 1992;26:208-12. Veiga EV, Nogueira MS

2018 Hypertension Canada

10. Hypertension Evaluation Exam

Hypertension Evaluation Exam Hypertension Evaluation Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hypertension Evaluation Exam (...) Hypertension Evaluation Exam Aka: Hypertension Evaluation Exam From Related Chapters II. Goals Identify end organ damage Identify signs Identify reversible exacerbating factors Document progression III. Exam: Vitals Consider arm to leg systolic BP measurements (difference >20 mmHg suggests ) Assess for Weight and Height or BMI (assess for ) IV. Exam: Head See increased in V. Exam: Neck exam s Neck vein exam VI. Exam: Chest signs Palpable intercostal pulses VII. Exam: Cardiovascular rhythm (decreased LV

2015 FP Notebook

11. Prostate size, nocturia, and the digital rectal exam: a cohort study of 30,500 men. (PubMed)

Prostate size, nocturia, and the digital rectal exam: a cohort study of 30,500 men. To evaluate the utility of the digital rectal examination (DRE) in estimating prostate size and the association of DRE with nocturia in a population-based cohort.We identified all men randomized to the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) trial for whom DRE results were available. Men were excluded if they had a history of prostate surgery or incident prostate (...) posterior surface area estimates had an ICC of 0.547 (95% CI 0.541-0.554) and were significantly yet modestly correlated with elevated PSA level (rs = 0.18, P < 0.001) and TRUS prostate volume (rs = 0.32, P < 0.001). Prostate posterior surface area was significantly associated with nocturia on multivariable analysis, but was not significant in stratified analysis of men with cardiovascular risk factors (hypertension, diabetes, high body mass index, stroke). In men without these risk factors, the highest

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2016 BJU international Controlled trial quality: uncertain

12. Hypertension Evaluation Labs

) (evaluate for coarctation, heart size) 24 hour IV. Evaluation: Secondary Hypertension Indications Onset under age 30 years (and esp. under age 12) or over age 60 years old to maximal medical management (especially if previously controlled) Accelerated or Signs OR symptoms of Labs Arm to leg systolic difference (abnormal if >20 mmHg) (notching of the lower rib borders) (Children) MRI (Adults) Late night ry cortisol Low dose 24h Plasma free metanephrines Renal parenchymal disease with microscopic exam (...) Hypertension Evaluation Labs Hypertension Evaluation Labs Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hypertension Evaluation Labs

2018 FP Notebook

13. Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma

Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Sections Education Fellowships Research Journal Club Events Open Search Vignette You’re working a shift at a level II trauma center in the community one rainy afternoon when EMS brings in Mr. Q a 62-year old man with hypertension and hyperlipidemia who (...) for evaluation of the thoracic and lumbar spine. At least one observational study from LA County/USC Medical Center ( ) suggested that physical exam alone performed poorly at evaluating for a “clinically significant” injury of the thoracic or lumbar spine, with with a sensitivity of 78.6%, specificity of 83.4%, LR+ of 4.73, and LR- of 0.26. A recent systematic review on this topic ( ) similarly found that aspects of the history and physical exam (when looked at independently) were inadequate at ruling

2019 Washington University Emergency Medicine Journal Club

14. BNP in the Evaluation of Syncope

. His wife helped him clean the mashed potatoes off his face and brought him to the ED. His past medical history includes hypertension and diet-controlled diabetes, and he endorses a family history of coronary artery disease in both parents. He denies chest pain, shortness of breath, or palpitations, and his vital signs and physical exam are currently normal. You go to put in orders, including an EGC, BMP, CBC, and troponin, when your large Russian attending, whose hairstyle reminds you of Eddie (...) BNP in the Evaluation of Syncope Emergency Medicine > Journal Club > Archive > August 2018 Toggle navigation August 2018 BNP in the Evaluation of Syncope Vignette You are working an evening shift in your ED as the senior resident when you encounter Mr. Drop, a 58-year old male presenting with syncope. He was sitting at the dinner table, getting ready to eat when he suddenly lost consciousness and fell face-first into his mashed potatoes. he had no seizure activity and awoke within a few seconds

2018 Washington University Emergency Medicine Journal Club

15. Diagnostic evaluation of cryptogenic stroke

Diagnostic evaluation of cryptogenic stroke Diagnostic Evaluation of Cryptogenic Stroke – Clinical Correlations Search Diagnostic Evaluation of Cryptogenic Stroke April 2, 2019 8 min read Dixon Yang, MD Peer Reviewed Case and Introduction A 52-year-old right-handed woman with hypertension is brought in by ambulance after her daughter notices a sudden onset of nonsensical speech and trouble walking. On exam, she has an expressive aphasia with right-sided hemiparesis. Her vitals are stable (...) a few atrial premature complexes and cardiac ultrasound reveals only a small inter-atrial shunt. At this point, the etiology of her ischemic stroke remains unclear. How should this case be further evaluated? Despite advances in testing, many ischemic strokes are y [1,2]. Less well-understood mechanisms are thought to comprise of cryptogenic strokes including occult arrhythmias, paradoxical emboli, undefined hypercoagulable states, and atherosclerotic disease of the aorta or supra-aortic vasculature

2019 Clinical Correlations

16. Portal Hypertension Bleeding in Cirrhosis, Guidance

Portal Hypertension Bleeding in Cirrhosis, Guidance Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases - Garcia‐Tsao - 2017 - Hepatology - Wiley Online Library Search within Search term Search term Practice Guidance Free Access Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association (...) , Hepatic Hemodynamic Laboratory, Institute of Biomedical Research, August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain First published: 27 October 2016 Cited by: Potential conflict of interest: Dr. Bosch consults for Gilead, Conatus, Exalenz, Actelion, Chiasma, and Novo A/S. Dr. Garcia‐Tsao consults for BioVie, Conatus, Galectin and Intercept. Correction added May 30, 2017, after publication: the keyword “portal hypertension” was added. All AASLD Practice Guidelines are updated

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2016 American Association for the Study of Liver Diseases

17. Exams Are Coming

Exams Are Coming Renal Fellow Network: Exams Are Coming | | | | | Monday, June 16, 2014 Exams Are Coming This season's Game of Thrones finished last night and as a nephrology-themed homage, a trainee from Malaysia, Lee Jun, created this poster during downtime while studying for his exams. Enjoy. Posted by Gearoid McMahon at Labels: , , No comments: Subscribe to: Interested in Contributing to the Renal Fellow Network? Email Matt or Gearoid NSMC Founding Member Get notified of new RFN posts (...) by email Partner A nice repository of landmark articles and reviews in the field of nephrology at . are also included. Partner Endorsed by Follow RFN on Twitter NephJC The Online Nephrology Journal Club The Glomerular Disease Study & Trial Consortium (GlomCon) Endorsed Educational Resource Subscribe to the Concepts in Hypertension Newsletter Blog Archive (78) (2) (5) (6) (4) (7) (5) (15) (26) (8) (76) (6) (6) (4) (9) (5) (5) (5) (6) (8) (7) (7) (8) (48) (7) (3) (3) (2) (3) (4) (6) (4) (6) (6) (4) (55

2014 Renal Fellow Network

18. Evaluation and Management of Testosterone Deficiency

Evaluation and Management of Testosterone Deficiency 1 Executive Summary Testosterone testing and prescriptions have nearly tripled in recent years; however, it is clear from clinical practice that there are many men using testosterone without a clear indication. 1-3 Some studies estimate that up to 25% of men who receive testosterone therapy do not have their testosterone tested prior to initiation of treatment. 2, 3 Of men who are treated with testosterone, nearly half do not have (...) of interest and author/staff contribu- tions appear at the end of the article. © 2018 by the American Urological Association American Urological Association (AUA) EVALUATION AND MANAGEMENT OF TESTOSTERONE DEFICIENCY: AUA GUIDELINE John P. Mulhall, MD; Landon W. Trost, MD; Robert E. Brannigan, MD; Emily G. Kurtz, MD; J. Bruce Redmon, MD; Kelly A. Chiles, MD MSc; Deborah J. Lightner, MD; Martin M. Miner, MD; M. Hassan Murad, MD, MPH; Christian J. Nelson, PhD; Elizabeth A. Platz, ScD, MPH; Lakshmi V

2018 American Urological Association

19. Hypertension - Diagnosis and Management

to BCGuidelines.ca – Chronic Kidney Disease – Identification, Evaluation and Management of Adult Patients. Initial Investigations: • eGFR • Urinalysis - albumin to creatinine ratio (ACR), hematuria • Physical exam & medical history • Renal ultrasound Cushing’s Syndrome Signs/symptoms: • Cushingoid facies • Central obesity • Proximal muscle weakness • Ecchymoses Initial Investigations may include any of: • late-night salivary cortisol levels • 24-hour urine free cortisol (UFC) • low-dose (1-mg overnight or 48 (...) Hypertension - Diagnosis and Management Guidelines & Protocols Advisory Committee Hypertension – Diagnosis and Management Effective Date: March 1, 2015 Revised Date: June 22, 2016 Scope This guideline provides recommendations on how to diagnose and manage hypertension (HTN) in adults aged = 19 years. Outside the scope of this guideline is the management of secondary causes of HTN, * accelerated HTN, acute HTN in emergency settings, and in pregnant adults. The amount of randomized controlled

2015 Clinical Practice Guidelines and Protocols in British Columbia

20. Hypertensive Urgency: Considerations for Management

on the floor & arm supported) (Please refer to Hypertension Canada’s Blood Pressure Measurement Information Sheet for more detailed guidance). ? Obtain medical history & current medication list (prescription, OTC, recreational) ? Physical exam - focus on any signs of target organ damage (e.g. shortness of breath, chest pain, numbness/weakness) ? Lab tests & investigations may be required (e.g. CBC, ECG, urinalysis, renal function; ultrasound for aortic dissection if very high BP) ? Hypertensive urgency (...) , Calcium Channel Blocker Chronic Kidney Disease ACE Inhibitor (or ARB) WHAT ARE THE FOLLOW-UP & MONITORING PARAMETERS FOR HYPERTENSIVE URGENCY? 2-11 ? The patient should be observed for a few hours to confirm that they are stable/improving & asymptomatic ? Once stable, the patient can be sent home with close follow-up (every 1-2 days) involving: - Evaluation for signs of hypertension or hypotension - Attainment of BP goals with the help of antihypertensives and lifestyle interventions (e.g. low salt

2014 RxFiles

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